Can a DPT student accurately palpate a spinous process? Is exercise good for back pain? 17 chiropractic colleges are grumpy about the state of chiropractic and penned a document to prove it. - ED.
ART
The influence of body painting on L4 spinous process palpation accuracy in novice palpators
What happens when you ask a group of 38 DPT students to palpate an L4 spinous process (using two methods to mark their landmark), and then verify their findings with diagnostic ultrasound?
Only 45% could accurately identify L4. Also, there was not much difference between the two methods used. Fortunately, 95% of those students were only off by one vertebrae.
Similar studies have been performed in the past by chiropractors who seemed to have a higher skill level when palpating. Is palpation still a valid method for assessing vertebral level/location? Perhaps, only among chiropractors.
SCIENCE
Exercise enthusiasts for low back pain may need to rethink their approach. A new Cochrane review looked at the current best evidence and concluded:
“No clinically relevant effect on pain or functional status in the short term.”
This is definitely at odds with the prevailing sentiment in chiropractic as well as manual therapy in general.
This Cochrane review of exercise for back pain may still have some useful implications despite the “very low quality evidence” it had to work with. Garbage in, garbage out? Certainly a concern with all reviews like this, but it’s also just kind of interesting how crappy the evidence is on this topic!
POLITICS
Clinical and Professional Chiropractic Education: a Position and Implementation Statement
A group of 17 chiropractic colleges have signed a 7-page position statement against the teaching of traditional chiropractic practices such as x-ray analysis, open concept adjusting, and wellness care.
The collective wastes no time positioning their schools as the bastion of evidence-based chiropractic care, citing:
Teachings outside the above (evidence-based criteria) should either be removed as part of the core curriculum or alternatively be taught in a historical context.
The chiropractic schools, many of which have fewer than 100 students, seek to form strategic partnerships with universities. One of the schools, AECC in the UK, has recently merged with an osteopathic school.
It will be interesting to see how this plays out. Who will decide what is considered best evidence? Is cherry-picked evidence still considered evidence-based?