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

Although rare, vertebrobasilar stroke is the best known of the possible side effects of cervical manipulation. Due to the serious sequelae that may result from cervical manipulation, chiropractors and osteopaths must take the appropriate steps to ensure the risk is minimised. This article outlines how the astute practitioner can minimise this risk. Practitioners must decide on the options for treatment of a patient with neck problems. Practitioners must also advise the patient of these options as part of an appropriate informed consent.

Introduction: Continuing professional education activities such as professional conferences and passive dissemination of literature appear to have no little or no impact on changing clinicians' practice. A clinical activities audit was carried out with a group (44) of chiropractors and osteopaths as part of the Chiropractic and Osteopathic College of Australasia's continuing professional development program to determine whether it was likely to generate improvement in practice.Methods: The participants gathered data relating to six audit criteria on ten patient records in round 1 and ten in round 2 (six months later). Each participant received a learning guide relating to useful clinical tools for pain and disability measurement immediately after completing the first round. The audit criteria relate to: methods used to assess the site and severity of pain, methods used to assess disability, other investigations performed or ordered, referrals made and outcome measures used for pain and disability. The data were analysed to determine whether the participants increased their use of objective pain and disability and outcome measures over the course of the audit.Results: Results of the first round of audit were compared with those of the second round. Practitioners' use of objective measures of pain and disability and outcome measures was significantly higher in the second round of audit.Conclusion: This indicates that this clinical activities audit is a useful tool for improving practice.

Objectives: To re-investigate the effect of a cervical isometric contract-relax technique on hamstring extensibility and examine the duration of any treatment effect.Methods: Forty asymptomatic participants were randomly assigned equally to either an experimental or control group. Both groups underwent pre and post hamstring extensibility measurements using passive knee extension with the thigh maintained at 90 degrees of hip flexion, with the examiner blinded to treatment allocation of the participants. Torque was measured with a hand held dynamometer to maintain consistent force in pre and post measurements. The experimental group received an upper cervical isometric contract-relax treatment. A digital camera recorded the knee extension angles and the images were computer analysed to determine hamstring extensibility.Results: A split plot ANOVA (SPANOVA) revealed no significant hamstring extensibility differences between or within the groups, immediately or at 30 minutes.Conclusion: The cervical isometric contract-relax treatment produced no significant effect to the extensibility of the hamstring. This study does not support the use of cervical techniques to alter hamstring extensibility.

Background: Fibromyalgia is a common chronic musculoskeletal pain syndrome, however its characteristics, diagnosis and management have not always been well understood. There is now increasing understanding of the pathophysiological mechanisms of fibromyalgia and development of more effective management strategies.

Objective: To explain the characteristics and diagnostic features of fibromyalgia. A discussion of current management strategies is included.

Discussion: Fibromyalgia patients have a central pain system problem that results in widespread musculoskeletal pain, and many other disabling features in the absence of tissue damage. The ability to exclude other pathology and recognize the disorder is important, as there are very real management options available. Management is most effective as a multidisciplinary, layered approach. It is important to involve the patient in their own treatment program, to enhance its success.