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Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
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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