Development and psychometric evaluation of an information literacy self-efficacy survey and an information literacy knowledge test.

OBJECTIVE: To develop and psychometrically evaluate an information literacy (IL) self-efficacy survey and an IL knowledge test. METHODS: In this test-retest reliability study, a 25-item IL self-efficacy survey and a 50-item IL knowledge test were developed and administered to a convenience sample of 53 chiropractic students. Item analyses were performed on all questions. RESULTS: The IL self-efficacy survey demonstrated good reliability (test-retest correlation = 0.81) and good/very good internal consistency (mean κ = .56 and Cronbach's α = .92). A total of 25 questions with the best item analysis characteristics were chosen from the 50-item IL knowledge test, resulting in a 25-item IL knowledge test that demonstrated good reliability (test-retest correlation = 0.87), very good internal consistency (mean κ = .69, KR20 = 0.85), and good item discrimination (mean point-biserial = 0.48). CONCLUSIONS: This study resulted in the development of three instruments: a 25-item IL self-efficacy survey, a 50-item IL knowledge test, and a 25-item IL knowledge test. The information literacy self-efficacy survey and the 25-item version of the information literacy knowledge test have shown preliminary evidence of adequate reliability and validity to justify continuing study with these instruments.

Learning and Study Strategies Inventory subtests and factors as predictors of National Board of Chiropractic Examiners Part 1 examination performance.

OBJECTIVE: This study was designed to extend research on the relationship between chiropractic students' learning and study strategies and national board examination performance. METHODS: Sixty-nine first trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Linear trends tests (for continuous variables) and Mantel-Haenszel trend tests (for categorical variables) were utilized to determine if the 10 LASSI subtests and 3 factors predicted low, medium and high levels of National Board of Chiropractic Examiners (NBCE) Part 1 scores. Multiple regression was performed to predict overall mean NBCE examination scores using the 3 LASSI factors as predictor variables. RESULTS: Four LASSI subtests (Anxiety, Concentration, Selecting Main Ideas, Test Strategies) and one factor (Goal Orientation) were significantly associated with NBCE examination levels. One factor (Goal Orientation) was a significant predictor of overall mean NBCE examination performance. CONCLUSIONS: Learning and study strategies are predictive of NBCE Part 1 examination performance in chiropractic students. The current study found LASSI subtests Anxiety, Concentration, Selecting Main Ideas, and Test Strategies, and the Goal-Orientation factor to be significant predictors of NBCE scores. The LASSI may be useful to educators in preparing students for academic success. Further research is warranted to explore the effects of learning and study strategies training on GPA and NBCE performance.

Review of methods used by chiropractors to determine the site for applying manipulation.

BACKGROUND: With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. METHODS: Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation. RESULTS: A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement. CONCLUSIONS: A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care- methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine-such as skin conductance or thermography-tend not to be supported by the available evidence.

Differences in learning and study strategies inventory scores between chiropractic students with lower and higher grade point averages.

PURPOSE: This pilot study was designed to investigate the relationship between chiropractic students' learning and study strategies and academic performance. Differences in strategic learning between chiropractic students with higher grade points averages (GPAs) and those with lower GPAs have not been previously reported. METHODS: Fifty-seven consenting first-trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Differences between high and low GPA groups were evaluated for 10 subtests and three factors using independent samples t-tests. RESULTS: The high GPA group scored significantly higher (p < .05) on LASSI subtests Anxiety, Attitude, Concentration, Motivation, Test Strategies, and Selecting Main Ideas, and on factors Effort-Related Activities and Goal Orientation. No differences between groups were found for subtests Information Processing, Self-Testing, Study Aids, and Time Management or for the Cognitive Activities factor. CONCLUSIONS: The results of this study show that differences in LASSI subtest and factor scores are associated with academic performance. For the participants studied, motivational and affective aspects of strategic learning contributed to higher academic performance, whereas cognitive strategies did not. Higher performing students utilized Effort-Related and Goal Orientation learning strategies at significantly higher levels than lower performing students. The LASSI may be useful in identifying students who could benefit from learning and study skills development. Longitudinal study is recommended to investigate the effects of students' learning and study strategies on different academic content domains as well as the effects of strategic study and learning skills training on academic performance.

A pilot study to determine the effects of a supine sacroiliac orthopedic blocking procedure on cervical spine extensor isometric strength.

OBJECTIVE: The purpose of this study was to determine if an orthopedic pelvic blocking procedure affects cervical spine extensor isometric strength. METHODS: Twenty-two participants were sequentially assigned into treatment and control groups. Treatment consisted of a 2-minute procedure using orthopedic blocks (padded wedges with a 45 degrees incline) that were placed bilaterally under the ilia as determined by leg length assessment. Isometric strength measurements took place in 2 sessions with a day of rest between. The treatment group received therapy at the second session immediate to postisometric measures. RESULTS: Outcome measures were the pre- and posttreatment measurements of cervical isometric extension strength in pounds. The t tests showed no statistically significant difference between groups in isometric extension strength before treatment. One-way analysis of variance demonstrated a significant difference between groups after treatment (F(1,21) = 7.174, P = .014). The treatment group demonstrated an average increase of 6.35 (8.18) lb in extensor strength. CONCLUSIONS: The current study showed a statistically significant change in cervical isometric extensor strength after sacroiliac joint blocking.

Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study.

OBJECTIVE: This randomized controlled study was designed to determine the pain-relieving effect of Biofreeze (Performance Health Inc., Export, PA) body surface application and chiropractic adjustments on subjects with acute low back pain (LBP). METHODS: The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity. RESULTS: A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups. CONCLUSION: Biofreeze combined with chiropractic adjustment showed significant reduction in LBP.

The effects of active release technique on hamstring flexibility: a pilot study.

OBJECTIVE: The aim of this study is to determine if active release technique (ART) significantly increases hamstring flexibility in healthy male participants. METHODS: Twenty physically active male participants with no current or previous history of lower extremity injury received ART on the origins and insertions of the hamstrings and dorsal sacral ligament. The sit-and-reach test was used before and after treatment to determine hamstring flexibility. Summary statistics were calculated, and pre and post hamstring flexibility scores were compared using a related samples t test. RESULTS: There was a significant difference between the pre- and posttest groups (mean pre = 35.5 cm, df = 19, SD = 7.56; mean post = 48.3 cm, df = 19, SD = 7.07; P = .0015). All 20 participants increased their sit-and-reach scores following the application of ART. CONCLUSIONS: This study demonstrated that a single ART treatment increased hamstring flexibility in a group of healthy, active male participants.

A case series of reduced urinary incontinence in elderly patients following chiropractic manipulation.

OBJECTIVE: This report presents a spinal adjustment approach to treat elderly patients with urinary incontinence. METHODS: This retrospective case series reports the clinical observation of 13 patients with urinary incontinence. They were treated for 1-8 weeks with Pro-Adjuster technique without any other additional drug and physical therapy treatment. The primary outcome measure for this analysis was the frequency of nocturia reported by the patients during each office visit to the chiropractor. Bladder control was reported by the patients as frequency of nocturia or the urgency of urination or instances of leakage, and the number of pad changes per day or a return of the sense of urinary urge. RESULTS: A total of 13 patients' data (6 female, mean ages 65.7 +/- 12.9 years) were included in the study. After 1-8 weeks of chiropractic adjustments, the urinary frequency at night was significantly reduced from 3.8 to 1.2 time a night (P < 0.001). Three patients improved bladder control with only 2 adjustments. CONCLUSION: The Pro-adjuster treatment program seemed to reduce nocturia in patients with urinary incontinence.

The effects of active release technique on carpal tunnel patients: A pilot study.

OBJECTIVE: To examine changes in electromyography (EMG) and a valid self-administered outcome measure after applying active release technique to carpal tunnel syndrome (CTS) patients. METHODS: Five subjects (mean age 48.2 SD +/- 16.7) with CTS were included in the trial. Subjects completed the Boston Questionnaire (BQ) and an EMG examination before the first treatment. Participants were treated with Active Release technique using a protocol intended to affect the median nerve 3 times a week for 2 weeks. The BQ was re-administered following the final treatment. The mean scores for the initial and final BQ were compared using a paired samples t-test. An analysis of variance compared the mean contraction amplitudes for EMG parameters before and after the first treatment. RESULTS: There was significant improvement (p < 0.05) in the mean symptom severity and functional status scores of the BQ following the intervention. There were no significant differences found in the EMG analyses. CONCLUSION: The preliminary data from this clinical pilot trial suggest that active release technique may be an effective conservative management strategy for CTS patients. These results support the need for further clinical trials with larger samples.