Journal of Chiropractic Medicine RSS feed: Current Issue. The Journal of Chiropractic Medicine is a peer-reviewed journal devoted to providing a forum for the chiropractic profession to disseminate information dedicated to the developing primary care emphasis within the profession. The journal focuses on providing practical and applicable information for the practicing doctor of chiropractic. http://www.journalchiromed.com/?rss=yesElsevier Inc.en © 2012 National University of Health Sciences. Published by Elsevier Inc. All rights reserved. Journal of Chiropractic Medicine1556-3707111March 2012 © 2012 National University of Health Sciences. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.journalchiromed.com/article/PIIS1556370711001647/abstract?rss=yesAbstract: Objective: The purpose of this study was to evaluate if manual muscle testing (MMT) could identify fetal sex in women who did not know the sex of their babies. The null hypothesis was that MMT is no more accurate than chance.Methods: A prospective case series of 27 sequential pregnant patients who did not know the sex of their fetus were included in this study. The examiner was also blind to the sex of the fetus. Manual muscle testing was evaluated after the mother stated “I am having a boy.” Likelihood ratios, specificity, sensitivity, positive predictive value, and negative predictive value were calculated.Results: Fourteen girl babies and 13 boy babies were born. Manual muscle testing accurately predicted the sex 13 times. The positive likelihood ratio was 0.92 (95% confidence interval, 0.42-2.03), sensitivity was 0.40, specificity was 0.54, positive predictive value was 0.46, and negative predictive value was 0.44.Conclusion: Manual muscle testing was no better than chance at predicting fetal sex in this case series.A case series evaluating the accuracy of manual muscle testing for predicting fetal sexKristopher B. Peterson, Caroline D. Peterson10.1016/j.jcm.2011.06.010Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports16http://www.journalchiromed.com/article/PIIS1556370711001659/abstract?rss=yesAbstract: Introduction: The purpose of this study is to report the findings resulting from chiropractic care using flexion distraction spinal manipulation for a patient with low back and radicular pain due to spinal stenosis caused by a synovial cyst.Case Report: A 75-year-old man presented with low back pain radiating to the right anterior thigh and down the left posterior leg of 3 years' duration. Physical and imaging examinations showed a synovial cyst–induced spinal stenosis at the right L3-L4 level and bilateral L4-L5 spinal stenosis.Intervention and Outcomes: Flexion distraction spinal manipulation and physiological therapeutics were applied at the levels of stenosis. After 4 visits, the patient noted total absence of the right and left lower extremity pain and no adverse reaction to treatment. After 3 months of treatment and 16 visits, his low back and buttock pain were minimal; and he had no leg pain.Conclusion: Lumbar synovial cyst and stenosis–generated low back and radicular pain was 80% relieved in a 75-year-old man following Cox flexion distraction spinal manipulation.Chiropractic management of a patient with lumbar spine pain due to synovial cyst: a case reportJames M. Cox10.1016/j.jcm.2011.08.007Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports715http://www.journalchiromed.com/article/PIIS1556370711001672/abstract?rss=yesAbstract: Objective: The purpose of this report is to describe the response of a geriatric patient with low back pain and a history of leukemia, multiple compression fractures, osteoporosis, and degenerative joint disease using Activator chiropractic technique.Case Report: An 83-year-old man who is the primary caretaker for his disabled wife had low back pain after lifting her into a truck. The patient had a history of leukemia, multiple compression fractures, osteoporosis, and degenerative joint disease. His Revised Oswestry Low Back Pain Disability Questionnaire was 26%, with a 10/10 pain rating at its worst on the Numeric Pain Scale. The patient presented with a left head tilt, right high shoulder, and right high ilium with anterior translation and flexion of the torso and spasm and tenderness from the lower thoracic spine to lumbar spine.Intervention and Outcome: The patient was cared for using Activator Methods protocol. After 8 treatments, the patient was stable and remained stable for 4 months without spasm or tenderness in his spine. His Revised Oswestry score dropped to 6%, with a 4/10 Numeric Pain Scale pain rating when at its worst; and the patient reported being able to take care of his wife.Conclusion: The findings of this case suggest that Activator-assisted spinal manipulative therapy had a positive effect on low back pain and function in an elderly patient with a complex clinical history.Chiropractic spinal manipulative therapy for a geriatric patient with low back pain and comorbidities of cancer, compression fractures, and osteoporosisJan A. Roberts, Tristy M. Wolfe10.1016/j.jcm.2011.05.001Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports1623http://www.journalchiromed.com/article/PIIS1556370711001660/abstract?rss=yesAbstract: Objective: The purpose of this article is to present the case of a patient with an anatomical anomaly of the piriformis muscle who had a piriformis syndrome and was managed with chiropractic care.Case Report: A 32-year-old male patient presented to a chiropractic clinic with a chief complaint of low back pain that radiated into his right buttock, right posterior thigh, and right posterior calf. The complaint began 5 years prior as a result of injuries during Airborne School in the US Army resulting in a 60% disability rating from the Veterans Administration. Magnetic resonance imaging demonstrated a mildly decreased intradiscal T2 signal with shallow central subligamentous disk displacement and low-grade facet arthropathy at L5/S1, a hypolordotic lumbar curvature, and accessory superior bundles of the right piriformis muscle without morphologic magnetic resonance imaging evidence of piriformis syndrome.Intervention and Outcome: Chiropractic treatment included lumbar and sacral spinal manipulation with soft tissue massage to associated musculature and home exercise recommendations. Variations from routine care included proprioceptive neuromuscular facilitation stretches, electric muscle stimulation, acupressure point stimulation, Sacro Occipital Technique pelvic blocking, CranioSacral therapy, and an ergonomic evaluation.Conclusion: A patient with a piriformis anomaly with symptoms of low back pain and piriformis syndrome responded positively to conservative chiropractic care, although the underlying cause of the piriformis syndrome remained.Chiropractic management of a US Army veteran with low back pain and piriformis syndrome complicated by an anatomical anomaly of the piriformis muscle: a case studyCynthia Chapman, Barclay W. Bakkum10.1016/j.jcm.2011.06.011Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports2429http://www.journalchiromed.com/article/PIIS1556370711001623/abstract?rss=yesAbstract: Objective: This report describes the treatment of 3 patients with previous spinal fusion surgery who had subsequently regressed to their previous levels of pain and disability.Clinical Features: Three patients with chronic intractable pain presented to a private integrative medicine clinic for manipulation under anesthesia (MUA) evaluation. All 3 patients had previously had lumbar spine fusion surgery for intervertebral disk herniation. All surgeries were performed at least 2 years before clinical presentation. Patients had plateaued with other conservative pain management strategies before seeking MUA treatment.Intervention and Outcomes: The patients were evaluated for MUA. The patients received a serial MUA over 3 consecutive days by trained chiropractic and osteopathic physicians. Outcome assessments used for each patient included a quadruple numerical pain rating scale and functional rating index. Patients completed a course of post-MUA physiotherapy and rehabilitation lasting 8 weeks immediately after the serial MUA. Clinical improvements were observed in all 3 outcome assessments after the MUA, the post-MUA therapy, and were essentially maintained 1 year after conclusion of treatment.Conclusion: Three patients with failed back surgery were treated conservatively using MUA by trained chiropractic and osteopathic physicians followed by 8 weeks of post-MUA therapy. Pain and disability outcomes all improved immediately following treatment.Manipulation under anesthesia for patients with failed back surgery: retrospective report of 3 cases with 1-year follow-upMark W. Morningstar, Megan N. Strauchman10.1016/j.jcm.2011.08.006Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports3035http://www.journalchiromed.com/article/PIIS1556370711001611/abstract?rss=yesAbstract: Objectives: This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care.Clinical Features: A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction.Intervention and Outcomes: Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh.Conclusion: In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient.Chiropractic management of chronic idiopathic meralgia paresthetica: a case studySébastien Houle10.1016/j.jcm.2011.06.008Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports3641http://www.journalchiromed.com/article/PIIS155637071200003X/abstract?rss=yesAbstract: Objective: The purpose of this case report is to describe a chiropractic rehabilitation program for a patient with postsurgical lateral retinaculum release.Clinical Features: A 26-year-old male ice hockey goalie presented 1 month after having lateral retinaculum release surgery for his left knee with residual mild discomfort and edema in his left knee.Intervention and Outcome: The patient was treated using a multimodal approach of both passive and active chiropractic care focusing on the restoration of full range of motion, increased proprioception, balance, strength, and endurance to return the patient to competitive ice hockey.Conclusion: This case study demonstrated that, after 14 weeks of care, the patient was able to return to ice hockey training with no residual symptoms.Chiropractic management of a patient with postoperative lateral retinacular release using a multimodal approach: a case reportThomas J. Solecki, Kurt D. Hostnik10.1016/j.jcm.2011.10.003Journal of Chiropractic Medicine 11, 1 (2012)2012-03-07Journal of Chiropractic Medicine2012-03-07111S1556-3707(11)X0006-8Case reports4248http://www.journalchiromed.com/article/PIIS1556370712000028/abstract?rss=yesAbstract: Objective: The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI).Clinical Features: Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI.Intervention and Outcome: Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable.Conclusion: The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time.Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series reportScott C. Cuthbert, Anthony L. Rosner10.1016/j.jcm.2011.10.002Journal of Chiropractic Medicine 11, 1 (2012)2012-03-09Journal of Chiropractic Medicine2012-03-09111S1556-3707(11)X0006-8Case reports4957http://www.journalchiromed.com/article/PIIS1556370711001635/abstract?rss=yesAbstract: Objective: The purpose of this report is to present the case of a 10-year-old football player with bilateral plantar fasciitis who improved with a multimodal conservative approach using chiropractic treatment.Clinical Features: The patient presented with bilateral plantar heel pain at the origin of the plantar fascia with a duration of 3 weeks.Intervention and Outcome: Treatment was provided for 6 visits over a 6-week period. Chiropractic care consisted of manipulative therapy, soft tissue therapy, and home rehabilitation exercises. The soft tissue technique (Graston Technique) was performed to the origin of the plantar fascia and the triceps surae bilaterally. High-velocity, low-amplitude manipulation was applied to the restricted ankle mortise joint. After 6 treatments, the patient reported resolution of foot pain bilaterally and improvements in activities of daily livings. Three months later, the patient reported no further complications and the absence of pain.Conclusion: This patient with bilateral plantar fasciitis improved after a course of a multimodal treatment approach using chiropractic manipulation and soft tissue therapy in addition to exercise and stretching therapies.Chiropractic management of pediatric plantar fasciitis: a case reportClinton J. Daniels, Adam P. Morrell10.1016/j.jcm.2011.06.009Journal of Chiropractic Medicine 11, 1 (2012)2011-11-14Journal of Chiropractic Medicine2011-11-14111S1556-3707(11)X0006-8Case reports5863http://www.journalchiromed.com/article/PIIS1556370712000090/abstract?rss=yesAbstract: Objective: Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments.Methods: PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors' libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA.Results: Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers.Conclusion: Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.Methicillin-resistant Staphylococcus aureus: an overview for manual therapistsBart N. Green, Claire D. Johnson, Jonathon Todd Egan, Michael Rosenthal, Erin A. Griffith, Marion Willard Evans10.1016/j.jcm.2011.12.001Journal of Chiropractic Medicine 11, 1 (2012)2012-03-07Journal of Chiropractic Medicine2012-03-07111S1556-3707(11)X0006-8Clinical update6476http://www.journalchiromed.com/article/PIIS1556370712000156/abstract?rss=yesEditorial Board10.1016/S1556-3707(12)00015-6Journal of Chiropractic Medicine 11, 1 (2012)2012-03-01Journal of Chiropractic Medicine2012-03-01111S1556-3707(11)X0006-8FrontmatterA1A1http://www.journalchiromed.com/article/PIIS155637071200017X/abstract?rss=yesMasthead10.1016/S1556-3707(12)00017-XJournal of Chiropractic Medicine 11, 1 (2012)2012-03-01Journal of Chiropractic Medicine2012-03-01111S1556-3707(11)X0006-8FrontmatterA2A2http://www.journalchiromed.com/article/PIIS1556370712000193/abstract?rss=yesTable of Contents10.1016/S1556-3707(12)00019-3Journal of Chiropractic Medicine 11, 1 (2012)2012-03-01Journal of Chiropractic Medicine2012-03-01111S1556-3707(11)X0006-8FrontmatterA3A4http://www.journalchiromed.com/article/PIIS1556370712000211/abstract?rss=yesInstructions for Authors10.1016/S1556-3707(12)00021-1Journal of Chiropractic Medicine 11, 1 (2012)2012-03-01Journal of Chiropractic Medicine2012-03-01111S1556-3707(11)X0006-8FrontmatterA5A8http://www.journalchiromed.com/article/PIIS1556370712000235/abstract?rss=yesCopyright Form10.1016/S1556-3707(12)00023-5Journal of Chiropractic Medicine 11, 1 (2012)2012-03-01Journal of Chiropractic Medicine2012-03-01111S1556-3707(11)X0006-8FrontmatterA9A9