Journal of the Canadian Chiropractic Association最新文献

Objective: To highlight a case of an athlete with a symptomatic pretibial cyst 4-years post-ACL reconstruction surgery.

Case presentation: A 23-year-old female soccer athlete presented with right-sided knee pain, locking and catching, and diminished sensation along the anteroinferior knee. She had a history of an ipsilateral ACL hamstring autograft four years prior. Physical evaluation revealed a visible and palpable swelling medial to the patellar tendon, limited and painful range, and hypoesthesia within the infrapatellar branch of the saphenous nerve. MRI revealed a tubular ganglion cyst along the anterior aspect of the tibial tunnel, medial to the patellar tendon, and anterior to the ACL graft.

Summary: Post-surgical ganglion cyst formation in the reconstructed ACL is a rare complication that can present years following ACL surgery. This case aims to bring awareness to this condition as a potential long-term complication in the ACL-reconstructed athlete.

Background: Shoulder problems are common in swimmers. Previous research has focused on elite swimmers. Our research questions were: 1) what is the prevalence of shoulder problems among Ontario age group swimmers and 2) how does prevalence relate to age, sex and years of experience?

Methods: A cross sectional survey was administered to youth swimmers from two Ontario clubs. Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC) was used to assess four-week prevalence of shoulder problems. Prevalence (%) with 95% confidence intervals (95% CI) was constructed and prevalence across age, sex and years of experience was investigated using cross-tabulations and chi-square tests.

Results: There were 83 surveys completed (response rate 50%). The 4-week prevalence of shoulder pain was 35% (95% CI 25%, 45%). Shoulder problems were not significantly related to age, sex or years of experience.

Conclusion: These results can inform future studies on injury prevention and risk mitigation strategies in swimmers.

Objectives: To identify and prioritize research to inform research agenda development for Canadian chiropractors working in sport.

Methods: Clinicians, researchers and leaders from the Canadian sports chiropractic field were invited to participate in 1) a survey to refine a list of research priorities, 2) a Delphi procedure to determine consensus on these priorities, and 3) a prioritization survey.

Results: The top three research priorities were 1) effects of interventions on athletic outcomes, 2) research about sports healthcare teams, and 3) clinical research related to spinal manipulative and mobilization therapy. The three highest ranked conditions to research were 1) low back pain, 2) neck pain, and 3) concussion. Collaborations with sports physicians and universities/ colleges were rated as important research collaborations to pursue.

Conclusions: These results represent the Canadian sports chiropractic perspective to research priority setting and will be used alongside stakeholder input to set the first research agenda for the Canadian sports chiropractic field.

The brain utilizes glucose as its main source of energy. Traumatic brain injuries may alter the brain's ability to shuttle glucose effectively; therefore, the symptoms experienced may be a signal of the dysregulation. The objective of this cross-sectional study was to investigate the presence of any specific food cravings during the first week post-concussion and if the consumption of such a food decreased the symptoms of concussion. The link to the survey was posted on 4 Canadian organization websites from November 2020 to February 2021. Any individual over 18 years old who had suffered one of more concussions in the past 12 months was included. 73 females and 24 males, the majority aged 18-40 years, completed the survey. Participants with combined carbohydrate and sweet cravings reported significantly more symptoms of increased emotions (p=0.04), irritability (p=0.03), sadness (p=0.04), nervousness (p=0.03), and sleep disturbances (p=0.05) than those without these cravings. Consumption of the craved food did not change the concussion symptoms.

In the past several years, concussions and post-concussion syndrome (PCS) have become more commonly recognized conditions. However, with limited physiological explanation for post-concussion syndrome, there is also limited evidence supporting effective treatment. The vestibular system plays a role in postural reflexes and coordinated eye and cervical spine movements and is often disrupted in patients with prolonged concussion symptoms. This disruption has contributed to some of the most debilitating symptoms in PCS patients including dizziness, nausea, and balance deficits. Ongoing, post-concussion, vestibulo-ocular/cervical-ocular disruption due to an underlying structural leg length discrepancy as a contributing factor has not been previously described in the literature. A case of PCS with initial conservative treatment of their structural leg length discrepancy and subsequent vestibulo-ocular/cervical-ocular rehabilitation is presented.

This case series presents four cases of scapholunate interosseous ligament (SLIL) injury. We discuss the process of early recognition and highlight difficulties encountered in current diagnostic and conservative management strategies. The cases profile interdisciplinary management of four scapholunate (SL) injuries that have different clinical presentations and injury mechanisms. Three sport-related SL injuries were managed conservatively by a sport specialist chiropractor and one sport-related case was self-managed. Management strategies included early wrist immobilization, soft tissue manual therapy, low-level laser therapy, proprioceptive and strengthening exercises, and early orthopedic referral. This case series highlights: (1) the spectrum of SL injuries (2) the importance of early specialty referral, (3) the paucity of literature with respect to conservative management of these injuries and (4) the role of manual therapy and rehabilitation professionals as part of the healthcare team in detecting and helping manage these wrist injuries.

Objective: We set out to create a Family Medicine EHR (electronic health record) embedded exercise application. This was done to evaluate the utility of the exercise app for providers and to understand the usefulness of the exercise app from the perspective of patients.

Methods: This exercise application was developed through an iterative process with repeated pre-testing and feedback from an interprofessional team and embedded into the EHR at an academic family medicine clinic. Anecdotal feedback from patients was used to inform pre-testing adaptations.

Results: The application required six iterations prior to clinical utility. It had several features that clinicians and patients felt were beneficial. These features involved a customizable exercise directory with pre-made templated plans which could be further modified. To overcome accessibility barriers, the application was developed to include digital and printable copies with an integrated direct email option for ease of remote sharing with patients.

Conclusion: A customizable, open-source exercise application was developed to facilitate provider exercise prescription and support patient self-management. This project may be useful for other providers interested in developing similar programs to address musculoskeletal conditions in their patients. Next steps are to undertake pilot testing of the app with broader provider and patient feedback.

Context: Sarcopenia is a prevalent syndrome that has seen increased awareness in the last twenty years.

Objective: To systematically assess and evaluate the utility of bioelectrical impedance analysis (BIA) in the diagnosis of sarcopenia in adults over the age of 60.

Methods: An electronic search strategy of databases was conducted, including Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and SportDiscus. Included articles were evaluated using The Quality Appraisal for Reliability Studies (QAREL) checklist.

Results: Seven articles (1336 participants) met the inclusion criteria of evaluating the diagnostic ability of BIA. Results indicate that that there is a high degree of heterogeneity in how BIA is used to diagnose sarcopenia. While BIA is an affordable and easy to use measurement tool, it does not consistently demonstrate high levels of diagnostic sensitivity.

Conclusion: The current evidence does not consistently support the utility of BIA as an accurate diagnostic tool for sarcopenia in adults over 60. If utilizing BIA, clinicians should select a validated BIA equation for their patient's demographics. Clinicians should also consider the use of functional tests and validated screening questionnaires. This systematic review was registered at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=211586.

Introduction: The objectives of this study was to conduct an updated comparative audit involving a larger and more representative group of accredited chiropractic programs in order to determine if (i) if there has been any changes in the delivery of JEB curricula since the first audit was conducted in 2010, and (ii) provide recommendations that could lead toward a standardized or model JEB curriculum worldwide.

Methods: This study was approved by the ERB of the University of South Wales. Twenty-one chiropractic programs agreed to provide JEB course outlines for review.

Results: A total of 88 different course outlines, which listed 83 different topics pertaining to JEB course content, were submitted for review.

Conclusion: The results of this comparative audit revealed there has been an increase in the variability of JEB course content taught to students over time. Recommendations are provided for the next steps that could lead toward a standardized or model JEB curriculum curricula.