Journal of the Canadian Chiropractic Association最新文献

Objectives: 1) To determine which characteristics of adolescent athletes with SRC are associated with 'early' versus 'late' presentation for multimodal treatment; 2) to build a propensity score to investigate the effects of treatment timing during the management of SRCs.

Methods: Associations between early (0-7 days) versus late (8-28 days) presentation for treatment and pre-specified sociodemographic, pre-injury and injury characteristics were investigated in a historical cohort study of 2949 multi-sport athletes across Canada aged 12-18 years diagnosed with a SRC in community-based healthcare clinics.

Results: Early presentation was associated with being male, completing a pre-injury baseline assessment, and responding 'yes' or 'no' to having a diagnosed learning disability. Older athletes who reported previous SRCs were less likely to present early. The propensity score demonstrated an area under the curve of 0.71 (95% CI, 0.69 to 0.73).

Conclusions: Male athletes with a completed baseline assessment were more likely to seek early treatment following a SRC, and older athletes who reported a greater number of previous SRCs were less likely to present early. External validation of the propensity score is needed before examining the impact of treatment timing on adolescent athlete recovery outcomes.

Objective: We present a case of an elite cyclist that hesitated to follow the medical advice from her practitioners, as she was determined to train and compete resulting in delayed diagnosis and management of a rare hip pathology.

Case presentation: A 51-year old elite female cyclist had a history of years of hip pain with insidious onset. The chiropractor in this case observed a lack of response to treatment, and advised the patient to get an MRI with suspicion of a labral tear. She eventually agreed to further investigations and was diagnosed with Non-Hodgkin's follicular lymphoma and a labral tear.

Summary: Elite athletes are not immune to serious pathology. Chiropractors should be vigilant and ensure to investigate any patients with a lack of response to conservative management. Chiropractors should be aware of the risk of athletic patients that continue to train and compete when advised not to.

Background: Vertebral osteomyelitis (OM) is an infectious condition of bone caused by an infecting organism, most commonly Staphylococcus aureus (S. aureus). Though rare in adolescents, it is important to remember that this population has vascularized intervertebral discs prior to skeletal maturity and, therefore, is more susceptible to an osteodiscitis infection.

Purpose: To determine the possible factors that lead to a delayed diagnosis of osteodiscitis compared to an early diagnosis in an adolescent athlete.

Summary: This case provides a unique example of osteodiscitis in an adolescent rowing athlete where an infected heel blister was the only indication toward a diagnosis. Early diagnosis and successful management of osteodiscitis are dependent on recognizing constitutional and non-constitutional signs and symptoms of infection.

Clinical relevance: In sport, when skin barriers may be compromised more readily, the risk of infection should be considered in the differential diagnosis of unprovoked back pain.

Objective: To provide the practicing chiropractor foundational knowledge to enhance the understanding of relevant primary, secondary, and tertiary public health measures for suicide prevention.

Methods: A descriptive literature review was performed using keywords low back pain, neck pain, psychosocial, pain, public health, suicide, suicide risk factors, and suicide prevention. English language articles pertaining to suicide prevention and the chiropractic profession were retrieved and evaluated for relevance. Additional documents from the Centers for Disease Control, Veterans Health Administration, and the World Health Organization were reviewed. Key literature from the clinical social work and clinical psychology fields were provided by authorship team subject matter experts.

Conclusion: No articles reported a position statement regarding suicide prevention specific to the chiropractic profession. Risk, modifiable, and protective factors associated with self-directed violence are important clinical considerations. A proactive approach to managing patients at-risk includes developing interprofessional and collaborative relationships with mental health care professionals.

Introduction: Previous analysis of registered clinical trials has found a number of protocols result in changes in the registered primary outcome measures. This investigation determined if reported primary outcomes in chiropractic-related clinical trials registered in clinicaltrials.gov match their published results. Additionally, we assessed secondary outcomes, publication status and whether raw data were posted to the registry.

Methods: Clinicaltrials.gov was searched for chiropractic-related trials and having a completed status. If the study was published, outcome measures were compared between the clinicaltrials.gov entry and the published paper to assess for consistency.

Results: Within clinicaltrials.gov 171 chiropracticrelated protocols were identified with 102 of those published (59.6% publication rate). Ninety-two of the published papers (90.2%) had agreement between their primary outcome and the entry on clinicaltrials.gov and 82 (80.4%) agreed with the secondary outcomes.

Conclusion: A modest rate of agreement between clinicaltrials.gov entries and the published papers was found. While chiropractic-related clinical trials are fewer compared to medical trials, chiropractic-related research has a substantially better rate of primary and secondary outcome concordance with registered protocols.

Background: The purpose of this cross-sectional study was to compare the number of males and females in leadership positions, and whether there is a relationship between gender and degrees held in those positions, within chiropractic academic institutions, national regulatory bodies and the most widely representative national professional associations in the United States and Canada.

Methods: Publicly accessible websites from chiropractic institutions and organizations were used to collect data. Pearson χ² tests of independence were conducted to determine the relationship between gender (male vs. female) and other variables, including position (principal vs secondary), and chiropractic and other advanced professional degrees.

Results: A total of 107 leaders were identified across institutions and organizations. Under one-third of leaders (30.8%) were identified as female. Males were more likely to be in principal leadership roles (86.2%) and more likely to be in a secondary leadership position (62.8%).

Conclusion: Male leaders significantly outnumber female leaders in both principal and secondary leadership positions within American and Canadian chiropractic institutions. Strategies should be developed to include gender diversity within all chiropractic organizations.

Objectives: A bibliometric survey was conducted, using network and textual analysis tools, to assess the current state of the research enterprise at Canadian Memorial Chiropractic College and to augment planning processes.

Methods: Searches were conducted via several databases to identify publications attributable to the institution. Bibliometric data were summarized and post-processed using the programme VosViewer and analysis tools provided in the Web of Science.

Results: Canadian Memorial Chiropractic College is a productive source of peer-reviewed publications supported by a diverse suite of funding agencies and collaborating institutions, and published across a broad range of journals.

Conclusions: As a private, single-purpose educational institution, awarding a qualification only in chiropractic, Canadian Memorial Chiropractic College probably performs well in its class of institution in terms of research productivity. However, assessment is constrained by inconsistencies on the part of authors, journals and databases in archiving data.

Objective: To describe an anatomical variant wherein, bilaterally, the C5 ventral root passes anterior to the anterior scalene muscle.

Clinical implications: This and other variants in the anatomy of brachial plexus may complicate diagnosis of thoracic outlet syndrome, by producing unconventional signs and symptoms. Additionally, the passage of C5 ventral root anterior to the anterior scalene muscle, as in this case, may render the nerve root more susceptible to injury, including injury during manual therapy directed to this region.

Background: This study aimed to validate a questionnaire to address an absence of a measure to evaluate Australian chiropractic students' perceptions of the quality of chiropractic programs.

Method: Potential relevant questionnaire items were selected from the Australian chiropractic accreditation standards. Chiropractic students rated these items for clarity and relevance, which resulted in a pilot questionnaire of 47 items. Principal components analysis was used to establish the structure of the scales. Finally, intra-class correlation coefficients were used to establish the scales' test-retest reliability.

Results: Thirty-four items were omitted resulting in the retention of 13 items that strongly loaded onto five factors. Internal consistency was adequate. The test-retest reliability ranged from adequate to good for four of the derived factors. The fifth was poor and omitted.

Conclusion: A valid questionnaire for assessing Australian chiropractic programs has been developed comprising four scales that enquire about: 1) quality of the educational program; 2) provision of student support services; 3) enablement of independent learning; and 4) adequacy of teaching resources.