Chiropractic care of children with nocturnal enuresis: a prospective outcome study.

Functional nocturnal enuresis is a common problem which causes a great deal of stress to the suffering children and their families. Some chiropractors advocate chiropractic care as a mode of therapy for this complaint. One hundred and seventy-one enuretic children, aged 4 to 15, were treated with chiropractic adjustments, and their number of wet nights was monitored by their parents. The median number of wet nights per week was 7.0 at the onset of the study. After 2 wk without any therapy, the number of wet nights had decreased to 5.6 (p = .01) and by the end of the treatment this figure was 4.0 (p less than .0001). Following the course of treatment, 15.5% of subjects wet a maximum of 2 nights per fortnight, or, where data for the last 2 wk of therapy were unavailable, a maximum of 1 night/wk. This result is less favorable than the therapeutic success of other common types of therapy, which have reported "cure" rates well above 50%. The only variable which predicted treatment outcome was the initial estimate of bed-wetting; the more severe the condition at the onset, the less likely was the child to improve by the end of the study. In the absence of a control group there appears to be no validity in the claim that chiropractic is a treatment of choice for functional nocturnal enuresis.

Chiropractic chronic low back pain sufferers and self-report assessment methods. Part II. A reliability study of the Middlesex Hospital Questionnaire and the VAS Disability Scales Questionnaire.

The subjective complaints of 41 chronic low back pain sufferers attending a chiropractic clinic were assessed twice prior to therapy with a widely used psychological self-report assessment tool, the Middlesex Hospital Questionnaire (MHQ) and a newly developed VAS Disability Scales Questionnaire (DISQ), both of which investigate various aspects of certain basic positions and activities. Reliability was generally acceptable with these two questionnaires. Subjects participating in the study were commonly found to score within the normal range on the MHQ, indicating that psychological disturbance was not a major feature of their presentation. However, mild mood disturbance was commonly reported, and a more sensitive tool may need to be developed for this type of mildly affected chronic low back pain sufferers. The DISQ generally indicated subjects were mildly to moderately affected by their low back trouble and that sitting and leisure activities were the most pain provoking. Recommendations for further development of the disability scale are made.

Chiropractic chronic low back pain sufferers and self-report assessment methods. Part I. A reliability study of the Visual Analogue Scale, the Pain Drawing and the McGill Pain Questionnaire.

Comprehensive assessment of the problems of low back pain sufferers requires that (in addition to objective measures and clinicians' judgments) an examination of subjective perception of their difficulties should also be made. Subjective measurement has, in the past, presented several problems to researchers. However, in recent years, several new methods of exploring individual reactions to pain and disability have been developed. These assessment measures have, in the main, been carefully explored with severe chronic, acutely ill and surgical patients, but they have not been shown to be appropriate for use with mild chronic low back pain sufferers. This study examines the reliability of several widely used self-report measures. In general, the measures were shown to have acceptable levels of reliability for use with this population, although recommendations for caution in the use of the pain drawing is urged.