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Simon D. French - One of the best experts on this subject based on the ideXlab platform.
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So, what is Chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies
Chiropractic & Manual Therapies, 2020Co-Authors: Jan Hartvigsen, Simon D. FrenchAbstract:This commentary brings the 2017–2019 thematic series What is Chiropractic? to a close. The 18 papers published in the series contribute to a better understanding of what Chiropractic is, where chiropractors practice and function, who seeks their care, what chiropractors do, and how they interact with other healthcare professionals. Several papers in the series highlighted deeply rooted disagreements within Chiropractic about fundamental issues pertaining to ideology, acceptance of scientific evidence as the basis for clinical practice and the future of Chiropractic. If the Chiropractic profession is to remain relevant in today’s evidence-based healthcare environment, there is an urgent for the profession to undertake further research to describe what Chiropractic is, what chiropractors do, and provide evidence for the value of these activities to patients and healthcare decision makers.
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The Chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided
Chiropractic & Manual Therapies, 2017Co-Authors: Peter J. H. Beliveau, Jessica J Wong, Deborah Sutton, Nir Ben Simon, André E. Bussières, Silvano A. Mior, Simon D. FrenchAbstract:Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of Chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving Chiropractic services; and 4) reported on the following theme(s): utilization rates of Chiropractic services; reasons for attending Chiropractic care; profiles of Chiropractic patients; or, types of Chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., Chiropractic utilization rate) stratified by study population or condition. The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on Chiropractic utilization (245 studies), reason for attending Chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of Chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending Chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%). This comprehensive overview on the world-wide state of the Chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of Chiropractic practice, although common trends emerged.
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The Chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided
Chiropractic & Manual Therapies, 2017Co-Authors: Peter J. H. Beliveau, Jessica J Wong, Deborah A. Sutton, Nir Ben Simon, André E. Bussières, Silvano A. Mior, Simon D. FrenchAbstract:Background Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of Chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Methods Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving Chiropractic services; and 4) reported on the following theme(s): utilization rates of Chiropractic services; reasons for attending Chiropractic care; profiles of Chiropractic patients; or, types of Chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., Chiropractic utilization rate) stratified by study population or condition. Results The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on Chiropractic utilization (245 studies), reason for attending Chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of Chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending Chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%). Conclusions This comprehensive overview on the world-wide state of the Chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of Chiropractic practice, although common trends emerged.
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What is Chiropractic
Chiropractic & manual therapies, 2017Co-Authors: Jan Hartvigsen, Simon D. FrenchAbstract:While in some jurisdictions Chiropractic is fully integrated in public and insurance funded health care systems, in others it is outside and considered as complementary or alternative health care. There is a paucity of data and rigorous scientific studies regarding most aspects of Chiropractic practice although research activity has been increasing in recent years. We call for papers for a thematic series in Chiropractic and Manual Therapies that can help define Chiropractic better to stakeholders inside and outside the profession under the theme What is Chiropractic?
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Extending ICPC-2 PLUS terminology to develop a classification system specific for the study of Chiropractic encounters
Chiropractic & Manual Therapies, 2013Co-Authors: Melanie J Charity, Kirsty Forsdike, Barbara Polus, Simon D. French, Helena Britt, Jane GunnAbstract:Background Typically a large amount of information is collected during healthcare research and this information needs to be organised in a way that will make it manageable and to facilitate clear reporting. The Chiropractic Observation and Analysis STudy (COAST) was a cross sectional observational study that described the clinical practices of chiropractors in Victoria, Australia. To code Chiropractic encounters COAST used the International Classification of Primary Care (ICPC-2) with the PLUS general practice clinical terminology to code Chiropractic encounters. This paper describes the process by which a Chiropractic-profession specific terminology was developed for use in research by expanding the current ICPC-2 PLUS system. Methods The coder referred to the ICPC-2 PLUS system when coding chiropractor recorded encounter details (reasons for encounter, diagnoses/problems and processes of care). The coder used rules and conventions supplied by the Family Medicine Research Unit at the University of Sydney, the developers of the PLUS system. New Chiropractic specific terms and codes were created when a relevant term was not available in ICPC-2 PLUS. Results Information was collected from 52 chiropractors who documented 4,464 chiropractor-patient encounters. During the study, 6,225 reasons for encounter and 6,491 diagnoses/problems were documented, coded and analysed; 169 new Chiropractic specific terms were added to the ICPC-2 PLUS terminology list. Most new terms were allocated to diagnoses/problems, with reasons for encounter generally well covered in the original ICPC 2 PLUS terminology: 3,074 of the 6,491 (47%) diagnoses/problems and 274 of the 6,225 (4%) reasons for encounter recorded during encounters were coded to a new term. Twenty nine new terms (17%) represented Chiropractic processes of care. Conclusion While existing ICPC-2 PLUS terminology could not fully represent Chiropractic practice, adding terms specific to Chiropractic enabled coding of a large number of Chiropractic encounters at the desired level. Further, the new system attempted to record the diversity among Chiropractic encounters while enabling generalisation for reporting where required. COAST is ongoing, and as such, any further encounters received from chiropractors will enable addition and refinement of ICPC-2 PLUS (Chiro). More research is needed into the diagnosis/problem descriptions used by chiropractors.
Anthony J Lisi - One of the best experts on this subject based on the ideXlab platform.
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veteran response to dosage in Chiropractic therapy verdict study protocol of a pragmatic randomized trial for chronic low back pain
Pain Medicine, 2020Co-Authors: Cynthia R Long, Anthony J Lisi, Robert D Vining, Robert B Wallace, Stacie A Salsbury, Zacariah K Shannon, Stephanie Halloran, Amy L Minkalis, Lance Corber, Paul G. ShekelleAbstract:Background Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of Chiropractic provide therapeutic interventions focused on the management of low back pain and other musculoskeletal conditions. However, important knowledge gaps remain regarding the effectiveness of Chiropractic care in terms of the number and frequency of treatment visits needed for optimal outcomes in veterans with low back pain. Design This pragmatic, parallel-group randomized trial at four Veterans Affairs sites will include 766 veterans with chronic low back pain who are randomly allocated to a course of low-dose (one to five visits) or higher-dose (eight to 12 visits) Chiropractic care for 10 weeks (Phase 1). After Phase 1, participants within each treatment arm will again be randomly allocated to receive either monthly Chiropractic chronic pain management for 10 months or no scheduled Chiropractic visits (Phase 2). Assessments will be collected electronically. The Roland Morris Disability Questionnaire will be the primary outcome for Phase 1 at week 10 and Phase 2 at week 52. Summary This trial will provide evidence to guide the Chiropractic dose in an initial course of care and an extended-care approach for veterans with chronic low back pain. Accurate information on the effectiveness of different dosing regimens of Chiropractic care can greatly assist health care facilities, including Veterans Affairs, in modeling the number of doctors of Chiropractic that will best meet the needs of patients with chronic low back pain.
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opioid use among veterans of recent wars receiving veterans affairs Chiropractic care
Pain Medicine, 2018Co-Authors: Anthony J Lisi, Christine Goertz, Kelsey L Corcoran, Eric C Derycke, Lori A Bastian, William C Becker, Sara N Edmond, Joseph L Goulet, Sally G Haskell, Diana M HigginsAbstract:Objective To examine patient sociodemographic and clinical characteristics associated with opioid use among Veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who receive Chiropractic care, and to explore the relationship between timing of a Chiropractic visit and receipt of an opioid prescription. Methods Cross-sectional analysis of administrative data on OEF/OIF/OND veterans who had at least one visit to a Veterans Affairs (VA) Chiropractic clinic between 2004 and 2014. Opioid receipt was defined as at least one prescription within a window of 90 days before to 90 days after the index Chiropractic clinic visit. Results We identified 14,025 OEF/OIF/OND veterans with at least one Chiropractic visit, and 4,396 (31.3%) of them also received one or more opioid prescriptions. Moderate/severe pain (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.72-2.03), PTSD (OR = 1.55, 95% CI = 1.41-1.69), depression (OR = 1.40, 95% CI = 1.29-1.53), and current smoking (OR = 1.39, 95% CI = 1.26-1.52) were associated with a higher likelihood of receiving an opioid prescription. The percentage of veterans receiving opioid prescriptions was lower in each of the three 30-day time frames assessed after the index Chiropractic visit than before. Conclusions Nearly one-third of OEF/OIF/OND veterans receiving VA Chiropractic services also received an opioid prescription, yet the frequency of opioid prescriptions was lower after the index Chiropractic visit than before. Further study is warranted to assess the relationship between opioid use and Chiropractic care.
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trends in the use and characteristics of Chiropractic services in the department of veterans affairs
Journal of Manipulative and Physiological Therapeutics, 2016Co-Authors: Anthony J Lisi, Cynthia BrandtAbstract:Abstract Objectives The purpose of this study was to analyze national trends and key features of the Department of Veterans Affairs’ (VA’s) Chiropractic service delivery and Chiropractic provider workforce since their initial inception. Methods This was a serial cross-sectional analysis of the VA administrative data sampled from the first record of Chiropractic services in VA through September 30, 2015. Data were obtained from VA’s Corporate Data Warehouse and analyzed with descriptive statistics. Results From October 1, 2004, through September 30, 2015, the annual number of patients seen in VA Chiropractic clinics increased from 4052 to 37 349 (821.7%), and the annual number of Chiropractic visits increased from 20 072 to 159 366 (693.9%). The typical VA Chiropractic patient is male, is between the ages of 45 and 64, is seen for low back and/or neck conditions, and receives Chiropractic spinal manipulation and evaluation and management services. The total number of VA Chiropractic clinics grew from 27 to 65 (9.4% annually), and the number of chiropractor employees grew from 13 to 86 (21.3% annually). The typical VA chiropractor employee is a 45.9-year-old man, has worked in VA for 4.5 years, and receives annual compensation of $97 860. VA also purchased care from private sector chiropractors starting in 2000, growing to 159 533 Chiropractic visits for 19 435 patients at a cost of $11 155 654 annually. Conclusions Use of Chiropractic services and the Chiropractic workforce in VA have grown substantially over more than a decade since their introduction.
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management of operation iraqi freedom and operation enduring freedom veterans in a veterans health administration Chiropractic clinic a case series
Journal of Rehabilitation Research and Development, 2010Co-Authors: Anthony J LisiAbstract:Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans commonly seek care for musculoskeletal complaints in Veterans Health Administration (VHA) facilities. Chiropractic services for musculoskeletal conditions have recently been introduced to VHA. No reports have been published on Chiropractic care for OIF/OEF veterans. This study was designed to describe elements of the processes and outcomes of care for OIF/OEF veterans in a VHA Chiropractic clinic. A retrospective review of consecutive cases consulted to one VHA Chiropractic clinic was conducted. Thirty-one cases were identified. Consultations originated in primary care and specialty clinics that commonly manage musculoskeletal conditions. Military traumatic injury and posttraumatic stress disorder were common. Adverse effects of treatment were mild and transitory. In 19 cases (61%), a pain decrease above the threshold for minimally important change was reported. This article is the first description of health services delivered to OIF/OEF veterans in a VHA Chiropractic clinic. Chiropractic management was safe in these cases, and results support the hypothesis that such management may be effective in certain OIF/OIF veterans. A better understanding of the characteristics of these particular patients and the processes of care received in VHA Chiropractic clinics is needed to improve the clinical care of these veterans.
Jan Hartvigsen - One of the best experts on this subject based on the ideXlab platform.
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So, what is Chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies
Chiropractic & Manual Therapies, 2020Co-Authors: Jan Hartvigsen, Simon D. FrenchAbstract:This commentary brings the 2017–2019 thematic series What is Chiropractic? to a close. The 18 papers published in the series contribute to a better understanding of what Chiropractic is, where chiropractors practice and function, who seeks their care, what chiropractors do, and how they interact with other healthcare professionals. Several papers in the series highlighted deeply rooted disagreements within Chiropractic about fundamental issues pertaining to ideology, acceptance of scientific evidence as the basis for clinical practice and the future of Chiropractic. If the Chiropractic profession is to remain relevant in today’s evidence-based healthcare environment, there is an urgent for the profession to undertake further research to describe what Chiropractic is, what chiropractors do, and provide evidence for the value of these activities to patients and healthcare decision makers.
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What is Chiropractic
Chiropractic & manual therapies, 2017Co-Authors: Jan Hartvigsen, Simon D. FrenchAbstract:While in some jurisdictions Chiropractic is fully integrated in public and insurance funded health care systems, in others it is outside and considered as complementary or alternative health care. There is a paucity of data and rigorous scientific studies regarding most aspects of Chiropractic practice although research activity has been increasing in recent years. We call for papers for a thematic series in Chiropractic and Manual Therapies that can help define Chiropractic better to stakeholders inside and outside the profession under the theme What is Chiropractic?
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Spine Care as a Framework for the Chiropractic Identity
Journal of chiropractic humanities, 2016Co-Authors: Michael Schneider, Donald R. Murphy, Jan HartvigsenAbstract:Abstract Objective The purpose of this commentary is to provide an argument for the role and identity of chiropractors as spine care providers within the context of the greater health care system. Discussion Surveys of the general public and chiropractors indicate that the majority of patients seek Chiropractic services for back and neck pain. Insurance company utilization data confirm these findings. Regulatory and legal language found in Chiropractic practice acts reveals that most jurisdictions define the Chiropractic scope of practice as based on a foundation of spine care. Educational accrediting and testing organizations have been shaped around a Chiropractic education that produces graduates who focus on the diagnosis and treatment of spine and musculoskeletal disorders. Spine care is thus the common denominator and theme throughout all aspects of Chiropractic practice, legislation, and education globally. Conclusion Although the Chiropractic profession may debate internally about its professional identity, the Chiropractic identity seems to have already been established by society, practice, legislation, and education as a profession of health care providers whose area of expertise is spine care.
Stephen M. Perle - One of the best experts on this subject based on the ideXlab platform.
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Chiropractic identity, role and future: a survey of North American Chiropractic students
Chiropractic & Manual Therapies, 2015Co-Authors: Jordan A Gliedt, Michelle Anderson, Kashif Ahmad, Dinah Bunn, Jerrilyn Cambron, Brian Gleberzon, Cheryl Hawk, Anupama Kizhakkeveettil, John Hart, Stephen M. PerleAbstract:Background The literature pertaining to Chiropractic students’ opinions with respect to the desired future status of the Chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single Chiropractic college. This current study is an expansion of this pilot project to collect data from Chiropractic students enrolled in colleges throughout North America. Objective The purpose of this study is to investigate North American Chiropractic students’ opinions concerning professional identity, role and future. Methods A 23-item cross-sectional electronic questionnaire was developed. A total of 7,455 Chiropractic students from 12 North American English-speaking Chiropractic colleges were invited to complete the survey. Survey items encompassed demographics, evidence-based practice, Chiropractic identity and setting, and scope of practice. Data were collected and descriptive statistical analysis was performed. Results A total of 1,247 (16.7% response rate) questionnaires were electronically submitted. Most respondents agreed (34.8%) or strongly agreed (52.2%) that it is important for chiropractors to be educated in evidence-based practice. A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of Chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes. A large number of respondents (55.2%) were not in favor of expanding the scope of the Chiropractic profession to include prescribing medications with appropriate advanced training. Most respondents estimated that chiropractors should be considered mainstream health care practitioners (69.1%). Several respondents (46.8%) think that Chiropractic research should focus on the physiological mechanisms of Chiropractic adjustments. Conclusion The Chiropractic students in this study showed a preference for participating in mainstream health care, report an exposure to evidence-based practice, and desire to hold to traditional Chiropractic theories and practices. The majority of students would like to see an emphasis on correction of vertebral subluxation, while a larger percent found it is important to learn about evidence-based practice. These two key points may seem contradictory, suggesting cognitive dissonance. Or perhaps some students want to hold on to traditional theory (e.g., subluxation-centered practice) while recognizing the need for further research to fully explore these theories. Further research on this topic is needed.
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Chiropractic identity, role and future: a survey of North American Chiropractic students.
Chiropractic & manual therapies, 2015Co-Authors: Jordan A Gliedt, Michelle Anderson, Dinah Bunn, Jerrilyn Cambron, Brian Gleberzon, Cheryl Hawk, Anupama Kizhakkeveettil, John Hart, Kashif A. Ahmad, Stephen M. PerleAbstract:Background The literature pertaining to Chiropractic students’ opinions with respect to the desired future status of the Chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single Chiropractic college. This current study is an expansion of this pilot project to collect data from Chiropractic students enrolled in colleges throughout North America.
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The necessary future of Chiropractic education: a North American perspective
Chiropractic & Manual Therapies, 2005Co-Authors: Lawrence H Wyatt, Stephen M. Perle, Donald R. Murphy, Thomas E. HydeAbstract:The Chiropractic educational system in North America is currently in a state of flux. The attempted conversion of some Chiropractic schools into "universities" and the want of university affiliation for Chiropractic schools suggests that we are searching for a better alternative to the present system. In the early 20th century, the Flexner Report helped transform modern medical education into a discipline that relies on scientific and clinical knowledge. Some have wondered if it is time for a Flexner-type report regarding the education of doctors of Chiropractic. This article outlines the current challenges within the Chiropractic educational system and proposes positive changes for that system.
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Chiropractic as spine care: a model for the profession.
Chiropractic & osteopathy, 2005Co-Authors: Craig F. Nelson, Stephen M. Perle, Dana J. Lawrence, John J. Triano, Gert Bronfort, R. Douglas Metz, Kurt Hegetschweiler, Thomas LabrotAbstract:More than 100 years after its inception the Chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care. To present a model for the Chiropractic profession to establish cultural authority and increase market share of the public seeking Chiropractic care. The continued failure by the Chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of Chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of Chiropractic philosophy; and the promotion of chiropractors as primary care providers. A Chiropractic professional identity should be based on spinal care as the defining clinical purpose of Chiropractic, Chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach. This paper presents the spine care model as a means of developing Chiropractic cultural authority and relevancy. The model is based on principles that would help integrate Chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.
Cheryl Hawk - One of the best experts on this subject based on the ideXlab platform.
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The Use of Chiropractic by Special Populations.
Journal of evidence-based complementary & alternative medicine, 2016Co-Authors: Cheryl HawkAbstract:Chiropractic care, known best for its emphasis on spinal manipulative therapy, is the most commonly used provider-based complementary and alternative medicine therapy in the United States. It has accumulated a substantial body of evidence for the management of low back pain and other musculoskeletal complaints in adults. However, at this time, fewer studies have focused on its use in different populations who may have different needs, risk factors, and response to treatment. Current recommendations and guidelines are based, for the most part, on research investigating Chiropractic care for primarily white adults with uncomplicated nonspecific musculoskeletal complaints. This is congruent with current patterns of use of Chiropractic. A recent population-based survey indicated that 93% of current Chiropractic users are white, and 18% were 65 years or older. A 2015 report using National Health Interview Survey data found that only 3% of children ages 4 to 17 years had used Chiropractic or osteopathic manipulation within the past year; infants were not included. However, it is important to investigate the use of Chiropractic among special populations in order to gather evidence on whether the general findings may appropriately be extrapolated to diverse population groups. This issue presents articles addressing issues related to Chiropractic care for special population groups. Broadly, the population groups targeted were children and older adults. However, military populations and racial/ethnic minorities were also addressed. It is important to note that an overarching theme throughout this issue is the importance of interdisciplinary collaboration, particularly for populations who need complex management strategies. Four of the articles specifically focus on Chiropractic care for children, including infants. Miller and colleagues report significant improvement in rates of breastfeeding after parents attended an interdisciplinary clinic of midwifery and Chiropractic. Weis and colleagues surveyed a sample of Canadian obstetricians and found that, even though there is some evidence that manipulation may benefit low back pain in pregnancy, referrals by obstetricians to doctors of Chiropractic is limited. They conclude that better interprofessional communication may be helpful in caring for pregnant women with low back pain. Pohlman and colleagues report on their efforts to establish a reporting system for adverse effects, to be used by doctors of Chiropractic treating children, toward optimizing safety. Finally, Hewitt and colleagues described a consensus process to establish a set of core competencies for doctors of Chiropractic treating children. Their recommendations reinforced the importance of interdisciplinary collaboration and communication, for the benefit of the patient. The other 3 articles emphasize the older adult population. Green and colleagues present a systematic review of the integration of Chiropractic services into both the active military and veterans’ health care systems in the United States. Their findings suggest that the integration of Chiropractic into these systems could provide guidance for its integration into other settings as well. Whedon and colleagues’ analysis of local Medicare data is similar to that of the general population, in finding that among older adults, Chiropractic patients are predominantly white. Finally, Ndetan and colleagues’ brief report explores the use of Chiropractic for patients with dizziness or balance disorders, using National Health Interview Survey data. They found that the number of respondents using Chiropractic for these types of disorders was very small—which is consistent with the trend to use Chiropractic primarily for spinerelated pain. Those who did use it tended to be aged 65 years or older, and the odds ratio of being helped was very high for those reporting symptoms arising from head or neck trauma or neurological or muscular conditions. In summary, these articles indicate that the Chiropractic profession is making efforts to develop effective interdisciplinary communication and collaboration, and beginning to explore issues of use and effectiveness among special populations.
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Chiropractic identity, role and future: a survey of North American Chiropractic students
Chiropractic & Manual Therapies, 2015Co-Authors: Jordan A Gliedt, Michelle Anderson, Kashif Ahmad, Dinah Bunn, Jerrilyn Cambron, Brian Gleberzon, Cheryl Hawk, Anupama Kizhakkeveettil, John Hart, Stephen M. PerleAbstract:Background The literature pertaining to Chiropractic students’ opinions with respect to the desired future status of the Chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single Chiropractic college. This current study is an expansion of this pilot project to collect data from Chiropractic students enrolled in colleges throughout North America. Objective The purpose of this study is to investigate North American Chiropractic students’ opinions concerning professional identity, role and future. Methods A 23-item cross-sectional electronic questionnaire was developed. A total of 7,455 Chiropractic students from 12 North American English-speaking Chiropractic colleges were invited to complete the survey. Survey items encompassed demographics, evidence-based practice, Chiropractic identity and setting, and scope of practice. Data were collected and descriptive statistical analysis was performed. Results A total of 1,247 (16.7% response rate) questionnaires were electronically submitted. Most respondents agreed (34.8%) or strongly agreed (52.2%) that it is important for chiropractors to be educated in evidence-based practice. A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of Chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes. A large number of respondents (55.2%) were not in favor of expanding the scope of the Chiropractic profession to include prescribing medications with appropriate advanced training. Most respondents estimated that chiropractors should be considered mainstream health care practitioners (69.1%). Several respondents (46.8%) think that Chiropractic research should focus on the physiological mechanisms of Chiropractic adjustments. Conclusion The Chiropractic students in this study showed a preference for participating in mainstream health care, report an exposure to evidence-based practice, and desire to hold to traditional Chiropractic theories and practices. The majority of students would like to see an emphasis on correction of vertebral subluxation, while a larger percent found it is important to learn about evidence-based practice. These two key points may seem contradictory, suggesting cognitive dissonance. Or perhaps some students want to hold on to traditional theory (e.g., subluxation-centered practice) while recognizing the need for further research to fully explore these theories. Further research on this topic is needed.
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Chiropractic identity, role and future: a survey of North American Chiropractic students.
Chiropractic & manual therapies, 2015Co-Authors: Jordan A Gliedt, Michelle Anderson, Dinah Bunn, Jerrilyn Cambron, Brian Gleberzon, Cheryl Hawk, Anupama Kizhakkeveettil, John Hart, Kashif A. Ahmad, Stephen M. PerleAbstract:Background The literature pertaining to Chiropractic students’ opinions with respect to the desired future status of the Chiropractic physician is limited and is an appropriate topic worthy of study. A previous pilot study was performed at a single Chiropractic college. This current study is an expansion of this pilot project to collect data from Chiropractic students enrolled in colleges throughout North America.
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Chiropractic: MORE THAN SPINAL MANIPULATION
Journal of Chiropractic Humanities, 1998Co-Authors: Cheryl HawkAbstract:ABSTRACT Chiropractic has made great advances in its acceptance by the general public and the biomedical establishment in recent years. However, the medical establishment still views Chiropractic as a procedure-spinal manipulation-rather than as a profession which operates based on a unique approach to health care. This article provides a rationale and support for Chiropractic as a profession that offers a unique approach to health care, based on the Chiropractic belief system and the interpretation of the Chiropractic clinical encounter developed by medical anthropologists. Requirements and implications for the future development of the profession in this direction are discussed.