Hasil untuk "Chiropractic"

Tristan Delion, Aurelien Noyer, Matthieu Gonzalès-Bandrès et al.

Abstract Objectives To comprehensively map the literature on the use of manual therapy (MT) in the management of traumatic brain injury (TBI). Background TBI is a leading cause of long-term disability worldwide, often resulting in persistent physical, cognitive, and emotional symptoms. MT, which is commonly used by chiropractors, osteopaths and physiotherapists (COPs), has been proposed as a nonpharmacological intervention for post-TBI symptom management. However, the scope of supporting evidence remains unclear. Design Scoping Review. Methods Four databases and Google Scholar were searched for peer-reviewed studies published in English or French from 2010 onwards. The inclusion criteria targeted all severities of TBI, with MT interventions delivered by COPs. Data extraction and assessment of methodological reporting were conducted independently by two reviewers via standardised tools. Results Forty-two articles were included, comprising primarily case reports, case series, and randomised controlled trials. Most studies have investigated mild, sport-related TBI and described MT interventions targeting headache, neck pain, and dizziness—often delivered within multimodal care frameworks. A subset of studies has also explored the impact of MT on cognitive, emotional, or sleep-related symptoms, suggesting potential benefits beyond physical outcomes. Moderate to severe TBI has rarely been examined. Reporting limitations were common, particularly regarding adverse events. Conclusion The literature reflects a growing interest in the use of MT for mild, sport related TBI, primarily for managing physical symptoms. Further research is needed to explore broader applications across different populations and TBI severities, investigate underlying MT mechanisms and improve the reporting of safety outcomes.

Julia Müller, Noah Köppel, Patrick Eggenberger et al.

Introduction Ice hockey can lead to high-energy collisions and traumas and is a sport with high risk of concussion (Ornon et al., 2020). Concussions represent 2–14% of all hockey injuries (Izraelski, 2014). Sports-related concussions (SRC) sustained in professional ice hockey are a common in-competition injury leading to highly individual return to sport that can be associated with symptoms lasting days to months (Höllerer et al., 2023). Following SRC there is an increased risk of subsequent concussion and musculoskeletal injury upon return to play, however, assessments that can detect subclinical changes in function following a concussion are lacking (Dunne et al., 2023). A COSMIN systematic review suggests gait-based assessments using inertial measurement units to capture pre-concussion baseline scores (Dunne et al., 2023). This study measured pre-season pre-concussion gait data in Swiss National League Ice hockey players. Baseline scores will be compared with measures from players sustaining in-season SRC. Methods Temporal and spatial gait parameters were measured with the Physilog (https://www.physilog.com/ , Lausanne, Switzerland) movement sensors. The sensors were fixed to the shoes for flat overground gait analysis. Over a 20-30 m walkway, participants performed a single-task (ST) walking condition (preferred gait speed) and a dual-task (DT) walking condition, i.e., preferred gait speed whilst counting backwards. Application of the dual-task paradigm aimed at quantifying the automaticity of movement (Soulard et al., 2021). The focus of this study was on gait speed, cadence (+ cv%), and stride length (+ cv%) (Dunne et al., 2023). Results Thirteen male National League players from SC Rapperswil-Jona Lakers, 21.9 ± 3.1 years, 182.5 ± 5.9 cm height, 83.3 ± 7.6 kg body weight performed a pre-season gait analysis. The players sustained 1.5 ± 1.4 [range 0 – 3] concussions in the past. ST/DT walking revealed a walking speed of 1.3 ± 0.14/1.12 ± 0.14 m/s; step length 0.72 ± 0.09/0.67 ± 0.07 m; step length coefficient of variation (cv, %) 5.4 ± 1.9/5.6 ± 1.4 %; cadence 106.7 ± 5.1/100.5 ± 5.7 steps/min; cadence cv 2.8 ± 1/2.9 ± 0.9 %. Discussion/Conclusion Our results will shed light on the reliability and validity of using inertial measurements in the context of concussion management. Practitioners can use this resource at their disposal to help make informed decisions regarding concussion management. References Dunne, L. A. M., et al. (2023). Validity and reliability of methods to assess movement deficiencies following concussion: A COSMIN systematic review. Sports Medicine - Open, 9, 76. https://doi.org/10.1186/s40798-023-00625-0 Höllerer, D., et al. (2023). Injury incidence, outcomes, and return to competition times after sports-related concussions during one professional ice hockey season: A prospective cohort study. Healthcare, 11, 3153. https://doi.org/10.3390/healthcare11243153 Izraelski, J. (2014). Concussions in the NHL: A narrative review of the literature. Journal of the Canadian Chiropractic Association, 58(4), 346–352. Ornon, G., et al. (2020). Epidemiology of injuries in professional ice hockey: A prospective study over seven years. Journal of Experimental Orthopaedics, 7, 87. https://doi.org/10.1186/s40634-020-00300-3 Soulard, J., et al. (2021). Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions. Scientific Reports, 11, 10229. https://doi.org/10.1038/s41598-021-88794-4

Ushani Ambalavanar, Rufeyda Wise, Heidi Haavik et al.

Background: Sensory feedback from the upper cervical regions is used by the central nervous system to stabilize the occipito-atlantal (C0-C1) joint for leveled vision and to assess head position, which is used in sensorimotor integration (SMI) of neck and upper limb motor control. However, few studies have specifically investigated the impact of C0-C1 dysfunction and/or its rectification on SMI related outcomes. This study sought to determine the impact of restricted C0-C1 mobility and musculoskeletal pain on neck and upper limb motor control, whether these motor control deficits persist without treatment, and whether motor control improves following treatment designed to improve C0-C1 mobility. Methods: Twenty-two participants with restricted C0-C1 mobility attended three data collection sessions (baseline, control (2 to 5 days later), and post-treatment) at a private clinic. The One-to Zero (OTZ) system which treats the C0-C1 first followed by other spinal regions if clinically indicated, was administered twice weekly until participants reached 80% improvement from baseline symptoms. Shoulder range of motion, peak force and electromyography during maximal resisted scapular elevation (upper trapezius) and neck flexion (sternocleidomastoid), peak grip, and quadricep strength were measured before and after treatment. Repeated measures ANOVAs with pre-planned contrasts (e.g., control to baseline, and post-treatment to baseline) were conducted. Results: Neck and limb control impairments persisted without treatment, with no changes between the double baseline (p > 0.05). Shoulder abduction and extension, and peak force output of the sternocleidomastoid, upper trapezius, and quadriceps improved post-intervention (all p < 0.05). Conclusions: Selective improvement in neck and limb motor control outcomes post-treatment suggests that increased corticospinal drive/motor neuron excitability from normalized afferent input may impact gross motor output first. Clinical Registration Number: ACTRN12625000627459. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=389394&isReview=true.

Hina Shafi, Hina Shafi, Waqar Ahmed Awan et al.

BackgroundTreadmill training and body-weight supported treadmill training are effective for improving gait and balance in various populations. Lower-body positive pressure (PP) treadmill training uses positive air pressure to support body weight, potentially offering advantages over traditional treadmill training by reducing joint impact and allowing longer sessions. However, no studies have directly compared PP treadmill training with traditional treadmill training in adults with mild balance impairment.MethodIn this three-armed parallel design randomised controlled trial, 72 adults were randomly assigned to: i) PP treadmill training with 20% bodyweight support (PP-BWS), ii) PP treadmill training without bodyweight support (PP-noBWS), and iii) traditional treadmill training without bodyweight support (TT). Participants in all three groups completed 25 min of treadmill training, three times per week, for 8 weeks. Outcomes included the Berg Balance Scale (BBS), Timed Up and Go (TUG), Functional Reach Test (FRT), and postural sway and gait measured with smartphone accelerometry and force plates. Outcomes were collected at baseline, at the end of the 2nd, 4th, 6th, and 8th week, and follow-up data were collected in the 10th week. Data were analysed using linear mixed-effects models, with multiple-imputation sensitivity analyses.ResultsAll interventions resulted in significant within-group improvements in balance and mobility measured with the BBS, TUG and FRT. For balance measures, the primary analysis revealed a group by time interaction (p = 0.003) for the BBS, favouring traditional treadmill training and PP-noBWS at week 10, but no between-group differences for the FRT. TUG measures of functional mobility showed a significant group by time interaction (p = 0.028), initially favouring novel PP-BWS, but there were no between-group differences after week 4. This aligned with smartphone accelerometry outcomes, which showed no between-group differences for comfortable walking speed and gait symmetry. Between-group differences in standing postural sway did not consistently favour one group. Due to a large dropout rate at follow-up, a sensitivity analysis was completed; this confirmed the significant within-group effects on balance and mobility at week 10, but between-group differences in balance were no longer statistically significant.ConclusionAll treadmill interventions led to significant within-group improvements in balance and mobility over the 10-week period. The initial analysis suggested treadmill interventions without body weight support, traditional treadmill training and PP-noBWS, demonstrated larger improvements in balance at week 10, but between-group differences were not sustained after accounting for dropout rates in the sensitivity analysis. This may suggest that the altered gait mechanics and reduced sensory input during PP treadmill training with bodyweight support may limit the improvements in balance that accompany treadmill training.

Han-Hao Chang, Katie de Luca, Matthew Fernandez et al.

Abstract Background Research on perception of chiropractic is abundant in Western contexts, yet sparse in Asia. This study aims to bridge this gap by examining the perceptions of chiropractic among Taiwanese adults, focusing on demographics, utilisation, beliefs, and understanding. Methods An adapted survey with 27 close-ended items was administered to assess Taiwanese adults’ perception of chiropractic. The electronic survey, using Qualtrics, was delivered worldwide via Taiwanese Facebook groups from January 31 to March 31, 2024. Descriptive statistics, including frequencies and cross tabulations, were performed. Results A total of 769 individuals were surveyed, with 475 participants providing complete data. Over half of the participants (62%) had never visited a chiropractor, but in those who had visited a chiropractor 78% reported satisfaction. Of 475 participants, 45% considered chiropractic care safe while 34% were unsure. Though almost half (42%) were unclear about what chiropractors do, most participants (67%) expressed interest in learning more. Among the 151 participants with prior experience of chiropractic care, the demographic profile was 54% women, and individuals aged 28 to 37 (44%), and those with an undergraduate degree (52%) were most common. Conclusion Overall, our study found a positive perception and high acceptance of chiropractic among the Taiwanese population; however, generalisability may be limited due to the risk of selection bias. An understanding of the chiropractic profession was notably limited. Hence, efforts are needed to enhance awareness of chiropractic accreditation, clinical competencies, and its potential role in public healthcare in Taiwan.

Melissa Corso, Krystle Martin, Louis Rachid Salmi et al.

Abstract Background Patients with mood and anxiety disorders commonly visit primary care providers in Canada. Screening tools can support providers in identifying patients who need further mental health care. Objectives Identify screening tools that are valid and reliable for ruling out mood and anxiety disorders in adults in primary care settings. Data sources Our rapid review searched MEDLINE, Embase and PsycInfo from January 1, 2006, to May 27, 2025. Study selection A single reviewer conducted screening, critical appraisal and data extraction. Low risk-of-bias studies were included. Sensitivity, specificity, and negative likelihood ratios (NLRs) with 95% confidence intervals were extracted or calculated. A threshold of NLR < 0.1 was used to interpret strong rule-out performance. Synthesis We included 11 low risk-of-bias studies evaluating validity in 13 tools. No reliability studies were included due to high risk-of-bias. The Patient Health Questionnaire (PHQ)-2 (≥ 1/7), PHQ-9 (≥ 10/17), Generalised Anxiety Disorder (GAD)-2 (≥ 2/6), and GAD-7 (≥ 5/21) demonstrated the strongest evidence for ruling out depression and anxiety (NLR < 0.1). Conclusions The PHQ-2, PHQ-9, HADS-D, 15-item GDS, QIDS-SR16, GAD-2, and GAD-7 are brief, valid tools with strong rule-out performance for depression and anxiety in primary care. Future research should evaluate reliability and performance in diverse providers and patients, including non-physician settings and underserved communities.

Dorthe S. Ziegler, Maria Emilie Iversen, Kasper S. Hvid et al.

Abstract Background Neck pain and headaches often co-occur, and the presence of degenerative cervical Magnetic Resonance Imaging (MRI) findings has been associated with the presence of headaches. However, previous studies have not provided conclusive evidence about their association, and imaging studies examining the associations between headache severity and MRI findings have been suggested. This study aims to investigate the associations between independent variables, single MRI findings, and an aggregate score of MRI findings, and the outcome variable, headache severity. Methods This cross-sectional study examined patients with neck pain and headaches in specialist care. MRI findings and outcome measures were collected at the time of clinical entrance between 2011 and 2014. The headache severity was assessed using the Neck Disability Index questionnaire. Ten degenerative MRI findings were routinely evaluated, and an overall score was derived by aggregating single findings across levels C2–C7. Univariate and multivariable ordinal logistic regression analyses assessed the associations expressed as odds ratios (OR) and 95% confidence interval (95% CI). Results A total of 574 patients were included. Higher headache severity was significantly associated with female sex and younger age. The presence of single cervical MRI findings was linked to lower odds of severe headaches (ORs < 1), and having two or three findings further decreased the likelihood (OR 0.40, 95% CI 0.23–0.68) compared to having none. A sensitivity analysis assessed the OR estimates for the aggregate score as robust. Conclusions This study showed that, among patients with persistent neck pain referred to secondary care, degenerative MRI findings in the cervical spine were inversely associated with headache severity. The association between an aggregated score of MRI findings and headache severity was stronger than that of single findings. These findings reflect associations observed within a selected clinical population and warrant further investigation in populations with differing symptom profiles.

Tobias Sundberg, Matthew J. Leach, Stina Lilje et al.

Abstract Background Evidence-based practice (EBP) is fundamental to the delivery of high-quality, safe and effective health care. Naprapaths, manual therapy providers that specialize in the treatment of musculoskeletal pain and dysfunction, became a Swedish licensed health profession in 1994. This study investigated the attitudes, skills and implementation of EBP among licensed naprapaths in Sweden. Methods Licensed naprapaths (n = 950) of Svenska Naprapatförbundet (the Swedish Naprapathy Association) were invited by email to take part in this cross-sectional anonymous online study using the Evidence-Based Practice Attitude and Utilisation Survey in February 2019. Results Fourteen percent (137/950) of invited naprapaths completed the survey. There was an approximately equal gender divide among responders; most were in the mid-career age range, practiced in city areas, and had a university or college certificate/diploma as their highest qualification. The majority of naprapaths agreed or strongly agreed that EBP was necessary in the practice of naprapathy, assisted them in making care decisions, and improved the quality of patient care. Naprapaths’ self-reported skills in EBP were mostly in the moderate to moderate-high range. The majority of participating naprapaths reported infrequent implementation of EBP. Perceived minor or moderate barriers to EBP uptake included a lack of colleague support for EBP and a lack of relevant resources. Access to the internet and free online databases were reported as very useful enablers to improving EBP uptake. Conclusions The licensed naprapaths participating in this survey reported positive attitudes toward EBP, moderate levels of EBP skills, and infrequent implementation of EBP.

Shannon Schueren, Hugh Hunger, Huong Pham et al.

Objective: This study explored the influence of lower extremity manipulation on the postural after-effects of standing on an inclined surface.Methods: Eight healthy individuals (28.0 ± 4.1 years) were recruited for this open-label, crossover study. Participants stood on an incline board for 3 min to develop a known form of somatosensory illusion. After randomization to either a lower-extremity joint manipulation or no intervention, participants immediately stood on a force plate for 3 min with eyes closed. After a 24-h washout period, participants completed the remaining condition. Center of pressure (CoP) position data was measured by a force plate and evaluated using statistical parametric mapping. Pathlength, mean velocity, and RMS were calculated for significant time periods and compared with corrected paired t-tests.Results: Parametric maps revealed that CoP position of control and intervention conditions differed significantly for two time periods (70–86 s—control: 0.17 ± 1.86 cm/intervention: −1.36 ± 1.54 cm; 141–177 s—control: −0.35 ± 1.61 cm/intervention: −1.93 ± 1.48 cm). CoP pathlength was also significantly decreased for the second period (control: 6.11 ± 4.81 cm/intervention: 3.62 ± 1.92 cm).Conclusion: These findings suggest that extremity manipulation may be a useful intervention for populations where CoP stability is an issue. This study contributes to the growing body of evidence that manipulation of the extremities can drive global postural changes, as well as influence standing behavior. Further, it suggests these global changes may be driven by alterations in central integration.Clinical Trial Registration:ClinicalTrials.gov, NCT Number: NCT05226715.

Laurianne Pinloche, Solène Souvignet, Michèle Germain et al.

Abstract Background Falling is a major trauma that can occur with aging, leading to very significant psychological and physical health effects with financial and societal consequences. It is therefore essential to explore therapeutic treatments that can reduce this risk. Some recognized effective treatments exist, concerning in particular the re-education of the muscles of the lower limbs. However, to our knowledge, none of them focus on the cervical spine although the latter is located at an essential physiological crossroads. Manual therapy, which has already demonstrated its impact on pain and balance parameters in the elderly, could be a painless and non-invasive tool of choice in addressing this problem. Methods Interventional study (not related to a health product), monocentric, prospective, controlled, randomized double-blind (patient and evaluator performing the measurements). The experiment will take place over three measurement periods on D0, D7 and D21. On D0 subjects will be randomized in 2 groups: experimental and placebo group. Both groups will be assessed on: Short Physical Performance Battery test score, walking speed, lower limb strength, balance, heart rate variability and cervical spine strength and mobility. Then the experimental group will receive a myofascial release protocol applied to the cervical spine and the placebo group will receive a placebo light touch protocol. The intervention will be followed by the same measurements as before. This schedule will be reproduced on D7. On D21, only one assessment will be done. Discussion This study started in 2020 but could not go beyond the inclusion phase due to the COVID pandemic. It is envisaged that recruitment could resume during 2022. Trial registration: Registered by the Comité de Protection des Personnes—Sud Méditerranée; under the title “Prévention des troubles de l’équilibre chez le senior: influence de la thérapie manuelle appliquée au rachis sur les paramètres statiques et dynamiques», n° 19.12.27.47.259 in date of February 4, 2020. Registered by ClinicalTrials.gov ID: NCT05475652; under the title « The Influence of Manual Therapy Applied to the Cervical Spine in the Prevention of Balance Disorders in the Elderly (ManEq)”.

James M Whedon, Curtis L Petersen, Zhongze Li et al.

Abstract Background Cervical artery dissection and subsequent ischemic stroke is the most serious safety concern associated with cervical spinal manipulation. Methods We evaluated the association between cervical spinal manipulation and cervical artery dissection among older Medicare beneficiaries in the United States. We employed case-control and case-crossover designs in the analysis of claims data for individuals aged 65+, continuously enrolled in Medicare Part A (covering hospitalizations) and Part B (covering outpatient encounters) for at least two consecutive years during 2007–2015. The primary exposure was cervical spinal manipulation; the secondary exposure was a clinical encounter for evaluation and management for neck pain or headache. We created a 3-level categorical variable, (1) any cervical spinal manipulation, 2) evaluation and management but no cervical spinal manipulation and (3) neither cervical spinal manipulation nor evaluation and management. The primary outcomes were occurrence of cervical artery dissection, either (1) vertebral artery dissection or (2) carotid artery dissection. The cases had a new primary diagnosis on at least one inpatient hospital claim or primary/secondary diagnosis for outpatient claims on at least two separate days. Cases were compared to 3 different control groups: (1) matched population controls having at least one claim in the same year as the case; (2) ischemic stroke controls without cervical artery dissection; and (3) case-crossover analysis comparing cases to themselves in the time period 6–7 months prior to their cervical artery dissection. We made each comparison across three different time frames: up to (1) 7 days; (2) 14 days; and (3) 30 days prior to index event. Results The odds of cervical spinal manipulation versus evaluation and management did not significantly differ between vertebral artery dissection cases and any of the control groups at any of the timepoints (ORs 0.84 to 1.88; p > 0.05). Results for carotid artery dissection cases were similar. Conclusion Among Medicare beneficiaries aged 65 and older who received cervical spinal manipulation, the risk of cervical artery dissection is no greater than that among control groups.

Rendelle Bolton, Grant Ritter, Krista Highland et al.

Abstract Background Nonpharmacologic therapies (NPTs) are recommended as first-line treatments for pain, however the impact of expanding professional capacity to deliver these therapies on use has not been extensively studied. We sought to examine whether an effort by the US Military Health System (MHS) to improve access to NPTs by expanding professional capacity increased NPT utilization in a cohort at higher risk for pain – Army soldiers returning from deployment. Methods Our study involved secondary analysis of MHS workforce data derived from the Defense Medical Human Resources System Internet (DMHRSi), and healthcare utilization data obtained from two ambulatory record systems of the Military Health System (MHS) for a sample of 863,855 Army soldiers previously deployed to Iraq or Afghanistan over a 10-year period (2008–2017). We measured clinical provider capacity in three occupational groups responsible for pain management at 130 military treatment facilities (MTFs): physical therapy, chiropractic, and behavioral health, measured annually as full-time equivalence per 100,000 patients served at each MTF. Utilization in both direct and purchased care settings was measured as annual mean NPT users per 1000 sample members and mean encounters per NPT user. Generalized estimating equation models estimated the associations of facility-level occupational capacity measures and facility-level utilization NPT measures. Results In 2008, nearly all MTFs had some physical therapist and behavioral health provider capacity, but less than half had any chiropractor capacity. The largest increase in capacity from 2008 to 2017 was for chiropractors (89%) followed by behavioral health providers (77%) and physical therapists (37%). Models indicated that increased capacity of physical therapists and chiropractors were associated with significantly increased utilization of six out of seven NPTs. Acupuncture initiation was associated with capacity increases in each occupation. Increased professional capacity in MTFs was associated with limited but positive effects on NPT utilization in purchased care. Conclusions Increasing occupational capacity in three professions responsible for delivering NPTs at MTFs were associated with growing utilization of seven NPTs in this Army sample. Despite increasing capacity in MTFs, some positive associations between MTF capacity and purchased care utilization suggest an unmet need for NPTs. Future research should examine if these changes lead to greater receipt of guideline-concordant pain management.

Paul A. Oakley, Joseph W. Betz, Deed E. Harrison et al.

Fears over radiation have created irrational pressures to dissuade radiography use within chiropractic. Recently, the regulatory body for chiropractors practicing in British Columbia, Canada, the College of Chiropractors of British Columbia (CCBC), contracted Pierre Côté to review the clinical use of X-rays within the chiropractic profession. A “rapid review” was performed and published quickly and included only 9 papers, the most recent dating from 2005; they concluded, “Given the inherent risks of radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine.” The CCBC then launched an immediate review of the use of X-rays by chiropractors in their jurisdiction. Member and public opinion were gathered but not presented to their members. On February 4, 2021, the College announced amendments to their Professional Conduct Handbook that revoked X-ray rights for routine/repeat assessment and management of patients with spine disorders. Here, we highlight current and historical evidence that substantiates that X-rays are not a public health threat. We also point out critical and insurmountable flaws in the single paper used to support irrational and unscientific policy that discriminates against chiropractors who practice certain forms of evidence-based X-ray-guided methods.

Hainan Yu, Heather Shearer, Anne Taylor-Vaisey et al.

Abstract Prevost et al. published a systematic review evaluating the use of manual therapy for clinical conditions in the pediatric population in 2019. However, several methodological flaws in the conduct of the review limit the internal validity of its conclusions. We caution readers about the validity of the recommendations and suggest that the review not be used to inform the clinical management of pediatric patients.

Greg Kawchuk, Christine Goertz, Iben Axén et al.

Angela J Todd, M. Carroll, A. Robinson et al.

Marzieh Mohamadi, Soraya Piroozi, Iman Rashidi et al.

Abstract Background Latent trigger points in the upper trapezius muscle may disrupt muscle movement patterns and cause problems such as cramping and decreased muscle strength. Because latent trigger points may spontaneously become active trigger points, they should be addressed and treated to prevent further problems. In this study we compared the short-term effect of kinesiotaping versus friction massage on latent trigger points in the upper trapezius muscle. Methods Fifty-eight male students enrolled with a stratified sampling method participated in this single-blind randomized clinical trial (Registration ID: IRCT2016080126674N3) in 2016. Pressure pain threshold was recorded with a pressure algometer and grip strength was recorded with a Collin dynamometer. The participants were randomly assigned to two different treatment groups: kinesiotape or friction massage. Friction massage was performed daily for 3 sessions and kinesiotape was used for 72 h. One hour after the last session of friction massage or removal of the kinesiotape, pressure pain threshold and grip strength were evaluated again. Results Pressure pain threshold decreased significantly after both friction massage (2.66 ± 0.89 to 2.25 ± 0.76; P = 0.02) and kinesiotaping (2.00 ± 0.74 to 1.71 ± 0.65; P = 0.01). Grip strength increased significantly after friction massage (40.78 ± 9.55 to 42.17 ± 10.68; P = 0.03); however there was no significant change in the kinesiotape group (39.72 ± 6.42 to 40.65 ± 7.3; P = 0.197). There were no significant differences in pressure pain threshold (2.10 ± 0.11 & 1.87 ± 0.11; P = 0.66) or grip strength (42.17 ± 10.68 & 40.65 ± 7.3; P = 0.53) between the two study groups. Conclusions Friction massage and kinesiotaping had identical short-term effects on latent trigger points in the upper trapezius. Three sessions of either of these two interventions did not improve latent trigger points. Trial registration Registration ID in IRCT: IRCT2016080126674N3 .

W. Weeks, C. Goertz, W. Meeker et al.

OBJECTIVES The purpose of this study was to determine whether general perceptions of doctors of chiropractic (DCs) varied according to likeliness to use chiropractic care, whether particular demographic characteristics were associated with chiropractic care use, and whether perception of DCs varied according to the per-capita supply of DCs in local health care markets. METHODS We performed a secondary analysis of results from a 26-item nationally representative survey of 5422 members of The Gallup Panel that was conducted in the spring of 2015 (response rate, 29%) that sought to elicit the perceptions and use of DCs by US adults. We compared survey responses across: (1) respondents who had different likelihoods to use DCs for treatment of neck or back pain and (2) respondents who had different experiences using DCs. We linked respondents' zip codes to hospital referral regions for which we had the per-capita supply of DCs. Using the χ(2) test, we examined relationships between likeliness to use a DC, experience using a DC, respondent demographic variables, perceptions of DCs, and the per-capita supply of DCs in the local health care market. RESULTS Most (61.4%) respondents believed that chiropractic care was effective at treating neck and back pain, 52.6% thought DCs were trustworthy, and 24.2% thought chiropractic care was dangerous; however, as respondents' likelihood to use a DC increased, perceptions of effectiveness and trustworthiness increased, and perceptions of danger decreased. Of all 5422 survey respondents, 744 or 13.7% indicated that they had seen a DC within the last 12 months. As one moved from distant to more recent experience using a DC, respondents were more likely to be female, married, white, and employed; those who had a distant history of using a DC were older and more likely to be retired than the other groups. A higher per-capita supply of DCs was associated with higher utilization rates and showed a more favorable regard for DCs. CONCLUSIONS US adults often use chiropractic care, generally regard DCs favorably, and largely perceive that chiropractic care is safe. Where there is a higher per-capita supply of DCs in the local health care market, utilization and positive perceptions of chiropractic are higher.

A. Bussières, L. Terhorst, M. Leach et al.

F. Karpouzis, R. Bonello, M. Pribicevic et al.

BackgroundReviews indicate that the quality of reporting of randomised controlled trials (RCTs) in the medical literature is less than optimal, poor to moderate, and require improving. However, the reporting quality of chiropractic RCTs is unknown.As a result, the aim of this study was to assess the reporting quality of chiropractic RCTs and identify factors associated with better reporting quality. We hypothesized that quality of reporting of RCTs was influenced by industry funding, positive findings, larger sample sizes, latter year of publication and publication in non-chiropractic journals.MethodsRCTs published between 2005 and 2014 were sourced from clinical trial registers, PubMed and the Cochrane Reviews. RCTs were included if they involved high-velocity, low-amplitude (HVLA) spinal and/or extremity manipulation and were conducted by a chiropractor or within a chiropractic department. Data extraction, and reviews were conducted by all authors independently. Disagreements were resolved by consensus. Outcomes: a 39-point overall quality of reporting score checklist was developed based on the CONSORT 2010 and CONSORT for Non-Pharmacological Treatments statements. Four key methodological items, based on allocation concealment, blinding of participants and assessors, and use of intention-to-treat analysis (ITT) were also investigated.ResultsThirty-five RCTs were included. The overall quality of reporting score ranged between 10 and 33 (median score 26.0; IQR = 8.00). Allocation concealment, blinding of participants and assessors and ITT analysis were reported in 31 (87 %), 16 (46 %), 25 (71 %) and 21 (60 %) of the 35 RCTs respectively. Items most underreported were from the CONSORT for Non-Pharmacological Treatments statement. Multivariate regression analysis, revealed that year of publication (t32 = 5.17, p = 0.000, 95 % CI: 0.76, 1.76), and sample size (t32 = 3.01, p = 0.005, 95 % CI: 1.36, 7.02), were the only two factors associated with reporting quality.ConclusionThe overall quality of reporting RCTs in chiropractic ranged from poor to excellent, improving between 2005 and 2014. This study suggests that quality of reporting, was influenced by year of publication and sample size but not journal type, funding source or outcome positivity. Reporting of some key methodological items and uptake of items from the CONSORT Extension for Non-Pharmacological Treatments items was suboptimal. Future recommendations were made.