Viewing Issue:  Volume 2, Issue 4 (2011)

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


Topics in Integrative Health Care 2011, Vol. 2(4)     ID: 2.4001   

Each issue of TIHC focuses on a particular theme. Although many of the articles are invited, we also welcome unsolicited manuscripts with original research, Grand Rounds, clinical briefs and “fast facts” collections. All submissions are peer-reviewed. For the spring 2012 issue, the theme “Integrative approaches to chronic disease prevention and management” is tentatively scheduled.

Commentary

Finding a Common Ground in Chiropractic: The Key to Progression


Jordan Gliedt, D.C.    

Topics in Integrative Health Care 2011, Vol. 2(4)     ID: 2.4002   

The chiropractic profession has survived many challenges in its brief lifetime.  As a result of its many trials, the profession has a history filled with inner discord and external confusion, carrying over to the present.  Conflict among chiropractors with differing opinions in scope of practice, education and the chiropractor’s role has been embedded in the profession.  Chiropractors have traditionally vocalized passionately to each other and to each new generation of chiropractic students and patients their positions on these topics, creating an environment of intra-professional disorder and public uncertainty.  In order for chiropractic to mature to its highest potential, the profession must connect and present itself as a consistent and united group.  If chiropractors hope to unite, a bond must be created with some form of commonality in each area of dispute, overcoming the culture of internal friction.  This commentary, from a chiropractic student’s perspective, provides a historical look into how dispute in chiropractic has become so deeply rooted and presents a unifying principle in which chiropractors can relate to and overcome the profession’s divisions and public confusion while advancing chiropractic’s future.

Research

Methodology of a Randomized Controlled Trial of Manipulation and Physical Therapy for Chronic Low Back Pain and Balance Problems in the Geriatric Population.


Dennis E. Enix, DC, MBA

; 

Joseph H. Flaherty, MD

; 

Kasey Sudkamp, PT, DPT

; 

Theodore K. Malmstrom, PhD

Topics in Integrative Health Care 2011, Vol. 2(4)     ID: 2.4003   

Introduction: Postural control problems are one of the most common conditions affecting the geriatric population.  This paper discusses the design of a prospective randomized controlled trial that examines a mixed modal treatment protocol for geriatric patients with non-vestibular related balance problems with or without chronic low back pain.   

Methods: This three-year study will randomly assign a total of 300 consecutive community dwelling subjects between the ages of 65 and 80 years old into treatment groups receiving 6 weeks of either physical therapy or chiropractic care. Primary outcomes for balance include the NeuroCom balance tests, Berg Balance Scale, and POMA. The primary outcomes for low back pain are the VAS and 21-point box scale. Secondary outcomes are the Timed Up and Go Test for mobility and the Falls Efficacy Scale for confidence in performing everyday activities.  Participants will be tested prior to randomization, and after 6 weeks of treatment, and again 6 weeks later.  The data analysis for this intent-to-treat design will be mixed-model analysis of variance (ANOVA) with an alpha level of 0.05 for statistical significance for each outcome measure. 

Conclusion: The methodology and design of a multimodal treatment protocol for balance disorders and low back pain in the geriatric population is described in this paper.  By examining geriatric patients in separate cohorts with or without cLBP, we hope to identify effective treatment protocols and further define the relative contribution of cLBP to balance problems. 

Chiropractic Students’ Perceptions about Interdisciplinary Collaboration


Cheryl Hawk, DC, PhD, CHES

; 

Jerrilyn A. Cambron, LMT, DC, MPH, PhD

; 

Anupama Kizhakkeveettil, BAMS (Ayurveda), MAOM, L. Ac.

; 

Marion Willard Evans, Jr., DC, PhD, MCHES, CWP

Topics in Integrative Health Care 2011, Vol. 2(4)     ID: 2.4004   

Objective: To assess the attitudes of chiropractic students toward interdisciplinary collaboration, as well as to compare the attitudes of students at chiropractic-only colleges to those in chiropractic institutions training multiple health professions.

Methods: This was a cross-sectional survey conducted in 4 chiropractic institutions. Two are universities offering training in chiropractic and other CAM health professions, and two are chiropractic colleges offering only chiropractic training. Students were approximately midway in their course of training. The study instrument was the Interdisciplinary Education Perception Scale (IEPS), an 18-item questionnaire comprising 4 factors, with a 6-point Likert response scale. Mean total scores for each group of students were compared using an analysis of variance (ANOVA), with a post-hoc Bonferroni test of multiple comparisons. The mean total score of the two chiropractic-only colleges was compared to the mean total score of the two multiple health professions colleges using a t-test for independent samples.

Results: The survey was conducted in 2011 with 248 students. The mean total scores did not differ significantly among the 4 colleges (p = 0.57), nor did they when comparing the 2 chiropractic-only colleges to the 2 multiple health professions colleges (p = 0.47).

Conclusion: Based on the non-significant differences between the scores at the 4 institutions we surveyed, as well as their overall similarity to the students’ scores in the 2000 study, we feel it is appropriate to aggregate all DC students’ scores in our planned study involving samples from a number of health professions students.

Clinical Brief: Acromegaly in Adults


Ronald D. Williams, Jr., PhD, CHES

Topics in Integrative Health Care 2011, Vol. 2(4)     ID: 2.4005   

Acromegaly is a condition affecting the growth of extremities and facial features, in addition to increasing the risk of life-threatening diseases such as obesity, diabetes, and cardiovascular disease among adults. The National Organization of Rare Disorders classifies acromegaly as an orphan disease due its rare occurrence; however, medical researchers and practitioners suggest that the prevalence is much higher than current estimates. The health risks associated with this condition indicate a need for additional approaches to recognition and clinical diagnosis among healthcare providers.

Fast Facts

Fast Facts


THIC Staff    

Topics in Integrative Health Care 2011, Vol. 2(4)     ID: 2.4006   

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:

This report describes school health guidelines for promoting healthy eating and physical activity, including coordination of school policies and practices; supportive environments; school nutrition services; physical education and physical activity programs; health education; health, mental health, and social services; family and community involvement; school employee wellness; and professional development for school staff members. It is available free of charge to the public at http://www.cdc.gov/mmwr/pdf/rr/rr6005.pdf

CDC. School health guidelines to promote healthy eating and physical activity. MMWR 2011;60(5).