Chiropractors have an important role to play in managing patients with
concussion and persistent post-concussion symptoms. We can offer a
comprehensive assessment of pre-injury, injury and comorbid factors for
instance, in addition to education, exercise and Canadian Chiropractic
Guideline Initiative (CCGI) tools and interdisciplinary collaboration.
Chiropractors’ focus should be re-integration not treating symptoms until zero
pain – this is unrealistic, might be futile, and is not the only important patient
outcome. Concussion is like the new low back pain or whiplash; bed rest and
dark room confinement are not recommended (at least not beyond the initial
24-48 hours). Essentially, the evidence demonstrates that the principles of
concussion management are like low back pain and whiplash management.
Let’s be mindful of the evidence and not repeat history.
Here’s a link where you can
find a plethora of current
research reviews: https://www.
rrseducation.com/research-
reviews/recent-reviews. OCA
members have access to this
portal through their CCA
membership account.
Dr. Carolina Cancelliere on ONF Guidelines on the Management of
Concussion and Persistent Symptoms 7
To reduce the burden of spinal disorders, World Spine Care created the Global
Spine Care Initiative to develop a model of spine care; a biopsychosocial
model focused on patient-centered care that is collaborative, proactive and
integrated, and that can be implemented worldwide. To implement the model,
the initiative developed a classification system of spinal disorders, an evidence-
based care pathway and accompanying resources and recommendations.
This research is important to the chiropractic profession and patient care as
it establishes a model for prevention and care of spinal disorders that could
be considered in communities with varying levels of resources. Notably, the
initiative considered the resources available in underserved and low-income
communities when developing the model. Future research testing the model
of care to assess its feasibility in different settings is warranted, given the
model’s great potential to reduce the burden of spinal disorders globally. References
Dr. Jessica Wong on The Global Spine Care Initiative: World Spine Care
Executive Summary on Reducing Spine-related Disability in Low- and
Middle-income Communities 8 6 Buchbinder, R., van Tulder, M., Öberg, B., Costa, L. M., Woolf,
A., Schoene, M., ... & Maher, C. G. (2018). Low back pain: a
call for action. The Lancet, 391(10137), 2384-2388.
What are the practical uses of research?
Many! Use it to inform and influence your practice, from standards
of care to best and leading practices. Findings can be used in
conversations with other health professionals to develop referral
relationships. Use research when advocating for the profession and to
explain new health care developments. Raise awareness with patients,
friends and family on social media by sharing relevant findings and
stats that impact the future of health care.
8
FALL/WINTER 2018
1 Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S.,
Cogo, E., Strifler, L., ... & Riva, J. J. (2017). Comparisons of
interventions for preventing falls in older adults: a systematic
review and meta-analysis. Jama, 318(17), 1687-1699.
2 Busse, J. W., Craigie, S., Juurlink, D. N., Buckley, D. N., Wang,
L., Couban, R. J., ... & Cull, C. (2017). Guideline for opioid
therapy and chronic noncancer pain. Canadian Medical
Association Journal, 189(18), E659-E666.
3 Clark, S., & Horton, R. (2018). Low back pain: a major global
challenge. The Lancet.
4 Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q.,
Ferreira, M. L., Genevay, S., ... & Smeets, R. J. (2018). What low
back pain is and why we need to pay attention. The Lancet.
5 Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P.,
Gross, D. P., ... & Turner, J. A. (2018). Prevention and treatment
of low back pain: evidence, challenges, and promising
directions. The Lancet.
7 Ontario Neurotrauma Foundation. (2018). Guideline
for Concussion/Mild Traumatic Brain Injury & Persistent
Symptoms: 3rd Edition, For Adults Over 18 Years of Age.
Retrieved from http://braininjuryguidelines.org/concussion/
8 Haldeman, S., Nordin, M., Chou, R., Côté, P., Hurwitz, E.
L., Johnson, C. D., ... & Ameis, A. (2018). The Global Spine
Care Initiative: World Spine Care executive summary on
reducing spine-related disability in low-and middle-income
communities. European Spine Journal, 1-10.