Clinical Chiropractic RSS feed: Current Issue. As an international, peer reviewed journal, Clinical Chiropractic aims to enhance the standards and quality of the practice of chiropractic by providing authoritative information of use to the clinical chiropractor in development of their professional career; clinical skills and performance; and ability to deliver optimal patient care. It further seeks to improve the level of knowledge about chiropractic and ensure its widest dissemination. The journal utilises the double-blind peer review process. The Editor welcomes the following types of article for publication, provided they are deemed to be of relevance, benefit or interest to the clinically practicing chiropractor: • Best Evidence Topics • Book Reviews • Case Challenge • Case Reports • Case Reviews • Clinical Audits • Clinical Procedures • Commentaries • Conferences - reports and abstracts • Editorials • Indices of academic works produced by associations or academic institutions • Letters to the Editor • Literature Reviews • Original Articles • Preliminary Studies • Resource Documents • Special Reports • Technical Reports http://www.clinchiropractic.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Clinical Chiropractic1479-2354151March 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.clinchiropractic.com/article/PIIS1479235412000119/abstract?rss=yesEditorial Board10.1016/S1479-2354(12)00011-9Clinical Chiropractic 15, 1 (2012)2012-03-01Clinical Chiropractic2012-03-01151S1479-2354(12)X0002-6iihttp://www.clinchiropractic.com/article/PIIS1479235412000028/abstract?rss=yesIn August 2011, a patient (themselves a chiropractor) dove into a pool at the deep end and hit the slope of the bottom of the pool. The wrist was in hyperextension resulting in a right triquetral fracture. The wrist was braced for 4 weeks. The patient underwent rehabilitation with good results before beginning to participate in sport. The patient had pain performing push-ups and yoga when using the hands for a long time. The patient worked through the pain for a few weeks thinking the wrist was still healing but finally had to stop due to the persistent pain. The patient is concerned that the wrist is not healing correctly. Imaging was performed (a–c).Wrist trauma in a pool: Case presentationKevin Mernissi, Xavier de Wailly, Antoine Barrier, Tim Mick, Michelle A. Wessely10.1016/j.clch.2012.01.001Clinical Chiropractic 15, 1 (2012)2012-02-20Clinical Chiropractic2012-02-20151S1479-2354(12)X0002-6Case Challenge12http://www.clinchiropractic.com/article/PIIS1479235411001921/abstract?rss=yesDobson and colleagues are to be commended for their summary evaluation of the evidence for the chiropractic care of patients with infantile colic. We concur with the authors that indeed, with new research and further consideration of the existing literature, Bronfort and colleagues must re-evaluate their evaluation of the literature on this subject. Bronfort and colleagues concluded that there is, “Moderate quality evidence that spinal manipulation is no more effective than sham spinal manipulation for the treatment of infantile colic.” We respectfully disagree with Bronfort and colleagues given that no study on chiropractic and infantile colic has ever evaluated active chiropractic spinal manipulation versus sham spinal manipulation. Some may argue that the study by Olafsdottir and colleagues compared active SMT versus sham SMT; this, however, could not be further from the truth. A sham treatment group and no-treatment group differ in their intent and purpose in a clinical trial and have large ethical implications/ramifications in terms of informed consent. A no-treatment control group accounts for “spontaneous recovery” and the effects of time, the effects of repeated testing, and regression to the mean. In a no-treatment group, there is no attempt at placebo and therefore cannot account for expectancy effects. From an ethical perspective, a no treatment control group is defensible given that no “gold standard” exists for the treatment of infantile colic. It is also from an ethical perspective that a sham treatment is differentiated from no treatment. In keeping with informed consent, all study subjects must be completely informed of the possible treatments they may or may not receive (i.e., active treatment versus sham treatment versus no treatment) prior to participating in a clinical trial. Consequently, in studies involving no treatment as a possibility, lower consent rates and/or higher drop-out rates have been observed. More importantly, failure to maintain inform consent is a violation of ethical principles and guidelines for the protection of human subjects of research.What is the evidence for chiropractic management of infantile colic? Further considerationsJoel Alcantara, Joey D. Alcantara, Junjoe Alcantara10.1016/j.clch.2011.10.004Clinical Chiropractic 15, 1 (2012)2012-02-10Clinical Chiropractic2012-02-10151S1479-2354(12)X0002-6Correspondence34http://www.clinchiropractic.com/article/PIIS1479235412000089/abstract?rss=yesSummary: Background: To describe the chiropractic management of a patient with Scheuermann's kyphosis.Case presentation: An 18-year-old male sought care for thoracic spine pain of over 6weeks’ duration. Thoracic flexion and lumbar spine flexion/extension were decreased. Digital postural analysis showed postural kyphosis, anterior head carriage, shoulder protraction and posterior translation of the thorax relative to the pelvis. Radiographs demonstrated multiple spinal levels with endplate irregularities, suggestive of Schmorl's nodes primarily involving the thoracic spine with associated reduced anterior vertebral body heights. Thoracic kyphosis measured 90° from T1 to T11, with a left thoracic list and right rotation with right lateral lumbar curvature.Conclusions: An 18-year-old man with Scheuermann's kyphosis was successfully managed using a combination of chiropractic adjustments and postural exercises. This suggests a role for chiropractic care for Scheuermann's kyphosis. Further research is necessary to examine this in more detail.Chiropractic management of a patient with Scheuermann's kyphosisJames C. Boysen, Steven L. Silverman10.1016/j.clch.2012.01.005Clinical Chiropractic 15, 1 (2012)2012-02-27Clinical Chiropractic2012-02-27151S1479-2354(12)X0002-6Case Reports59http://www.clinchiropractic.com/article/PIIS1479235412000077/abstract?rss=yesSummary: In this report we present the case of a 25-year-old man with an insidious onset of wrist pain. The pain was constant and appeared to be work related where, as a packaging operator, the patient's wrist was exposed to repetitive trauma. Imaging studies revealed an avascular necrosis (AVN) of the capitate bone. The avascular necrosis (AVN) of the capitate is a rare finding with less than 20 cases having been reported in the literature thus far. There may be a multitude of causes for the development of this condition; however, minor repetitive trauma appears to be one of the most common reasons for the development of AVN.Insidious onset of wrist pain in a young male: Case report and a brief review of the literatureNewsha Azizi10.1016/j.clch.2012.01.004Clinical Chiropractic 15, 1 (2012)2012-02-29Clinical Chiropractic2012-02-29151S1479-2354(12)X0002-6Case Reports1014http://www.clinchiropractic.com/article/PIIS1479235412000053/abstract?rss=yesSummary: Acute traumatic injuries to the cervical spine are common consequences of motor vehicle accidents. Typically, routine radiographs are the first imaging approach to these injuries; however with the use of computed tomography and magnetic resonance scans, it can be appreciated how radiographs can miss important fractures. The aim of this article is to report a case study of a missed diagnosis of a fracture-subluxation of the lower cervical spine and present a literature review.What is the sensitivity and specificity of plain lateral radiographs in patients with acute trauma to the cervical spine? A case reportMatilde A. Bianchi10.1016/j.clch.2011.12.002Clinical Chiropractic 15, 1 (2012)2012-02-27Clinical Chiropractic2012-02-27151S1479-2354(12)X0002-6Case Reports1522http://www.clinchiropractic.com/article/PIIS1479235412000065/abstract?rss=yesSummary: Introduction: Estimates place some 300 million people worldwide suffer from asthma with 180,000 deaths attributed to the disease. The financial burden from Asthma in Western countries ranges from $300 to $1,300 per patient per year. In the United States, asthma medication costs between $1 billion and $6.2 billion per annum. With an increasing prevalence of 50% every decade, there is no question that the burden of asthma is tremendous. The prevalence of complementary and alternative medicine (CAM) use amongst adult asthmatics ranges from 4% to 79% whilst, in children, it ranges from 33% to 89%. Of the various practitioner-based CAM therapies, chiropractic stands as the most popular for both children and adults. As with other chiropractors, the authors aspire to the principles of evidence-based practice in the care of asthma sufferers. Recent systematic reviews of the literature places into question the effectiveness of chiropractic. To assuage the discord between our clinical experience and those of our patients with the dissonant literature, we performed a systematic review of the literature on the chiropractic care of patients with asthma.Methods: Our systematic review utilized the following databases for the years indicated: MANTIS [1965–2010]; Pubmed [1966–2010]; ICL [1984–2010]; EMBASE [1974–2010], AMED [1967–2010], CINAHL [1964–2010], Index to Chiropractic Literature [1984–2010], Alt-Health Watch [1965–2010] and PsychINFO [1965–2010]. Inclusion criteria for manuscript review were manuscripts of primary investigation/report published in peer-reviewed journals in the English language involving the care of asthmatic patients.Results: The studies found span of research designs from non-experimental to true experimental studies consisting of 3 randomized controlled clinical trials (RCTs), 10 case reports, 3 case series, 7 cohort studies, 3 survey studies, 5 commentaries8 and 6 systematic reviews. The lower level design studies provide some measure of evidence on the effectiveness of chiropractic care for patients with asthma while a critical appraisal of 3 RCTs revealed questionable validity of the sham SMTs involved and hence the conclusions and interpretations derived from them. The RCTs on chiropractic and asthma are arguably comparison trials rather than controlled clinical trials per se.Conclusion: Chiropractic may offer an alternative care approach for asthmatic patients. Future investigations of this conservative care approach for patients with asthma should pave the way for higher-level design studies such as randomized controlled clinical trials.The chiropractic care of patients with asthma: a systematic review of the literature to inform clinical practiceJoel Alcantara, Joey D. Alcantara, Junjoe Alcantara10.1016/j.clch.2012.01.003Clinical Chiropractic 15, 1 (2012)2012-02-27Clinical Chiropractic2012-02-27151S1479-2354(12)X0002-6Literature Reviews2330http://www.clinchiropractic.com/article/PIIS1479235411001167/abstract?rss=yesSummary: Paratonia and gegenhalten – the involuntary resistance to passive movement – are terms used in the field of neurology to describe a form of hypertonia often associated with dementia. It is however also found to be present in children suffering from developmental delay where it may be accompanied by signs of dyspraxia and learning disabilities. Its presence may cause an elderly patient to appear to be being deliberately difficult and the child to be misbehaving.Objective: To bring an awareness of how common paratonia/gegenhalten are in a general patient population.Method: An overview of the literature retrieved from searches of computerised databases, the world-wide web and authoritative texts.Discussion: As paratonia in children and gegenhalten in the elderly population occur at significantly high rates, as has been found with many of the primitive reflexes, it is suggested that their retention and reappearance may be associated with the postnatal development of the brain and its demise associated with ageing.Conclusion: With such a high percentage of both the juvenile and elderly population manifesting signs of resisted movement it is considered essential that practitioners dealing with either of these groups have a good working knowledge of this common neurological sign.Paratonia and gegenhalten in childhood and senescenceRobin Pauc, Antoinette Young10.1016/j.clch.2011.08.001Clinical Chiropractic 15, 1 (2012)2011-10-14Clinical Chiropractic2011-10-14151S1479-2354(12)X0002-6Literature Reviews3134http://www.clinchiropractic.com/article/PIIS147923541200003X/abstract?rss=yesIn August 2011, a patient themselves a (chiropractor) dove into a pool at the deep end and hit the slope of the bottom of the pool. The wrist was in hyperextension resulting in a right triquetral fracture. The wrist was braced for 4 weeks. The patient underwent rehabilitation with good results before beginning to participate in sport. The patient had pain performing push-ups and yoga when using the hands for a long time. The patient worked through the pain for a few weeks thinking the wrist was still healing but finally had to stop due to the persistent pain. The patient is concerned that the wrist is not healing correctly. Imaging was performed (a–c).Wrist trauma in a pool: Case discussionKevin Mernissi, Xavier de Wailly, Antoine Barrier, Tim Mick, Michelle A. Wessely10.1016/j.clch.2012.01.002Clinical Chiropractic 15, 1 (2012)2012-02-20Clinical Chiropractic2012-02-20151S1479-2354(12)X0002-6Case Challenge3538http://www.clinchiropractic.com/article/PIIS1479235412000041/abstract?rss=yes This practical guide on pain management is intended to provide readers with an overview of pain mechanisms, tools for the assessment of pain and approaches to multi-disciplinary management. Though the book lacks a preface or introduction, it is clear the book is intended for all physicians involved in the management of pain. The co-editors and contributing authors range from physicians and psychologists to pharmacists and nurses, each providing their expertise on the management of pain.Ismat Kanga10.1016/j.clch.2011.12.001Clinical Chiropractic 15, 1 (2012)2012-02-20Clinical Chiropractic2012-02-20151S1479-2354(12)X0002-6Book Review3940http://www.clinchiropractic.com/article/PIIS1479235412000259/abstract?rss=yesEditorial Board10.1016/S1479-2354(12)00025-9Clinical Chiropractic 15, 1 (2012)2012-03-01Clinical Chiropractic2012-03-01151S1479-2354(12)X0002-6II