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

Objective: To assess the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine.

Design: A prospective clinical trial of twelve months duration. The trial consisted of 3 stages: two month pre-treatment, two month treatment, and two months post treatment. Comparison of outcomes to the initial baseline factors was made and also 6 months after the cessation of the study.

Setting: Chiropractic Research Centre of Macquarie University.

Participants: Thirty two volunteers, between the ages of 20 to 65 were recruited through media advertising. The diagnosis of migraine was based on a self reported detailed questionnaire, with minimum of one migraine per month.

Interventions: Two months of chiropractic SMT at vertebral fixations determined by the practitioner, through orthopedic and chiropractic testing.

Main outcome measures: Participants completed diaries during the entire trial noting the frequency, intensity (visual analogue score), duration, disability, associated symptoms and use of medication for each migraine episode.

Results: The initial 32 participants showed statistically significant (p < 0.05) improvement in migraine frequency, VAS, disability, and medication use, when compared to initial baseline levels. A further assessment of outcomes after a six month follow up (based on 24 participants), continued to show statistically significant improvement in migraine frequency (p < 0.005), VAS (p < 0.01), disability (p < 0.05), and medication use (p < 0.01), when compared to initial baseline levels. In addition, information was collected regarding any changes in neck pain following chiropractic SMT. The results indicated that 14 participants (58%) reported no increase in neck pain as a consequence of the two months of SMT. Five participants (21%) reported a slight increase, three participants (13%) reported mild pain, and two participants (8%) reported moderate pain.

Conclusion: The results of this study support the hypothesis that Chiropractic SMT is an effective treatment for migraine, in some people. However, a larger controlled study is required.

Chiropractors in Australia face some challenges that are unique in their history. The value of their primary treatment modality is now widely recognised. The process of professionalisation of this occupation is well advanced. Yet the integration of chiropractic services within the mainstream Australian health care system remains problematic. It is contended in this paper that chiropractors' integration will be facilitated by two genuine and strategic moves by the medically minded segment of, or the entire, profession. One is to abandon metaphysical notions as part of the 'philosophy of chiropractic' and the other is to pursue limited prescription rights allowing chiropractors to play fully the role of the primary contact practitioners of neuromusculoskeletal medicine. This development is deemed to be beneficial and appropriate for the profession as well as the patients served by this profession.

Objective: To assess the attitudes of undergraduate chiropractic and osteopathic students at Royal Melbourne Institute of Technology (RMIT) in 1992 on the education they are receiving and on the effectiveness of chiropractic and osteopathic care.

Design: Cross-sectional descriptive survey.

Participants: Undergraduate chiropractic and osteopathic students enrolled at RMIT School of Chiropractic and Osteopathy in 1992.

Results: This study surveyed 272 students, 196 who were chiropractic students and 76 who were osteopathic students from RMIT School of Chiropractic and Osteopathy in Melbourne, Australia. The students that responded represented 73.4% of chiropractic students and 85.4% of osteopathic students currently enrolled in their respective courses. Chiropractic and osteopathic students entered their respective courses from non-chiropractic/non-osteopathic families. More chiropractic students than osteopathic students (1.3:1.0) had their respective course as their first choice when applying for tertiary education. A majority (95.8 chiropractic students and 94.8% osteopathic students) of both groups surveyed were pleased with their choice of course. Students from both disciplines held considerable respect for each other in the care of certain conditions, but did not see the other profession's care as effective as their own. A greater percentage of osteopathic students believed there was sufficient difference between chiropractic and osteopathy to justify two separate professions (57.6% compared to 97.2%).

Discussion: High quality education is a major aim in our schools and colleges. For this standard to be maintained it requires continual re-evaluation and assessment. Surveys such as this should be performed regularly as a method of evaluating student attitude and how these attitudes change during the course. This would also allow administrators to determine whether they are achieving their academic intentions. An immediate follow up survey asking the same questions is suggested to ascertain whether the same attitudes exist today.

Background: The audible release or cracking sound associated with spinal manipulation is familiar to practitioners of spinal manipulative therapy. Furthermore, some authors believe the articular crack to be at least in part responsible for the therapeutic benefits derived from spinal manipulative therapy. Although some research has been directed towards the investigation of some aspects of this phenomenon, little research has be conducted in order to establish from which side and vertebral level the audible release occurs during the manipulative process.

Objective: To assess the reliability and accuracy of multiple surface mounted microphones to detect the audible release of the target joint during manipulation of the third metacarpophalangeal joint.

Design: Observational study.

Setting: Private practice of chiropractic, Ringwood, Victoria, Australia.

Participants: Twenty volunteers recruited from staff and patients of the private practice of chiropractic.

Method: Eight omnidirectional microphones were affixed to the palmar surface of the hand. Microphone No.1 was positioned directly over the third metacarpophalangeal joint while the remaining microphones were arranged in a uniform pattern over the palmar surface of the hand. Manipulation in the form of long axis traction was then applied to the third metacarpophalangeal joint. Where an audible release was associated with the manipulation the resultant signals were captured via computer and stored for later analysis.

Main outcome measure: A difference of greater than one volt in peak amplitude between the microphone positioned over the target joint and the other microphones. The student's t-test was then applied to the data in order to determine if the mean output of the target joint microphone was statistically different to the mean output of the other microphones.

Results: A total of eighteen manipulations resulted in nineteen audible release signals. The mean voltage of channel 1 was consistently greater than all the other channels in this group of subjects. This difference was statistically significant for all the channels.

Conclusion: This research suggests that multiple surface mounted microphones are capable of consistently detecting the audible release from the target joint, with manipulation directed to the third MCP joint. It is hoped that this method will be able to be applied to the audible release associated with spinal manipulative therapy and a better understanding of the manipulative process will ensue.

Chiropractors and other healthcare practitioners primarily concerned with the treatment and diagnosis of disorders of the musculoskeletal system are often presented with patients complaining of extremity joint pain. The signs and symptoms of Ross River and Barmah Forrest arbovirus infections can often be confused with a number of other conditions including local joint infection, rheumatoid diseases and other systemic diseases causing arthralgic or myalgic symptoms. This paper presents a review of the often debilitating conditions caused by the Ross River and Barmah Forest arboviruses. These increasingly common viruses can produce symptoms of arthralgia, fever, myalgia, rash and headache. A systematic review of the structure of these viruses, their epidemiology, clinical manifestations, treatment and prevention are presented.

The objective of this research was to identify the most common combination of methods used by chiropractors in Victoria to identify manipulable lesions or subluxations. A postal survey of chiropractors in Victoria achieved an 85% response rate and revealed that eight methods are commonly used in combination to detect subluxation. They are: visual posture analysis, pain description of the patient, plain static erect x-rays, leg length discrepancy, neurological tests, motion palpation, static palpation, orthopaedic tests. These methods have also been found to be used commonly and regarded as reliable.