Journal of the Canadian Chiropractic Association最新文献

Background: Axillary-subclavian venous thrombosis (ASVT) is a type of upper extremity deep vein thrombosis (UEDVT). UEDVTs are classified as either primary or secondary depending on their etiology. Although uncommon, clinicians should be aware of the clinical presentation of UEDVT as timely diagnosis and early treatment is critical in preventing possible post-thrombotic complications.

Case presentation: We report a rare case of axillary-subclavian and internal jugular vein thrombosis in the absence of clear risk factors in a 78-year-old male weightlifter who presented to the office with two-week duration of left upper extremity pain and swelling following strenuous exercise at the gym.

Summary: The combination of unusual thrombi location, in addition to the unusual absence of existing thoracic-outlet compression or indwelling medical hardware, makes our case of UEDVT especially uncommon. Clinicians should be aware of this rare disease due to the debilitating effects both in the short and long term.

Although most cases of Achilles tendinitis are caused by some form of biomechanical stress, other factors may play a role in its etiology. Fluoroquinolone use is a well-known contributing factor to Achilles tendon pathology. This report describes a case of fluoroquinolone-induced Achilles tendinitis in a 77-year-old woman. Eight weeks after she presented to our office, the patient reported significant improvements after a course of care that included low level laser therapy (LLLT), activity modification and graduated exercises. Management can include many of the treatment tools used for biomechanically induced tendinopathy, with particular consideration given to delaying more advanced weight-bearing rehabilitative exercise due to the increased risk of rupture.

Objectives: To investigate the research capacity and productivity of Canadian sports chiropractors.

Methods: A cross-sectional survey (phase one) and scoping review (phase two) investigated the research capacity and productivity (from 2015-2020) of the Canadian sports chiropractic field.

Results: Most respondents (72%) reported obtaining research training from fellowship and master's programs, with only 2 (1%) PhD qualifications identified. Approximately, 30% reported active involvement in research, with 28% being part-time clinician researchers. Access to human and technological research resources were limited. We identified 67 publications and 16 conference presentations within a five-year period, with clinical, population health, and basic science research as the areas most studied.

Conclusion: The research effort of Canadian sports chiropractors is primarily conducted by clinicians involved in research on a part-time basis. Its research outputs predominantly reflect the research requirements of the RCCSS(C) Sports Sciences Residency Program, highlighting its contribution in developing capacity and producing research for the Canadian sports chiropractic field.

Objective: To identify, appraise and synthesize the evidence of autonomic nervous system (ANS) dysfunction following sport-related concussion in pediatric populations.

Methods: A literature search was conducted using MEDLINE (Ovid), SportDiscus (EBSCO), CINAHL (EBSCO), EMBASE (Ovid) and PsycINFO (Ovid). Studies were selected and appraised using the Joanna Briggs Institute (JBI) critical appraisal tools. Data was extracted from the included studies and qualitatively synthesized.

Results: Eleven studies were included in the synthesis. There was variability in the methods used to measure ANS function between studies, and sample populations and time to assessment following concussion varied considerably. There was also variability in the direction of change of ANS function between some studies.

Conclusion: This systematic review identifies that concussion is associated with dysregulation of ANS function in pediatric athletes. We identified some weaknesses in the extant literature which may be due to existing logistical and financial barriers to implementing valid ANS measurements in clinical and sports settings.

Objective: To present a unique case of pulmonary embolism (PE) in an elite-Ironman triathlete and review athlete-specific risk factors associated with venous thromboembolism (VTE).

Case presentation: A 57-year-old male triathlete presented for chiropractic care of midback pain and dyspnea one day before competition. During competition, he was removed and unable to complete the event with dyspnea, chest, and midback pain. Vitals revealed prolonged elevated resting heart rate. He was triaged to the hospital with a high index of suspicion for PE. He was diagnosed with multiple PE in both lungs.

Summary: VTE is not normally considered in athletes. A combination of athlete-specific risk factors may predispose athletes to a higher propensity of VTE. Due to life-threatening consequences, it is important to include a differential diagnosis of VTE in patients presenting with midback pain and dyspnea.

Distal radius fractures are a common sports injury, often managed with reduction, immobilization, and rehabilitation. However, structured sport specific return to play protocols have yet to be developed, specifically within hockey. This case report reviews the various factors to consider when managing an athlete's recovery from a radius fracture, and objective measures to aid with return to play decision making when managing a hockey player.

Objective: To understand Canada-based sports chiropractors' attitudes, beliefs, and practical application of sport psychology in the sports injury rehabilitation process.

Methods: A cross-sectional, mixed-methods study design was employed. A questionnaire was emailed to 144 eligible participants including Fellows and Residents of the Royal College of Chiropractic Sports Sciences (Canada) (RCCSS(C)). Fifty-two surveys were returned fully completed. Fifteen respondents completed semi-structured interviews to further examine attitudes and beliefs in sport psychology training, delivery, and referrals.

Results: Approximately two-thirds of Canada-based sports chiropractors felt that athletes were affected psychologically 100% of the time when injured. Sports chiropractors reported using some basic psychological techniques during the sports injury rehab process and expressed interest in having more training in more advanced techniques and practical application of these skills, as well as developing a referral network with sport psychology professionals in Canada.

Conclusions: Sports chiropractors in Canada reported receiving entry level training in sports psychology and understood the importance of addressing the psychological aspects of sports injury. Further research is warranted to explore the effectiveness of current and future sports psychology education interventions for sports chiropractors.

The Beighton Score (BS) is a tool that dichotomizes those who have generalized joint hypermobility (GJH) and those who do not. Unfortunately, the BS is often used in populations that it was not originally developed for, including athletes for screening purposes. The construct validity of the BS remains unknown in this population. This secondary analysis investigated the construct validity of the BS by comparing varsity athletes' passive shoulder and hip ranges of motion (ROMs) to their respective BS and individual forward bend tests (FBTs). There were statistically significant but weak correlations between shoulder ROMs and the BS (r=0.142, p=0.021). Mean hip ROMs were greater by 5-degrees in those with positive FBTs compared to those with negative FBTs. This difference falls within typical measurement errors that occur in practice. Therefore, our results do not support the construct validity of the BS as a measure of GJH in healthy athletes.

Background: Physical activity and exercise (PAE) counselling and exercise prescriptions increase patient physical activity. However, the perceptions/practices of chiropractors are poorly understood.

Methods: We surveyed the practices among chiropractors working in Canada (n=50) and Internationally (n=37). Chiropractors completed self-reflection questionnaires regarding their current practices and perceptions towards providing PAE counselling to patients. Chiropractor responses were obtained via Canadian provincial survey and educational workshops.

Results: Chiropractor respondents included PAE content and exercise prescriptions in most patient appointments (67±27% and 59±35%, respectively), but the largest barriers (2.5/4.0) and least confidence were in their patients to follow through (52±21%). Canadian respondents reported higher knowledge (~0.4/4.0 higher), greater self-confidence (10-20% higher), and provided more PAE recommendations (8%) and prescriptions (16%) than International respondents. Chiropractor respondents were least comfortable advising patients with cancer.

Conclusion: Chiropractor respondents may serve as health promotors to address patient inactivity, and the challenges identified should be addressed through educational training.