Australasian chiropractic & osteopathy : journal of the Chiropractic & Osteopathic College of Australasia最新文献

Background: Chiropractic and Osteopathy are categorised within the family of Complementary and Alternative Medicine (CAM) by most indexers and database managers. CAM therapies can be difficult to search because relevant resources are spread over a number of databases.

Objective: This paper aims to introduce basic searching skills for six databases which offer CAM literature.

Methods: Six readily available databases which can be used by a busy clinician to remain informed about best practice were chosen. The databases were searched and compared using two clinical scenarios as sample searches.

Discussion: Evidence-based practice demands that practitioners maintain their information gathering skills, but no one source provides all the answers. We are lured by the thought that everything is available on the web easily and speedily, but may sacrifice quality for ease and speed of retrieval.

Objectives: To review the biomechanics of the swimming stroke and examine common injuries which occur in swimming. A review of diagnosis and management strategies of these injuries is also performed.

Background: Most injuries and complaints encountered in swimming athletes occur because of repetitive microtrauma or overuse, with many injuries originating from faulty technique and poor swimming biomechanics. As a result, assessment of an injured athlete requires the practitioner to have an understanding of the four swimming strokes and hydrodynamics.

Methods: A Literature search of the MEDLINE and MANTIS databases was performed on all swimming related articles.

Results: Twenty seven journal articles and 7 text books were chosen that satisfied the search criteria and related to the aims of this review.

Discussion: The correct swimming technique is discussed and predisposing factors to injury in the stroke are identified. Specific injury sites are examined and pathologies to these areas are detailed.

Conclusion: The shoulder, neck and back are the injuries considered in this review. These regions are considered in the total training program of the athlete to identify other factors, such as weight training or other dry land programs that may be contributing to injury. However, whilst rest or reduced training may be necessary for recovery, every effort must be made to keep the swimmer "in the water" as cessation of training may lead to a rapid detraining effect and loss of competitive advantage.

Background: Disorders of the cervical spine are common and often disabling. The etiology of these disorders is often multifactorial and a comprehensive approach to both diagnosis and management is essential to successful resolution.

Objective: This article provides an overview of a clinical model of the diagnosis and management of patients with disorders related to the cervical spine. This model is based in part on the scientific literature, clinical experience, and communication with other practitioners over the course of the past 20 years.

Discussion: The clinical model presented here involves taking a systematic approach to diagnosis, and management. The diagnostic process is one that asks three essential questions. The answers to these questions then guides the management process, allowing the physician to apply specific methods that address the many factors that can be involved in each individual patient. This clinical model allows the physician to individualize the management strategy while utilizing principles that can be applied to all patients. At times, the management strategy must be multidisciplinary, and cooperation with other physicians and therapists is often necessary for effective patient care. This model is currently being used by the author in practice, as well as forming the basis upon which further research can be conducted to refine or, if necessary, abandon any of its aspects, as the evidence dictates. It is the purpose of this paper to present this clinical model and the clinical and scientific evidence, or lack thereof, of its components.

Frozen shoulder (adhesive capsulitis) is a common, painful and disabling condition which is typically slow to resolve. Patients with this condition will be seen in every musculoskeletal practitioner's clinic on a regular basis. There is a wide variety of treatment modalities available, some more effective than others. This article reviews the literature on the aetiology and natural history of the condition, and the common treatments provided. The literature on hydraulic arthrographic capsular distension (hydrodilatation) is reviewed and six cases referred for this treatment from a chiropractic clinic are presented.

Background: Spine pain is a common presenting complaint of patients who visit physicians and although spine cancer accounts for a very small percentage of cases of back pain, metastasis is a relatively common cause of spine pain in the elderly. The presentation of patients with spine cancers is highly variable, and in many cases the clinical findings of benign and cancerous causes of spine pain can be similar, often confounding the clinical picture. This can create difficulties in interpreting the clinical data available to the physician, particularly with a disease with such a devastating prognosis.

Objective: This manuscript discusses the more common causes of malignant lesions of the spine, including an overview of the incidence/prevalence data and clinical features of both primary and secondary malignancies. It also provides the reader with a clinical overview of patients with spine cancer.

Discussion: It is important to appreciate the myriad epidemiologic and clinical features of primary and secondary spine cancers. Patients with malignant skeletal lesions may be asymptomatic in the area of cancerous bone disease and, as a consequence, these lesions can be overlooked. This may result in dismal consequences for the patient, given the generally poor prognosis associated with spine cancers. Knowledge of the features discussed in this paper will assist the clinician in appropriately raising his/her index of suspicion for spine cancer in suitable clinical circumstances.

Obtaining the informed consent of a patient before undertaking chiropractic or osteopathic treatment is a common law requirement in Australia. This paper outlines the essential elements of informed consent and provides some practice tips on streamlining the process.

This article is the second in a series of articles dealing with risk management in the practise of chiropractic and osteopathy, prepared by the COCA Risk Management Subcommittee.Background: Radiographic examination carries risks that must be weighed against the possible benefits when determining patient care.Objective: The objective of this article is to propose guidelines for the use of imaging in chiropractic and osteopathic practice.Discussion: Plain film radiography, CT scan, magnetic resonance imaging (MRI) and other forms of imaging are available for use in chiropractic and osteopathic practice in Australia. The astute practitioner utilises these imaging procedures for clinical decision making in order to make an accurate diagnosis that will determine a patient's management. This article attempts to guide the practitioner in the proper use of these imaging procedures for different regions of the body.

Introduction: There is little research available on the effects of peripheral joint manipulation. Only a few studies have examined the effect of manipulation on ankle range of motion, with conflicting results. This study aimed to determine whether a single high-velocity, low-amplitude (HVLA) thrust manipulation to the talo-crural joint altered ankle range of motion in subjects with a history of lateral ligament sprain.Methods: Male and female volunteers (N=52) with a history of lateral ligament sprain were randomly assigned into either an experimental group (n=26) or a control group (n=26). Those in the experimental group received a single HVLA thrust to the talo-crural joint, whilst those in the control group received no treatment intervention. Pre-test and post-test measurements of passive dorsiflexion range of motion were taken.Results: No significant changes in dorsiflexion range of motion were detected between manipulated ankles and those of control subjects using dependent and independent t-tests. Ankles that cavitated displayed a greater mean DFR and large effect size (d=0.8) compared to those that did not gap and cavitate, but analysis with ANOVA revealed these differences to be not significant.Conclusion: HVLA manipulation of the ankle did not increase dorsiflexion range of motion in subjects with a history of lateral ligament sprain.

Background: Australian Rules Football is one of the most popular sports in Australia. Successful injury prevention relies on injury surveillance to establish the extent of injuries, to monitor injury patterns and to evaluate prevention strategies. Despite the popularity of participation at the community level, few injury surveillance studies have been published, so a detailed review of the literature is vital. There is limited information available outside of the elite level. Injury statistics for any professional sport may not necessarily be translatable to community sport level.Objective: To document the most prevalent injuries at the elite, junior elite, amateur and junior level and determine if incidences differ across levels of play. Aetiology and significant risk factors for injuries are emphasized and prevention and treatment discussed.Discussion: Injuries on average are more common at the elite level compared with other levels of participation. The type of injury varies slightly, with non contact injuries, particularly muscle strains, being the most common. Of these, the hamstring strain is the most common. Aetiology and risk factors vary between levels of play due to a time basis, physical development, speed of play and skill level. Recurrence rates are a concern for clubs and players, although rates are decreasing at the elite level, indicating better treatment and conservative management of injured players.