Chiropractic at the crossroads or are we just going around in circles?

Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia

A demographic and epidemiological study of a Mexican chiropractic college public clinic

<p>Abstract</p> <p>Background</p> <p>Descriptive studies of chiropractic patients are not new, several have been performed in the U.S., Australia, Canada, and Europe. None have been performed in a Latin American country. The purpose of this study is to describe the patients who visited a Mexican chiropractic college public clinic with respect to demographics and clinical characteristics.</p> <p>Methods</p> <p>This study was reviewed and approved by the IRB of Parker College of Chiropractic and the Universidad Estatal del Valle de Ecatepec (UNEVE). Five hundred patient files from the UNEVE public clinic from May 2005 to May 2007 were selected from an approximate total number of 3,700. Information was collected for demographics, chief complaints, associated complaints, and previous care sought.</p> <p>Results</p> <p>The sample comprised 306 (61.2%) female. Most files (44.2%) were in the age range of 40–59 years (mean of 43.4 years). The most frequent complaints were lumbar pain (29.2%) and extremity pain (28.0%), most commonly the knee. Most (62.0%) described their complaints as greater than one year. Trauma (46.6%) was indicated as the initial cause. Mean VAS score was 6.26/10 with 20% rated at 8/10.</p> <p>Conclusion</p> <p>Demographic results compared closer to studies conducted with private clinicians (females within the ages of 40–59). The primary complaint and duration was similar to previous studies (low back pain and chronic), except in this population the cause was usually initiated by trauma. The most striking features were the higher number of extremity complaints and the marked increased level of VAS score (20% rated as 8/10).</p

A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

BACKGROUND: Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs) and general practitioners (GPs) in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. METHODS: Data are from the Joint Canada/U.S. Survey of Health (JCUSH), 2002–03, a random sample of adults in Canada (N = 3505) and the U.S. (N = 5183). Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios) weighted to reflect the complex survey design were produced. RESULTS: Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. CONCLUSION: Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and research implications

The postural effects of load carriage on young people – a systematic review

BACKGROUND: Spinal pain in young people is a significant source of morbidity in industrialised countries. The carriage of posterior loads by young people has been linked with spinal pain, and the amount of postural change produced by load carriage has been used as a measure of the potential to cause tissue damage. The purpose of this review was to identify, appraise and collate the research evidence regarding load-carriage related postural changes in young people. METHODS: A systematic literature review sought published literature on the postural effects of load carriage in young people. Sixteen databases were searched, which covered the domains of allied health, childcare, engineering, health, health-research, health-science, medicine and medical sciences. Two independent reviewers graded the papers according to Lloyd-Smith's hierarchy of evidence scale. Papers graded between 1a (meta-analysis of randomised controlled trials) and 2b (well-designed quasi-experimental study) were eligible for inclusion in this review. These papers were quality appraised using a modified Crombie tool. The results informed the collation of research evidence from the papers sourced. RESULTS: Seven papers were identified for inclusion in this review. Methodological differences limited our ability to collate evidence. CONCLUSIONS: Evidence based recommendations for load carriage in young people could not be made based on the results of this systematic review, therefore constraining the use of published literature to inform good load carriage practice for young people

The Prevalence of the Term Subluxation in Chiropractic Degree Program Curricula Throughout the World

Background: The subluxation construct generates debate within and outside the profession. The International Chiropractic Education Collaboration, comprised of 10 chiropractic programs outside of North America, stated they will only teach subluxation in a historical context. This research sought to determine how many chiropractic institutions worldwide still use the term in their curricula and to expand upon the previous work of Mirtz & and Perle. Methods: Forty-six chiropractic programs, 18 United States (US) and 28 non-US, were identified from the World Federation of Chiropractic Educational Institutions list. Websites were searched by multiple researchers for curricular information September 2016–September 2017. Some data were not available on line, so email requests were made for additional information. Two institutions provided additional information. The total number of mentions of subluxation in course titles, technique course (Tech) descriptions, principles and practice (PP) descriptions, and other course descriptions were reported separately for US and non-US institutions. Means for each category were calculated. The number of course titles and descriptions using subluxation was divided by the total number of courses for each institution and reported as percentages. Results: Means for use of subluxation by US institutions were: Total course titles = .44; Tech = 3.83; PP = 1.50; other = 1.16. For non-US institutions, means were: Total course titles = .07; Tech = .27; PP = .44; other = 0. The mean total number of mentions was 6.94 in US vs. 0.83 in non-US institutions. Similarly, the mean course descriptions was 6.50 in US vs. 0.72 in non-US institutions. Conclusions: The term subluxation was found in all but two US course catalogues. The use of subluxation in US courses rose from a mean of 5.53 in 2011 to 6.50 in 2017. US institutions use the term significantly more frequently than non-US. Possible reasons for this were discussed. Unscientific terms and concepts should have no place in modern education, except perhaps in historical context. Unless these outdated concepts are rejected, the chiropractic profession and individual chiropractors will likely continue to face difficulties integrating with established health care systems and attaining cultural authority as experts in conservative neuro-musculoskeletal health care.https://doi.org/10.1186/s12998-018-0191-

Best of books for 2005 - with critical self-reflection

Reviews are presented of a number of books published during 2005. A variety of publications for the year were selectively sampled by the author as to whether or not they held relevance to the clinical practice of chiropractic and its contemporary context. Twenty-eight texts and a DVD-set were chosen for inclusion in this review addressing a range of clinical and professional issues. The reviews are gathered under the headings Patient Centred, History, Clinical Practice, Clinical Technique, Basic/Clinical Science, Professional Development/Marketing, Critical Thinking, and Reference. There are two new works on chiropractic technique and several new editions of works by authors who are widely respected by chiropractors including Meridel Gatterman (Foundations ¿ Subluxation 2e) and Greg Cramer (Basic Clinical Anatomy of the Spine 2e). This paper is the tenth consecutive Best of Books paper and commences with a critical self-reflection on the review process as presented in this style of paper. As in previous years the inescapable conclusion is that chiropractors continue to be sustained by high quality texts that provide strong support for many aspects of professional practice

Palpatory literacy and the subluxation complex: developing a model to represent what we think we feel

Objective: To explore the development of a model for use as a learning object to convey to students the clinical understanding and interpretation of palpation findings chiropractors think they derive from an entity that is yet to be shown to exist. Discussion: The model presented in this paper attempts to capture traditional beliefs within chiropractic that surround the act of spinal palpation largely in the absence of published data or even interpretative speculation. The identification and correction of the putative spinal subluxation complex seems to lie at the heart of the identity of chiropractic, yet the clinical act of identifying the lesion continues to demonstrate low agreement. The literature is even more silent on connecting the findings from palpation with the determination of the manner and characteristics of the spinal adjustment, the therapeutic intervention germane to the practice of chiropractic. While the answers to these questions may lie under the blanket of clinical experience, they present a challenge to chiropractic educators who teach palpation and spinal adjustive technique. In the absence of factual knowledge or evidence descriptive of the clinical entity supposedly addressed by the chiropractic adjustment, the question becomes one of which theoretical constructs are appropriate for presentation in the classroom. Conclusion: A better understanding of palpatory literacy is critical to drive the optimal application of the chiropractic adjustment as the preferred therapeutic intervention to correct dysfunctional movement of spinal segments

One hundred issues over 25 continuous years: The editorship of Chance and Peters

Purpose: To examine the 100 journal issues edited by Chance and Peters with a view to providing a descriptive analysis of the published elements that not only describe the quality of their work but also demonstrate the Journal is indeed a worthwhile vehicle for continuing practitioner education and a responsible voice within the discipline of chiropractic. Methods: Hand-search of the author¿s library to locate and order all issues of the Journal of the Australian Chiropractors¿ Association from and including December 1983 and all issues of the Chiropractic Journal of Australia from March 1991 to and including September 2008. Pre-identified items of content were entered into an electronic spreadsheet for grouping, counting and further analysis. Results: During the 25 year period of this review the 100 issues edited by Chance and Peters included 1,232 individual articles not including advertisements, news reports, reprints of abstracts and contact data relating to the professional association. The journal has strengths in the fields of clinical research (113 papers), history (94 papers) and case reports (52 papers). The Journal includes papers on research in chiropractic education and on the philosophy of chiropractic and has provided a rich forum for professional debate through its ¿Letters¿ and ¿Reply¿ column. Other key elements of a quality journal are evident including many reviews of new books relevant to the discipline and a consistently strong Editorial page. Discussion: Mary Ann Chance and Rolf Peters have given the profession a bountiful legacy of their own writing and the priceless legacy of a journal with sufficient breadth to respect and value the history of chiropractic as equally as its science. It is also apparent they have invested in the future of the profession and are owed a significant legacy for this part of their life¿s work. Chance and Peters have nurtured the art of writing as there are 29 authors in addition to themselves who have each published in the Journal as first author six or more times during this 25 year period. Conclusion: The 25-year Editorship of Mary Ann Chance and Rolf Peters stands as a remarkable testimony to two remarkable people. Their record of 100 consecutive journal issues is unheard of and their legacy unquestionable

Learning style changes in chiropractic students moving from academic learning to clinical application

The transition period from basic science studies to full-time clinical studies, including the internship or preceptorship, is often a difficult time for students because of the differences and complexities between basic science knowledge and clinical circumstances. This is commonly seen with many students in a variety of health care programs including chiropractic. This article reviews concepts which may aid educators in determining the most effective ways to help students transition from didactic learner to student-clinician. The paper reviews several theoretical concepts focusing on the application of student learning preferences and the pedagogical implications for how to best address these preferences in clinical training

The best of books for 2006: Beyond the retro-spectoscope

Abstract not available