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Chiropractic Education and Radiography Best Practices

ACA’s Choosing Wisely recommendations are consistent with X-ray guidance in today’s classroom and trusted texts.

In the past year, many chiropractors have discussed indications for radiographic examination with renewed interest. In particular, they have questioned the X-ray recommendations of the Choosing Wisely initiative, a project of the American Board of Internal Medicine that seeks to promote more effective use of healthcare resources. The recommendations are hardly revolutionary, and well in line with current radiology education. In my own final radiology classes, professors emphasized that what we learned was only the foundation of what we would need in practice, and a mere fraction of what our peers would learn should they choose to become chiropractic radiologists. The recommendations in Choosing Wisely are shorthand for what we already know. 

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Essential Skills for Managing Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness and vertigo. The condition is characterized by brief episodes of dizziness, nausea, and/or nystagmus triggered by head movement. Over 7 percent of the population will experience BPPV at some point in their lifetime and 80 percent of those patients will require medical treatment. Chiropractors are uniquely suited to differentiate BPPV from the similar-looking cervicogenic vertigo. Both conditions are very amenable to treatment; however, each is managed quite differently. Successful outcomes are predicated upon a solid understanding of both.

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Research Review: Exercise Interventions for Cognitive Function in Adults Older Than 50

As any population ages, cognitive decline becomes more of an issue. Maintaining a physically active lifestyle has been shown to help reduce age-related cognitive declines and incidence of dementia. This research review focuses on a systemic review with meta-analysis summarizing the evidence specific to cognitive benefits of exercise for people over 50. Prior research has shown conflicting results, due in part to the use of restrictive inclusion criteria. However, the results of this review show promise for both aerobic and resistance training.

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Choosing Wisely: Separating Facts from Fears

It has been just over a year since many in the chiropractic profession first learned that the American Chiropractic Association (ACA) joined more than 80 medical specialty society partners to participate in an initiative that is sponsored by the American Board of Internal Medicine Foundation. This initiative’s mission is to “promote conversations between clinicians and patients by helping patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” It is called the Choosing Wisely campaign1 and it has generated more spirited discussion among doctors of chiropractic than I can recall since release of the Mercy Conference Proceedings in 1993.

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Engaging the Community Through Diversity in Research

An Introduction to Diverse Needs

While a chiropractic student, I traveled with a group of medical providers to a community in Ghana to provide supplies, assist with health screens in remote villages, and work in a local hospital within a variety of departments. During my time there, I interviewed different community members employed by the hospital or by non-governmental organizations working with the hospital about their perceived health burdens and openness to chiropractic. Unexpectedly, interviewees expressed that while they practiced a Western medicine model, there was some uncertainty on how much that body of knowledge applied to them since they felt so underrepresented in the studies that contributed to that knowledge. The patients and study participants described were rarely people that came from similar geography, cultures, and lifestyles or had physical characteristics they identified with. 

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Research Review: Chiropractic Care and Risk for Acute Lumbar Disc Herniation: a Population-based Self-controlled Case Series Study

The objective of this study was to compare the associations between primary care physician and chiropractic care in relation to acute lumbar disc herniation (LDH) with early surgery. The clinical picture of LDH in the early stages (i.e. the prodromal phase), in which low back pain progresses to radicular leg pain and possible neurologic signs, is often uncertain and can be a confusing time for both patients and clinicians. Thus, making a diagnosis of LDH during the early course of symptoms is often very difficult. The study's hypothesis was that chiropractic care could only be thought to increase the risk for acute LDH if the measured association between chiropractic visits and acute LDH exceeded the association between PCP visits and acute LDH.

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Choosing Wisely: It’s About Communication, Not Coverage

It’s been one year since the American Chiropractic Association released its Choosing Wisely list, which features recommendations designed to help patients start conversations with their chiropractors about appropriate care. In an era of evidence-based care and shared decision making, patients need this type of information to have meaningful discussions with their doctors that lead to better care and, ultimately, better outcomes.

Author: N. Ray Tuck
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Research Review: Manipulation and Mobilization for Treating Chronic Low Back Pain: a Systematic Review and Meta-analysis

Spinal manipulation and mobilization for the treatment of back and neck pain have been the topic of several systematic reviews, with some suggesting that the evidence in support of the view that spinal manipulative therapy is superior to other standard treatments for chronic low back pain is sparse. On the other hand, more recent systematic reviews have reported that spinal manipulation and mobilization are “viable” options for treating pain. Despite this degree of variability among studies, manipulation and mobilization are still considered to be effective treatments when compared with other therapies. The purpose of this systematic review was to unravel these differences and inconsistent findings. 

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What Does Research Reveal About Chiropractic Costs?

According to ACA Senior Scientific Advisor Christine Goertz, DC, PhD, the most common issues raised by those outside the chiropractic profession relate to the quality and consistency of chiropractic care delivery. The second most commonly asked question invariably pertains to the costs associated with chiropractic care. While there is no definitive answer and more research is needed, Dr. Goertz reveals what the evidence we have to date tells us about the costs associated with chiropractic.

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Research Review: Low-level Laser for Neck Pain vs. Randomised Placebo

When searching for low-risk, cost-effective modalities possessing the ability to aid practitioners in the treatment of non-complicated musculoskeletal complaints, research must lead the way. Often, we see the newest and the latest technology or apparatus put forth as the cure for everything we have been waiting for. Low-level laser (LLLT) has, on the surface, the appearance of the latest and greatest apparatus. But what research is out there backing up claims commonly seen with low-level laser marketing in the healthcare field?

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