LAKELAND SPINE CENTER - CHIROPRACTIC & MEDICAL CENTER

Abstract: There is a stigma surrounding the reporting of conflicts of interest (COIs) that should be overcome. This article provides a discussion about COI, a brief historical review of requirements, and an update of policy for the Journal of Manipulative and Physiological Therapeutics that includes the alignment of the International Committee of Medical Journal Editors new COI form requirement. This article reviews types of COI and suggests that professions (eg, chiropractic, physical therapy, acupuncture) not directly affiliated with pharmaceutical and device companies, though they may be faced with different circumstances, should still comply with current COI reporting standards. There should be no disgrace in properly declaring interests; instead, COI declaration should be considered an important part of publication and recognized as an honorable action. Declaration of COI helps to provide transparency and disclosure to all involved including editorial staff, peer reviewers, and the readers.

Abstract: Objective: The purpose of this study was to evaluate standard measures of health behavior for association with back pain among college students using data from the standardized National College Health Assessment survey. This investigation evaluated potential risk factors among a population of students at a Colorado university.Methods: This cross-sectional study included 963 survey results that were assessed using backward selection logistic regression techniques to evaluate the associations between common college-life health behaviors and back pain occurrence within the past school year.Results: Thirty-eight percent of college students surveyed reported having back pain within the past school year. Investigators found that univariate associations included multiple domains, but only psychosocial factors remained statistically significant in a final regression model and were associated with back pain. Feeling chronically fatigued (odds ratio, 3.89; 95% confidence interval, 1.09-13.86) and being in an emotionally abusive relationship (odds ratio, 2.78; 95% confidence interval, 1.69-4.57) were the factors most strongly associated with back pain in the final model.Conclusions: Psychosocial factors were identified to be associated with back pain. The prevalence of back pain among this younger population is of significant concern and warrants further investigation to identify contributing factors that may help in the development of interventions to reduce the epidemic of back pain within college students and lessen the burden upon college health providers.

Abstract: Objective: The purpose of this study was to examine the effect of manipulative therapy on the shoulder girdle, in addition to usual care provided by the general practitioner, on the outcomes of physical examination tests for the treatment of shoulder complaints.Methods: This was a randomized controlled trial in a primary care setting in the Netherlands. A total of 150 participants were recruited from December 2000 until December 2002. All patients received usual care by the general practitioner. Usual care included one or more of the following depending on the needs of the patient: information/advice, oral analgesics or nonsteroidal antiinflammatory drugs, corticosteroid injections, exercises, and massage. In addition to usual care, the intervention group received manipulative therapy, up to 6 treatment sessions in a 12-week period. Twenty-four physical examination tests were done at baseline and after 6, 12, and 26 weeks. Factor analysis was done to reduce the number of outcome measures.Results: The factor analysis resulted in 4 factors: “shoulder pain,” “neck pain,” “shoulder mobility,” and “neck mobility.” At 6 weeks, no significant differences between groups were found. At 12 weeks, the mean changes of all 4 factors favored the intervention group; the factors “shoulder pain” and “neck pain” reached statistical significance (95% confidence interval [CI], 0.1-2.1). At 26 weeks, differences in the factors “shoulder pain” (95% CI, 0.0-2.6), “shoulder mobility” (95% CI, 0.2-1.7), and “mobility neck” (95% CI, 0.2-1.3) statistically favored the intervention group.Conclusion: In this pragmatic study, manipulative therapy, in addition to usual care by the general practitioner, diminished severity of shoulder pain and neck pain and improved shoulder and neck mobility.