Barriers and Facilitators of Implementing Injury Prevention Practices by Massage Therapists.

Objective: Massage therapy involves pervasive ergonomic hazards with the majority of massage therapists (MTs) experiencing adverse musculoskeletal health issues. A variety of barriers and facilitators exist that can impact the efficacy of safety programs.

Methods: A longitudinal study to characterize individual and organizational barriers and facilitators that influence the implementation of self-care techniques designed to reduce musculoskeletal health issues.

Attitudes and behaviors of chiropractic interns toward occupational history taking.

Objective: This study uses a pre- and post-training program evaluation of chiropractic interns to (1) describe changes in their frequency of occupational history taking before and after a 1-hour training and (2) to document the attitudes and beliefs regarding occupational health and history taking.

Methods: All chiropractic interns at 1 clinic location completed questionnaires assessing their attitudes and perceptions regarding documenting the occupational history of their patients each trimester they were enrolled in the study. Each intern enrolled in the study for 2 or more trimesters participated in a 1-hour-long training session on taking an occupational history.

Needs Assessment for a Comprehensive Reemployment Program Among Residents of a Work Rehabilitation Program for Individuals With Unstable or Lack of Housing.

Objective: Individuals in transitional housing programs often have a goal of reaching stable employment, but the unique needs and barriers for achieving this warrants further study.

Methods: A structured interview guide was administered orally and descriptive data analysis was done for this exploratory mixed-methods study.

Results: Commonly reported reemployment challenges included legal barriers and unmet transportation, housing, and financial needs.

Advancing health promotion through massage therapy practice: A cross-sectional survey study.

The human resources needed to provide health promotion services to improve health behaviors in populations are currently limited. Health promotion and education is included in the definition of massage therapy, and many within the massage therapy profession understand that health promotion and education are a part of massage therapy practice. However, the amounts and types of health promotion activities in massage therapy practice have not been thoroughly explored.

Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial.

Objectives: To investigate the efficacy of shoe orthotics with and without chiropractic treatment for chronic low back pain compared with no treatment.

Design: Randomized controlled trial.

Setting: Integrative medicine teaching clinic at a university.

Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium.

Background: Massage therapists are at times unclear about the definition of massage therapy, which creates challenges for the profession. It is important to investigate the current definitions and to consider the field as a whole in order to move toward clarity on what constitutes the constructs within the profession.

Purpose: To determine how a sample of experts understand and describe the field of massage therapy as a step toward clarifying definitions for massage and massage therapy, and framing the process of massage therapy practice.

Process for massage therapy practice and essential assessment.

Background: Little evidence exists about processes in massage therapy practice. Investigating current frameworks is warranted. This qualitative study is a secondary data analysis using grounded theory to understand how massage therapy experts describe massage therapy practice.

Exploratory Analysis of Clinical Predictors of Outcomes of Nonsurgical Treatment in Patients With Lumbar Spinal Stenosis.

Objective: The purpose of this study was to explore potential baseline physical examination and demographic predictors of clinical outcomes in patients with lumbar spinal stenosis.

Methods: This was a secondary analysis of data obtained from a pilot randomized controlled trial. Primary and secondary outcome measures were the Swiss Spinal Stenosis (SSS) Questionnaire and visual analog scale (VAS) for leg pain.

A pilot randomized controlled trial of flexion-distraction dosage for chiropractic treatment of lumbar spinal stenosis.

Objective: The purpose of this pilot clinical trial was to assess the feasibility of recruiting older adults with lumbar spinal stenosis (LSS) into a clinical trial that used different dosages of flexion-distraction manipulation.

Methods: This randomized controlled trial used a 4-group design. Three groups consisted of chiropractic flexion-distraction manipulation applied at different dosages (8, 12, or 18 treatments).

Prevalence of nonmusculoskeletal versus musculoskeletal cases in a chiropractic student clinic.

Objective : We sought to identify the percentage of nonmusculoskeletal and musculoskeletal conditions treated by interns in the National University of Health Sciences (NUHS) Student Clinic compared to chiropractic and allopathic health care professionals. Methods : The information gathered was taken from the charts of patients treated in the fall trimester, dated September 12, 2011 through December 9, 2011. The data collected included ICD-9 codes for the conditions treated, the number of patient visits, age, and gender, and was evaluated using Microsoft Excel.

Prevalence of nonmusculoskeletal versus musculoskeletal cases in a chiropractic student clinic.

Objective : We sought to identify the percentage of nonmusculoskeletal and musculoskeletal conditions treated by interns in the National University of Health Sciences (NUHS) Student Clinic compared to chiropractic and allopathic health care professionals. Methods : The information gathered was taken from the charts of patients treated in the fall trimester, dated September 12, 2011 through December 9, 2011. The data collected included ICD-9 codes for the conditions treated, the number of patient visits, age, and gender, and was evaluated using Microsoft Excel.

A possible correlation between vitamin D deficiency and loss of smell: 2 case reports.

Objective: The purpose of this report is to present 2 cases of diminished olfaction that improved with increasing serum levels of vitamin D3.

Clinical Features: Both patients were under the care of medical and chiropractic physicians for various complaints. A 47-year-old hyposmic woman was diagnosed with vitamin D deficiency who incidentally noticed a progressive return of her sense of smell while taking vitamin D supplements as prescribed by her medical doctor.

Cox decompression chiropractic manipulation of a patient with postsurgical lumbar fusion: a case report.

Objective: The purpose of this case report is to describe a patient with an L5/S1 posterior surgical fusion who presented to a chiropractic clinic with subsequent low back and leg pain and was treated with Cox decompression manipulation.

Clinical Features: A 55-year-old male postal clerk presented to a private chiropractic practice with complaints of pain and spasms in his low back radiating down the right buttock and leg. His pain was a 5 of 10, and Oswestry Disability Index score was 18%.

Large C4/5 spondylotic disc bulge resulting in spinal stenosis and myelomalacia in a Klippel-Feil patient.

Objectives: The purpose of this report is to document a case of cervical spinal stenosis and myelomalacia in a patient with Klippel-Feil (KF) syndrome with a large C4/5 disc bulge presenting with cervical radiculopathy.

Subject: A 39-year-old man was referred to a private chiropractic practice for a consultation. He complained of limited motion in his neck with pain and numbness radiating down both arms and left leg.

Distribution of cavitations as identified with accelerometry during lumbar spinal manipulation.

Objective: This project determined the location and distribution of cavitations (producing vibrations and audible sounds) in the lumbar zygapophyseal (Z) joints that were targeted by spinal manipulative therapy (SMT).

Methods: This randomized, controlled, clinical study assessed 40 healthy subjects (20 men, 20 women) 18 to 30 years of age who were block randomized into SMT (group 1, n = 30) or side-posture positioning only (group 2; control, n = 10) groups. Nine accelerometers were placed on each patient (7 on spinous processes/sacral tubercles of L1-S2 and 2 placed 3 cm left and right lateral to the L4/L5 interspinous space).

Shoe orthotics for the treatment of chronic low back pain: a randomized controlled pilot study.

Objectives: The purpose of this pilot study was to investigate the feasibility of a randomized clinical trial of shoe orthotics for chronic low back pain.

Methods: The study recruited 50 patients with chronic low back pain through media advertising in a midwestern suburban area. Medical history and a low back examination were completed at a chiropractic clinic.

Reliability of zygapophysial joint space measurements made from magnetic resonance imaging scans of acute low back pain subjects: comparison of 2 statistical methods.

Objective: This purpose of this study was to assess the reliability of measurements made of the zygapophysial (Z) joint space from the magnetic resonance imaging scans of subjects with acute low back pain using new equipment and 2 different methods of statistical analysis. If found to be reliable, the methods of Z joint measurement can be applied to scans taken before and after spinal manipulation in a larger study of acute low back pain subjects.

Methods: Three observers measured the central anterior-to-posterior distance of the left and right L4/L5 and L5/S1 Z joint space from 5 subject scans (20 digitizer measurements, rounded to 0.

Recruitment methods and costs for a randomized, placebo-controlled trial of chiropractic care for lumbar spinal stenosis: a single-site pilot study.

Objective: The purpose of this article is to describe the methods for recruitment in a clinical trial on chiropractic care for lumbar spinal stenosis.

Methods: This randomized, placebo-controlled pilot study investigated the efficacy of different amounts of total treatment dosage over 6 weeks in 60 volunteer subjects with lumbar spinal stenosis. Subjects were recruited for this study through several media venues, focusing on successful and cost-effective strategies.

Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain, and dizziness in older adults.

Objective: The purpose of this study was to collect preliminary information on the effect of a limited and extended course of chiropractic care on balance, chronic pain, and associated dizziness in a sample of older adults with impaired balance.

Methods: The authors conducted a randomized pilot study targeting a sample size of 30, comparing 2 schedules of chiropractic care to a no-treatment group. Group 1 (limited schedule) was treated for 8 weeks, group 2 (extended schedule) was treated for 8 weeks and then once per month for 10 months, and group 3 received no treatment.

Clinical trial variability: quality control in a randomized clinical trial.

Introduction: A major issue in clinical trials in manual medicine is treatment variability. The challenge is to insure that the bounded treatment options are both representative of field practitioner behavior and consistent among research clinicians. This investigation assesses the treatment comparability of field practitioners and research clinicians, for a flexion-distraction treatment procedure, as quality control for a randomized clinical trial.

Side-effects of massage therapy: a cross-sectional study of 100 clients.

Objective: The purpose of this study was to determine the amount and type of negative side-effects and positive (unexpected) effects experienced after a massage session.

Study Design: Cross-sectional.

Setting: Massage clinic at a health sciences university.

Clinical utilization and cost outcomes from an integrative medicine independent physician association: an additional 3-year update.

Objective: Our initial report analyzed clinical and cost utilization data from the years 1999 to 2002 for an integrative medicine independent physician association (IPA) whose primary care physicians (PCPs) were exclusively doctors of chiropractic. This report updates the subsequent utilization data from the IPA for the years 2003 to 2005 and includes first-time comparisons in data points among PCPs of different licensures who were oriented toward complementary and alternative medicine (CAM).

Methods: Independent physician association-incurred claims and stratified random patient surveys were descriptively analyzed for clinical utilization, cost offsets, and member satisfaction compared with conventional medical IPA normative values.

Patient perceptions of chiropractic treatment for primary care disorders.

Objective: Although some surveyed groups of chiropractors consider themselves qualified as primary care providers, consumer attitudes of such may affect practice success. The purpose of this study is to determine chiropractic patients' perception of chiropractors as primary care providers and to determine what disorders patients believe chiropractors can treat.

Methods: A 2-page survey was developed to collect information from current chiropractic patients at a teaching chiropractic clinic in the United States.

One-year follow-up of a randomized clinical trial comparing flexion distraction with an exercise program for chronic low-back pain.

Objective: Flexion distraction is a commonly used form of chiropractic care with chiropractor utilization rates of 58%. However, no previous randomized clinical trial has assessed the effectiveness of this form of care. The objective of this investigation was to compare the pain and disability during the year after active care based on treatment group allocation (Flexion Distraction versus Exercise Program).