Monday

Chiropractic , Wikipedia

Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system.[1] It is generally considered to be complementary and alternative medicine,[2] a characterization that many chiropractors reject.[3] The main treatment involves manual therapy including manipulation of the spine, other joints, and soft tissue; treatment also includes exercises and health and lifestyle counseling.[4] Traditionally, chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function and its innate intelligence,[5] a notion that brings ridicule from mainstream science and medicine.[6]

D.D. Palmer founded chiropractic in the 1890s and his son B.J. Palmer helped to expand it in the early 20th century.[7] It has two main groups: "straights", now the minority, emphasize vitalism, innate intelligence and spinal adjustments, and consider subluxations to be the leading cause of all disease; "mixers" are more open to mainstream and alternative medical techniques such as exercise, massage, nutritional supplements, and acupuncture.[8] Chiropractic is well established in the U.S., Canada and Australia.[9]

Tuesday

Correlates of complementary and alternative medicine (CAM) use in Chicago area children with diabetes (DM).

Prim Care Diabetes. 2009 Jul 15; Miller JL, Cao D, Miller JG, Lipton RBAIMS: To correlate complementary and alternative medicine (CAM) use in children with diabetes mellitus (DM) with DM control and other family or disease characteristics. METHODS: Parents/guardians of children with DM were interviewed about demographics, clinical characteristics, CAM use, health care beliefs, psychosocial variables, and religious beliefs. The child's hemoglobin A1c (HgbA1c) value from the visit was collected. Statistical analyses included chi(2), Fisher's exact test, and 2-sample t-tests. RESULTS: 106 families with type 1 DM were interviewed. 33% of children tried CAM in the last year; 75% of parents had ever tried CAM. Children most commonly tried faith healing or prayer; parents most commonly tried faith healing or prayer, chiropractic, massage, and herbal teas. Children were more likely to have used CAM if their parents or siblings used CAM or their family was more religious. They were more likely to have discussed CAM with their providers if they used CAM. Parents of child CAM users reported more problems with DM treatment adherence. CONCLUSIONS: Children with DM used CAM. There were no differences in DM control, demographics, healthcare beliefs, stress, or quality of life between CAM users and non-users. Practitioners should inquire about CAM use to improve DM care for children.

Wednesday

The Nordic Maintenance Care Program: case management of chiropractic patients with low back pain - defining the patients suitable for various management strategies.

Chiropr Osteopat. 2009 Jul 12; 17(1): 7Malmqvist S, Leboeuf-Yde CABSTRACT: BACKGROUND: Maintenance care is a well known concept among chiropractors, although there is little knowledge about its exact definition, its indications and usefulness. As an initial step in a research program on this phenomenon, it was necessary to identify chiropractors' rationale for their use of maintenance care. Previous studies have identified chiropractors' choices of case management strategies in response to different case scenarios. However, the rationale for these management strategies is not known. In other words, when presented with both the case, and different management strategies, there was consensus on how to match these, but if only the management strategies were provided, would chiropractors be able to define the cases to fit these strategies? The objective with this study was to investigate if there is a common pattern in Finnish chiropractors' case management of patients with low back pain (LBP), with special emphasis on long-term treatment. METHOD: Information was obtained in a structured workshop. Fifteen chiropractors, members of the Finnish Chiropractors' Union, and present at the general assembly, participated throughout the entire workshop session. These were divided into five teams each consisting of 3 people. A basic case of a patient with low back pain was presented together with six different management strategies undertaken after one month of treatment. Each team was then asked to describe one (or several) suitable case(s) for each of the six strategies, based on the aspects of 1) symptoms/findings, 2) the low back pain history in the past year, and 3) other observations. After each session the people in the groups were changed. Responses were collected as key words on flip-over boards. These responses were grouped and counted. RESULTS: There appeared to be consensus among the participants in relation to the rationale for at least four of the management strategies and partial consensus on the rationale for the remaining two. In relation to maintenance care, the patient's past history was important but also the doctor-patient relationship. CONCLUSIONS: These results confirm that there is a pattern among Nordic chiropractors in how they manage patients with LBP. More information is needed to define the "cut-point" for the indication of prolonged care.