http://www.researchonline.mq.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:24926 Objective: To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicating and critically reviewing a paper commonly cited when reviewing adverse events of SMT as reported by Ernst (J Roy Soc Med 100:330-338, 2007). Method: Replication of a 2007 Ernst paper to compare the details recorded in this paper to the original source material. Specific items that were assessed included the time lapse between treatment and the adverse event, and the recording of other significant risk factors such as diabetes, hyperhomocysteinemia, use of oral contraceptive pill, any history of hypertension, atherosclerosis and migraine. Results: The review of the 32 papers discussed by Ernst found numerous errors or inconsistencies from the original case reports and case series. These errors included alteration of the age or sex of the patient, and omission or misrepresentation of the long term response of the patient to the adverse event. Other errors included incorrectly assigning spinal manipulation therapy (SMT) as chiropractic treatment when it had been reported in the original paper as delivered by a non-chiropractic provider (e.g. Physician).The original case reports often omitted to record the time lapse between treatment and the adverse event, and other significant clinical or risk factors. The country of origin of the original paper was also overlooked, which is significant as chiropractic is not legislated in many countries. In 21 of the cases reported by Ernst to be chiropractic treatment, 11 were from countries where chiropractic is not legislated. Conclusion: The number of errors or omissions in the 2007 Ernst paper, reduce the validity of the study and the reported conclusions. The omissions of potential risk factors and the timeline between the adverse event and SMT could be significant confounding factors. Greater care is also needed to distinguish between chiropractors and other health practitioners when reviewing the application of SMT and related adverse effects. 2013-03-28T02:24:24.038Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:24870 Differences in chiropractic education exist both internationally and nationally, despite regional accreditation standards and the quality assurance role of the Councils on Chiropractic Education International (CCEI). This is not necessarily a major problem, as the role and responsibilities of the chiropractor may vary - not only between countries, but also within them. However, the goal common to all chiropractic educational institutions is to train primary care practitioners that can - at a minimum - function effectively in the community in which they are trained. 2013-03-20T11:11:37.846Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:24873 The association between language and knowledge is well established. Alfred Korzybski discussed the significance of a concept called 'time binding' where language is used as a 'tool' to reflect knowledge that is built up over time leading to the development of an epistemology. The language we use to describe chiropractic tells of ideas and beliefs which in differing ways and, perhaps unknowingly to us, mislead and channel us into 'arguments' resulting in false conclusions and conflicts. An appreciation of the role of our 'chiropractic' language comes from my unique position of being on three organisations within the chiropractic profession. Having experience as a regulator, practitioner and academic, the author finds that three different languages are being utilised interchangeably which may lead to confusion and false perceptions by outside stakeholders such as government bodies, scientists, skeptics. 2013-03-20T11:11:24.501Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:24874 This paper reports on the proceedings of the Anatomy Education in Chiropractic Programs Symposium, held at Macquarie University on 20 July 2012. At the symposium, the first of its kind, representatives from four Australian and New Zealand chiropractic schools presented and discussed their respective institutions' anatomy programs. All schools, it would appear, have very strong and well-conceived anatomy programs. Several research papers on anatomy education were also presented. In a panel discussion which concluded this symposium, it was highlighted that there was a need for better collaboration between schools and for the development of a community of practice. Ways of achieving this were discussed. 2013-03-20T11:11:20.779Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:24244 Universities in Australia and worldwide, are building a new generation of learning and teaching spaces which are designed to encourage and support active and collaborative modes of learning and teaching. However, there is little evidence to show that students will recognise the contribution these spaces make to their learning. Temple (2008) argued that spaces may become more salient to students once they are satisfied with the quality of learning and teaching that occurs within them. In the present study, ten teachers worked collaboratively to develop and implement active and collaborative approaches to learning and teaching in their respective units. These approaches drew upon the affordances of one of these new generation spaces at Macquarie University, namely, the Collaborative Learning Forum. Evidence from a student evaluation survey (n=279) confirms Temple’s (2008) proposition and also suggests ways to encourage students to adopt a deeper approach to learning and to increase their satisfaction with the value and quality of their learning experience. 2013-02-18T06:00:27.411Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:24139 Although it was one of the most important events in the history of palaeoanthropology, many details of the Taung discovery and the events that followed it are still not completely elucidated. In this paper, we recount the events surrounding three early photographs (stored in the University of the Witwatersrand Archives) showing the Taung Child skull being held in the hands of the renowned anthropologist Raymond Dart. Having, what seems to be, a mosaic of evidence both for and against, we deliberate upon whether the archival photographs presented here are among the first photographs of the fossil itself or are of the first plaster cast of the Taung Child which was prepared for the 1925 British Empire Exhibition held at Wembley, London. We interpreted the photographs and determined their provenance through analyses which included historical examination of published accounts of the Taung discovery and archival materials, as well as comparisons of the photographed material in question with both archival and current (digital, high quality) photographs of the Taung fossil itself and Taung skull casts (as the skull underwent changes over time). We conclude that the early photographs presented here are of the original fossil itself and not of a cast. At the same time, these photographs represent some of the first pictorial depictions of the Taung Child skull. 2013-02-11T03:20:47.953Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:23848 Increasing prevalence rates of pediatric and adolescent attention-deficit/hyperactivity disorder (ADHD), concerns over the safety and efficacy of psychostimulants, and fears about long-term use of psychostimulants have led many parents to seek alternative therapies for their children. Numerous environmental factors have been suspected of influencing ADHD. Over the last few decades, there has been an increasing awareness of the importance of nutrition and the potential role it has on influencing ADHD and ADHD symptomatology. This article focuses on nutrition, dietary modifications, and nutraceuticals, which are the most commonly used complementary and alternative medicine (CAM) therapies for the management of pediatric and adolescent ADHD. The aim is to present a narrative literature review for dietary modifications and nutritional supplementation for pediatric and adolescent ADHD. Searches were made in full-text English language articles from 2000 to February 2012 in the PubMed Central, Medline, Cochrane Library, Psych INFO, Scopus, and CINAHL databases. The review revealed a full range of research strategies, but this article concentrates on randomized controlled trials, observational studies, longitudinal studies, epidemiological studies, surveys, qualitative reviews, narrative reviews, systematic reviews, and meta-analyses. The literature reveals a mixture of results in respect to dietary modifications and nutritional supplementation for children and adolescents with ADHD; however, the future of nutritional research appears promising. 2013-01-24T03:20:59.527Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:23774 Background: Few studies have investigated the effect of levodopa on parkinsonian swallowing with findings thus far being equivocal. Methods: We used surface electromyography and accelerometry to investigate submental and laryngeal muscle activation during swallowing in 14 parkinsonian subjects before and after levodopa and in 22 age-matched controls. Our aims were (1) to demonstrate the clinical utility of noninvasive electromyography, (2) to identify electromyographic features of parkinsonian swallowing, and (3) to investigate the effect of levodopa on parkinsonian swallowing. Results: The parkinsonian group showed increased burst amplitudes and durations and increased swallow duration, clearing activity and latency between submental and laryngeal bursts (P <.05) and used more swallows than did controls to consume water boluses (P <.001). Levodopa decreased the latency between submental and laryngeal bursts (P <.05) but did not produce effects on individual muscle bursts. Conclusions: The clinical utility of electrophysiological and biomechanical methods of swallowing assessment was demonstrated. Levodopa tended to normalize the timing of the combined swallow response but not the activity of individual muscles. 2013-01-17T07:31:15.069Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:23410 The aim of this report is to describe the demographic characteristics including the age profile, gender differences, income and perceptions of supply and demand of the chiropractic profession in Australia. This workforce study (WFS) was divided into three components, Australian Chiropractors (Stage 1), their patients (Stage 2), and members of the general public (Stage 3). Methods: A web-based, 64-item, cross-sectional survey questionnaire was issued to registered chiropractors (CAA and non-CAA members) throughout Australia in 2010. At the time of the survey there were 3,892 registered chiropractors. Survey invitations were sent to those who were registered chiropractors, and had provided email addresses (n=1,917). Results: Demographic Characteristics: There is evidence to suggest that the profession may be becoming increasingly female over time. Income exclusively from chiropractic care included 27.9% who reported an annual pre-tax net income of $115,000 or less and 32.3% earned more than $115,000. Of the latter group, 12% indicated that they were earning more than $215,000. Income was not related to the hours worked per week particularly for males. Supply and Demand: When considering their home state and their local region, more chiropractors thought that there was undersupply in their state, but an adequate supply in their local region. A large proportion (40%) of the sample felt that universities in Australia were graduating the correct number of chiropractors per year, and 32% reported that too many were being produced in Australia. Very few reported that the Universities were not graduating enough chiropractors. Conclusion: This paper reflects some of the findings from Stage 1 of the three stage Workforce study, showing a profession heading towards a more even gender balance and characterised by a higher than average annual income. Future research should include the impact on supply and demand of the possibility of an increasingly female profession. In addition to this, although there is a perception that there is under-utilisation of chiropractic services in inland, rural and remote areas, the extent of which should be further explored. Information from this study will assist with strategic decision making and planning. A strategic framework for the profession should not only consider the findings from this study but also explore other factors that may have an impact on supply and demand, for example general trends in health and aging from local and national government reports. 2012-12-17T02:10:27.901Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:23320 73 page(s) 2012-12-10T01:50:13.376Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:23023 7 page(s) 2012-11-28T02:24:47.493Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:22119 Objectives: The purpose of this study was to describe the chiropractic profession in NSW, in terms of the demographic, educational and socio-demographic background of the chiropractic profession. Information regarding clinics and patient characteristics was also collected and discussed. Methods: A 64 item, cross-sectional survey questionnaire was constructed using a structured questionnaire in consultation with the local regulatory authority at that time, the NSW Chiropractic Registration Board. Survey questions were sent to 1244 registered chiropractors in NSW in 2005/2006 (CAA and non CAA members) Results: Demographic information: The sample of surveyed chiropractors comprised of 171 male (76%), and 54 female (24%) respondents with the majority of respondents being between 30 and 50 years (71.2%). Of the chiropractors surveyed, 94% were still in active practice. From this sample, chiropractors in NSW tend to live and work in metropolitan areas, with the remaining 30% living and practicing in rural and remote areas (or interstate). Education of Respondents: Close to 90% of participants graduated from one of three Australian chiropractic schools (Macquarie University, Sydney College of Chiropractic, RMIT/Phillip Institute of Technology) with a total of 16 chiropractic schools represented in our sample. Overall, respondents felt they were better trained in the medical aspects compared to the business and administration aspects of the profession. Eighty six percent (86%) of respondents believed that clinical practice met their expectations as a student. Practice Characteristics: At the time of the survey, of those who were active in practice, the majority of respondents (79%) reported they were at only one clinic. For the majority of respondents who were not in practice, the main reason was retirement. Income and Operation of Practice: The most reported income bracket was $90-114k (20%) with approximately 62% of surveyed chiropractors earned over $90k per annum. The most common way for patients to hear about a chiropractor was through word of mouth, with 92% of respondents indicating this referral method. Surveyed chiropractors indicated that standard musculoskeletal complaints (75.8%) were the most frequently encountered problem among chiropractic patients. Forty percent of chiropractors indicated ‘pediatrics’ as a common patient group, followed by geriatrics, sporting injuries and women’s health. Conclusion: The socio-demographic and practice characteristics found in this study are in line with previously published data from the United States, UK and Europe. The information found in this survey may be used as a guide to assist undergraduate and postgraduate chiropractic educational programs in ‘closing the gap’ between chiropractic education and clinical practice. 2012-10-23T00:35:31.155Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:22236 The Health Practitioner regulation National Law Act was implemented in 2010, and brought with it the Australian Health Practitioner Agency and the Chiropractic board of Australia. this resulted in the production of a new National Chiropractic Code of Conduct. aim of this study was to assess the attitudes and compliance of the chiropractic profession to these changes one year on. was achieved by a cross sectional survey of both the Chiropractic Association of Australia and Chiropractic and Osteopathic College of Australia members. results indicate that participating chiropractors are generally compliant towards and supportive of most of the requirements within the National Chiropractic Code of Conduct.. study serves to inform the chiropractic profession of their ethical and legal obligations, and as a comparison for future studies. 2012-10-23T00:31:35.104Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:21929 Aims: To test the feasibility of identifying Staphylococcus aureus with a fluorescence in situ hybridization (FISH) assay that uses a single hot-plate and urea-NaCl reagents. Methods and Results: Slides spotted with S. aureus and treated with methanol and lysozyme were incubated with urea-NaCl reagents on a hot-plate with a precise temperature control and identified with specific DNA probes. Conclusions: Staphylococcus aureus was detected and differentiated from Staphylococcus epidermidis in 1h with a novel FISH method that used a single hot-plate and in the absence of dimethyl formamide. Significance and Impact of Study: A rapid hot-plate FISH assay with urea-NaCl and without toxic dimethyl formamide might be useful if FISH is run infrequently or where resources are limited. 2012-10-08T03:40:55.806Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:20853 Objective: Studies investigating the efficacy of intraoral myofascial therapies (IMTs) for chronic temporomandibular disorder (TMD) are rare. The present study was an expansion of a previously published pilot study that investigated whether chiropractic IMT and the addition of education and self-care were superior to no-treatment or IMT alone for 5 outcome measures-interincisal opening range, jaw pain at rest, jaw pain upon opening, jaw pain upon clenching, and global reporting of change-over the course of 1 year. Methods: Ninety-three participants with myogenous TMD between the ages of 18 and 50 years experiencing chronic jaw pain of longer than 3 months in duration were recruited for the study. Successful applicants were randomized into 1 of 3 groups: (1) IMT consisting of 2 treatment interventions per week for 5 weeks, (2) IMT plus education and "self-care" exercises (IMTESC), and (3) wait-list control. The main outcome measures were used. Range of motion findings were measured by vernier callipers in millimeters, and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Global reporting of change was a 7-point self-reported scale, balanced positively and negatively around a zero midpoint. Results: There were statistically significant differences in resting, opening and clenching pain, opening scores, and global reporting of change (P <.05) in both treatment groups compared with the controls at 6 months and 1 year. There were also significant differences between the 2 treatment groups at 1 year. Conclusions: The study suggests that both chiropractic IMT and IMTESC were superior to no-treatment of chronic myogenous TMD over the course of 1 year, with IMTESC also being superior to IMT at 1 year. 2012-08-10T04:25:39.268Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:9849 The erythrocyte is exposed to reactive oxygen species in the circulation and also to those produced by autoxidation of hemoglobin. Consequently, erythrocytes depend on protection by the antioxidant glutathione. Mathematical models based on realistic kinetic data have provided valuable insights into the regulation of biochemical pathways within the erythrocyte but none have satisfactorily accounted for glutathione metabolism. In the current model, rate equations were derived for the enzyme-catalyzed reactions, and for each equation the nonlinear algebraic relationship between the steady-state kinetic parameters and the unitary rate constants was derived. The model also includes the transport processes that supply the amino acid constituents of glutathione and the export of oxidized glutathione. Values of the kinetic parameters for the individual reactions were measured predominately using isolated enzymes under conditions that differed from the intracellular environment. By comparing the experimental and simulated results, the values of the enzyme-kinetic parameters of the model were refined to yield conformity between model simulations and experimental data. Model output accurately represented the steady-state concentrations of metabolites in erythrocytes suspended in plasma and the changing glutathione concentrations in whole and hemolyzed erythrocytes under specific experimental conditions. Analysis indicated that feedback inhibition of γ-glutamate-cysteine ligase by glutathione had a limited effect on steady-state glutathione concentrations and was not sufficiently potent to return glutathione concentrations to normal levels in erythrocytes exposed to sustained increases in oxidative load. 2012-08-08T15:49:40.550Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:20808 Ethnopharmacological relevance: Documentation of Australian bush medicines is of utmost importance to the preservation of this disappearing and invaluable knowledge. This collaboration between the Yaegl Aboriginal community in northern New South Wales (NSW), Australia and an academic institution, demonstrates an effective means of preserving and adding value to this information. Materials and methods: Questionnaire-guided interviews were performed with community Elders under a framework of participatory action research. Medicinal plant knowledge was collated in a handbook to aid interviews and to be used as an ongoing resource by the community. Specimens for all non-cultivar plants that were discussed were collected and deposited in herbaria with unique voucher numbers. This medicinal knowledge was checked against the literature for reports of related use and studies of biological activity. Results: Nineteen Elders were interviewed, leading to discussions on fifty four plant preparations used for medicinal purposes. These plant preparations involved thirty two plants coming from twenty one families, reflecting the botanical diversity of the area. The plants retained in the Yaegl pharmacopoeia correspond to their accessibility and ease of preparation, reflected in their ongoing utilisation. Several plant uses did not appear elsewhere in the literature. Conclusions: This study is the first comprehensive documentation of the medicinal knowledge of the Yaegl Aboriginal community. It has been conducted using participatory action research methods and adds to the recorded customary knowledge of the region. The customary medicinal knowledge retained by the Yaegl Aboriginal community is related to the evolving needs of the community and accessibility of plants. 2012-08-08T14:48:32.649Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:20504 4 page(s) 2012-07-19T22:50:12.916Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:20183 Objective: To determine the short-term effectiveness of full kinematic chain manual and manipulative therapy (MMT) plus exercise compared with targeted hip MMT plus exercise for symptomatic mild to moderate hip osteoarthritis (OA). Design: Parallel-group randomized trial with 3-month follow-up. Setting: Two chiropractic outpatient teaching clinics. Participants: Convenience sample of eligible participants (N=111) with symptomatic hip OA were consented and randomly allocated to receive either the experimental or comparison treatment, respectively. Interventions: Participants in the experimental group received full kinematic chain MMT plus exercise while those in the comparison group received targeted hip MMT plus exercise. Participants in both groups received 9 treatments over a 5-week period. Main Outcome Measures: Western Ontario and McMasters Osteoarthritis Index (WOMAC), Harris hip score (HHS), and Overall Therapy Effectiveness, alongside estimation of clinically meaningful outcomes. Results: Total dropout was 9% (n=10) with 7% of total data missing, replaced using a multiple imputation method. No statistically significant differences were found between the 2 groups for any of the outcome measures (analysis of covariance, P=.45 and P=.79 for the WOMAC and HHS, respectively). Conclusions: There were no statistically significant differences in the primary or secondary outcome scores when comparing full kinematic chain MMT plus exercise with targeted hip MMT plus exercise for mild to moderate symptomatic hip OA. Consequently, the nonsignificant findings suggest that there would also be no clinically meaningful difference between the 2 groups. The results of this study provides guidance to musculoskeletal practitioners who regularly use MMT that the full kinematic chain approach does not appear to have any benefit over targeted treatment. 2012-07-02T09:03:30.157Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:14842 "August 2010" 2012-05-30T09:55:19.361Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19501 Background: Ankle injuries account for 23,000 inversion sprains daily. Lateral ankle sprains are predisposed by previous injury and a decrease in balance. This prospective randomized clinical trial compared the use of high-velocity, low-amplitude (HVLA) manipulation and Muscle Energy Technique mobilization in the treatment of chronic ankle sprains Methods: Forty candidates diagnosed with chronic recurrent ankle sprain were randomized into the trial. The primary outcome measures were the One Leg Standing Test and the Numerical Pain Rating Scale-101. Results: The One Leg Standing Test and Numerical Pain Rating Scale-101 had statistically significant and clinically meaningful intra-group changes. The One Leg Standing Test eyes closed showed an increase with High Velocity Low Amplitude manipulation of 10.24 seconds and with Muscle Energy Technique mobilization of 10.05 seconds, both t-tests p=.003 suggestive of a centrally mediated positive neurological effect on the function of the locomotive system. The Numerical Pain Rating Scale-101 showed significant decrease in High Velocity Low Amplitude manipulation of 37.1 points and Muscle Energy Technique of 39.6 points, both t-tests p<0.000. Conclusion: Both High Velocity Low Amplitude manipulation and Muscle Energy Technique mobilization significantly increased balance, range of motion, and function while decreasing shortterm pain. These promising results merit further research with a fully powered trial. 2012-05-30T09:51:17.682Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19514 2 page(s) 2012-05-30T09:50:28.860Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19314 2 page(s) 2012-05-22T01:20:43.664Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19315 1 page(s) 2012-05-22T01:20:39.616Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19316 2 page(s) 2012-05-22T01:20:39.443Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19317 2 page(s) 2012-05-22T01:20:33.164Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19318 2 page(s) 2012-05-22T01:20:32.895Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19211 14 page(s) 2012-05-21T18:48:08.516Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19164 24 page(s) 2012-05-15T14:13:23.110Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19178 Comments on the Australasian College of Chiropractors' Research Summit which investigated the significance of strategic research are offered. 2012-05-15T14:11:22.239Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19114 774 page(s) 2012-05-15T04:01:37.925Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19099 ABSTRACT:Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness.A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria.A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity.Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is present ed.There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended. 2012-05-10T09:52:10.790Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19060 This paper presents the newly opened Anatomy and Surgical Skills Facility at the Macquarie University’s Australian School of Advanced Medicine. The facility has been used, since second semester of the 2010 academic year, for anatomy teaching in the chiropractic program. The new facility contains up-to-date equipment organised around 10 workstations. The additional rooms are also available for anatomy teaching. The laboratory enables implementation of the recently revamped anatomy curriculum and provides opportunity for interaction with other medical professionals. It also offers possibilities for the development of the basic sciences orientated chiropractic research. 2012-05-08T16:21:14.805Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:19061 The relevance of the modern evolutionary theory for medical practice and research has been generally acknowledged. It is, however, still debated whether there is enough benefit to be gained from the evolutionary theory to justify its inclusion in the ever expanding medical curriculum. It is argued in this paper that in addition to the numerous benefits already explicated in other works, the inclusion of the evolutionary theory into the medical education offers yet another potential gain for medicine - it provides the key for the understanding of human biological variation and its relevance within the medical discourse. 2012-05-08T16:21:00.990Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:18916 It is argued in this article that the human body both in health and disease cannot be fully understood without adequately accounting for the different levels of human variation. The article focuses on variation due to ancestry, arguing that the inclusion of information pertaining to ancestry in human anatomy teaching materials and courses should be carried out and implemented with care and in line with latest developments in biological anthropology and related sciences. This seems to be of particular importance in the education of health professionals, as recent research suggests that better knowledge of human variation can improve clinical skills. It is also argued that relatively small curricular changes relating to the teaching of human variation can produce significant educational gains. 2012-04-30T19:50:40.481Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:18735 In this paper we present a pilot survey focusing on the chiropractors' views on possible racial differences in their patients' response to treatment. A questionnaire was developed and validated through this study. Results of this - pilot survey -show that the majority of respondents did not see biological race as a significant factor in chiropractic treatment and response to it. Thus, one may hypothesize that the race concept in chiropractic might not be as critical and contentious as it seems to be in the "mainstream" medicine. The inclusion of questions on patients' cultural differences is suggested for future surveys. Further studies, based on bigger and more diverse samples of chiropractors could shed more light on this issue. 2012-04-20T05:44:06.925Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:18750 Objective: The purpose of this systematic review is to discuss the evidence for manipulative methods of management of shoulder pain and chiropractic management techniques used within the literature. Methods: A literature search of MEDLINE, CINAHL, MANTIS, the Cochrane Musculoskeletal Group trials register and the Cochrane Controlled Trials Register was conducted. Search terms included chiropractic or manipulative therapy and shoulder pain, impingement, rotator cuff, shoulder instability, shoulder joint, treatment or rehabilitation exercises. Publications were included if they contained shoulder pain or contained a specific clinical diagnosis of a shoulder pain syndrome in the title; a detailed description of the treatment intervention which was typical of the profession; treatment performed by a registered practitioner and outcome measures were included in the studies. Exclusion criteria included the diagnosis of adhesive capsultis or referred/pathological pain. The articles were reviewed and clinical trials ranked on the Physiotherapy Evidence Database scale. Results: From a total of 913 retrieved publications, 22 case reports, 4 case series and 4 randomi zed, controlled trials met the inclusion and exclusion criteria for this review. Conclusions: The literature contains 2 articles of reasonably sound methodology. The evidence for chiropractic management of shoulder pain is limited to low level evidence in the form of case reports and case series and 1 small controlled trial. There is a need for more welldesigned, trials investigating multi-modal chiropractic management for shoulder pain. 2012-04-20T05:43:02.027Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:18306 BACKGROUND: Banked red blood cells (RBCs) undergo changes that reduce their viability after transfusion. Dysfunction of the glutathione (GSH) antioxidant system may be implicated. We measured the rate of GSH synthesis in stored RBCs and applied a model of GSH metabolism to identify storage-dependent changes that may affect GSH production. STUDY DESIGN AND METHODS: RBC units (n = 6) in saline-adenine-glucose-mannitol (SAGM) solution were each divided into four transfusion bags and separate treatments were applied: 1) SAGM (control), 2) GSH precursor amino acids, 3) aminoguanidine, and 4) glyoxal. RBCs were sampled during 6 weeks of storage. Rejuvenated RBCs were also analyzed. RESULTS: After 6 weeks, the ATP concentration declined to 50 ± 5.5% (p < 0.05) of that in the fresh RBCs. For control RBCs, the GSH concentration decreased by 27 ± 6.5% (p < 0.05) and the rate of GSH synthesis by 45 ± 8% (p < 0.05). The rate of GSH synthesis in rejuvenated and amino acid-treated RBCs was unchanged after 6 weeks. Modeling identified that the decline in GSH synthesis was due to decreased intracellular substrate concentrations and reduced amino acid transport, secondary to decreased ATP concentration. CONCLUSION: This study has uniquely shown that the glutathione synthesis rate decreased significantly after 6 weeks in stored RBCs. Our results have identified potential opportunities for improvement of banked blood storage. 2012-03-26T16:01:00.297Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:17789 All CAM courses include Legal, Ethical, and Professional Practice issues as an essential component of curriculum. Statutory bodies, professional associations, educational institutions and accreditation authorities require that such content be incorporated into CAM courses. 2012-02-27T03:30:26.347Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:17614 3 page(s) 2012-02-20T03:48:15.582Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16949 Background: As a proof-of-concept, the feasibility of detecting Staphylococcus aureus faster than previous whole-cell fluorescent in situ hybridization (FISH) methods was tested. Methods: Isolates of Staphylococcus were treated with three rapid slide-based FISH protocols and DNA probes. Protocols were shortened by optimizing, combining or omitting steps. Results: All FISH protocols detected S. aureus and not the phenotypically similar Staphylococcus epidermidis. The express FISH assay was completed in 24 minutes. The one-step FISH assay with NaCl and the one-step with phosphate buffered saline (PBS) assay took 19 minutes, but yielded a weaker signal. Conclusions: The exploratory study identified S. aureus two to three times faster than previous methods. Additional testing in a clinical laboratory scenario (for example with positive blood-culture bottles) is warranted. 2012-01-16T06:10:55.679Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:14745 Introduction: Anatomy has been at the foundation of medical students' training. In recent decades, medical programs in many countries have undergone major reform in both pedagogy and content. These reforms generated intense debates, focusing mainly on the way the new programs affected medical graduates' knowledge of anatomy and their clinical capabilities. Anatomy, however, is not only core to medicine, but also to a number of allied and complementary health disciplines. While the evaluation of anatomy teaching and learning in the medical programs has been heavily scrutinized, anatomy education in the complementary and alternative medicine (CAM) professions, including those, such as chiropractic, in which anatomy has traditionally been one of the main preclinical subjects, has been less frequently evaluated. Objectives: The study aimed to make a preliminary assessment of the final year chiropractic students' knowledge of anatomy using the "carpal bone test." Subjects and methods: The testing was conducted on the final-year chiropractic students at Macquarie University in 2009. In this test, the students were given 5 minutes to label an illustration of the bony skeleton of the carpal region. The results of this assessment were then compared to results of previously published surveys using the "carpal bone test." Results: A total of 84 students participated in the study. Thirty-eight percent (38%) of students identified a ll eight bones, while 60% of students identified five or more carpal bones. The most frequent correctly identified bone was the pisiform, followed by the scaphoid bone (82% and 74% of students, respectively). The trapezium and trapezoid bones were least frequently identified: both by 52% of students each. These results were generally better than those of the previously tested final-year medical students. Discussion and conclusions: The importance of anatomy in chiropractors' education has been generally acknowledged. This study suggests that the comparatively high number of hours devoted to anatomy in Macquarie University chiropractic curriculum and underpinning of clinical skills to anatomy knowledge in the senior year have increased retention of anatomy knowledge. The study, preliminary in nature, has also recognized the need for more detailed assessment of teaching and learning of the basic medical sciences in chiropractic and other CAM disciplines. 2012-01-12T19:27:08.877Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16464 10 page(s) 2012-01-12T19:13:25.006Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16492 22 page(s) 2012-01-12T19:13:23.790Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16846 152 page(s) 2012-01-12T19:12:42.481Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16858 4 pages(s) 2012-01-12T19:11:49.984Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16817 7 page(s) 2012-01-11T10:41:21.362Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16688 Numerous controversies and misunderstandings surround the study of human biological variation. It is agued in this paper that terminological clarification could result in a better understanding of several important issues within this field of research. Following on the work of George Fredrickson, the terms “racialism” and “racism” are defined and a new phrase – “racial hierarchism” – is introduced and defined. 2012-01-05T14:31:37.910Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16516 The Raymond A. Dart Collection of Human Skeletons (Dart Collection) is housed in the School of Anatomical Sciences at the University of the Witwatersrand, Johannesburg, South Africa, and comprises one of the largest documented cadaver-derived human skeletal assemblages in the world. This collection originated in the early 1920s as a result of the efforts of Raymond Dart and continues to grow. The skeletons included represent varied indigenous and immigrant populations from southern Africa, Europe and Asia. This contribution documents the history of the collection and provides an updated inventory and demographic assessment of this valuable research collection. According to a recent inventory the Dart Collection currently comprises 2,605 skeletons representing individuals from regional SA African (76%), White (15%), Coloured (4%) and Indian (0.3%) populations. A large proportion of the skeletons (71%) represent males. The recorded ages at death range from the first year to over 100 years of age, but the majority of individuals died between the ages of 20 and 70. The Dart Collection has been affected by collection procedures based on availability. All of the cadavers collected before 1958, and large proportions subsequently, were derived from unclaimed bodies in regional South African hospitals. Some details of documentation (age at death, population group) are estimates and some aspects of the collection demographics (sex ratios) do not closely reflect any living South African population. Our inventory and analysis of the Dart Collection is aimed to assist researchers planning research on the materials from this collection. 2011-12-21T05:00:44.970Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16517 Significant differences in views on race (once a core anthropological concept) occur between scientists from different countries. In light of the ongoing race debate, we present the concept's current status in Europe. On three occasions in 2002–03, we surveyed European anthropologists' opinions toward the biological race concept. The participants were asked whether they agreed that there are biological races within the species Homo sapiens. A dependence was sought between the type of response and several factors. Three of these factors—country of academic education, discipline, and age—were found to be significant in differentiating the replies. Respondents educated in Western Europe, physical anthropologists, and middle-aged persons reject race more frequently than respondents educated in Eastern Europe, people in other branches of science, and those from both younger and older generations. The survey shows that the views of anthropologists on race are sociopolitically (ideologically) influenced and highly dependent on education. 2011-12-21T05:00:44.568Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16488 Migraine occurs in about 15% of the general population. Migraine is usually managed by medication, but some patients do not tolerate migraine medication due to side effects or prefer to avoid medication for other reasons. Non-pharmacological management is an alternative treatment option. We systematically reviewed randomized clinical trials (RCTs) on manual therapies for migraine. The RCTs suggest that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine. However, the evaluated RCTs had many methodological shortcomings. Therefore, any firm conclusion will require future, well-conducted RCTs on manual therapies for migraine. 2011-12-20T23:30:54.384Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16487 Background: Staphylococcus aureus is a clinically important pathogen. A small number of whole-cell fluorescence in situ hybridization (FISH) probes have been reported to detect S. aureus. New online computational tools for in silico design and testing make it possible to assess candidate FISH probes for S. aureus. Materials and Methods: Six online tools, NCBI-Nucleotide, Ribosomal Database Project, NCBI-Blast, Reverse-Complement, Probecheck, and mathFISH, were employed in a workflow to evaluate FISH probes for S. aureus. A previously reported probe, Staaur-16S69, was compared to a new probe, KT18-16S68, predicted by mathFISH to have the same performance. Results: A number of new probes for S. aureus were predicted to perform as well or better in silico as those previously reported. When tested in a FISH assay, Staaur and a new probe, KT18, were found to have the same performance. Conclusion: Existing and new FISH probes for S. aureus were found to be accurately identified and characterized with online computational tools. In silico evaluation of probes has the potential to reduce the time spent evaluating probes in the laboratory. 2011-12-20T23:30:53.889Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16489 The premise that lung function can regulate chest wall mobility is an accepted concept. Descriptions of the primary and accessory respiratory structures do not usually include spinal components as a part of these classifications. The case for including these components as a part of the respiratory mechanism and their role in the development of dyspnea and chest wall rigidity in chronic obstructive pulmonary disease (COPD) is reviewed. Mechanical impairment of the chest wall is a contributing factor in the prognosis of COPD. Reducing this impairment improves prognosis. Because spinal manipulation and soft-tissue therapy increase joint mobility and decrease muscle hypertonicity, respectively, applying these interventions to the chest wall in COPD could reduce chest wall rigidity, thereby improving breathing mechanics. Improvements in breathing mechanics reduce the work of the respiratory muscles and delay the onset of dyspnea. Exercise capacity is reliant on the ability to overcome activity-limiting dyspnea, which usually occurs prior to maximum exercise capacity being reached. Delaying the onset of dyspnea permits more exercise to be performed before dyspnea develops. Spinal manipulation and soft-tissue therapy have the potential to deliver such a delay. Because exercise tolerance is considered to be a strong predictor of quality of life and survival in COPD, any increase in exercise capacity would therefore improve prognosis for the disease. 2011-12-20T23:30:49.121Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16306 Objective: The objective of this case series is to report the results of spinal manipulative therapy (SMT) for people with chronic obstructive pulmonary disease (COPD) who were older than 65 years. Methods: The study design was a prospective case series. Six patients of a long-term care center who were older than 65 years and having COPD underwent a course of 12 SMT sessions over a 4-week period. Each SMT session consisted of manually applied spinal manipulation and instrument-assisted spinal manipulation delivered by a doctor of chiropractic. Lung function measurements were recorded at baseline and at 2 and 4 weeks. The occurrence and type of any adverse events (AEs) related to SMT were recorded at each SMT session. Results: One male and 5 female patients took part in the study. The average age was 79.1 years (range, 68-89 years). There was a clinically significant increase in forced expiratory volume in the first second after SMT in 4 of the 6 patients at 2 weeks. This was sustained in only 1 patient at 4 weeks. No clinically significant changes were observed for forced vital capacity at 2 or 4 weeks. One hundred forty-four manually applied spinal manipulations and 72 instrument-assisted spinal manipulations were administered during the intervention period. No ma jor or moderate AEs were reported. Only minor AEs were reported after 29% of the intervention sessions, with 1 AE being reported for each patient. All AEs resolved within 48 hours. Conclusions: This case series offers preliminary evidence that SMT may have the potential to benefit lung function in patients with COPD who are older than 65 years. 2011-12-09T21:15:12.345Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16309 Objective: The purpose of this case report is to present the response of a patient with chronic nonresponsive cervicogenic dizziness to chiropractic care. Case report: A 29-year-old man had a 10-year history of progressive cervicogenic dizziness with symptoms including a sensation of excessive motion, imbalance, and spinning associated with neck pain and stiffness. After treatment, he reported a reduction in pain and dizziness and an improved quality of life following Gonstead method of chiropractic spinal manipulative therapy. Conclusion: This case study suggests that a patient with nonresponsive cervicogenic dizziness might respond to chiropractic spinal manipulative therapy approach using Gonstead method. 2011-12-09T21:15:02.319Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16311 Objective: The purpose of this article is to present a case study of chiropractic spinal manipulative treatment (CSMT) using the Gonstead method for a patient with migraines. Clinical Features: The patient was a 52-year-old married woman with a long-term history of chronic migraines, which included nausea, vomiting, and photophobia. The patient had endometriosis, but did not relate the migraines to her menstrual cycles. She also reported not using medication for her migraines due to previous drug-related issues. The average frequency of episodes before treatment was 1 per month, and her migraines often included an aura. The pain was moderate, was located on the right side, was pulsating, and lasted for approximately 15 hours. The numeric pain scale for an average episode was 8 out of a possible 10. The aura involved nausea, photophobia, and visual disturbances including black dots in the visual field lasting for approximately 10 minutes. Intervention and Outcome: The patient reported all episodes being eliminated following CSMT. At 6-month follow-up, the patient had not had a single migraine episode in this period. The patient was certain that there had been no other lifestyle changes that could have contributed to her improvement. Conclusion: This case adds to previous research suggesting that some migraine patients may respond favorably to CSMT. The case also provides information on the Gonstead method. A case study does not represent significant scientific evidence in context with other studies conducted; this study suggests that a trial of CSMT using the Gonstead methods could be considered for chronic, no nresponsive migraines. 2011-12-09T21:14:58.045Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16243 2 page(s) 2011-12-02T15:10:26.773Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:16244 Background: Aspects of the fluorescence in situ hybridization (FISH) method for the detection of clinically important bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli, were investigated for optimization. Methods: Various approaches to optimizing the FISH procedure were taken and different methods were compared. To save time, hybridization and washing buffers were prepared beforehand and stored at -20°C and mixed to their final formamide and NaCl concentrations just before use. The use of 50-ml tubes for hybridizationincubation reduced drying out, reagent wastage, and reaction times. Results: A two-step permeabilization FISH assay was developed that used phosphate-buffered saline as a buffer for lysostaphin. It could detect bacteria with DNA probes conjugated to fluorophores with a higher signal intensity and the less expensive biotinylated DNA probes with minimal cell lysis in 1hr. Conclusions: The two-step assay might be used when the FISH signal is weak, bacterial numbers are low or if there is a need to use other reporter molecules. 2011-12-02T15:10:20.922Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:15393 The issue of human variation has recently become of great interest in medical research and practice, but numerous disagreements and misunderstandings surround this complex subject. It might be argued that these negative aspects could be reduced significantly if elements of human variation were taught to medical students. Even small changes in the curriculum, if efficiently implemented, could produce considerable gains. 2011-10-13T11:50:32.665Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:15394 This paper argues that the history of science - specifically the experimental history of science- may be profitably used in the education of biological anthropologists for teaching human variation. E. 0. Manoiloffs research in racial serology conducted in the mid-1920s is used as an example. It is suggested that in addition to reading texts on the histoty of human variation studies, students could repeat Manioloffs experiments using both original and modem equipment. These learning activities will demonstrate to students the weaknesses of the typological approach and racial paradigm, contribute toward the development of a better understanding of the scientific process, and cultivate an appreciation of past and present research on human variation. 2011-10-13T11:50:30.235Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:15058 The purpose of this study was to provide further understanding of the consequences of technology transfer in the Cotui-Pueblo Viejo region in the Dominican Republic. The intent was to examine the transfer of the technology to the gold mine, the rationale for project implementation at Pueblo Viejo, and the eventual closure of the gold mining operations. Three relevant events have been identified in this case study: (a) The establishment of the gold mining operations at Pueblo Viejo, (b) the operation of the Rosario gold mine at Pueblo Viejo, and (c) the closure of the mining operations at Pueblo Viejo. A cross-site instrumental case study was used to examine the effects of technology transfer on the Pueblo Viejo gold mine. Following the identification of key informants in all sites, in-depth interviews of these informants were conducted followed by a review of relevant documents and a series of additional interviews for clarification and triangulation purposes (Mulenga, 2001). 2011-09-27T06:11:05.464Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:14865 Objectives: Studies investigating the efficacy of intra-oral myofascial therapies (IMT) for chronic temporomandibular disorder (TMD) are rare. The objective of this randomized, controlled pilot study was to compare the effects of IMT and the addition of self-care and education over 6 months on four common TMD outcome measures: inter-incisal opening range, jaw pain at rest, jaw pain upon opening, and jaw pain upon clenching. Participants: Thirty myogenous TMD participants between the ages of 18 and 50 years, experiencing chronic jaw pain of longer than 3-month duration, were recruited for the present study. Intervention: Included patients were randomized into one of three groups: (1) IMT consisting of two treatment interventions per week for 5 weeks; (2) IMT plus 'self-care' involving education and exercises; and (3) wait list control. Main outcome measures: Range of motion findings were measured in millimetres by vernier callipers and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Measurements were taken at baseline, 6 weeks post-treatment, and 6 months post-treatment. Results: The results showed statistically significant differences in resting, opening, and clenching pain and opening range scores (P<0.05) in both treatment groups compared to control at 6 months. No significant differences were observed between the two treatment groups during the course of the trial. Conclusions: This study suggests that IMT alone or with the addition of self-care may be of some benefit in the management of chronic TMD over the short-medium term. A larger scale study over a longer term (1–2 years) may be of further value. 2011-09-08T20:20:24.314Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:14371 Obejectives: The purpose of this study was to systematically review studies that quantify the high-velocity, low-amplitude (HVLA) spinal thrust, to qualitatively compare the apparatus used and the force-time profiles generated, and to critically appraise studies involving the quantification of thrust as an augmented feedback tool in psychomotor learning. Methods: A search of the literature was conducted to identify the sources that reported quantification of the HVLA spinal thrust. MEDLINE-OVID (1966-present), MANTIS-OVID (1950-present), and CINAHL-EBSCO host (1981-present) were searched. Eligibility criteria included that thrust subjects were human, animal, or manikin and that the thrust type was a hand-delivered HVLA spinal thrust. Data recorded were single force, force-time, or displacement-time histories. Publications were in English language and after 1980. The relatively small number of studies, combined with the diversity of method and data interpretation, did not enable meta-analysis. Results: Twenty-seven studies met eligibility criteria: 17 studies measured thrust as a primary outcome (13 human, 2 cadaver, and 2 porcine). Ten studies demonstrated changes in psychomotor learning related to quantified thrust data on human, manikin, or other device. Conclusions: Quantifiable parameters of the HVLA spinal thrust exist and have been described. There remain a number of variables in recording that prevent a standardized kinematic description of HVLA spinal manipulative therapy. Despite differences in data between studies, a relationship between preload, peak force, and thrust duration was evident. Psychomotor learning outcomes were enhanced by the application of thrust data as an augmented feedback tool. 2011-08-09T12:03:48.587Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:14208 Background: Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods: Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29) or control group (n = 30), being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months). The main outcome measure was an injury surveillance with a missed match injury definition. Results: After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051) and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051). The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025). There was no significant difference for weeks missed due to hamstring injury (4 v14, χ2:1.12, p = 0.29) and lower-limb muscle strains (4 v 21, χ2:2.66, p = 0.10). A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, χ2:6.70, p = 0.01). Conclusions: This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management. 2011-08-01T06:25:16.892Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13594 For a short period of time in the early 20th century, indentured labourers from China were imported to work on the South African gold mines. The Raymond A. Dart Collection of Human Skeletons contains 36 skeletons sourced from a Chinese cemetery of this time period on the site of the old Witwatersrand Deep Gold Mine. An earlier morphometric study on this collection recorded a high number of female individuals. However, the general historical records from the early gold mining era conflict with the results of this study, stating that very few Chinese females were among those to arrive in South Africa. In this study, the sex profile of this collection was analysed using molecular sex identification through the amelogenin gene. Results were obtained for 13 (41.93%) specimens, all of which were determined to be male – data that correspond well with the historical records. 2011-06-10T10:30:49.620Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13418 Available online 18 December 2010. Objectives. To collate and appraise incidence and severity data for neck injury in Rugby Union. To report risk factors for neck injury in Rugby Union that are supported by incidence and severity data. Design. Systematic review. Methods. Original journal articles were retrieved from electronic searches of AusportMed, AUSPORT, Scopus, Medline (Ovid), CINAHL, Mantis, and Pubmed databases and relevant bibliographic hand searches. Selection criteria were restricted to: (a) prospective study designs including cohort, case–control, and intervention methodologies; (b) populations of Rugby Union players, either male or female of any age; (c) studies must report on neck injury incidence and/or severity specifically; (d) articles with republished neck injury data were excluded. The STROBE Statement was adapted for the quality assessment of included studies and categorised as either poor, moderate or good. Results. Thirty-three original articles met the selection criteria. Wide variation of injury and exposure definitions and population sampling was identified in the included articles. Neck injury incidence ranged between 0.26 (CI: 0.08, 0.93) and 9.17 (CI: 1.89, 26.81) per 1000 player hours for mixed populations that adopted an all inclusive sports injury definition. There is a paucity of severity data and analytical data which evaluates causal roles of risk factors for neck injury in Rugby Union. Conclusions. Meaningful understanding of neck injury incidence and severity in Rugby Union is restricted to a few studies which adopt comparable methodological construct. This paper provides an index for future neck injury studies in Rugby Union. 2011-05-30T14:10:29.471Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13344 Aim: Despite known risks of spinal manipulative therapy (SMT), current radiographic guidelines do not allow assessment of all potential contraindications to treatment. Congenital or developmental anomalies are often asymptomatic but can represent an important contraindication to SMT. Although congenital or developmental anomalies are thought to be quite rare, prevalence data could not be found for the majority of these anomalies within the literature. Therefore, this research aimed to determine the prevalence of various congenital and developmental anomalies within a chiropractic-patient population and hence assess the suitability of current x-ray guidelines for the chiropractic profession. Methods: A retrospective study was undertaken on 3519 spinal plain-film x-ray reports taken within the Macquarie University Chiropractic Outpatient Clinics from 2000 to 2005. The number of congenital or developmental anomalies that would contraindicate SMT, or change the treatment approach, were collated. Prevalences of each anomaly were calculated per spinal region. Total prevalence of all congenital anomalies per spinal region was also calculated. Results: 2814 cervical films, 695 thoracic films and 1052 lumbar films were assessed for anomalies. The total percentage of congenital or developmental anomalies potentially contraindicating SMT was 30% (cervical spine), 0.9% (thoracic spine) and 22.5% (lumbar spine). The most common anomalies found were posterior ponticles (21.3%), transitional lumbar vertebrae (16.6%), lumbar spondylolisthesis (8.3%) and cervical ribs (5.1%). Conclusion: The prevalence of clinically significant congenital and developmental anomalies in the cervical and lumbar spine is significantly high as to warrant closer inspection of the current x-ray guidelines. However, the effect that the majority of these anomalies have on treatment is controversial. 2011-05-27T04:31:48.745Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:12690 Background: Low back pain in junior Australian Rules footballers has not been investigated despite findings that back pain is more prevalent, severe and frequent in senior footballers than non-athletic controls and findings that adolescent back pain is a strong predictor for adult back pain. The aim of this study was to determine the prevalence, intensity, quality and frequency of low back pain in junior Australian Rules footballers and a control group and to compare this data between groups. Methods: A cross-sectional survey of male non-elite junior (n = 60) and elite junior players (n = 102) was conducted along with a convenience sample of non-footballers (school children) (n = 100). Subjects completed a self-reported questionnaire on low back pain incorporating the Quadruple Visual Analogue Scale and McGill Pain Questionnaire (short form), along with additional questions adapted from an Australian epidemiological study. Linear Mixed Model (Residual Maximum Likelihood) methods were used to compare differences between groups. Log-linear models were used in the analysis of contingency tables. Results: For current, average and best low back pain levels, elite junior players had higher pain levels (p < 0.001), with no difference noted between non-elite juniors and controls for average and best low back pain. For low back pain at worst, there were significant differences in the mean pain scores. The difference between elite juniors and non-elite juniors (p = 0.040) and between elite juniors and controls (p < 0.001) was significant, but not between non-elite juniors and controls. The chance of suffering low back pain increases from 45% for controls, through 55% for non-elite juniors to 66.7% for elite juniors. The chance that a pain sufferer experiences chronic pain is 16% for controls and 41% for non-elite junior and elite junior players. Elite junior players experienced low back pain more frequently (p = 0.002), with no difference in frequency noted between non-elite juniors and controls. Over 25% of elite junior and non-elite junior players reported that back pain impacted their performance some of the time or greater. Conclusions: This study demonstrated that when compared with non-elite junior players and non-footballers of a similar age, elite junior players experience back pain more severely and frequently and have higher prevalence and chronicity rates. 2011-05-25T22:05:02.020Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:12719 Background Hypothyroidism is a prevalent endocrine condition. Individuals with this disease are commonly managed through supplementation with synthetic thyroid hormone, with the aim of alleviating symptoms and restoring normal thyroid stimulating hormone levels. Generally this management strategy is effective and well tolerated. However, there is research to suggest that a significant proportion of hypothyroid sufferers are being inadequately managed. Furthermore, hypothyroid patients are more likely to have a decreased sense of well-being and more commonly experience constitutional and neuropsychiatric complaints, even with pharmacological intervention. The current management of hypothyroidism follows a biomedical model. Little consideration has been given to a biopsychosocial approach to this condition. Within the chiropractic profession there is growing support for the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET) for this population. Methods/Design A placebo-controlled, single-blinded, randomised clinical pilot-trial has been designed to assess the influence of Neuro-Emotional Technique on a population with primary overt hypothyroidism. A sample of 102 adults (≥18 years) who meet the inclusion criteria will be randomised to either a treatment group or a placebo group. Each group will receive ten treatments (NET or placebo) over a six week period, and will be monitored for six months. The primary outcome will involve the measurement of depression using the Depression, Anxiety and Stress Scale (DASS). The secondary outcome measures to be used are; serum thyroid stimulating hormone, serum free-thyroxine, serum free-triiodothyronine, serum thyroid peroxidase auto-antibodies, serum thyroglobulin auto-antibodies as well as the measurement of functional health and well-being using the Short-Form-36 Version 2. The emotional states of anxiety and stress will be measured using the DASS. Self-measurement of basal heart rate and basal temperature will also be included among the secondary outcome measures. The primary and secondary measures will be obtained at commencement, six weeks and six months. Measures of basal heart rate and basal temperature will be obtained daily for the six month trial period, with recording to commence one week prior to the intervention. Discussion The study will provide information on the influence of NET when added to existing management regimens in individuals with primary overt hypothyroidism. Trial Registration ANZCTR Number: 12607000040460 2011-05-25T22:04:01.752Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13143 Background: There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer. Methods: All treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA) manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed. Results: A total of 487 treatments were provided (mean 16.8 consultations/player) with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies). Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%), knee (20%), hip (19%), sacroiliac joint (13%) and lumbar (11%). For soft tissue therapies it was gluteal (22%), hip flexor (14%), knee (12%) and lumbar (11%). The most common symptomatic regions treated with joint therapies were lumbar (25%), thoracic (15%) and hip (14%). For soft tissue therapies it was gluteal (22%), lumbar (15%) and posterior thigh (8%). Of the joint therapy, 56% was HVLA manipulation only, 36% high-HVLA and mobilization and 9% mobilization only. Of the HVLA manipulation, 63% was manually performed and 37% mechanically assisted. Conclusions: The intervention applied was multimodal and multi-regional. Most treatment was for asymptomatic benefit, particularly for joint based therapies, which consisted largely of HVLA manipulation techniques. Most treatment was applied to non-local hamstring structures, in particular the knee, hip, pelvis and spine. 2011-05-25T21:46:22.213Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13159 Objective: The purpose of this systematic review is to discuss the evidence for manipulative methods of management of shoulder pain and chiropractic management techniques used within the literature. Methods: A literature search of MEDLINE, CINAHL, MANTIS, the Cochrane Musculoskeletal Group trials register and the Cochrane Controlled Trials Register was conducted. Search terms included chiropractic or manipulative therapy and shoulder pain, impingement, rotator cuff, shoulder instability, shoulder joint, treatment or rehabilitation exercises. Publications were included if they contained shoulder pain or contained a specific clinical diagnosis of a shoulder pain syndrome in the title; a detailed description of the treatment intervention which was typical of the profession; treatment performed by a registered practitioner and outcome measures were included in the studies. Exclusion criteria included the diagnosis of adhesive capsultis or referred/pathological pain. The articles were reviewed and clinical trials ranked on the Physiotherapy Evidence Database scale. Results: From a total of 913 retrieved publications, 22 case reports, 4 case series and 4 randomized, controlled trials met the inclusion and exclusion criteria for this review. Conclusions: The literature contains 2 articles of reasonably sound methodology. The evidence for chiropractic management of shoulder pain is limited to low level evidence in the form of case reports and case series and 1 small controlled trial. There is a need for more well-designed, trials investigating multi-modal chiropractic management for shoulder pain. 2011-05-25T21:45:35.679Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13173 Background There is a paucity of epidemiological data on neck injury in amateur rugby union populations. The objective of this study was to determine the incidence, severity, aetiology and type of neck injury in Australian men's amateur rugby union. Methods Data was collected from a cohort of 262 participants from two Australian amateur men's rugby union clubs via a prospective cohort study design. A modified version of the Rugby Union Injury Report Form for Games and Training was used by the clubs physiotherapist or chiropractor in data collection. Results The participants sustained 90 (eight recurrent) neck injuries. Exposure time was calculated at 31143.8 hours of play (12863.8 hours of match time and 18280 hours of training). Incidence of neck injury was 2.9 injuries/1000 player-hours (95%CI: 2.3, 3.6). As a consequence 69.3% neck injuries were minor, 17% mild, 6.8% moderate and 6.8% severe. Neck compression was the most frequent aetiology and was weakly associated with severity. Cervical facet injury was the most frequent neck injury type. Conclusions This is the first prospective cohort study in an amateur men's rugby union population since the inception of professionalism that presents injury rate, severity, aetiology and injury type data for neck injury. Current epidemiological data should be sought when evaluating the risks associated with rugby union football. 2011-05-25T21:45:08.498Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:13074 Objective: Hip osteoarthritis (HOA) affects 30 million Americans or more, and is a leading cause of disability, suffering, and pain. Standard treatments are minimally effective and carry significant risk and expense. This study assessed treatment effects of a chiropractic protocol for HOA. Methods: Eighteen individuals, who did not qualify due to low baseline Western Ontario and McMaster Osteoarthritis Index scores (WOMAC) for other ongoing HOA randomized control trials, were selected. A prospectively planned protocol, consisting of axial manipulation to the affected hip with modified Thomas and active assisted stretch, was combined with full kinetic chain treatment or manipulative therapy to the spine, knee, ankle, or foot and assessed with use of valid and reliable outcome measures. Results: The primary outcome measure, the Overall Therapy Effectiveness Tool, was assessed with χ2 and demonstrated that 83.33% of participants were improved after the ninth visit, P = .005, and 78% improved at the 3-month follow-up, P = .018. Using the paired t test, WOMAC was improved 64% at the ninth visit, P = .000, and 47% at follow-up, P = .016. Conclusion: In HOA patients with lower WOMAC scores, a highly organized HOA treatment appears to have resulted in statistically and clinically meaningful intragroup changes in the Overall Effectiveness Therapy Tool, WOMAC, Harris Hip Scale, and range of motion, all with P ≤ .05. Although the directionality and strength of the findings are encouraging, fully powered clinical trials are necessary to report generalizable findings. 2011-05-13T03:33:35.209Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:12160 Background A variety of fluorophores are present in normal human urine. Alteration in the autofluorescence of urine could result from physiological or pathological changes. Method This study investigates the differences in the autofluorescence of 45 normal urine samples from 25 individuals with bacteriuria. Results Excitation at 290 nm showed good discrimination between these 2 groups. Principal Component Analysis (PCA) of the data revealed statistically significant differences between the fluorescence spectra for samples with bacteriuria as compared to the control group. Conclusion The findings indicate the potential of the fluorescence spectrum of urine to be developed as a simple and rapid diagnostic tool. 2011-03-10T12:50:28.982Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:12008 The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder (AD/HD). 2011-03-01T04:30:10.155Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:9382 Objective: The purpose of this literature review is to critically review the evidence for chiropractic as a treatment of primary insomnia. Methods: A search of the following databases up to October 2006 was conducted: PubMed, PEDro, MANTIS, CINAHL, and the specialized register of the Cochrane review group. We also performed hand searching of relevant journals. Randomized clinical trials, clinical trials, and case studies of chiropractic treatment of insomnia were included. It was required that each study used at least one form of standard patient outcome measure. Treatment strategies included manual therapy such as spinal manipulative therapy or muscle relaxation techniques. The review focused on articles published in indexed, peer-reviewed journals. Results: Fifteen studies met the selection criteria. There were no randomized clinical trials specific to chiropractic and insomnia. One study was a survey of opinion for treatment regimens for insomnia, which had low methodological scores. Another study assessed osteopathic cranial manipulation for insomnia, which appeared to have positive effects. Four studies identified physiotherapy treatment and manual therapy. A further 9 studies related to mind-body medical therapies and impaired health status, sleep disorders, and pain in the craniomandibular and cervical spinal regions. Conclusion: Some studies have noted improvement in insomnia following manual therapy; however, based on clinical trials, there is minimal evidence of support for chiropractic in insomnia. Further studies with high methodological scores need to be conducted. 2011-02-21T21:33:01.079Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:11888 Urinary tract infections (UTIs) are known to alter the normal urine composition which, in principle, can lead to changes in urine autofluorescence. This paper describes the study of human urine (normal and UTI) by using UV fluorescence excitation/emission matrices and synchronous spectra and proposes a method of diagnosing UTI without any sample preparation. The method is based on excitation in the shorter UV region (250–350 nm) which shows good discrimination between the normal urine and UTI samples. The synchronous scans with an offset of Δλ = 90 nm were also able to differentiate between normal urines and UTI samples. These differences were observed even though the two known major urine fluorophores, tryptophan and indoxyl sulfate were present in the normal urine and UTI samples in similar concentration as established by HPLC analysis. Although the identity of substances responsible for the altered autofluorescence in UTI is not established, our study shows that autofluorescence has the potential to differentiate between normal human urine samples and those with UTI. 2011-02-21T21:10:38.569Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:11377 Obtaining a bone sample for DNA analysis has traditionally been a destructive practice, which has resulted in reluctance on behalf of curators for skeletal collections to allow invasive testing. A novel minimally invasive bone sampling method for DNA analysis is presented here. This method uses a conventional hand drill wherein the bone sample is extracted from the intercondylar fossa of the femur; it does not interfere with any known anthropometric landmarks and only leaves a small hole on the surface of the bone. The temperature of the drill is documented and it was established due to the minor increase in temperature, that this should not affect the molecular integrity of the sample. This method is easily replicated and is suitable for both human and other animal skeletal material and can be applied to rare specimens with little risk. 2011-01-20T23:41:28.896Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:9537 Objective. To perform an epidemiological study in order to determine the golf-related injury locations, injury rates and possible risk factors for golf injury in amateur golfers across Australia. Method. A retrospective cross-sectional survey of Australian golf club members was used to collect data for the study. Chi-square testing was used to evaluate the association between golf injury and each possible risk factor at univariate level. All the possible risk factors were further examined in multivariate analysis using logistical regression. Results. There were 1 634 golfers included in the present study. Of these, 288 reported having had one or more golf related injuries in the previous year. The most common injury location was the lower back (25.3%), followed by the elbow (15.3%) and shoulder (9.4%). The most common injury mechanism was poor technique in execution of the golf swing (44.8%). Age, warm-up status, conditioning habits, wearing a golf glove/s and injury acquired in other sports / activities were significantly associated with risk of golf injury (p < 0.05). Equipment use such as type of golf club shaft used, type of shoes used and other factors studied were not statistically significant. Conclusion. The most injured sites identified in this study were the lower back, elbow and shoulder respectively. Risk of injury during golfing varied according to age group, warm-up status, conditioning habits, whether the player wore a golf glove/s, and whether the golfer had been injured in other activities. 2010-09-24T07:41:29.204Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:9271 Wrist injury is common in golfers and normally occurs at the impact of the club with the ball. The unusual case is reported of a low handicap golfer with wrist pain aggravated by the putting stroke. The condition was resolved with treatment. The likely mechanism for the injury is discussed. 2010-08-25T07:00:34.436Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:9265 Background: Considering its popularity, little epidemiologic literature exists on golf injuries. Hypothesis: The low back is the most common injury location for golf-related injury. Most golf injuries occur as a result of the golf swing, and occur mostly at impact. The variables age, handicap, practice habits, and warm-up habits are associated with injury. Methods: A prospective survey over 1 year was used to study golf injuries among 588 golfers at 8 Australian golf clubs. Information collected included golfers’ injuries sustained during the year, location of injury, onset, mechanism of injury, and whether injury occurred during the golf swing or at another time. Additional information was sought on the type of treatment received after injury. Logistic regression was used to examine the epidemiologic patterns of golf-related injury and any possible risk factors for the injury. Results: The overall 1-year incidence rate of golf injury was 15.8 injuries per 100 golfers, which equates to a range of 0.36 to 0.60 injuries/1000 hours/person. Recurrent injuries were most common, while injuries were more likely to occur over time as opposed to an acute onset. The lower back was the most common injury site (18.3%), closely followed by the elbow/forearm (17.2%), foot/ankle (12.9%), and shoulder/upper arm (11.8%). A total of 46.2% of all injuries were reportedly sustained during the golf swing, and injury was most likely to occur at the point of ball impact (23.7%), followed by the follow-through (21.5%). Multivariate analysis revealed that the amount of game play (odds ratio [OR] = 3.73, 95% confidence interval [CI] 1.29–10.75) and the last time clubs were changed (OR = 0.32, 95% CI 0.12–0.86) were significantly associated with the risk of golf injury (P < .05). Other factors such as age, gender, handicap, practice habits, and warm-up habits were not significantly associated with golf injury. Conclusions: Nearly 16% of Australian amateur golfers may expect to sustain a golf-related injury per year. The injuries in golf are most likely sustained in the lower back region as a result of the golf swing. Based on statistical analysis, only game play and a changing of clubs seem to be significantly associated with risk of injury after adjusting for other risk factors (P < .05). Other factors such as age, gender, handicap, practice habits, and warm-up habits were not significant. 2010-08-23T12:50:10.044Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8940 Quadrilateral space syndrome is an uncommon injury. The true prevalence is unknown because of a lack of literature and possible misdiagnosis. Prevalence may increase as knowledge of the syndrome increases. The case is presented of a recreational triathlete who had a spontaneous onset of quadrilateral space syndrome. The diagnosis was made by physical examination and confirmed with magnetic resonance imaging. A conservative, yet aggressive rehabilitation programme resulted in functional improvement within six weeks. Results have been maintained for eight weeks. 2010-08-11T06:50:03.738Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8938 Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in recognition and inclusion of sports chiropractic in both chiropractic and multi-disciplinary sports medicine alike. 2010-07-16T15:30:42.889Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8939 Background: Australian Rules Football is one of the most popular sports in Australia. Successful injury prevention relies on injury surveillance to establish the extent of injuries, to monitor injury patterns and to evaluate prevention strategies. Despite the popularity of participation at the community level, few injury surveillance studies have been published, so a detailed review of the literature is vital. There is limited information available outside of the elite level. Injury statistics for any professional sport may not necessarily be translatable to community sport level. Objective: To document the most prevalent injuries at the elite, junior elite, amateur and junior level and determine if incidences differ across levels of play. Aetiology and significant risk factors for injuries are emphasized and prevention and treatment discussed. Discussion: Injuries on average are more common at the elite level compared with other levels of participation. The type of injury varies slightly, with non contact injuries, particularly muscle strains, being the most common. Of these, the hamstring strain is the most common. Aetiology and risk factors vary between levels of play due to a time basis, physical development, speed of play and skill level. Recurrence rates are a concern for clubs and players, although rates are decreasing at the elite level, indicating better treatment and conservative management of injured players. 2010-07-16T15:30:33.327Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8942 Background: Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET) could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods: Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S); levator scapulae region (LS); sternocleidomastoid region (SCM) and temporomandibular region (TMJ). For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables) using forward stepwise General Linear Model. Results: The visual analog scale (0 to 10) had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P < 0.001). Conclusion: After a short course of NET treatment, measurements of visual analog scale and pressure algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly improved when compared to a control group which received a sham protocol of NET. Chronic neck pain sufferers may benefit from NET treatment in the relief of trigger point sensitivity. Further research including long-term randomised controlled trials for the effect of NET on chronic neck pain, and other chronic pain syndromes are recommended. 2010-07-16T15:30:26.856Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8722 Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was no recurrence through preventative treatment over a twelve and sixteen week period. The use of spinal manipulation for treatment or prevention of hamstring injury has not been documented in sports medicine literature and should be further investigated in prospective randomized controlled trials. 2010-07-14T07:50:55.325Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8723 Objective: To discuss the role of depression in chronic lower back pain and comment on appropriate methods of screening and co-management. Data Sources: The current scientific literature was investigated using the online web databases CINAHL, Medline/PUBMED, Proquest, Meditext and from manual library searches. Data Extraction: Databases were searched from 1980 to the present (2005). Articles were searched with the key words "depression" and "low back pain". Over three hundred articles were sourced and articles were then selected on their relevance to the chronic spinal pain states that present to manual therapy practitioners. Data synthesis: Pain is a subjective awareness of peripheral nociceptive stimulation, projected from the thalamus to the cerebral cortex with each individual's pain experience being mediated by his or her psychological state. Thus a psychological component will often be associated with any painful experience. A number of studies suggest (among other things) that the incidence of depression predicts chronicity in lower back pain syndromes but that chronic lower back pain does not have the reciprocal action to predict depression. Conclusion: The aetiology of chronic pain is multifactorial. There is sufficient evidence in the literature to demonstrate a requirement to draw treatment options from many sources in order to achieve a favourable pain relief outcome. The treatment should be multimodal, including mental and emotional support, counseling and herbal advice. While a strong correlation between depression and chronic low back pain can be demonstrated, an apparent paucity of literature that specifically addresses the patient response to chiropractic treatment and concurrent psychotherapy identifies the need for prospective studies of this nature to be undertaken. It is likely that multimodal/multidisciplinary treatment approaches should be encouraged to deal with these chronic lower back pain syndromes. 2010-06-21T10:10:15.651Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8721 Background: Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective: To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion: An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury. 2010-06-21T10:10:08.816Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:8720 Background: This paper describes a case of C7 radiculopathy in a professional rugby league player after repeated cervical spine trauma. The report outlines the management of the patient following an acute cervical hyperflexion injury with chiropractic manipulation and soft tissue therapies. It also presents a change in approach to include distractive techniques on presentation of a neurological deficit following re-injury. The clinical outcomes, while good, were very dependent upon the athlete restricting himself from further trauma during games, which is a challenge for a professional athlete. Case presentation: A 30-year old male front row Australian rugby league player presented complaining of neck pain after a hyperflexion and compressive injury during a game. Repeated trauma over a four month period resulted in radicular pain. Radiographs revealed decreased disc height at the C5-C6 and C6-C7 levels and mild calcification within the anterior longitudinal ligament at the C6-C7 level. MRI revealed a right postero-lateral disc protrusion at the C6-C7 level causing a C7 nerve root compression. Conclusion: Recommendations from the available literature at the present time suggest that conservative management of cervical discogenic pain and disc protrusion, including chiropractic manipulation and ancillary therapies, can be successful in the absence of progressive neurological deficit. The current case highlights the initial successful management of a football athlete, and the later unsuccessful management. This case highlights the issues involvement in the management of a collision sport athlete with a serious neck injury. 2010-06-21T10:10:07.588Z ]]> http://www.researchonline.mq.edu.au/vital/access/manager/Repository/mq:6036 This paper argues that hypnotherapy is a potentially effective adjunct to complementary medicine. Using existing research and professional publications, the paper considers the impact hypnosis could make as an adjunct to complementary medicine. Just as hypnosis is effective within the orthodox health arena, it could have application in complementary medicine. 2010-01-27T22:23:04.966Z ]]>