Current Issue:  Volume 6, Issue 1 (2015)

Topics in Integrative Health Care: an International Journal (TIHC) is a peer-reviewed, open-access online journal. It is dedicated to advancing the integration of multiple disciplines, both complementary and mainstream, into diverse health care settings in order to provide optimal patient care. It presents themed issues on topics of current relevance to health care providers interested in integrative, conservative care, health promotion and disease prevention. It includes international, interdisciplinary Grand Rounds in order to facilitate communication and patient comanagement among various health professions, for the good of patients everywhere.

Topics in Integrative Health Care (TIHC) is published by Healthindex, Inc. (ChiroACCESS).

Editorial

Topics in Integrative Health Care


Cheryl Hawk, DC, PhD, CHES    

Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1001   

Topics in Integrative Health Care welcomes unsolicited manuscripts with original research, Grand Rounds, clinical briefs and “fast facts” collections. All submissions are peer-reviewed.

Research

A Randomized Controlled Trial of Chiropractic Compared to Physical Therapy for Chronic Low Back Pain in Community Dwelling Geriatric Patients


Dennis E. Enix, DC, MBA

Kasey Sudkamp, PT, DPT

Theodore K. Malmstrom, PhD

Joseph H. Flaherty, MD

Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1002   

Background: Chronic low back pain is the most frequently reported musculoskeletal condition in the elderly, affecting up to 50% of this age cohort. It is a leading falls related comorbidity and robust predictor of morbidity among the elderly.

Methods: This analysis of a randomized controlled trial evaluated the use of either chiropractic care (CC) or physical therapy (PT) as a treatment for geriatric patients with balance problems and with or without chronic low back pain. Of the one hundred and eighteen participants enrolled, sixty one participants (51.7%) were randomized into the CC group and fifty seven participants (48.3%) into the PT group. A pain questionnaire was administered at baseline, after 6 weeks of treatment, and again at week 12. University ethics committee approval was obtained and written informed consent was given.

Results: There was statistically significant reductions in pain for this intent-to-treat design mixed model analysis of variance (ANOVA) (p < 0.05) and Bonferroni correction (p < 0.025; 95% CI). The CC and PT groups had similar reductions at week 6 for Box 21 current pain scores (52.7%, 50.9%); Box 21 least pain scores (40.4%, 45.4%); Box 21 worst pain scores (42.1%, 37.2%); Box 21 usual pain scores (41.1%, 46.7%); and Box 21 number of days per week in pain scores (24.3%, 18.9%). There were no significant between group effects.

Conclusion: There were statistically and clinically significant improvements in pain outcome measures in both the chiropractic care and physical therapy treatment groups at week six and at week twelve.

Trial registration: NCT02031562

The Impact of Kinesiology Tape Over the Posterior Lower Limb on Runner Fatigue


John Ward, DC, MA, MS

Kenneth Sorrels, DC

Jesse Coats, D.C., B.S., D.A.A.P.M.

Pourmoghaddam Amir, PhD

Tiffany Sarmiento, BS

Carlos DeLeon, BS

JoAnn Moskop, BS

Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1003   

Purpose: The purpose of this study was to determine if placing kinesiology tape on the posterior lower limbs helps preserve runner gait in a fatigued state. The hypothesis was that the elastic properties of the tape may help the runners push off with each step.

Methods: Sixty healthy participants (age= 26.7 + 4.3 yrs, height= 1.72 + 0.09 m, body mass= 75.4 + 17.0 kg: mean + SD) engaged in a baseline 90-second running gait analysis at 6 mph without kinesiology tape. Participants then completed an Åstrand cycle ergometer maximal test until they reached maximal volitional exhaustion and had over 8 mmol/l blood lactate, which correlates with maximal to near maximal exercise effort. Following this, participants were randomized to one of two interventions: 1) Intervention, which had kinesiology tape placed on the back of the lower limbs bilaterally from their gluteal fold to their heel under tension or 2) Control, no-tape group. All participants then engaged in a running gait analysis in a fatigued state at 6 mph. Researchers used a 2-way repeated measures analysis of variance considering fatigue (pre-fatigue, post-fatigue) and group (tape, no-tape) as subject factors.

Results: There were no statistically significant within-group differences amongst the groups. However, in fatigued runners kinesiology tape placed on the back of the lower limbs was shown to decrease hip functional range of motion, step length, and stride length bilaterally more than participants who did not receive kinesiology tape.

Conclusions: Preliminarily this suggests kinesiology tape placed exclusively on the back of the lower limbs of a fatigued runner will alter and potentially impair running gait by reducing stride length at submaximal running intensities.

The Extent of Interprofessional Education in the Clinical Training of Integrated Health and Medicine Students: A Survey of Educational Institutions


Beth Rosenthal, MPH, MBA, PhD

Anthony J. Lisi, DC

Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1004   

Today’s healthcare environment requires collaboration and cooperation among healthcare professions, whether working in a ‘virtual’ team or in an integrated clinical setting. Patients are best served when healthcare providers understand and respect each other’s professions and are able to work well together. The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) conducted a survey to assess the extent and characteristics of interprofessional education (IPE) in the clinical training of students at accredited programs, colleges and universities of the licensed integrative health and medicine disciplines (chiropractic, acupuncture and Oriental medicine, naturopathic medicine, massage therapy, direct-entry midwifery). The survey was sent to 134 clinical training administrators, and we received responses from 88 for an overall response rate of 66%. There was much variation in the reported amount of IPE and the particular disciplines engaged in IPE activities with other disciplines during clinical training. Chiropractic institutions reported the most IPE, whereas direct-entry midwifery reported the least. Across all disciplines, multidisciplinary institutions generally reported more IPE in clinical training than single discipline institutions. Further work assessing the quality of such training, and its effect on subsequent practice, may help inform future educational strategies for the integrative health and medicine disciplines.

A Case Report on the Management of a Patient Presenting With Post-concussion Syndrome and Post-traumatic Stress Disorder, Using the Upper Cervical Chiropractic Technique


Scott Bales, DC

Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1005   

Introduction: This case report describes the chiropractic management of a patient with a history of multiple mild traumatic brain injuries, using Upper Cervical manipulative technique.

Clinical Features: A 42 year old man presenting with symptoms of post-concussion syndrome, and diagnosed with post-traumatic stress disorder and depression.

Intervention and Outcome: The Kale Upper Cervical Procedure was utilized to assess, monitor, and correct the effects of an upper cervical subluxation in a patient over an 8 week period. The patient reported significant improvement in symptoms of post- concussion syndrome, and small positive improvements in PTSD symptoms. Follow up at 11 months showed continued improvement in most symptoms.

Conclusion: Upper cervical chiropractic management of a patient with multiple mild traumatic brain injuries was presented. Significant improvements in post-concussion symptoms were observed.

Special Feature Abstracts of presentations made at the Upper Cervical Experience Conference February 26th-28th, 2015 in New Orleans LA.


Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1006   

Special Feature
Abstracts of presentations made at the Upper Cervical Experience Conference
February 26th-28th, 2015 in New Orleans LA.

Fast Facts

Fast Facts


THIC Staff    

Topics in Integrative Health Care 2015, Vol. 6(1)     ID: 6.1007   

Readers are welcome to contribute to Fast Facts. Please include the original abstract (with citation) that is the source of your contribution. Contributors’ names will be included along with the item.


The following is an excerpt:

Mindfulness-based stress reduction (MBSR) is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptoms.

Greeson JM, Smoski MJ, Suarez EC, et al. Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age. J Altern Complement Med. Feb 19 2015.