Use of the measure your medical outcome profile (MYMOP2) and W-BQ12 (Well-Being) outcomes measures to evaluate chiropractic treatment: an observational study

Background: The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2) and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods: Chiropractic care of the patients involved spinal manipulative therapy (SMT), mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12). Results: Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions: The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions

Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults

Background: Analysis of rhythmic patterns embedded within beat-to-beat variations in heart rate (heart rate variability) is a tool used to assess the balance of cardiac autonomic nervous activity and may be predictive for prognosis of some medical conditions, such as myocardial infarction. It has also been used to evaluate the impact of manipulative therapeutics and body position on autonomic regulation of the cardiovascular system. However, few have compared cardiac autonomic activity in supine and prone positions, postures commonly assumed by patients in manual therapy. We intend to redress this deficiency. Methods: Heart rate, heart rate variability, and beat-to-beat blood pressure were measured in young, healthy non-smokers, during prone, supine, and sitting postures and with breathing paced at 0.25 Hz. Data were recorded for 5 minutes in each posture: Day 1 - prone and supine; Day 2 - prone and sitting. Paired t-tests or Wilcoxon signed-rank tests were used to evaluate posture-related differences in blood pressure, heart rate, and heart rate variability. Results: Prone versus supine: blood pressure and heart rate were significantly higher in the prone posture (p < 0.001). Prone versus sitting: blood pressure was higher and heart rate was lower in the prone posture (p < 0.05) and significant differences were found in some components of heart rate variability. Conclusion: Cardiac autonomic activity was not measurably different in prone and supine postures, but heart rate and blood pressure were. Although heart rate variability parameters indicated sympathetic dominance during sitting (supporting work of others), blood pressure was higher in the prone posture. These differences should be considered when autonomic regulation of cardiovascular function is studied in different postures

Chiropractors` experience and readiness to work in Indigenous Australian Communities: a preliminary cross-sectional survey to explore preparedness, perceived barriers and facilitators for chiropractors practising cross-culturally

Abstract Background Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors’ readiness to treat Indigenous patients. This study explores chiropractors` experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors’ participation in Indigenous Healthcare and their willingness to engage in cultural competency training. Methods This study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants` level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text. Results One hundred and twenty-five chiropractors participated in the survey. The majority of participants (86%, n = 108) were employed in private practice. 62% of respondents were members of the Chiropractors' Association of Australia, 41% were Chiropractic and Osteopathic College of Australasia members. 60% of chiropractors considered that they had, or do treat Indigenous patients yet only 4% of respondents asked their patients if they identified as Indigenous. A majority of participants expressed a high level of ‘comfort’ or confidence in working with Indigenous people while only 17% of respondents had undertaken some form of cultural proficiency training. A majority of respondents (62.7%, n = 74) expressed an interest in working with Indigenous Australians and a majority (91%, n = 104) were willing to participate in training to develop Indigenous cultural competency. Conclusions The study points to a need for chiropractors to have access to cultural proficiency training in order to develop the capability and confidence to engage respectfully with their Indigenous patients. This preliminary study has provided the researchers with valuable insights aiding the development and implementation of an Indigenous cultural proficiency program for chiropractors

Embedding chiropractic in Indigenous Health Care Organisations: applying the normalisation process model

Abstract Background Improving the health of Indigenous Australians remains a major challenge. A chiropractic service was established to evaluate this treatment option for musculoskeletal illness in rural Indigenous communities, based on the philosophy of keeping the community involved in all the phases of development, implementation, and evaluation. The development and integration of this service has experienced many difficulties with referrals, funding and building sustainability. Evaluation of the program was a key aspect of its implementation, requiring an appropriate process to identify specific problems and formulate solutions to improve the service. Methods We used the normalisation process model (May 2006) to order the data collected in consultation meetings and to inform our strategy and actions. The normalisation process model provided us with a structure for organising consultation meeting data and helped prioritise tasks. Our data was analysed as it applied to each dimension of the model, noting aspects that the model did not encompass. During this process we reworded the dimensions into more everyday terminology. The final analysis focused on to what extent the model helped us to prioritise and systematise our tasks and plans. Results We used the model to consider ways to promote the chiropractic service, to enhance relationships and interactions between clinicians and procedures within the health service, and to avoid disruption of the existing service. We identified ways in which chiropractors can become trusted team members who have acceptable and recognised knowledge and skills. We also developed strategies that should result in chiropractic practitioners finding a place within a complex occupational web, by being seen as similar to well-known occupations such as physiotherapy. Interestingly, one dimension identified by our data, which we have labelled ‘emancipatory’, was absent from the model. Conclusions The normalisation process model has resulted in a number of new insights and questions. We have now established thriving weekly chiropractic clinics staffed by a team of volunteer chiropractors. We identified an ‘emancipatory’ dimension that requires further study. We provide a worked example of using this model to establish, integrate and evaluate a chiropractic service in an Indigenous Australian community.</p

Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults-2

<p><b>Copyright information:</b></p><p>Taken from "Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults"</p><p>http://www.chiroandosteo.com/content/15/1/19</p><p>Chiropractic & Osteopathy 2007;15():19-19.</p><p>Published online 28 Nov 2007</p><p>PMCID:PMC2222597.</p><p></p>ght scale only to HR; DIA = diastolic blood pressure, HR = heart rate, MAP = mean arterial pressure, SYS = systolic blood pressure, BPM = beats per minute, and * = statistically significant difference from value in prone posture

Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults-0

<p><b>Copyright information:</b></p><p>Taken from "Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults"</p><p>http://www.chiroandosteo.com/content/15/1/19</p><p>Chiropractic & Osteopathy 2007;15():19-19.</p><p>Published online 28 Nov 2007</p><p>PMCID:PMC2222597.</p><p></p>ght scale only to HR; DIA = diastolic blood pressure, HR = heart rate, MAP = mean arterial pressure, SYS = systolic blood pressure, BPM = beats per minute, and * = statistically significant difference from value in prone posture

Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults-1

<p><b>Copyright information:</b></p><p>Taken from "Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults"</p><p>http://www.chiroandosteo.com/content/15/1/19</p><p>Chiropractic & Osteopathy 2007;15():19-19.</p><p>Published online 28 Nov 2007</p><p>PMCID:PMC2222597.</p><p></p>, right scale only to HR; DIA = diastolic blood pressure, HR = heart rate, MAP = mean arterial pressure, SYS = systolic blood pressure, BPM = beats per minute, and * = statistically significant difference from a value in the prone posture

Chiropractors' experience and readiness to work in Indigenous Australian communities : a preliminary cross-sectional survey to explore preparedness, perceived barriers and facilitators for chiropractors practising cross-culturally

Background: Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors’ readiness to treat Indigenous patients. This study explores chiropractors` experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors’ participation in Indigenous Healthcare and their willingness to engage in cultural competency training. Methods: This study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants` level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text. Results: One hundred and twenty-five chiropractors participated in the survey. The majority of participants (86%, n = 108) were employed in private practice. 62% of respondents were members of the Chiropractors' Association of Australia, 41% were Chiropractic and Osteopathic College of Australasia members. 60% of chiropractors considered that they had, or do treat Indigenous patients yet only 4% of respondents asked their patients if they identified as Indigenous. A majority of participants expressed a high level of ‘comfort’ or confidence in working with Indigenous people while only 17% of respondents had undertaken some form of cultural proficiency training. A majority of respondents (62.7%, n = 74) expressed an interest in working with Indigenous Australians and a majority (91%, n = 104) were willing to participate in training to develop Indigenous cultural competency. Conclusions: The study points to a need for chiropractors to have access to cultural proficiency training in order to develop the capability and confidence to engage respectfully with their Indigenous patients. This preliminary study has provided the researchers with valuable insights aiding the development and implementation of an Indigenous cultural proficiency program for chiropractors