ACC Research Agenda Conference 2019: Peer Reviewer Acknowledgments and Abstracts of Proceedings
2019; Volume: 33; Issue: 1 Linguagem: Inglês
10.7899/jce-18-32
ISSN2374-250X
Autores Tópico(s)Delphi Technique in Research
ResumoThe conference organizers wish to thank the many reviewers for their wonderful and necessary service. Their work makes the program successful and we are quite grateful.Medhat Alattar, Robert Appleyard, Iben Axen, Barclay Bakkum, Deborah Barr, Patrick Battaglia, Edward Bednarz, Judy Bhatti, Charles Blum, Karen Bobak, Ron Boesch, Linda Bowers, Rick Branson, Teresa Brennan, Joseph Brimhall, Leo Bronston, Thomas Brozovich, Paul Bruno, Jeanmarie Burke, Kara Burnham, Alana Callender, Jerrilyn Cambron, Marni Capes, Beth Carleo, Jonathan Carlos, Cynthia Chapman, Chin-Suk Cho, Ngai Chow, Jesse Coats, Alena Coleman, Stephan Cooper, Elaine Cooperstein, Robert Cooperstein, Matthew Cote, Brian Cunningham, Stuart Currie, Vincent DeBono, Renee DeVries, Scott Donaldson, Paul Dougherty, Stephen Duray, Jonathan Emlet, Melissa Engelson, Dennis Enix, Ana Facchinato, Mary Frost, Ricardo Fujikawa, Craig Fuller, Charles Gay, Gene Giggleman, Craig Gillam, Brian Gleberzon, Jordan Gliedt, Kenice Grand, Thomas Grieve, Jaroslow Grod, Joseph Guagliardo, Tim Guest, Mitchell Haas, Michael Hall, Marcy Halterman-Cox, Daniel Haun, Xiasohua He, Nathan Hinkeldey, Kathryn Hoiriis, Dana Hollandsworth, Greg Hollandsworth, Kelley Humphries, Adrian Hunnisett, Thomas Hyde, Theodore Johnson, Aimee Jokerst, Martha Kaeser, Normal Kettner, Yasmeen Khan, Stuart Kinsinger, Anupama Kizhakkeveettil, Carolina Kolberg, Charmaine Korporaal, Thomas Kosloff, William Lauretti, Alexander Lee, Brent Leininger, Makani Lew, Kathleen Linaker, Tracey Littrell, Ashley Long, Dana Madigan, Chris Major, Katherine Manley-Buser, Barbara Mansholt, Marc McRae, Silvano Mior, Veronica Mittak, Vanessa Morales, Stephanie Mussmann, Jason Napuli, Shawn Neff, Lia Nightingale, Casey Okamoto, Michael Oppelt, Tolulope Oyelowo, Kimberly Paddock-O'Reilly, Per Palmgren, Rachel Pandzik, David Paris, Steven Passmore, Georgina Pearson, Stephen Perle, Mark Pfefer, Jean-Phillippe Pialasse, Lynn Pownall, Mario Pribicevic, Mohsen Radpasand, Paula Robinson, Christopher Roecker, Anthony Rosner, Robert Rowell, Lisa Rubin, Drew Rubin, Stacie Salsbury, Michael Schneider, Gary Schultz, Zacariah Shannon, William Sherwood, Peter Shipka, Brian Snyder, Brynne Stainsby, Gerald Stevens, John Stites, Kent Stuber, Carla Sullivan, Stephanie Sullivan, Randy Swenson, Dorrie Talmage, Janet Tapper, Vinicius Tieppo Francio, Steven Torgerud, Elsisa Twist, Joseph Unger, Michael VanNatta, Robert Vining, Robet Walker, Paul Wanlass, Breanne Wells, Keith Wells, James Whedon, Jon Wilson, Jessica Wong, Charles Woodfield, Shari Wynd, Niu Zhang.Ahmad Abdella, Patrick BattagliaObjective: Describe demographics and presenting complaints of patients referred for chiropractic care within one Federally Qualified Health Center (FQHC). Methods: Descriptive data was collected from clinic inception (April 15, 2017) to June 30, 2018 and ranked by frequency. Results: 912 unique patients were seen. 66% were Female. 91% were at or below poverty level. 70% were African America, 27% White. 49% were uninsured, 18% Medicaid, 16% had a bridge-type of insurance unique to the area, 11% commercial insurance, and 6% Medicare. English (85%) and Spanish (7%) were most common languages. Comorbidities include obesity (69%), depression, other mental health disorder excluding drug or alcohol dependence, and anxiety (61%), hypertension (57%), asthma or COPD (28%), diabetes mellitus (20%). Reasons for chiropractic referral were low back pain (44%), neck pain (16%), mid back pain (12%), shoulder pain (8%), hip pain (6%), and knee pain (6%). Conclusion: Knowledge of patient demographics, comorbidities, and presenting complaints informs appropriate development of chiropractors operating within FQHCs. Awareness of cultural differences, appropriate co-management of listed comorbidities and mental health diagnoses, and expertise level understanding of non-specific spinal, shoulder, hip, and knee complaints is apparently warranted to best serve this patient population. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Andrew Whetten, Jeanne Ohm, Joey AlcantaraObjective: To determine changes in patients' sense of coherence (SOC) with chiropractic care. Methods: In addition to socio-demographic data and clinical covariates, baseline and comparative SOC was measured using the SOC-29 survey. Statistical analysis utilized a bootstrap paired t-test with a linear mixed model approach with practitioner as random blocking factor to examine the effects of a number of covariates. Results: A convenience sample of 1419 responders (1060 females; mean age =40.96 years) comprised our study population. They were highly educated with 87% (N=1240) attaining “some college education” or higher. The majority (N=720; 51%) indicated an MD/DO as their primary care provider. Wellness care and to improve symptoms were the major motivation for care (N=963; 68%). Baseline/comparative SOC scores were 148 (SD=22.19) and 150.70 (SD=23.59) with the observed mean for the bootstrap sample having a difference of 1.989 (95% CI:1.299, 2.759) at p=0.005 of the detected difference. We found minimal evidence (p>0.05) that covariates (i.e., age, gender, visit number, patient status, educational level, primary provider, motivation for care and duration of pain complaint) played a role in SOC change. Conclusion: The SOC of patients significantly increased with a course of chiropractic care. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Andrew Whetten, Jeanne Ohm, Joey AlcantaraObjective: To determine changes in patients' global physical health (GPH) and global mental health (GMH) following a course of chiropractic care. Methods: In addition to socio-demographic data and clinical covariates (i.e., motivation for care), baseline and comparative GPH and GMH were measured using the PROMIS global health survey. Statistical analysis utilized a bootstrap paired t-test with a linear mixed model approach with practitioner as random blocking factor to examine the effects of a number of covariates. Results: A convenience sample of 1419 responders (1060 females; mean age =40.96 years) comprised our study population. The mean number of visits between measures was 4.15 (SD=4.24). Baseline/comparative scores were: GPH (49.52/50.73) and GMH: 50/52.41. The observed mean for the GPH bootstrap sample had a difference of 1.117 (95% CI:0.88, 1.405) with p=0.0071. The observed mean for the GMH bootstrap sample had a difference of 1.453 (95% CI: 1.122, 1.751) with p=0.0128. Increases in GPH and GMH were statistically significant. We found minimal evidence (p>0.05) that covariates (i.e., age, gender, educational level and motivation for care) played a role in the observed improvement in QoL. Conclusion: The quality of life of patients improved with a course of chiropractic care. (This is a conference presentation abstract and not a full work that has been published.)Joel Alcantara, Andrew Whetten, Jeanne Ohm, Joey AlcantaraObjective: To assess the predictive relationship between various quality of life (QoL) domains and sense of coherence (SOC). Methods: We measured the SOC and QoL of patients using the SOC-29 and the Patient Reported Outcomes Measurement Information System, respectively. Predictive relationships utilized random forest regression analysis. Results: Our convenience sample consisted of 1980 responders (average age=40.72 years; 1494 females). The mean SOC score was 148.3 (SD=22.37). The mean PROMIS T scores were: physical functioning (50.97), anxiety (52.03), depression (47.47), fatigue (51.15), sleep disturbance (49.85), ability to participate in social roles and activities (54.44), pain interference (51.27), global physical health (GPH) (49.34) and global mental health (GMH) (50.7). The variable importance plots indicated that GMH, anxiety and depression were several magnitudes higher as predictors for SOC compared to physical domains (i.e., physical functioning, pain interference). However, multi-dimensional partial dependence plots demonstrated interaction between physical domains such as fatigue and sleep disturbance to SOC. Therefore, physical domains of QoL cannot be discredited as nonessential in the prediction and understanding of a person's SOC. Conclusion: Despite the strong predictive relationship of mental health domains to SOC, physical domains cannot be discounted as playing a role. (This is a conference presentation abstract and not a full work that has been published.)Daniel Ault, Ashley Ruff, Stacey Cornelson, Aimee Jokerst, Norman KettnerObjective: To describe a patient with bilateral femoral head cam-deformity, early-onset osteoarthritic (OA) changes, and clinically correlated femoroacetabular impingement (FAI) on the left. Clinical Features: A 25-year-old male presented with left deep groin pain. The onset of provocation occurred while performing squat exercises. Left hip pain, reduced flexion range of motion, and positive orthopedic FAI tests were identified at examination. Interventions and Outcome: Following the radiographic diagnosis of bilateral cam-deformity and early-onset OA changes, an ultrasound (US) examination was performed, which showed real-time dynamic FAI. For further evaluation of acetabular labral pathology, a magnetic resonance imaging (MRI) examination was recommended. At last follow-up, the patient elected to pursue an orthopedic consultation. Conservative care included Class IV therapeutic laser, soft tissue manipulation, assisted stretching, and psoas trigger point therapy. The patient reported no alleviation of symptoms. Conclusion: This case demonstrates the clinical manifestation and radiologic diagnoses in a rare presentation of early-onset bilateral hip OA changes. We present the efficacy of US in the diagnosis of FAI, but emphasize the value of MRI for labral pathology. To our knowledge, this is the first case demonstrating real-time impingement with a femoral head cam-deformity using US. (This is a conference presentation abstract and not a full work that has been published.)Jeffrey Baier, Mark Pfefer, Rebecca Wates, D'sjon ThomasObjective: To investigate whether negative implicit racial and obesity attitudes and beliefs exist among chiropractic students and faculty at an academic institution, and to compare these findings to the implicit bias evident in the general population. Methods: Students and faculty participants (n=88) completed a series of implicit attitude and belief measures. Results were compared to normative population values. Participants completed attitude- and belief-based Implicit Association Tests based on race- or obesity-based implicit biases. This reaction time measure of automatic memory-based associations asked participants to classify words into category pairs: good versus bad (attitude measure) and motivated versus lazy (stereotype measures). Results: Clear evidence for implicit negative racial and/or obesity bias was found in this group of participants. Compared with findings from the general public (race: 3,725,723 respondents; obesity: 334,135 respondents), respondents trended towards having more negative implicit biases concerning both race and weight. Conclusion: Future health care providers and faculty in this sample have strong negative racial and obesity bias, indicating pervasiveness of stigma toward racial minorities and obese persons. Additional research is needed to investigate how these attitudes and beliefs impact delivery of care. (This is a conference presentation abstract and not a full work that has been published.)Florian Barbier-Cazorla, Hainan Yu, Pierre Cote, Paula Stern, David Cote, Anne Taylor-Vaisey, Chelsea D'silva, Nadege LemeunierObjective: To study the reliability and validity of orthopaedic tests used in the assessment of Low Back Pain adults (LBP). Data Sources and Selection: We conducted a systematic and critical review searching on three databases from 2000 to 2017. Paired reviewers screened and critically appraised studies using the modified QUAREL and modified QUADAS-2 checklists. We used best evidence synthesis evidence from studies with low risk of bias and classified validity studies following Sackett and Haynes system. Results: We screened 1646 articles, 15 were low risk of bias. Twenty orthopaedic tests were studied. These studies reported: 1) modified Schobert test may be reliable [0.91<ICC (CI95% not reported)<0.97] but couldn't distinguish low back pain patients than controls; 2) hip extension test reliability [k=0.76 (IC 95 % : 0.57-0.95)] with validity phase II findings; 3) active straight leg raise reliability [0,53 (IC 95 % : 0,20-0,84) <k< 0,76 (IC 95 % : 0,57-0,96)] with phase I/II validity findings. Conclusions: Evidence is too preliminary to support reliability and validity of orthopaedic tests. More research (phase III) is needed to conclude on their clinical utility. (This is a conference presentation abstract and not a full work that has been published.)Patrick BattagliaObjective: To describe a series of cases where the availability of diagnostic ultrasound at the point of care was indispensable in providing an accurate diagnosis without delay or need for more expensive imaging, such as MRI. Clinical Features: This series highlights the following cases: rib fracture (negative radiographs), bilateral de Quervain stenosing tenosynovitis, gouty arthritis (negative radiographs), carpal tunnel syndrome with severe median nerve compression, and finger extensor tendon dislocation. Intervention and outcome: With an accurate diagnosis established, each patient received appropriate care. Patients with rib fracture and de Quervain stenosing tenosynovitis were managed conservatively. The patient with gouty arthritis was referred to primary care for medical management. Patients with carpal tunnel syndrome and extensor tendon dislocation were referred to orthopedics. Conclusion: Modern high frequency ultrasound transducers and systems can resolve musculoskeletal anatomy with superb resolution. As this case series demonstrates, making ultrasound available at the point of care may improve patient outcomes by establishing a correct diagnosis with minimal increase in cost. (This is a conference presentation abstract and not a full work that has been published.)Patrick Battaglia, Jesse Cooper, Todd ReiterObjective: To present a case report that highlights the risks of self-neck manipulation and describe a clinical scenario in which practitioners of spinal manipulation therapy (SMT) should exercise appropriate caution with patients undergoing anticoagulation therapy. Clinical Features: A 63-year-old man presented to the emergency department with worsening interscapular pain radiating to his neck 1 day following self-neck manipulation. He was found to be coagulopathic upon admission secondary to chronic warfarin therapy. The patient subsequently developed quadriparesis. Magnetic resonance imaging revealed multilevel spinal epidural hematoma (SEH) from the lower cervical to thoracic spine. Intervention and Outcome: The patient underwent emergency laminectomy for evacuation of SEH with placement of an epidural drainage catheter. He was admitted to an acute inpatient rehabilitation center for 2 weeks of physical and occupational therapy. The patient ultimately made a complete recovery. Conclusion: To the best of our knowledge, we present the first case of a patient with an underlying coagulopathy performing self-neck manipulation, which resulted in SEH and subsequent quadriparesis. The relationship between SEH and SMT warrants further investigation. Until then, anticoagulation therapy or known coagulopathy should be considered a relative contraindication to SMT. (This is a conference presentation abstract and not a full work that has been published.)Kyle Bills, Scott SteffensenObjective: Very little is known about the extra-somatosensory effects of spinal mechanoreceptor-based therapies on the supraspinal central nervous system. We examined changes in firing rate and neurotransmitter release in the mesolimbic system, an area highly involved in addiction, induced by activation of spinal mechanoreceptors at the cervical spine in a rodent model. Methods: We utilized single-cell in vivo electrophysiology, fast-scan cyclic voltammetry and microdialysis to measure changes in neuron firing rate and dopamine (DA) release. Spinal mechanoreceptors were activated by microcontroller driven implanted motors. Results: We show that spinal mechanoreceptor activation transiently depresses GABA neurons and excites DA neurons in the ventral tegmental area while increasing DA release in the nucleus accumbens. These effects are frequency and anatomically dependent and driven by endogenous release of opioids. Conclusion: Spinal mechanoreceptor activation modulates neuron firing and neurotransmitter release in the mesolimbic system. This study demonstrates that peripheral stimulation at the spine is sufficient to alter supraspinal neuronal function at the cellular level. Further, that spinal-based therapies carry potential as adjunctive treatments for drug-abuse disorders. (This is a conference presentation abstract and not a full work that has been published.)Barton Bishop, Jay Greenstein, jena Etnoyer-Slaski, Robert ToppPurpose: To compare the effect of Biofreeze and TheraBand Kinesiology Tape (TBKT) to advice on acute low back pain (LBP) pain, disability and fear avoidance over 1-week. Methods: Participants completed informed consent, Numeric Pain Rating Scale(NPRS), Roland-Morris LBP and Disability Questionnaire(RMDQ), and Fear Avoidance Beliefs Questionnaire(FABQ). Subjects were randomized into 1 of 4 at-home pain management groups, [Group 1 (Biofreeze+Tape), Group 2 (Tape), Group 3 (Biofreeze), Group 4 (Advice)]. The groups followed the same protocol, rating their pain at 2nd (T2) and 3rd (T3) office visits. At one week(T4) participants completed the NPRS, RMDQ, and FABQ. In addition to pain and outcomes, at home pain management compliance and pain medication were documented on a daily basis. Results: A total of 106 participants completed the study (Group 1 = 25, Group 2 = 28, Group 3 = 26, Group 4 = 27). Group 1 significantly changed their for FABQ-PA score over time (p=0.000) from T1(x=19.2) to T2(x=14.2). There was also a significant decrease in FABQ-Total score over time (p=0.002) for all groups except Group 4. All groups except Group 4 also significantly improved (p=0.000) RMDQ scores from T1 to T4. Pain significantly declined (p=0.000) in all groups over time. Conclusion: The use of TBKT, Biofreeze, or combination improved pain and function in participants with acute, non-complicated LBP. (This is a conference presentation abstract and not a full work that has been published.)Thomas Bloink, Charles BlumObjective: This case presents novel care for a 65-year-old female patient presenting subsequent to a slip and fall accident. Clinical Features: The patient fell and struck her left-zygoma (zygomatic-nasomaxilla region), which was fractured and lost consciousness due to the head trauma. Following the accident she received physical, vestibular, and chiropractic spinal therapies for approximately three-months with no relief or change in symptomatology. Three-months post-trauma she presented to this office with chronic symptoms (VAS 8/10): pelvic pain, upper-cervical spine pain, difficulty swallowing due to supra/infrahyoidal myofascial disorder, pain in the left-maxillozygomatic joint (radiated into her nose), numbness to region of facial trauma, vertigo and tinnitus. Intervention/Outcome: In the first four-weeks at this office (seen twice-a-week) she received sacro occipital technique (SOT), cranial manipulative care, TMJ care, and co-treated with dentist (lower dental splint therapy) with marked improvement (VAS 3-4/10). In the ensuing four-months she was seen twice-a-month with steady improvement following each office visit. By the 5-month mark her symptomatology had predominately resolved (VAS 1/10), with only mild intermittent brief pains in the cervical spine and ear. Conclusion: Further research is indicated to determine if other patients with similar presentations might benefit from these chiropractic methods. (This is a conference presentation abstract and not a full work that has been published.)Thomas Bloink, Charles BlumObjective: Mal de Debarquement syndrome (MdDS) is an atypical vertigo related to the continued sensation of movement after a subject may have finished boating, surfing or taking a sea voyage. MdDS's underlying pathogenesis is poorly understood and therefore, treatment options are limited. Clinical Features: For 4-years, prior to being seen at this office, the patient had chronic atypical vertigo with 2-3 flareups per year with durations lasting 3-4 months. A brain MRI was unremarkable though a cervical MRI revealed spondolytic and discogenic degenerative changes. She reported that prior to 4-years she traveled on approximately 20-cruise ship vacations. Intervention and Outcome: The patient was treated for eight-visits over a 6-week period of time. SOT and cranial/TMJ care was rendered with adjustments to the cervical/thoracic spine. She also received cranial/dental co-treatment with a lower occlusal splint and seen at this office once-a-week for three-weeks in a row, with her splint being dentally equilibrated immediately following cranial treatment. After the eighth-visit she experienced complete relief of symptoms. A year following her 8th-office-visit her condition has remained stable. Conclusion: Conservative care for complex patient presentations are always an optimal option and further study in chiropractic care of MdDS might be warranted. (This is a conference presentation abstract and not a full work that has been published.)Charles BlumObjective: Ideally chiropractic seeks to optimize patient care collaboratively working within interdisciplinary relationships. One condition discussed in both dental and chiropractic arenas involves the ramifications of forward-head-posture (FHP) positioning. Determining causation is a crucial part of the differential diagnostic process since misdiagnosis can lead to poor patient outcomes. Data Sources and Selection: A selective search of PubMed was performed to assess both chiropractic and dental perspectives of FHP. Results: Chiropractic studies tended to focus on FHP as related to a spinal curve that needed to be “corrected,” secondary to poor posture/ergonomics. Dental studies tended to focus on FHP as being an adaptation secondary to airway compromise, related to craniomandibular joint disorders (CMD). Yet another group of studies determined that FHP conversely leads airway compromise. Conclusion: Airway compromise and apneas have drastic long-term effects on patient mortality and morbidity. Chiropractic care needs to take into account possible adaptive FHP positioning, since “correcting” a spinal curve may aggravate airway compromise. Likewise dentistry treating CMD may need to consider co-treatment with chiropractors since FHP may contribute to a patient's airway compromise. Therefore obstructive sleep related apneas related to FHP might require dental/chiropractic interdisciplinary care for optimal patient outcomes. (This is a conference presentation abstract and not a full work that has been published.)Ron Boesch, Misty Stick, Elissa Twist, Dustin Derby, Kimberly Merchant, Stephanie BurroughObjective: Describe pre- and post-training knowledge of eating disorders (ED) for clinical faculty and interns 4 months post training. Methods: Investigators developed an ED training session for teaching clinicians and interns in a DC program. Pre- and post-training surveys captured long-term knowledge retention. The surveys contained a 20 items centered on respondents' self-perceptions of their ED knowledge (1 = minimal, 5 = extensive), ability to identify ED, and common clinical signs / symptoms of ED. Investigators used cumulative scores ranging from 0 (no correct responses) to 17 (all correct responses) to assess respondent understanding. Results: The study had 107 pre- and 96 post-training respondents (83/77students, 24/19 instructors). Chance differences occurred for pre- (M=13.63) and post-training (M= 13.71) and mean cumulative scores (t(153) = -1.399, p = .164). Significant pre- (M=2.73) and post-training (M=3.11) differences occurred for respondents' knowledge (t(196) = -2.951, p < .01). Respondents' confidence in ED patient identification rose from 2.7 to 3.1 post-training. Conclusion: Although the training did not significantly impact respondents' cumulative scores, it did seem to impact their perceptions of knowing more about ED and slightly increased their confidence in identifying patients with ED. (This is a conference presentation abstract and not a full work that has been published.)Scott Carpenter, Elissa Twist, Judy BhattiObjective: To examine if differences exist in projected income expectations between male and female Doctor of Chiropractic (DC) students in their final term of chiropractic college. Methods: Gender and projected income of 1, 5, and 10 years as well as a calculated break-even month was extracted from class business plans of end-of-term 9th trimester students. Change in income was computed based on expected income from month 1 to 10 years. Projected income was adjusted for the median income of the practice location. Non-parametric tests were run in SPSS V25. Results: 123 (80 male) cases were examined. Males reached a break-even point median at month 7, females 5 months. Median projected income year 1 males n=74 (19811.5) females n=40 (11581.0) p=.7, year 5 males n=80 (63300.0) females n=43 (34813.0) p=.003 and year 10 males n=80 (150699.0) females n=43 (305039.44) p<.001. Change in adjusted income males n=74 (210842.00) females n=40 (130913.5) p<.001. Conclusion: In this population of DC students, women have lower projected income expectations by five years and ten years in practice than their male colleagues. Women also have lower expectations of income increase over 10 years. Males expect an earlier projected break-even point than females. (This is a conference presentation abstract and not a full work that has been published.)Cynthia Chapman, Barclay Bakkum, Lisa BarkerObjective: The purpose of this case report is to describe the co-management of a 9-year-old with idiopathic scoliosis and headaches using chiropractic care and optometric vision therapy. It was hypothesized that the combined care could impact the vestibulocollic reflex pattern and thereby address the scoliosis and headaches. Clinical Features: Optometric diagnoses included convergence insufficiency and significant visually-guided body movement (gross motor) deficits. Initial chiropractic exam findings were 4° right thoracic and 9° left lumbar curvatures along with multiple levels of vertebral joint dysfunction. Her headaches were rated as moderate and frequent. Outcome measurements included: Neck Index, Back Index, Berg Balance Scale, Timed Up and Go Test, and International Co-operative Ataxia Rating Scale. Intervention and Outcome: The patient received therapeutic glasses with mild prisms and underwent standard optometric vision therapy for a year. During that same time, she was assessed and received monthly manipulative therapy. At the conclusion of therapy, headaches were moderate and occasional with 3° thoracic and 3° lumbar curvatures. At 3-month follow-up her headaches were moderate and frequent with 3° thoracic and 5° lumbar curvatures. Conclusion: No statistically significant changes in outcome measures were found, showing that the scoliosis had not progressed. (This is a conference presentation abstract and not a full work that has been published.)Brian Coleman, Kelsey Corcoran, Eric DeRycke, Lori Bastian, Cynthia Brandt, Anthony LisiObjective: This study examined factors associated with post-traumatic stress disorder (PTSD) prevalence among Veterans of Operation Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who receive Veterans Affairs (VA) chiropractic care. Methods: A cross-sectional analysis of administrative data from a national cohort study of OEF/OIF/OND Veterans with at least one visit to a VA chiropractic clinic from 2001-2014 was performed. The prevalence of PTSD was modeled by logistic regression using covariates of sex, race, age, body mass index (BMI), pain intensity, alcohol and substance use disorders, and smoking status. Results: We identified 14,205 Veterans who received chiropractic care, with a mean age of 38 years, 15.8% women Veterans, and 54.24% having a diagnosis of PTSD. On multivariate analysis, significant association was found between PTSD prevalence and male sex, younger age, BMI ≥ 30, moderate to severe pain intensity, alcohol and substance use disorders, and current smoking status. Conclusions: PTSD among OEF/OIF/OND Veterans receiving VA chiropractic care is common and associated with several patient demographic and clinical factors. Recognition of these factors is important for appropriate diagnosis and management of Veterans with PTSD who seek chiropractic treatment for pain conditions, given the biopsychosocial model of pain. (This is a conference presentation abstract and not a full work that has been published.)Kelsey Corcoran, Lori Bastian, Eric DeRycke, Cynthia Brandt, Sally Haskell, Anthony LisiObjective: This study aims to examine patient factors associated with the use of chiropractic services among Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) Veterans with low back pain (LBP). Methods: This was a cross-sectional analysis of a cohort of OEF/OIF/OND Veterans with a primary care visit associated with an ICD-9 code for LBP from 10/01/11 to 09/30/14 at Veterans Affairs (VA) facilities that also offered on-station chiropractic services. Chiropractic service use was defined as ≥1 chiropra
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