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Auswahl der wissenschaftlichen Literatur zum Thema „Outcome assessment chiropractic“
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Zeitschriftenartikel zum Thema "Outcome assessment chiropractic"
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Hunnisett, Adrian G. W., und Christina Cunliffe. „A comparison of the academic outcome of chiropractic students on full-time and full-time equivalent chiropractic education routes“. Journal of Chiropractic Education 34, Nr. 2 (08.08.2019): 140–46. http://dx.doi.org/10.7899/jce-18-4.
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Objective To compare the academic equivalence of full-time (FT) and full-time equivalent (FTE) delivery routes for chiropractic training and to assess nontraditional education delivery as a viable method for training chiropractors. Methods A retrospective analysis of student summative assessment data was undertaken on a total of 196 FT and FTE students studying for the master's in chiropractic degree at a UK chiropractic college between 2009 and graduating by 2017. The analysis consisted of within-group comparison and between-group comparisons using the Kruskal-Wallis test and the Mann-Whitney U test. Results The demographics of the 2 student groups varied in terms of gender and age distribution. The analysis of summative data indicated no differences between the 2 routes of delivery. There was also no difference in the distribution of final degree classification outcome between the 2 routes. Conclusions While it is possible that demographic differences influence the outcomes in each training route, this preliminary study indicates that, based only on analysis of overall achievement, there is no difference in either FT or FTE programs in training chiropractors, allowing them to register with the UK regulatory body. It suggests that a nontraditional mode of delivery is an achievable route to qualification as a chiropractor, enabling a greater number of students to consider chiropractic as a career choice while managing other life commitments.
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Rogers, Casey, Madeleine Hackney, Lisa Zubkoff und Katharina Echt. „ACTIVITY GOAL SETTING ON CHRONIC LOWER BACK PAIN FOR OLDER VETERANS RECEIVING CHIROPRACTIC CARE“. Innovation in Aging 6, Supplement_1 (01.11.2022): 797–98. http://dx.doi.org/10.1093/geroni/igac059.2878.
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Abstract There is currently no literature addressing the impact that chiropractic services have on older adults achieving individualized specific goals throughout a course of care for chronic low back pain. This study aims to explore the impact of setting a self-determined, “what matters most” activity/goal of rehabilitation care with relevant activities as part of standard chiropractic care on the self-rated pain and disability of older Veterans. Participants were randomized into two groups. The first, an experimental group where participants identified a goal and received standard chiropractic care. The second, a control group that received standard chiropractic care only. Participants underwent six sessions of care. Outcome assessment tools were utilized at pre- and post-treatment for both groups as primary measures and an individualized goal setting measurement tool was utilized for those randomized to the experimental group. After treatment, all participants had self-reported improvement in their condition and all participants assigned to a “goal setting group” achieved their desired goal. Despite some outcome measures remaining unchanged, this self-reported improvement may be important in the future of chiropractic services for the older Veteran population suffering with chronic low back pain in achieving self-determined goals of importance.
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Derby, Dustin C., Robert E. Percuoco und Amy Everetts. „Scarlet letters: The association of alternative admissions track plan status with key programmatic outcomes in a chiropractic training program“. Journal of Chiropractic Education 34, Nr. 1 (01.03.2020): 8–14. http://dx.doi.org/10.7899/jce-19-6.
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Objective: In 2012, the Council on Chiropractic Education (CCE) enacted new admission standards with related provisions under a new Policy 7, the Alternative Admissions Track Plan (AATP). The current study examined the relationships between typically admitted students and their AATP counterparts on three student success outcome measures: Graduation at the 150th percentile time frame, National Board of Chiropractic Examiners (NBCE) Part I pass rates, and completion of all four NBCE examinations within 6-months after graduation. Methods: The authors used three random samples (n = 1050) drawn from a relational database, containing program outcome variables and student characteristics. Assessment of the outcome measures occurred using Pearson χ2 test of independence and the Φ coefficient effect size measure. Results: Significant relationships with small effect sizes and weak associations were found between AATP status and graduation at the 150th percentile (p < .01, Φ = .118) and NBCE Part I pass rates (p < .01, Φ = .114). No significant association between AATP status and NBCE Completion rates 6-months after graduation (p = .144, Φ = .045) was found. Conclusion: The weak associations between variables indicate that AATP status did not meaningfully relate to the outcome variables. There likely are other subtle characteristics and attributes that influence successful completion of key programmatic outcomes. The weak associations found in the current study suggest that when governed under the same academic policies with equal access to support resources, there does not appear to be a meaningful association between the programmatic success of AATP and non-AATP students on key outcomes.
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Lady, Suzanne D., und Leslie A. K. Takaki. „Development of a clinical skills remediation program for chiropractic students at a university“. Journal of Chiropractic Education 32, Nr. 2 (25.07.2018): 152–58. http://dx.doi.org/10.7899/jce-17-23.
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Objective: An important goal of chiropractic educational institutions is to ensure that all graduates reach an acceptable level of clinical competency and thus institutions are equipped to offer traceable remediation when skills fall below certain benchmarks. Methods: Working with key individuals in the faculty, administration, and assessment department, a process of remediation was created and materials were produced that could be used by faculty and assessment staff to focus on a student's lack of knowledge, technique, or documentation in specific clinical skill areas. The primary goal was to create an individualized remediation plan that suits the specific needs of the student. Results: Utilization of the remediation center continues to increase. Referrals to the center for fiscal years 2015, 2016, and 2017 were 60, 125, and 126 students, respectively. Retesting rates after remediation continue to be high, with 98.3%, 95.2%, and 95.8% for fiscal years 2015, 2016, and 2017, respectively. Conclusion: We developed and implemented a chiropractic remediation program to satisfy the need for objectively identifying and remediating clinical skill deficiencies. This remediation program experienced an increase in use in its initial 3 years of operation, indicating more inclusion of the program across the departments, clinics, and assessment. The outcome of remediation is still not clear because there are no consistent assessment measures in place to determine pre- and postremediation student performance.
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Hecimovich, Mark D., Jo-Anne Maire und Barrett Losco. „Effect of Clinician Feedback Versus Video Self-Assessment in 5th-Year Chiropractic Students on an End-of-Year Communication Skills Examination“. Journal of Chiropractic Education 24, Nr. 2 (01.10.2010): 165–74. http://dx.doi.org/10.7899/1042-5055-24.2.165.
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Purpose: To compare the effect of two learning opportunities, clinician feedback and video self-assessment, on 5th-year chiropractic students' patient communication skills, specifically those required for history taking. Methods: A cohort of 51 final-year students was divided into two groups. The first group received immediate feedback from a clinical supervisor following a history-taking encounter with a patient. The second group performed self-assessments of their videotaped history-taking encounter. An end-of-year Viva Voce examination was used to measure the effectiveness of the students' history-taking skills, using two subscores, one for behavior and another for content, as well as an overall total score. An unpaired t-test was performed to determine whether any significant difference occurred between the two groups of students. Each group was then subdivided into two subgroups based on gender, and a two-way analysis of variance was performed to determine whether the type of feedback or the students' gender had any significant effect on the outcome of the Viva Voce. Results: There were no significant differences between the two groups of students in terms of their final scores in the Viva Voce. After dividing each group into their gender subgroups and further analysis of the results, neither the mode of feedback nor the students' gender had any significant effect on the outcome of the Viva Voce. Conclusion: This study suggests that, for a mixed cohort, video self-assessment and clinician feedback are equivalent in their ability to enhance students' communication skills relating to history taking.
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Amorin-Woods, Lyndon Gene, Gregory F. Parkin-Smith, Vincenzo Cascioli und Dianne Kennedy. „Manual care of residents with spinal pain within a therapeutic community“. Therapeutic Communities: The International Journal of Therapeutic Communities 37, Nr. 3 (12.09.2016): 159–68. http://dx.doi.org/10.1108/tc-06-2015-0019.
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Purpose The purpose of this paper is to examine the outcomes of chiropractic manipulative and manual therapy (MMT) provided to residents experiencing spinal pain in a substance misuse therapeutic community (TC). Design/methodology/approach Clinical audit to explore the potential benefits of the interventions offered to residents experiencing spinal pain in a TC. Residents seeking care underwent an assessment by either general practitioner or chiropractic intern. Eligible participants could choose one of the four interventions: usual care without any additional treatment (Group 1), usual care with simple analgesics (Group 2), usual care plus MMT without simple analgesics (Group 3), or usual care plus MMT with simple analgesics (Group 4). Outcome measures were the RAND-36-item short form health-related quality-of-life survey and the patient satisfaction questionnaire (PSQ). Data were collected at baseline and after six weeks for each participant, with those participants choosing MMT receiving up to six treatments over the study period. Two cycles of six weeks of data collection was used. Data were analysed for statistically significant (repeated measures ANOVA with Bonferroni correction) and clinically meaningful changes in scores. Findings Of 71 self-presenting residents seeking care, 68 were eligible to participate. Of these, 32 chose usual care with simple analgesics (Group 2) and 36 chose usual care plus the package of MMT but without simple analgesics (Group 3). None chose usual care without additional treatment or usual care plus the package of MMT with analgesics, thus offering only the data from two groups for analysis. Group allocation was non-random and based on patient choice. Between-group analysis of the cumulative and component RAND-36 data indicated a significant difference between the two groups (p=0.034), particularly in the physical outcomes (p=0.012), indicating that Group 3 had improved scores over Group 2. Group 3 showed a significant change in RAND-36 scores (p<0.01) when compared with Group 2 (p=0.23) over the six-week treatment period. The PSQ scores of the two groups showed a statistically significant difference (p=0.0093), suggesting that Group 3 had greater patient satisfaction with care. The outcomes suggest that the package of MMT in Group 3, delivered by an appropriately trained clinician may have added to therapeutic effect that extended beyond physical outcomes but also influenced psychological outcomes. Research limitations/implications The results of this clinical outcome-based audit suggest that the addition of a package of chiropractic MMT to usual care may be of benefit over usual care with simple analgesics for residents of a TC with spinal pain. The results intimate that benefits may extend across both the physical and psychological components of the pain experience, although a confirmatory study is recommended to substantiate these insights. Originality/value As far as the authors are aware, this trial is the first of this type in a TC, with the insights and experience gained supporting a definitive trial.
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Ailliet, Luc, Sidney M. Rubinstein, Trynke Hoekstra, Maurits W. van Tulder und Henrica C. W. de Vet. „Adding Psychosocial Factors Does Not Improve Predictive Models for People With Spinal Pain Enough to Warrant Extensive Screening for Them at Baseline“. Physical Therapy 96, Nr. 8 (01.08.2016): 1179–89. http://dx.doi.org/10.2522/ptj.20150304.
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Abstract Background Chiropractors throughout the world by and large focus on patients with musculoskeletal complaints who are generally in good health. Currently, it is widely accepted that neck pain and low back pain are best understood as biopsychosocial phenomena. Objective The purpose of this study was to determine whether certain psychosocial factors provide added value for predicting recovery. Design This was a prospective, multicenter, chiropractic, practice-based cohort study in Belgium and the Netherlands. Methods A total of 917 participants, 326 with neck pain and 591 with low back pain, completed self-administered questionnaires at baseline and at 3, 6, and 12 months. They provided information on several demographic, biomedical, and psychosocial variables. Lasting perceived recovery was used as the outcome measure, that is, recovery at all follow-up assessments from 3 months on. Twenty-seven potential predictors of outcome were used to build the predictive model. Stepwise, backward generalized estimating equation regression models were used to take into account the clustering of participants within practices. For assessment of the added value of psychosocial variables, 2 model fit indexes were compared. Results After the addition of psychosocial variables, predictors in the final model for neck pain included occupational status, body mass index, duration of complaints, previous treatment, and participant expectations (the model fit was marginally improved from 0.684 to 0.695 for the area under the curve and from 65.0% to 66.1% for the percentage correctly predicted). In the final model for low back pain, the selected predictors included country of treatment, age, duration of complaints, previous imaging, and somatization (the area under the curve changed from 0.669 to 0.715, and the percentage correctly predicted changed from 68.6% to 69.5%). Only a minority of participants had high scores on psychological variables. Limitations The reliability and validity of lasting recovery as an outcome measure have not been tested. The cohort needs to be seen as a convenience sample. Selection bias, therefore, not be ruled out. There are no indications, however, that patients with complex psychosocial profiles were excluded from this study. Conclusions Psychosocial variables provided little added value for predicting outcome in people who had neck pain or low back pain and sought chiropractic care. Therefore, chiropractors should not screen extensively for them at baseline. With regard to the identification of the small subgroup of people with high scores on psychosocial variables and a high risk for chronic pain, further investigation is needed.
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Trager, Robert James, Clinton J. Daniels, Kevin W. Meyer, Amber C. Stout und Jeffery A. Dusek. „Clinical decision-making for spinal manipulation for persistent spinal pain following lumbar surgery: a protocol for a systematic review and meta-analysis of individual participant data“. BMJ Open 11, Nr. 12 (Dezember 2021): e054070. http://dx.doi.org/10.1136/bmjopen-2021-054070.
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IntroductionThere are limited available research and guidance regarding the use of spinal manipulative therapy (SMT) in patients with low back-related symptoms following lumbar spine surgery, a condition called persistent spinal pain syndrome type 2 (PSPS-2). This publication outlines a review protocol to identify and synthesise individual participant data (IPD) to examine associations between patient, clinical and surgical variables and SMT application in adults with PSPS-2.Methods and analysisPubMed, OVID, Web of Science, Scopus, PEDro, Index to Chiropractic Literature and KoreaMed will be searched from inception to 1 January 2022 without language restrictions. Case reports, series, observational studies and cases from grey literature of adults receiving SMT for PSPS-2 will be included. Two investigators will independently screen citations, abstracts and full-text articles. A risk-of-bias assessment will be performed in duplicate to rate cases according to exposure and outcome ascertainment and data completeness. Data extraction will be performed in duplicate and missing IPD will be requested from corresponding authors. Multiple binary logistic regression will be used to identify independent predictors of the use of lumbar–SMT, lumbar–manual-thrust SMT and SMT within 1-year postsurgery. Patient, clinical and surgical variables will be summarised using descriptive statistics, while SMT-related outcomes (lumbar–SMT, lumbar–manual-thrust SMT and 1-year surgery-to-SMT interval) will be described using adjusted ORs with 95% CIs.Ethics and disseminationThis study was deemed not human subjects research by the University Hospitals’ institutional review board. The results of this review will be disseminated at conferences and/or published in a peer-reviewed journal.PROSPERO registration numberCRD42021250039.
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Holt, Kelly, Imran Khan Niazi, Imran Amjad, Nitika Kumari, Usman Rashid, Jens Duehr, Muhammad Samran Navid, Muhammad Shafique und Heidi Haavik. „The Effects of 4 Weeks of Chiropractic Spinal Adjustments on Motor Function in People with Stroke: A Randomized Controlled Trial“. Brain Sciences 11, Nr. 6 (21.05.2021): 676. http://dx.doi.org/10.3390/brainsci11060676.
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Chiropractic spinal adjustments have been shown to result in short-term increases in muscle strength in chronic stroke patients, however, the effect of longer-term chiropractic spinal adjustments on people with chronic stroke is unknown. This exploratory study assessed whether 4 weeks of chiropractic spinal adjustments, combined with physical therapy (chiro + PT), had a greater impact than sham chiropractic with physical therapy (sham + PT) did on motor function (Fugl Meyer Assessment, FMA) in 63 subacute or chronic stroke patients. Secondary outcomes included health-related quality of life and other measures of functional mobility and disability. Outcomes were assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). Data were analyzed using linear mixed-effects models or generalized linear mixed models. A post-hoc responder analysis was performed to investigate the clinical significance of findings. At 4 weeks, there was a larger effect of chiro + PT, compared with sham + PT, on the FMA (difference = 6.1, p = 0.04). The responder analysis suggested the improvements in motor function seen following chiropractic spinal adjustments may have been clinically significant. There was also a robust improvement in both groups in most measures from baseline to the 4- and 8-week assessments, but between-group differences were no longer significant at the 8-week assessment. Four weeks of chiro + PT resulted in statistically significant improvements in motor function, compared with sham + PT, in people with subacute or chronic stroke. These improvements appear to be clinically important. Further trials, involving larger group sizes and longer follow-up and intervention periods, are required to corroborate these findings and further investigate the impacts of chiropractic spinal adjustments on motor function in post-stroke survivors. ClinicalTrials.gov Identifier NCT03849794.
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Price, Jonathan, Alison Rushton, Isaak Tyros und Nicola R. Heneghan. „Effectiveness and optimal dosage of resistance training for chronic non-specific neck pain: a protocol for a systematic review with a qualitative synthesis and meta-analysis“. BMJ Open 9, Nr. 2 (Februar 2019): e025158. http://dx.doi.org/10.1136/bmjopen-2018-025158.
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IntroductionThe prevalence of neck pain is increasing rapidly with a high percentage of patients going on to experience recurrent or chronic symptoms. The resulting pain and disability are commonly managed using a variety of treatments including exercise. Resistance training exercise aimed at the neck and shoulders is advocated to treat chronic non-specific neck pain (CNSNP), however the dosage of prescribed exercise varies considerably between studies. The aim of this study is to evaluate the effectiveness of resistance training in CNSNP and to determine an optimal dosage that should be prescribed in clinical practice.Methods and analysisA systematic review with qualitative synthesis and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, PEDro, Zetoc, Index to Chiropractic Literature ChiroAcces, PubMed, grey literature sources and key journals will be searched. Randomised clinical trials investigating resistance training exercise in adults with CNSNP using outcome measures of pain and/or disability will be eligible for inclusion. Two reviewers will independently screen for eligibility, extract data and assess risk of bias (Cochrane risk of bias tool) with a third reviewer mediating in cases of disagreement. Data will be synthesised qualitatively to investigate intervention effectiveness and to determine the effect of exercise dosage on pain and disability. Meta-analysis using a random-effects model will be conducted where sufficient clinical homogeneity exists. The strength of the overall body of evidence will be assessed and reported using Grading of Recommendations Assessment, Development and Evaluation.Ethics and disseminationThis study raises no ethical issues. Results will inform exercise prescription to improve management of CNSNP. Results will be published in a peer-reviewed journal and presented at conferences.PROSPERO registration numberCRD42018096187.
Buchteile zum Thema "Outcome assessment chiropractic"
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E. Harrison, Deed, und Paul A. Oakley. „An Introduction to Chiropractic BioPhysics® (CBP®) Technique: A Full Spine Rehabilitation Approach to Reducing Spine Deformities“. In Complementary Therapies [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102686.
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Chiropractic Biophysics® (CBP®) technique is a full-spine and posture correcting method that incorporates mathematical principles into a unique approach to treat spinal disorders. It considers that the identification of postural rotations and translations of human postures are first evaluated and compared to the radiographic assessment of the spine alignment. Mirror image® postural positions and movements are utilized including spinal extension positions to improve the spine and posture towards a normal/ideal alignment. Specifically, corrective exercises, corrective traction and chiropractic adjustments are performed encompassing a multimodal rehabilitation program with the goal of improving the posture and spine alignment. CBP Rehabilitation programs are typically performed in-office with supportive at-home measures. Repeat assessment including radiographs are used to quantify and monitor structural improvements. CBP technique is an evidence-based approach to treat spine deformities and is supported by all forms of clinical evidence including systematic literature reviews, randomized controlled trials, non-randomized controlled trials, case reports/series as well as is supported by biomechanical posture-spine coupling validity, radiographic and posture analysis reliability/repeatability and use of a validated biomechanical spinal model as the outcome goal of care. CBP technique is a proven method to improve pain, disability and quality of life in those with structural deformities.
Konferenzberichte zum Thema "Outcome assessment chiropractic"
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Jones, Fiona, Abigail Baker, Raymond A’Court und Jo Hardy. „Reimagining Information Literacy teaching and learning during the COVID-19 pandemic: Research and evidence-based practice skills training redesigned for online delivery“. In ASCILITE 2020: ASCILITE’s First Virtual Conference. University of New England, Armidale, 2020. http://dx.doi.org/10.14742/ascilite2020.0132.
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Information literacy teaching and learning for Master of Chiropractic students undertaking systematic reviews was re-envisioned from hybrid to fully online mode due to COVID-19 pandemic restrictions. Collaboration with the academic unit convener informed design and development of appropriate online learning activities and assessment for student achievement of required learning outcomes. Using flipped classroom methodology, a pre-recorded lecture demonstrated research question formulation and advanced database search strategies. Tutorial activities were redesigned for Zoom delivery using breakout rooms to replicate the collaborative aspect of face-to-face tutorials. Learning was supported by a refreshed online research guide, research consultations, and emails. Consultations were delivered via Zoom upon request for more specific advice including question formulation, search terms, choosing appropriate research databases, and advanced database search techniques. Feedback and assessments were positive and review will inform future offerings.