Hasil untuk "Chiropractic"

Laurence Leduc, Jean Théroux, Caroline Marois et al.

Abstract Background A significant body of research has examined how the attire of physicians and nurses affects patients’ perceptions, preferences, and outcomes. However, limited research has focused on the clothing worn by other health professionals, such as chiropractors. The present study aims to explore patients’ preferences and perceptions of chiropractors’ attire. Methods Using a cross-sectional image-based procedure, new patients to a university clinic were questioned regarding their preferences for four different attires (casual, formal, scrub, and white coat) worn by both a male and a female chiropractor. Patients also reported their perceptions in terms of chiropractors’ knowledge, trustworthiness, competence, professionalism, and comfortable for each photograph. Results From August 10, 2022, to January 23, 2023, 75 new patients participated in the study. Results indicated a strong preference for scrubs for both male and female chiropractors. Chiropractors in scrubs were also seen as more knowledgeable, trustworthy, competent, and professional, and comfortable. This was closely followed by those wearing white coats and formal attire. Notably, the white coat worn by the female chiropractor received significantly more positive ratings than when worn by her male counterpart. Conclusion In conclusion, our findings suggest that chiropractors’ attire influences patients’ perceptions and should be considered in the development of dress codes for public and private clinics. Further research is essential to understand better how the gender and age of care providers affect patient evaluations.

Elin Mihlberg, Bodil Al-Mashhadi Arnbak

Abstract Background Prognostic research in low back pain (LBP) is essential for understanding and managing the condition. This study aimed to, (1) describe the proportions with mild-moderate and severe pain and disability at baseline, 1-year and 4-year follow-up, and (2) investigate prognostic factors for improvement in pain and disability over 4 years in a cohort of secondary care LBP patients. Methods This was a secondary analysis of a cohort of patients with LBP aged 18–40 years recruited from a non-surgical outpatient spine clinic between March 2011 and October 2013 (n = 1037). Questionnaires were collected at baseline, 1-year, and 4-year follow-up. Disability was assessed using the Roland Morris Disability Questionnaire (RMDQ 0-100) and pain intensity using the Numeric Rating Scale (NRS 0–10). ’Mild-moderate pain’ was defined as NRS < 7 and ’severe pain’ as NRS ≥ 7. Likewise, ’mild-moderate disability’ was defined as RMDQ < 58.3, and ’severe disability’ was RMDQ ≥ 58.3. In the prognostic analysis, improvement in pain and disability over 4 years was defined as meeting both criteria: decrease of ≥ 2 on the NRS and of ≥ 20.8 on the RMDQ. Sixteen candidate prognostic factors were assessed by multivariate logistic regression. Results Among patients with information available at all three time points (n = 241), 54%/48% had persistent mild-moderate pain/disability, while only 7%/15% had persistent severe pain/disability. Of patients included in the multivariate prognostic analysis regarding improvement over 4 years (n = 498), 32% had improved in pain and disability after 4 years. Positive associations were found for pain intensity (OR 1.34 [95%CI: 1.17–1.54]), disability (OR 1.01 [1.00-1.02]), and regular employment or studying (OR 1.67 [1.06–2.64]), and negative associations for episode duration (OR 0.99 [0.99-1.00]) and risk of persistent pain (OR 0.58 [0.38–0.88]). Conclusion Patients with persistent LBP in secondary care had mostly mild-moderate pain and disability consistently at all three time points, with few having consistently severe symptoms over 4 years. Moreover, approximately half of the included patients improved in pain and disability. We found that pain intensity, disability, episode duration, regular employment or studying, and risk of persistent pain predicted a long-term improvement. However, the limited availability of complete follow-up data may affect generalisability.

Jessica J. Wong, Sheilah Hogg-Johnson, Wouter De Groote et al.

Abstract Background The World Health Organization Disability Assessment Schedule 2.0 12-item survey (WHODAS-12) is a questionnaire developed by the WHO to measure functioning across health conditions, cultures, and settings. WHODAS-12 consists of a subset of the 36 items of WHODAS-2.0 36-item questionnaire. Little is known about the minimal important difference (MID) of WHODAS-12 in persons with chronic low back pain (LBP), which would be useful to determine whether rehabilitation improves functioning to an extent that is meaningful for people experiencing the condition. Our objective was to estimate an anchor-based MID for WHODAS-12 questionnaire in persons with chronic LBP. Methods We analyzed data from two cohort studies (identified in our previous systematic review) conducted in Europe that measured functioning using the WHODAS-36 in adults with chronic LBP. Eligible participants were adults with chronic LBP with scores on another measure as an anchor to indicate participants with small but important changes in functioning over time [Short-form-36 Physical Functioning (SF36-PF) or Oswestry Disability Index (ODI)] at baseline and follow-up (study 1: 3-months post-treatment; study 2: 1-month post-discharge from hospital). WHODAS-12 scores were constructed as sums of the 12 items (scored 0–4), with possible scores ranging from 0 to 48. We calculated the mean WHODAS-12 score in participants who achieved a small but meaningful improvement on SF36-PF or ODI at follow-up. A meaningful improvement was an MID of 4–16 on ODI or 5–16 on SF36-PF. Results Of 70 eligible participants in study 1 (mean age = 54.1 years, SD = 14.7; 69% female), 18 achieved a small meaningful improvement based on SF-36 PF. Corresponding mean WHODAS-12 change score was − 3.22/48 (95% CI -4.79 to -1.64). Of 89 eligible participants in study 2 (mean age = 65.5 years, SD = 11.5; 61% female), 50 achieved a small meaningful improvement based on ODI. Corresponding mean WHODAS-12 change score was − 5.99/48 (95% CI − 7.20 to -4.79). Conclusions Using an anchor-based approach, the MID of WHODAS-12 is estimated at -3.22 (95% CI -4.79 to -1.64) or -5.99 (95% CI − 7.20 to -4.79) in adults with chronic LBP. These MID values inform the utility of WHODAS-12 in measuring functioning to determine whether rehabilitation or other health services achieve a minimal difference that is meaningful to patients with chronic LBP.

Mariève Houle, Mariève Houle, Julien Ducas et al.

ObjectivesThe objectives were (1) to describe and compare headache-related clinical features between teleworkers with migraine and those with tension-type headache (TTH) and (2) to determine the association between coping strategies and headache frequency, and intensity in the context of the COVID-19 pandemic.MethodsThis cross-sectional online survey was conducted with 284 teleworkers (127 with migraine and 157 with TTH). Sociodemographic data, information related to work factors, headache clinical features, coping strategies used during the COVID-19 pandemic, and headache-related clinical features were compared between headache profiles. Bivariate logistic regression analyses were used to determine the association between coping strategies and headache frequency, and intensity.ResultsResults showed that teleworkers with migraine had longer and more painful headache episodes than teleworkers with TTH (ps &lt; 0.001). Higher migraine frequency was associated with the use of the denial coping strategy (p = 0.006) while lower migraine intensity was associated with planning (p = 0.046) and the use of positive reframing (p = 0.025). Higher TTH frequency was associated with the use of venting, self-blame, and behavioral disengagement (ps &lt; 0.007) while higher TTH intensity was associated with substance use and behavioral disengagement (ps &lt; 0.030). All associations remained significant after adjusting for BMI as a covariate.Discussion/conclusionTeleworkers with migraine had more intense and longer headache episodes than teleworkers with TTH. This could be explained by the fact that a greater proportion of individuals suffering from migraine experienced headaches prior to the beginning of the pandemic compared with teleworkers suffering from TTH. Regarding coping strategies, both primary headache profiles were associated with different types of coping strategies. Most of the coping strategies associated with headache frequency or intensity were maladaptive except for planning and positive reframing that were found to be inversely associated with migraine intensity.

Magdalena Albrecht-Bisset, Dan Wang, Krystle Martin et al.

Postsecondary students frequently report high rates of anxiety and poor sleep quality. The association between poor sleep quality and anxiety is poorly understood in this population. We conducted a cross-sectional study of students enrolled in two faculties at Ontario Tech University (OTU) - Faculty of Health Sciences (FHS) and Faculty of Education (FEd), and students attending the Canadian Memorial Chiropractic College (CMCC) during the fall of 2017 to determine the prevalence of poor sleep quality and moderate to extremely severe anxiety, as well as the association between them. Participants completed self-report questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]), anxiety (Depression, Anxiety, and Stress Scale – 21 Items [DASS-21]), socio-demographic, lifestyle and health-related variables. Multivariable logistic regression was used to measure the association between poor sleep quality and moderate to extremely severe anxiety, as well as to control for covariates. A significant correlation between PSQI scores and DASS-21 anxiety scores was found in both populations: students who reported poor sleep quality were more likely to report moderate to extremely severe anxiety. This association decreased but still remained high even after controlling for important covariates (i.e., biological sex, stress, and depression).

Christian J. Fludder, Braden G. Keil, Melissa J. Neave

BackgroundLate diagnosed Developmental Dysplasia of the Hip (DDH) is the detection of DDH after 3 months of age and is associated with significantly poorer outcomes than when diagnosed and managed early. Late diagnosed DDH has lower rates of success with bracing, higher rates of surgery and higher rates of complications, including avascular necrosis of the femoral head and early osteoarthritis of the hip. We describe two cases of late-diagnosed DDH which demonstrated changes in femoroacetabular joint morphology on radiographic interpretation after a 6-month trial period of manual therapy.Case PresentationTwo cases (13 and 30 months of age) with late-diagnosed DDH presented to a private chiropractic clinic for conservative, non-bracing management. One case had unilateral DDH and the other bilateral DDH. A trial of manual therapy was utilized over a 6-month period. Both cases demonstrated changes to femoroacetabular morphology as well as improvements in gross motor activity and lower extremity muscle tone.ConclusionManual therapy, as an adjunct or alternative to static bracing, may be of benefit in individuals with late-diagnosed DDH not responding to bracing, and prior to more invasive interventions. Additional cases of manual therapy-based management of this condition are required to inform the design of future trials to investigate this hypothesis.

Lucien Robinault, Imran Khan Niazi, Nitika Kumari et al.

Non-specific low back pain (NSLBP) is a significant and pervasive public health issue in contemporary society. Despite the widespread prevalence of NSLBP, our understanding of its underlying causes, as well as our capacity to provide effective treatments, remains limited due to the high diversity in the population that does not respond to generic treatments. Clustering the NSLBP population based on shared characteristics offers a potential solution for developing personalized interventions. However, the complexity of NSLBP and the reliance on subjective categorical data in previous attempts present challenges in achieving reliable and clinically meaningful clusters. This study aims to explore the influence and importance of objective, continuous variables related to NSLBP and how to use these variables effectively to facilitate the clustering of NSLBP patients into meaningful subgroups. Data were acquired from 46 subjects who performed six simple movement tasks (back extension, back flexion, lateral trunk flexion right, lateral trunk flexion left, trunk rotation right, and trunk rotation left) at two different speeds (maximum and preferred). High-density electromyography (HD EMG) data from the lower back region were acquired, jointly with motion capture data, using passive reflective markers on the subject’s body and clusters of markers on the subject’s spine. An exploratory analysis was conducted using a deep neural network and factor analysis. Based on selected variables, various models were trained to classify individuals as healthy or having NSLBP in order to assess the importance of different variables. The models were trained using different subsets of data, including all variables, only anthropometric data (e.g., age, BMI, height, weight, and sex), only biomechanical data (e.g., shoulder and lower back movement), only neuromuscular data (e.g., HD EMG activity), or only balance-related data. The models achieved high accuracy in categorizing individuals as healthy or having NSLBP (full model: 93.30%, anthropometric model: 94.40%, biomechanical model: 84.47%, neuromuscular model: 88.07%, and balance model: 74.73%). Factor analysis revealed that individuals with NSLBP exhibited different movement patterns to healthy individuals, characterized by slower and more rigid movements. Anthropometric variables (age, sex, and BMI) were significantly correlated with NSLBP components. In conclusion, different data types, such as body measurements, movement patterns, and neuromuscular activity, can provide valuable information for identifying individuals with NSLBP. To gain a comprehensive understanding of NSLBP, it is crucial to investigate the main domains influencing its prognosis as a cohesive unit rather than studying them in isolation. Simplifying the conditions for acquiring dynamic data is recommended to reduce data complexity, and using back flexion and trunk rotation as effective options should be further explored.

Lindsay M Gorrell, Luana Nyirö, Mégane Pasquier et al.

Abstract Background Spinal manipulation (SM) is a recommended and effective treatment for musculoskeletal disorders. Biomechanical (kinetic) parameters (e.g. preload/peak force, rate of force application and thrust duration) can be measured during SM, quantifying the intervention. Understanding these force-time characteristics is the first step towards identifying possible active ingredient/s responsible for the clinical effectiveness of SM. Few studies have quantified SM force-time characteristics and with considerable heterogeneity evident, interpretation of findings is difficult. The aim of this study was to synthesise the literature describing force-time characteristics of manual SM. Methods This scoping literature review is reported following the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) statement. Databases were searched from inception to October 2022: MEDLINE (Ovid), Embase, CINAHL, ICL, PEDro and Cochrane Library. The following search terms and their derivatives were adapted for each platform: spine, spinal, manipulation, mobilization or mobilisation, musculoskeletal, chiropractic, osteopathy, physiotherapy, naprapathy, force, motor skill, biomechanics, dosage, dose-response, education, performance, psychomotor, back, neck, spine, thoracic, lumbar, pelvic, cervical and sacral. Data were extracted and reported descriptively for the following domains: general study characteristics, number of and characteristics of individuals who delivered/received SM, region treated, equipment used and force-time characteristics of SM. Results Of 7,607 records identified, 66 (0.9%) fulfilled the eligibility criteria and were included in the analysis. Of these, SM was delivered to the cervical spine in 12 (18.2%), the thoracic spine in 40 (60.6%) and the lumbopelvic spine in 19 (28.8%) studies. In 6 (9.1%) studies, the spinal region was not specified. For SM applied to all spinal regions, force-time characteristics were: preload force (range: 0-671N); peak force (17-1213N); rate of force application (202-8700N/s); time to peak thrust force (12-938ms); and thrust duration (36-2876ms). Conclusions Considerable variability in the reported kinetic force-time characteristics of SM exists. Some of this variability is likely due to differences in SM delivery (e.g. different clinicians) and the measurement equipment used to quantify force-time characteristics. However, improved reporting in certain key areas could facilitate more sophisticated syntheses of force-time characteristics data in the future. Such syntheses could provide the foundation upon which dose-response estimates regarding the clinical effectiveness of SM are made.

Deep Jyoti Bhuyan, Indeewarie Hemamali Dissanayake, Kayla Jaye et al.

Different modalities of traditional and complementary medicine (T&CM) are extensively used worldwide including Australia to treat ailments, maintain well-being either alone or in conjunction with conventional medicine. This wide prevalence also emphasizes the necessity for more research, education and regulation of different T&CM modalities to ensure their safety and efficacy. While several reports in the literature highlight different aspects of T&CM including clinical practice, research, education and regulation globally, recent comprehensive reviews on the current status of T&CM in Australia are limited. Therefore, this review was designed to critically analyze the literature on the present status of T&CM modalities including Traditional Chinese Medicine, chiropractic, naturopathy and Ayurveda in Australia and comprehensively summarize the key studies from an Australian perspective. Several key gaps in the evidence-based clinical practice (e.g., lack of patient-focused approach and communication between patients and health professionals), research (e.g., methodological flaws/inconsistencies, limited government funding, collaborative research, facilities, capability, and resources), education (e.g., lack of uniform minimum standard of education and limited courses) and regulation (e.g., self-regulated naturopathy) of T&CM in Australia were identified through this review. Furthermore, studies in the literature underlined that some T&CM modalities including naturopathy and Ayurveda require statutory and updated regulations, formal registration and proper training and education. A patient-focused approach in clinical practice and the generation of evidence through collaborative research (establishment of more practice-based research networks) among universities, T&CM industry and practitioners and more support from the government to conduct research and improve training and education are imperative for effective evidence-based practice of T&CM in Australia.

SONG Limei (宋利梅), YANG Dongying (杨冬颖), GUO Miao (郭淼) et al.

Objective To investigate the effect of chiropractic therapy on the recovery of gastrointestinal function after gynecological abdominal surgery. Methods Totally 60 patients who meet the inclusion criteria were randomly divided into control group and study group, with 30 cases in each group. The control group was given routine nursing, while the Study group received chiropractic therapy on the basis of routine nursing. The postoperative time to first anal exhaust, time to first defecation and length of hospital stay were compared between two groups. Results There was no significant difference in time to first defecation between two groups (P＞0. 05). The postoperative time to first anal exhaust in the study group was shorter than that in the control group (P＜0. 05)). There was a significant difference in length of stay between two groups(P＜0. 05). Conclusion The chiropractic therapy is effective to improve the recovery of gastrointestinal function after gynecological abdominal surgery (目的 探讨捏脊疗法促进妇科腹部手术患者术后胃肠功能恢复的效果。方法 将符合诊断标准的60例患者随机分为对照组和研究组, 各30例。对照组给予常规护理, 研究组在常规护理的基础上实施捏脊疗法。对比两组术后首次排气、排便时间、住院时间。结果 两组患者术后首次排便时间比较, 差异无统计学意义(P＞0. 05)。研究组术后首次排气较对照组缩短, 差异有统计学意义(P＜0. 05)。两组住院时间比较, 有统计学意义(P＜0. 05)。结论 捏脊疗法能够促进妇科腹部术后胃肠功能恢复。)

J. Keith Simpson, Stanley Innes

Abstract Background While chiropractic care is most commonly provided within a private practice context, the ‘traditional’ solo practice is now uncommon. Chiropractors, manual therapists and related health professionals commonly work within the same practice bringing obvious advantages to both the practitioners and their patients. However, multi-practitioner, multi-disciplinary clinics also carry often unrecognized liabilities. We refer here to vicarious liability and non-delegable duties. Vicarious liability refers to the strict liability imposed on one person for the negligent acts of another person. The typical example is an employer being held vicariously liable to the negligent acts of an employee. However, vicarious liability can arise outside of the employer-employee relationship. For example, under non-delegable duty provisions, an entity owing a non-delegable duty can be liable for an independent contractor’s wrongdoing. After a plain English explanation of this complex area of law, we provide seven scenarios to demonstrate how vicarious liability can envelop practice principals when things go wrong. We also make suggestions for risk mitigation. Conclusion Practice owners may unexpectedly find themselves legally liable for another’s actions with dire consequences. A knowledge of vicarious liability along with implementing risk mitigation strategies has the potential to minimize the likelihood of this unwanted event. Recommendations are made to this end.

Daphne To, Mana Rezai, Kent Murnaghan et al.

Abstract Purpose Low back pain (LBP) is prevalent in military personnel. We aimed to systematically review the literature regarding risk factors for first-time LBP during military service among active duty military personnel. Methods We searched six electronic databases (inception-April 2020) for randomised controlled trials, cohort studies, and case–control studies published in English in peer-reviewed journals. Eligible studies were independently critically appraised by paired reviewers and a descriptive synthesis was conducted. Results We screened 1981 records, reviewed 118 full-text articles, and synthesised data from eight acceptable quality cohort studies. Studies assessed physical (n = 4), sociodemographic (n = 2), and/or occupational factors (n = 5) associated with LBP. Two studies reported prior LBP was associated with a greater than twofold increased risk of LBP compared to those without prior LBP. Other factors consistently associated with LBP included previous musculoskeletal injury (n = 2), less time spent on physical training (n = 2), female sex (n = 2), and lower rank (n = 2). Factors associated with LBP from single studies included marital status, lower education level, blast injury, job duties, and service type. We found inconsistent associations for performance on physical fitness tests, age, and occupation type. Psychological risk factors were not assessed in any included studies. Conclusion In active duty personnel, prior history of LBP, previous musculoskeletal injury, less time in physical training, female sex, and lower rank were consistent risk factors for LBP. This information is relevant for researchers, active duty military personnel, and other decision makers. Future studies should explore causal relationships for LBP in this population. PROSPERO registration number: CRD42018084549.

Maliheh Hadizadeh, Greg Kawchuk, Simon French

Abstract Background Spinal stiffness assessment has the potential to become an important clinical measure. Various spinal stiffness-testing devices are available to help researchers objectively evaluate the spine and patient complaints. One of these is VerteTrack, a device capable of measuring posteroanterior displacement values over an entire spinal region. This study aimed to develop a best-practice protocol for evaluating spinal stiffness in human participants using VerteTrack. Methods Twenty-five individuals with research experience in measuring spinal stiffness, or who were trained in spinal stiffness measurement using the VerteTrack device, were invited to participate in this 3-Round Delphi study. Answers to open-ended questions in Round 1 were thematically analyzed and translated into statements about VerteTrack operation for spinal stiffness measurements. Participants then rated their level of agreement with these statements using a 5-point Likert scale in Rounds 2 and 3. A descriptive statistical analysis was performed. Consensus was achieved when at least 70% of the participants either strongly agreed, agreed, (or strongly disagreed, disagreed) to include a statement in the final protocol. Results Twenty participants completed Round 1 (80%). All these participants completed Rounds 2 and 3. In total, the pre-defined consensus threshold was reached for 67.2% (123/183) of statements after three rounds of surveys. From this, a best-practice protocol was created. Conclusions Using a Delphi approach, a consensus-based protocol for measuring spinal stiffness using the VerteTrack was developed. This standard protocol will help to improve the accuracy, efficiency, and safety of spinal stiffness measurements, facilitate the training of new operators, increase consistency of these measurements in multicenter studies, and provide the synergy and potential for data comparison between spine studies internationally. Although specific to VerteTrack, the resulting standard protocol could be modified for use with other devices designed to collect spinal stiffness measures.

Nilesh Kumar Mitra, Htar Htar Aung, Mangala Kumari et al.

Background: To accommodate the increased number of students and shorter learning time, anatomy instructors are increasingly developing web-based learning resources that can fulfil program-specific anatomical learning objectives and replace existing learning environment of the anatomy laboratory sessions. The study evaluated the quantitative change in the performance score in gross anatomy by replacement of face-to-face demonstration with an e-learning tool in practical sessions of chiropractic program. Materials &amp; methods: This quasi-experimental one-group pre-test and post-test design was employed longitudinally in two consecutive cohorts of semester 2 students. Teacher-led demonstration was used for first two sessions. E-learning tool was used in the next two sessions. Structured OSPE-based pre-test and post-test were held before and after the sessions. Wilcoxon Signed-Rank test was used to find out percentage of students showing improvement in the post-test score. Pearson correlation coefficient between pre-test and post-test scores was also done. A short questionnaire assessed the use of e-learning tools by the students. Results: The mean difference between the post-test and pre-test score was higher in e-learning tool-led practical sessions. In 2018 cohort, 85.4% and 83.3% of students and 2019 cohort, 95% of students secured higher scores in post-test in two sessions with e-learning tool. In 2018 cohort, 62% and 70% of students and 2019 cohort, 81% and 70% of students secured higher scores in post-test in two sessions with teacher-led demonstration. A lower R2 coefficient was observed between post-test and pre-test scores in sessions with e-learning tool. Perception analysis indicated that majority of students agreed about e-learning tool allowing them to revise identification of anatomical structures themselves. Conclusion: The e-learning tool was able to raise the post-test score in a higher percentage of students, indicating improved learning process in practical sessions using e-learning tools. The study would motivate anatomy instructors to use web-based learning tools to identify structures during the laboratory sessions.

Jaap Swanenburg, Anke Langenfeld, Christopher A. Easthope et al.

The objective of this study was to determine the response of the lumbar spinal motor control in different gravitational conditions. This was accomplished by measuring indicators of lumbar motor control, specifically lumbar spinal stiffness, activity of lumbar extensor and flexor muscles and lumbar curvature, in hypergravity and microgravity during parabolic flights. Three female and five male subjects participated in this study. The mean age was 35.5 years (standard deviation: 8.5 years). Spinal stiffness of the L3 vertebra was measured using impulse response; activity of the erector spinae, multifidi, transversus abdominis, and psoas muscles was recorded using surface electromyography; and lumbar curvature was measured using distance sensors mounted on the back-plate of a full-body harness. An effect of gravity condition on spinal stiffness, activity of all muscles assessed and lumbar curvature (p’s &lt; 0.007) was observed (Friedman tests). Post hoc analysis showed a significant reduction in stiffness during hypergravity (p &lt; 0.001) and an increase in stiffness during microgravity (p &lt; 0.001). Activity in all muscles significantly increased during hypergravity (p’s &lt; 0.001). During microgravity, the multifidi (p &lt; 0.002) and transversus abdominis (p &lt; 0.001) increased significantly in muscle activity while no significant difference was found for the psoas (p = 0.850) and erector spinae muscles (p = 0.813). Lumbar curvature flattened in hypergravity as well as microgravity, albeit in different ways: during hypergravity, the distance to the skin decreased for the upper (p = 0.016) and the lower sensor (p = 0.036). During microgravity, the upper sensor showed a significant increase (p = 0.016), and the lower showed a decrease (p = 0.005) in distance. This study emphasizes the role of spinal motor control adaptations in changing gravity conditions. Both hypergravity and microgravity lead to changes in spinal motor control. The decrease in spinal stiffness during hypergravity is interpreted as a shift of the axial load from the spine to the pelvis and thoracic cage. In microgravity, activity of the multifidi and of the psoas muscles seems to ensure the integrity of the spine. Swiss (BASEC-NR: 2018-00051)/French “EST-III” (Nr-ID-RCB: 2018-A011294-51/Nr-CPP: 18.06.09).

Agustina W. Djuma, Novian A. Yudhaswara, Suzanne Patricia Dardeau

East Nusa Tenggara is a province of high alcohol abuse in Indonesia. Ngada Regency has a prevalence of 38.8%. The high prevalence is inseparable from traditional factors and socio-cultural norms which strongly influence the habit of consuming alcohol, the cold temperature in this area further strengthens this habit. The impact of alcohol consumption is the emergence of various types of diseases, one of which is impaired liver function such as alcoholic liver disease. The objective of this study is to determine the relationship between alcohol consumption and impaired liver function in communities in Bajawa and Golewa Districts, Ngada Regency. This research method is an observational analytic with cross-sectional design. The research subjects were 55 people who consumed alcohol in Golewa and Bajawa Districts, who had met the inclusion criteria. Alcohol consumption was measured by the AUDIT (The Alcohol Use Disorders Identification Test) questionnaire, while the parameter for liver disorders was the level of Gamma Glutamyl Transferase (GGT). The prevalence of liver dysfunction based on GGT examination was 15%. Meanwhile, the relationship between alcohol consumption and impaired liver function was tested with the Spearman correlation with α 0.05, the correlation value was p = 0.413, which means it has a moderate or significant, not too strong relationship. It is recommended that the people of Ngada Regency reduce alcohol consumption so that it can reduce the risk of impaired liver function.

Giancarlo Carpino, Steven Tran, Stuart Currie et al.

Abstract Introduction Manual therapy (MT) hypothetically affects discrepant neuromuscular control and movement observed in populations with low back pain (LBP). Previous studies have demonstrated the limited influence of MT on movement, predominately during range of motion (ROM) testing. It remains unclear if MT affects neuromuscular control in mobility-based activities of daily living (ADLs). The sit-to-stand (STS) task represents a commonly-performed ADL that is used in a variety of clinical settings to assess functional and biomechanical performance. Objective To determine whether MT affects functional performance and biomechanical performance during a STS task in a population with LBP. Methods Kinematic data were recorded from the pelvis and thorax of participants with LBP, using an optoelectronic motion capture system as they performed a STS task before and after MT from November 2011 to August 2014. MT for each participant consisted of two high-velocity low-amplitude spinal manipulations, as well as two grade IV mobilizations of the lumbar spine and pelvis targeted toward the third lumbar vertebra and sacroiliac joint in a side-lying position; the order of these treatments was randomized. Pelvis and thorax kinematic data were used to derive the time-varying lumbar angle in the sagittal plane for each STS trial. The difference between the maximum and minimum lumbar angles during the STS trial determined the sagittal ROM that was used as the biomechanical outcome. Time to complete each STS trial was used as a functional measure of performance. Pre-MT and post-MT values for the lumbar sagittal ROM and time to completion were statistically analysed using paired samples t-tests. Results Data were obtained from 40 participants with 35 useful datasets (NRS = 3.3 ± 1.2; 32.4 ± 9.8 years; 16 females, 19 males). After MT, lumbar sagittal ROM increased by 2.7 ± 5.5 degrees (p = 0.007). Time to complete the STS test decreased by 0.4 ± 0.4 s (p < 0.001). Discussion These findings provide preliminary evidence that MT might influence the biomechanical and functional performance of an STS task in populations with LBP. The MT intervention in this study involved a combination of spinal manipulations and mobilizations. Future work will expand upon these data as a basis for targeted investigations on the effects of either spinal manipulation and mobilization on neuromuscular control and movement in populations with LBP.

Simon A. Senzon

Mette Jensen Stochkendahl, Ole Kristoffer Larsen, Casper Glissmann Nim et al.

Abstract Background Despite extensive publication of clinical guidelines on how to manage musculoskeletal pain and back pain in particular, these efforts have not significantly translated into decreases in work disability due to musculoskeletal pain. Previous studies have indicated a potential for better outcomes by formalized, early referral to allied healthcare providers familiar with occupational health issues. Instances where allied healthcare providers of comparable professional characteristics, but with differing practice parameters, can highlight important social and organisational strategies useful for informing policy and practice. Currently, Norwegian chiropractors have legislated sickness certification rights, whereas their Danish and Swedish counterparts do not. Against the backdrop of legislative variation, we described, compared and contrasted the views and experiences of Scandinavian chiropractors engaging in work disability prevention and sickness absence management. Methods This study was embedded in a two-phased, sequential exploratory mixed-methods design. In a comparative qualitative case study design, we explored the experience of chiropractors regarding sickness absence management drawn from face-to-face, semi-structured interviews. We subsequently coded and thematically restructured their experiences and perceptions. Results Twelve interviews were conducted. Thematically, chiropractors’ capacity to support patients in sickness absence management revolved around four key issues: issues of legislation and politics; the rationale for being a sickness absence management partner; whether an integrated sickness absence management pathway existed/could be created; and finally, the barriers to service provision for sickness absence management. Conclusion Allied health providers, in this instance chiropractors, with patient management expertise can fulfil a key role in sickness absence management and by extension work disability prevention when these practices are legislatively supported. In cases where these practices occur informally, however, practitioners face systemic-related issues and professional self-image challenges that tend to hamper them in fulfilling a more integrated role as providers of work disability prevention practices.