CJA Vol.23 Issue 3Editorial: Abstract Art: Competing for Attention. Dynamic Spinal Analysis - Fact or
Fiction? Pain Drawing Analysis: A Review. A Descriptive Report of the Case-Mix Within
Australian Chiropractic Practice, 1992. Chiropractic Holism: Interactively Becoming in a
Reductionist Health Care System. For Debate: Cranial Adjusting- An
Overview. ABSTRACTS Dynamic Spinal Analysis - Fact or Fiction? WYATT H. PAGE, WILLIAM MONTEITH and LES WHITEHEAD This paper describes a new dynamic spinal motion analysis system which utilises advanced digital image processing techniques to extract motion parameters from video radiographic sequences. Automated tracking of vertebral motion results in accurate assessment of translational and rotational, displacement, velocity and acceleration. The use of these measurements in dysfunction diagnosis provides a major challenge for chiropractic and health care professionals. INDEX TERMS: MeSH: cineradiography;image processing, computer assisted;computer graphics;Other: spinal kinematics Chiropractic J Aust 1993 Sep;23(3):82-5 Pain Drawing Analysis: A Review PETER BRYNER Drawings of pain by patients using body outlines is an adjunct to other forms of assessment of musculoskeletal pain. Drawings are analysed for their anatomical appropriateness, based on the assessors knowledge of the sources of pain from the back. New information about sources of pain needs to be incorporated into such systems of analysis. Where an appropriate pattern is lacking, or other marks (like arrows or unsolicited comments) it has been assumed that psychological involvement is likely. a number of studies have used this approach in studying back pain. These results are reviewed along with the reliability of this method of assessment which is generally high. The instructions and the criteria used to score drawings vary from study to study. The other main form of pain drawing analysis is that assessing the area involved. The number of sections of the body affected by pain is used to estimate the area. The number of body sections ranges from 27 to 15,000. Computers are now being used for analysing drawings and predicting a diagnosis. These forms of assessment have high levels of inter-rater agreement. Crude forms of pain distribution analysis do not seem to be responsive to changes in clinical status. It has yet to be shown that greater accuracy in assessment will show adequate responsiveness in patients undergoing treatment. Pain distribution is a promising area for further research in a chiropractic setting because it may prove to demonstrate change over time with treatment. Pain drawings could then be used to demonstrate improved patient care. INDEX TERMS: MeSH: chiropractic;backache;body surface area;pain measurement. Other:pain drawings;pain distribution. Chiropractic J Aust 1993 Sep;23(3):86-91 A Descriptive Report of the Case-Mix Within Australian Chiropractic Practice, 1992 PHILLIP S. EBRALL The objective of this study was to generate a description of the case-mix of chiropractic practice in Australia by using a prospective recording instrument provided to volunteer chiropractors. The 25 respondents were located in private practice throughout six of the eight jurisdictions in Australia. They were members of the Chiropractors' Association of Australia and recorded details of 100 consecutive patient visits from Monday, 7 September 1992. A total of 2,500 patient visits were recorded. Of these, 1148 (46%) were made by males and 1352 (54%) by females. There were 246 (9.8%) new patient visits and 2254 (90.2%) return patient visits. The mean age of the patients was 39.45 years, and half of the patient visits were generated by patients in the age range of 30-50 years. The presenting complaint was back pain in 41% of patient visits, neck pain in 23% and headache in 14%. There were 85 (3.4%) patient visits at which an apparently non-musculoskeletal presenting complaint was reported. Patients with workers' compensation accounted for less than 10% of all visits. Slightly over half of all visits were funded by a private health fund, with the highest percentage being in South Australia (76.8%) and Western Australia (74.3%), falling to 25% in the ACT. This study is an early attempt to define the case-mix of Australian chiropractic practice, and concludes that chiropractors mostly treat musculoskeletal complaints where the patient is reimbursed for the cost of treatment by a third party. The proportion of non-musculoskeletal diagnosis, while very small, can be seen as demanding the retention of differential diagnostic skills by chiropractors, even though the number of patients with a primary presenting complaint of a visceral nature is extremely small. INDEX TERMS: MeSH: diagnostic related groups; quality assurance, health care; physician's practice patterns; chiropractic. Chiropractic J Aust 1993 Sep;23(3):92-7 Chiropractic Holism: Interactively Becoming in a Reductionist Health Care System JENNIFER R. JAMISON Contemporary chiropractic holism is a construct which is interactively evolving as chiropractors practise within a largely reductionist health care system. Chiropractic holism, while it may encompass conventional holism with its multifactorial approach and focus on the individualisation of patient care, can be differentiated from conventional holism through the global response anticipated to result from chiropractic manual intervention. Dominant features of chiropractic holism would furthermore appear to focus on the dynamic nature of patient-practitioner interaction, the educational commitment of practitioners and the regular use of exercise prescriptions which further ensure that patients become active partners in the healing process. The practitioner's perception that chiropractic intervention will enhance the patient's global wellbeing is an essential component of chiropractic holism and consistent with traditional chiropractic philosophy. INDEX TERMS: MeSH: chiropractic; holistic health; physician-patient relations Chiropractic J Aust 1993 Sep;23(3):98-105 For Debate: Cranial Adjusting - An Overview FRANK O. PEDERICK Cranial adjusting procedures have been a part of osteopathic and chiropractic therapeutic repertoires for over 60 years. Although the osteopathic literature is extensive, there is no known chiropractic peer reviewed literature on this field. This paper seeks to change this situation and begin the process of examining cranial concepts in the chiropractic peer reviewed literature. Cranial adjusting appears to be soundly based in anatomy, physiology and histological studies as well as clinical results. It may be likened to spinal adjusting in that "scientific" definition and demonstration of the subluxation may at present be beyond our technology. As with spinal adjusting, unless there is evidence which absolutely refutes the current literature on cranial adjusting, it could be accepted as a part of mainstream chiropractic, be included in the curriculum of chiropractic schools and become part of the therapeutic repertoire of most chiropractors. INDEX TERMS: MeSH: chiropractic; deva water; Other: manipulation, cranial; adjustment, cranial. Chiropractic J Aust 1993 Sep;23(3):106-12 |
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