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 © 2011 Published by Elsevier Inc. All rights reserved. Clinical Chiropractic1479-2354144December 2011 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.clinchiropractic.com/article/PIIS1479235411001763/abstract?rss=yesEditorial Board10.1016/S1479-2354(11)00176-3Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6iihttp://www.clinchiropractic.com/article/PIIS1479235411001738/abstract?rss=yesThis issue of Clinical Chiropractic concludes a year in which the need to develop an adequate research base to inform the profession's clinical practice has never been more clearly demonstrated.EditorialMartin Young10.1016/j.clch.2011.10.003Clinical Chiropractic 14, 4 (2011)2011-11-07Clinical Chiropractic2011-11-07144S1479-2354(11)X0005-6141141http://www.clinchiropractic.com/article/PIIS1479235411001714/abstract?rss=yesA 27-year-old female patient presented to a chiropractic complaining of neck pain and headaches. She described how her symtpoms appeared to have started 3 years previously when she had a horse-riding accident. The chiropractor decided to perform imaging (). What are your findings, and what is the clinical significance?Post traumatic cervicalgia: Case presentationAntoine Barrier, Michelle A. Wessely10.1016/j.clch.2011.10.001Clinical Chiropractic 14, 4 (2011)2011-10-31Clinical Chiropractic2011-10-31144S1479-2354(11)X0005-6Case Challenge142142http://www.clinchiropractic.com/article/PIIS1479235411001180/abstract?rss=yesIntroduction: Consistent with calls to improve the clinical training of chiropractic students, a program was initiated to provide supervised, pre-participation sports physicals to the student athletes (SAs) of a local high school. In addition, chiropractic interns (CIs) conduct a weekly injury status review and provide athletic training services during games.Preparing for the field: A comprehensive program to train chiropractic students to conduct pre-season sports physicals and manage athletic injuries in high school athletesJonathon Williams, Paul Osterbauer10.1016/j.clch.2011.09.002Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings143144http://www.clinchiropractic.com/article/PIIS1479235411001192/abstract?rss=yesIntroduction: The literature reveals that two treatments have been validated as effective treatment modalities for pediatric AD/HD: psychosocial treatments, pharmacological treatments and their combination. However, controversy exists over the efficacy and safety of pharmacological therapies. As a result of this controversy, parents have been seeking complementary and alternative medicine (CAM) such as chiropractic for their children with AD/HD. The objective of this study was to determine whether the addition of the emotional component of NET therapy to an existing treatment program could improve clinical outcomes (i.e. reduce inattention, hyperactivity and impulsivity) in pediatric AD/HD. The purpose of this study was to test anecdotal claims of treatment success made by chiropractors using NET therapy for pediatric AD/HD.Final data of the effects of the Neuro Emotional Technique (NET) for pediatric Attention-Deficit/Hyperactivity Disorder (AD/HD): A randomized controlled trialFay Karpouzis, Rod Bonello, Henry Pollard10.1016/j.clch.2011.09.003Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings144144http://www.clinchiropractic.com/article/PIIS1479235411001209/abstract?rss=yesObjective: Spinal manipulation (SM) is a commonly used treatment for low back pain (LBP), but results of randomized controlled trials have not been consistent and questions remain about the specific clinical role of SM, especially for possible subgroups of LBP patients. The primary goal of our study was to determine if select patient characteristics were associated with clinical improvement in response to a course of SM.Patient characteristics associated with improvement of subacute and chronic low back pain treated with high velocity low amplitude (HVLA) or low velocity variable amplitude (LVVA) spinal manipulationWilliam C. Meeker, Cynthia R. Long, Maria A. Hondras, Edward F. Owens, M. Ram Gudavalli, James W. DeVocht, David G. Wilder, Robert M. Rowell, Christine M. Goertz10.1016/j.clch.2011.09.004Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings145145http://www.clinchiropractic.com/article/PIIS1479235411001210/abstract?rss=yesIntroduction: In 2007 and 2008, Palmer Chiropractic College received 2 separate four-year developmental center grant awards from the National Center for Complementary and Alternative Medicine, National Institutes of Health, U.S. The goal of the Data Management Core for both of these centers was to enhance our ability to provide project-specific data collection and management services simultaneously for multiple clinical trials conducted both on and off site. This paper describes enhancements made to our existing secure web systems through the development and implementation of innovative web-based tools.Building clinical trial infrastructure through innovative web-based toolsCynthia Long, Lynne Carber, Lance Corber, Katherine Pohlman, Maria Hondras, Robert Vining, Christine Goertz10.1016/j.clch.2011.09.005Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings145146http://www.clinchiropractic.com/article/PIIS1479235411001222/abstract?rss=yesObjective: Some voices within the chiropractic profession have recently advocated that chiropractors would be better served abandoning extremity diagnosis and treatment in exchange for the increased likelihood of an improved level of public and professional acceptance, growth, cultural authority and utilization. It is important for the profession to consider the arguments and the evidence carefully prior to endorsing such a radical departure from historic chiropractic practice. In order to not keep you waiting, and if the title did not give the ending away, we would like to a priori disclose that, on the face of it, it is rather difficult for the authors of this commentary to believe that treating sports injuries and the like have been the fundamental problem with and facing the profession.Whither chiropractic extremity diagnosis and treatment?James Brantingham, Gary Globe, Tammy Kay Cassa, Surasha Khandai, Stever Mayer10.1016/j.clch.2011.09.006Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings146147http://www.clinchiropractic.com/article/PIIS1479235411001234/abstract?rss=yesIntroduction: Diabetes Mellitus (DM) is a syndrome characterized by hyperglycemia resulting from absolute/relative impairment in insulin secretion and/or insulin action. Type II DM (T2DM) usually affects adults >30 years and affects 23.6 million Americans; another 57 million are pre-diabetic. The current standard of care for T2DM includes oral medications, insulin injections, and general lifestyle and nutritional advice. Conditions associated with T2DM include obesity, hypertension, hyperlipidemia, pancreatitis and hypothyroidism. Complications include neuropathy, heart disease, stroke, kidney failure, blindness, and death.Functional medicine and chiropractic: A case series in Type 2 Diabetes Mellitus reversalStephanie Chaney, Tom Chaney, Paul A. Oakley10.1016/j.clch.2011.09.007Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings147148http://www.clinchiropractic.com/article/PIIS1479235411001246/abstract?rss=yesIntroduction: When starting clinical practice, students in the health arena face many difficulties within the scope of patient therapy. Unlike theoretical learning, which is proving increasingly effective in introducing the student to problem-based learning and performing tests in groups, to learn clinical practice requires venturing beyond theoretical knowledge to develop practical skills associated with the psychological factors that influence the student's conduct when attending a patient. This study aimed to verify the causes and the prevalence of difficulties presented by chiropractic students when starting their clinical practice; verify the most used chiropractic technique as well as identify those that are more difficult to implement in the beginning of clinical performance.Difficulties in entering clinical practiceFábio Dal Bello, Luis Costa Cantera10.1016/j.clch.2011.09.008Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings148148http://www.clinchiropractic.com/article/PIIS1479235411001258/abstract?rss=yesIntroduction: Efficacy of chiropractic for the treatment of chronic spinal pain has been studied in populations from high-income countries, but few studies have been made in countries of lower income. Likewise, improvement is usually assessed by measurements pertaining specifically to painful symptoms, but the overall effect of treatment on the quality of life of patients is rarely assessed.Effect of chiropractic treatment and ergonomic orientation on pain grade and quality of life for persons with chronic spinal pain: A randomized controlled trialJidiene D.P. Depintor, Daniel Duenhas, Eduardo S.B. Bracher10.1016/j.clch.2011.09.009Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings149149http://www.clinchiropractic.com/article/PIIS147923541100126X/abstract?rss=yesIntroduction: The flexion-relaxation phenomenon (FRP) is defined by reduced lumbar erector spinae (ES) muscle myoelectric activity during full trunk flexion. Previous investigations have explored the effect of load, angular velocity and muscle fatigue on FRP. Recent research showed that when back and hip extensor muscles are fatigued changes in FRP parameters and lumbo-pelvic motion occur, possibly altering lumbar spine stability. Since it is widely accepted that the abdominal muscles also contribute to lumbar stability, and because many authors have suggested that inadequate trunk muscle endurance could contribute to the development and chonicization of low back pain, the objective of this study was to investigate the impact of abdominal muscle fatigue on trunk neuromuscular and kinematic responses during a flexion-relaxation task.Changes in the flexion-relaxation response induced by abdominal muscle fatigueMartin Descarreaux, Charles Tétreau, Jean-Daniel Dubois, Vincent Cantin10.1016/j.clch.2011.09.010Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings149150http://www.clinchiropractic.com/article/PIIS1479235411001271/abstract?rss=yesBackground: Numerous demographic surveys have described the chiropractor and their practice characteristics. Minimal data exists to describe chiropractic paediatric care. This survey was designed to begin filling this gap.A multinational survey of the demographics of chiropractic paediatric careMatthew Doyle10.1016/j.clch.2011.09.011Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings150151http://www.clinchiropractic.com/article/PIIS1479235411001283/abstract?rss=yesIntroduction: There are both congenital and acquired variations in morphology of the articular surface of the sacral contribution to the sacroiliac joint. The pelvis is subject to loads transmitted primarily through the layer of cortical bone to the sacroiliac joint and the surrounding stabilizing ligament system. These compressive and vertical shearing forces, which place the sacroiliac joint under unequal loads, vary with the angulations of the pelvis. This biomechanical and anatomical study is designed to better understand these forces, by modeling the topography of the articular surface of the sacral contribution of the sacroiliac joint.Preliminary analysis of the sacroiliac joint in the hyperlordotic spine, a finite element modelDennis Enix, Douglas Smith10.1016/j.clch.2011.09.012Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings151152http://www.clinchiropractic.com/article/PIIS1479235411001295/abstract?rss=yesIntroduction: Breathing and posture are intimately linked and are important for players of a wind instruments. The sound produced when air is exhaled is partially obstructed by the instrument nozzle. Peak Expiratory Flow (PEF), a measurement of pulmonary capacity, can be defined as the greatest flow obtained during a forced expiration starting at the full inspiratory volume. It has been demonstrated that reliable measurements of PEF can be taken from a portable expiratory measurement apparatus.Analysis of peak expiratory flow in musicians of a military band before and after spinal manipulative therapyCristiano da Silva Pareja, Murilo Marinho Franco, Ana Paula Albuquerque Facchinato, Eliana Correia dos Santos, Djalma José Fagundes10.1016/j.clch.2011.09.013Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings152152http://www.clinchiropractic.com/article/PIIS1479235411001301/abstract?rss=yesIntroduction: Standardizing manipulative procedures in clinical trials for patients with low back pain (LBP) is important to ensure consistent, reproducible, and measurable treatment delivery which enhances generalizability of results, pedagogical applications, and the conduct of future trials. This paper describes the results from attempts to initiate a standardization process for high-velocity, low-amplitude spinal manipulation (HVLA-SM) preparing for a NIH funded randomized controlled trial (RCT) to evaluate how SM impacts sensorimotor functions in LBP patients.Toward standardizing the delivery of spinal manipulation for patients with low back painChristine Goertz, David Wilder, Cynthia Long, Robert Vining, James DeVocht, Katherine Pohlman, Edward Owens, Maruti Gudavalli10.1016/j.clch.2011.09.014Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings152153http://www.clinchiropractic.com/article/PIIS1479235411001313/abstract?rss=yesBackground: Cryotherapy has long been used by physical therapists and chiropractors in the management of acute pain and more recently it has been shown to effectively manage chronic pain. Multiple studies have demonstrated that both ice and menthol decrease blood flow and help to control pain; however, there is limited research to determine which form of cryotherapy works better on individual patients.Effects of Biofreeze vs. ice on acute, non-complicated neck painBart Bishop, Jay Greenstein, Robert Topp10.1016/j.clch.2011.09.015Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings153154http://www.clinchiropractic.com/article/PIIS1479235411001325/abstract?rss=yesIntroduction: There is increasing evidence that suggests the efficacy of spinal manipulation for the treatment of chronic low back pain (LBP). Yet, there have been no large trials to determine optimal number of treatments with manipulation. Our pilot study suggested greater pain and disability improvement for higher doses of manipulation. The current study is the first full-scale randomized trial to evaluate optimal dose and efficacy of manipulation, while controlling attention bias, patient touch, and expectation associated with quantity of care.Dose–response of spinal manipulation for low back pain: Short-term outcomes from a randomized trialMitchell Haas, Darcy Vavrek, David Peterson, Mikel Aickin10.1016/j.clch.2011.09.016Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings154154http://www.clinchiropractic.com/article/PIIS1479235411001337/abstract?rss=yesIntroduction: Anatomical leg length inequality (LLI) is very common in general practice. In fact, a leg length difference of greater than 5–10mm results in a predictable, full postural compensation pattern. Even small discrepancies are implicated in the pathogenesis of many spinal disorders including back pain.A study of the effects of central ray vertical (y-axis) positioning, pelvis (y-axis) rotation and pelvis (x-axis) translation on measurement of the anatomical short leg from the anteroposterior (AP) Ferguson radiographPaul A. Oakley, Kevin S. Grice, Deed E. Harrison10.1016/j.clch.2011.09.017Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings155155http://www.clinchiropractic.com/article/PIIS1479235411001349/abstract?rss=yesIntroduction: The knee joint is frequently affected by inflammation, which is constantly monitored by the nervous system. Neuronal response of the spinal cord and dorsal root ganglia (DRG) to the knee inflammation, therefore, involves the complex functions of the nervous system that may be studied in a clinically relevant pathological condition. The present study was carried out to investigate the neuronal response to complete Freund's adjuvant (CFA)-induced knee arthritis in a guinea pig model to determine if manual palpation could alter the neuronal response in the spinal cord and DRG.Manual palpation attenuates immunochemical reactivities of pain mediators in the nervous system in response to adjuvant knee arthritis: An animal modelShawn (Xiaohua) He, Veronica Dishman, HanSuk Jung10.1016/j.clch.2011.09.018Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings155156http://www.clinchiropractic.com/article/PIIS1479235411001350/abstract?rss=yesBackground: Falls are the leading cause of injury related hospital admissions and death in the elderly. Every year, approximately one third of community-dwelling older adults experience one or more falls. A number of risk factors have been identified that increase the risk of falling, including increasing age, lower limb disorders and balance disorders amongst others. Manual therapists routinely treat patients with lower limb dysfunction, muscle weakness, neck pain, back pain and other conditions that may affect balance and lead to an increased risk of falling. If manual therapy results in successful treatment of conditions that increase the risk of a fall, then it may be possible that manual therapists can play a positive role in falls prevention programmes.The effects of manual therapy on balance and falls: A systematic reviewKelly Holt, Heidi Haavik, C. Raina Elley10.1016/j.clch.2011.09.019Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings156157http://www.clinchiropractic.com/article/PIIS1479235411001362/abstract?rss=yesIntroduction: Healthcare practitioners have been using muscular strength testing to assess neuromusculoskeletal system integrity since early last century. In the 1970s, another application of manual muscle testing (MMT), called Applied Kinesiology (AK), was developed by Dr. George Goodheart. Its premise is that a muscle will be less able to resist a force when there is aberrant nervous input, and muscles are labeled as either strong or weak accordingly. Since then, other MMT techniques have been developed that assess a patient's response to semantic stimuli. Monti et al. found that, following the speaking of congruent statements, a muscle was able to resist significantly more force compared to after speaking incongruent statements. A congruent statement is defined as one which the speaker believes to be true, whether or not their belief reflects actual reality. It was found that congruent statements usually result in a strong MMTs, while incongruent statements usually result in weak MMTs.The accuracy of kinesiology-style manual muscle testing to distinguish congruent from incongruent statements under varying levels of blinding: Results from a study of diagnostic test accuracyAnne Jensen, Richard Stevens, Timothy Kenealy, Joanna Stewart, Amanda Burls10.1016/j.clch.2011.09.020Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings157158http://www.clinchiropractic.com/article/PIIS1479235411001374/abstract?rss=yesBackground: General flexibility is a key component of health and wellbeing. A lack of flexibility has been associated with an increased risk of developing musculoskeletal injuries and athletic underperformance. The cause of reduced flexibility can be multifactorial, with both physical and mental/emotional etiologies. It has been previously shown that stretching regularly may quickly improve flexibility; however, when it is discontinued, gains are promptly lost. An alternative intervention with greater durability is needed. We hypothesized that Neuro Emotional Technique (NET), a technique previously shown to be effective at reducing stress, may also be effective at improving general flexibility. The aim of this study was to examine the effects of NET, a mind-body technique, on general flexibility.Improving flexibility with a mind-body approach: A randomized controlled trial using neuro emotional techniqueAnne Jensen, Adaikalavan Ramasamy, Katie Marten, Michael Hall10.1016/j.clch.2011.09.021Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings158158http://www.clinchiropractic.com/article/PIIS1479235411001386/abstract?rss=yesIntroduction: Frozen Shoulder Syndrome (FSS) is a condition characterized by a restricted and painful arc of the shoulder that can persist for months to years, and has a high co-morbidity rate with diabetes mellitus, Parkinson disease, hypothyroidism, and stroke. It is speculated that with FSS there is a breakdown of the entire dynamic shoulder complex, but particularly of the scapulothoracic joint mediated by neuropathology of cranial nerve 11 causing malfunction of the trapezius muscle. The purpose of this paper is to describe the outcomes of patients presenting to a private chiropractic practice specializing in the treatment of FSS using the OTZ Tension Adjustment.OTZ Tension Adjustments for Frozen Shoulder Syndrome: A retrospective case series of 50 patientsFrancis Murphy, Michael Hall, Anne Jensen10.1016/j.clch.2011.09.022Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings159159http://www.clinchiropractic.com/article/PIIS1479235411001398/abstract?rss=yesIntroduction: Chiropractic manipulative therapy can be helpful in alleviating some of the pain in knee joint problems; however, studies on the effects of chiropractic manipulative therapy in knee joint problem are rare. Recent interest in nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) and nitric oxide synthase (NOS) has focused on its expression in motor neurons in the central nervous system (CNS) after peripheral nerve injury. The induction and up-regulation of NADPH-d and NOS have been suggested to be related to neuronal degeneration. The aim of the present study was to investigate effects of manipulative therapy in neurochemical changes of NADPH-d and NOS of the spinal motor neurons after right knee joint immobilisation (RKJI) and in ultrastructural changes of femoral nerves innervating the muscles acting on RKJI.Effects of manipulative therapy on the expressions of NADPH-diaphorase and nitric oxide synthase in the spinal motor neurons after right knee joint immobilization in the guinea pigHanSuk Jung, JooHyun Ham, SoonJeong Jeong, JooHan Kang, MinSun Lee10.1016/j.clch.2011.09.023Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings159160http://www.clinchiropractic.com/article/PIIS1479235411001404/abstract?rss=yesBackground: Review of the literature clearly reveals the lack of research investigating the relationship between injury and performance or success in Taekwondo athletes. The available studies looked at performance in one bout or in only one competition. To this date there is no study that investigated the relationship between injury pre-competition and during the competition with success in means of attaining a medal in elite Taekwondo athletes looking at multiple international championships over a 10 year span.Relationships between injury and success in elite Taekwondo athletesMohsen Kazemi10.1016/j.clch.2011.09.024Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings160161http://www.clinchiropractic.com/article/PIIS1479235411001416/abstract?rss=yesBackground: Chronic Low Back Pain (cLBP) costs the United States over $100 billion annually. Primary study objective: This study reports pain intensity, general health and functional disability outcomes after 4 weeks of Directional Non-Force Technique (DNFT) chiropractic care for cLBP patients.Health-related quality of life improvements in adult patients with chronic low back pain under low-force chiropractic care: A practice-based studyKim Khauv, Christopher John10.1016/j.clch.2011.09.025Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings161161http://www.clinchiropractic.com/article/PIIS1479235411001428/abstract?rss=yesObjective: To study chiropractors graduated in Brazil in the role of practice managers. Methods: A standardized questionnaire with 31 multiple-choice questions and one open-end question was created, with a focus on understanding the factors that interfere with the opening of a chiropractic practice and challenges faced by those professionals to keep their practice active, as well as to verify possible factors related to a successful practice. This instrument was formatted to the program Google Docs and sent by electronic mail to the total population of chiropractors graduated from Brazilian university level chiropractic courses (n=341). Further electronic messages and telephone calls were made to ensure the largest response rate possible.A survey on the performance of chiropractors graduated from Brazilian universities in the role of practice managersChoo H. Kim, Márcia Daniela Carniel Almeida, Eduardo Sawaya Botelho Bracher, Ana Paula Albuquerque Facchinato, Djalma José Fagundes10.1016/j.clch.2011.09.026Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings161162http://www.clinchiropractic.com/article/PIIS147923541100143X/abstract?rss=yesIntroduction: Although several studies have demonstrated a reduction of painful symptoms and improved range of motion in patients with neck pain treated with high velocity–low amplitude (HVLA) spinal manipulation, the physiological mechanisms involved in this treatment remain unknown. The painful sensitivity observed in acute or chronic injuries of synovial joints involves the formation of different local proinflammatory agents, including reactive oxygen species. Previous studies by our research group demonstrated an increase in systemic catalase activity after six treatment sessions of HVLA manipulation, suggesting a correlation between the analgesic effects of this treatment and oxidative stress parameters. Catalase is involved in detoxification of hydrogen peroxide, which acts on the signaling pathways responsible for modulating pain sensitivity. Another enzyme with activity similar to catalase is glutathione peroxidase (GPx). The enzyme superoxide dismutase (SOD), also with antioxidant activity, is responsible for converting superoxide to hydrogen peroxide. To investigate the possible involvement of other enzymatic antioxidants in the analgesic effect of HVLA treatment, this study investigated the effects of this treatment on SOD and GPx activities in erythrocytes of men with neck pain.Effect of high velocity–low amplitude treatment on superoxide dismutase and glutathione peroxidase activities in erythrocytes from men with neck painCarolina Kolberg, Andréa Horst, Maira Moraes, Angela Kolberg, Wania Aparecida Partata10.1016/j.clch.2011.09.027Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings162163http://www.clinchiropractic.com/article/PIIS1479235411001441/abstract?rss=yesBackground: Manual palpation of tissue compliance forms the basis for professions who diagnose and treat soft tissue; however, tissue compliance depends not only on elastic properties, but also shape, thickness, and boundary conditions, making direct comparison between subjects and sites difficult. Characterizing non-linear tissue elasticity would overcome this limitation.A mechano-acoustic indentor system for in vivo measurement of non-linear elasticity of soft tissues: Its development, reliability, and applicationTerry Koo, Jeffrey Cohen, Lisa Papenbrock, Yongping Zheng10.1016/j.clch.2011.09.028Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings163163http://www.clinchiropractic.com/article/PIIS1479235411001453/abstract?rss=yesIntroduction: Muscle organs are critical actuators generating tension that may (1) initiate movement, (2) alter multi-joint segment rigidity or (3) attenuate external loads on the body. Pathways of force transmission include myotendinous and epimuscular myofascial networks. Epimuscular pathways are intermuscular, between adjacent muscles, and extramuscular for transmission to nonmuscular structures. Intramuscular transmission may be nonuniform, with motor units and connective tissue components contributing to tension gradients in different proportions when active or stretched. The question is, how significant these mechanical linkages are to health and disease. This study determined whether ultrasound elastography can quantify the relative activity within and between soft tissue structures. Such information is necessary to measure and confirm the relative role of the different tissue strata in transmitting loads during injury, in manual therapy and exercise.Differential tissue strain estimation across strata of tissues under intrinsic motionJohn Triano, Helene Langevin, Elisa Konofagou10.1016/j.clch.2011.09.029Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings164164http://www.clinchiropractic.com/article/PIIS1479235411001465/abstract?rss=yesBackground: The kinematics of the pelvis result from the synergism between the lumbar spine, inominate bones and sacrum. The evaluation of kinematics is of great value for kinetic functional diagnosis made by health professionals. The lumbopelvic kinematics can be determined directly using radiological examination or by indirect methods, which are usually based on kinemetry. Among the indirect methods that use kinemetry, photogrammetry has been often used as a kinetic functional diagnostic tool. This tool can provide information of body segments based on the use of external markers placed on the skin surface.Development of an indirect method for the determination of lumbosacral angle and pelvic tilt by photogrammetryMariana Tonietto Marques, Marcelo La Torre, Jefferson Fagundes Loss, Juliana Collares Vanassi, Felipe Osório Marques, Danilo Messa da Silva10.1016/j.clch.2011.09.030Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings164165http://www.clinchiropractic.com/article/PIIS1479235411001477/abstract?rss=yesObjective: Infant colic or unexplained infant crying is a condition of unknown aetiology affecting approximately 20% of infants. The condition has been found to be highly distressing for both infant and caregivers. Current available evidence has thus far proved inconclusive to support chiropractic manual therapy as efficacious in the treatment of the condition.Reduced crying time for infants with colic presenting for chiropractic treatmentJoyce Miller, Maria Torheim Bjelkarøy, Maria Browning10.1016/j.clch.2011.09.031Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings165166http://www.clinchiropractic.com/article/PIIS1479235411001489/abstract?rss=yesIntroduction: Complementary and alternative medicine (CAM) use, including chiropractic, is increasing in the United States (US). The National Board of Chiropractic Examiners reports care to children increased 7.4% from 2005 to 2010. Both doctors of chiropractic (DCs) and pediatric groups have called for more research on this topic. The aim of this study was to report usage of manipulative therapy (chiropractic/osteopathy) by children in the United States along with the specific health conditions for which they sought care; and examine any potential relationship of usage with various patient/parent-based characteristics.Chiropractic care of children under age 18 in the United States: Patterns of use and recommendations for careHarrison Ndetan, Will Evans, Cheryl Hawk, Ronald Rupert, Clark Walker10.1016/j.clch.2011.09.032Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings166166http://www.clinchiropractic.com/article/PIIS1479235411001490/abstract?rss=yesIntroduction: Vitamin D was originally classified a vitamin when it is actually a hormone. It was originally thought to be related merely to bone health, when in fact its presence is essential for optimal extra-skeletal health including: adrenal gland, hair follicle, pancreatic, respiratory, skin, heart, circulation and immune system health; blood sugar, weight and pain control; sleeping, vision, fertility, hearing, mood, mind, memory, behavior, brain and nervous system development and function; digestion and nutrient absorption; muscle and nerve function; athletic performance; normal blood pressure; healthy aging and longevity. Coincident with the increasing reports of the benefits of vitamin D for skeletal and especially for extra-skeletal health, patients are more apt to inquire about its use for their health needs; therefore, regardless of health benefits, the chiropractor needs to be mindful of considerations surrounding vitamin D use.Vitamin D—The “Sunshine Vitamin”: Should chiropractors recommend its use?Paul A. Oakley10.1016/j.clch.2011.09.033Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings167167http://www.clinchiropractic.com/article/PIIS1479235411001507/abstract?rss=yesIntroduction: The Northwestern Health Sciences University (NWHSU) Summer Science Academy was formed to encourage and motivate minority students to go to college. The academy was based on the premise that if youth are mentored by college-age students, they will be more inclined to go to college. While this was the original intent, it became clear that a second unintended outcome of the academy was that it provided an effective method of introducing students and their families from minority and underserved populations to the Chiropractic, Acupuncture and Oriental Medicine professions.Summer Science Academy—Introducing students from underserved communities to the chiropractic professionTolu Oyelowo, Bill Kuehl10.1016/j.clch.2011.09.034Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings167168http://www.clinchiropractic.com/article/PIIS1479235411001519/abstract?rss=yesIntroduction: Recent evidence suggests that chronic low back pain (LBP) is a complex, multi-factorial phenomenon with physical and biopsychosocial components. Chiropractors have begun to embrace the biopsychosocial concept by incorporating “mind-body” treatments in both assessment and therapy. To date few “mind-body” treatments have been scrutinized under controlled conditions. Neuro-emotional technique (NET) is a new mind-body stress reduction technique that combines traditional desensitization principles with complementary modalities including acupuncture points and muscle testing.A randomized controlled trial of neuro-emotional technique for low back painPeter Bablis, Henry Pollard10.1016/j.clch.2011.09.035Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings168169http://www.clinchiropractic.com/article/PIIS1479235411001520/abstract?rss=yesObjective: Previous studies on the effects of chiropractic treatment on blood pressure (BP) and pulse rate (PR) have reported decreases in both systolic and diastolic BP as well as PR. However, those studies have been criticized as being flawed, and accused of drawing erroneous conclusions, due to small sample size and various methodological concerns. The purpose of this randomized controlled trial (RCT) was to measure the effects of specific thoracic (T5 to T1) chiropractic adjustments on BP and PR in a larger sample size of both normotensive and hypertensive humans.A randomized controlled trial to measure the effects of specific thoracic chiropractic adjustments on blood pressure and pulse rateSteven Roffers, Laura Huber, David Morris, Anquonette Stiles, Derek Barton, Therese House10.1016/j.clch.2011.09.036Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings169170http://www.clinchiropractic.com/article/PIIS1479235411001532/abstract?rss=yesObjective: Several studies have reported the effects of various specific cervical chiropractic adjustments on blood pressure and pulse rate; however, those studies have been criticized due to small sample size and various methodological concerns. The purpose of this randomized controlled trial (RCT) was to measure the effects of specific cervical (C3 to Occiput [C0]) chiropractic adjustments on blood pressure (BP) and pulse rate (PR) in a larger sample size of both normotensive and hypertensive humans.Measuring the effects of specific cervical chiropractic adjustments on blood pressure and pulse rate: A randomized controlled trialSteven Roffers, Anquonette Stiles, Laura Huber, David Morris, Derek Barton, Therese House10.1016/j.clch.2011.09.037Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings170170http://www.clinchiropractic.com/article/PIIS1479235411001544/abstract?rss=yesIntroduction: Fibromyalgia is a chronic condition characterized by diffuse widespread pain with associated symptoms of persistent fatigue and sleep disturbance. Since the original American College of Rheumatology (ACR) diagnostic criteria for fibromyalgia were first published in 1990, American and European guidelines have been developed for the standard medical management of this elusive condition. However, these guidelines only contain modest information about complementary and alternative medical (CAM) treatments, despite the common use of CAM therapies by fibromyalgia patients. The purpose of this study was to systematically review the literature for randomized trials of CAM interventions for fibromyalgia.Complementary and alternative medicine for the treatment of pain in fibromyalgia: A systematic review of the literatureLauren Terhorst, Michael Schneider, Lee Goozdich, Kevin Kim, Carol Stilley10.1016/j.clch.2011.09.038Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings171171http://www.clinchiropractic.com/article/PIIS1479235411001556/abstract?rss=yesIntroduction: The pelvic girdle and lumbar spine receive the weight of the head, upper extremities and trunk and distribute it to the lower extremities (LE). It is possible that a relationship exists between low-back pain (LBP) and modifications of the center of gravity and of load distribution to the LE. It is also hypothesized that chiropractic adjustment (CA) may modify these measurements.Comparison of symmetry and body weight distribution in asymptomatic subjects and subjects with low back pain submitted to chiropractic adjustmentSerena Eluf, Eduardo Bracher, Djalma Fagundes10.1016/j.clch.2011.09.039Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings171172http://www.clinchiropractic.com/article/PIIS1479235411001568/abstract?rss=yesObjective: To establish the correlation between the measured leg length and weight distribution on the right and left lower limbs in patients with low back pain, vertebral disc herniation and asymptomatic volunteers.The role of body symmetry in patients with low back pain, herniated discs and asymptomatic volunteersSerena Eluf, Djalma Fagundes, Ana Paula Facchinato10.1016/j.clch.2011.09.040Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings172173http://www.clinchiropractic.com/article/PIIS147923541100157X/abstract?rss=yesIntroduction: Headache is a common experience in adults. Repeated headaches burden sufferers and negatively impact family life, social activity and work capacity. Worldwide, according to the World Health Organization, migraine alone is 19th among all causes of years lived with disability. Headache is third among reasons for seeking chiropractic care in North America. Treatment modalities typically used by chiropractors to care for headache patients include spinal manipulation, mobilization, device assisted spinal manipulation, education about modifiable lifestyle factors, physical therapy modalities, heat/ice, massage, advanced soft tissue therapies such as trigger point therapy, strengthening and stretching exercises. There is a growing expectation for health professions, including chiropractic, to adopt and use research-based knowledge taking sufficient account of the quality of available research evidence to inform clinical practice. Our purpose is to provide practice recommendations for the chiropractic treatment of headache disorders in adults.Evidence-based guideline for the chiropractic treatment of adults with headacheRick Ruegg, Lynn Shaw, Martin Descarreaux, Karin Sorra, Roland Bryans, Mireille Duranleau, Henri Marcoux, Brock Potter, Robert Watkin, Eleanor White10.1016/j.clch.2011.09.041Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings173174http://www.clinchiropractic.com/article/PIIS1479235411001581/abstract?rss=yesBackground: Previous work has shown changes in somatosensory evoked potentials (SEPs) following cervical spine manipulation and following 20min of motor skills training, particularly in the N30 SEP peak which relates to sensorimotor integration. Furthermore, spinal manipulation delivered to dysfunctional joints prior to motor skill training is known to modulate these changes. The importance of the cerebellum in motor learning and motor skill acquisition is increasingly being recognized. The N18 SEP potential is thought to reflect inhibitory activity at the level of the medulla, most likely in the dorsal column nuclei and/or the accessory inferior olives. The inferior olives are a vital component of the spino-cerebellum pathway. The N24 SEP peak is thought to reflect activity in the pathway connecting the cerebellum and primary somatosensory cortex. This peak is however usually masked as the N24 peak forms part of the N30 SEP complex. The use of a faster rate of nerve stimulation to elicit SEPs can uncouple the N24 from the N30 peak and enable changes in the N24 to be measured.An approach using fast rate stimulation to investigate changes in cerebellar processingHeidi Haavik, Bernadette Murphy10.1016/j.clch.2011.09.042Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings174174http://www.clinchiropractic.com/article/PIIS1479235411001593/abstract?rss=yesIntroduction: The experimental use of animals is extremely important in developing the understanding of phenomena related to immobilization, the generation of pain and hyperalgesia, and the effects of chiropractic techniques.Evaluation of mechanical sensitivity in animal model of hyperalgesic limb pain using the Von Frey method, after lumbar manipulation: Preliminary resultsFabio Stieven, Jaqueline Trierweiler, Douglas Lenz, Gunther Gehlen10.1016/j.clch.2011.09.043Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings174175http://www.clinchiropractic.com/article/PIIS147923541100160X/abstract?rss=yesIntroduction: Studies to clarify the neurophysiologic mechanisms of chiropractic adjustment on pain are extremely important for better understanding this process, because most of the people who seek chiropractic care have some kind of spine pain.Evaluation of mechanical sensitivity in an animal model of immobilization using the Von Frey methodJaqueline Trierweiler, Débora Negrini Göttert, Günther Gehlen10.1016/j.clch.2011.09.044Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings175176http://www.clinchiropractic.com/article/PIIS1479235411001611/abstract?rss=yesIntroduction: There is increasing evidence which suggests the efficacy of spinal manipulation (SMT) for the treatment of chronic low back pain (cLBP) yet there have been no large trials to determine optimal number of treatments with manipulation. Our pilot study suggested greater pain and disability improvement for higher doses of manipulation. The current study is the first full-scale randomized trial to evaluate optimal dose and efficacy of manipulation, while controlling attention bias, patient touch, and expectation associated with quantity of care.Dose–response of spinal manipulation for low back pain: Quality and compliance outcomes from a randomized trialDarcy Vavrek, Mitchell Haas, David Peterson, Mikel Aickin10.1016/j.clch.2011.09.045Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings176177http://www.clinchiropractic.com/article/PIIS1479235411001635/abstract?rss=yesBackground: No clinical trial of spinal manipulation for chronic neck pain, either of a single or multiple intervention session(s), has employed a sham-manipulation control group.Validation of a novel sham cervical manipulation procedureHoward Vernon, John Triano, Kim Ross, David Soave, Steve Tran10.1016/j.clch.2011.09.047Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings177177http://www.clinchiropractic.com/article/PIIS1479235411001647/abstract?rss=yesIntroduction: The Family Health Program (FHP), part of the Brazilian Healthcare System, provides primary care for 27.324 families of the Brazilian population. Chiropractic care is offered at a health unit from the FHP in Sao Paulo city. No previous studies have investigated the profile of the population treated with chiropractic at the FHP.Study of patient population treated at a chiropractic clinic at a Brazilian Family Health ProgramVerônica Nepomuceno Kreidel, Jidiene D.P. Depintor, Ramiro Becker Pellegrini, Eduardo S.B. Bracher10.1016/j.clch.2011.09.048Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings178178http://www.clinchiropractic.com/article/PIIS1479235411001659/abstract?rss=yesPurpose: The purpose of this study was to investigate the relationship of sacroiliac joint dysfunction (SIJD) and additional somatic areas of neuromuscular compensatory postural stresses changes. Furthermore, this study investigate whole body compensation to the sacroiliac syndrome (SIS).A clinical trial to investigate whole body compensation due to sacroiliac joint dysfunctionMary Unger-Boyd, Nelson DeCamp, Stephane Provencher10.1016/j.clch.2011.09.049Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings178179http://www.clinchiropractic.com/article/PIIS1479235411001660/abstract?rss=yesBackground: Healthcare-related transmission of infectious diseases is a serious cause of concern for public health agencies. Bacterial contaminants on chiropractic treatment tables as well as attitudes and behaviors of chiropractic students have been investigated with respect to disinfection in the college environment in the Unites States; however, no such studies have addressed the attitudes and disinfection practices of chiropractors in the field nor have there been studies examining the bacterial load on treatment tables in the field. We undertook to determine the knowledge, frequency, and uniformity of usage of disinfectants among interns and clinicians at the Canadian Memorial Chiropractic College as well as a cohort of practicing chiropractors in Southern Alberta, Canada. In addition, the bacterial contaminants present on treatment tables in private chiropractic clinics, and the effectiveness of the paper barrier in preventing bacterial deposition were investigated.Disinfectant usage in chiropractic practice: From school to private clinic settingH. Stephen Injeyan, Aaron A. Puhl, Christine J. Reinhart, Nathan J. Puhl, L. Brent Selinger10.1016/j.clch.2011.09.050Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings179180http://www.clinchiropractic.com/article/PIIS1479235411001672/abstract?rss=yesBackground: The Objective Structured Clinical Examination (OSCE) has become a standard for performance-based assessment in many health professions. Originally developed for assessment in medical schools, the OSCE has been widely adapted for teaching, assessment, and certification purposes in most health professions. An OSCE usually comprises a circuit of short stations. At each station there is an examiner to evaluate the student and one standardized patient. Candidates rotate through all the stations, completing the whole circuit. In this way, all candidates take the same stations. The OSCE is designed to test the clinical performance, skills and competencies of students in clinical practice. It is considered to be an improvement over traditional examination methods because the stations can be standardized enabling fairer peer comparison and complex procedures can be assessed without endangering patients health. The Chiropractic Graduation in Brazil is a four years and six months course with a 5000h curriculum, of which 1000h is an internship. The University Anhembi Morumbi (SÃo Paulo Brazil), beginning in 2004, performs a test which follows the principles and logistics of OSCE before the students start the internship. After six months of clinical practice, the OSCE is applied again in order to check the progress of the student.The Objective Structured Clinical Examination applied to chiropractic students before the internship and after six months of professional practiceAna Paula Albuquerque Facchinato, Camila Carvalho Benedicto, Ana Paula Quilici, Dayane Maia Costa Cabral, Leandro Giavarotti10.1016/j.clch.2011.09.051Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6Proceedings180181http://www.clinchiropractic.com/article/PIIS1479235411001726/abstract?rss=yesA 27-year-old female patient presented to a chiropractic complaining of neck pain and headaches. She described how the symptoms appeared to have started 3 years previously when she had a horse-riding accident. The chiropractor decided to perform imaging (). On further questioning, the patient reported being hospitalized after the trauma and MR imaging (which was not available) had demonstrated spinal cord oedema.Post traumatic cervicalgia: Case discussionAntoine Barrier, Michelle A. Wessely10.1016/j.clch.2011.10.002Clinical Chiropractic 14, 4 (2011)2011-10-31Clinical Chiropractic2011-10-31144S1479-2354(11)X0005-6Case Challenge182185http://www.clinchiropractic.com/article/PIIS1479235411001891/abstract?rss=yesContents of Volume 1410.1016/S1479-2354(11)00189-1Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6186189http://www.clinchiropractic.com/article/PIIS1479235411001908/abstract?rss=yesAuthor Index to Volume 1410.1016/S1479-2354(11)00190-8Clinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6190191http://www.clinchiropractic.com/article/PIIS147923541100191X/abstract?rss=yesKeyword Index to Volume10.1016/S1479-2354(11)00191-XClinical Chiropractic 14, 4 (2011)2011-12-01Clinical Chiropractic2011-12-01144S1479-2354(11)X0005-6192192