Chiropractic & Manual Therapies最新文献

Objective: To describe the primary complaints of infants presenting to Danish chiropractic clinics and explore the secondary complaints, and type of referrals from other healthcare professionals.

Methods: A cross-sectional study based on routinely collected medical records from a national sample of chiropractic clinics in Denmark. Data were collected retrospectively in December 2019 and January 2020, covering infants (0-1 year) seen between November 2018 and October 2019. All 238 chiropractic clinics in the Danish Chiropractors' Association were invited to participate via an electronic survey. The questionnaire captured demographic characteristics, primary and secondary complaints, symptom duration, and referral sources.

Results: A total of 1,049 completed questionnaires were received. The most common primary complaint was abnormal range of motion (ROM) (48%), followed by crying/infantile colic (17%), feeding problems (5%), and disturbed sleep (5%). The majority of complaints had lasted between 1 week and 3 months, prior to consultation. Secondary complaints were reported in 58% of cases, most commonly abnormal ROM (41%), disturbed sleep (22%), and feeding problems (21%). Referrals were reported for 51% of infants, with healthcare visitors being the primary source (44%).

Conclusion: This study provides insights into the clinical presentations and referral patterns of infants attending chiropractic clinics in Denmark. The findings highlight abnormal ROM as the predominant complaint, the central role of healthcare visitors in referrals, and the multifaceted nature of parental concerns. These results emphasize the need for evidence-based guidelines and stronger interdisciplinary collaboration to optimize infant care.

Background: Injuries sustained during healthcare consultations are a significant concern, and compensation claims relating to injuries in health systems are increasing. Extensive research has addressed injuries in the secondary sector, whereas knowledge about injuries sustained in primary care remains sparse. This retrospective register-based study aimed to describe compensation claims involving chiropractors in Denmark between 2013 and 2022.

Methods: All claims related to chiropractors from 2013 to 2022 were accessed in the Danish Patient Compensation Association Register and analyzed using the Healthcare Complaints Analysis Tool. Data on patient characteristics, injuries, processing time, decisions, appeals, and financial compensation were collected. Claims were categorized as relating to clinical, management, or patient-clinician relationship, alongside nine symptom-based injury classifications. Data relating to cervical artery dissection were examined separately and in greater detail, including information on presenting symptoms, International Classification of Primary Care, Second Edition code recorded by the chiropractor, treatment modalities used, time from treatment to onset of symptoms, and type of vascular injury subsequently diagnosed. Descriptive statistics summarized findings.

Results: A total of 535 chiropractor-related claims were identified, with 519 included for analysis. The number of claims per 100,000 consultations increased from 1.03 in 2013 to 3.57 in 2022. Most claims (84%) concerned treatment outcomes and side effects, primarily worsening of symptoms (23%) or delayed referral (23%). Of the 519 claims, only 32 (6%) were approved for compensation. Cervical artery dissection-related claims had the highest approval rate within category (29%; ~ 0.7 approved claims per million consultations) and accounted for 94% of total financial compensation (14 approved claims, 3,025,000 €).

Conclusion: Compensation claims related to chiropractic care in Denmark increased between 2013 and 2022, but approval rates remained low. Most claims concerned dissatisfaction with treatment outcome or worsening of symptoms. Cervical artery dissection-related claims had the highest approval rate and accounted for the highest compensation. When approved, they were compensated based on the fairness rule stating that the outcome could neither have been predicted nor expected from patients' individual cases. Better communication between patients and chiropractors about expectations for treatment, natural course of conditions, and expected reactions to treatment will likely reduce the number of claims.

Background: Chronic primary low back pain (CLBP) and fibromyalgia (FM) have complex etiologies and management approaches. Further research is needed, particularly on subgroups like individuals with CLBP who also report signs and symptoms of FM (CLBP/FM+) to better understand their pain mechanisms and clinical profile. Examining psychological, pain-related characteristics, and physical activity could help identify subgroups of individuals with CLBP/FM+ and guide the development of targeted interventions. This study aimed to compare physical activity practice, pain and psychological characteristics of individuals with CLBP without signs and symptoms of FM (CLBP/FM-), CLBP/FM + and FM to better understand similarities and differences between these chronic pain conditions.

Methods: Ninety-four individuals self-reporting CLBP (83% women) and 101 individuals self-reporting FM (96% women) were recruited online and completed a 30-min online survey. Among those with CLBP, 39 were classified as CLBP/FM+ and 55 as CLBP/FM-. Analyses of variance (ANOVAs) with polynomial contrasts were conducted to assess linear trends across the three groups on pain intensity (Numeric Rating Scale), psychological characteristics (Short Form-12, Tampa Scale for Kinesiophobia) and physical activity practice.

Results: Individuals with CLBP/FM- were more likely to participate in high-intensity physical activities. The analysis revealed a significant linear trend across the CLBP/FM-, CLBP/FM+, and FM groups for all pain and psychological characteristics except for the physical component of the quality of life and moderate-intensity physical activity.

Conclusions: Individuals reporting a diagnosis of FM exhibit greater symptoms severity and engage less in high-intensity physical activities than individuals with CLBP/FM+ and CLBP/FM-. Identifying a subgroup of individuals with CLBP/FM+ may help recognize mixed pain profiles and inform more personalized tailor management strategies.