Enhancing patient-centred chiropractic care in Canada: identifying barriers, enablers, and strategies through a qualitative needs assessment.

Background: The Canadian Chiropractic Association (CCA) initiated a quality improvement project to develop best practices aimed at enhancing the patient experience.

Objectives: (1) Identify and prioritise the key moments in the new patient experience that could be improved by providing chiropractors with focused support and resources; (2) explore views, barriers, and enablers to implementing these best practices; and (3) develop recommendations to facilitate the adoption of these practices.

Methods: We conducted a qualitative needs assessment using a human-centred design approach, focused on understanding the needs and experiences of end-users to create tailored solutions.

Agreement and concurrent validity between telehealth and in-person diagnosis of musculoskeletal conditions: a systematic review.

Objectives: To assess the concurrent validity and inter-rater agreement of the diagnosis of musculoskeletal (MSK) conditions using synchronous telehealth compared to standard in-person clinical diagnosis.

Methods: We searched five electronic databases for cross-sectional studies published in English in peer-reviewed journals from inception to 28 September 2023. We included studies of participants presenting to a healthcare provider with an undiagnosed MSK complaint.

Rehabilitation of back pain in the pediatric population: a mixed studies systematic review.

Background: A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking.

Objectives: To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population.

Effectiveness of postsurgical rehabilitation following lumbar disc herniation surgery: A systematic review.

Introduction: The effectiveness of post-surgical rehabilitation following lumbar disc herniation (LDH) surgery is unclear.

Research Question: To investigate the effectiveness and safety of rehabilitation interventions initiated within three months post-surgery for adults treated surgically for LDH.

Material And Methods: This systematic review searched seven databases from inception to November 2023.

A systematic review and meta analysis of measurement properties for the flexion relaxation ratio in people with and without non specific spine pain.

This review sought to identify, critically appraise, compare, and summarize the literature on the reliability, discriminative validity and responsiveness of the flexion relaxation ratio (FRR) in adults (≥ 18 years old) with or without spine pain (any duration), in either a clinical or research context. The review protocol was registered on Open Science Framework ( https://doi.org/10.

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Primary Low Back Pain in Adults.

Purpose: To evaluate benefits and harms of transcutaneous electrical nerve stimulation (TENS) for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.

Methods: We searched for randomized controlled trials (RCTs) from various electronic databases from July 1, 2007 to March 9, 2022. Eligible RCTs targeted TENS compared to placebo/sham, usual care, no intervention, or interventions with isolated TENS effects (i.

Eligibility Criteria of Participants in Randomized Controlled Trials Assessing Conservative Management of Cervical Radiculopathy: A Systematic Review.

Study Design: Systematic review.

Objective: The aim of this study was to evaluate the inclusion and exclusion criteria for participants in randomized control trials (RCTs) assessing conservative management for cervical radiculopathy (CR), to determine if any consensus exists within the literature.

Summary Of Background Data: A 2012 systematic review identified a lack of uniformity for the eligibility criteria of participants in RCTs evaluating conservative interventions for CR.

A qualitative study exploring perceived barriers and enablers to fidelity of training and delivery for an intervention to reduce non-indicated imaging for low back pain.

Background: Non-specific low back pain (LBP) commonly presents to primary care, where inappropriate use of imaging remains common despite guideline recommendations against its routine use. Little is known about strategies to enhance intervention fidelity (i.e.

Conservative Management of Cervical Radiculopathy: A Systematic Review.

Objective: The purpose of this systematic review was to assess the effectiveness and safety of conservative interventions compared with other interventions, placebo/sham interventions, or no intervention on disability, pain, function, quality of life, and psychological impact in adults with cervical radiculopathy (CR).

Methods: We searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022 to identify studies that were randomized controlled trials, had at least one conservative treatment arm, and diagnosed participants with CR through confirmatory clinical examination and/or diagnostic tests. Studies were appraised using the Cochrane Risk of Bias 2 tool and the quality of the evidence was rated using the Grades of Recommendations, Assessment, Development, and Evaluation approach.

Exploring factors influencing chiropractors' adherence to radiographic guidelines for low back pain using the Theoretical Domains Framework.

Background: The inappropriate use of lumbar spine imaging remains common in primary care despite recommendations from evidence-based clinical practice guidelines to avoid imaging in the absence of red flags. This study aimed to explore factors influencing ordering behaviours and adherence to radiographic guidelines for low back pain (LBP) in chiropractors in Newfoundland and Labrador (NL), Canada.

Methods: We conducted two focus groups in December 2018 with chiropractors in different regions of NL (eastern, n = 8; western, n = 4).

Risk factors for low back pain in active military personnel: a systematic review.

Purpose: Low back pain (LBP) is prevalent in military personnel. We aimed to systematically review the literature regarding risk factors for first-time LBP during military service among active duty military personnel.

Methods: We searched six electronic databases (inception-April 2020) for randomised controlled trials, cohort studies, and case-control studies published in English in peer-reviewed journals.

Appraisal and summary of patellofemoral pain clinical practice guideline.

Objective: The purpose of this commentary was to critically appraise the patellofemoral pain clinical practice guideline published by the Academy of Orthopaedic Physical Therapy in 2019 and to summarize their recommendations for chiropractic practice.

Methods: Quality and reporting of this guideline was assessed with the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Three reviewers independently scored between 1-7 (strongly disagree-strongly agree) for 23 items organized into six quality domains.

Knowledge of and adherence to radiographic guidelines for low back pain: a survey of chiropractors in Newfoundland and Labrador, Canada.

Background: Low back pain (LBP) rarely requires routine imaging of the lumbar spine in the primary care setting, as serious spinal pathology is rare. Despite evidence-based clinical practice guidelines recommending delaying imaging in the absence of red flags, chiropractors commonly order imaging outside of these guidelines. The purpose of this study was to survey chiropractors to determine the level of knowledge, adherence to, and beliefs about, clinical practice guidelines related to the use of lumbar radiography for LBP in Newfoundland and Labrador (NL), Canada.

Investigator analytic repeatability of two new intervertebral motion biomarkers for chronic, nonspecific low back pain in a cohort of healthy controls.

Background: Understanding the mechanisms underlying chronic, nonspecific low back pain (CNSLBP) is essential to advance personalized care and identify the most appropriate intervention. Recently, two intervertebral motion biomarkers termed "Motion Sharing Inequality" (MSI) and "Motion Sharing Variability" (MSV) have been identified for CNSLBP using quantitative fluoroscopy (QF). The aim of this study was to conduct intra- and inter-investigator analytic repeatability studies to determine the extent to which investigator error affects their measurement in clinical studies.

Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety.

Objective: To identify commonalities among cases of rib fractures after spinal manipulative therapy (SMT); discuss chiropractors' case management perspectives; and propose strategies for prevention and/or management of future cases.

Methods: Semi-structured interviews were conducted with chiropractors who identified cases of rib fractures after SMT at a chiropractic institution's teaching clinics. Patient characteristics, incident characteristics, and chiropractors' perspectives were collected and analysed.