The Chiropractors' Association of Australia

Chiropractic: healthy spine, healthier life

CJA Vol.28 Issue 1

Editorial: We May Never Pass This Way Again
Mary Ann Chance and Rolf E. Peters

A Multidisciplinary Specialised Spinal Pain Syndrome Unit
Lynton G.F. Giles and Peter G. Baker

Stress Management: Experiential Learning of Chiropractic Philosophy
Jennifer R. Jamison

Case Report: Acute Recurrent Hamstring Strains, The Lunge Exercise and Functional Rehabilitation
Nigel Nulty

History Corner: Smith’s Weekly Investigates
Stanley P. Bolton

In Memoriam

A Multidisciplinary Specialised Spinal Pain Syndrome Unit

Lynton G.F. Giles and Peter G. Baker

Objective: The main objective of this paper is to evaluate the need for a hospital-based multidisciplinary specialised spinal pain syndrome team to diagnose and manage patients. Design and Setting: Seven hundred and seventy-one patients (380 males: 391 females) who presented to the National Unit for Multidisiplinary Studies of Spinal Pain, Townsville General Hospital, Townsville, Queensland, Australia, within the first 25 months of the opening of the unit, were studied with regard to age, gender, pathology, pain duration, and their satisfaction with the unit.
Interventions: A flow diagram summarises the patient management approach for the longitudinal, prospective evidence-based pilot study which is in progress.
Results: Medical referral accounted for 30% of patients, chiropractic and osteopathic referral for 1% and self-referral for 69%. Ninety-seven percent (97%) of patients with chronic pain (>13 weeks duration) and only 3% with acute pain (<7 days). Following extensive investigations. We determined that 56.3% of patients had identifiable pathology. Seven percent were referred for surgical opinions. A high level of satisfaction was reported by patients with an average score of 3.2 (range 2.6-3.6) out of a maximum of 4 for each patient satisfaction question.
Conclusion: The results support the hypothesis that a hospital-based specialised spinal pain syndrome unit would prove popular among referring medical practitioners and patients alike.

INDEX TERMS: (MeSH) Pain Clinics; Clinical Trials; Pain. (Other): Multidisciplinary Study; Spinal Pain

Chiropr J Aust 1998; 28:2-6

Stress Management: Experiential Learning of Chiropractic Philosophy

Jennifer R. Jamison

A student-centered learning experience is described in which formulation of a stress management contract is used to demonstrate how mind-body medicine influences health care assumptions and clinical behaviour.
Research Design: A case study describing a learning experience during which 62 undergraduate students developed patient-centred stress management contracts is reported. Each student was required to select a client and use a standard stress management package as an aid to negotiating a personalised stress management program. Each stress management package contained questions to enhance self-awareness of the impact of personal stress and provided a range of stress management options. The process involved clients identifying their level of perceived stress, negotiating a stress management package and implementing the preferred options. A questionnaire was used to ascertain the client’s response to the stress management experience.
Results: Eighteen percent (18%) of clients included in the study considered themselves to be stress-free or to suffer minimal stress. The remainder assessed themselves as moderately or severely stressed in one or more dimensions. Overall, routine exercise emerged as the most preferred stress management strategy for chronic stress. Muscle relaxation and deep breathing were the favoured strategies in instances of acute stress. Stressed individuals found they benefited from a combination of intervention options. The majority of stressed clients considered that implementation of their stress contract reduced their stress levels. Discussion: This preclinical experience provided an opportunity for students to develop an intellectual and emotional appreciation of the meaning of patient-centred care and to observe how management triggers in one dimension of health care can contribute to wellness in another.
Conclusion: In addition to refining the skills necessary for negotiating health management contracts, this experiential learning opportunity created an environment in which the assumptions and implications of health care within the framework of the infomedical model could be demonstrated.

Index Terms: (MeSH): Chiropractic; Stress. (Other): Mind-Body Medicine; Chiropractic Philosophy.

Chirop J Aust 1998;28:7-12

Case Report: Acute recurrent Hamstring Strains, the Lunge Exercise and Functional Rehabilitation

Nigel Nulty

Objective: To examine the lunge exercise as a tool in functional rehabilitation of the hamstrings. Design/Setting: Study of a case presenting to the RMIT teaching clinic at Bundoora. Patient: A 19year-old male athlete, reporting his third recurrent strain of the left hamstring within a seven-month period. Intevention: Chiropractic management involved manual adjustive procedures to the lumbar and sacroiliac regions, soft tissue therapy, cryotherapy, phonphoresis, nutritional supplementation and a home-based stretching and strengthening program involving the lunge exercise. Outcomes: Re-examination after a six week period revealed a marked decrease in the area of induration and tenderness, an increase in strength and flexibility of the left hamstring group, with an overall improvement in the mechanics of the lumbosacral area. Conclusion: These results, with previous treatment associated with earlier occurences, suggests this management strategy seemed appropriate and beneficial in the rehabilitation of the injury. The contribution of the lunge exercsie to recovery is speculative, however it must be consider when compared with other strengthening exercises due to its 'functionality' in hamstring rehabilitation.

INDEX TERMS: MeSH: CHIROPRACTIC; ATHLETIC INJURIES; REHABILITATION; SPRAINS AND STRAINS; EXERCISE: OTHER: LUNGE EXERCISE; HAMSTRING INJURY.

Chiropr J Aust 1998; 28:13-6.

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