Abstract:
OBJECTIVE:Nonspecific back pain is associated with high use of diagnostic imaging in primary care, yet current evidence suggests that routine imaging of the spine is unnecessary. The objective of this study is to describe current practice patterns in spine radiograph utilization among doctors of chiropractic enrolled in an American provider network. METHODS:A cross-sectional analysis of administrative claims data from one of the largest providers of complementary health care networks for health plans in the United States was performed. Survey data containing provider demographics were linked with routinely collected data on spine radiograph utilization and patient characteristics aggregated at the provider level. We calculated rates and variations of spine radiographs over 12 months. Negative binomial regression was performed to identify significant predictors of high radiograph utilization and to estimate the associated incidence risk ratio. RESULTS:Complete data for 6946 doctors of chiropractic and 249193 adult patients were available for analyses. In 2010, claims were paid for a total of 91542 new patient examinations and 23369 spine radiographs (including 17511 ordered within 5 days of initial patient examination). The rate of spine radiographs within 5 days of an initial patient visit was 204 per 1000 new patient examinations. Significant predictors of higher radiograph utilization rates included the following: practicing in the Midwest or South US census regions, practicing in an urban or suburban setting, chiropractic school attended, and being a male provider in full-time practice with more than 20 years of experience. CONCLUSION:Chiropractic school attended and practice location were the most influential predictors of spine radiograph utilization among network chiropractors. This information may help to inform the development and evaluation of a tailored intervention to address overuse of radiograph utilization.
journal_name
J Manipulative Physiol Therjournal_title
Journal of manipulative and physiological therapeuticsauthors
Bussières AE,Sales AE,Ramsay T,Hilles S,Grimshaw JMdoi
10.1016/j.jmpt.2013.04.002subject
Has Abstractpub_date
2013-03-01 00:00:00pages
127-42issue
3eissn
0161-4754issn
1532-6586pii
S0161-4754(13)00054-7journal_volume
36pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to investigate the changes in passive ankle dorsiflexion range of motion (ROM), maximum plantar force, force-time integral, and time to heel off during walking between pre- and postapplication of modified mobilization with movement (MWM) using talus glide taping in people with li...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2014.01.007
更新日期:2014-06-01 00:00:00
abstract::This editorial reviews the current health care marketplace in the United States as it relates to chiropractic and the complementary and alternative medicine community. A 4-part strategy of research, education, alliance-building, and politics, is offered to address current obstacles. ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 社论,评审
doi:10.1016/j.jmpt.2007.06.005
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:To demonstrate the errors in surface electromyogram (EMG) interpretation that can be made when the EMG signal is not normalized. DESIGN:A case study as a proof of principle. MAIN OUTCOME MEASURES:The EMG amplitude between the upper and lower portions of the rectus abdominis in one subject during a trunk cur...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/s0161-4754(99)70032-1
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare ranges of motion (ROM) between dominant and nondominant sides for the joints of the upper and lower extremities. METHODS:Ninety healthy white women from 18 to 59 years of age were measured in this study. Active and passive ROM were measured for the ankle, knee, hip,...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2008.09.003
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:Few studies have addressed the practice of chiropractic care of children in Europe. No systematic classification of conditions currently exists in chiropractic pediatrics. The objective of this study was to investigate characteristics of clinical chiropractic practice, including the age of pediatric patients,...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2012.04.008
更新日期:2012-06-01 00:00:00
abstract:STUDY DESIGN:Best evidence synthesis. OBJECTIVE:To critically appraise and synthesize the literature on assessment of neck pain. SUMMARY OF BACKGROUND DATA:The published literature on assessment of neck pain is large and of variable quality. There have been no prior systematic reviews of this literature. METHODS:The...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2008.11.016
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Nerve palpation is a method of clinically identifying mechanosensitivity of neural tissue by means of pressure algometry and manual palpation. There are few investigations of the reliability of lower limb nerve palpation, and femoral nerve palpation has never been previously reported. The aim of this study wa...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2013.12.006
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To present diagnostic imaging findings of two cases of cervical myelopathy, with different etiologies, presenting to a chiropractic office. CLINICAL FEATURES:The patient with acute transverse myelitis had neck and upper back pain and nonspecific headaches for 40 years. The patient with posttraumatic syringom...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2005.07.013
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To assess, through qualitative studies of 4 medically underserved communities, the receptivity of chiropractors, other health care providers, and consumers to the idea of chiropractors' assuming a focal role in primary care. METHOD:Visits by a team of 2 researchers to 4 medically underserved communities: (1)...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1067/mmt.2000.110945
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To present the clinical and neurological features of a patient suffering from cervical spondylotic myelopathy. CLINICAL FEATURES:Cervical spondylotic myelopathy (CSM) is a condition in which the vascular and neural structures are compressed by bony spurring and soft tissue hypertrophy, causing ischemic damag...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:Manual medicine treatments (MMTs) rely on biophysical techniques that use manually guided forces in numerous strain directions to treat injuries and somatic dysfunctions. Although clinical outcomes post-MMT are positive, the underlying cellular mechanisms responsible remain elusive. We previously described an...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2007.07.013
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:This study compared the effects of high-force versus low-force lumbar traction in the treatment of acute lumbar sciatica secondary to disc herniation. METHODS:A randomized double blind trial was performed, and 17 subjects with acute lumbar sciatica secondary to disc herniation were assigned to high-force tra...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmpt.2016.09.006
更新日期:2016-01-01 00:00:00
abstract::This issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) includes the publication of the scientific papers that won the 3 major open awards at the International Conference on Chiropractic Research (ICCR) held at the Hilton Bonaventure Hotel, Montreal, Canada, from April 30 to May 2, 2009. ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 社论
doi:10.1016/j.jmpt.2010.05.011
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To describe the chiropractic care of a patient with cervical subluxation and complaints associated with temporomandibular disorder. CLINICAL FEATURES:A 41-year-old woman had bilateral ear pain, tinnitus, vertigo, altered or decreased hearing acuity, and headaches. She had a history of ear infections, which h...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1067/mmt.2002.120415
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate interrater reliability in the diagnosis of myofascial trigger points (MTrPs) in the tibialis anterior, peroneus brevis, and extensor digitorum longus muscles. METHODS:A reliability research study was performed. Three physical therapists with clinical experience in my...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2016.09.002
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to develop and validate a multivariate prediction model, guided by palpation and personal information, for locating the seventh cervical spinous process (C7SP). METHODS:A single-blinded, cross-sectional study at a primary to tertiary health care center was conducted for model develo...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2016.10.012
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this review was to determine the most commonly reported and utilized low back pain (LBP) Patient Reported Outcome Measures (PROMs) within the chiropractic literature and to investigate their temporal and methodological publication characteristics. METHODS:A systematic search of English-languag...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2017.11.007
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Finite helical axis parameters (FHAP) of the cervical spine and clinical measures were obtained to evaluate neck function and the clinical effects of spinal manipulative therapy in patients with "whiplash" (WL) type neck injury. DESIGN:Descriptive case series, 1 yr follow-up. SETTING:Three private chiroprac...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test an educational intervention designed to increase hand and treatment table sanitizing on 3 chiropractic college campuses using a theory-based intervention. The second purpose is to see if an increase in observed hand hygiene would be noted as a result of the intervention. ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2009.06.007
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:This study systematically reviewed the published evidence regarding chiropractic care, including spinal manipulation, for pregnancy-related low back pain (LBP). METHODS:A multimodal search strategy was conducted, including multiple database searches along with reference and journal hand searching. Studies we...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,评审
doi:10.1016/j.jmpt.2008.06.009
更新日期:2008-07-01 00:00:00
abstract::A survey of 390 patients receiving care in the teaching clinics of the Northwestern College of Chiropractic (NWCC) was conducted to obtain information about patient satisfaction with their chiropractic care and about their prior or subsequent utilization of other types of health care services. Patients were contacted ...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To present the design of a trial on the effectiveness of a behavioral-graded activity model. DESIGN:Randomized clinical trial. PATIENTS:Patients undergoing first-time lumbar disk surgery who still have low-back pain at the 6-week neurosurgical consultation. INTERVENTIONS:A patient-tailored behavioral-grade...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the effects of including 1 session of trigger point dry needling (TrP-DN) into a multimodal physiotherapy treatment on pain and function in postoperative shoulder pain. METHODS:Twenty patients (5 male; 15 female; age, 58 ± 12 years) with postoperative shoulder pain a...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmpt.2014.11.007
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:The objectives of this study were to investigate whether elbow joint position sense (JPS) accuracy differs between participants with a history of subclinical neck pain (SCNP) and those with no neck complaints and to determine whether adjusting dysfunctional cervical segments in the SCNP group improves their J...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2010.12.009
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to research the distribution of stresses and displacements in cervical nuclei pulposi during simulated cervical spine manipulation (CSM). METHODS:A 3-dimensional finite element model of C3/4~C6/7 was established. The detailed mechanical parameters of CSM were analyzed and simu...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2014.05.007
更新日期:2014-10-01 00:00:00
abstract::Applied Kinesiology (AK) is a diagnostic and therapeutic approach used by a large number of chiropractors. AK seminars are conducted worldwide; during these seminars mention is frequently made of the presence of supportive research. A review was undertaken of the type and scientific quality of 50 papers which had been...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:To assess the intraexaminer and interexaminer reliability of clinicians trained in flexion-distraction technique to determine the need for chiropractic adjustment of each segment of the lumbar spine. DESIGN:This was an intraexaminer and interexaminer reliability study of commonly used chiropractic assessment...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0161-4754(99)70083-7
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Few studies exist on the prognostic value of demographic, clinical, or psychosocial factors on long-term outcomes for patients with chronic low back pain. OBJECTIVE:This study reports on long-term pain and disability outcomes for patients with chronic low back pain, evaluates predictors of long-term outcome...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate survey data from a national cross-sectional sample of 1427 urban and nonurban Australian women focusing on the relationship between the use of specific complementary and alternative medicine (CAM) practitioner types and the levels of CAM use across urban and nonurban...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 杂志文章
doi:10.1016/j.jmpt.2012.12.010
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility of patient recruitment, the ability of patients and clinicians to comply with study protocols, and the use of data collection instruments to collect cost-effectiveness data, and to obtain variability estimates for sample-size calculations for a full-scale trial. STUDY DESIGN:Prospe...
journal_title:Journal of manipulative and physiological therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mmt.2000.109678
更新日期:2000-10-01 00:00:00