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Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
September, 2001, Vol. 01, Issue 09
How Accurate Is That Test?
By Whitney Lowe, LMT
Physical assessment is considered one of the most accurate ways to assess function of the locomotor tissues of the body. While we can often gain valuable information about structural problems through high-tech diagnostic procedures like X-ray or MRI, these procedures tell us very little about the function of the tissues involved in creating and limiting movement.
Some of the most detailed information practitioners gather from physical examination comes from a group of procedures called special tests. This group includes methods such as active range of motion; passive range of motion; manual resistive tests; and special regional orthopedic tests. The special regional orthopedic test is a particularly important element of the assessment process. This test is designed to give information about a particular injury or condition.
A practitioner's success in identifying a client's problem is often directly related to his/her ability to perform good assessment procedures such as special regional orthopedic tests. The practitioner must be able to perform the test correctly. Other factors also come into play in determining how effective that assessment procedure is, and consequently how effective the practitioner is at identifying the client's problem.
Accuracy in special regional orthopedic tests is affected by the relationship of two related concepts - sensitivity and specificity of the test. Sensitivity is the percentage of subjects with the condition who also show a positive result on the test. It determines how "sensitive" (accurate) the test is at determining the condition when it is present. Specificity is the percentage of subjects without the condition who show a negative result on the test. It determines whether the test can show if someone doesn't have the condition.
Take as example a sample of people in an experiment: some with carpal tunnel syndrome, and some without. If a special regional orthopedic test like the Phalen's test is performed, and everyone tests positive for carpal tunnel syndrome, it means that everyone in this group who had carpal tunnel syndrome got a positive test. The sensitivity of the test in this instance is considered high. However, all the people who don't have carpal tunnel syndrome also tested positive; there were no negative tests, even for people without the condition. Therefore, this test's specificity is low.
Certain commonly utilized special orthopedic tests may not have a high degree of sensitivity or specificity, yet are frequently used as guidelines for evaluating the presence of a particular condition. A good example of this is Adson's maneuver, used for identifying thoracic outlet syndrome. To perform Adson's maneuver, the practitioner finds the client's radial pulse at the wrist, then brings the client's arm back into extension and lateral rotation. The client is instructed to look over his/her shoulder toward the affected side and take in a deep breath. If the intensity of the pulse diminishes, the client is suggested to have entrapment of the brachial plexus and subclavian artery by the anterior and middle scalene muscles -- commonly referred to as thoracic outlet syndrome. The problem with this procedure is that a large number of people who do not have any symptoms test positive (diminishing radial pulse) when this test is performed. Thus, this test does not have a high degree of specificity.
The most accurate special regional orthopedic tests have high degrees of specificity and sensitivity; however, this is not always easy to demonstrate. Many studies attempt to evaluate the effectiveness of different assessment procedures, and to illustrate the strengths and weaknesses of each. The more you know about the clinical accuracy of these procedures, the more capable you are of identifying your client's primary complaint.
Click here for more information about Whitney Lowe, LMT.
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