shoulder pain manual therapy

Nondrug and Nonsurgical Treatment of Shoulder Conditions

shoulder pain manual therapyShoulder pain is one of the most common musculoskeletal disorders. The lifetime prevalence is estimated to be in the range of 6.7–66.7%. Shoulder pain and stiffness may reduce family life or social life functions as well as reduce productive activities. It also has a strong statistical correlation with somatizing tendency and poor mental health. There are many cases of shoulder pain that have not improved over time, remain persistent, or occur repeatedly. The prognosis becomes poorer the longer the illness is present.  A review of the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder was published in the Journal of Manipulative and Physiological Therapeutics in June, 2017. Shoulder conditions addressed in the article were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs), adhesive capsulitis (AC), and nonspecific shoulder pain. Eligibility criteria for the scientific studies included randomized controlled trials (RCTs), systematic reviews, or meta-analyses. Treatments included nondrug, nonsurgical procedures. Results indicated low- to moderate-quality evidence supporting the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for SIS and AC. For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions.

Bottom line:

  • Manual therapy is beneficial for common shoulder conditions.
  • Low-level laser therapy is beneficial for common shoulder conditions.
  • Exercise protocols are beneficial for SIS and AC.

 

025- Chiropractic Maintenance Care with Andreas Eklund, DC, PhD

Dr. Andreas Eklund, Chiropractic, Chiropractor, Maintenance Care

Dr. Eklund and I discuss topics such as: the effect and cost-effectiveness of Chiropractic Maintenance Care (MC) in a population with recurrent and persistent LBP, the demarcation of a LBP episode, psychological and behavioral characteristics of chiropractic patients compared to the other primary care patients, and predictive properties of the West-Haven Yale Multidimensional Pain Inventory (MPI-S) among patients with recurrent and persistent LBP receiving chiropractic care.

Andreas Eklund, DC, PhD graduated from the Anglo European College of Chiropractic 2002 and was in full time Chiropractic practice up until 2012 when he was enrolled in a PhD program at Karolinska Institutet.

In 2015 he was a co-founder of a multidisciplinary rehab unit, which today employs 23 persons working as an integrated team of health professionals, Chiropractors, Physiotherapists, Occupational therapists, Dietitians, and massage therapists.
He earned his PhD degree in 2016, and the title of his thesis was “Recurrent and persistent low back pain – course and prevention”. He currently works as a post Doc at Karolinska Institutet along with his clinical duties. At the moment he also serves as the chair of the scientific committee of the Swedish Chiropractic Association.

See Dr. Eklund’s profile at researchgate.

Below are the articles we discussed in this interview:

1. Absence of low back pain to demarcate an episode: a prospective multicentre study in primary care.
Eklund A, Jensen I, Lohela-Karlsson M, Leboeuf-Yde C, Axén I.
Chiropr Man Therap. 2016 Feb 18;24:3. doi: 10.1186/s12998-016-0085-z. eCollection 2016.
PMID: 26893824 [PubMed] Free PMC Article
Similar articles
2. Do psychological and behavioral factors classified by the West Haven-Yale Multidimensional Pain Inventory (Swedish version) predict the early clinical course of low back pain in patients receiving chiropractic care?
Eklund A, Bergström G, Bodin L, Axén I.
BMC Musculoskelet Disord. 2016 Feb 12;17:75. doi: 10.1186/s12891-016-0933-y.
PMID: 26867930 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles
3. Psychological and behavioral differences between low back pain populations: a comparative analysis of chiropractic, primary and secondary care patients.
Eklund A, Bergström G, Bodin L, Axén I.
BMC Musculoskelet Disord. 2015 Oct 19;16:306. doi: 10.1186/s12891-015-0753-5.
PMID: 26483193 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles
4. Prevention of low back pain: effect, cost-effectiveness, and cost-utility of maintenance care – study protocol for a randomized clinical trial.
Eklund A, Axén I, Kongsted A, Lohela-Karlsson M, Leboeuf-Yde C, Jensen I.
Trials. 2014 Apr 2;15:102. doi: 10.1186/1745-6215-15-102.
PMID: 24690201 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles
Dr. Donald Murphy

024- Chiropractic Research with Clinician-Scientist Dr. Donald Murphy

Dr. Donald MurphyI am really excited that in this interview, we’ll discuss topics such as: spine care as a framework for the chiropractic identity (as well as primary spine care), psychologic factors in spinal pain, lumbar spinal stenosis and, the Clinical Reasoning in Spine Pain (CRISP) protocols.

Dr. Donald Murphy is Medical Director of the Spine Care Program for Care New England, a large multi-hospital system in Rhode Island where he oversees the development and implementation of an integrated spine care pathway.  He is also Clinical Assistant Professor in the Department of Family Medicine at Alpert Medical School of Brown University.  His other faculty appointments include Professor, Part-Time University Faculty at Southern California University of Health Sciences and Adjunct Associate Professor of Research at New York Chiropractic College.  Dr. Murphy has been admitted as a Fellow of the Royal College of Chiropractors in the United Kingdom.  Dr. Murphy has served on the Expert Panel for several spine care guidelines, including those of the American College of Environmental and Occupational Medicine, American College of Physicians and American Pain Society.

Dr. Murphy has 29 years’ experience practicing and teaching primary spine care and has nearly 100 publications in peer-reviewed scientific journals and book chapters.  He is the lead instructor for the certification course for Primary Spine Practitioners offered by the University of Pittsburgh.  His recent books, Clinical Reasoning in Spine Pain, Volume I and II serve as the required texts for that course.  His consulting activities include assisting hospitals, healthcare systems and insurers implement high-value spine care services through Spine Care Partners, LLC.

Here are Dr. Murphy’s textbooks that were discussed in the interview. Click on the books to examine and purchase.

Clinical Reasoning in Spine Pain, Dr. MurphyCRISP Dr. Murphy

 

 

 

 

 

 

 

 

 

See Dr. Murphy’s scientific articles on researchgate.

Articles that we discuss in this interview are below:

1. Spine Care as a Framework for the Chiropractic Identity.
Schneider M, Murphy D, Hartvigsen J.
J Chiropr Humanit. 2016 Nov 4;23(1):14-21. eCollection 2016 Dec. Review.
PMID: 27920614 [PubMed – in process] Free PMC Article
Similar articles
2. Comparison of non-surgical treatment methods for patients with lumbar spinal stenosis: protocol for a randomized controlled trial.
Schneider M, Ammendolia C, Murphy D, Glick R, Piva S, Hile E, Tudorascu D, Morton SC.
Chiropr Man Therap. 2014 May 10;22:19. doi: 10.1186/2045-709X-22-19. eCollection 2014.
PMID: 24872875 [PubMed] Free PMC Article
Similar articles
3. The usefulness of clinical measures of psychologic factors in patients with spinal pain.
Murphy DR, Hurwitz EL.
J Manipulative Physiol Ther. 2011 Nov;34(9):609-13. doi: 10.1016/j.jmpt.2011.09.009. Epub 2011 Oct 21.
PMID: 22018754 [PubMed – indexed for MEDLINE]
Similar articles

 

023- Statistics in Chiropractic Science with Dr. Cynthia Long

Dr. Cynthia Long and I discuss the importance of statistics in chiropractic science. We talk about the role of statistics in research, when to involve a biostatistician into the research process, and the top statistical terms (such as power, effect size, significance, confidence intervals and many more). Dr. Long is Professor and Director of Research at Palmer College of Chiropractic, Davenport, IA, and Director of the Office of Data Management & Biostatistics (ODM) at the Palmer Center of Chiropractic Research (PCCR). She holds an M.S. degree in statistics from Iowa State University and a Ph.D. in biostatistics from the University of Iowa. Dr. Long joined the faculty of the PCCR at its inception in 1995 and contributed to developing PCCR’s research infrastructure, in particular creating the ODM to support the research design, data management and data analysis needs of PCCR research investigators. Since 2000, she has directed the ODM staff as data coordinating centers for 15 on-site, off-site and multi-site federally-funded clinical trials of chiropractic care. Dr. Long is the principal investigator of “Expanding Evidence-Based Clinical Practice and Research Across the Palmer College of Chiropractic”, a grant awarded by the National Center of Complementary and Integrative Health of the National Institutes of Health. She is also the director of Palmer’s MS in Clinical Research where she teaches 10 credit hours of biostatistics. She is on the editorial boards of JMPT and JCCA and has just completed a 3-year term as an elected member of the American Statistical Association board of directors.

Take a look at Dr. Long’s publications at researchgate.

Here is a link to Dr. Long’s webpage at Palmer Center for Chiropractic Research.

Dr. Long mentioned the following paper in the show “Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache“.

 

Dr. Jonathan Field

022- Patient Reported Outcomes and Care Response with Dr. Jonathan Field

Dr. Jonathan FieldDr. Field and I discuss the clinical significance of patient reported outcomes and Care Response. Care Response is a free and pragmatic system to help practices gather and report clinical outcome and patient satisfaction information with minimal work from practice staff.  Dr. Field is a clinical and NHS services lead at the Back2Health partnership providing community based MSK services to NHS and private patients. He has an active interest in research particularly relating to the impact of non-physical factors on recovery of chiropractic patients and the use of patients reports of changes in their health status (PROMs) and their experiences with care (PREMS).

This interest has been developed through a MSc and most recently by submission of his PhD Thesis on ‘Collecting and predicting patient reported outcomes in chiropractic practice’. Dr. Field chairs the Pain Faculty of the RCC which seeks to help chiropractors improve their evidence based management of patients presenting with the symptom of pain. To help practices interested in patient centred and outcome focused care Dr. Field has developed the Care Response system to facilitate the collection and collation of PROM and PREM data. This system is provided free to any practitioner who wishes to use it, and it has been adopted by over two hundred clinicians around Europe and Australasia thanks to funding from the European Chiropractic Union and European Academy of Chiropractic it is available in 7 languages.

Learn more about Care Response.

Take a look at Dr. Field’s publications at researchgate.

Here are the articles we discuss in this interview.

1. The impact of patient-reported outcome measures in clinical practice for pain: a systematic review.
Holmes MM, Lewith G, Newell D, Field J, Bishop FL.
Qual Life Res. 2017 Feb;26(2):245-257. doi: 10.1007/s11136-016-1449-5. Review.
PMID: 27815820 [PubMed – in process] Free PMC Article
Similar articles
2. Clinical Outcomes in a Large Cohort of Musculoskeletal Patients Undergoing Chiropractic Care in the United Kingdom: A Comparison of Self- and National Health Service-Referred Routes.
Field JR, Newell D.
J Manipulative Physiol Ther. 2016 Jan;39(1):54-62. doi: 10.1016/j.jmpt.2015.12.003.
PMID: 26837228 [PubMed – indexed for MEDLINE]
Similar articles
3. Reconceptualising patient-reported outcome measures: what could they mean for your clinical practice
Holmes MM, Bishop FL, Field J
Pain News 2016, Vol 14(2) 79 –82

 

chiropractic neck pain whiplash
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The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders

chiropractic neck pain whiplashA clinical practice guideline on the management of neck pain–associated disorders (NADs) and whiplash-associated disorders (WADs) was recently developed and replaces existing chiropractic guidelines on these topics (Bussières, Stewart et al, 2016). The Guideline Development Group of the Canadian Chiropractic Guideline Initiative (CCGI) conducted the updated guidelines. They considered recently published systematic reviews on NAD and WAD from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Below is a brief summary of the guidelines.  Please refer to the numerous links in this blog post to gain access to the original paper and the full guidelines which are freely available.

Neck pain and its associated disorders (NAD), including headache and radiating pain into the arm and upper back, are common. These disorders often result in significant social, psychological, and economic burden.  Neck pain is a common reason for people to seek chiropractic care.

Motor vehicle collisions most commonly are associated with neck pain related to whiplash-associated disorders (WADs). Whiplash-associated disorders also affect the daily functioning of our patients in terms of considerable pain, suffering, disability, and costs.  Whiplash-associated disorders are defined as an injury to the neck that occurs with sudden acceleration or deceleration of the head and neck relative to other body parts.  Symptoms of WADs commonly include headache, stiffness, shoulder and back pain, numbness, dizziness, sleeping difficulties, fatigue, and cognitive deficits.

The 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders recommended that all types of neck pain, including WADs, be included under the classification of NAD.  The 4 grades of NAD are:

  • I – No signs or symptoms suggestive of major structural pathology and no or minor interference with activities of daily living
  • II – No signs or symptoms of major structural pathology, but major interference with activities of daily living
  • III – No signs or symptoms of major structural pathology, but presence of neurologic signs such as decreased deep tendon reflexes, weakness or sensory deficits
  • IV – Signs or symptoms of major structural pathology (e.g., fracture, tumor, infection)

After searching and synthesizing the latest scientific literature on these topics, the guideline committee provided their recommendations.  Below is the summary of the recommendations.  The full guideline and accompanying documents are available from the CCGI website at www.chiroguidelines.org. There are excellent resources for practitioners and patients available from this website including exercise videos and forms.

Global summary of recommendations: A multimodal approach including manual therapy, self-management advice and exercise is an effective treatment strategy for both recent onset and persistent neck pain and whiplash associated disorders.

A) Summary of Recommendations for Grades I-III Neck Pain and Associated Disorders (NAD)

  • For recent-onset (0-3 months) neck pain grades I-II, based on patient preference and practitioner experience we suggest offering advice with:
    • multimodal care;
    • manipulation or mobilization;
    • Range of motion home exercises or multimodal manual therapy.
  • For recent-onset (0-3 months) neck pain grade III, based on patient preference and practitioner experience we suggest offering advice with:
    • supervised graded strengthening exercises.
  • For persistent (>3 months) neck pain grades I-II, based on patient preference and practitioner experience we suggest offering advice with:
    • multimodal care or stress self-management;
    • multimodal care or advice alone;
    • manipulation in conjunction with soft tissue therapy;
    • supervised yoga; supervised group exercise; supervised strengthening exercises or home exercises;
    • mixed supervised and unsupervised high-intensity strength training or advice alone for workers with persistent neck and shoulder pain;
    • high dose massage.
  • For persistent (>3 months) neck pain grade III, based on patient preference and practitioner experience we suggest offering advice with:
    • multimodal care or advice alone;
    • mixed supervised and unsupervised high-intensity strength training or advice alone for workers with persistent neck and shoulder pain.

B) Summary of Recommendations for Grade I-III Whiplash and Associated Disorders (WAD)

  • For recent onset (0-3 months) whiplash grades I-III, based on patient preference and practitioner experience we suggest offering advice with:
    • multimodal care.
  • For persistent (>3 months) whiplash grades I-II, based on patient preference and practitioner experience we suggest offering advice with:
    • supervised exercise or advice alone.

Source: Bussières AE, Stewart G, Al-Zoubi F et al. The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther. 2016 Oct;39(8):523-564.

Dr. Martin Descarreaux

021- Learning to Adjust and Neuromuscular Responses to Manipulation with Martin Descarreaux, DC, PhD

Dr. Martin Descarreaux and I discuss his research regarding learning to perform chiropractic adjustments, neuromuscular responses following spinal manipulation and several other studies.  Dr. Descarreaux graduated from the UQTR’s first cohort of the chiropractic program in 1998, and completed a PhD in kinesiology at the Université Laval 6 years later. He is now a full professor in the Human Kinetics Department (UQTR), and an invited professor and researcher at the Institut Franco-Européen de Chiropraxie, in Paris and Toulouse. His current research projects involve the characterization of the neurophysiological and biomechanical effects of spinal manipulation, the various effects of pain and pain-related psychological components on trunk neuromuscular strategies, as well as spinal manipulation learning, as can attest the numerous articles he has published on these topics. Over the years, he has developed several strategies to better integrate motor learning principles, which have been shared with students, professors and those responsible for clinical training within chiropractic teaching institutions not only in Canada, but also in Europe. His work in this specific area has contributed to the characterization of the adjustment learning sequence, and showed the importance of augmented feedback in the technical training of future chiropractors. He is currently the Director of graduate studies in human kinetics and director of the Groupe de recherche sur les affections neuromusculosquelettiques at UQTR.

Take a look at Dr. Descarreaux’s publications at researchgate.

Here are the links to the articles we discussed in this interview:

1. Effects of practice variability on spinal manipulation learning.
Marchand AA, Mendoza L, Dugas C, Descarreaux M, Pagé I.
J Chiropr Educ. 2017 Jan 25. doi: 10.7899/JCE-16-8. [Epub ahead of print]
PMID: 28121458 [PubMed – as supplied by publisher]
Similar articles
2. Influence of Lumbar Muscle Fatigue on Trunk Adaptations during Sudden External Perturbations.
Abboud J, Nougarou F, Lardon A, Dugas C, Descarreaux M.
Front Hum Neurosci. 2016 Nov 14;10:576.
PMID: 27895569 [PubMed – in process] Free PMC Article
Similar articles
3. Physiological and Psychological Predictors of Short-Term Disability in Workers with a History of Low Back Pain: A Longitudinal Study.
Dubois JD, Cantin V, Piché M, Descarreaux M.
PLoS One. 2016 Oct 26;11(10):e0165478. doi: 10.1371/journal.pone.0165478.
PMID: 27783666 [PubMed – in process] Free PMC Article
Similar articles
4. Neuromechanical response to spinal manipulation therapy: effects of a constant rate of force application.
Nougarou F, Pagé I, Loranger M, Dugas C, Descarreaux M.
BMC Complement Altern Med. 2016 Jun 2;16:161. doi: 10.1186/s12906-016-1153-6.
PMID: 27249939 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles
5. Systematic Augmented Feedback and Dependency in Spinal Manipulation Learning: a Randomized Comparative Study.
Lardon A, Cheron C, Pagé I, Dugas C, Descarreaux M.
J Manipulative Physiol Ther. 2016 Mar-Apr;39(3):185-91. doi: 10.1016/j.jmpt.2016.02.002.
PMID: 27016338 [PubMed – in process]
Similar articles
6. Effects of a prehabilitation program on patients’ recovery following spinal stenosis surgery: study protocol for a randomized controlled trial.
Marchand AA, Suitner M, O’Shaughnessy J, Châtillon CÉ, Cantin V, Descarreaux M.
Trials. 2015 Oct 27;16:483. doi: 10.1186/s13063-015-1009-2.
PMID: 26507388 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles
Dr. Michele Maiers

020- Patient Perspectives, Integrative Care and Health Policy with Dr. Michele Maiers

Dr. Michele Maiers

Dr. Michele Maiers and I discuss the patient perspective in chiropractic clinical trials, integrative care and  leveraging research to inform health care policy.

“We’re drowning in information and starving for knowledge.”   ~Rutherford Rogers

This axiom aptly characterizes how many see research as it relates to health care delivery.  Dr. Maiers’ professional goal is to facilitate the pragmatic use of research to both inform clinical practice and shape public health policy. Her research has focused on clinical trials that answer practical questions, including, are patient outcomes improved with co-management by different provider types? Is short term treatment or long term management a better approach for chronic musculoskeletal conditions? What aspects of care matter most to patients? It is essential that the information gained in these and other studies is translated into knowledge that improves patient care, policy guidelines, access and reimbursement. Dr. Maiers is excited about her work because she believes in the capacity for integrative and complementary professions to be a positive force to improving the landscape of health care.  When not at work, she enjoys traveling, reading, running and baking pies.

See Dr. Maiers publications on researchgate.

Here are the links to the articles we discussed in this interview:

1. What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial.
Maiers M, Hondras MA, Salsbury SA, Bronfort G, Evans R.
Man Ther. 2016 Dec;26:183-191. doi: 10.1016/j.math.2016.09.008.
PMID: 27705840 [PubMed – in process]
Similar articles
2. Adverse events among seniors receiving spinal manipulation and exercise in a randomized clinical trial.
Maiers M, Evans R, Hartvigsen J, Schulz C, Bronfort G.
Man Ther. 2015 Apr;20(2):335-41. doi: 10.1016/j.math.2014.10.003.
PMID: 25454683 [PubMed – indexed for MEDLINE]
Similar articles
3. Perceived value of spinal manipulative therapy and exercise among seniors with chronic neck pain: a mixed methods study.
Maiers M, Vihstadt C, Hanson L, Evans R.
J Rehabil Med. 2014 Nov;46(10):1022-8. doi: 10.2340/16501977-1876.
PMID: 25258045 [PubMed – indexed for MEDLINE] Free Article
Similar articles
4. Spinal manipulative therapy and exercise for seniors with chronic neck pain.
Maiers M, Bronfort G, Evans R, Hartvigsen J, Svendsen K, Bracha Y, Schulz C, Schulz K, Grimm R.
Spine J. 2014 Sep 1;14(9):1879-89. doi: 10.1016/j.spinee.2013.10.035.
PMID: 24225010 [PubMed – indexed for MEDLINE]
Similar articles
5. Integrative care for the management of low back pain: use of a clinical care pathway.
Maiers MJ, Westrom KK, Legendre CG, Bronfort G.
BMC Health Serv Res. 2010 Oct 29;10:298. doi: 10.1186/1472-6963-10-298.
PMID: 21034483 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles

DC2017 – Chiropractic Research and Funding

In addition to the profession’s largest presentation of research abstracts, DC2017 has added a Researcher’s Forum for Saturday, March 18 that will focus on funding opportunities from around the globe followed by a general discussion of all things research. See you there! https://www.acatoday.org/DC2017

1400 Introduction – WFC Research Council Chair and Vice-Chair
1410 Funding opportunities around the globe
NCCIH, USA – Wendy Weber or delegate (10 min total)
ECCRE, Europe – Henrik Wulff Christensen or delegate (10 min total)
CCRF, Canada – Alison Dantas / Ronda Parks or delegate (10 min total)
CAA, Australia – Scott Charlton or delegate (10 min total)
COCA, Australia – Simon French or delegate (10 min total)
CRC, England – Elisabeth Angier or delegate – (10 min total)
Crowd-Sourced Funding – Greg Kawchuk – (10 min total)
Questions – (10 min)

Break 15:30 – 16:00

16:00 Open Research Forum (all) – WFC Research Council Chair and Vice-Chair
An open forum for all attendees to discuss research topics related to the profession
1730 – End

Dr. Alan Breen

019- Spine Dynamics, Spine Control and Chiropractic with Dr. Alan Breen

Alan BreenDr. Alan Breen and I discuss spine dynamics and spine control along with quantitative fluoroscopy in chiropractic research and practice. Dr. Alan Breen graduated from the Canadian Memorial Chiropractic College in 1967, then travelled in North America, Australia and Europe before starting a part time teaching post at the Anglo-European College of Chiropractic (AECC) in Bournemouth UK in 1971, he established a practice in Salisbury in 1974, which continues. In 1986 Dr. Breen became Director of Research at AECC and focussed on musculoskeletal research and epidemiology, encouraging staff to undertake doctoral studies. In 1999 he became director of a new musculoskeletal research institute – the Institute for Musculoskeletal Research and Clinical Implementation, where he continues to work. Dr. Breen is also Professor of Musculoskeletal Research in the Faculty of Science and Technology at Bournemouth University.

Dr. Breen published the first epidemiology paper by a chiropractor in a medical journal in 1977 then built a collaboration that resulted in a trial by the Medical Research Council in the UK. This was published in 1991 and had a positive outcome for chiropractors. His PhD project, which was completed in 1991, involved the invention of Quantitative Fluoroscopy, a technology that measures inter-vertebral motion in living subjects and which has now entered clinical use. He is a former member of the World Federation of Chiropractic’s Research Council.

Here is the link to Dr. Alan Breen’s website at the Institute for Musculoskeletal Research and Clinical Implementation.

To view Dr. Breen’s research publications please visit researchgate.

Here are the links to the articles we discussed in this interview:

1. Relationships between Paraspinal Muscle Activity and Lumbar Inter-Vertebral Range of Motion.
du Rose A, Breen A.
Healthcare (Basel). 2016 Jan 5;4(1). pii: E4. doi: 10.3390/healthcare4010004.
PMID: 27417592 [PubMed] Free PMC Article
Similar articles
2. Proportional lumbar spine inter-vertebral motion patterns: a comparison of patients with chronic, non-specific low back pain and healthy controls.
Mellor FE, Thomas PW, Thompson P, Breen AC.
Eur Spine J. 2014 Oct;23(10):2059-67. doi: 10.1007/s00586-014-3273-3.
PMID: 24676852 [PubMed – indexed for MEDLINE]
Similar articles
3. Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study.
Branney J, Breen AC.
Chiropr Man Therap. 2014 Jul 1;22:24. doi: 10.1186/s12998-014-0024-9.
PMID: 25035795 [PubMed] Free PMC Article
Similar articles
4. Measurement of intervertebral motion using quantitative fluoroscopy: report of an international forum and proposal for use in the assessment of degenerative disc disease in the lumbar spine.
Breen AC, Teyhen DS, Mellor FE, Breen AC, Wong KW, Deitz A.
Adv Orthop. 2012;2012:802350. doi: 10.1155/2012/802350.
PMID: 22666606 [PubMed] Free PMC Article
Similar articles