Logan University, formerly Logan College of Chiropractic until 2013, is a private special focus university providing college education in chiropractic and the health sciences in Chesterfield, Missouri..
BACKGROUND:Chiropractors commonly manage cervicogenic headache (CGH) and tension-type headache (TTH) using nonpharmacological interventions such as spinal manipulative therapy. However, dedicated guidelines on chiropractic management of headaches are outdated. METHODS:We first conducted an umbrella review. A search for systematic reviews and clinical practice guidelines on nonpharmacological interventions for adults with CGH or TTH published from 2017 to August 2023 was conducted. At least two authors independently performed article screening, risk of bias/quality assessment, certainty of evidence, and data extraction. A steering committee developed statements from the synthesized data and seed documents, which were refined by anonymous feedback from a 57-member Delphi panel until reaching at least 80% consensus. The statements were then subjected to public comment, prompting further revisions that were subsequently reviewed by the Delphi panel. RESULTS:Thirty-two relevant articles were identified (31 systematic reviews and 1 clinical practice guideline). Statements included recommendations regarding history (e.g., red flags) and examination for CGH/TTH, recommendation to use of spinal manipulation for CGH, and for TTH only within multimodal care. Certainty of evidence and strength of recommendations for other nonpharmacological interventions (e.g., acupuncture and exercise) varied. Limitations in evidence precluded strong recommendations for acupuncture, education, meditation/mindfulness, and modalities used in isolation for CGH and electroacupuncture for TTH. CONCLUSIONS:This clinical practice guideline created evidence-based consensus recommendations for chiropractic management of adults with CGH and TTH. Chiropractors may appropriately care for individuals with CGH and TTH using a variety of nonpharmacological interventions, while considering best practices in diagnosis, referral, and other aspects of care management.
Background:This systematic review evaluated the efficacy of SMT for chronic spinal conditions in adults aged 55 years and older. Methods:We searched multiple databases for randomized controlled trials (RCTs) on SMT for older adults with chronic spinal conditions (≥ 12 weeks) published from February 2016 through October 2024. Additionally, studies from the prior article being updated were included as appropriate. Eligible studies compared SMT to active or inert comparators, measuring pain, function, or quality of life. Results:Nine reports were included, evaluating SMT for chronic low back pain (5 RCTs, n=544), chronic neck pain (2 RCTs, n=241), lumbar spinal stenosis (1 RCT, n=259), and combined neck/back disability (1 RCT, n=182). Conclusion:SMT may offer comparable or modestly greater benefit than other treatments for chronic spinal conditions in older adults, particularly for neck pain and LSS. Evidence certainty remains very low to moderate. Registration:PROSPERO (CDR42024615084).
ABSTRACT:Katz, NS, Rossow, LM, and Fahs, CA. The acute effect of a diaphragmatic breathing warm-up on maximal deadlift performance. J Strength Cond Res 40(8): 1030-1033, 2026-The purpose of this study was to investigate the effect of acute diaphragmatic breathing practice on muscular strength (deadlift 1 repetition maximum) performance. Forty resistance-trained adults (32 men, 8 women; age 24.8 ± 6.8 years) completed 2 testing sessions in a randomized crossover design. Each session involved a standardized warm-up followed by a 1-repetition maximum (1RM) deadlift assessment. In the experimental condition, subjects performed a 5-minute diaphragmatic breathing protocol in the supine position before testing. Deadlift 1RM was significantly greater in the diaphragmatic breathing condition than control (163.6 ± 47.1 vs. 160.7 ± 49.6 kg; mean difference = 2.9 kg, +2.8%; p < 0.05). The effect size was small (Cohen's d = 0.34). Twenty-four subjects (60%) demonstrated improved performance (mean +8.1 kg, +6.6%), while 16 (40%) subject showed no change or a decrease in 1RM (mean -4.8 kg, -2.8%). A brief diaphragmatic breathing warm-up produced a statistically significant but small improvement in maximal deadlift performance. Given its simplicity, minimal time requirement, and the fact it requires basic equipment (e.g., a bench or box for foot support and a foam roller placed between the knees), diaphragmatic breathing may serve as a practical warm-up strategy for athletes and lifters seeking marginal gains in maximal strength performance.
Abstract Background Rehabilitation is described as the care needed when a person is experiencing, or is likely to experience, limitations in everyday functioning. In 2019, it was estimated that 2.4 billion people were living with a condition that could benefit from rehabilitation. Chiropractors have contributed meaningfully to the delivery of rehabilitation due to their training in musculoskeletal health and person-centred care. Building on the World Federation of Chiropractic’s chiropractic rehabilitation competency framework, this commentary highlights chiropractic's role in strengthening rehabilitation in health systems. Under the “Role of Chiropractic in Rehabilitation”, we explore the postoperative setting, sports injury recovery, and neurorehabilitation. We share how the “Integration of Chiropractors into Health Systems” exists in multidisciplinary rehabilitation teams, publicly funded health systems and in hospitals. We discuss the “Economic and Social Impacts” of the chiropractic profession in low- and middle-income countries, for equity, diversity and inclusion, and regarding cultural competencies. We present “Challenges for the Chiropractic Profession” that include varying legislations within and between countries, limited recognition among other healthcare professionals, and advanced integration within multidisciplinary rehabilitation programs. Finally, we make a “Call to Action” for theory driven implementation strategies, to advocate for improved recognition of the chiropractic profession, and to enhance interprofessional education and advance rehabilitation in chiropractic curricular. Conclusions Chiropractors can play an important role in strengthening rehabilitation in health systems as they deliver interventions for rehabilitation for people with health conditions throughout the life course, and across the continuum of care. However, barriers remain. As a profession we must align with global rehabilitation priorities and uptake taxonomies to enable equitable access to chiropractors focused on optimising function and participation.
ABSTRACT Objective The purpose of this study was to evaluate the alignment between chiropractic educational outcomes, the National Board of Chiropractic Examiners (NBCE) prelicensure exams, and the Council on Chiropractic Education (CCE) meta-competencies. Methods A qualitative thematic analysis was performed between January 2024 and December 2024. A detailed coding framework was used to systematically assess coherence among the content of NBCE prelicensure exams, the competencies from 4 sample chiropractic educational outcomes, and the CCE meta-competency framework. Data were analyzed to identify the presence and depth of key professional domains. Results The thematic analysis revealed a substantial degree of alignment between the NBCE exams and the CCE meta-competencies. The essential domains included assessment and diagnosis, patient case management, disease prevention, communication and documentation, professional ethics, jurisprudence, spinal adjustment and manipulation, interprofessional collaboration, clinical reasoning, and practical skills. Conclusion This study provides valuable insight into the degree of alignment among chiropractic educational outcomes, NBCE exams, and the CCE meta-competency framework. The analyses offer a detailed evaluation of the extent to which NBCE exam content reflects the knowledge, skills, and professional behaviors outlined in the CCE competencies. Collectively, the findings contribute to a deeper understanding of how exam standards support the preparation of competent, entry-level chiropractic practitioners.
