This research sought to identify the individual and work characteristics that were related to the frequency of stressful events for chiropractors in Victoria, and to identify the sources of stress. Data were collected from 305 Victorian chiropractors using questionnaires that were completed anonymously. Seven sources of work stress were identified using principal component analysis of the Health Professionals Stress Inventory (HPSI). The results demonstrated that chiropractors in practice for over 20 years experienced fewer stressful incidents at work than their younger colleagues. Practice experience was negatively associated with stressful incidents from dealing with patient care and conflict. Chiropractors seeing more than 150 patients per week reported fewer stressful incidents than those with fewer than 150 patient visits per week. Increasing patient numbers per week was largely beneficial, demonstrating a negative association with stressful incidents dealing with personal job opportunities, patient care, and professional performance. The only shortcoming of a busier practice was more conflict issues. The results highlight the importance of experience in clinical practice and that busier practices are largely associated with fewer stressful work incidents.

INDEX TERMS: MeSH: CHIROPRACTIC. Other: OCCUPATIONAL STRESS; CLINICAL EXPERIENCE; PATIENT VOLUME.

Chiropr J Aust 2006; 36:51-7.

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Can the Ileocecal Valve Point Predict Low Back Pain Using Manual Muscle Testing?

HENRY P. POLLARD, PETER BABLIS and ROD BONELLO

Background: According to some technique groups in chiropractic the ileocecal valve may malfunction and be associated with a large array of health problems that can lead to common chronic health issues prevalent in our society. Many tests commonly used in chiropractic are presumed to identify painful and/or dysfunctional anatomical structures, yet many have undemonstrated reliability. Despite this lack of evidence, they form the basis of many clinical decisions. One cornerstone procedure that is frequently used by chiropractors involves the use of manual muscle testing for diagnostic purposes not considered orthopaedic in nature. A point of the body referred to as the ileocecal valve point is said to indicate the presence of low back pain. This procedure is widely used in Applied Kinesiology (AK) and Neuroemotional Technique (NET) chiropractic practice. Objective: To determine if correlation of tenderness of the “ileocecal valve point” can predict low back pain in sufferers with and without low back pain. It was the further aim to determine the sensitivity and specificity of the procedure. Methods: One hundred (100) subjects with and without low back pain were recruited. Subjects first completed information about their pain status, then the practitioner performed the muscle testing procedure in a separate room. The practitioner provided either a yes or no response to a research assistant as to whether he had determined if the subject had back pain based on the muscle test procedure. Results: Of 67 subjects who reported low back pain, 58 (86.6%) reported a positive test of both low back pain and ICV point test. Of 33 subjects, 32 (97.0%) with no back pain positively reported no response to ICV point test. Nine (9) subjects (13.4%) reported false negative ICV tests and low back pain, and 1 subject (3%) reported a false positive response for ICV test and no low back pain. Conclusion: The majority of subjects with low back pain reported positive ileocecal valve testing, and all but one of the subjects without low back pain reported negative ileocecal valve testing. The application of ileocecal valve testing as a diagnostic measure of low back pain was found to have excellent measures of sensitivity, specificity and diagnostic competency. This study confirms that the use of this test within the limitations of this study is reliably associated with the presence of low back pain. Further testing is required to investigate all aspects of the diagnostic milieu commonly used by proponents of this form of diagnostic testing.

INDEX TERMS: MeSH: CHIROPRACTIC; ILEOCECAL VALVE. Other: APPLIED KINESIOLOGY; NEUROEMOTIONAL TECHNIQUE; MANUAL MUSCLE TEST.

Chiropr J Aust 2006; 36:58-62.

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The Private and Public Faces of Chiropractic in Australia: Focus on Integration

STANLEY P. BOLTON

Integration of chiropractic into the healthcare system of any country may be perceived as a measure of the effectiveness of its principles and practice, the vision of its practitioners, and the vitality of its organisations. Full integration of chiropractic into the totality of Australia’s healthcare system involves both its private and public healthcare sectors. This paper notes integration of chiropractic into Australia’s private healthcare sector and records pioneer efforts of Dr Lynton F. Giles to integrate chiropractic into Australia’s public healthcare sector, and the project’s demise. It identifies a new private hospital initiative in New South Wales, significant broadening of the definition of medical practitioner in that State, and discusses future prospects.

INDEX TERMS: MeSH: AUSTRALIA; CHIROPRACTIC; HISTORICAL ARTICLE; ALTERNATIVE MEDICINE; HEALTH SYSTEM; PRIVATE SECTOR; PUBLIC SECTOR. Other: INTEGRATION.

Chiropr J Aust 2006; 36:63-8.

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