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1.  A CASE SERIES OF MIGRAINE CHANGES FOLLOWING A MANIPULATIVE THERAPY TRIAL 
Objective: To present the characteristics of four cases of migraine, who were included as participants in a prospective trial on chiropractic spinal manipulative therapy for migraine.
Method: Participants in a migraine research trial, were reviewed for the symptoms or clinical features and their response to manual therapy.
Results: The four selected cases of migraine responded dramatically to SMT, with numerous self reported symptoms being either eliminated or substantially reduced. Average frequency of episodes was reduced on average by 90%, duration of each episode by 38%, and use of medication was reduced by 94%. In addition, several associated symptoms were substantially reduced, including nausea, vomiting, photophobia and phonophobia.
Discussion: The various cases are presented to assist practitioners making a more informed prognosis.
PMCID: PMC2050634  PMID: 17987154
Migraine; diagnosis; manual therapy
2.  ACCELERATIONS RECORDED FROM THE SPINOUS PROCESSES DURING SPINAL MANIPULATIVE TREATMENTS OF THE THORACIC SPINE 
The purpose of this study was to identify the frequency components of accelerations measured on the spinous processes of vertebrae caused by chiropractic treatments, and to speculate as to the origin of the various components. We found distinct acceleration signals in the range of 0-50 Hz and above 200 Hz. The low frequency components were convincingly matched to the displacements caused by the manipulative forces; the high frequency components were found to be similar in duration and shape to confirmed cavitations in synovial joints, thus they were speculated to originate from the spinal facet joints.
PMCID: PMC2050633  PMID: 17987152
Chiropractic; biomechanics; spine; conservative treatments; frequency analysis
3.  THE EFFECT OF SACROILIAC MANIPULATION ON HIP FLEXION RANGE OF MOTION 
Chiropractors claim to be able to influence sites far removed from the point of application of spinal adjustment. Little scientific research has, however, been conducted showing conclusively that the spine and associated structures have an influence on distal function. Demonstration of such influence on distal tissues would aid in the scientific validation of Chiropractic by other health professionals and facilitate treatment of peripheral injuries such as hamstring strains. This study aimed to investigate the effect of a manipulation of the sacroiliac joint on the mechanical function of the hip joint. The results demonstrate that the sacroiliac joint manipulation did not statistically alter the range of motion of the hip joint.
PMCID: PMC2050632  PMID: 17987153
Chiropractic; manipulation; hip; sacroiliac joint; range of motion
4.  HEALTH PROMOTION IN A PRIMARY HEALTH CARE SETTING 
Primary care practitioners are ideally situated to carry out health promotion activities. Neural tube defects are of a fairly low incidence, but the consequences are tragic. They range from life long physical and often intellectual disabilities, to death at birth. Increased folate intake, either through eating folate rich foods or through supplementation, has been shown to reduce the incidence of neural tube defects in newborns by up to 75%. Encouraging all women of child-bearing age to increase their folate intake could thus prevent a significant number of neural tube defects occurring in the Australian population.
PMCID: PMC2050631  PMID: 17987155
Primary health care; neural tube defects; folate
6.  THE EFFICACY OF CHIROPRACTIC SPINAL MANIPULATIVE THERAPY (SMT) IN THE TREATMENT OF MIGRAINE 
Objective: To test the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine, using an uncontrolled clinical trial.
Design: A clinical trial of six months duration. The trial consisted of 3 stages: two months of pre-treatment, two months of treatment, and two months post treatment. Comparison was made to initial baseline episodes of migraine preceding commencement of SMT.
Setting: Chiropractic Research Centre of Macquarie University.
Participants: Thirty two volunteers, between the ages of 23 to 60 were recruited through media advertising. The diagnosis of migraine based on a detailed questionnaire, regarding self reported symptoms or signs, with minimum of one migraine with aura per month.
Interventions: Two months of SMT provided by an experienced chiropractor at a university clinic.
Main Outcome Measures: Participants completed diaries during the entire trial noting the frequency, intensity, duration, disability, associated symptoms and use of medication for each migraine episode. In addition, clinic records were compared to their diary entries of migraine episodes.
Results: A total of fifty nine participants responded to the advertising, with twenty five being excluded or deciding not to continue in the trial. Two participants (5.9%) withdrew during the trial, one due to alteration in work situation and one following soreness after SMT. The Chiropractic SMT group showed statistically significant improvement (p < 0.05) in migraine frequency and duration, when compared to initial baseline levels. Only one participant (3.1%) reported that the migraine episodes were worse after the two months of SMT, and this was not sustained at the two month post treatment follow up period.
Conclusion: The results of this study suggest that Chiropractic SMT is an effective treatment for migraine with aura. However, due to the cyclical nature of migraine with aura, and the finding that episodes usually reduce following any intervention, further research is required. A prospective randomised controlled trial utilising detuned EPT (interferential), a sham manipulation group and an SMT group is nearing conclusion. It is anticipated this trial will provide further information of the efficacy of Chiropractic SMT in the treatment of migraine with aura.
PMCID: PMC2050630  PMID: 17987148
Migraine; chiropractic; spinal manipulation; clinical trial
7.  MANAGEMENT OF ACHILLES TENDON DISORDERS 
A case of heel pain is presented. The clinical presentation implicates the pathological processes of acute retrocalcaneal bursitis, Achilles tendinosis, partial rupture of the tendon possibly as a result of repetitive corticosteroid injection, and subsequent calf atrophy and functional disability. Finally, aspects of predisposing factors, biomechanics, pathology, and clinical management of Achilles tendon disorders are reviewed in the discussion.
PMCID: PMC2050628  PMID: 17987151
Achilles tendon; pain; management
8.  POST-MENOPAUSAL OSTEOPOROSIS 
Millions of women will be prescribed hormone replacement therapy (HRT) and be told that it will prevent osteoporosis occuring, despite the fact that there is doubt about its long term usefulness. Preventive measures outlined in this article are much more preferable, but need to be directed towards the whole population, not just menopausal women. The prevention of osteoporosis is an important public health issue which needs to be addressed now, not in the next century. This article explores the issues that surround the medicalisation of post-menopausal osteoporosis.
PMCID: PMC2050627  PMID: 17987149
Osteoporosis; menopause; medicalization; prevention
9.  HOW TO CRITIQUE AN ARTICLE ON THERAPY 
The ability to critique the literature and source out relevant information to answer a clinical question is a skill that is being introduced into the under-graduate curricula of most health professions. Posing a clinical question on therapy, sourcing the literature, reviewing critically what you find and then hopefully answering the question is central to the evidence-based method. The very foundation of clinical teaching and clinical practice will in the future rely on the "evidence-based method". A checklist is the easiest and quickest way to review journal articles.
PMCID: PMC2050626  PMID: 17987150
Therapy; chiropractic; evidence-based method; clinical epidemiology; evidence-based chiropractic; checklist
12.  REQUIREMENTS FOR CHIROPRACTORS INVOLVED AS OCCUPATIONAL HEALTH AND SAFETY CONSULTANTS IN AUSTRALIA 
A literature review was conducted to determine significant factors for chiropractors progressing towards classification as an Occupational Health & Safety (OHS) consultant in Australia.
A number of priority areas for investigation were identified as significant for OHS consultants. These included: work site assessment, risk control and prevention, spinal care awareness and injury prevention, OHS committee, training procedures and induction manuals, ergonomic improvements, stress management, first aid, forklift safety, accident records, job rotation and supervisor training.
Several issues are important considerations where chiropractor's knowledge may be deficient. Lack of awareness of the issues may leave the chiropractor liable for prosecution due to misrepresentation as an OHS consultant.
PMCID: PMC2050625  PMID: 17987146
Chiropractic; OHS; ergonomics
13.  EFFECTS OF FOCUS FILM DISTANCE (FFD) VARIATION ON ENTRANCE TESTICULAR DOSE IN LUMBAR-PELVIC RADIOGRAPHY 
Introduction: With the steady increase in public and professional concern regarding the biological effects of ionising radiation, there is a need for both the Chiropractic and Radiography professions to improve imaging techniques for the lowering of patient radiation doses. Lumbar radiographs are essential in chiropractic general practice for biomechanical diagnosis and postural analysis. Detailed anatomical measurements are taken from spinal radiographs for the determination of various biomechanical alterations for clinical purposes. The quality of spinal radiograph is dependent on a number of factors, including Focus Film Distance (FFD), magnification ratios, penumbra, contrast and density. Variation in FFD will vary magnification factor (MF) and Penumbra.
Objectives: The study aims to investigate the relationship between FFD and received radiation dose to patients, where the radiation dose to the testes may be significantly lowered whilst still maintaining acceptable image quality.
Methods: Radiographic images and dosimetry were obtained with a Seimans wall-mounted X-ray unit. All anterior/posterior (AP) and lateral lumbar-pelvic radiographs were taken of an anthromorphological phantom that resembles human tissues, at both 100cm and 200cm FFD. Five central beam air doses were measured for all parameters to demonstrate patient entrance doses.
Results: For AP lumbar-pelvic radiography, increasing FFD by a factor of two resulted in an approximately 30% decrease in entrance dose to the testes. For lateral lumbar-pelvic radiography a two fold increase in FFD resulted in a 70% reduction in entrance dose.
Conclusions: The study suggests for the first time that an FFD of 200 cm, which is largely utilised by the chiropractic profession, is an efficient method of minimising radiation dose to patient, during lumbar radiography.
PMCID: PMC2050622  PMID: 17987147
Chiropractic; radiography; focus film distance; lumbar spine
14.  SPONDYLOLYSIS IN A PROFESSIONAL FAST BOWLER 
Spondylolysis is a common nemesis of the professional cricket fast bowler. This case study demonstrates a series of clinical presentations beginning with spondylolysis in the same professional fast bowler over a one year period. The initial presentation of the injury received chiropractic evaluation and successful management. The second presentation of the patient eight months later was an aggravation of the first injury, but the second presentation did not respond to chiropractic management. Highlighted is the subsequent clinical presentation of the fast bowler two hours prior to sustaining a fracture of the opposite pedicle (left) and the presentation one hour post fracture. The goals of appropriate conservative management are discussed. The role of aberrant intersegmental spinal and sacroiliac joint mobility in the aetiology of spondylolysis is also discussed.
PMCID: PMC2050621  PMID: 17987145
Spondylolysis; spondylolisthesis; sacroiliac joint; chiropractic; manipulation; cricket; biomechanics

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