Publications by authors named "Silvano Mior"

Background: Chiropractors and chiropractic students commonly report low back pain (LBP). However, the burden of LBP in this occupational group has not been synthesized in the literature. This systematic review aims to describe the epidemiology of LBP in chiropractors and chiropractic students.

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Background: Research enables a profession to establish its cultural authority, validate its professional roles and ensure ongoing improvement in the quality of its academic programming. Despite the clear importance of research, a mature research culture has eluded the chiropractic profession. A fostering institutional culture that enables, values, and supports research activity is essential to building research capacity.

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Background: Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001-2010 and 2015-2018.

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Introduction: Individuals with participation and activity limitations face important healthcare challenges.

Objectives: We investigated healthcare utilization and characteristics of Canadians living with participation and activity limitations between 2001 and 2010.

Methods: We pooled data from 5 cycles of the Canadian Community Health Survey (2001-2010 CCHS).

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Interprofessional healthcare teams have become the benchmark for optimising athlete health and performance in high-stakes sports. Despite a history of utility as provider partners, chiropractors are currently a relatively underutilised human resource in this rapidly developing and challenging field. Consequently, our study explored the global experiences and distinct perspectives of elite-level career sports chiropractors.

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Background: Clinicians make clinical decisions using the dual process theory. The dual process theory comprises two approaches, System 1, based on heuristics, and System 2, involving an analytical and effortful thought process. However, there are inherent limitations to the dual process theory, such as relying on inaccurate memory or misinterpreting cues leading to inappropriate clinical management.

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Background: Back pain is very common and a leading cause of disability worldwide. Due to health care system inequalities, Indigenous communities have a disproportionately higher prevalence of injury and acute and chronic diseases compared to the general Canadian population. Indigenous communities, particularly in northern Canada, have limited access to evidence-based spine care.

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Musculoskeletal (MSK) conditions are the leading cause of disability, resulting in up to 40% of visits to family physicians. Current primary care workforce shortages in Canada require other providers to maximize scopes of practice. Few MSK providers have been trained in team-based primary care settings.

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This prospective, community-based, active surveillance study aimed to report the incidence of moderate, severe, and serious adverse events (AEs) after chiropractic (n = 100) / physiotherapist (n = 50) visit in offices throughout North America between October-2015 and December-2017. Three content-validated questionnaires were used to collect AE information: two completed by the patient (pre-treatment [T0] and 2-7 days post-treatment [T2]) and one completed by the provider immediately post-treatment [T1]. Any new or worsened symptom was considered an AE and further classified as mild, moderate, severe or serious.

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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.

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Introduction: Understanding healthcare utilization by Canadians with back problems informs healthcare planning nationally.

Research Question: What is the prevalence of utilization of healthcare providers (medical doctors, chiropractors, physiotherapists, nurses), and associated characteristics among Canadians with chronic back problems (2001-2016)?

Material And Methods: This population-based study used Canadian Community Health Survey data (2001-2016) restricted to respondents with chronic back problems (aged ≥12 years). We used self-reported consultation with healthcare providers (medical doctors, chiropractors, physiotherapists, nurses) from 2001-2010, and self-reported regular healthcare provider from 2015-2016.

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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.

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Background: Little is known about lived experience of synchronous telehealth in patients with musculoskeletal (MSK) disorders.

Objective: We conducted a rapid systematic review to answer: (1) what are the lived experiences and/or perspectives of people with MSK disorders receiving non-pharmacological interventions delivered through synchronous telehealth; and (2) what clinical implications can be inferred from qualitative studies focusing on lived experiences for how telehealth is delivered in the management of MSK disorders?

Data Sources: A comprehensive search of MEDLINE, CINAHL, PsycINFO, ProQuest, and Google Scholar from June 2010 to July 2023. Eligible qualitative and mixed methods studies capturing lived experiences of adults with MSK disorders receiving non-pharmacological interventions via synchronous telehealth were included.

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Objectives: Developing a research agenda is one method to facilitate broad research planning and prioritise research within a discipline. Despite profession-specific agendas, none have specifically addressed the research needs of the specialty of sports chiropractic. This study determined consensus on research priorities to inform a global sports chiropractic research agenda.

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Objective: This study aimed to describe the characteristics associated with unmet rehabilitation needs in a sample of Canadians with long-term health conditions or disabilities during the first wave of the COVID-19 pandemic.

Design: We used data from the Impacts of COVID-19 on Canadians Living With Long-Term Conditions and Disabilities, a national cross-sectional survey with 13,487 respondents. Unmet needs were defined as needing rehabilitation (ie, physiotherapy/massage/chiropractic, speech therapy, occupational therapy, counseling services, or support groups) but not receiving due to the pandemic.

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Article Synopsis
  • The study aimed to evaluate the effectiveness of education and advice for adults suffering from chronic primary low back pain (CPLBP) to inform WHO guidelines.
  • After reviewing over 2,500 studies, 15 randomized controlled trials (RCTs) were included, indicating that education/advice can improve pain, function, and quality of life compared to no intervention.
  • Despite these improvements, the evidence supporting these benefits is considered to be of very low certainty, highlighting the need for further research.
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Chronic primary low back pain (CPLBP) is a prevalent and disabling condition that often requires rehabilitation interventions to improve function and alleviate pain. This paper aims to advance future research, including systematic reviews and randomized controlled trials (RCTs), on CPLBP management. We provide methodological and reporting recommendations derived from our conducted systematic reviews, offering practical guidance for conducting robust research on the effectiveness of rehabilitation interventions for CPLBP.

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Article Synopsis
  • The study aimed to assess the effectiveness and risks of needling therapies (NT) for adults with chronic primary low back pain (CPLBP) to guide WHO clinical guidelines.
  • After examining 1831 articles, 37 randomized controlled trials were included, revealing low certainty in evidence and minimal differences between NT and other treatments across most measures.
  • NT showed some positive effects on health-related quality of life and pain reduction at different time points, especially compared to no intervention and usual care, although overall, the evidence was not strong.
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Article Synopsis
  • The study aimed to assess the effectiveness and potential drawbacks of structured exercise programs for adults suffering from chronic primary low back pain (CPLBP), to help shape WHO clinical guidelines.* -
  • Researchers analyzed randomized controlled trials (RCTs) focused on different structured exercise programs, comparing them to placebos, usual care, or no treatment, ultimately synthesizing data from 13 RCTs with low or unclear bias.* -
  • The findings indicate that structured exercise likely leads to a reduction in pain and functional limitations for adults with CPLBP, with moderate certainty supporting the benefits of various exercise types such as aerobic exercise, Pilates, and motor control exercises.*
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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.

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As commissioned by the WHO, we updated and expanded the scope of four systematic reviews to inform its (in development) clinical practice guideline for the management of CPLBP in adults, including older adults. Methodological details and results of each review are described in the respective articles in this series. In the last article of this series, we discuss methodological considerations, clinical implications and recommendations for future research.

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Driving posture can lead to musculoskeletal pain. Most work focuses on the lower back; therefore, we know little about automobile seat design and neck posture. This study evaluated an automobile driver seat that individualized upper back support to improve head and neck posture.

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Purpose: The aim of our study is to inform the development of a rehabilitation program of care from the perspectives of those suffering from degenerative cervical radiculopathy (DCR).

Material And Methods: We conducted a qualitative study, purposefully recruiting individuals with DCR. Transcripts from virtual semi-structured interviews were iteratively analyzed using interpretative phenomenological methods.

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Background: Chiropractors use a variety of therapeutic interventions in clinical practice. How the selection of interventions differs across musculoskeletal regions or with different patient and provider characteristics is currently unclear. This study aimed to describe how frequently different interventions are used for patients presenting for chiropractic care, and patient and provider characteristics associated with intervention selection.

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Degenerative cervical radiculopathy (DCR) can lead to severe pain, paraesthesia, and/or motor weakness, resulting in significant morbidity, disability, and reduced quality of life. Typically, individuals suffer from prolonged symptoms, with time to complete recovery spanning months to years. Little is known about the impact DCR has on peoples' lives.

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