Prevention-Focused Care: The Potential Role of Chiropractors in Hong Kong's Primary Healthcare Transformation.

Hong Kong's healthcare system is moving toward preventive and primary care to address the complicated demands of the aging population. Chiropractic professionals are in an advantageous position to support a prevention-focused strategy by identifying musculoskeletal problems early, reducing risks, and promoting healthy lifestyles. This article examines how the involvement of chiropractors in public health programs could improve population health in Hong Kong and boost primary care. The inclusion of chiropractors in district health centers and other initiatives would offer safer and more cost-effective choices for treating functional problems and chronic pain. Chiropractors should be involved in policymakers' attempts to create a sustainable healthcare system that meets Hong Kong's long-term healthcare requirements.

Meeting Future Demand for Chiropractic Services in Hong Kong: A Strategic Manpower Planning Approach.

Chiropractic treatment in Hong Kong has demonstrated high effectiveness in cases where traditional therapies have failed, with minimal associated adverse events. The growing aging population, prevalence of disabilities, and musculoskeletal conditions have increased the demand for rehabilitation services. Over the past few years, the chiropractic profession has raised awareness of treatment benefits. Providing high-quality training and education, licensing/regulation, interprofessional collaboration, increased accessibility, and research are factors influencing the chiropractic workforce and meeting the population's health needs. To achieve the number of chiropractors required by Hong Kong for adequate service according to international standards, future efforts could include increased licensing/registration efficiency, expanded coverage of public/private insurance, system integration/interprofessional collaboration, public education, and local research to build evidence and to support workforce growth and acceptance.

Measurement and Analysis of Biomechanical Outcomes of Chiropractic Adjustment Performance in Chiropractic Education and Practice.

OBJECTIVE: The purpose of this study was to compare biomechanical measures of chiropractic adjustment performance of the McTimoney toggle-torque-recoil (MTTR) technique among students and chiropractors. METHODS: Fifty-three participants (15 year-3 [Y3] and 16 year-5 chiropractic students and 22 McTimoney chiropractors [DCs]) participated in this study. Each applied 10 MTTR thrusts to a dynamic load cell, 5 each with their left and right hands. Biomechanical variables including preload force, peak force, time to peak force, thrust duration, and total thrust time were computed from each of the force-time histories and compared within groups using a series of 2-way analysis of variance to evaluate the effects of sex and handedness, and between groups to determine the effect of experience using a series of 3-way analysis of variance. The Games-Howell post hoc test was used to further assess pairwise comparisons. RESULTS: Mean time to peak force was more than 3 × shorter for DCs (69.96 ms) compared with Y3 students (230.36 ms) (P = .030). Likewise, mean thrust duration was also found to be nearly 2.5-fold significantly shorter for DCs (117.77 ms) compared with Y3 students (283.84 ms) (P = .030). The DCs took significantly less total thrust time (mean = 1.27 seconds) in administering MTTR thrusts than Y3 students (1.89 seconds) (P = .006). No significant differences were found among any of the 3 clinician groups for peak force or in time to peak force or thrust duration for comparisons of all 10 MTTR thrusts among year-5 students and DCs. Higher peak forces were observed for thrusts delivered with clinicians' dominant hands (P = .001), and the fastest thrusts were found for the dominant hands of DCs (P = .001). Sex had no significant effect on biomechanical variables. The Y3 students had significant greater variability in thrust times for each hand and for analyses of both hands combined (P = .001). CONCLUSION: Training and experience were found to result in shorter MTTR thrust times and other biomechanical variables that have been identified as important factors in the mechanisms of chiropractic adjustments. Identification of such biomechanical markers as performance outcomes may be of assistance in providing feedback for training in chiropractic education and technique application.

A comparison of the academic outcome of chiropractic students on full-time and full-time equivalent chiropractic education routes.

OBJECTIVE: To compare the academic equivalence of full-time (FT) and full-time equivalent (FTE) delivery routes for chiropractic training and to assess nontraditional education delivery as a viable method for training chiropractors. METHODS: A retrospective analysis of student summative assessment data was undertaken on a total of 196 FT and FTE students studying for the master's in chiropractic degree at a UK chiropractic college between 2009 and graduating by 2017. The analysis consisted of within-group comparison and between-group comparisons using the Kruskal-Wallis test and the Mann-Whitney U test. RESULTS: The demographics of the 2 student groups varied in terms of gender and age distribution. The analysis of summative data indicated no differences between the 2 routes of delivery. There was also no difference in the distribution of final degree classification outcome between the 2 routes. CONCLUSIONS: While it is possible that demographic differences influence the outcomes in each training route, this preliminary study indicates that, based only on analysis of overall achievement, there is no difference in either FT or FTE programs in training chiropractors, allowing them to register with the UK regulatory body. It suggests that a nontraditional mode of delivery is an achievable route to qualification as a chiropractor, enabling a greater number of students to consider chiropractic as a career choice while managing other life commitments.

Public health engagement: detection of suspicious skin lesions, screening and referral behaviour of UK based chiropractors.

BACKGROUND: UK morbidity and mortality rates from skin cancer are increasing despite existing preventative strategies involving education and early detection. Manual therapists are ideally placed to support these goals as they see greater quantities of exposed patient skin more often than most other healthcare professionals. The purpose of this study therefore was to ascertain the ability of manual therapists to detect, screen and refer suspicious skin lesions. METHOD: A web-based questionnaire and quiz was used in a sample of UK chiropractic student clinicians and registered chiropractors to gather data during 2011 concerning skin screening and referral behaviors for suspicious skin lesions. RESULTS: A total of 120 questionnaires were included. Eighty one percent of participants agreed that screening for suspicious skin lesions was part of their clinical role, with nearly all (94%) assessing their patients for lesions during examination. Over 90% of the participants reported regularly having the opportunity for skin examination; with nearly all (98%) agreeing they would refer patients with suspicious skin lesions to a medical practitioner. A third of respondents had referred a total of 80 suspicious lesions within the last 12 months with 67% warranting further investigation. CONCLUSIONS: Nearly all respondents agreed that screening patients for suspicious skin lesions was part of their clinical role, with a significant number already referring patients with lesions.

Stress in chiropractic education: a student survey of a five-year course.

Objective : Stress encompasses academic issues, such as time management, increased work load, and new subject matter, but cannot be separated from stressors, such as social adjustment and financial pressure. Our study investigated whether perceived level of academic or practical attainment and the method of study were associated with the amount of perceived stress during students" studies. Methods : A semi-structured self-administered questionnaire was piloted and distributed to 134 students at a chiropractic college at the end of a lecture. Results : The survey had a response rate of 81%. Students in their fourth year consistently reported the highest perceived levels of stress, with 81% feeling that their ability to study was affected by their financial situation and 56% felt overwhelmed at their ability to cope with their college workload. All year groups were stressed during their course of studies, but the stressor varies depending on the year of study. Conclusions : Year 4 consistently demonstrated the highest levels of stress. All students, regardless of year group, experienced varying degrees of stress while studying and the central stressor changed depending on the time position within the course.

An investigation into the demographics and motivations of students studying for a chiropractic degree.

Objective : This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic. Methods : The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom. Results : The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic's holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had "changed their life." Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this. Conclusion : Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic.

Chiropractic treatment for primary nocturnal enuresis: a case series of 33 consecutive patients.

OBJECTIVE: The purpose of this study was to evaluate the effect of a specific type of chiropractic treatment on the wet night frequency of patients between the ages of 3 and 18 years who were treated for primary nocturnal enuresis (PNE) in the chiropractic setting. CLINICAL FEATURES: Thirty-three consecutive patient records, dating over a 3-year period, of children 3 to 18 years old who had been treated for PNE using a form of chiropractic treatment method (NeuroImpulse Protocol) were included. INTERVENTION AND OUTCOME: All patient records were analyzed for a baseline wet night frequency and at 3, 6, 9, and 12 months after the commencement of treatment. Data were collected regarding the number of treatment visits over the 12-month period and the presence of constipation and/or positive family history at presentation. Data were analyzed using descriptive statistics, Friedman's test, and Dunn's Multiple Comparison test. Of the 33 patient records analyzed, 22 showed resolution of PNE during the 12 months after commencement of chiropractic care. The mean number of treatments in the responders group was 2.05 +/- 1.33. Ten responders presented with constipation and a further 8 with a positive family history of PNE. Resolution of constipation was noted to be essential to the successful response to treatment. A combination of constipation and positive family history at presentation represented a poor prognostic factor. CONCLUSIONS: There was a 66.6% resolution rate within 1 year in 33 consecutive children and teenagers who experienced PNE. This study provides an indication for possible effectiveness of chiropractic treatment in patients with PNE.

Force-time profile characterization of the McTimoney toggle-torque-recoil technique.

OBJECTIVES: The purpose of this study was to characterize the force-time profile of the McTimoney toggle-torque-recoil (MTTR) technique. METHODS: Two licensed chiropractors trained in the McTimoney Method applied MTTR thrusts to a tabletop where a dynamic load cell had been mounted. Each clinician applied 10 thrusts (5 with each hand) to the load cell in a repeated measures design. Peak forces, time durations, and time to peak force were computed from each of the force-time histories. Descriptive statistics were performed to compare the forces, durations, and times to peak force of the MTTR thrusts. A Mann-Whitney U test compared variables between the 2 clinicians, whereas a Wilcoxon signed-rank test compared right- and left-handed thrusts within clinicians. RESULTS: Considering all MTTR thrusts, the average peak force was 87.22 N (SD = 24.18 N), the average overall thrust duration was 36.38 milliseconds (SD = 9.58 milliseconds), and the average time to peak force was 12.31 milliseconds (S.D. = 4.39 milliseconds). No significant differences in mean peak force, duration, or time to peak force were observed between clinicians. When comparing intraclinician right and left hand thrusts, differences in peak force and duration were observed individually (P < .05). CONCLUSION: For the 2 chiropractors tested, MTTR thrusts were relatively lower in peak force and appreciably faster than other commonly used chiropractic techniques. Future work aims to investigate the relationships between the force-time profiles of MTTR thrusts and resultant physiologic and clinical responses.