Research for the AECC School of Chiropractic

An Observational Study of Spinal Manipulative Therapy

The objectives of this study were to determine (1) if maximal intervertebral range of motion and laxity interactions exist in the cervical spine during flexion, (2) if there are differences in these range or laxity parameters between baseline and follow-up in both patients with neck pain and asymptomatic controls, and (3) if there is an effect on intervertebral range/laxity relationships in patients with neck pain after spinal manipulative therapy.

Dr du Rose and the team found that there were distinct relationships between both intraregional intervertebral ranges and laxity, many of which were present in both groups at baseline and follow-up, suggestive of normal kinematic behaviours. Changes in correlations unique to the patient group may be indicative of a change in regional kinematics resulting from the manipulation intervention. Spinal manipulative therapy may have a therapeutic effect by influencing cervical kinematics at the regional level.

A Comparative Study into Isolated Lumbar Extension Strength

The objective of this study was to compare isolated lumbar extension strength between healthy asymptomatic participants and participants with chronic low back pain (CLBP), while controlling for previous lumbar spine surgery.

Dr Neil Osborne and his team found that maximal isometric isolated lumbar extension (ILEX) weakness and lumbar extensor deconditioning is present independent of surgery and may be a factor involved in CLBP. As such, lumbar extensor deconditioning would appear to be a reasonable target for interventions in CLBP.

Patient Safety in Spinal Manipulative Therapy

An international research team including Michelle Holmes from AECC University College explored how chiropractors and physical therapists think about patient safety within their practice. The results suggest that practitioners are committed to prioritising safety in clinical practice.

putting patients first. Also, practitioners highlighted the importance of working and learning together and organising processes and procedures within their practice. This study provides a basis for future initiatives to address and improve patient safety within chiropractic care.

Looking at How Clinical Terminology Impacts Patient Perception During Prognosis

Emerging research suggests that words themselves used by clinicians may have an impact on the prognosis and severity of a pain-based condition. Professor Dave Newell was part of a team of high-profile low back pain experts that explored how patients perceived terms commonly used by clinicians in lumbar spine imaging reports. that describe and how they were perceived in terms of seriousness, persistence of the condition, fear in moving, beliefs about back pain and back pain intensity. The study, published in the BMJ, was across sectional survey of patients form 5 countries including UK, USA, Canada, New Zealand and Australia.

Results included nearly 700 respondents and nearly half had had lumbar spine imaging. Generally patients understanding of the meaning of terms was poor and around half to nearly three quarters considered these terms indicated that their back pain was serious, that their pain might persists and that they would be fearful of movement even though many of the terms did not indicate seriousness of the condition.

Generally, the study concluded that common and usually non-serious terms used in lumbar spine imaging reports are poorly understood by the general population and may actually make things worse when not appropriately explained by the clinician.

Collaboration with Transforming Adolescent Lives through Nutrition (TALENT)

“I should be disease free, healthy and be happy in whatever I do”

This paper aimed to explore perceptions of how context shapes adolescent diet and physical activity in eight low- and middle-income (LMIC) sites at varying stages of economic and nutrition transition. The methods included a qualitative secondary analysis of eight data sets generated as part of the international Transforming Adolescent Lives through Nutrition (TALENT) collaboration (TALENT). Fifty-two focus group discussions were carried out with 491 participants (303 adolescents aged 10–17 years; 188 caregivers) in Cote d’lvoire, Ethiopia, India, The Gambia, and South Africa. Three themes were identified from the data: (1) transitions in generational nutrition education and knowledge; (2) transition in caregiver–adolescent power balance and (3) the implications of societal and economic transition for diet and physical activity.

Dr Polly Hardy-Johnson and the team concluded that future interventions to improve adolescent diet and activity in LMICs need to be complex, tailored to individual settings, acknowledge gender inequalities and engage with both adolescent and caregiver perspectives.