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News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
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.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
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.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
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.
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.
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.
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!
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
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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