A descriptive study of sports chiropractors with an International Chiropractic Sport Science Practitioner qualification: a cross-sectional survey.

BACKGROUND: This paper describes the education and case management profile of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate qualification: International Chiropractic Sport Science Practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic qualification. METHODS: A cross-sectional survey, carried out between 22/10/2014 and 22/12/2014,was utilized with a 39-item web-based survey examining practitioner, practice and clinical management characteristics, and was distributed via email to all sports chiropractors who held an ICSSP qualification (n = 240) in 2014. RESULTS: The survey response rate was 64% (n = 154). 36% of chiropractors were aged between 31 and 40 years, just over three quarters were male, and 27% had been in practice for 5-10 years. The majority of respondents were based in North America. All sports chiropractors surveyed reported treating neuromusculoskeletal conditions outside of the spine. 91% utilized a multimodal approach in most of their treatments, prescribing rehabilitative exercises in 76% of consultations. Almost 64% of respondents reported current treatment of professional athletes, and 78% reported current treatment of semi-professional athletes, whilst the vast majority of those surveyed endorsed past treatment of professional (91%) and semi-professional (95%) athletes. All respondents reported referring to a range of conventional and allied health providers. CONCLUSIONS: This study of ICSSP-qualified sports chiropractors describes a small but well-educated workforce treating high-level athletes, managing a wide range of spine and non-spinal neuromusculoskeletal conditions, utilising multimodal approaches (including active and passive strategies), and referring to and co-managing with other health practitioners.

Functional Knee Extension Test (FKET): Inter-rater palpatory agreement and visual analysis during a non-weight bearing functional assessment of the knee.

OBJECTIVE: The purpose of this study was to evaluate the inter-rater reliability of the Functional Knee Extension Test (FKET), a non-weight bearing functional assessment of the knee that is utilized within clinical practice. METHODS: The design was a single-session, test-retest reliability study. Active knee extension was assessed and documented by each examiner for each of the visual, palpatory and vastus medialis obliqus (VMO) components of the FKET on fifty-seven healthcare professionals. RESULTS: The Kappa (κ) statistic for the inter-rater reliability for the visual, palpatory and VMO variables of the FKET were slight-to-fair (0.13-0.26), fair-to-moderate (0.39-0.50), and moderate-to-almost perfect (0.57-0.93) reliability, respectively. The p-values for all variables, besides 'Visual RIGHT: TibTubExt' and 'Visual LEFT: TibTubExt' indicated statistically significant evidence of agreement above random guessing. Estimates for κ on the 'VMO Quantity: No contact' and 'VMO Timing: Start then stop' variables could not be calculated as ratings only existed across one row of the crosstabulation. CONCLUSION: This study demonstrated that the palpatory and VMO components of the FKET have sufficient reliability to justify utilization within clinical practice. Future research is needed to determine whether the implementation of a functional knee assessment protocol, including the FKET could enhance levels of reliability in clinical decision-making of knee function.

The effect of close proximity holographic wristbands on human balance and limits of stability: a randomised, placebo-controlled trial.

The purpose of this study was to investigate the effect of holographic technology wristbands on human balance and stability performance. Forty-two individuals volunteered to participate in the study. A performance technology silicone wristband containing two holograms was utilised as the 'Device'. A 'placebo' performance technology silicone wristband was utilised where the two holograms were removed and replaced with two stainless steel discs to the same dimensions and weight as the Device. Each participant was randomly allocated into two different testing protocol groups: Protocol 1 (Device-baseline-placebo) and Protocol 2 (placebo-baseline-Device). One week following the initial testing, the Protocol 1 group was tested under the conditions of Protocol 2, and vice versa, so that all participants were taken through both protocols. Results indicated that there was no statistically significant mean change in balance performance brought about by either the placebo or the Device. Notably, the sample data indicated an overall decrease in balance and stability. However, these mean changes are still within the bounds of what would be expected assuming the Device had no overall effect. The findings of this study indicate that holographic technology wristbands have no effect on human balance and stability performance.

Chiropractic management of a medial meniscus tear in a patient with tibiofemoral degeneration: a case report.

OBJECTIVE: The purpose of this case report is to describe and discuss the clinical diagnosis of a medial meniscus tear in an older patient using a multimodal management approach provided by a chiropractor. CLINICAL FEATURES: A 60-year-old woman reported to a chiropractic clinic with left knee pain and swelling. The history and physical examination findings suggested a medial meniscus tear, which was confirmed with magnetic resonance imaging. INTERVENTION AND OUTCOME: Treatment consisted of therapeutic ultrasound; rest, ice, compression, and elevation protocol; soft tissue therapy using effleurage and lymphatic drainage; chiropractic mechanically assisted adjusting techniques to the left knee using a handheld mechanical thrusting instrument; sports taping applied to assist facilitation of the vastus medialis obliquus; and a specific rehabilitation program aimed at strengthening this musculature. The patient's pain was assessed using a quadruple numeric pain scale. Function of the left knee was examined using McMurray, Apley, and a variation of Helfet orthopedic tests, as well as joint line tenderness. Monitoring was done at the initial consultation and at the sixth and 12th treatments. The patient reported being able to walk, swim, and ride a bicycle asymptomatically. Her pain score at the concluding visit was 16.7%, indicating low-intensity pain. CONCLUSION: This case indicated that conservative management of a meniscus tear through a chiropractic multimodal treatment approach provided an alternative or adjunctive therapy to routine orthopedic surgery for this patient.

Relief of internal snapping hip syndrome in a marathon runner after chiropractic treatment.

OBJECTIVE: To discuss the assessment, diagnosis and chiropractic management of a patient with sacroiliac joint dysfunction (SIJ) complicated by psoas major snapping hip syndrome (coxa saltans interna). CLINICAL FEATURES: A 32-year-old male marathon runner experienced low-back and left hip pain without radiation accompanied by a "popping" in the anterior hip. He ran approximately 100 to 150 km/wk for the prior 3 years. He had stopped running for the previous 3 weeks because of worsening and consistent pain. INTERVENTION AND OUTCOME: Treatment consisted of side posture SIJ "diversified" manipulation and myofascial release to the psoas muscle twice weekly for 2 weeks. The patient was also taught proprioceptive neuromuscular facilitation exercises of the psoas and iliotibial band muscles. He was instructed to substitute swimming instead of running on a daily basis. Reassessment at 3 weeks found the patient without pain in his hip or back and no clicking or popping in his left hip. CONCLUSION: Clinicians should consider that runners who present with coexisting SIJ dysfunction and internal snapping hip syndrome may benefit from the combined management of both conditions.