Medline contains more than 24 million articles, with almost one million new citations added each year. Evidence-based chiropractors know that they must employ and continually refine “best practices” to obtain great outcomes. The following up-to-date chiropractic research review offers 11 new studies that impact our patients and practices.
1.A new paper provides additional confirmation that patellofemoral pain syndrome (PFPS) and dynamic knee valgus do not arise from within the knee, rather from hip abductor/ external rotator weakness and/or foot hyperpronation: “The most effective intervention programs included exercises targeting the hip external rotator and abductor muscles and knee extensor muscles.” and “PFPS patients with foot abnormalities, such as those with increased rearfoot eversion or pes pronatus, may benefit the most from foot orthotics.”Petersen W, Rembitzki I, Liebau C. Patellofemoral pain in athletes. Open Access Journal of Sports Medicine. 2017;8:143-154.
2.A systematic review and meta-analysis of more than 1700 cases determined that patients with a decreased lumbar lordosis have significantly higher levels of lumbar disc herniation and LBP. Chun, Se-Woong et al. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. The Spine Journal , Volume 17 , Issue 8 , 1180 – 1191
3.A study of more than 300 adult patients found that both hypo- and hyper-lordosis correlate with DJD in the lumbar spine. Murray KJ, Le Grande MR, Ortega de Mues A, Azari MF. Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study. BMC Musculoskeletal Disorders. 2017;18:330.
4.Weakness of the deep neck flexors is a known contributor to chronic neck pain, particularly cervicogenic headaches and cervicogenic vertigo. A systematic review confirmed that low-load craniocervical flexion exercise is highly effective for improving deep cervical flexor muscle impairments in these patients. Amiri AS, et al. The Effect of Different Exercise Programs on Size and Function of Deep Cervical Flexor Muscles in Patients With Chronic Nonspecific Neck Pain: A Systematic Review of Randomized Controlled Trials. Am J Phys Med Rehabil. 2017 Aug;96(8):582-588.
5.In a small study of patients with cervicogenic headache, chiropractic spinal manipulation resulted in decreased headache frequency and intensity with only mild and transient adverse events. Chaibi A, Knackstedt H, Tuchin PJ, Russell MB. Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial. BMC Research Notes. 2017;10:310. doi:10.1186/s13104-017-2651-4.
6.In patients exhibiting a loss of the cervical lordosis, a 12-week home exercise program consisting of isometric cervical extension improves cervical lordosis and reduces pain levels. Alpayci M et. al. Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2017 Sep;96(9):621-626.
7.Regarding cervical spine pain, the definition “acute” should be reserved for the period of 0-4 weeks. Nyirö L, Peterson CK, Humphreys BK. Exploring the definition of «acute» neck pain: a prospective cohort observational study comparing the outcomes of chiropractic patients with 0–2 weeks, 2–4 weeks and 4–12 weeks of symptoms. Chiropractic & Manual Therapies. 2017;25:24. doi:10.1186/s12998-017-0154-y.
8.In patients with neck pain, intermittent cervical traction provides significant immediate relief but little functional improvement or long-term benefit. Yang JD et al. Intermittent Cervical Traction for Treating Neck Pain: A Meta-analysis of Randomized Controlled Trials. Spine (Phila Pa 1976). 2017 Jul 1;42(13):959-965.
9.A randomized clinical trial of patients with shoulder impingement syndrome determined that thoracic manipulation decreased pain and improved scapular upward rotation i.e. lessened the impingement effect of scapular dyskinesis. Haik, Melina N. et al. Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome. Archives of Physical Medicine and Rehabilitation , Volume 98 , Issue 8 , 1594 – 1605
10.Belief about the relative risk of acute lumbar disc herniation (LDH) resulting from chiropractic spinal manipulation varies by profession. Chiropractors generally fell into a group with the most optimistic views, believing that chiropractic SMT reduces the incidence of acute LDH by about 60%. Family physicians expressed a neutral belief, while orthopedic surgeons comprised the majority of a group with the most pessimistic views believing that chiropractic SMT increases the incidence of acute LDH by about 30%. Hincapié, C.A., Cassidy, J.D., Côté, P. et al. Chiropractic spinal manipulation and the risk for acute lumbar disc herniation: a belief elicitation study Eur Spine J (2017).
11.An electromyographic study confirms that athletes with rotator cuff tendinopathy demonstrate an aberrant patter of scapular movement, i.e. delayed activation of the serratus anterior and lower trapezius. This muscular dysfunction impairs upward rotation of the scapula resulting in further rotator cuff impingement. Leong HT. et al. Rotator cuff tendinopathy alters the muscle activity onset and kinematics of scapula. J Electromyogr Kinesiol 2017 Aug;35:40-46.
Reprinted with permission from Chiro Up
Cliff Atwell, B.S., D.C.