Chiropractic Journal of Australia <p>The Chiropractic Journal of Australia (CJA) is a peer-reviewed journal of record dedicated to the advancement of chiropractic science, principles and practice. CJA seeks to fulfil this purpose by critical review and publication of research and scholarly works relating to the scientific bases and clinical applications of chiropractic, and supportive presentations of an educational and/or professional nature.</p> <p>CJA is proudly supported by <strong><a title="Guild" href="" target="_blank" rel="noopener">Guild Insurance</a></strong>.</p> <p><strong><a title="Contact" href="">CONTACT</a></strong></p> <p>Any enquiries</p> <p>Phone: +61 2 8844 0400<br />Fax: +61 2 8844 0499<br />Email: <a href="" target="_blank" rel="noopener"></a></p> en-US <p>Authors retain copyright and grant the journal right of first publication and allow others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</p> <p>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</p> <p>This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.</p> (Dr Henry Pollard) (Glynis Grace) Tue, 08 Feb 2022 05:38:03 +0000 OJS 60 DOES CHIROPRACTIC BRANDING REFLECT CURRENT CHIROPRACTIC PRACTICE? <p>Welcome to Volume 49 of the new look Chiropractic Journal of Australia. As I ponder the start of 2022, I find myself reflecting upon a chiropractic career, that has spanned 35 years. Within this retrospective journey, my thoughts have travelled to where it all began; in 1986, when I had completed my studies at the Sydney College of Chiropractic (now Macquarie University) and was eager to start a Christmas locum for one of the three associateship positions I had acquired.</p> Henry Pollard Copyright (c) 2022 Henry Pollard, PhD Tue, 08 Feb 2022 00:00:00 +0000 CHIROPRACTIC SCOPE OF PRACTICE AND CLINICAL COMPETENCIES IN AUSTRALIA <p>This is the first of a three-part editorial series on the scope of practice (SOP) for general chiropractors in Australia as determined by undergraduate education and the development of extended scopes of practice for advanced chiropractors based on the accreditation of post-graduate educational pathways, advanced clinical competencies and titling within the Australasian Institute of Chiropractic Education (AICE).(1)</p> Peter McGlynn, Peter McCann, Carl Thistlethwayte, Lisa McInerney Copyright (c) 2022 Peter McGlynn, Peter McCann, Carl Thistlethwayte, Lisa McInerney Fri, 08 Apr 2022 00:00:00 +0000 THE CHIROPRACTIC SCOPE OF PRACTICE AND CLINICAL COMPETENCIES IN AUSTRALIA <p>This editorial is the second of a three-part series and focuses on the advanced competency framework for Well-being and Lifestyle Management chiropractors in Australia. It is based on the accreditation of advanced post-graduate educational pathways, extended scope of practice, and titling within the Australasian Institute of Chiropractic Education (AICE). (1) This editorial is preceded by Part 1 – “Scope of practice and advanced titling.” (2)</p> Peter McGlynn, Peter McCann, Carl Thistlethwayte, Lisa McInerney Copyright (c) 2022 Peter McGlynn, Peter McCann, Carl Thistlethwayte, Lisa McInerney Thu, 23 Jun 2022 00:00:00 +0000 REMISSION OF HEADACHE AND NECK PAIN FOLLOWING CHIROPRACTIC MANIPULATIVE TREATMENT IN A PATIENT WITH NEUROFIBROMATOSIS <p><strong>ABSTRACT</strong></p> <p><strong> </strong><strong>Objective</strong>: To describe the case of a 21-year-old male with a 10-year history of neurofibromatosis type 1 (NF1) who complained of nuchal pain (2 on a 0-10 point numeric pain rating scale, NRS) and right frontal headache (8 on NRS) for six months.</p> <p><strong> </strong><strong>Clinical features</strong>: The painful symptoms were associated with a great impact on the sleep and routine tasks during the month preceding the first presentation to the practitioner. The patient scored an 84% on the Neck Disability Index (NDI). Spinal palpation revealed restricted range of motion at C2/3, C4/5, C5/6, T1/2, T3/4 and T7/8 vertebral segments. Radiographic evaluation of the cervical spine revealed reduced cervical lordosis with Cobb angle 3°.</p> <p><strong>Intervention and outcomes</strong>: Chiropractic treatment aimed to reduce pain, muscle hypertonicity and restore spinal mobility. Treatment consisted of thermal ultrasound therapy, cervical manipulation with a high-velocity, low-amplitude force, and skin to skin contact manual adjustment. As the result of 12-month treatment, the patient experienced a resolution of neck pain and headache. He reported a reduced headache score from 8 to 0 on a scale of 10. His NDI reduced from 84 % to 8%, and cervical lordosis was restored from 3° to 20° as measured by the Cobb angle between the inferior endplate of C2 to the inferior endplate of C7.</p> <p><strong>Conclusion</strong>: This case report details the long-term recovery of a patient with NF1 from severe headaches and neck pain following chiropractic treatment. It provides evidence and highlights the value of chiropractic intervention in improving neuromuscular functions and resolving cervicogenic headache in a patient with NF1, especially when the problems cannot be effectively solved by pharmacological or other conservative means. Chiropractic manipulative therapy may be a viable option as conservative management of musculoskeletal dysfunction resulting from NF1.</p> Eric Chun Pu Chu, Valerie Kok Yan Chu, Alan Te-Chang Chen, Benjamin Kah Chun Cheong Copyright (c) 2022 Eric, Valerie, Alan, Benjamin Tue, 08 Feb 2022 00:00:00 +0000 A CRITICAL REVIEW OF A PUBLISHED CASE REPORT THAT INCORRECTLY ATTRIBUTED CHIROPRACTIC CARE AS A CAUSE OF VERTEBRAL ARTERY DISSECTION (VAD) <p><strong>ABSTRACT</strong></p> <p>Case reports are sometimes published regarding a possible association between chiropractic and cervical artery dissection (CAD). However, case reports that are poorly written or have significant omissions or weaknesses, may led to incorrect conclusions in relation to the cause of the CAD and potential negligence.</p> <p>It is important to review the issues and assess the evidence for and against chiropractic manipulation as a trigger for CAD. Using a recently published case study to highlight weaknesses and omissions in such reports. A case report is reviewed in detail and discusses the evidence assessing chiropractic manipulation as a potential trigger for CAD.</p> Peter Tuchin Copyright (c) 2022 Peter Tuchin Tue, 08 Feb 2022 00:00:00 +0000 A SPORTS CHIROPRACTIC POST-SURGICAL REHABILITATION OF AN ELBOW FRACTURE DISLOCATION FOLLOWING A BRAZILIAN JIU-JITSU INJURY <table> <tbody> <tr> <td width="601"> <p><strong>Background</strong>: Term ‘the terrible triad of the elbow’ describes posterior dislocation with fracture of radial head and coronoid process, and tear of lateral collateral ligament (LCL) complex. This type of injury is historically known to be a challenging injury to rehabilitate. This paper presents a case of the “terrible triad” type injury acquired by a Brazilian Jiu-Jitsu (BJJ) practitioner during a training session and who received chiropractic post-surgical rehabilitation.</p> </td> </tr> <tr> <td width="601"> <p><strong>Case presentation</strong>: A 26-year-old Asian male injured his left elbow during BJJ training session. After transport to the hospital, closed reduction in the emergency was attempted twice but failed to reduce radial head dislocation. Later, CT scan revealed a tear of the LCL complex and a fracture dislocation of the radial head.</p> <p><strong>Intervention and outcome</strong>: The injury was managed surgically via open reduction and internal fixation procedure. The patient chose to receive chiropractic post-surgical rehabilitation. The outcome of treatment was measured using patient reported outcome measures and achieved desirable outcome after 12 weeks of management which consisted of total 15 treatment sessions. The elbow motion arc improved from 60° (extension 60° - flexion 120°) to 150° (extension 5° - flexion 155°). His Disabilities of the Arm, Shoulder, and Hand score improved by 78.3 points, Patient Rated Elbow Evaluation score increased by 61 points, and Upper Extremity Functional Index achieved a full score.</p> </td> </tr> <tr> <td width="601"> <p><strong>Conclusion</strong>: This report discusses the post-surgical chiropractic rehabilitation of a unique BJJ-related injury. Despite the limitation of available literature to guide development, multimodal chiropractic rehabilitation can be successful in post-surgical rehabilitation.</p> </td> </tr> </tbody> </table> Woosang Lee, Henry Pollard Copyright (c) 2022 Woosang Lee, Henry Pollard Mon, 28 Mar 2022 00:00:00 +0000 SPORTS CHIROPRACTIC MANAGEMENT OF OSTEOARTHRITIC KNEE PAIN IN A MASTERS LEVEL TRIATHLETE/RUNNER <p>The purpose of this paper is to present a case study of a female masters’ level triathlete/runner with severe medial knee osteoarthritis, a history of multiple lower limb stress fractures and knee pain of 6 months duration who has been treated by a titled sports chiropractor (Australasian Institute of Chiropractic Education; AICE) using current multimodal evidenced-based management protocols. The overall burden of osteoarthritis and its management to the individual and to society is also discussed.</p> <p><strong>Clinical features</strong>: a female master’s level triathlete/runner aged 51 years who is highly competitive in her age group category at local, regional and state level events. The athlete presented to a sports and exercise chiropractor with knee pain which had prevented her from running over the previous 6 months. MRI imaging revealed severe medial knee osteoarthritis, subchondral oedema at the medial femoral condyle and full thickness chondral loss, indicating Grade 4 on the Kellgren-Lawrence classification scale.</p> <p><strong>Intervention and outcome</strong>: management consisted of 6 weeks running gait retraining, specific corrective exercise prescription and monitoring and gradual progression of exercises and running load. No manual therapy was provided during this study. At the end of 6 weeks the athlete reported subjective improvements in knee pain and running capacity. Objectively there were improvements in orthopaedic resisted muscle grading testing, joint range of motion and The Knee Injury and Osteoarthritis Outcome Score (KOOS).</p> <p><strong>Conclusion</strong>: diagnosed with severe medial knee osteoarthritic deterioration and pain, the athlete had subjective and objective improvements in function and symptoms following this six-week evidenced based intervention. Further research involving larger sample sizes, longer term follow-up, males, non/binary or transgender subjects and alternative exercise protocols would assist in clarifying the optimum management in a variety of situations.</p> Gary Smith Copyright (c) 2022 Gary Smith Fri, 08 Apr 2022 00:00:00 +0000 A NOVEL TREATMENT FOR PERSISTENT POSTURAL PERCEPTUAL DIZZINESS <p>&nbsp;</p> <p>A case of Persistent Postural Perceptual Dizziness (PPPD) or (3PD) presented to a Chiropractor with significant symptoms and few neurological signs. This condition had been present for over three decades. These, largely vestibular signs and symptoms included: ‘foggy brain’, difficulty concentrating and reading, an almost constant&nbsp;feeling of disorientation, a feeling of “motion sickness”, and poor balance. Additional symptoms included peripheral vision being sensitive to bright light, phono-phobia and an intolerance to any constant background noise.</p> <p>&nbsp;</p> <p>Other symptoms of note included that when travelling in a car, the patient would feel like the vehicle was still moving for about twenty seconds after the car had stopped.</p> <p>He suffered dizziness when arising from the supine to sitting position, especially upon awakening and had reduced neck mobility, which was the reason for his initial consultation to a Chiropractor. Also, upon lifting binoculars to his eyes, he would fall forward to the degree that he had to brace himself before lifting the binoculars up to his face.</p> <p>&nbsp;</p> <p>The patient had sought various treatments in the past and was given several diagnoses including: Motion Sickness, Benign Paroxysmal Positional Vertigo (BPPV) and ‘vertigo’. Treatment has previously included medication from several general medical practitioners, two neurologists and multiple sessions of physiotherapy. The patient claimed the treatment for BPPV by a physiotherapist reduced symptoms by 50% but the treatment effects did not last beyond 3 days. Medications of various types were reported as ineffective.</p> <p>&nbsp;</p> <p>Novel vestibular rehabilitation techniques, included using a rotating chair, saccade training, a reaction timer panel and home exercises were utilised to good effect. Four weeks of treatment, alleviated the condition for the first time in over 30 years. The methods used were novel and not considered within the realm of typical general chiropractic management. This case presents a novel ‘Functional Neurological’ approach to management of a condition by a Chiropractor with a special interest in vestibular rehabilitation.</p> <p>&nbsp;</p> <p><strong>Key Words:</strong> PPPD, Chiropractic, Vestibular Rehabilitation, Rotating Chair, Sensory-Motor connectivity.</p> David Richardson Copyright (c) 2022 David Richardson Fri, 15 Jul 2022 00:00:00 +0000