{"results":[{"id":"doaj_10.3390/app15052433","title":"Chronotropic Incompetence Does Not Impede Attainment of High-Intensity Exercise During Non-Contact Boxing in Parkinson’s Disease","authors":[{"name":"Tone Ricardo Benevides Panassollo"},{"name":"Usman Rashid"},{"name":"Sue Lord"},{"name":"Denise Taylor"},{"name":"Grant Mawston"}],"abstract":"Recent evidence points to the effect of chronotropic incompetence (CI), which refers to a blunted heart rate (HR) response to exercise, influencing physiological outcomes in people with Parkinson’s disease (PD). This study explores the effect of CI on physiological responses and examines whether a high-intensity training zone is attained during non-contact boxing training in people with PD. In total, 11 PD participants with CI (PDCI), 13 without CI (PD non-CI), and 14 age-matched controls performed two non-contact boxing sessions on different days. The primary outcomes were the maximum HR (HRmax), average HR (HRavg), percentage of the highest HR from cardiopulmonary exercise test (%HR-CPET) and predicted maximum HR (%MA-PHR), time exercising above 85%HRmax (HI-85%), and second ventilatory threshold (HI-VT2). PDCI participants displayed significantly lower HRavg and HRmax values during all rounds than PD non-CI participants and controls for both sessions (\u003ci\u003ep\u003c/i\u003e ≤ 0.001). No significant differences were observed between PD non-CI participants and controls (\u003ci\u003ep\u003c/i\u003e ≥ 0.05). Although all participants exercised at approximately 100% of %HR-CPET, PDCI participants showed a significantly lower %MA-PHR than PD non-CI participants and controls (\u003ci\u003ep\u003c/i\u003e ≤ 0.001). HI-85% and HI-VT2 were not significantly different between PDCI and PD non-CI participants. Despite exhibiting a lower absolute HRmax and HRavg during boxing compared to PD non-CI participants and aged-match controls, PDCI participants exercise at a similar intensity within the high-intensity training zone when expressed as a percentage of the individualized HRmax.","source":"DOAJ","year":2025,"language":"","subjects":["Technology","Engineering (General). Civil engineering (General)","Biology (General)","Physics","Chemistry"],"doi":"10.3390/app15052433","url":"https://www.mdpi.com/2076-3417/15/5/2433","is_open_access":true,"published_at":"","score":69},{"id":"doaj_10.1016/j.tria.2025.100388","title":"Odontoid process angulation range in a South African skeletal population sample: An osteological study","authors":[{"name":"Ricardo Jonker"},{"name":"Glen J. Paton"},{"name":"Shahed Nalla"}],"abstract":"Background: This study investigated the angulation of the odontoid process in a South African skeletal population to establish normative vertical angulation in the sagittal plane and assess variations across population affinity groups, biological sexes, and age categories. The study also investigated standardizing techniques for measuring the angle of the odontoid process. Methods: A cross-sectional study was conducted on 200 cervical axis vertebrae from the Raymond A. Dart Collection. Angulation measurements were taken using digital photographs, ImageJ software and statistical analyses (one-way ANOVA and t-tests). Results: The mean odontoid process angulation (degrees; °) across the sample was 60.45° (±3.10°). No statistically significant differences in angulation were found. Minor variations were observed, with males (60.77° ± 2.94°) showing a slightly higher mean angulation than females (60.08° ± 3.25°). The age groups, “20–40 years” (60.71° ± 3.56°) and “41–55 years” (60.43° ± 3.04°), displayed greater angulation than the 56–70 years age group (60.19° ± 2.68°). Population affinity groups showed that the Black African group had a mean angulation of 60.57° (±3.01°), the White group had 60.06° (±3.04°), and the Coloured group had a slightly higher mean of 60.64° (±3.26°). Conclusions: The study concluded there are statistically insignificant differences in the odontoid process angulation based on population affinity, sex, and age. The findings contribute to a better understanding of cervical spine anatomy and assist in clinical interventions related to the cervical spine.","source":"DOAJ","year":2025,"language":"","subjects":["Human anatomy"],"doi":"10.1016/j.tria.2025.100388","url":"http://www.sciencedirect.com/science/article/pii/S2214854X2500007X","is_open_access":true,"published_at":"","score":69},{"id":"doaj_10.1186/s12998-024-00565-w","title":"A multi-level implementation strategy to increase adoption of chiropractic care for low back pain in primary care clinics: a randomized stepped-wedge pilot study protocol","authors":[{"name":"Eric J. Roseen"},{"name":"André Bussières"},{"name":"Rocky Reichman"},{"name":"Celia Bora"},{"name":"Jennifer Trieu"},{"name":"Kirsten Austad"},{"name":"Charles Williams"},{"name":"Ryan A. Fischer"},{"name":"Danielle Parrilla"},{"name":"Lance D. Laird"},{"name":"Michael LaValley"},{"name":"Roni L. Evans"},{"name":"Robert B. Saper"},{"name":"Natalia E. Morone"}],"abstract":"Abstract Introduction Limited adoption of first line treatments for low back pain (LBP) in primary care settings may contribute to an overreliance on pain medications by primary care providers (PCPs). While chiropractic care typically includes recommended nonpharmacologic approaches (e.g., manual therapy, exercise instruction, advice on self-care), implementation strategies to increase adoption of chiropractic care for LBP in primary care clinics are understudied, particularly in underserved communities. Methods We will use a stepped-wedge cluster randomized controlled pilot trial design to evaluate the feasibility of a multi-level implementation strategy to increase adoption of chiropractic care for LBP in primary care clinics at community health centers. Key barriers and facilitators identified by site champions and other key stakeholders will help us to develop and tailor implementation strategies including educational materials and meetings, developing a network of local chiropractors, and modifying the electronic health record to facilitate referrals. Three primary care clinics will be randomized to receive the implementation strategy first, second, or third over a fourteen-month study period. At our first clinic, we will have a four-month pre-implementation period, a two-month implementation deployment period, and a subsequent eight-month follow-up period. We will stagger the start of our implementation strategy, beginning in a new clinic every two months. We will evaluate the proportion of patients with LBP who receive a referral to chiropractic care in the first 21 days after their index visit with PCP. We will also evaluate adoption of other guideline concordant care (e.g., other nonpharmacologic treatments) and non-guideline concordant care (e.g., opioids, imaging) over the study period. Discussion LBP is currently the leading cause of disability worldwide. While there are several treatment options available for individuals with LBP, patients in underserved populations do not often access recommended nonpharmacologic treatment options such as chiropractic care. The results from this study will inform the development of practical implementation strategies that may improve access to chiropractic care for LBP in the primary care context. Furthermore, results may also inform policy changes needed to expand access to chiropractic care in underserved communities. Clintrials.gov NCT# NCT06104605.","source":"DOAJ","year":2025,"language":"","subjects":["Chiropractic","Diseases of the musculoskeletal system"],"doi":"10.1186/s12998-024-00565-w","url":"https://doi.org/10.1186/s12998-024-00565-w","is_open_access":true,"published_at":"","score":69},{"id":"ss_76a1f1030ba8bb9add717f9392100e6247ea7e2b","title":"A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy","authors":[{"name":"Eric Chun Pu Chu"},{"name":"R. Trager"},{"name":"L. Y. Lee"},{"name":"I. Niazi"}],"abstract":"This study examined the incidence and severity of adverse events (AEs) of patients receiving chiropractic spinal manipulative therapy (SMT), with the hypothesis that  60 with osteoporosis, while none were grade ≥ 4, yielding an incidence of grade ≥ 3 AEs of 0.21 per 100,000 SMT sessions (95% CI 0.00, 0.56 per 100,000). There were no AEs related to stroke or cauda equina syndrome. The sample size was insufficient to identify predictors of grade ≥ 3 AEs using multiple logistic regression. In this study, severe SMT-related AEs were reassuringly very rare.","source":"Semantic Scholar","year":2023,"language":"en","subjects":["Medicine"],"doi":"10.1038/s41598-023-28520-4","url":"https://www.semanticscholar.org/paper/76a1f1030ba8bb9add717f9392100e6247ea7e2b","pdf_url":"https://www.nature.com/articles/s41598-023-28520-4.pdf","is_open_access":true,"citations":54,"published_at":"","score":68.62},{"id":"ss_666a53fe50e3d3839646a59d6b157a8df6888b62","title":"The World Federation of Chiropractic Global Patient Safety Task Force: a call to action","authors":[{"name":"Brian C. Coleman"},{"name":"Sidney M. Rubinstein"},{"name":"S. Salsbury"},{"name":"Michel S Swain"},{"name":"Richard Brown"},{"name":"Katherine A Pohlman"}],"abstract":"The Global Patient Safety Action Plan, an initiative of the World Health Organization (WHO), draws attention to patient safety as being an issue of utmost importance in healthcare. In response, the World Federation of Chiropractic (WFC) has established a Global Patient Safety Task Force to advance a patient safety culture across all facets of the chiropractic profession. This commentary aims to introduce principles and call upon the chiropractic profession to actively engage with the Global Patient Safety Action Plan beginning immediately and over the coming decade. This commentary addresses why the chiropractic profession should pay attention to the WHO Global Patient Safety Action Plan, and what actions the chiropractic profession should take to advance these objectives. Each strategic objective identified by WHO serves as a focal point for reflection and action. Objective 1 emphasizes the need to view each clinical interaction as a chance to improve patient safety through learning. Objective 2 urges the implementation of frameworks that dismantle systemic obstacles, minimizing human errors and strengthening patient safety procedures. Objective 3 supports the optimization of clinical process safety. Objective 4 recognizes the need for patient and family engagement. Objective 5 describes the need for integrated patient safety competencies in training programs. Objective 6 explains the need for foundational data infrastructure, ecosystem, and culture. Objective 7 emphasizes that patient safety is optimized when healthcare professionals cultivate synergy and partnerships. The WFC Global Patient Safety Task Force provides a structured framework for aligning essential considerations for patient safety in chiropractic care with WHO strategic objectives. Embracing the prescribed action steps offers a roadmap for the chiropractic profession to nurture an inclusive and dedicated culture, placing patient safety at its core. This commentary advocates for a concerted effort within the chiropractic community to commit to and implement these principles for the collective advancement of patient safety.","source":"Semantic Scholar","year":2024,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-024-00536-1","url":"https://www.semanticscholar.org/paper/666a53fe50e3d3839646a59d6b157a8df6888b62","pdf_url":"https://chiromt.biomedcentral.com/counter/pdf/10.1186/s12998-024-00536-1","is_open_access":true,"citations":7,"published_at":"","score":68.21000000000001},{"id":"ss_e5e0252bbaee5903671faec171137fd82987a08c","title":"Social inequity in chiropractic utilisation – a cross-sectional study in Denmark, 2010 and 2017","authors":[{"name":"Kristine Bihrmann"},{"name":"M. T. Pedersen"},{"name":"J. Hartvigsen"},{"name":"K. Wodschow"},{"name":"A. Ersbøll"}],"abstract":"Inequity in healthcare utilisation refers to differences between groups that remain after adjustment for need for health care. To our knowledge, no previous studies have aimed to assess social inequity in chiropractic utilisation in a general population. Therefore, the objective of this study was to evaluate social inequity in chiropractic utilisation in the general Danish population adjusted for health status as a proxy of need for chiropractic care. A population-based repeated cross-sectional study design was used based on the Danish National Health Survey in 2010 and 2017. Overall, we included 288,099 individuals aged 30 years or older in 2010 or 2017. For each individual, information on chiropractic utilisation, socioeconomic status, and health status as a proxy of need for chiropractic care was retrieved from nationwide registers using the unique personal identification number. Measures of health status included demographics, poor self-rated physical health, activity limitations, musculoskeletal pain, number of musculoskeletal conditions, and number of chronic diseases. We investigated social inequity in chiropractic utilisation (yes, no) using logistic regression adjusted for health status, stratified by sex and year. Three characteristics of socioeconomic status (educational level, employment status and income) were investigated. To further quantify the degree of social inequity in chiropractic utilisation, we estimated the concentration index of inequity for each of the three characteristics of socioeconomic status. We found significantly higher odds of chiropractic utilisation among individuals with short or medium/long education compared with individuals with elementary education, and among employed individuals compared with individuals who were unemployed, receiving disability pension or retired. Furthermore, the odds of chiropractic utilisation increased with higher income. The concentration index indicated social inequity in chiropractic utilisation in favour of individuals with higher socioeconomic status, with income and employment status contributing more to inequity than educational level. The study demonstrated social inequity in chiropractic utilisation in Denmark beyond differences in health status as a proxy of need for chiropractic care in the general population. The results suggest that new strategies are required if equal treatment for equal need is the goal.","source":"Semantic Scholar","year":2024,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-024-00548-x","url":"https://www.semanticscholar.org/paper/e5e0252bbaee5903671faec171137fd82987a08c","pdf_url":"https://doi.org/10.1186/s12998-024-00548-x","is_open_access":true,"citations":7,"published_at":"","score":68.21000000000001},{"id":"ss_4ba0f20b328369a0e313b6bd31f3ffcb9f721cd0","title":"The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided","authors":[{"name":"P. Beliveau"},{"name":"Jessica J. Wong"},{"name":"Deborah Sutton"},{"name":"Nir Ben Simon"},{"name":"A. Bussières"},{"name":"S. Mior"},{"name":"S. French"}],"abstract":"BackgroundPrevious research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided.MethodsSystematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition.ResultsThe literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%).ConclusionsThis comprehensive overview on the world-wide state of the chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of chiropractic practice, although common trends emerged.","source":"Semantic Scholar","year":2017,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-017-0165-8","url":"https://www.semanticscholar.org/paper/4ba0f20b328369a0e313b6bd31f3ffcb9f721cd0","pdf_url":"https://chiromt.biomedcentral.com/track/pdf/10.1186/s12998-017-0165-8","is_open_access":true,"citations":222,"published_at":"","score":67.66},{"id":"ss_f58fa291e4ffe586c32682575050c8c4fa3c549c","title":"Unlocking Athletic Potential: The Integration of Chiropractic Care into the Sports Industry and Its Impact on the Performance and Health of Athletes and Economic Growth in China and Hong Kong","authors":[{"name":"A. Lin"},{"name":"Shun Zhe Piong"},{"name":"William MH Wan"},{"name":"Peng Li"},{"name":"V. Chu"},{"name":"Eric Chun Pu Chu"}],"abstract":"This study explores the significant role chiropractic care can play in the sports industry, with a focus on countries like China and Hong Kong. As a vital component of sports medicine, chiropractic care can enhance athletic performance, health, and competitiveness by addressing biomechanical imbalances and optimizing neuromuscular function. The potential impact of chiropractic care on the sports industry includes attracting international events and investments, leading to increased economic opportunities, and the overall growth of the industry. Key strategies for promoting chiropractic care in the sports industry encompass developing a robust chiropractic care infrastructure, raising public awareness through targeted campaigns, and implementing supportive policies by governments and sports organizations. The integration of chiropractic care within sports medicine not only benefits individual athletes but also contributes to the broader development and success of the sports industry as a whole.","source":"Semantic Scholar","year":2023,"language":"en","subjects":["Medicine"],"doi":"10.7759/cureus.37157","url":"https://www.semanticscholar.org/paper/f58fa291e4ffe586c32682575050c8c4fa3c549c","pdf_url":"https://assets.cureus.com/uploads/review_article/pdf/148784/20230405-19238-162zvm6.pdf","is_open_access":true,"citations":17,"published_at":"","score":67.50999999999999},{"id":"doaj_10.1186/s12998-023-00509-w","title":"A descriptive analysis of the contents of Care Response, an international data set of patient-reported outcomes for chiropractic patients","authors":[{"name":"Kenneth J Young"},{"name":"Jane Fitzgerald"},{"name":"Jonathan Field"},{"name":"David Newell"},{"name":"Jim Richards"}],"abstract":"Abstract Background Databases have become an important tool in understanding trends and correlations in health care by collecting demographic and clinical information. Analysis of data collected from large cohorts of patients can have the potential to generate insights into factors identifying treatments and the characteristics of subgroups of patients who respond to certain types of care. The Care Response (CR) database was designed to capture patient-reported outcome measures (PROMs) for chiropractic patients internationally. Although several papers have been published analysing some of the data, its contents have not yet been comprehensively documented. The primary aim of this study was to describe the information in the CR database. The secondary aim was to determine whether there was suitable information available to better understand subgroups of chiropractic patients and responsiveness to care. This would be achieved by enabling correlations among patient demographics, diagnoses, and therapeutic interventions with machine learning approaches. Methods Data in all available fields were requested with no date restriction. Data were collected on 12 April 2022. The output was manually scanned for scope and completeness. Tables were created with categories of information. Descriptive statistics were applied. Results The CR database collects information from patients at the first clinical visit, 14, 30, and 90 days subsequently. There were 32,468 patient responses; 3210 patients completed all fields through the 90 day follow up period. 45% of respondents were male; 54% were female; the average age was 49. There was little demographic information, and no information on diagnoses or therapeutic interventions. We received StartBack, numerical pain scale, patient global impression of change, and Bournemouth questionnaire data, but no other PROMs. Conclusions The CR database is a large set of PROMs for chiropractic patients internationally. We found it unsuitable for machine learning analysis for our purposes; its utility is limited by a lack of demographic information, diagnoses, and therapeutic interventions. However, it can offer information about chiropractic care in general and patient satisfaction. It could form the basis for a useful clinical tool in the future, if reformed to be more accessible to researchers and expanded with more information collected.","source":"DOAJ","year":2023,"language":"","subjects":["Chiropractic","Diseases of the musculoskeletal system"],"doi":"10.1186/s12998-023-00509-w","url":"https://doi.org/10.1186/s12998-023-00509-w","is_open_access":true,"published_at":"","score":67},{"id":"ss_72409b6bcd9949d536e4aa98525cacdc71026e9c","title":"Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain","authors":[{"name":"Carlos Gevers-Montoro"},{"name":"B. Provencher"},{"name":"M. Descarreaux"},{"name":"Arantxa Ortega de Mues"},{"name":"M. Piché"}],"abstract":"Together, neck pain and back pain are the first cause of disability worldwide, accounting for more than 10% of the total years lived with disability. In this context, chiropractic care provides a safe and effective option for the management of a large proportion of these patients. Chiropractic is a healthcare profession mainly focused on the spine and the treatment of spinal disorders, including spine pain. Basic studies have examined the influence of chiropractic spinal manipulation (SM) on a variety of peripheral, spinal and supraspinal mechanisms involved in spine pain. While spinal cord mechanisms of pain inhibition contribute at least partly to the pain‐relieving effects of chiropractic treatments, the evidence is weaker regarding peripheral and supraspinal mechanisms, which are important components of acute and chronic pain. This narrative review highlights the most relevant mechanisms of pain relief by SM and provides a perspective for future research on SM and spine pain, including the validation of placebo interventions that control for placebo effects and other non‐specific effects that may be induced by SM.","source":"Semantic Scholar","year":2021,"language":"en","subjects":["Medicine"],"doi":"10.1002/ejp.1773","url":"https://www.semanticscholar.org/paper/72409b6bcd9949d536e4aa98525cacdc71026e9c","pdf_url":"https://depot-e.uqtr.ca/id/eprint/9573/1/PICHE_M_106_POST.pdf","is_open_access":true,"citations":53,"published_at":"","score":66.59},{"id":"ss_3042299cf84db64f5f87c6e6cb86a6ad04dfd433","title":"Association between chiropractic care and use of prescription opioids among older medicare beneficiaries with spinal pain: a retrospective observational study","authors":[{"name":"J. Whedon"},{"name":"Sarah Uptmor"},{"name":"A. Toler"},{"name":"Serena Bezdjian"},{"name":"T. Mackenzie"},{"name":"L. A. Kazal"}],"abstract":"Background The burden of spinal pain can be aggravated by the hazards of opioid analgesics, which are still widely prescribed for spinal pain despite evidence-based clinical guidelines that identify non-pharmacological therapies as the preferred first-line approach. Previous studies have found that chiropractic care is associated with decreased use of opioids, but have not focused on older Medicare beneficiaries, a vulnerable population with high rates of co-morbidity and polypharmacy. The purpose of this investigation was to evaluate the association between chiropractic utilization and use of prescription opioids among older adults with spinal pain. Methods We conducted a retrospective observational study in which we examined a nationally representative multi-year sample of Medicare claims data, 2012–2016. The study sample included 55,949 Medicare beneficiaries diagnosed with spinal pain, of whom 9,356 were recipients of chiropractic care and 46,593 were non-recipients. We measured the adjusted risk of filling a prescription for an opioid analgesic for up to 365 days following diagnosis of spinal pain. Using Cox proportional hazards modeling and inverse weighted propensity scoring to account for selection bias, we compared recipients of both primary care and chiropractic to recipients of primary care alone regarding the risk of filling a prescription. Results The adjusted risk of filling an opioid prescription within 365 days of initial visit was 56% lower among recipients of chiropractic care as compared to non-recipients (hazard ratio 0.44; 95% confidence interval 0.40–0.49). Conclusions Among older Medicare beneficiaries with spinal pain, use of chiropractic care is associated with significantly lower risk of filling an opioid prescription.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-022-00415-7","url":"https://www.semanticscholar.org/paper/3042299cf84db64f5f87c6e6cb86a6ad04dfd433","pdf_url":"https://chiromt.biomedcentral.com/counter/pdf/10.1186/s12998-022-00415-7","is_open_access":true,"citations":15,"published_at":"","score":66.45},{"id":"ss_cf004c387e1f1781518871bebf85184e2970b8a2","title":"Diversity of the chiropractic profession in Canada: a cross-sectional survey of Canadian Chiropractic Association members","authors":[{"name":"D. Southerst"},{"name":"Nora Bakaa"},{"name":"Pierre Côté"},{"name":"Luciana G Macedo"},{"name":"Lisa C. Carlesso"},{"name":"J. Macdermid"},{"name":"S. Mior"}],"abstract":"Background Little is known about the diversity of the chiropractic profession with respect to gender, sexual orientation, race, ethnicity and community of practice. This knowledge is important as profession representation of key equity seeking groups may impact quality of care and access for vulnerable communities. The aim of this cross-sectional survey was to explore the diversity of the chiropractic profession in Canada. Methods All registered members of the Canadian Chiropractic Association ( N  = 7721) were invited to participate in a web-based survey between May and June 2021. Survey questions explored diversity with respect to personal demographics (age, sex, gender, sexual orientation, race, ethnicity, language) and practice characteristics (community setting, practice type). Where possible, survey data was compared to data from the 2016 Census of the Canadian population. Results We received a total of 3143 survey responses (response rate—41%). The average age of our sample was 44.7 years (standard deviation 12.7). Forty-five percent were female with the same proportion (45.2%) self-identifying as women. Ninety-one percent of the sample self-identified as heterosexual. With respect to race, 80% of respondents were Caucasian. Seventy percent of chiropractors in our sample identified with Canadian ancestry and 29% with European ancestry. In comparison to the Canadian population, some visible minorities were underrepresented. The greatest discrepancy between the Canadian population and our sample was in the proportion of Black and Indigenous chiropractors. With respect to ethnicity, chiropractors identifying themselves with Canadian ancestry were overrepresented in our sample compared to others, specifically those with North American Indigenous and South, Central and Latin American ancestry. Sixty-one percent of chiropractors practiced in major cities and most work in interdisciplinary clinics (42% Complementary and Alternative Medicine and 33% rehabilitation). Conclusions This study provides an initial description of diversity within the chiropractic profession in Canada. Women represent less than 50% of the profession nationally. Overall, there is little racial and ethnic diversity in the chiropractic profession compared to the Canadian population, with Black and Indigenous peoples being underrepresented. Future work should focus strategies to foster the development of a more diverse chiropractic workforce.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-022-00463-z","url":"https://www.semanticscholar.org/paper/cf004c387e1f1781518871bebf85184e2970b8a2","pdf_url":"https://chiromt.biomedcentral.com/counter/pdf/10.1186/s12998-022-00463-z","is_open_access":true,"citations":11,"published_at":"","score":66.33},{"id":"ss_eac0fa2bdec8fceb448e3b0f0753c2cda5179b46","title":"Factors that influence scope of practice of the chiropractic profession in Australia: a scoping review","authors":[{"name":"D. Wiggins"},{"name":"A. Downie"},{"name":"Roger M. Engel"},{"name":"Benjamin T. Brown"}],"abstract":"Introduction The World Health Organization describes chiropractic as a health profession that treats the musculoskeletal system and the effects of that system on the function of the nervous system and general health. Notwithstanding such descriptions, scope of practice remains a contentious issue in Australia chiropractic with various authors defining it differently. To date, the peak governing body, the Chiropractic Board of Australia, has focused on title protection rather than defining a scope of practice for the profession. A well-defined scope of practice is important, as it helps to identify what is acceptable in the profession and the role chiropractic has in the broader healthcare system. Objective The objective of this scoping review was to explore the literature on the factors that influence scope of practice of chiropractic in Australia. Methods This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the chiropractic profession in Australia. Results A total of 1270 articles were identified from the literature search. Six studies fulfilled the inclusion criteria and were included in the final analysis. Four factors that influence scope of practice were identified: education, professional identity, patient safety, and organisational structure. Conclusion The results of this study will inform future discussions around establishing a framework for a more comprehensive scope of practice for the chiropractic profession in Australia. Such a framework has the potential to benefit patient safety, professional identity, public perception, education, and regulation of the profession.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-022-00428-2","url":"https://www.semanticscholar.org/paper/eac0fa2bdec8fceb448e3b0f0753c2cda5179b46","pdf_url":"https://chiromt.biomedcentral.com/counter/pdf/10.1186/s12998-022-00428-2","is_open_access":true,"citations":9,"published_at":"","score":66.27000000000001},{"id":"ss_30539d3bc801f4ad738cbaafefbbb82b8ac7143f","title":"Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas.","authors":[{"name":"M. Acharya"},{"name":"D. Chopra"},{"name":"Allen M. Smith"},{"name":"J. Fritz"},{"name":"B. Martin"}],"abstract":"Objective The objective of this study was to estimate the association between early use of physical therapy (PT) or chiropractic care and incident opioid use and long-term opioid use in individuals with a low back pain (LBP) diagnosis. Methods A retrospective cohort study was conducted using data from Arkansas All Payers' Claims Database. Adults with incident LBP diagnosed in primary care or emergency departments between July 1, 2013, and June 30, 2017, were identified. Participants were required to be opioid naïve in the 6-month baseline period and without cancer, cauda equina syndrome, osteomyelitis, lumbar fracture, and paraplegia/quadriplegia in the entire study period. PT and chiropractic treatment were documented over the ensuing 30 days starting on the date of LBP. Any opioid use and long-term opioid use (LTOU) in 1-year follow-up were assessed. Multivariable logistic regressions controlling for covariates were estimated. Results A total of 40 929 individuals were included in the final sample, with an average age of 41 years and 65% being women. Only 5% and 6% received PT and chiropractic service, respectively, within the first 30 days. Sixty-four percent had incident opioid use, and 4% had LTOU in the follow-up period. PT was not associated with incident opioid use (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.98-1.18) or LTOU (OR, 1.19; 95% CI, 0.97-1.45). Chiropractic care decreased the odds of opioid use (OR, 0.88; 95% CI, 0.80-0.97) and LTOU (OR, 0.56; 95% CI, 0.40-0.77). Conclusion In this study we found that receipt of chiropractic care, though not PT, may have disrupted the need for opioids and, in particular, LTOU in newly diagnosed LBP.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1016/j.jcm.2022.02.007","url":"https://www.semanticscholar.org/paper/30539d3bc801f4ad738cbaafefbbb82b8ac7143f","pdf_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237579","is_open_access":true,"citations":9,"published_at":"","score":66.27000000000001},{"id":"ss_d6ac9e8456d90521e623064116c6c1c64b211c2c","title":"A Brief Review of Chiropractic Educational Programs and Recommendations for Celebrating Education on Chiropractic Day.","authors":[{"name":"Claire D. Johnson"},{"name":"B. Green"},{"name":"Richard Brown"},{"name":"A. Facchinato"},{"name":"Stephen Foster"},{"name":"Martha A. Kaeser"},{"name":"Randy L. Swenson"},{"name":"Michael J. Tunning"}],"abstract":"Objective The purpose of this article is to provide an overview of the growth of chiropractic education globally and a chronological list of current training programs. Another purpose is to provide exemplars of enduring programs and offer suggestions for how chiropractic practitioners may celebrate education on Chiropractic Day, which is September 18. Discussion Chiropractic education has transformed considerably over the past 125 years, and there are now 52 programs globally. We consider the 5 longest-existing chiropractic programs and propose hypotheses for what may have contributed to their durability. In addition, we offer ideas and opportunities for how chiropractic practitioners may focus on chiropractic education when celebrating the founding of the profession. Conclusion Since its inception, chiropractic education has expanded around the world and continues to develop. Recognized accreditation agencies and testing organizations are ensuring that standards of education are established and maintained internationally. With innovation, international collaboration, and a commitment to continuous professional development, the future of chiropractic education is bright. We urge chiropractic practitioners from all over the world to celebrate these accomplishments on Chiropractic Day.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1016/j.echu.2022.09.001","url":"https://www.semanticscholar.org/paper/d6ac9e8456d90521e623064116c6c1c64b211c2c","is_open_access":true,"citations":7,"published_at":"","score":66.21000000000001},{"id":"ss_cd41e690e24e705a43bf52a801bbf1acc4f7cdf4","title":"The rate of use of Veterans Affairs chiropractic care: a 5-year analysis","authors":[{"name":"Ryan J Burdick"},{"name":"Kelsey L. Corcoran"},{"name":"Xiwen Zhao"},{"name":"A. Lisi"}],"abstract":"Background The US Department of Veterans Affairs (VA) has initiated various approaches to provide chiropractic care to Veterans. Prior work has shown substantial increase in use of VA chiropractic care between fiscal years (FY) 2005–2016. However, the extent of the availability of these services to the Veteran population remains unclear. The purpose of this study was to analyze the rate of Veteran use of VA chiropractic services, both from on-site care at VA facilities and VA purchased care from community care providers. This study analyzed facility characteristics associated with chiropractic use by both care delivery mechanisms (on-site and in the community). Methods Cross-sectional analyses of administrative data were conducted for FY 2014–2019. Data were obtained from VA’s Corporate Data Warehouse. The variables extracted included number of unique Veterans receiving VA chiropractic care on-site and in the community, total Veteran population of the VA facilities, size of the VA chiropractic workforce (measured as Full-Time Equivalent, FTE), and facility characteristics (geographic region and the facility complexity). Descriptive statistics, mixed model, and multivariant models were used to analyze data. Results Use of VA chiropractic care increased over the six-year period for both on-site and community care. National average for on-site use of the population was 1.27% in FY14 and 1.48% in FY19. Community care use was 0.29% and 1.76% for the same years. Use at individual facilities varied widely in each FY. Factors such as chiropractor FTE, geographic locations, and the complexity of the VA facility are associated with use of chiropractic services. Conclusion The VA has expanded the non-pharmacologic treatments available to Veterans by providing chiropractic services, yet chiropractic use remains low compared to other US populations. As Veterans have a high prevalence of pain and musculoskeletal conditions, continued work to assess and achieve the optimal levels of chiropractic use in this population is warranted.","source":"Semantic Scholar","year":2022,"language":"en","subjects":["Medicine"],"doi":"10.1186/s12998-022-00413-9","url":"https://www.semanticscholar.org/paper/cd41e690e24e705a43bf52a801bbf1acc4f7cdf4","pdf_url":"https://chiromt.biomedcentral.com/counter/pdf/10.1186/s12998-022-00413-9","is_open_access":true,"citations":7,"published_at":"","score":66.21000000000001},{"id":"doaj_10.1089/IMR.2022.0002","title":"Changes in Intradiscal Pressure During Flexion-Distraction Type of Chiropractic Procedure: A Pilot Cadaveric Study","authors":[{"name":"Maruti R. Gudavalli"},{"name":"Gregory D. Cramer"},{"name":"Avinash G. Patwardhan"}],"abstract":"Objective: The study objective was to quantify the changes in intradiscal pressure (IDP) during the application of a chiropractic procedure known as the Cox flexion-distraction technique.\nMaterials and Methods: Pressure sensors were inserted into lumbar intervertebral discs of eight unembalmed cadavers (five male and three female, age range 43?75 years). Five 4-second cycles of flexion distraction were performed for a 20-sec period. Pressure data were collected while the discs were in an unpressurized state as well as a pressurized state (with water). The pressure data were collected during three separate applications of the flexion-distraction procedure with transducers inserted into the L2-L3, L3-L4, and L4-L5 intervertebral discs. The mean pressure values were documented before, during (in the distracted position), and after the treatment procedure (calculated). Pressure differences were compared using the paired t-test for significance in pressure changes from initial prone position to distracted treatment position.\nResults: The IDPs significantly decreased in both pressurized and unpressurized discs at all studied disc levels. The average IDP decreases in unpressurized discs were as follows: 5.6?kPa at L2-L3, 20.6?kPa at L3-L4, and 22.0?kPa at L4-L5. The IDP decrease range in pressurized-in-the-initial-prone-position discs were as follows: 17.8?kPa at L2-L3, 35.2?kPa at L3-L4, and 122.0?kPa at L4-L5.\nConclusions: IDP was found to decrease during the flexion-distraction procedure, which is consistent with the hypothesis that this procedure may be able to draw a protruded nucleus pulposus back toward the intervertebral disc's center and allow for the nutrients flow into the disc.","source":"DOAJ","year":2022,"language":"","subjects":["Other systems of medicine"],"doi":"10.1089/IMR.2022.0002","url":"https://www.liebertpub.com/doi/full/10.1089/IMR.2022.0002","is_open_access":true,"published_at":"","score":66},{"id":"doaj_10.3389/fpain.2022.863751","title":"Editorial: Mechanisms and Effectiveness of Complementary and Alternative Medicine for Pain Management","authors":[{"name":"Nobuhiro Watanabe"},{"name":"Mathieu Piché"}],"abstract":"","source":"DOAJ","year":2022,"language":"","subjects":["Neurology. Diseases of the nervous system"],"doi":"10.3389/fpain.2022.863751","url":"https://www.frontiersin.org/articles/10.3389/fpain.2022.863751/full","is_open_access":true,"published_at":"","score":66},{"id":"doaj_10.1136/bmjopen-2021-058769","title":"Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA","authors":[{"name":"Jeffery A Dusek"},{"name":"Robert James Trager"},{"name":"Zachary A Cupler"},{"name":"Kayla J DeLano"},{"name":"Jaime A Perez"}],"abstract":"Objectives Although chiropractic spinal manipulative therapy (CSMT) and prescription benzodiazepines are common treatments for radicular low back pain (rLBP), no research has examined the relationship between these interventions. We hypothesise that utilisation of CSMT for newly diagnosed rLBP is associated with reduced odds of benzodiazepine prescription through 12 months’ follow-up.Design Retrospective cohort study.Setting National, multicentre 73-million-patient electronic health records-based network (TriNetX) in the USA, queried on 30 July 2021, yielding data from 2003 to the date of query.Participants Adults aged 18–49 with an index diagnosis of rLBP were included. Serious aetiologies of low back pain, structural deformities, alternative neurological lesions and absolute benzodiazepine contraindications were excluded. Patients were assigned to cohorts according to CSMT receipt or absence. Propensity score matching was used to control for covariates that could influence the likelihood of benzodiazepine utilisation.Outcome measures The number, percentage and OR of patients receiving a benzodiazepine prescription over 3, 6 and 12 months’ follow-up prematching and postmatching.Results After matching, there were 9206 patients (mean (SD) age, 37.6 (8.3) years, 54% male) per cohort. Odds of receiving a benzodiazepine prescription were significantly lower in the CSMT cohort over all follow-up windows prematching and postmatching (p\u0026lt;0.0001). After matching, the OR (95% CI) of benzodiazepine prescription at 3 months was 0.56 (0.50 to 0.64), at 6 months 0.61 (0.55 to 0.68) and 12 months 0.67 (0.62 to 0.74). Sensitivity analysis suggested a patient preference to avoid prescription medications did not explain the study findings.Conclusions These findings suggest that receiving CSMT for newly diagnosed rLBP is associated with reduced odds of receiving a benzodiazepine prescription during follow-up. These results provide real-world evidence of practice guideline-concordance among patients entering this care pathway. Benzodiazepine prescription for rLBP should be further examined in a randomised trial including patients receiving chiropractic or usual medical care, to reduce residual confounding.","source":"DOAJ","year":2022,"language":"","subjects":["Medicine"],"doi":"10.1136/bmjopen-2021-058769","url":"https://bmjopen.bmj.com/content/12/6/e058769.full","is_open_access":true,"published_at":"","score":66},{"id":"doaj_10.1183/23120541.00532-2021","title":"Predictors of chronic obstructive pulmonary disease in women who have never smoked: a cohort study","authors":[{"name":"Roger M. Engel"},{"name":"Katie de Luca"},{"name":"Petra L. Graham"},{"name":"Masoumeh Kaboli Farshchi"},{"name":"Subramanyam Vemulpad"},{"name":"Julie Byles"}],"abstract":"COPD is responsible for an increasing number of deaths worldwide. Smoking is the most reliable predictor for developing COPD later in life. However, women make up the majority of patients with COPD who have never smoked. There is therefore a need to identify other factors that can predict COPD in women. The aim of this study is to identify factors associated with increasing the risk of developing COPD later in life in women who have never smoked. Data from the Australian Longitudinal Study on Women's Health (ALSWH) cohort born between 1946 and 1951 were used to investigate potential predictors of COPD. Retrospective analyses were performed on data from two of the ALSWH surveys: wave 1 (1996) and wave 9 (2019). There were 3584 women who self-reported as being never-smokers (at waves 1 and 9) and did not have COPD at baseline, of which 109 had developed COPD at wave 9. Logistic regression showed a significant relationship between COPD at wave 9 and baseline breathing difficulties (p\u003c0.001), asthma (p\u003c0.001) and allergies (p=0.026), though significance of asthma and allergies disappeared when included together in a single model, implying that women with these symptoms earlier in life were more likely to be diagnosed with COPD later in life compared to women without these symptoms. Our study supports the inclusion of lung function testing in primary care settings for women over the age of 45 years who have never smoked and have a history of breathing difficulties, asthma or allergies.","source":"DOAJ","year":2022,"language":"","subjects":["Medicine"],"doi":"10.1183/23120541.00532-2021","url":"http://openres.ersjournals.com/content/8/2/00532-2021.full","is_open_access":true,"published_at":"","score":66}],"total":19944,"page":1,"page_size":20,"sources":["DOAJ","CrossRef","Semantic Scholar"],"query":"Chiropractic"}