Clinical Chiropractic最新文献

Multiple sclerosis (MS) is a chronic neurodegenerative condition increasingly recognized as a painful disease. Pain has been identified as an important contributor to disability and quality of life in patients with MS. We present two cases of MS patients presenting to chiropractors with musculoskeletal pain, highlighting the impact pain can have on function and quality of life. A review of the MS literature highlights the prevalence and severity of pain in this population, the impact that pain can have on quality of life, and the biopsychosocial correlates of pain and disability among these patients. Pain management strategies are discussed based on key themes and outcomes identified in the literature.

Objective

In addition to manipulation, and in line with evidence, many manual therapists include prescribed home exercise for patients with musculoskeletal problems; however, compliance to these exercises can be low and patients potentially miss the added benefit these interventions can provide. Increasing patient compliance is, therefore, important and previous attempts have been met with varying success. The emergence of mobile technology may offer efficient methods whereby the practitioner can stay in contact with the patient and impact compliance positively. We therefore investigated the use of SMS messages in increasing compliance in chiropractic patients who were given exercise advice.

Design

This was a prospective pilot clinical trial.

Subjects

New patients consenting to the study with musculoskeletal problems amenable to chiropractic treatment, who were given exercise advice as part of their care and who possessed a mobile phone.

Methods

Thirty-two patients attending chiropractic clinics in Germany were assigned pseudo randomly into two groups, one that received SMS messages and one that did not. Three messages were sent each week over a 4 week period. A follow up questionnaire ascertained self reported compliance to the exercises given.

Results

Patients in the SMS group were 6 times more likely [OR = 6.3 (95% CI (2.2–17.9)] to complete the exercises given than those who did not receive an SMS. In addition, only the SMS group reported significant increases in self reported compliance in comparison to previous episodes where exercise was also given. Annoyance scores indicated that patients receiving SMS texts did not find them onerous.

Conclusions

This pilot study indicates that SMS messaging to patients increases self reported compliance. This is in line with other areas of compliance research and warrants further development.

Introduction

When comparing satisfaction studies of medical and chiropractic back pain care, chiropractic care does better than medical care overall. Treatment length may be a contributing factor as may treatment frequency. There is no current literature that compares chiropractic styles and satisfaction, therefore inter-satisfaction differences between the various styles of chiropractic practice is not known. An understanding of these factors is a key part of increasing patient satisfaction and confidence.

Methods

The study design was a cross sectional survey. A self-administered questionnaire was mailed out to a number of pre-recruited chiropractic clinics in varying locations in the UK. The questionnaires were completed anonymously by the patients in these clinics.

Results

A total of 186/250 valid questionnaires were received, giving a response rate of 75%. Most respondents attended chiropractic clinics for the treatment of back pain. The results showed some clear and important opinions regarding treatment length and frequency. Overall satisfaction and quality of life scores were highest in clinics with treatments times over 20 min. In addition clinics practising wellness care had lower satisfaction scores with higher frequency of care, than those with less frequent care sessions.

Conclusion

The results would imply more emphasis is placed on patient choice for treatment frequency. This element, along with less frequency, may optimise satisfaction. The results of this study have shown that patient satisfaction is influenced by different chiropractic styles, but further studies are required to clarify a wider range of variables.