aaCM 13 in design

More documents

Recommendations

Info

RESEARCH From the McTimoney College of Chiropractic All of these abstracts have been previously represented at both national and international research conferences. Neurophysiological response to spinal adjustment: An investigation using changes in electrodermal activity. John-Paul Taylor MChiro, Adrian Hunnisett PhD MPhil, Christina Cunliffe DC PhD Introduction Chiropractic theories postulate a relationship between the spine and the nervous system. An important manifestation being pathophysiology of the subluxation and the effects of spinal adjustment on the body’s organ systems. If such theories are correct, there should be an aetiological connection between spinal dysfunction and visceral dysfunction as well as a therapeutic connection [1]. Changes in Autonomic Nervous System (ANS) activity can result from a variety of factors including physical movement, sleeping, disease and ageing [2]. In terms of spinal adjustments the value of examining the ANS is to determine a neurophysiologic basis for the therapeutic benefits chiropractic patients report following chiropractic healthcare. This study is a basic science investigation into the neurophysiologic response of a specified chiropractic spinal adjustment, building on scientifically acknowledged spinal adjustment/manipulation research and utilising EDA as an accepted objective measure of neurophysiologic effect. Method Following ethical approval from the university IRB, a prospective, double-blind, placebo-controlled, randomized trial was designed to determine the percentage difference in skin conductance measures, obtained before and after a specific chiropractic spinal adjustment relative to sham and control conditions. A total of 45 eligilble healthy, asymptomatic, volunteers from the student, ex-student and staff populations of a chiropractic college were recruited to make up the total sample population. All volunteers gave informed consent prior to participating in the research study. Participants were randomly allocated to one of three groups: 1) Treatment: pre-intervention protocol, intervention protocol, and post-intervention protocol. Treatment involved specific high velocity low amplitude (HVLA) adjustment to the relative anterior transverse process of C1, on the Subject’s asymptomatic side. 2) Placebo: pre-intervention protocol, mimic the intervention protocol, and post-intervention protocol. In this case manual contact applied in the same manner as the treatment group to perform adjustment set-up (pisiform preload to transverse process), but with no adjustment of the vertebra. 3) Control: Pre-intervention protocol and post-intervention protocol while investigator neither undertakes or mimics the intervention on subjects. Introduction In the United Kingdom chiropractors are required to be evidence-based practitioners[1]. Evidence based practice (EBP) is the integration of best available evidence with clinical expertise and patient values in order to select the most appropriate management and deliver the best outcome for that patient. This necessitates that healthcare practitioners are able to access relevant research, understand how to appraise the quality of evidence that it provides and integrate this with their clinical expertise and apply it in practice[2]. One of the major barriers to the advancement of EBP in chiropractic is the lack of relevant clinical research and the funds to undertake high quality research[3]. No studies have been carried out in the UK to evaluate the willingness of chiropractors to provide funds for research, nor of their attitudes toward the necessity to generate research, perceived priority areas of research or opinions regarding administration of any funds. That is the aim of this study. Pre-intervention protocol consisted of an initial 2 minute ‘stabilisation’ period followed by a 3 minute ‘baseline-data’ period, giving a total of 5 minutes SC data. Intervention protocol represented the ‘intervention’ period when one of the three conditions was undertaken. The post-intervention protocol included a 3 minute ‘final-data’ period immediately after the intervention and a further 2 minute ‘rest‘ period, another total of 5 minutes SC data. Data was analysed using InStat v3 (www.GraphPad.com) following data preparation with Microsoft Excel. Results The chiropractic adjustment to C1 produced a sympathoexcitatory response compared with control group (p
of chiropractic adjustment should be a priority along with improving patient outcomes, 79% and 78% respectively (Fig.1). Conclusion This appears to be the first study of this type. It clearly demonstrates that UK chiropractors are willing to donate funds for further research, via subscription from their Associations. An infrastructure will need to be developed to manage potential funds. Additionally further research will be required to assess chiropractors priorities and beliefs regarding further research. References [1] GCC (2010) Code of Practice and Standards of Proficiency. General Chiropractic Council, UK. [2] Sackett DL. (1997) Evidence-based medicine. How to practice and teach EBM, 2nd ed. Churchill Livingstone, New York. [3] Stuber K, Bussieres A, Gotlib A (2009) Chiropractic research capacity in Canada in 2008 – Phase 3. J Can Chiropr Assoc 2009; 53(4). Fig 1: Participant responses regarding research priorities. Presenting complaints to Chiropractors: Has there been any change in the last 10 years? Daniel Piper MChiro, Adrian Hunnisett PhD MPhil, Christina Cunliffe DC PhD Introduction Each year 150,000 new patients consult a chiropractor[1]. A study carried out in 2002 recognised that the typical new patient presenting to a chiropractic practitioner was female, between the age of 41-60 years old and mostly presented with low back pain (LBP)[2]. This profile is supported by other research in the field [3,4]. The aim of the study is to collect new data that may show any change of trends of primary presenting complaint as well as any other presenting complaints that have increased in affliction frequency. It helps to answer the question ”Is there any change in the ‘typical’ patient?”. This may provide a beneficial indicator of target demographics for marketing and teaching purposes. Method Following ethical approval, a retrospective survey of patient notes was undertaken. Records were reviewed from all new patients (n=556) attending a student clinic of a Chiropractic College. The data collection instrument was similar to that of the original 2002 study [2] but with some added data fields, including referral source and occupation. There was also a change to the segmentation of the body to provide data for overlapping symptoms. This strategy allowed direct comparison of results but the changes made to the chart also worked to address the original authors’ recognised limitation of the data quality and quantity. Results In 2012 there were a total number of 556 new patients with 43% male and 57% female. The primary presenting complaint are indicated in Figure 1. It is clear that the most common complaint was LBP (57%) followed by lower extremity pain (11%). This compared with 47% and 10% respectively in 2002. Analysis of other presenting complaints showed similar patterns of presentation over both sample years. There were no statistically significant differences shown between the 2 year groups. Conclusion This study clearly shows that low back pain is still the most common primary presenting complaint. Comparing the results directly with the 2002 study body segmentation, there would appear to be an increase of 12% of new patients presenting with low back pain. The study data indicates a perception that chiropractic is still viewed predominantly for low back pain alone. It is in the interest of the profession to change this stereotype by educating the population at large of the benefits to total body health that chiropractic can provide. References [1] Hawk C, Long C R, Boulanger K T (2001). Prevalence of non-musculoskeletal complaints in chiropractic practice: report from a practice based research programme. JMPT March-April 2001, Vol 24, No 3. [2] Smith S (2003). What are the primary complaints of new patients visiting a McTimoney chiropractor in 1997 compared with 2002? BSc dissertation, McTimoney College of Chiropractic, Abingdon, UK. [3] Hartvigsen J, Bolding-Jensen O, Hviid H, Grunnet-Nilsson N (2003). Danish Chiropractic, patients then and now: a comparison between 1962 and 1999. JMPT Feb 2003, Vol 26, No 2, Pages 66-69. [4] Hartvigsen J, Sorensen L P, Graesborg K, Grunnet-Nilsson N (2002). Chiropractic patients in Denmark: a short description of basic characteristics. JMPT 2002 Vol 25, No 3, Pages 162-67.
Page 2 and 3: itor’s no editor’s note Change
Page 4 and 5: Con Bern Boo
Page 6: Liz Interview.
Page 9 and 10: Neurology Shimizu Reflex Orthopaedi
Page 11 and 12: fantastic as it gave us new delegat
Page 15 and 16: Chiropractors, Chiropractic and The
Page 18 and 19: NEWS FROM The Royal College of Chir
Page 22 and 23: 2 pages ads Edinburgh Lectures? WCC

aaCM 13 in design

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?