Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial.

Background: Mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives. Little research exists to guide the choice of therapy for acute and subacute neck pain.

Objective: To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.

Advancing integration through evidence informed practice: Northwestern Health Sciences University's integrated educational model.

A consistent theme running through the healthcare debate is the need for new care models that include collaborative, team-based care. There is also growing recognition that interprofessional education is critical to achieving collaborative, patient-centered care. Not unlike conventional, biomedical professions, CAM (complementary and alternative medicine) professions have also educated students in silos with little interaction between various disciplines.

Supervised exercise with and without spinal manipulation performs similarly and better than home exercise for chronic neck pain: a randomized controlled trial.

Study Design: Randomized controlled trial using mixed methods.

Objective: To evaluate the relative effectiveness of high-dose supervised exercise with and without spinal manipulation and low-dose home exercise for chronic neck pain.

Summary Of Background Data: Neck pain is a common global health care complaint with considerable social and economic impact.

Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial.

Background Context: Several conservative therapies have been shown to be beneficial in the treatment of chronic low back pain (CLBP), including different forms of exercise and spinal manipulative therapy (SMT). The efficacy of less time-consuming and less costly self-care interventions, for example, home exercise, remains inconclusive in CLBP populations.

Purpose: The purpose of this study was to assess the relative efficacy of supervised exercise, spinal manipulation, and home exercise for the treatment of CLBP.

Chiropractic and self-care for back-related leg pain: design of a randomized clinical trial.

Background: Back-related leg pain (BRLP) is a common variation of low back pain (LBP), with lifetime prevalence estimates as high as 40%. Often disabling, BRLP accounts for greater work loss, recurrences, and higher costs than uncomplicated LBP and more often leads to surgery with a lifetime incidence of 10% for those with severe BRLP, compared to 1-2% for those with LBP.In the US, half of those with back-related conditions seek CAM treatments, the most common of which is chiropractic care.

Spinal manipulation or mobilization for radiculopathy: a systematic review.

In this systematic review, we present a comprehensive and up-to-date systematic review of the literature as it relates to the efficacy and effectiveness of spinal manipulation or mobilization in the management of cervical, thoracic, and lumbar-related extremity pain. There is moderate quality evidence that spinal manipulation is effective for the treatment of acute lumbar radiculopathy. The quality of evidence for chronic lumbar spine-related extremity symptoms and cervical spine-related extremity symptoms of any duration is low or very low.

Integrative care for the management of low back pain: use of a clinical care pathway.

Background: For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to guide treatment by an integrative group of providers within a randomized controlled trial.

Methods: A clinical care pathway was used by a multidisciplinary group of providers, which included acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary care physicians.

Individualized chiropractic and integrative care for low back pain: the design of a randomized clinical trial using a mixed-methods approach.

Background: Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care.

Effectiveness of manual therapies: the UK evidence report.

Background: The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.

Methods: The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.

Traumatic hand fracture in a patient with osteogenesis imperfecta.

Objective: This article presents a case of osteogenesis imperfecta and reviews the clinical and radiographic features of this condition.

Clinical Features: A 27-year-old woman presented with pain in her left hand after a fall while dancing. Plain films revealed multiple fractures in the digits of her left hand.

A survey of geriatrics courses in north american chiropractic programs.

Purpose: There has been a growing interest in meeting the health care needs of the anticipated "age wave." In order to prepare for the current demographic trends, we sought to describe the status of geriatrics curricula in the 18 North American English-speaking chiropractic colleges by reviewing geriatric course syllabi.

Methods: A cross-sectional survey was conducted using syllabi and catalog information solicited from each English-speaking chiropractic college in North America, collected from January 1, 2007 through June 30, 2007.

The development of a prospective data collection process in a traditional Chinese medicine teaching clinic.

Objective: There is a growing need for students and practitioners of Traditional Chinese Medicine to gain experience with standardized data collection, patient outcomes measurement, and practice-based research. The purpose of this paper is to describe the development of a process for standardized data collection that could eventually be adopted for clinical, research, and quality assurance purposes.

Settings/location: The setting for this study was an acupuncture and Oriental medicine teaching clinic in Bloomington, Minnesota.

Patient outcomes at a traditional Chinese medicine teaching clinic: a prospective data collection project.

Objective: The purpose of this study was to describe patients who seek treatment at an acupuncture and Oriental medicine teaching clinic in the United States, and to systematically measure and describe patients' responses after treatment using a prospective study design.

Design: This is a prospective survey of clinic patients at intake and one month following the initial treatment. SETTINGS AND LOCATION: Data were collected in an acupuncture and Oriental medicine teaching clinic located in Bloomington, Minnesota.

Slow progressing cardiac complications-a case report.

Objective: This case presentation describes an uncommon development of complete heart block. Within 48 hours after a motor vehicle accident with the deployment of the air bag against the patient's chest, the patient reported exertional bradycardia and shortness of breath.

Clinical Features: A 51-year-old man was in a motor vehicle accident.

Evidence-informed management of chronic low back pain with spinal manipulation and mobilization.

The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient.

Chiropractic and exercise for seniors with low back pain or neck pain: the design of two randomized clinical trials.

Background: Low back pain (LBP) and neck pain (NP) are common conditions in old age, leading to impaired functional ability and decreased independence. Manual and exercise therapies are common and effective therapies for the general LBP and NP populations. However, these treatments have not been adequately researched in older LBP and NP sufferers.

Pregnancy and chiropractic: a narrative review of the literature.

Objective: The purpose of this article is to review the literature on the topic of chiropractic care during pregnancy.

Methods: A PubMed search was performed using the terms pregnancy and chiropractic. Sources were cross-referenced to obtain further articles and research information after reviewing the articles obtained through the search.

Chiropractic treatment of hand and wrist pain in older people: systematic protocol development Part 2: cohort natural-history treatment trial.

Objectives: This study examines (a) the feasibility of continued research with an older population; (b) the variety of hand-wrist conditions presented by older patients; (c) the accommodations to standard chiropractic treatment for older patients; and (d) the validity, reliability, responsiveness of measures, and preliminary estimates of outcome of treatment for general hand-wrist pain.

Methods: A cohort of 55 volunteers, first evaluated over a 5-week natural-history baseline period, was offered 5-week chiropractic treatment and then interviewed at 6 months posttreatment. Descriptive and preliminary inferential analyses are reported.

Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews.

Introduction: Conditions of the hand and wrist often occur in older patients, but decision-making algorithms and manual treatment protocols for this age group have not been developed or assessed. Further, effects of age-related co-morbidities are poorly understood.

Objective: To build an understanding of an appropriate treatment protocol from the ground up that does not assume that generic spinal or extremity manipulative therapy is indicated.

Spinal manipulation, epidural injections, and self-care for sciatica: a pilot study for a randomized clinical trial.

Objective: To assess the feasibility of recruiting sciatica patients and to evaluate their compliance in preparation for a full-scale randomized clinical trial. We also aimed to determine the responsiveness of key outcome measures.

Methods: Thirty-two subjects were randomly assigned to spinal manipulation (n=11), epidural steroid injections (n=11), or self-care education (n=10).

Non-invasive physical treatments for chronic/recurrent headache.

Background: Non-invasive physical treatments are often used to treat common types of chronic/recurrent headache.

Objectives: To quantify and compare the magnitude of short- and long-term effects of non-invasive physical treatments for chronic/recurrent headaches.

Search Strategy: We searched the following databases from their inception to November 2002: MEDLINE, EMBASE, BIOSIS, CINAHL, Science Citation Index, Dissertation Abstracts, CENTRAL, and the Specialised Register of the Cochrane Pain, Palliative Care and Supportive Care review group.

Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.

Background Context: Despite the many published randomized clinical trials (RCTs), a substantial number of reviews and several national clinical guidelines, much controversy still remains regarding the evidence for or against efficacy of spinal manipulation for low back pain and neck pain.

Purpose: To reassess the efficacy of spinal manipulative therapy (SMT) and mobilization (MOB) for the management of low back pain (LBP) and neck pain (NP), with special attention to applying more stringent criteria for study admissibility into evidence and for isolating the effect of SMT and/or MOB.

Study Design: RCTs including 10 or more subjects per group receiving SMT or MOB and using patient-oriented primary outcome measures (eg, patient-rated pain, disability, global improvement and recovery time).

What do patients think? Results of a mixed methods pilot study assessing sciatica patients' interpretations of satisfaction and improvement.

Background: Little is known about the issues low back pain patients take into account when deciding their satisfaction with care, the importance placed on such satisfaction, or the factors they consider when assessing their overall improvement.

Objective: The purpose of this study was to explore these issues and to assess the feasibility of implementing qualitative research methods within a clinical trial.

Methods: Study participants were volunteers taking part in a randomized clinical pilot study comparing nonsurgical treatments for sciatica.

Probable inflammatory bowel disease in a child: assessment and conservative management.

Objective: This case presentation describes a method of evaluation and a conservative management plan for a child with probable inflammatory bowel disease (Crohn's Disease). Possible causes for this clinical presentation and a brief review of the literature are offered.

Clinical Features: A 9-year-old female had a history of headaches, stomach ache, foulsmelling soft stools, canker and cold sores, dry skin, stuffy nose with postnasal drip, difficulty concentrating in school, mood swings and growing pains with leg cramps.