Investigacion y deporte

Curator:  Stephen M. Perle DC MS ICCSP


Showing 1-10 of 10

A survey of Fellows in the College of Chiropractic Sports Sciences (Canada): their intervention practices and intended therapeutic outcomes when treating athletes.

Miners, Andrew L & Degraauw, Christopher
The Journal of the Canadian Chiropractic Association
OBJECTIVE: To compile baseline data regarding the treatment practices and therapeutic outcomes that fellows of the College of Chiropractic Sports Sciences Canada (CCSS(C)) strive for when treating athletes. DESIGN: Cross-sectional self-report mail out survey of CCSS(C) fellows. PARTICIPANTS: Current registered fellows of the CCSS(C) as determined by the College at the time of survey distribution. RESULTS: The majority of questioned fellows believe that they can cause direct and specific improvements in an athlete’s sport performance. The most commonly utilized therapeutic intervention was spinal joint manipulation/mobilization. The most anticipated outcomes following the treatment of athletes with the goal of affecting athletic performance were changing or improving aberrant body mechanics
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The integration of chiropractors into healthcare teams: a case study from sport medicine.

Theberge, Nancy
Sociology of health \& illness
This article examines the integration of chiropractors into multi-disciplinary healthcare teams in the specialisation of sport medicine. Sport medicine is practised in a number of contexts in professional and amateur sport. The current analysis focuses on the highest levels of amateur sport, as exemplified by the Olympics. Data are taken from interviews with 35 health professionals, including physicians, physiotherapists, athletic therapists and chiropractors. A defining feature of sport medicine is an emphasis on performance, which is the basis for a client-centred model of practice. These two elements have provided the main grounds for the inclusion of chiropractic in sport medicine. While the common understanding that ‘athletes wanted them’ has helped to secure a position for chiropractic within the system of sport medicine professions, this position is marked by ongoing tensions with other professions over the scope and content of practice, and the nature of the patient-practitioner relationship. In the context of these tensions, chiropractors’ success in achieving acceptance on sport medicine teams is contingent on two factors: (a) reduced scope of practice in which they work primarily as manual therapists; and (b) the exemplary performance of individual practitioners who ‘fit’ into multi-disciplinary sport medicine teams.
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Manipulative therapy for lower extremity conditions: update of a literature review.

Brantingham, James W; Bonnefin, Debra; Perle, Stephen M; Cassa, Tammy Kay; Globe, Gary; Pribicevic, Mario; Hicks, Marian & Korporaal, Charmaine
Journal of manipulative and physiological therapeutics
OBJECTIVE: The purpose of this study is to update a systematic review on manipulative therapy (MT) for lower extremity conditions. METHODS: A review of literature was conducted using MEDLINE, MANTIS, Science Direct, Index to Chiropractic Literature, and PEDro from March 2008 to May 2011. Inclusion criteria required peripheral diagnosis and MT with or without adjunctive care. Clinical trials were assessed for quality using a modified Scottish Intercollegiate Guidelines Network (SIGN) ranking system. RESULTS: In addition to the citations used in a 2009 systematic review, an additional 399 new citations were accessed: 175 citations in Medline, 30 citations in MANTIS, 98 through Science Direct, 54 from Index to Chiropractic Literature, and 42 from the PEDro database. Forty-eight clinical trials were assessed for quality. CONCLUSIONS: Regarding MT for common lower extremity disorders, there is a level of B (fair evidence) for short-term and C (limited evidence) for long-term treatment of hip osteoarthritis. There is a level of B for short-term and C for long-term treatment of knee osteoarthritis, patellofemoral pain syndrome, and ankle inversion sprain. There is a level of B for short-term treatment of plantar fasciitis but C for short-term treatment of metatarsalgia and hallux limitus/rigidus and for loss of foot and/or ankle proprioception and balance. Finally, there is a level of I (insufficient evidence) for treatment of hallux abducto valgus. Further research is needed on MT as a treatment of lower extremity conditions, specifically larger trials with improved methodology.
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Manipulative therapy for shoulder pain and disorders: expansion of a systematic review.

Brantingham, James W; Cassa, Tammy Kay; Bonnefin, Debra; Jensen, Muffit; Globe, Gary; Hicks, Marian & Korporaal, Charmaine
Journal of manipulative and physiological therapeutics
OBJECTIVE: The purpose of this study was to conduct a systematic review on manual and manipulative therapy (MMT) for common shoulder pain and disorders. METHODS: A search of the literature was conducted using the Cumulative Index of Nursing Allied Health Literature; PubMed; Manual, Alternative, and Natural Therapy Index System; Physiotherapy Evidence Database; and Index to Chiropractic Literature dating from January 1983 to July 7, 2010. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, musculoskeletal, physical therapies, shoulder, etc. Inclusion criteria required a shoulder peripheral diagnosis and MMT with/without multimodal therapy. Exclusion criteria included pain referred from spinal sites without a peripheral shoulder diagnosis. Articles were assessed primarily using the Physiotherapy Evidence Database scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring were complete, with subsequent participant review and agreement, evidence grades of A, B, C, and I were applied. RESULTS: A total of 211 citations were retrieved, and 35 articles were deemed useful. There is fair evidence (B) for the treatment of a variety of common rotator cuff disorders, shoulder disorders, adhesive capsulitis, and soft tissue disorders using MMT to the shoulder, shoulder girdle, and/or the full kinetic chain (FKC) combined with or without exercise and/or multimodal therapy. There is limited (C) and insufficient (I) evidence for MMT treatment of minor neurogenic shoulder pain and shoulder osteoarthritis, respectively. CONCLUSIONS: This study found a level of B or fair evidence for MMT of the shoulder, shoulder girdle, and/or the FKC combined with multimodal or exercise therapy for rotator cuff injuries/disorders, disease, or dysfunction. There is a fair or B level of evidence for MMT of the shoulder/shoulder girdle and FKC combined with a multimodal treatment approach for shoulder complaints, dysfunction, disorders, and/or pain.
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Sports chiropractic in prevention of pain and injury.

Lawrence, DJ. & Hoskins, WW.
Focus On Alternative And Complementary Therapies
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Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review.

Brantingham, James W; Cassa, Tammy Kay; Bonnefin, Debra; Pribicevic, Mario; Robb, Andrew; Pollard, Henry; Tong, Victor & Korporaal, Charmaine
Journal of manipulative and physiological therapeutics
OBJECTIVE: The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ). METHODS: A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of A
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The efficacy of manual joint mobilisation/manipulation in treatment of lateral ankle sprains: a systematic review.

Loudon, Janice K; Reiman, Michael P & Sylvain, Jonathan
British journal of sports medicine
BACKGROUND: Lateral ankle sprains are common and can have detrimental consequences to the athlete. Joint mobilisation/manipulation may limit these outcomes. OBJECTIVE: Systematically summarise the effectiveness of manual joint techniques in treatment of lateral ankle sprains. METHODS: This review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A computer-assisted literature search of MEDLINE, CINHAL, EMBASE, OVID and Physiotherapy Evidence Database (PEDro) (January 1966 to March 2013) was used with the following keywords alone and in combination ‘ankle’, ‘sprain’, ‘injuries’, ‘lateral’, ‘manual therapy’, and ‘joint mobilisation’. The methodological quality of individual studies was assessed using the PEDro scale. RESULTS: After screening of titles, abstracts and full articles, eight articles were kept for examination. Three articles achieved a score of 10 of 11 total points; one achieved a score of 9; two articles scored 8; one article scored a 7 and the remaining article scored a 5. Three articles examined joint techniques for acute sprains and the remainder examined subacute/chronic ankle sprains. Outcome measures included were pain level, ankle range of motion, swelling, functional score, stabilometry and gait parameters. The majority of the articles only assessed these outcome measures immediately after treatment. No detrimental effects from the joint techniques were revealed in any of the studies reviewed. CONCLUSIONS: For acute ankle sprains, manual joint mobilisation diminished pain and increased dorsiflexion range of motion. For treatment of subacute/chronic lateral ankle sprains, these techniques improved ankle range-of-motion, decreased pain and improved function.
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Australian chiropractic sports medicine: half way there or living on a prayer?

Pollard, Henry; Hoskins, Wayne; McHardy, Andrew; Bonello, Rod; Garbutt, Peter; Swain, Mike; Dragasevic, George; Pribicevic, Mario & Vitiello, Andrew
Chiropractic \& osteopathy
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.
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A pilot study on the effects of pre-event manipulation on jump height and running velocity.

Shrier, I; Macdonald, D & Uchacz, G
British journal of sports medicine
PURPOSE: To compare changes in jump height and running velocity with and without pre-event high-velocity, low-amplitude manipulation (HVLA). METHODS: A crossover study design with elite healthy athletes was used. After a 15 min warm-up, the subjects were tested for countermovement jump height (CMJ) and flying 40 m sprint time (SPRINT). A sport chiropractor then evaluated each subject. Subjects were randomised to either HVLA (applied to joints based on examination) or placebo (simulated performance-enhancement stickers). They then rested for 60 min, performed another 15 min warm-up, and were retested. The protocol was repeated 48 h later with the alternative intervention. The mean of two sprints and three jumps were analysed, as well as peak performances. The sample size was based on prior results from the effects of stretching. RESULTS: 19 subjects involved in sprint sports were enrolled; two were too sore to participate on day 2, and one could only participate in the jump (all had HVLA on day 1). Of the 17 participants analysed, seven were female, age range was 19-35, and 17 were national or world-class athletes. The ranges for baseline measures were: SPRINT 4.1-5.5 s; CMJ 47.4-92.7 cm. Overall, the greater than expected variability in this pilot study led to the study being underpowered. Subjects tended to perform better after HVLA for both CMJ and SPRINT (both mean and peak results), but none of the results were statistically significant (p = 0.30-0.61). CONCLUSION: Although the larger than expected variability in the pilot study means that the observed clinically relevant differences were not statistically significant, the direction and magnitude of the changes associated with HVLA suggest that it may be beneficial. That said, the increased soreness after HVLA suggests that it may be detrimental. HVLA warrants further study.
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An exploratory mixed-method study to determine factors that may affect satisfaction levels of athletes receiving chiropractic care in a nonclinic setting.

Talmage, Grant; Korporaal, Charmaine & Brantingham, James W
Journal of chiropractic medicine
OBJECTIVES: The objectives of this study were to determine factors that may affect satisfaction levels of participants in a nonclinic (sport) setting through participant observation and participation. Factors associated with general satisfaction (observed) were determined along with a participant demographic profile, participant knowledge about chiropractic, and satisfaction with treatment received from a chiropractic student. Thereafter, the relationships between the demographic factors, participant knowledge, and participant general satisfaction were determined. Lastly, factors affecting satisfaction levels were compared between the participants and the observers. METHODS: An exploratory mixed-method observational study that compared results reported by 30 participants and 2 observers, regarding the treatment process, by completion of a self-administered questionnaire. Statistical significance was set at P less than or equal to .05. RESULTS: Of the 30 participants, 83.3\% were South African, 90\% were white, and 63.3\% were male, with a mean age of 35.6 years, who reported they were very satisfied with chiropractic care (P = .229). The only factor to produce a significant difference between participants and observers was communication (P = .082 with Spearman = .332). CONCLUSION: In this study, communication had the greatest impact; therefore, it is suggested that positive verbal and nonverbal communication be emphasized in the training of future chiropractic professionals.
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