Public Awareness of the Traditional and Complementary Medicine Act Governing Chiropractic in Malaysia: A Survey of Adults in Klang Valley.

Objective: This study aimed to assess the level of awareness of the traditional and complementary medicine law governing chiropractic among adults in Klang Valley, Malaysia.

Methods: A cross-sectional study was conducted of patients attending the following 4 health care services: medicine, dentistry, pharmacy, and chiropractic. The study ran from July to November 2018.

Ergonomic Risk Factors of Fourth- and Fifth-Year International Medical University Dental Students.

Objective: The purpose of this study was to identify and compare the ergonomic risk factors of year 4 and year 5 dental students attending International Medical University.

Methods: This was an exploratory, observational study evaluating ergonomic risk factors among year 4 and year 5 dental students, with a total of 89 participants. The students' ergonomic risk components were evaluated using the Rapid Upper Limb Assessment (RULA) worksheet.

Demographic Factors Associated With Public Awareness of Chiropractic in Klang Valley, Malaysia: A Cross-sectional Study.

Objective: The purposes of this study were to determine the public awareness of chiropractic in Klang Valley and to identify sociodemographic factors associated with this awareness.

Methods: A cross-sectional study with a total of 440 respondents was conducted in medical, chiropractic, pharmacy, and dental health care facilities in Klang Valley. A self-administrated questionnaire was enclosed in an envelope and handed to the participants by the health care facilities' staff.

Chiropractic Utilization Among Patients in Klang Valley, Malaysia.

Objective: The purpose of this study was to estimate the utilization of chiropractic in Klang Valley, Malaysia.

Methods: This research was a cross-sectional study conducted in 4 health care centers, namely Klinik Mediviron Sri Rampai, Queck Dental Surgery, International Medical University (IMU) Healthcare Chiropractic Centre, and Be Pharmacy Bandar Sri Permaisuri, in Klang Valley from July to November 2018, with a total of 440 respondents. The data collection was done by the self-administration method using questionnaires that were enclosed in envelopes and passed on to the participants by the center's staff.

Attitudes of dental and chiropractic students towards a shared learning programme-An interprofessional learning model.

Introduction: Interprofessional learning (IPL) is the first stage towards the goal of interprofessional collaborative care. To enhance IPL experience, the School of Dentistry, International Medical University developed an IPL model based on the core competencies and the learning outcomes for dental and chiropractic students in their second and fourth year, respectively. The model was based on experiential learning and adult learning theories in addition to Miller's framework for clinical competencies.

Effects of Upper and Lower Cervical Spinal Manipulative Therapy on Blood Pressure and Heart Rate Variability in Volunteers and Patients With Neck Pain: A Randomized Controlled, Cross-Over, Preliminary Study.

Objective: The aims of this study were to examine autonomic nervous system responses by using heart rate variability analysis (HRV), hemodynamic parameters and numeric pain scale (NPS) when either upper (C1 and C2) or lower (C6 and C7) cervical segments were manipulated in volunteers, and whether such response would be altered in acute mechanical neck pain patients after spinal manipulative therapy (SMT).

Methods: A randomized controlled, cross-over, preliminary study was conducted on 10 asymptomatic normotensive volunteers and 10 normotensive patients complaining of acute neck pain. HRV, blood pressure (BP) and heart rate (HR), and NPS were recorded after upper cervical and lower cervical segments SMT in volunteer and patient groups.

The location of the inferior angle of the scapula in relation to the spine in the upright position: a systematic review of the literature and meta-analysis.

Practitioners in several of the health care professions use anatomical landmarks to identify spinal levels, both in order to enhance diagnostic accuracy and to specifically target the site of intervention. Authoritative sources usually state the upright inferior scapular angle (IAS) aligns with the spinous process (SP) of T7, but some specify the T7-8 interspace or the T8 SP. The primary goals of this study were to systematically review the relevant literature; and conduct a meta-analysis of the pooled data from retrieved studies to increase their statistical power.

Interexaminer reliability of cervical motion palpation using continuous measures and rater confidence levels.

Introduction: Motion palpators usually rate the movement of each spinal level palpated, and their reliability is assessed based upon discrete paired observations. We hypothesized that asking motion palpators to identify the most fixated cervical spinal level to allow calculating reliability at the group level might be a useful alternative approach.

Methods: Three examiners palpated 29 asymptomatic supine participants for cervical joint hypomobility.

Interexaminer reliability of thoracic motion palpation using confidence ratings and continuous analysis.

Objective: Motion palpation is integral to most chiropractic techniques and can be found in curricula of most every chiropractic college. Paradoxically, most studies do not show strong reliability for motion palpation. The purpose of this study was to determine if allowing motion palpators to rate their confidence in their findings, as well using a continuous data analytic method, would influence the level of concordance.

Chiropractic care for patients with acute neck pain: results of a pragmatic practice-based feasibility study.

Objective: The purpose of this study was to determine the feasibility of a chiropractic practice-based research network to investigate the treatment of acute neck pain (ANP) and to report resulting findings.

Methods: Participating chiropractors recruited sequentially presenting ANP patients on their initial visit to the office. Patients were treated by the chiropractors using their usual methods.

Survey of health attitudes and behaviors of a chiropractic college population.

Objectives: We gathered information about health behaviors on a chiropractic campus, including compliance with recent guidelines for exercise as well as diet, smoking, and binge drinking. We also assessed the perceived importance of the chiropractic physician in role modeling and teaching healthy behaviors to patients.

Methods: A survey instrument composed of 16 questions was designed and distributed to 279 students, faculty, and staff at a chiropractic college campus in northern California.

The notion of a "whiplash culture": a review of the evidence.

Objective: Most whiplash patients eventually recover, although some are left with ongoing pain and impairment. Why some develop long-term symptoms after whiplash, whereas others do not, is largely unknown. One explanation blames the cultural expectations of the population wherein the injury occurred, engendering the moniker whiplash culture.

A review of intraexaminer and interexaminer reliability of static spinal palpation: a literature synthesis.

Objective: The purposes of this study were to locate articles that assessed the reliability of static palpation of the spine and sacroiliac joints, to appraise the quality of these studies, and synthesize their results.

Methods: A structured literature search was conducted of chiropractic and medical databases PubMed, Manual Alternative and Natural Therapy System, Index to Chiropractic Literature, and Cumulative Index to Nursing and Allied Health Literature from 1965 through October 2007. Reference sections were inspected for additional citations.

The location of the inferior angle of the scapula in relation to the spinal level of prone patients.

Background: In two previous studies we established the mean location of the upright inferior angle of the scapula (IAS) to be near the spinous process of T8. The current study investigates the common belief that the prone IAS lines up with the T6 SP.

Methods: The location of the IAS in relation to the spine of 20 mostly asymptomatic subjects was assessed on a Hi-Lo table in 7 different postures, 2 upright and 5 prone.

An annotated bibliography of spinal motion palpation reliability studies.

Background: Several literature reviews have addressed the reliability of spinal and sacroiliac (SI) motion palpation (MP), finding that, in general, interexaminer reliability is slight and intraexaminer reliability is moderate.

Methods: We performed a literature search of four biomedical databases to locate articles that dealt with MP of the spine or SI joints. The abstracts of the retrieved citations were independently screened for inclusion by two of the authors.

Chiropractic management of low back pain and low back-related leg complaints: a literature synthesis.

Objectives: The purpose of this project was to review the literature for the use of spinal manipulation for low back pain (LBP).

Methods: A search strategy modified from the Cochrane Collaboration review for LBP was conducted through the following databases: PubMed, Mantis, and the Cochrane Database. Invitations to submit relevant articles were extended to the profession via widely distributed professional news and association media.

Spinal motion palpation: a comparison of studies that assessed intersegmental end feel vs excursion.

Objective: Spinal motion palpation (MP) is a procedure used to detect intersegmental hypomobility/hypermobility. Different means of assessing intersegmental mobility are described, assessing either excursion of the segments (quantity of movement) or end feel (quality of motion when stressed against the paraphysiological space). The objective of this review was to classify and compare studies based on method of MP used, considering that some studies may have used both methods.

Chiropractic and public health: current state and future vision.

This article provides an overview of primary chiropractic issues as they relate to public health. This collaborative summary documents the chiropractic profession's current involvement in public health, reflects on past barriers that may have prevented full participation within the public health movement, and summarizes the relationship of current chiropractic and public health topics. Topics discussed include how the chiropractic profession participates in preventive health services, health promotion, immunization, geriatrics, health care in a military environment, and interdisciplinary care.

Determining spinal level using the inferior angle of the scapula as a reference landmark: a retrospective analysis of 50 radiographs.

Objective: The purpose of this study was to determine which spinal segment most closely corresponds to the level of the inferior angle of the scapula (IAS) using measurements taken on A-P full-spine radiographs.

Methods: Fifty sequentially selected radiographs were analyzed independently by two examiners. A straight edge was used to ascertain which spinal levels corresponded with the right and left IASs.

A narrative review of pathophysiological mechanisms associated with cervical artery dissection.

Objective: The purpose of this narrative review was to describe pathophysiological risk factors that have been reported in association with cervical artery dissection (CAD) and to discuss the strength of those associations.

Data Sources: MEDLINE, PubMed, Manual Alternative and Natural Therapy System (MANTIS), and CINAHL databases were searched for the years 1966 through September 2006. Additionally, the literature generated by the searches was culled for relevant citations incorporated within the articles.

The etiology of cervical artery dissection.

The etiology of cervical artery dissection (CAD) is unclear, although a number of risk factors have been reported to be associated with the condition. On rare occasions, patients experience CAD after cervical spine manipulation, making knowledge about the cervical arteries, the predisposing factors, and the pathogenesis of the condition of interest to chiropractors. This commentary reports on the relevant anatomy of the cervical arteries, developmental features of CAD, epidemiology of the condition, and mechanisms of dissection.

A review of the use of likelihood ratios in the chiropractic literature.

Objective: The objective of this review is to determine how frequently likelihood ratios (LRs) have been used or described in the chiropractic literature and to depict their appropriate use in the clinical setting.

Methods: A literature search was conducted of the MEDLINE, Manual Alternative and Natural Therapy Index System, and Index to Chiropractic Literature databases, with search years encompassing 1966 through June 2006. Citations in the English language that addressed the following search terms were retrieved: likelihood ratio in combination with manipulation and chiropractic.

Spinous process palpation using the scapular tip as a landmark vs a radiographic criterion standard.

Objective: This study aimed at determining the standing spinal landmark that corresponds to the inferior tip of the scapula and determining the accuracy of experienced palpators in locating a spinous process (SP) 3 levels above and below a given SP.

Methods: The study participants were 34 asymptomatic or minimally symptomatic chiropractic students. An experienced palpator located the inferior scapular tip on each and then positioned a 2-mm lead marker about 5 cm lateral to the nearest SP.

Identification of internal carotid artery dissection in chiropractic practice.

Internal carotid artery dissection (ICAD) is a condition involving separation of the artery's intimal lining from its medial division, with subsequent extension of the dissection along varying distances of the artery, usually in the direction of blood flow. ICAD may produce cerebral ischemia due to occlusion of the involved artery. This occlusion may occur at or near the site of the dissection, or "downstream" as a result of embolization from a dislodged thrombus fragment.