Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Nov 1, 1997
Objective: To present the characteristics of four cases of migraine, who were included as partici... more Objective: To present the characteristics of four cases of migraine, who were included as participants in a prospective trial on chiropractic spinal manipulative therapy for migraine.Method: Participants in a migraine research trial, were reviewed for the symptoms or clinical features and their response to manual therapy.Results: The four selected cases of migraine responded dramatically to SMT, with numerous self reported symptoms being either eliminated or substantially reduced. Average frequency of episodes was reduced on average by 90%, duration of each episode by 38%, and use of medication was reduced by 94%. In addition, several associated symptoms were substantially reduced, including nausea, vomiting, photophobia and phonophobia.Discussion: The various cases are presented to assist practitioners making a more informed prognosis.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Mar 1, 1998
Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropract... more Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropractor) in reducing the number of spinal injuries and their associated costs in the workplace.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Jul 1, 1997
Objective: To test the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatmen... more Objective: To test the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine, using an uncontrolled clinical trial.Design: A clinical trial of six months duration. The trial consisted of 3 stages: two months of pre-treatment, two months of treatment, and two months post treatment. Comparison was made to initial baseline episodes of migraine preceding commencement of SMT.Setting: Chiropractic Research Centre of Macquarie University.Participants: Thirty two volunteers, between the ages of 23 to 60 were recruited through media advertising. The diagnosis of migraine based on a detailed questionnaire, regarding self reported symptoms or signs, with minimum of one migraine with aura per month.Interventions: Two months of SMT provided by an experienced chiropractor at a university clinic.Main Outcome Measures: Participants completed diaries during the entire trial noting the frequency, intensity, duration, disability, associated symptoms and use of medication for each migraine episode. In addition, clinic records were compared to their diary entries of migraine episodes.Results: A total of fifty nine participants responded to the advertising, with twenty five being excluded or deciding not to continue in the trial. Two participants (5.9%) withdrew during the trial, one due to alteration in work situation and one following soreness after SMT. The Chiropractic SMT group showed statistically significant improvement (p < 0.05) in migraine frequency and duration, when compared to initial baseline levels. Only one participant (3.1%) reported that the migraine episodes were worse after the two months of SMT, and this was not sustained at the two month post treatment follow up period.Conclusion: The results of this study suggest that Chiropractic SMT is an effective treatment for migraine with aura. However, due to the cyclical nature of migraine with aura, and the finding that episodes usually reduce following any intervention, further research is required. A prospective randomised controlled trial utilising detuned EPT (interferential), a sham manipulation group and an SMT group is nearing conclusion. It is anticipated this trial will provide further information of the efficacy of Chiropractic SMT in the treatment of migraine with aura.
To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicati... more To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicating and critically reviewing a paper commonly cited when reviewing adverse events of SMT as reported by Ernst (J Roy Soc Med 100:330-338, 2007). Replication of a 2007 Ernst paper to compare the details recorded in this paper to the original source material. Specific items that were assessed included the time lapse between treatment and the adverse event, and the recording of other significant risk factors such as diabetes, hyperhomocysteinemia, use of oral contraceptive pill, any history of hypertension, atherosclerosis and migraine. The review of the 32 papers discussed by Ernst found numerous errors or inconsistencies from the original case reports and case series. These errors included alteration of the age or sex of the patient, and omission or misrepresentation of the long term response of the patient to the adverse event. Other errors included incorrectly assigning spinal manipulati...
Australasian chiropractic & osteopathy : journal of the Chiropractic & Osteopathic College of Australasia, 1998
Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropract... more Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropractor) in reducing the number of spinal injuries and their associated costs in the workplace.Method: A lecture was designed to increase employees awareness of spinal injury and how it might be prevented. The lecture was designed following a work-place inspection, to assess the most likely risk factors for injury. The lecture also included advice on posture, normal biomechanics and alternative strategies to improve spinal health.Subjects: Volunteer subjects, all from the same company, were randomly assigned to a study group (n = 34) and a control group (n = 27). The remaining employees (n = 60) formed a non intervention (baseline) comparison group.Main Outcome Measures: The number and severity of injuries for all groups was monitored over a six month period prior to and following the lecture. In addition, Oswestry pain and disability questionnaires were collected prior to the lecture and at ...
Australasian chiropractic & osteopathy : journal of the Chiropractic & Osteopathic College of Australasia, 1997
To present the characteristics of four cases of migraine, who were included as participants in a ... more To present the characteristics of four cases of migraine, who were included as participants in a prospective trial on chiropractic spinal manipulative therapy for migraine. Participants in a migraine research trial, were reviewed for the symptoms or clinical features and their response to manual therapy. The four selected cases of migraine responded dramatically to SMT, with numerous self reported symptoms being either eliminated or substantially reduced. Average frequency of episodes was reduced on average by 90%, duration of each episode by 38%, and use of medication was reduced by 94%. In addition, several associated symptoms were substantially reduced, including nausea, vomiting, photophobia and phonophobia. The various cases are presented to assist practitioners making a more informed prognosis.
Objective: The purpose of this study was to survey the choice of treatment provider by selected A... more Objective: The purpose of this study was to survey the choice of treatment provider by selected Australian office workers for common conditions that are managed in chiropractic practice. Methods: Office workers of a medium-sized legal company in Sydney, Australia, were surveyed. The participants (n = 125) were asked to complete a written questionnaire on their preferred treatment choices for common physical conditions, such as back pain, neck pain, and headache. Results: A total of 81 people returned completed questionnaires. Forty-two people (52%) reported that they would attend a general medical practitioner first for back pain. In comparison, 24% of people reported that they would attend a physiotherapist first for back pain. Eleven people (13%) reported that they would attend a chiropractor first for back pain. Fifty-one percent (51%) of employees reported that their preferred treatment first choice for neck pain was a general practitioner. Chiropractic was rated as third (30%) most common choice for the treatment of neck pain (equal with physiotherapy). The preferred first choice (63% of employees) for headache treatment was a general practitioner. The second most common choice for treatment of headache was a naturopath (50%). Eighty-one percent of employees ranked a general practitioner as their preferred treatment first choice for migraine, and 39% of employees also ranked the general practitioner as the second most common treatment choice for migraine. Conclusions: In this sample of Australian workers, chiropractic was rated within the top 3 choices for several common neuromusculoskeletal conditions for which they may have chosen a chiropractor. Because of the small sample size and limited parameters of this study, no strong conclusions can be made until further data are collected.
Objective: To present a case study of migraine sufferer who had a dramatic improvement after chir... more Objective: To present a case study of migraine sufferer who had a dramatic improvement after chiropractic spinal manipulative therapy (CSMT). Clinical features: The case presented is a 72-year-old woman with a 60-year history of migraine headaches, which included nausea, vomiting, photophobia, and phonophobia. Intervention and outcome: The average frequency of migraine episodes before treatment was 1 to 2 per week, including nausea, vomiting, photophobia, and phonophobia; and the average duration of each episode was 1 to 3 days. The patient was treated with CSMT. She reported all episodes being eliminated after CSMT. The patient was certain there had been no other lifestyle changes that could have contributed to her improvement. She also noted that the use of her medication was reduced by 100%. A 7-year follow-up revealed that the person had still not had a single migraine episode in this period. Conclusion: This case highlights that a subgroup of migraine patients may respond favorably to CSMT. While a case study does not represent significant scientific evidence, in context with other studies conducted, this study suggests that a trial of CSMT should be considered for chronic, nonresponsive migraine headache, especially if migraine patients are nonresponsive to pharmaceuticals or prefer to use other treatment methods.
Intracranial hypotension (IH) is caused by a leakage of cerebrospinal fluid (often from a tear in... more Intracranial hypotension (IH) is caused by a leakage of cerebrospinal fluid (often from a tear in the dura) which commonly produces an orthostatic headache. It has been reported to occur after trivial cervical spine trauma including spinal manipulation. Some authors have recommended specifically questioning patients regarding any chiropractic spinal manipulation therapy (CSMT). Therefore, it is important to review the literature regarding chiropractic and IH. To identify key factors that may increase the possibility of IH after CSMT. A systematic search of the Medline, Embase, Mantis and PubMed databases (from 1991 to 2011) was conducted for studies using the keywords chiropractic and IH. Each paper was reviewed to examine any description of the key factors for IH, the relationship or characteristics of treatment, and the significance of CSMT to IH. In addition, other items that were assessed included the presence of any risk factors, neck pain and headache. The search of the databases identified 39 papers that fulfilled initial search criteria, from which only eight case reports were relevant for review (after removal of duplicate papers or papers excluded after the abstract was reviewed). The key factors for IH (identified from the existing literature) were recent trauma, connective tissue disorders, or otherwise cases were reported as spontaneous. A detailed critique of these cases demonstrated that five of eight cases (63%) had non-chiropractic SMT (i.e. SMT technique typically used by medical practitioners). In addition, most cases (88%) had minimal or no discussion of the onset of the presenting symptoms prior to SMT and whether the onset may have indicated any contraindications to SMT. No case reports included information on recent trauma, changes in headache patterns or connective tissue disorders. Even though type of SMT often indicates that a chiropractor was not the practitioner that delivered the treatment, chiropractic is specifically cited as either the cause of IH or an important factor. There are so much missing data in the case reports that one cannot determine whether the practitioner was negligent (in clinical history taking) or whether the SMT procedure itself was poorly administered. This systematic review revealed that case reports on IH and SMT have very limited clinical details and therefore cannot exclude other theories or plausible alternatives to explain the IH. To date, the evidence that CSMT is not a cause of IH is inconclusive. Further research is required before making any conclusions that CSMT is a cause of IH. Chiropractors and other health practitioners should be vigilant in recording established risk factors for IH in all cases. It is possible that the published cases of CSMT and IH may have missed important confounding risk factors (e.g. a new headache, or minor neck trauma in young or middle-aged adults).
The purpose of this case report is to describe chiropractic management of a patient with pregnanc... more The purpose of this case report is to describe chiropractic management of a patient with pregnancy-related lumbopelvic pain. A pregnant 35-year-old woman experienced insidious moderate to severe pregnancy-related lumbopelvic pain and leg pain at 32 weeks&amp;amp;#39; gestation. Pain limited her endurance capacity for walking and sitting. Clinical testing revealed a left sacroiliac joint functional disturbance and myofascial trigger points reproducing back and leg pain. A diagnosis of pregnancy-related low back pain and pregnancy-related pelvic girdle pain was made. The patient was treated with chiropractic spinal manipulation, soft tissue therapy, exercises, and ergonomic advice in 13 visits over 6 weeks. She consulted her obstetrician for her weekly obstetric visits. At the end of treatment, her low back pain reduced from 7 to 2 on a 0-10 numeric pain scale rating. Functional activities reported such as walking, sitting, and traveling comfortably in a car had improved. This patient with pregnancy-related lumbopelvic pain improved in pain and function after chiropractic treatment and usual obstetric management.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Nov 1, 1996
Objective: To identify the main characteristics of classic migraine, with specific regard to diag... more Objective: To identify the main characteristics of classic migraine, with specific regard to diagnostic criteria for manual therapy practitioners, including chiropractors and osteopaths.Method: Ten case studies on migraine were reviewed for the symptoms and clinical features.Results: The majority of cases reviewed as classic migraines were in reality not correct diagnoses in accordance with standard classification systems. Some cases had classic signs which may have been missinterpreted, whilst other cases had possible inconsistent symptoms making diagnosis difficult.Discussion: The various classification systems are presented with guidelines for diagnosis to assist practitioners making the accurate diagnosis.
Journal of Manipulative and Physiological Therapeutics, Jan 2, 2000
Objective: To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatm... more Objective: To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Nov 1, 1996
A retrospective analysis of 500 patient radiographs was conducted to measure the clinical correla... more A retrospective analysis of 500 patient radiographs was conducted to measure the clinical correlation of cervical lordosis measurements and incidence of motor vehicle accident (MVA). Five hundred lateral cervical radiographs were selected at random from the practice of one of the authors (DLM). The C1-7 angle of the cervical curve was then measured by two blinded examiners. Inter-examiner reliability had a confidence interval of 95%. Eighty-two percent of patients who have had a MVA had an abnormal lordosis. The mean lordosis of patients who had been involved in a MVA was 26.1 degrees (SD 11.4), compared with 36.4 (SD 8.4) for those who had not been involved in a MVA. The results suggest a correlation of reduced cervical lordosis measurements following motor vehicle accident (MVA).
Objective: A pilot study was conducted to determine whether untrained examiners could agree on pa... more Objective: A pilot study was conducted to determine whether untrained examiners could agree on palpatory findings in the cervical spine.Design: Fifty-three university students, (most of whom were chiropractic students), had their cervical spines examined by seven different chiropractors using their own clinical methods, of which motion palpation was a common, but not standard component.Setting: Chiropractic Centre in Macquarie University.Participants: Volunteer university students.Main Outcome Measures: Individual clinical methods, which included static and/or motion palpation, vertebral springing, range of motion and applied kinesiology.Results: Statistically, for the total group, there was poor interexaminer reliability. Of eight examiners, four did not disagree significantly, the next two examiners disagreed with each other but only at a single level and the remaining two examiners disagreed with most of the other examiners and each other.Conclusion: In the cervical spine, it appears that C6 is the level of highest contention, followed by C1 and C5. Essentially the results suggest that combinations of examiners show reasonable consistency at identifying the same entity while using their own typical examination techniques. The nature of these palpable findings, leading to a diagnosis of subluxation or vertebral dysfunction is ill defined. Several issues were considered as important: expectations of examiners, research design, subject compliance, role of asymptomatic subjects and what the examiners were actually detecting.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Jul 1, 1999
Acute pain in peripheral joints is not a common presenting symptom for chiropractors or osteopath... more Acute pain in peripheral joints is not a common presenting symptom for chiropractors or osteopaths. However, chiropractors or osteopaths may be asked to assess peripheral joints when patients present with other conditions such as back pain.This paper reviews the literature on bacterial arthritis as a specific type of infectious arthritis. Information was obtained from Medline and internet search using the keyword: “bacterial arthritis”. The most common presenting symptoms are described, with specific reference for chiropractors and osteopaths in clinical presentation of patients' with this condition.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Nov 1, 1997
Objective: To present the characteristics of four cases of migraine, who were included as partici... more Objective: To present the characteristics of four cases of migraine, who were included as participants in a prospective trial on chiropractic spinal manipulative therapy for migraine.Method: Participants in a migraine research trial, were reviewed for the symptoms or clinical features and their response to manual therapy.Results: The four selected cases of migraine responded dramatically to SMT, with numerous self reported symptoms being either eliminated or substantially reduced. Average frequency of episodes was reduced on average by 90%, duration of each episode by 38%, and use of medication was reduced by 94%. In addition, several associated symptoms were substantially reduced, including nausea, vomiting, photophobia and phonophobia.Discussion: The various cases are presented to assist practitioners making a more informed prognosis.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Mar 1, 1998
Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropract... more Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropractor) in reducing the number of spinal injuries and their associated costs in the workplace.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Jul 1, 1997
Objective: To test the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatmen... more Objective: To test the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine, using an uncontrolled clinical trial.Design: A clinical trial of six months duration. The trial consisted of 3 stages: two months of pre-treatment, two months of treatment, and two months post treatment. Comparison was made to initial baseline episodes of migraine preceding commencement of SMT.Setting: Chiropractic Research Centre of Macquarie University.Participants: Thirty two volunteers, between the ages of 23 to 60 were recruited through media advertising. The diagnosis of migraine based on a detailed questionnaire, regarding self reported symptoms or signs, with minimum of one migraine with aura per month.Interventions: Two months of SMT provided by an experienced chiropractor at a university clinic.Main Outcome Measures: Participants completed diaries during the entire trial noting the frequency, intensity, duration, disability, associated symptoms and use of medication for each migraine episode. In addition, clinic records were compared to their diary entries of migraine episodes.Results: A total of fifty nine participants responded to the advertising, with twenty five being excluded or deciding not to continue in the trial. Two participants (5.9%) withdrew during the trial, one due to alteration in work situation and one following soreness after SMT. The Chiropractic SMT group showed statistically significant improvement (p < 0.05) in migraine frequency and duration, when compared to initial baseline levels. Only one participant (3.1%) reported that the migraine episodes were worse after the two months of SMT, and this was not sustained at the two month post treatment follow up period.Conclusion: The results of this study suggest that Chiropractic SMT is an effective treatment for migraine with aura. However, due to the cyclical nature of migraine with aura, and the finding that episodes usually reduce following any intervention, further research is required. A prospective randomised controlled trial utilising detuned EPT (interferential), a sham manipulation group and an SMT group is nearing conclusion. It is anticipated this trial will provide further information of the efficacy of Chiropractic SMT in the treatment of migraine with aura.
To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicati... more To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicating and critically reviewing a paper commonly cited when reviewing adverse events of SMT as reported by Ernst (J Roy Soc Med 100:330-338, 2007). Replication of a 2007 Ernst paper to compare the details recorded in this paper to the original source material. Specific items that were assessed included the time lapse between treatment and the adverse event, and the recording of other significant risk factors such as diabetes, hyperhomocysteinemia, use of oral contraceptive pill, any history of hypertension, atherosclerosis and migraine. The review of the 32 papers discussed by Ernst found numerous errors or inconsistencies from the original case reports and case series. These errors included alteration of the age or sex of the patient, and omission or misrepresentation of the long term response of the patient to the adverse event. Other errors included incorrectly assigning spinal manipulati...
Australasian chiropractic & osteopathy : journal of the Chiropractic & Osteopathic College of Australasia, 1998
Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropract... more Objective: To evaluate the cost effectiveness of a spinal care lecture (conducted by a chiropractor) in reducing the number of spinal injuries and their associated costs in the workplace.Method: A lecture was designed to increase employees awareness of spinal injury and how it might be prevented. The lecture was designed following a work-place inspection, to assess the most likely risk factors for injury. The lecture also included advice on posture, normal biomechanics and alternative strategies to improve spinal health.Subjects: Volunteer subjects, all from the same company, were randomly assigned to a study group (n = 34) and a control group (n = 27). The remaining employees (n = 60) formed a non intervention (baseline) comparison group.Main Outcome Measures: The number and severity of injuries for all groups was monitored over a six month period prior to and following the lecture. In addition, Oswestry pain and disability questionnaires were collected prior to the lecture and at ...
Australasian chiropractic & osteopathy : journal of the Chiropractic & Osteopathic College of Australasia, 1997
To present the characteristics of four cases of migraine, who were included as participants in a ... more To present the characteristics of four cases of migraine, who were included as participants in a prospective trial on chiropractic spinal manipulative therapy for migraine. Participants in a migraine research trial, were reviewed for the symptoms or clinical features and their response to manual therapy. The four selected cases of migraine responded dramatically to SMT, with numerous self reported symptoms being either eliminated or substantially reduced. Average frequency of episodes was reduced on average by 90%, duration of each episode by 38%, and use of medication was reduced by 94%. In addition, several associated symptoms were substantially reduced, including nausea, vomiting, photophobia and phonophobia. The various cases are presented to assist practitioners making a more informed prognosis.
Objective: The purpose of this study was to survey the choice of treatment provider by selected A... more Objective: The purpose of this study was to survey the choice of treatment provider by selected Australian office workers for common conditions that are managed in chiropractic practice. Methods: Office workers of a medium-sized legal company in Sydney, Australia, were surveyed. The participants (n = 125) were asked to complete a written questionnaire on their preferred treatment choices for common physical conditions, such as back pain, neck pain, and headache. Results: A total of 81 people returned completed questionnaires. Forty-two people (52%) reported that they would attend a general medical practitioner first for back pain. In comparison, 24% of people reported that they would attend a physiotherapist first for back pain. Eleven people (13%) reported that they would attend a chiropractor first for back pain. Fifty-one percent (51%) of employees reported that their preferred treatment first choice for neck pain was a general practitioner. Chiropractic was rated as third (30%) most common choice for the treatment of neck pain (equal with physiotherapy). The preferred first choice (63% of employees) for headache treatment was a general practitioner. The second most common choice for treatment of headache was a naturopath (50%). Eighty-one percent of employees ranked a general practitioner as their preferred treatment first choice for migraine, and 39% of employees also ranked the general practitioner as the second most common treatment choice for migraine. Conclusions: In this sample of Australian workers, chiropractic was rated within the top 3 choices for several common neuromusculoskeletal conditions for which they may have chosen a chiropractor. Because of the small sample size and limited parameters of this study, no strong conclusions can be made until further data are collected.
Objective: To present a case study of migraine sufferer who had a dramatic improvement after chir... more Objective: To present a case study of migraine sufferer who had a dramatic improvement after chiropractic spinal manipulative therapy (CSMT). Clinical features: The case presented is a 72-year-old woman with a 60-year history of migraine headaches, which included nausea, vomiting, photophobia, and phonophobia. Intervention and outcome: The average frequency of migraine episodes before treatment was 1 to 2 per week, including nausea, vomiting, photophobia, and phonophobia; and the average duration of each episode was 1 to 3 days. The patient was treated with CSMT. She reported all episodes being eliminated after CSMT. The patient was certain there had been no other lifestyle changes that could have contributed to her improvement. She also noted that the use of her medication was reduced by 100%. A 7-year follow-up revealed that the person had still not had a single migraine episode in this period. Conclusion: This case highlights that a subgroup of migraine patients may respond favorably to CSMT. While a case study does not represent significant scientific evidence, in context with other studies conducted, this study suggests that a trial of CSMT should be considered for chronic, nonresponsive migraine headache, especially if migraine patients are nonresponsive to pharmaceuticals or prefer to use other treatment methods.
Intracranial hypotension (IH) is caused by a leakage of cerebrospinal fluid (often from a tear in... more Intracranial hypotension (IH) is caused by a leakage of cerebrospinal fluid (often from a tear in the dura) which commonly produces an orthostatic headache. It has been reported to occur after trivial cervical spine trauma including spinal manipulation. Some authors have recommended specifically questioning patients regarding any chiropractic spinal manipulation therapy (CSMT). Therefore, it is important to review the literature regarding chiropractic and IH. To identify key factors that may increase the possibility of IH after CSMT. A systematic search of the Medline, Embase, Mantis and PubMed databases (from 1991 to 2011) was conducted for studies using the keywords chiropractic and IH. Each paper was reviewed to examine any description of the key factors for IH, the relationship or characteristics of treatment, and the significance of CSMT to IH. In addition, other items that were assessed included the presence of any risk factors, neck pain and headache. The search of the databases identified 39 papers that fulfilled initial search criteria, from which only eight case reports were relevant for review (after removal of duplicate papers or papers excluded after the abstract was reviewed). The key factors for IH (identified from the existing literature) were recent trauma, connective tissue disorders, or otherwise cases were reported as spontaneous. A detailed critique of these cases demonstrated that five of eight cases (63%) had non-chiropractic SMT (i.e. SMT technique typically used by medical practitioners). In addition, most cases (88%) had minimal or no discussion of the onset of the presenting symptoms prior to SMT and whether the onset may have indicated any contraindications to SMT. No case reports included information on recent trauma, changes in headache patterns or connective tissue disorders. Even though type of SMT often indicates that a chiropractor was not the practitioner that delivered the treatment, chiropractic is specifically cited as either the cause of IH or an important factor. There are so much missing data in the case reports that one cannot determine whether the practitioner was negligent (in clinical history taking) or whether the SMT procedure itself was poorly administered. This systematic review revealed that case reports on IH and SMT have very limited clinical details and therefore cannot exclude other theories or plausible alternatives to explain the IH. To date, the evidence that CSMT is not a cause of IH is inconclusive. Further research is required before making any conclusions that CSMT is a cause of IH. Chiropractors and other health practitioners should be vigilant in recording established risk factors for IH in all cases. It is possible that the published cases of CSMT and IH may have missed important confounding risk factors (e.g. a new headache, or minor neck trauma in young or middle-aged adults).
The purpose of this case report is to describe chiropractic management of a patient with pregnanc... more The purpose of this case report is to describe chiropractic management of a patient with pregnancy-related lumbopelvic pain. A pregnant 35-year-old woman experienced insidious moderate to severe pregnancy-related lumbopelvic pain and leg pain at 32 weeks&amp;amp;#39; gestation. Pain limited her endurance capacity for walking and sitting. Clinical testing revealed a left sacroiliac joint functional disturbance and myofascial trigger points reproducing back and leg pain. A diagnosis of pregnancy-related low back pain and pregnancy-related pelvic girdle pain was made. The patient was treated with chiropractic spinal manipulation, soft tissue therapy, exercises, and ergonomic advice in 13 visits over 6 weeks. She consulted her obstetrician for her weekly obstetric visits. At the end of treatment, her low back pain reduced from 7 to 2 on a 0-10 numeric pain scale rating. Functional activities reported such as walking, sitting, and traveling comfortably in a car had improved. This patient with pregnancy-related lumbopelvic pain improved in pain and function after chiropractic treatment and usual obstetric management.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Nov 1, 1996
Objective: To identify the main characteristics of classic migraine, with specific regard to diag... more Objective: To identify the main characteristics of classic migraine, with specific regard to diagnostic criteria for manual therapy practitioners, including chiropractors and osteopaths.Method: Ten case studies on migraine were reviewed for the symptoms and clinical features.Results: The majority of cases reviewed as classic migraines were in reality not correct diagnoses in accordance with standard classification systems. Some cases had classic signs which may have been missinterpreted, whilst other cases had possible inconsistent symptoms making diagnosis difficult.Discussion: The various classification systems are presented with guidelines for diagnosis to assist practitioners making the accurate diagnosis.
Journal of Manipulative and Physiological Therapeutics, Jan 2, 2000
Objective: To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatm... more Objective: To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Nov 1, 1996
A retrospective analysis of 500 patient radiographs was conducted to measure the clinical correla... more A retrospective analysis of 500 patient radiographs was conducted to measure the clinical correlation of cervical lordosis measurements and incidence of motor vehicle accident (MVA). Five hundred lateral cervical radiographs were selected at random from the practice of one of the authors (DLM). The C1-7 angle of the cervical curve was then measured by two blinded examiners. Inter-examiner reliability had a confidence interval of 95%. Eighty-two percent of patients who have had a MVA had an abnormal lordosis. The mean lordosis of patients who had been involved in a MVA was 26.1 degrees (SD 11.4), compared with 36.4 (SD 8.4) for those who had not been involved in a MVA. The results suggest a correlation of reduced cervical lordosis measurements following motor vehicle accident (MVA).
Objective: A pilot study was conducted to determine whether untrained examiners could agree on pa... more Objective: A pilot study was conducted to determine whether untrained examiners could agree on palpatory findings in the cervical spine.Design: Fifty-three university students, (most of whom were chiropractic students), had their cervical spines examined by seven different chiropractors using their own clinical methods, of which motion palpation was a common, but not standard component.Setting: Chiropractic Centre in Macquarie University.Participants: Volunteer university students.Main Outcome Measures: Individual clinical methods, which included static and/or motion palpation, vertebral springing, range of motion and applied kinesiology.Results: Statistically, for the total group, there was poor interexaminer reliability. Of eight examiners, four did not disagree significantly, the next two examiners disagreed with each other but only at a single level and the remaining two examiners disagreed with most of the other examiners and each other.Conclusion: In the cervical spine, it appears that C6 is the level of highest contention, followed by C1 and C5. Essentially the results suggest that combinations of examiners show reasonable consistency at identifying the same entity while using their own typical examination techniques. The nature of these palpable findings, leading to a diagnosis of subluxation or vertebral dysfunction is ill defined. Several issues were considered as important: expectations of examiners, research design, subject compliance, role of asymptomatic subjects and what the examiners were actually detecting.
Australasian Chiropractic Osteopathy Journal of the Chiropractic Osteopathic College of Australasia, Jul 1, 1999
Acute pain in peripheral joints is not a common presenting symptom for chiropractors or osteopath... more Acute pain in peripheral joints is not a common presenting symptom for chiropractors or osteopaths. However, chiropractors or osteopaths may be asked to assess peripheral joints when patients present with other conditions such as back pain.This paper reviews the literature on bacterial arthritis as a specific type of infectious arthritis. Information was obtained from Medline and internet search using the keyword: “bacterial arthritis”. The most common presenting symptoms are described, with specific reference for chiropractors and osteopaths in clinical presentation of patients' with this condition.
Uploads
Papers by Peter Tuchin