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SUMMARY OBJECTIVE: The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a meta-analysis of the available evidence. METHODS: The literature review for this systematic review was conducted between December 2022 and January 2023 using five electronic databases, namely PubMed, CINAHL, Scopus, Web of Science, and ULAKBİM. Published articles were scanned using MeSH-based keywords. Only randomized controlled trials conducted in the past 5 years were included. The data were analyzed using the Review Manager computer program. RESULTS: This meta-analysis included three studies involving a total of 386 infantile colic infants. After nonpharmacological treatment, it was found that infants with infantile colic reduced crying time (standardized mean difference: 0.61; 95%CI 0.29-0.92; Z=3.79; p=0.00002), improved sleep duration (standardized mean difference: 0.22; 95%CI −0.04 to 0.48; Z=1.64; p=0.10), and decreased crying intensity (mean difference: −17.24; 95%CI −20.11 to 14.37; Z=11.77; p<0.000001). CONCLUSION: According to the meta-analysis findings, it was determined that the risk of bias was low in the studies included and that nonpharmacological chiropractic, craniosacral, and acupuncture treatments applied to infantile colic infants in the three included studies reduced crying time and intensity and increased sleep duration.
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BACKGROUND@#Chiropractic is the largest complementary and alternative medicine profession in the United States, with increasing global growth. A preliminary literature review suggests a lack of widespread diversity of chiropractic patient profiles.@*OBJECTIVE@#There have been no prior studies to comprehensively integrate the literature on chiropractic utilization rates by race, ethnicity, and socioeconomic status. The purpose of this scoping review is to identify and describe the current state of knowledge of chiropractic utilization by race, ethnicity, education level, employment status, and income and poverty level.@*SEARCH STRATEGY@#Systematic searches were conducted in PubMed, Ovid MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, and Index to Chiropractic Literature from inception to May 2021.@*INCLUSION CRITERIA@#Articles that reported race or ethnicity, education level, employment status, income or poverty level variables and chiropractic utilization rates for adults (≥18 years of age) were eligible for this review.@*DATA EXTRACTION AND ANALYSIS@#Data extracted from articles were citation information, patient characteristics, race and ethnicity, education level, employment status, income and poverty level, and chiropractic utilization rate. A descriptive numerical summary of included studies is provided. This study provides a qualitative thematic narrative of chiropractic utilization with attention to race and ethnicity, education level, income and poverty level, and employment status.@*RESULTS@#A total of 69 articles were eligible for review. Most articles were published since 2003 and reported data from study populations in the United States. Of the race, ethnicity and socioeconomic categories that were most commonly reported, chiropractic utilization was the highest for individuals identifying as European American/White/non-Hispanic White/Caucasian (median 20.00%; interquartile range 2.70%-64.60%), those with employment as a main income source (median utilization 78.50%; interquartile range 77.90%-79.10%), individuals with an individual or household/family annual income between $40,001 and $60,000 (median utilization 29.40%; interquartile range 25.15%-33.65%), and individuals with less than or equal to (12 years) high school diploma/general educational development certificate completion (median utilization 30.70%; interquartile range 15.10%-37.00%).@*CONCLUSION@#This comprehensive review of the literature on chiropractic utilization by race, ethnicity and socioeconomic status indicates differences in chiropractic utilization across diverse racial and ethnic and socioeconomic populations. Heterogeneity existed among definitions of key variables, including race, ethnicity, education level, employment status, and income and poverty level in the included studies, reducing clarity in rates of chiropractic utilization for these populations. Please cite this article as: Gliedt JA, Spector AL, Schneider MJ, Williams J, Young S. Disparities in chiropractic utilization by race, ethnicity and socioeconomic status: A scoping review of the literature. J Integr Med. 2023; 21(2): 159-167.
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Humans , United States , Ethnicity , Socioeconomic Factors , Chiropractic , Systematic Reviews as Topic , Social ClassABSTRACT
Objective To observe the effectiveness of the three-dimensional balanced chiropractic technique in the treatment of lumbar disc herniation (LDH) and analyze predictive factors for resorption of the herniated nucleus pulposus based on magnetic resonance imaging (MRI). Methods From June 2015 to June 2021, 95 patients with LDH treated with the three-dimensional balanced chiropractic techniquein our hospital were followed up for clinical and MRI data. They were divided into resorption group and non-resorption group based on the nucleus pulposus resorption rate. Multivariable binary logistic regression analysis was performed to determine the association of 12 factors (sex, age, course of disease, etc.)with nucleus pulposus resorption. Results Thirty-two cases (33.7%)were found at follow-up to have nucleus pulposus resorption (resorption rate≥30%). Resorption was most likely to occur in patients with a disease course of less than a year (P < 0.001), type 3 LDH accoding to the Michigan State University (MSU) classification (P = 0.014), leg numbness (P = 0.006), and a L4/5 or L5/S1 disc herniation (P < 0.001). Conclusion MRI can be used as an important tool to observe nucleus pulposus resorption in LDH. A disease course of less than a year, MSU type 3, leg numbness, a L4/5 or L5/S1 disc herniation are associated with a higher possibility of nucleus pulposus resorption, which can be used as indicators predicting the outcome of patients with LDH treated with the three-dimensional balanced chiropractic technique.
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Objective: To explore the clinical efficacy of spine subtle adjusting manipulation for postpartum low back pain (PLBP). Methods: A total of 76 patients with PLBP were randomized into a control group and a treatment group, with 38 cases in each group. The control group was treated with core muscle strengthening exercises, and the treatment group was treated with spine subtle adjusting manipulation. After 3 weeks of treatment, the clinical efficacy was observed, and the visual analog scale (VAS) score and Oswestry disability index (ODI), and the changes of lumbar Cobb angle and pelvic rotation were compared between the two groups. Results: The total effective rate of the treatment group was 92.1％, and that of the control group was 78.9％. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS score and ODI in both groups decreased, and the intra-group differences were all statistically significant (P<0.05). There were no intra-group statistical differences in the lumbar Cobb angle or pelvic rotation in the two groups (P>0.05). After treatment, there were no statistical differences in the lumbar Cobb angle or pelvic rotation between the two groups (P>0.05); the VAS score and ODI in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion: Spine subtle adjusting manipulation can effectively relieve the pain for patients with PLBP, and improve their daily activity function.
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OBJECTIVE@#To observe the clinical efficacy of chiropractic plus plum-blossom needling combined with flexibility training for attention deficit in mentally-retarded adolescents.@*METHODS@#Thirty adolescents with mild mental retardation were randomly divided into a medical rehabilitation plus flexibility training group (10 cases, 2 cases dropped off), a flexibility training group (10 cases, 1 case dropped off) and a control group (10 cases). The patients in the flexibility training group received flexibility training, once every other day, 3 times a week for 12 weeks. The patients in the medical rehabilitation plus flexibility training group received chiropractic and plum-blossom needling at Baihui (GV 20) and Sishencong (EX-HN 1) on the basis of the treatment in the flexibility training group, once every other day, 3 times a week for 12 weeks. The patients in the control group did not receive any targeted physical training and medical rehabilitation. Tobii Pro Spectrum eye movement instrument was used to test the attention concentration (T), attention span (M), attention transfer (γ%) and attention distribution (η).@*RESULTS@#Compared before treatment, T and M in the medical rehabilitation plus flexibility training group and the flexibility training group were increased after treatment (P<0.01, P<0.05), and γ% in the medical rehabilitation plus flexibility training group was increased after treatment (P<0.05). The increasing range of T, M and γ% in the medical rehabilitation plus flexibility training group and the flexibility training group was greater than that in the control group (P<0.01), and the increasing range of T and γ% in the medical rehabilitation plus flexibility training group was greater than that in the flexibility training group (P<0.05).@*CONCLUSION@#The chiropractic plus plum blossom needling combined with flexibility training can improve the attention deficit in mentally-retarded adolescents.
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Adolescent , Humans , Acupuncture Therapy , Chiropractic , Flowers , Prunus domestica , Vascular Surgical ProceduresABSTRACT
OBJECTIVE@#To observe clinical efficacy of chiropractic manipulation in the treatment of degenerative scoliosis (DS).@*METHODS@#From June 2017 to September 2019, 120 patients with degenerative scoliosis were randomly divided into treatment group (60 cases) and control group(60 cases). The patients in treatment group were treated with chiropractic manipulation once every other day for 4 weeks. The patients in control group were treated with eperisone hydrochloride tablets combined with thoracolumbar orthopedic(TSLO)brace, oral eperisone hydrochloride tablets 50 mg three times a day, wearing TSLO brace for not less than 8 hours a day. The course of treatment was 4 weeks. After the patients were selected into the group, visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded before treatment, 1, 2, 3, 4 weeks after treatment and 1 month after treatment. The full length X-ray of the spine was taken before and 4 weeks after treatment, and the scoliosis Cobb angle, sagittal vertical axis (SVA) and lumbar lordosis (LL) were measured and compared. The adverse reactions during the treatment were recorded.@*RESULTS@#There were significant differences in VAS and ODI between two groups at each time point after treatment (P<0.001), VAS and ODI at 2 weeks after treatment (PVAS=0.025, PODI=0.032) and 3 weeks after treatment(PVAS=0.040, PODI=0.044) in treatment group were significantly different from those in control group, but there was no significant difference in VAS and ODI at other time points between treatment group and control group (P>0.05). There was significant difference in Cobb angle between treatment group(P=0.010) and control group(P=0.017) after treatment, but there was no significant difference in LL and SVA between treatment group and control group. There was no significant difference in Cobb angle, LL and SVA between two groups before and after treatment. During the treatment, there were 4 mild adverse reactions in the control group and no adverse reactions in the treatment group.@*CONCLUSION@#Chiropractic manipulation can effectively relieve pain and improve lumbar function in patients with degenerative scoliosis. The onset of action is faster than that oral eperisone hydrochloride tablets combined with TSLO brace, and it has better safety and can improve Cobb angle of patients with degenerative scoliosis.
Subject(s)
Humans , Lordosis , Lumbar Vertebrae , Manipulation, Chiropractic , Retrospective Studies , Scoliosis/therapy , Spinal Fusion , Treatment OutcomeABSTRACT
According to Chinese medicine, the atlantoaxial joint is a composite joint composed of tendons and bones, and the stability of the joint depends on the 'tendon-bone balance' involving tendons, ligaments, atlas and axis. Multiple causes of 'tendon off-position, joint subluxation' will lead to joint 'tendon-bone imbalance', which will evolve into atlantoaxial subluxation (AAS), endangering human health. Chinese therapeutic massage (tuina) is a very effective treatment for AAS in adults, but conventional manipulations are prone to ineffectiveness or accidents due to neglect of the causal relationship of the 'tendon-bone imbalance' and inappropriate manipulations. Compared with conventional manipulations, the rational choice of modified manipulations under the guidance of 'tendon-bone balance' theory is more effective and less risky, and more worthy of clinical promotion. From the 'tendon-bone balance' theory, we considered the shortcomings of conventional manipulations, and introduced several modified manipulations that have their own strengths in 'tendon smoothing' and 'bone setting', in order to provide new ideas for treatment of AAS in adults.
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Objective: To observe the effects of acupuncture plus spinal manipulations on the physical functioning and levels of alkaline phosphatase (ALP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and osteoprotegerin (OPG) in patients with ankylosing spondylitis (AS). Methods: A total of 128 AS cases were allocated into a control group and an observation group using random number table method, with 64 cases in each group. Patients in both groups took sulfasalazine and meloxicam. Patients in the observation group received additional acupuncture plus spinal manipulations. The efficacy, Bath AS functional index (BASFI), Bath AS disease activity index (BASDAI), and the levels of ALP, ESR, CRP and OPG were compared between the two groups after eight weeks of treatment. Results: After treatment, the symptom scores of traditional Chinese medicine in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); the VAS, BASFI and BASDAI scores in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); and the ALP, ESR, CRP and OPG levels in both groups were decreased (all P<0.05), and these levels in the observation group were significantly lower than in the control group (all P<0.05). The total efficacy rate was 92.2％ in the observation group, versus 78.1％ in the control group, presenting a statistical significance (P<0.05). Conclusion: Conventional medication combined with acupuncture and spinal manipulations can improve clinical symptoms, accelerate the recovery of physical functioning, and reduce the ALP, ESR, CRP and OPG levels.
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Objective: To compare the efficacy of different treatment protocols in treating transient synovitis of the hip (TSH) in children and to optimize the clinical treatment strategy for this condition. Methods: Ninety kids with TSH were divided into a control group, a chiropractic group and a chiropractic plus foot bath group using the random number table method, with 30 cases in each group. The control group was treated with conventional traction; the chiropractic group was given chiropractic treatment based on the control group; the chiropractic plus foot bath group was given Chinese medicine foot bath based on the chiropractic group. Traction and foot bath were conducted once daily while chiropractic was done once every other day, all with 14 d as a treatment course for a total of two courses. Changes in the visual analog scale (VAS) score and range of motion (ROM) of the hip joint in the three groups were observed, and the efficacy was compared. Results: The total effective rate was 93.3％ in the chiropractic plus foot bath group, versus 76.7％ in the chiropractic group and 66.7％ in the control group, and the total effective rate was notably higher in the chiropractic plus foot bath group than in the other two groups (both P<0.05). Respectively after the first and second treatment course, the VAS score decreased significantly in each of the three groups compared with that before treatment (all P<0.01), and the ROM of the hip joint in flexion increased significantly (all P<0.01). After two treatment courses, the VAS score was lower in the chiropractic plus foot bath group than in the other two groups (both P<0.05), and its ROM of the hip joint in flexion was larger than that in the other two groups (both P<0.05). Conclusion: Based on traction, chiropractic plus Chinese medicine foot bath can effectively reduce pain and improve motor function of the hip joint in treating TSH.
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BACKGROUND: Low back pain is one of the common orthopedic diseases, and nonspecific low back pain accounts for a very large proportion of all low back pains in clinic. In order to better treat the disease, in 2016, the American Orthopaedic Association developed a clinical guide for the osteopathic manipulative treatment of nonspecific low back pain. OBJECTIVE: To let orthopedic doctors, other doctors, other health professionals and third-party payers know the evidence of potential suggestions on the proper use of osteopathic manipulative treatment, so as to help clinical orthopedists to provide therapeutic reference for non-specific low back pain as well as to learn from the scientific and rigorous design ideas and evaluation methods in the guides. METHODS: The guideline is a revised version based on the previous guideline and the latest high-quality meta-analyses. It is determined that osteopathic manipulative treatment is an effective treatment for nonspecific low back pain with clear recommended level. In this paper, the definition, evaluation methods, specific contents of the guideline and results of evidence-based medicine regarding the clinical practice in China were analyzed and discussed. RESULTS AND CONCLUSION: Seventeen studies were included in the guidelines, which systematically evaluated the effect of osteopathic manipulative treatment for acute and chronic nonspecific low back pain, as well as for nonspecific low back pain in pregnant and postpartum women. After treatment, great improvement was achieved in pain relief and functional recovery. The final suggestion by the American Orthopaedic Association is to use osteopathic manipulative treatment for low back pain. The treatment method is safe and scientific, which can be generalized in China.
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Objective: To study the clinical efficacy of modified Zhenwutang combined with Zhengji technique on cold-dampness arthralgia syndrome caused by knee osteoarthritis (KOA) at episode and the effect on inflammatory factors of joint fluid. Method: One hundred and forty-eight patients were randomly divided into control group and observation group by random number table. Patients in control group got celecoxib capsules, 0.2 g/time, 1 time/day, and Zhengji technique with lumbar positioning oblique pulling and finger pressing for 12 times, 1 time for every two days, 3 times/week. Patients in observation group got modified Zhenwutang, 1 dose/day, and the same Zhengji technique. The course of treatment was 4 weeks. Before and after treatment, western Ontario and McMaster University Osteoarthritis index (WOMAC), pain and swelling, index of severity of osteoarthritis (ISOA), local signs of knee joint and cold-dampness obstruction syndrome were scored, and the score of quality of life were discussed by arthritis impact measurement scale 2 (AIMS2-SF). And levels of interleukin-1 beta (IL-1β), IL-17, tumor necrosis factor-alpha (TNF-α), substance P (SP) and calcitonin gene-related peptide (CGRP) were detected. Result: The clinical efficacy in observation group was better than that in control group (Z=2.131, PPPβ, IL-17, TNF-α, SP and CGRP were higher than those in control group (PConclusion: Modified Zhenwutang combined with Zhengji technique can relieve clinical symptoms of patients with cold-dampness arthralgia syndrome caused by knee osteoarthritis (KOA) at episode, ameliorate joint function to improve patients' quality of life, reduce the expression of proinflammatory factors and neuropeptides in synovial fluid, so as to inhibit the inflammatory response and controlling clinical symptoms.
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Torticollis is an abnormal, asymmetric head or neck position which usually caused by imbalance of paracervical muscles. The traumatic torticollis can be caused by following events; atlantoaxial rotatory subluxation, atlantoaxial dislocation, cervical vertebral fractures, and injury to the cervical musculature. Especially, acute traumatic atlantoaxial rotatory subluxation usually presents limitation of cervical range of motion without pain or neurologic deficit. We report a case of a 58 year-old man who developed the acute atlantoaxial rotatory subluxation right after the chiropractic therapy, which induced the limitation of cervical range of motion to 52.5% of normal range. The magnetic resonance image revealed the facture of the odontoid process and the partial injury in transverse ligaments of the atlas. He underwent intramuscular botulinum toxin injection and 10 days of continuous cervical traction 15 hours a day using a 5 kg weight. The range of the cervical motion restored up to 90.2% of normal range.
Subject(s)
Atlanto-Axial Joint , Botulinum Toxins , Chiropractic , Joint Dislocations , Head , Ligaments , Muscles , Neck , Neurologic Manifestations , Odontoid Process , Range of Motion, Articular , Reference Values , Torticollis , TractionABSTRACT
OBJECTIVE@#To analyze the clinical effect of Zhuang medicine tendon therapy combined with chiropractic manipulation in treating sacroiliac joint dislocation.@*METHODS@#From January 2017 to May 2018, 60 patients with sacroiliac joint dislocation were divided into treatment group and control group according to the order of admission. There were 19 males and 11 females in the treatment group, aged from 23 to 52 (38.97±3.23) years old, with a course of 2 h to 5.1 months, with an average of (2.19±1.12) months. There were 14 males and 16 females in the control group, aged from 26 to 50 (39.07±3.30) years old, with a course of 3 h to 6 months, with an average of(2.41±1.05) months. The treatment group was treated with Zhuang medicine tendon therapy combined with chiropractic manipulation, while the control group was treated with conventional acupuncture and massage. Before treatment, the main clinical symptoms of the patients were lumbosacral pain, posterior superior iliac spine not at the same level and accompanied with dyskinesia. The pelvic separation test and the "4" test were positive. After treatment, the curative effect was evaluated according to the improved Macnab standard and the "score of treatment of lumbar diseases".@*RESULTS@#Sixty patients were followed up for an average of 8 months. At the latest follow-up, the clinical effect of modified Macnab was better in the treatment group than in the control group(<0.01). After treatment, the treatment group was better than the control group on lumbar function score (<0.01).@*CONCLUSIONS@#The treatment of sacroiliac joint dislocation by Zhuang medicine tendon therapy combined with chiropractic manipulation has good clinical effect and is worth further application and development.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Fracture Fixation, Internal , Joint Dislocations , Therapeutics , Manipulation, Chiropractic , Sacroiliac Joint , TendonsABSTRACT
Objective:To observe the clinical effect of chiropractic on nonspecific low back pain (NLBP). Methods:From July, 2016 to January, 2018, 90 patients with NLBP were randomly divided into control group (n = 45) and observation group (n = 45). Both groups accepted core stabilization exercises (CSE) and routine physical therapy, and the observation group received chiropractic additionally. They were treated for four weeks and followed up for six months. Before, and two and four weeks after treatment, and at six-month follow-up, they were evaluated with Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), abdominal and dorsal muscle endurance test (AMET) and waist active range of motion (AROM). Results:Two and four weeks after treatment, the result of VAS, ODI, AMET, and waist AROM improved significantly in both groups (P < 0.05), and they were better in the observation group than in the control group (t > 0.263, P < 0.001). At six-month follow-up, the scores of VAS and ODI improved significantly (P < 0.05), and were better in the observation group than in the control group (t > 5.911, P < 0.001). Conclusion:CSE and routine physical therapy combined with chiropractic could better reduce the pain, improve the dysfunction, and increase the spinal stability for patients with NLBP.
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El síndrome de cola de caballo (SCC) es una urgencia quirúrgica poco frecuente con una incidencia estimada de hasta 1,8 casos por millón de habitantes, producida por la compresión de las raíces nerviosas en el extremo inferior del canal espinal. La manipulación espinal puede desempeñar un papel etiogénico, provocando la movilización y extrusión del disco. El diagnóstico temprano y el tratamiento oportuno son cruciales, ya que el pronóstico suele ser desfavorable si el tratamiento quirúrgico se retrasa produciendo un daño neurológico permanente. El objetivo de este trabajo es identificar los potenciales factores de riesgo para la manipulación espinal y optimizar esta práctica, evitando así posibles complicaciones derivadas del tratamiento quiropráctico. Presentamos 3 casos de SCC, observados y tratados en nuestro centro, en los que se sugiere una estrecha relación entre la manipulación espinal quiropráctica y la aparición de dicho síndrome. Tras realizarles una RM en la que se observó una hernia discal L5-S1 causante del SCC, los 3 pacientes fueron tratados quirúrgicamente de forma urgente. Los casos presentados demostraron la existencia de una asociación patogénica entre la manipulación espinal y el desarrollo del SCC, al producirse dicho síndrome en las horas siguientes a la manipulación debida a la protusión abrupta de un disco demostrado por RM.
Introduction: Cauda equine syndrome (CES) is a rare surgical emergency with an estimated incidence of up to 1.8 cases per million. It is caused by compression of the nerve roots at the lowest point of the spinal canal. Spinal manipulation can play a pathogenic role, resulting in mobilization and extrusion of the disc. Early diagnosis and timely treatment are crucial, since the prognosis is usually unfavorable and permanent neurological damage likely if surgical treatment is delayed. Objective: The aim of this study was to identify potential risk factors associated with spinal manipulation and, thereby, optimize this practice to reduce the risk of complications from chiropractic treatment. Methods: We present three cases of CES, observed and treated at our center, in which a close relationship between chiropractic spinal manipulation and the appearance of CES was apparent. Results: After magnetic resonance imaging (MRI) revealed an L5-S1 herniated disc causing the SCC, all three patients underwent urgent surgical treatment. Conclusion: The three presented cases demonstrate a strong pathogenic relationship between spinal manipulation and the development of CES, when this syndrome occurs within hours of spinal manipulation, secondary to MRI-documented acute disc protrusion.
Subject(s)
Humans , Spinal Canal , Therapeutics , Magnetic Resonance Imaging , Chiropractic , Emergencies , Hernia , Intervertebral Disc DisplacementABSTRACT
Esta pesquisa objetivou desvelar as percepções dos entrevistados profissionais da Fisioterapia, Fisioterapia Quiropráxica e os graduados em Quiropraxia em relação ao atual cenário político e ético-profissional da Quiropraxia no Brasil. A Quiropraxia é reconhecida como uma Especialização da profissão Fisioterapia. Porém, existem duas instituições de ensino superior que ofertam graduação em Quiropraxia no Brasil. Com o objetivo de regulamentar a profissão de Quiropraxia, tramitam no Senado Federal os Projetos de Lei n°. 4.199/2001, n°. 1436/2011, n°. 114/2015 e o Projeto de Lei do Senado n°. 599/2011. Trata-se de uma pesquisa exploratória e descritiva com abordagem qualitativa. Os sujeitos foram os profissionais da Fisioterapia, e indivíduos graduados em Quiropraxia. Para a coleta de dados utilizou-se de gravação de uma entrevista de voz a partir de um questionário semiestruturado. As entrevistas foram realizadas nos meses de novembro de 2017 até dezembro de 2017, respeitando os aspectos éticos. Na interpretação dos dados, empregou-se a análise de conteúdo proposta por Bardin (2009). As categorias identificadas foram: "O Atual cenário da Quiropraxia no Brasil", "Quem está com a razão?" e "Uma convivência pacífica". Com base nas categorizações foi possível refletir sobre novos pontos que emergiram como: os novos desafios e avanços das práticas de Quiropraxia no Brasil, Quiropraxia e Saúde Pública no Brasil. Esse trabalho conseguiu desenhar a percepção dos entrevistados sobre o atual cenário político e ético-profissional da Quiropraxia no Brasil, como uma nova ferramenta de debate, para transformar ideias enraizadas, na busca do desenvolvimento de novas reflexões entre profissionais Fisioterapeutas e graduados em Quiropraxia, promovendo um debate absolutamente importante, a fim de proporcionar a sociedade um profissional mais completo e preparado para a prática de atenção e preservação da saúde, livre das amarras de reserva de mercado.
This paper aims to show perceptions of Physiotherapy, Chiropractic Physiotherapy professionals and also Physiotherapy undergraduates concerning the current political and ethical-professional scene of Chiropractic in Brazil. Chiropractic is recognized as a specialization from Physiotherapy. However, there are two universities that oï¬er this graduation in Brazil. In order to regulate the Chiropractic Professional is under evaluation in the Federal Senate through the law projects n° 4.199/2001, n° 1436/2011, n° 114/2015 and the law project n° 599/2011. It is a descriptive and exploratory research with qualitative approach. The interviewees were Physiotherapy professionals and graduated people in Chiropractic. To the data collection was used the recording of a voice interview from a semi- structured questionnaire. The interviews were conducted from November 2017 until December 2017, with respect of all the ethics aspects. In interpretation of data, was used the content analysis suggested by Bardin (2009). The categories identiï¬ed were: " The current scenario of Chiropractic in Brazil", "Who has the reason?" and "A peaceful living". On the basis of the classiï¬cation it was possible to reï¬ect about new issues such as: the new challenges and the Chiropractic practices advances in Brazil, Chiropractic and Public Health in Brazil. This paper was able to show the interviewees' perception about the current political and ethical-professional scene of Chiropractic in Brazil, as a new debate tool to change old ideas in the search of new developments and new reï¬ections among phisiotherapists and chiropractors encouraged an absolutely and important debate in order to show the society a complete and prepared professional with attention experience, preserve health and free from the bonds of the market.
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We describe the case of a patient who had infarction of the posterior inferior cerebellar artery (PICA) after a chiropractic cervical manipulation. A 39-year-old man visited the emergency room with signs of cerebellar dysfunction, presenting with a 6-hour history of vertigo and imbalance. Two weeks ago, he was treated by a chiropractor for intermittent neck pain. At the time of admission, brain computed tomography, magnetic resonance imaging, and angiography revealed an acute infarction in the left PICA territory and occlusion of the extracranial vertebral artery (VA; V1/2 junction) as a result of the dissection of the VA. Angiography revealed complete occlusion of the left PICA and arterial dissection was shown in the extracranial portion of the VA. He was treated with antiplatelet therapy. Three weeks later, he was discharged without any sequelae. The possibility of VA dissection should be considered at least once in patients presenting with cerebellar dysfunctions with a recent history of chiropractic cervical manipulation.
Subject(s)
Adult , Humans , Angiography , Arteries , Brain , Cerebellar Diseases , Cerebral Infarction , Chiropractic , Emergency Service, Hospital , Infarction , Lateral Medullary Syndrome , Magnetic Resonance Imaging , Manipulation, Chiropractic , Manipulation, Spinal , Neck Pain , Pica , Vertebral Artery , VertigoABSTRACT
Objective:To observe the curative effect of cervical chiropractic for cervical spondylosis of vertebral artery type (CSA) and to explore its possible mechanism.Methods:Sixty CSA patients were randomly divided into two groups.Thirty patients in the treatment group were treated with chiropractic manipulation for cervical vertebrae,once every other day,7 treatments in total.The other 30 patients in the control group received oral administration of flunarizine hydrochloride,10 mg per night,for 14 d.Cervical vertigo and functional assessment scale and transcranial cerebral Doppler (TCD) were measured before treatment and 7 days after treatment.Results:The total effective rate was 96.7％ in the treatment group and 83.3％ in the control group.The curative rate was 66.7％ in the treatment group and 20％ in the control group.The differences between the two groups in the total effective rate and the curative rate were statistically significant (both P＜0.05).The scores of cervical vertigo symptom and functional assessment after treatment in both groups were significantly higher than those before treatment (both P＜0.01);the difference between the two groups was statistically significant (P＜0.05).After treatment,the maximum systolic velocity (Vs),the maximum diastolic velocity (Vd),the mean velocity (Vm),the pulsatility index (PI) and the vascular resistance index (RI) in both groups were significantly improved compared with those before the treatment (all P＜0.01);there were significant differences between the two groups (all P＜0.05).Conclusion:Cervical chiropractic is an effective method for CSA,and its curative effect is better than that of flunarizine hydrochloride alone.Its mechanism may relate to correcting cervical instability.
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Objective:To observe the clinical effect of needling gluteus medius muscle trigger point (TrP) plus chiropractic for sacroiliac joint subluxation.Methods:A total of 124 cases conforming to the inclusion criteria of sacroiliac joint subluxation were classified by anterior subluxation and posterior subluxation,and randomized into a TrP group and a conventional group respectively.There were 63 patients with anterior subluxation who were randomized into a TrP group of 32 cases (including 4 dropped out cases) and a conventional group of 31 cases (including 3 dropped out cases);and 61 patients with posterior subluxation who were randomized into a TrP group of 31 cases (including 3 dropped out cases) and a conventional group of 30 cases (including 3 dropped out cases).Patients in the TrP group received the treatment of needling gluteus medius muscle TrP plus chiropractic,while patients in the conventional group received conventional acupuncture treatment plus chiropractic.The treatment was done twice a week for a succession of 8 weeks.Then,the pain visual analog scale (VAS),Oswestry disability index (ODI) and therapeutic efficacy were evaluated.Results:After treatment,the total effective rate of TrP group with anterior subluxation was 96.9％,higher than 77.4％ in the conventional group,the difference showed a statistical significance (P＜0.05);the total effective rate was 93.5％ in the TrP group with posterior subluxation,higher than 73.3％ in the conventional group.After treatment,the VAS and ODI scores in both groups dropped obviously,the differences showed statistical significance (all P＜0.05);the scores of VAS and ODI in the TrP group were obviously lower than those in the conventional group (all P＜0.05).Conclusion:Needling gluteus medius muscle TrP plus chiropractic had a better therapeutic effect than conventional acupuncture plus chiropractic for sacroiliac joint subluxation.
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@#Objective To explore the clinical effect of sling exercise on postpartum low back pain (PLBP). Methods From February, 2017 to February, 2018, 66 PLBP patients were randomly divided into control group (n = 33) and observation group (n = 33). The control group received routine rehabilitation physiotherapy and American chiropractic, and the observation group was supplemented with sling exercise therapy additionally. They were evaluated with Numerical Rating Scale (NRS), Oswestry Disability Index (ODI) and the thickness of transversus abdominis before and six weeks after treatment. Results Before treatment, there was no significant difference in the scores of NRS, ODI and the thickness of transversus abdominis between two groups (P > 0.05). Six weeks after treatment, the scores of NRS and ODI significantly decreased (t > 14.579, P < 0.001), and the transversus abdominis thickness significantly improved (t > 15.855, P < 0.001) in both groups. All the above indexes were significantly better in the observation group than in the control group (t > 4.818, P < 0.001). Conclusions ling exercise therapy, combined with American chiropractic treatment and routine rehabilitation physiotherapy, can further relieve pain in patients with PLBP, and improve the function and the quality of life.