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At least 307 records · Page 17Linked to original sources
PubMed1986

The management of hypertensive disease: a review of spinal manipulation and the efficacy of conservative therapeusis.

When considering the ailments that plague mankind, certainly one of the enigmatic conditions is hypertensive disease. This perplexing disorder is recognized insidiously in the clinical setting. It is believed to occur because of the complex interactions of a variety of factors which act on the components of the blood vasculature. Although afflicted individuals may appear relatively asymptomatic, the additive influences of such factors eventually culminate in deleterious sequelae. Overall, hypertension appears to be related to stress, diet and lifestyle. The autonomic nervous system, particularly its sympathetic component, appears to mediate such accumulated factors, affecting the overall clinical scenario of hypertension. Although generally aligned with the aging process, this condition also may affect younger individuals. Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regimens, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice.

Chiropractic↗
PubMed1997

Loads transmitted during lumbosacral spinal manipulative therapy.

STUDY DESIGN: An in vivo biomechanical study of three separate manipulation procedures administered in random order. A biomechanical computer model estimated the loads passing through the spine at the level of interest. OBJECTIVES: The difference in loading effects from manipulation were contrasted for all six degrees of freedom based on treatment method. Quantitative information was compared with loads predicted by existing biomechanical models for work tasks in materials handling jobs. SUMMARY OF BACKGROUND DATA: Benefits to patients with low back pain from manipulation have been reported. Little is known about the biomechanics for any of the several types of procedures available or about how the loads that are applied affect the spine. Studies of isolated forces applied during high-velocity and low-amplitude procedures in constrained conditions have been made. Values have ranged from 20 N to 550 N at rates up to 7101 N/sec. Vertebral motions arising from these forces have been estimated to be up to 0.1 cm and 1.8 degrees. Complex loads that pass from common lumbar procedures through the spine have not been studied. METHODS: A total of 54 samples from procedures were administered in random order to 11 volunteers. The amplitude of loads was controlled, by intent of the procedure, to be as large as deemed clinically safe. Volunteers were positioned on a specially constructed treatment table capable of sensing forces and moments about three axes. Myoelectric measures of trunk muscles were obtained by surface electrode recordings. Measurements served as input to a biomechanical model that estimated the loads passing through the spine during the procedures. Statistical descriptions of the procedures and their component loads were constructed, and comparisons were made based on the high-velocity and low-amplitude procedure applied and variation in the volunteer's initial posture. Values were contrasted with spinal loads during materials handling activities. RESULTS: Validity and fidelity of the table reaction loads were confirmed. Muscular response during the procedures was negligible and did not enter into the estimates of loads transmitted through the spine. Statistical significance (0.000 < P < 0.180) was found for comparisons of transmitted load components based on high-velocity and low-amplitude procedures and initial posture. Effects on the spine were comparable with those encountered by airline baggage handlers, with 92% of men and 83% of women estimated to be of sufficient strength to sustain them. None of the volunteers experienced any discomfort or complications as a result of the tests. CONCLUSION: The data reported here support the hypothesis that transmitted loads may be influenced by patient posture and the procedure selected. These loads, however, were more complex than clinically assumed. Estimates of the loads transmitted were consistent with those observed in common tasks requiring lifting and twisting movements.

Adult↗
PubMed1992

Compression fractures in patients undergoing spinal manipulative therapy.

Increasing numbers of elderly patients are currently seeking chiropractic care. One condition commonly seen in the elderly is osteoporosis of the spine, which carries with it the risk of compression fractures. We present four cases in which patients were noted to have compression fractures following chiropractic adjustments. In each of these cases, serious questions are raised concerning the relationship between the adjustment and the occurrence of fracture. What is clear is that failure to diagnose a compression fracture, together with the application of adjustment into the area of fracture, can increase symptoms and prolong disability. It is recommended that patients with osteoporosis who have suffered a fall or injury be X rayed before treatment is given. In addition, special care should be exercised in elderly patients with osteoporosis.

Accidental Falls↗
PubMedDate not supplied

Three-dimensionality of direct contact forces in chiropractic spinal manipulative therapy.

OBJECTIVE: To perform three-dimensional (3-D) manual contact force measurements of chiropractic adjustments at the patient-chiropractor interface. METHODS: A new hand/palm-held computerized 3-D force measuring system was used to collect 3-D force data at the doctor-patient interface (direct measurement) during cervical, thoracic, and sacroiliac adjustments by 2 chiropractors on 10 healthy subjects. RESULTS: 3-D components of force were significantly greater than matching 1-dimensional (1-D) perpendicular force components, which have been the standard in direct measurement up until now. As well, 3-D components of force were significantly different between adjustment levels, suggesting different dynamics (kinetics) of adjustment techniques. Force magnitudes and statistically significant differences between loading rates and adjustment levels fit in the existing body of knowledge of chiropractic adjustment forces. CONCLUSION: To our knowledge, this is the first study which presents 3-D force-time histories of chiropractic adjustments recorded at the doctor-subject interface. Direct 3-D contact force data seem to have the potential to contribute to chiropractic research because of a more complete description of this biomechanical aspect of daily practice. Results can be used to study novice and experienced chiropractors' techniques and permit the development of training and evaluation protocols in teaching institutions.

Adult↗
PubMedDate not supplied

The centralization phenomenon in chiropractic spinal manipulation of discogenic low back pain and sciatica.

OBJECTIVE: To describe 3 cases of discogenic low back pain and leg pain in which the centralization phenomenon was used in determining chiropractic treatment and prognosis. CLINICAL FEATURES: Three men with low back pain and sciatica, positive straight leg raise, mild neurologic deficits, and evidence of discogenic disease requested chiropractic treatment. Two of the patients exhibited centralization of pain on provocation testing; the third did not. INTERVENTION AND OUTCOME: All patients were treated with chiropractic side-posture manipulation, ancillary therapies, and pain medications. The 2 subjects whose pain centralized had excellent outcomes to treatment. The one whose pain did not centralize had a poor outcome and eventually required surgery. CONCLUSION: Assessment of the centralization phenomenon provided valuable diagnostic and prognostic information regarding chiropractic side-posture manipulation in this case series.

Adult↗
PubMed1994

Spinal manipulation.

Explore the source record for details and available documents.

Biomechanical Phenomena↗
PubMed1994

A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain.

STUDY DESIGN: A randomized prospective trial of manipulation, massage, corset and transcutaneous muscle stimulation (TMS) was conducted in patients with subacute low back pain. OBJECTIVES: The authors determined the relative efficacy of chiropractic treatment to massage, corset, and TMS. SUMMARY OF BACKGROUND DATA: Although all of these treatments are used for subacute low back pain treatment, there have been few comparative trials using objective outcome criteria. Patients were enrolled for a period of 3 weeks. They were evaluated once a week by questionnaires, visual analog scale, range of motion, maximum voluntary extension effort, straight leg raising and Biering-Sorensen fatigue test. The dropout rate was highest in the muscle stimulation and corset groups and lowest in the manipulation group. Rates of full compliance did not differ significantly across treatments. A measure of patient confidence was greatest in the manipulation group. RESULTS: After 3 weeks, the manipulation group scored the greatest improvements in flexion and pain while the massage group had the best extension effort and fatigue time, and the muscle stimulation group the best extension. CONCLUSION: None of the changes in physical outcome measures (range of motion, fatigue, strength or pain) were significantly different between any of the groups.

Adult↗
PubMed1995

Exercise and spinal manipulation in the treatment of low back pain.

Current research clearly indicates the importance of exercise and mobility in the treatment of low back pain and also that bed rest and inactivity should play a relatively small part in treatment. The use of intensive, physical exercise and "work hardening" routines have been shown to be necessary for treating chronic low back pain and returning individuals to work. Evidence derived from valid clinical studies of the use of manipulation in the treatment of low back pain shows a role for it in the acute treatment of "mechanical" low back disorders. These studies have demonstrated that manipulative procedures result in more rapid pain and functional relief compared with other conservative therapies. Over a longer time frame, this advantage disappears.

Biomechanical Phenomena↗