Journal of the Canadian Chiropractic Association最新文献

Objective: To describe the utility of a tricompartmental offloading knee brace as an adjunct intervention for managing persistent PFP conditions.

Clinical features: Three cases of active adult females with persistent PFP following non-response to conventional and guideline aligned management strategies are presented.

Intervention and outcomes: Patients were managed using a tricompartmental offloading knee brace alongside individualized exercise programs for up to 12 weeks. Subjective and objective measures of pain and function were measured at three distinct time points. Each patient reported decreased pain, increased activity tolerance, and demonstrated improvements in both strength and functional performance over the course of the intervention period.

Summary: The use of tricompartmental offloading knee bracing alongside exercise therapy may be effective for the management of persistent PFP and should be considered for active adult females if unresponsive to both conventional and guideline aligned treatments.

Objectives: To explore the challenges and opportunities for research capacity development in the sports chiropractic field.

Methods: A qualitative description study was conducted using semi-structured interviews with 20 sports chiropractic researchers from eight countries and focus group interviews with 12 sports chiropractic leaders from Canada.

Results: Challenges and opportunities for research capacity development were identified within four main themes - 1) affiliations and collaborations, 2) human resources, 3) financial resources, and 4) operational resources. Profession-specific challenges included being "siloed", a lack of knowledge of the chiropractic profession, and its negative perception. Profession-specific opportunities included creating a sports chiropractic research chair/centre and engaging sports chiropractors in practice- and field-based research networks.

Conclusions: These results can inform strategies to advance research capacity development for the sports chiropractic field and develop context-specific indicators for ongoing research capacity assessment.

Objective: To investigate the prevalence of low back, pelvic girdle, and pelvic floor complaints in pregnant elite athletes.

Background: Common symptoms during pregnancy include low back pain, pelvic girdle pain, and pelvic floor dysfunction. There has been minimal investigation around the prevalence of these musculoskeletal disorders in the pregnant elite athlete.

Methods: A narrative review was conducted using electronic databases and hand reference searching. Articles were screened based on the inclusion/exclusion criteria.

Results: 727 articles were retrieved digitally, while hand and reference searching yielded one article. After removing those that did not fit the inclusion/exclusion criteria, there were a total of three articles.

Summary: Prevalence of these conditions in pregnant elite athletes is variable within the literature. The values appear to change based on trimester, parity, and description of these conditions. Similarly, frequency, duration, and type of exercise may also influence the prevalence. Further investigation is warranted to help guide safe participation in elite sport activity during pregnancy.

Objective: This case report discusses the diagnostic challenges associated with the early identification of cauda equina syndrome in a 25-year-old patient without lumbar spinal pain. It introduces a new classification scheme related to a more effective diagnosis.

Clinical features: The patient experienced pain in the right hamstring, diagnosed as a pulled muscle. Later, he experienced new symptoms of testicular pain and bladder issues.

Intervention and outcomes: Chiropractic treatments alleviated his right hamstring pain, albeit temporarily. Subsequently, new symptoms emerged, prompting the patient's referral to a local hospital. An MRI examination revealed a large lumbar disc herniation, leading to a microdiscectomy.

Summary: The reader will learn about a new classification of five different levels of CES. This classification is an important tool in clinical practice. This article also reviews critical information about the mixed neurological presentations of cauda equina syndrome, helping practitioners better understand these important clinical variants.

"The only constant is change" - Heraclitus, Greek Philosopher The objective of this article, Part 1 of a two part series, is to provide a narrative review of the evolution of teaching chiropractic manual skills by four tutors who taught in the technique trenches at the Canadian Memorial Chiropractic College collectively for 120 years. Based on their collective memories, this narrative review describes the evolution of: central demonstrations; inconsistency between tutors with respect to demonstrating and grading chiropractic manual skills; determining course content; policy on students providing high velocity, low amplitude thrusts on each other during class time and testing; quantitative versus qualitative grading; remediation; acknowledgment of risk and; changes to technique class due to Covid. The results of a unique survey evaluating students' perception of these changes is presented. The intent of this article is for faculty at other accredited educational programs to learn from our experiences and potentially strengthen their pedagogical approach to teaching chiropractic manual skills.

Cam-type deformities of the proximal femur have long been associated with femoroacetabular impingement (FAI); an orthopedic condition recognized in the etiology of early osteoarthritis (OA) in the non-dysplastic adult hip. However, the optimal clinical management (including the long-term prognosis) of patients with cam-type deformities with or without FAI symptoms remains uncertain. In this imaging case review (ICR), we present the 10-year follow-up of a retired chiropractor with bilateral cam-type femoral deformities who initially underwent total right hip joint arthroplasty for advanced hip joint OA, and subsequently developed advanced hip joint OA on the contralateral side.

Concussions are increasingly recognized as a public health concern. This paper evaluates Canadian concussion care guidelines, advocating for the inclusion of a broader range of healthcare professionals (HCPs) in concussion assessment, diagnosis, and management. It emphasizes the role of chiropractors, in addition to medical doctors (MDs) and nurse practitioners (NPs), highlighting their extensive training in musculoskeletal and neurological disorders. Chiropractors are adept at managing symptoms like headache, neck pain, and dizziness, and employing evidence-based, comprehensive interventions including patient education, exercise therapy, manual therapy, cervicovestibular rehabilitation, and return-to-sport (RTS) protocols. The paper also addresses regional variations in chiropractors' roles, focusing on Ontario's "Rowan's Law," and argues that limiting aspects of concussion care (assessment, diagnosis, RTS clearance) to MDs and NPs may result in healthcare inefficiencies and inequities. The findings are significant for policymakers and healthcare leaders, indicating a need for updated concussion care guidelines that integrate and utilize diverse HCPs. This could lead to improved patient outcomes, healthcare efficiency, and equity in concussion management across Canada.

Objectives: This sequential explanatory mixed-method study aimed to explore chiropractic students' attitudes toward incorporating maintenance care (MC) focused evidence.

Methods: Attitudes towards using an evidence-based clinical protocol for maintenance care (MC), the MAINTAIN instrument, were assessed via surveys, monologue responses, dialogues, and qualitative feedback. Participants from a single chiropractic educational institution completed questionnaires evaluating their perspectives on patient-centeredness, chronic pain, and evidence incorporation. Descriptive statistics summarized quantitative data, while content analysis was used for qualitative data.

Results: 74.4% (n=419) of students participated, mostly male (57.5%), with an average GPA of 3.15 (out of a maximum of 4.0). Qualitative analysis identified the need to clarify MC terminology and factors motivating students to adopt new evidence, such as quality and alignment with healthcare beliefs.

Conclusions: This study's findings emphasize the importance of refining healthcare training strategies, including defining terminology and addressing motivators for evidence incorporation, as evidence for MC for low back pain evolves.