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Fulltext A comparison of quality and satisfaction experiences of patients attending chiropractic and physician offices in Ontario

Crowther ER

J Can Chiropr Assoc, 2014 Mar;58(1):24-38.
PMID: 24587494

INTRODUCTION: Improving the quality of healthcare is a common goal of consumers, providers, payer groups, and governments. There is evidence that patient satisfaction influences the perceptions of the quality of care received.
METHODS: This exploratory, qualitative study described and analyzed, the similarities and differences in satisfaction and dissatisfaction experiences of patients attending physicians (social justice) and chiropractors (market justice) for healthcare services in Niagara Region, Ontario. Using inductive content analysis the satisfaction and dissatisfaction experiences were themed to develop groups, categories, and sub-categories of quality judgments of care experiences.
RESULTS: Study participants experienced both satisfying and dissatisfying critical incidents in the areas of standards of practice, professional and practice attributes, time management, and treatment outcomes. Cost was not a marked source of satisfaction or dissatisfaction.
CONCLUSION: Patients may be more capable of generating quality judgments on the technical aspects of medical and chiropractic care, particularly treatment outcomes and standards of practice, than previously thought.
KEYWORDS: chiropractic care; quality; satisfaction

Matched MeSH terms: Chiropractic*
Fulltext The notion of a "whiplash culture": a review of the evidence

Haneline MT

J Chiropr Med, 2009 Sep;8(3):119-24.
PMID: 19703667 DOI: 10.1016/j.jcm.2009.04.001

OBJECTIVE: Most whiplash patients eventually recover, although some are left with ongoing pain and impairment. Why some develop long-term symptoms after whiplash, whereas others do not, is largely unknown. One explanation blames the cultural expectations of the population wherein the injury occurred, engendering the moniker whiplash culture. The purpose of this review was to locate and discuss studies that were used as a basis for developing the whiplash culture concept and to evaluate its plausibility.
METHODS: The PubMed database was searched using combinations of the terms whiplash culture, whiplash OR WAD, and chronic OR late OR long term. Search dates spanned from 1950 to June 2008. Filters were set to only retrieve English-language citations. Articles that dealt with the whiplash culture were selected and examined to determine which studies had been used to create the concept.
RESULTS: Nineteen articles discussed the cultural aspects of whiplash and were explored to determine which were used as a basis for the whiplash culture. Eight studies were found that met this final criterion.
CONCLUSION: There are many unanswered questions about the basis of chronic whiplash, and the notion of a whiplash culture is controversial. Chronic whiplash symptoms are surely not caused entirely by cultural issues, yet they are probably not entirely physical. Presumably, a tissue injury component exists in most chronic whiplash-associated disorder victims that becomes aggravated in those who are susceptible to biopsychosocial factors. As with many other controversial health care topics, the answer to the debate probably lies somewhere in the middle.

Matched MeSH terms: Chiropractic
Fulltext Chiropractic care for patients with acute neck pain: results of a pragmatic practice-based feasibility study

Haneline MT, Cooperstein R

J Chiropr Med, 2009 Dec;8(4):143-55.
PMID: 19948305 DOI: 10.1016/j.jcm.2009.08.003

OBJECTIVE: The purpose of this study was to determine the feasibility of a chiropractic practice-based research network to investigate the treatment of acute neck pain (ANP) and to report resulting findings.
METHODS: Participating chiropractors recruited sequentially presenting ANP patients on their initial visit to the office. Patients were treated by the chiropractors using their usual methods. Data were prospectively collected by having patients complete the Neck Disability Index, Characteristic Pain Intensity score, and a patient satisfaction questionnaire. Questionnaires were completed during routine office visits at baseline and then at weeks 1, 2, 4, 8, and 26, either in the office or by mail.
RESULTS: Ten chiropractors supplied data on 99 patients. The number of cases contributed by each of the participating chiropractors ranged from 1 to 54, with a mean (SD) of 9.2 (10.5). Mean (SD) Neck Disability Index scores were 36 (17.9) at baseline and 9.8 (12.2) at the final evaluation; the Characteristic Pain Intensity scores were initially 55.3 (20.4) and were 24.5 (21.5) at the final evaluation. Transient minimal adverse effects were reported by chiropractors for only 7 (7.8%) patients. No serious adverse reactions were reported.
CONCLUSION: The practice-based research methodology used in this study appears to be a feasible way to investigate chiropractic care for ANP, and its methodologies could be used to plan future research.

Matched MeSH terms: Chiropractic*
Fulltext The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia

Win NN, Nadarajah VD, Win DK

J Educ Eval Health Prof, 2015;12:17.
PMID: 25961676 DOI: 10.3352/jeehp.2015.12.17

PURPOSE: Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness.
METHODS: This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students' perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work.
RESULTS: Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students' motivation, cognitive skills, and perceived pressure to work (P<0.05). The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001).
CONCLUSION: The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources.
KEYWORDS: Chiropractic; Learning; Motivation; Perception; Problem-based learning

Matched MeSH terms: Chiropractic*
Fulltext Outcome of chiropractic therapy in idiopathic scoliosis – a preliminary study

Mohd Nizam Haron, Syahirah Zeti Azham, Lyanna Annura Sallehudin, Nur Firzanie Kamaruddin, Ezreen Elia Izzaty Afindi

Journal of Clinical and Health Sciences, 2017;2(2):26-30.
MyJurnal

The purpose of this study is to retrospectively report the results of scoliosis patients who underwent chiropractic therapy and to evaluate their outcome by looking at the potential to alter the natural progression of scoliosis after therapy.
Methods: Retrospective data collection was conducted at a private chiropractic centre in Kuala Lumpur. The data was collected from patients between the ages of 16 to 19 years old. A total of eight patients with 14 scoliotic curvatures (six thoracic, six lumbar and two thoracolumbar), who met the inclusion criteria, were selected as subjects for this study. All subjects received the same chiropractic therapy program. The outcome of the therapy was assessed by measuring the Cobb’s angle on the erect spine as captured on an x-ray. The Cobb’s angle was measured at the first presentation (to establish a baseline) after 6 and 24 months of therapy.
Results: The mean baseline Cobb’s angle for thoracic, lumbar and thoracolumbar scoliosis were 30.70 ± 19.40, 31.70 ± 12.30 and 25.00 ± 18.40 respectively. After 24 months of chiropractic therapy, there was no discernible effect on the magnitude of the Cobb’s angles on the subjects overall.
Conclusion: Our study showed no significant reduction in spine curvature in patients with scoliosis using chiropractic therapy after 24 months.

Matched MeSH terms: Chiropractic
Attitudes of dental and chiropractic students towards a shared learning programme-An interprofessional learning model

Omar H, Khan S, Haneline M, Toh CG

Eur J Dent Educ, 2021 Aug;25(3):592-599.
PMID: 33222374 DOI: 10.1111/eje.12636

INTRODUCTION: Interprofessional learning (IPL) is the first stage towards the goal of interprofessional collaborative care. To enhance IPL experience, the School of Dentistry, International Medical University developed an IPL model based on the core competencies and the learning outcomes for dental and chiropractic students in their second and fourth year, respectively. The model was based on experiential learning and adult learning theories in addition to Miller's framework for clinical competencies.
METHODS: The programme was developed as a student-centred, collaborative approach to achieve the learning outcomes for dental and chiropractic students. Second-year dental students (n = 46) and chiropractic students (n = 23) in their fourth year participated in the programme. The focus of the programme was to address the prevention of work-related musculoskeletal disorders (WMSDs) amongst dental students and to provide the chiropractic students with the opportunity to assess and identify risk factors for WMSDs in the dental setting. The readiness for interprofessional learning scale (RIPLS) questionnaire was completed prior to the interprofessional education programme and once again afterwards to determine dental and chiropractic students' awareness of roles and responsibilities of the other profession, and their attitudes to interprofessional education and teamwork.
RESULTS: Dental and chiropractic students showed similar levels of readiness for shared learning. The results of this study suggest that the IPL programme contributed to the development of the students' positive perceptions towards the positive professional identity and the roles of other healthcare professionals.
CONCLUSION: This study provides initial support for the integrated interprofessional learning experiences within the school. The results of the study will shape future curricula changes to further strengthen interprofessional education and subsequent interprofessional collaborative care.

Matched MeSH terms: Chiropractic*
Differences of Cutaneous Two-Point Discrimination Thresholds Among Students in Different Years of a Chiropractic Program

Dane AB, Teh E, Reckelhoff KE, Ying PK

J Manipulative Physiol Ther, 2017 09;40(7):511-516.
PMID: 29079256 DOI: 10.1016/j.jmpt.2017.06.011

OBJECTIVES: The aim of this study was to investigate if there were differences in the two-point discrimination (2-PD) of fingers among students at different stages of a chiropractic program.
METHODS: This study measured 2-PD thresholds for the dominant and nondominant index finger and dominant and nondominant forearm in groups of students in a 4-year chiropractic program at the International Medical University in Kuala Lumpur, Malaysia. Measurements were made using digital calipers mounted on a modified weighing scale. Group comparisons were made among students for each year of the program (years 1, 2, 3, and 4). Analysis of the 2-PD threshold for differences among the year groups was performed with analysis of variance.
RESULTS: The mean 2-PD threshold of the index finger was higher in the students who were in the higher year groups. Dominant-hand mean values for year 1 were 2.93 ± 0.04 mm and 1.69 ± 0.02 mm in year 4. There were significant differences at finger sites (P < .05) among all year groups compared with year 1. There were no significant differences measured at the dominant forearm between any year groups (P = .08). The nondominant fingers of the year groups 1, 2, and 4 showed better 2-PD compared with the dominant finger. There was a significant difference (P = .005) between the nondominant (1.93 ± 1.15) and dominant (2.27 ± 1.14) fingers when all groups were combined (n = 104).
CONCLUSIONS: The results of this study demonstrated that the finger 2-PD of the chiropractic students later in the program was more precise than that of students in the earlier program.

Matched MeSH terms: Chiropractic/education*
Fulltext Remission of recalcitrant dermatomyositis following a chiropractic adjustment

Chu ECP, Lo FS, Bhaumik A

J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.

Matched MeSH terms: Chiropractic