Chiropractic management of pubic symphysis shear dysfunction in a patient with overactive bladder.

Objective: The purpose of this case report is to describe chiropractic management of a patient with overactive bladder (OAB) and to describe an hypothetical anatomical basis for a somato-vesical reflex and possible clinical link between pelvic and symphysis pubis dysfunction to OAB.

Clinical Features: A 24-year-old nulliparous female with idiopathic OAB, with a primary complaint of nocturia presented for chiropractic care. Her sleep was limited to 2 consecutive hours due to bladder urgency.

Improving Our Nation's Health Care System: Inclusion of Chiropractic in Patient-Centered Medical Homes and Accountable Care Organizations.

Objective: This report summarizes the closing plenary session of the Association of Chiropractic Colleges Educational Conference-Research Agenda Conference 2014. The purpose of this session was to examine patient-centered medical homes and accountable care organizations from various speakers' viewpoints and to discuss how chiropractic could possibly work within, and successfully contribute to, the changing health care environment.

Discussion: The speakers addressed the complex topic of patient-centered medical homes and accountable care organizations and provided suggestions for what leadership strategies the chiropractic profession may need to enhance chiropractic participation and contribution to improving our nation's health.

Radiograph utilization and demographics in a chiropractic college teaching clinic.

Objective: The purpose of this study is to present radiograph utilization at a chiropractic college teaching clinic, the associated patient demographics, and the utilization rates by body region.

Methods: Data for outpatient services over a 3-year period were extracted from a college clinic administrative software program. Radiographic data were matched with patient demographic information providing the age, sex, and financial class for all patients.

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.

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.

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.

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.

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.

Symptomatic outcomes and perceived satisfaction levels of chiropractic patients with a primary diagnosis involving acute neck pain.

Objective: The aim of this study was to determine the extent to which a group of patients with acute neck pain managed with chiropractic manipulative therapy benefited from chiropractic care and the degree to which they were subsequently satisfied.

Methods: A two-part retrospective survey, each composed of 14 questions. One part was completed by practicing doctors of chiropractic concerning various aspects of their treatment for patients with former acute neck pain.

An analysis of the etiology of cervical artery dissections: 1994 to 2003.

Objective: To provide a literature review of the etiologic breakdown of cervical artery dissections.

Methods: A literature search of the MEDLINE database was conducted for English-language articles published from 1994 to 2003 using the search terms cervical artery dissection (CAD), vertebral artery dissection, and internal carotid artery dissection. Articles were selected for inclusion only if they incorporated a minimum of 5 case reports of CAD and contained sufficient information to ascertain a plausible etiology.

Chiropractic manipulation and acute neck pain: a review of the evidence.

Objective: The aim of this study was to review the chiropractic and medical literature in an effort to determine the extent of current evidence supporting the use of chiropractic manipulation for the treatment of acute neck pain.

Methods: A literature search of the MEDLINE/PubMed and MANTIS (Manual Alternative and Natural Therapy Index System) databases, extending from 1966 to September 2003, was conducted. Search terms included "cervical," "neck," "chiropractic," "neck pain," "patient satisfaction," and "manipulation.

Cervical artery dissection. A comparison of highly dynamic mechanisms: manipulation versus motor vehicle collision.

Objective: To examine the similarities and dissimilarities between cervical chiropractic manipulative therapy and whiplash, and their respective relation to cervical artery dissection.

Data Sources: A literature synthesis used MEDLINE-PubMed and MANTIS literature searches. A total list of 99 relevant articles was generated.

Cross-sectional validity study of compressive leg checking in measuring artificially created leg length inequality.

Objective: To determine the accuracy of instrumented, prone compressive leg checking.

Design: Point measures (n=29) on single participants.

Setting: Chiropractic college research clinic.

Validity of compressive leg checking in measuring artificial leg-length inequality.

Objective: To determine the accuracy of instrumented prone compressive leg checking.

Design: Repeated measures (n = 26) on single subjects (n = 3).

Setting: Chiropractic college research clinic.

Predicting academic success in the first year of chiropractic college.

Purpose: To determine if any existent preadmission academic or personal variables predict academic success in the first year of the Palmer College of Chiropractic West (PCCW) program.

Participants: One hundred ninety-two students at PCCW who had completed the first year of the program.

Methods: One-way analysis of variance and stepwise linear multiple regression.

The centralization phenomenon in chiropractic spinal manipulation of discogenic low back pain and sciatica.

Objective: To describe 3 cases of discogenic low back pain and leg pain in which the centralization phenomenon was used in determining chiropractic treatment and prognosis.

Clinical Features: Three men with low back pain and sciatica, positive straight leg raise, mild neurologic deficits, and evidence of discogenic disease requested chiropractic treatment. Two of the patients exhibited centralization of pain on provocation testing; the third did not.

Chiropractic management of a patient with lumbar spinal stenosis.

Objectives: To discuss the case of a patient with severe, multilevel central canal stenosis who was managed conservatively with flexion-distraction manipulation; to introduce a cautious approach to the application of treatment, which can reduce the risk of adverse effects and might make an apprehensive doctor more comfortable treating this condition; and to propose a theoretic mechanism for relief of symptoms through use of chiropractic manipulation.

Clinical Features: A 78-year-old man had low back pain and severe bilateral leg pains. Objective findings were minimal, yet magnetic resonance imaging demonstrated severe degenerative lumbar stenosis at L3-L4 and L4-L5 and to a lesser degree at L2-L3.

Functional rating index: a new valid and reliable instrument to measure the magnitude of clinical change in spinal conditions.

Study Design: A prospective cohort design was used to evaluate the Functional Rating Index in a multicentered setting with 139 participants. The Functional Rating Index is a self-reporting instrument consisting of 10 items, each with 5 possible responses that express graduating degrees of disability.

Objectives: The goal of this study was to evaluate the psychometric qualities of the Functional Rating Index.