The purpose of this article is to describe chiropractic management of a 5-year-old boy with urinary and bowel incontinence.
A 5-year-old boy presented with the primary symptoms of a complete lack of bowel and bladder control with prior surgical correction for lumbar meningocele, spinal lipoma, and tethered spinal cord. Examination revealed spinal and pelvic dysfunction.
Intervention and Outcome:
Chiropractic treatment methods included using the Activator adjusting instrument and shortwave diathermy to the lumbar spine and sacrum. A total of 5 treatments were initially provided over a period of 4 weeks. After the initial treatment period, he was able to maintain satisfactory control of his bladder and bowel, day and night, for a period of approximately 6 months. A second course of treatments was initiated approximately 6 months later because of a recurrence of bladder and bowel incontinence. Four additional treatments were provided over a period of 4 weeks. This second course of treatment reestablished satisfactory control of bladder and bowel function.
For this patient, chiropractic care was successful in establishing satisfactory bladder and bowel control.
J Chiropr Med. 2010 Mar;9(1):28-31. [PMID:21629396]
Author information: Kamrath KR. Chiropractor, Private Practice, Hutchinson, MN 55350.
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The purpose of this study was to survey 200 randomly selected post-1980 graduates of the Canadian Memorial Chiropractic College practicing in five Canadian provinces to determine which, if any, technique systems they sought out instruction in and/or are utilizing either primarily or secondarily for patient care. Using a systematic sampling approach, 83 eligible data sets were received. Respondents reported to have sought out instruction in a total of 187 technique systems other than Diversified technique. In addition, although 86% of respondents stated they primarily used Diversified technique in practice, they reportedly used 134 different technique systems secondarily for patient care. This calculates to an average of 2.27 different techniques used per respondent. Future studies should survey a larger percentage of practitioners to better assess the validity of these findings.
J Can Chiropr Assoc. 2009 Mar; 53(1): 32–39. [PMCID: PMC2652629]
Author information: Chad Mykietiuk, DC, Megan Wambolt, BSc(Hon), DC, Travis Pillipow, BSc, DC, Christa Mallay, BA, DC, and Brian J. Gleberzon, BA, DC. Applied Chiropractic & Clinical Sciences Departments, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1.
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Trigger points are a common cause of severe and disabling pain in chiropractic practice. While trigger points may be found in any skeletal muscle the majority are found in the upper trapezius. Relatively few studies have investigated non-invasive treatments for upper trapezius trigger points. Common manual therapy treatments utilized for upper trapezius trigger points in chiropractic include manual pressure and myofascial release. The purpose of this study was to compare the effect of a single treatment of ischaemic compression and activator trigger point therapy on active upper trapezius trigger points.
Fifty-two subjects with active upper trapezius trigger points met the participation criteria and were randomised to an ischaemic compression or activator trigger point therapy group. The primary outcome measure was Patient Global Impression of Change. Secondary outcome measures were an 11-point numerical rating scale for change in pain, and change in pressure pain threshold using an algometer for trigger point sensitivity. While the treating clinician and subjects were not masked to treatment assignment, the examiner was blind to treatment assignment until data analyses were completed. An independent t-test was used to compare the groups at baseline on the continuous variables. The Mann—Whitney U-test was used to compare the groups at baseline on the non-continuous variables. Relative risk ratios of improvement for the primary and secondary outcome measures were calculated with 95% confidence intervals for clinical significance.
Seventy volunteers were screened with 25 subjects randomised to the ischaemic compression group and 27 to the activator trigger point therapy group. There was no significant difference between the groups in any of the baseline variables. On the primary outcome measure both groups improved (78% of those in the activator group and 72% in the ischaemic compression group). Relative risk for improvement of 1.00 suggested that those treated with the Activator instrument were no more likely to improve than those treated with ischaemic compression (95% CI = 0.73—1.37). For the secondary outcome measure of pain reduction 41% of those treated with the Activator instrument improved compared to 36% of those in the ischaemic compression group. Those treated with the Activator instrument were 13% more likely to improve than those treated with ischaemic compression. However this relative risk of 1.13 in favour of the activator group was not significant (95% CI = 0.57— 2.26). For the secondary outcome of reduction in trigger point sensitivity 32% of those in the ischaemic compression group improved compared to 30% in the activator group. Those treated with ischaemic compression were 8% more likely to improve; however, the relative risk of 1.08 was not significant (95% CI = 0.48—2.44). As risk of improvement on the outcome measures between the groups was not significantly different, number needed to treat was not calculated.
Based on the primary outcome measure the results suggest that both ischaemic compression and Activator trigger point therapy have an equal immediate clinically important effect on upper trapezius trigger point pain.
Clin Chiropr. (2008) 11(4):175-181.
Author information: Gemmel H, Allen A. Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF, United Kingdom. Read More