Comparison of perceived comfort differences between standard and experimental load carriage systems.

The current popularity of backpack-type load carriage systems (LCS) by students has precipitated a prevalence of postural abnormalities and pain. This study compared subjective perceptual comfort in standard and vertically loaded LCSs. Sixteen females ages 18-23 years rated their personal LCSs for perceived shoulder, neck, and lower back comfort and for overall comfort, each day for two weeks using 100 mm visual analogue scales (VAS). Each scale contained polar extremities of 'very comfortable' to 'very uncomfortable' and a vertical mark placed on the 100 mm line by the participants indicated their perception of comfort. Following two weeks, participants were given LCSs that distributed the weight vertically and were asked to rate the system in the same way for an additional two-week period. Statistical analysis revealed significant differences in shoulder (p=0.015), neck (p=0.005), and lower back (p=0.036) comfort and overall comfort (p=0.001) between the participants' personal LCSs and the experimental LCS. In conclusion, vertical load placement may redistribute the load in a manner that reduces symptoms of selected anatomical discomfort.

Patient satisfaction with chiropractic physicians in an independent physicians' association.

BACKGROUND: Satisfaction with care is one of the variables that can be used in determining the results of medical care. Patient satisfaction surveys allow managed care plans to determine how well their providers meet certain standards. OBJECTIVE: To determine the level of satisfaction with chiropractic care in a random sample of patients seen by physician members of a chiropractic independent physicians' association. DESIGN: A visit-specific questionnaire was mailed to a random sample of 150 patients from health insurance claims filed in the first two months of 2000. RESULTS: The rate of return was 44%. Various aspects of chiropractic care were given a rating of "excellent" by the following percentage of respondents: Length of time to get an appointment (84.9%); convenience of the office (57.7%); access to the office by telephone (77.3%); length of wait at the office (75.7%); time spent with the provider (74.3%); explanation of what was done during the visit (72.8%); technical skills of the chiropractor (83.3%); and the personal manner of the chiropractor (92.4%). The visit overall was rated as excellent by 83.3% of responders, and 95.5% stated they would definitely recommend the provider to others. CONCLUSION: The study demonstrated a high satisfaction rate among managed-care patients.

The immediate effect of activator vs. meric adjustment on acute low back pain: a randomized controlled trial.

OBJECTIVE: To compare the immediate effects on pain of Meric and Activator adjustments in patients with acute low back pain (LBP). DESIGN: Adjustments were compared using a randomized, controlled clinical trial for relative effectiveness. SETTING: The study was conducted at a private chiropractic clinic in Tulsa, Oklahoma. PATIENTS: Thirty consecutive established patients presenting with acute LBP were studied. Sixteen subjects were randomly assigned to the Meric group and 14 to an Activator group. The mean (SD) age was 53.5 (9.5) for the Activator group and 51.8 (10.3) for the Meric group. INTERVENTION: The subjects received either a single Meric or Activator adjustment to the posterior joints involved. MAIN OUTCOME MEASURES: Before and immediately after the adjustments, subjects rated their pain intensity on a visual analog pain scale. RESULTS: The mean reduction in pain for the Activator group was means = 22.2, SD = 21.7; for the Meric group means = 21.8, SD = 21.5. The results indicate that there is no significant difference between Meric and Activator adjustments in reducing acute LBP (F = .005, df = 2, 27, p = .941). CONCLUSION: This study demonstrated no advantage of one procedure over the other for the reduction of pain.

Influence of caffeine on selected manual manipulation skills.

To assess the effects of caffeine on selected manual manipulation skills 16 college-age (21 +/- 1.7 yr.) caffeine-naive women (less than 90 mg/day), having avoided products containing caffeine for four days, reported for testing eight hours postprandial. Measurements included duration and frequency of error for hand steadiness, duration and frequency error for following a tracing pattern, and duration of completing a tweezer-pin placement dexterity test. Caffeine doses of either 2.5 or 5.0 mg/kg body weight or a placebo (200 mg. methylcellulose) were administered randomly to all subjects on three separate occasions using a double-blind format. A 2 x 3 repeated-measures analysis of variance and a Newman-Keuls post hoc test yielded a significant difference in hand steadiness error time from pre- to posttest for 5 mg/kg but not for 2.5 mg/kg or the placebo trial. For frequency of hand steadiness error, significant changes occurred for both 5.0 and 2.5 mg/kg. A dose of 5.0 mg/kg group resulted in significant differences in both tracing error time and error frequency. As both doses of caffeine significantly increased dexterity time, it was concluded that caffeine has detrimental effects on selected performance skills of young caffeine-naive women.

Interexaminer reliability of the electromagnetic radiation receiver for determining lumbar spinal joint dysfunction in subjects with low back pain.

Twenty subjects (6 male, 14 female) with low back pain were examined by two experienced and licensed chiropractic doctors (E1 and E2). Both examiners examined the patients using a Toftness Electromagnetic Radiation Receiver (EMRR) and by manual palpation (MP) of the spinous processes. Interexaminer reliability was calculated at three sites (L3, L4, L5) for the following combinations: a) E1,MP--E2,MP; b) E1,EMRR--E2,EMRR; c) E1,MP--E2,EMRR; and) d) E2,MP--E1,EMRR, and intraexaminer reliability was calculated for the following variables: e) E1,MP--E1,EMRR; and f) E2,MP--E2,EMRR. Results of a Kappa coefficient analysis for interexaminer reliability of the stated combinations and at the specific sites were: a) -0.071, 0.400, 0.200; b) -0.013, 0.100, -0.120; c) 0.286, 0.300, 0.200; d) -0.081, 0.000, 0.048. These results predominantly indicate a poor to fair interexaminer reliability. The results of a Kappa coefficient analysis for intraexaminer reliability of the stated combinations were: e) 0.111, 0.400, 0.737; f) 0.000, 0.100, 0.368. These results indicate a poor to fair reliability. It was concluded that in subjects with low back pain the EMRR may not be a reliable indicator of spinal joint dysfunction.

Incidence of sacroiliac joint dysfunction and low back pain in fit college students.

The incidence of low back pain and sacroiliac joint dysfunction and their relationship was studied in a sample of physically fit college students. An incidence of 26.5% was found for low back pain, while an incidence of 19.3% was found for sacroiliac joint dysfunction. This study found no significant relationship between sacroiliac joint dysfunction and low back pain.

Chiropractic management of enuresis: time-series descriptive design.

Researchers have indicated that single-subject experimental designs may be of value in chiropractic clinical practice, allowing for the development of a scientific data base. The purpose of this paper was to employ a single-case time-series descriptive design in a condition (enuresis) not commonly treated in chiropractic practice, but that which is thought by some to be responsive to manipulation.