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Thursday, September 18, 2014

Forget being a Chiropractor, be a Neurobiologist

Today you can be a Neurobiologist...



Dr. Alan Himmel



I am a subscriber to Medscape, which for those who don't know, is an email digest of significant new medical research that comes out almost daily from the medical community.  I have been a subscriber for at least the last 10 years, and I highly recommend that anyone who is involved in healthcare should also check this thing out.   
The reason I am writing this post, is that this is the first time since I have been a subscriber, that I have seen Medscape distribute this as news (front page headline, by the way) of an article written by chiropractors (half-doctors) and published in a distinguished and respected journal such as The Annals of Internal Medicine.  I mean, everyone knows that this is a journal that only real and "serious doctors" get their information.  
The article is written by CHIROPRACTORS (plus a MD and a PhD in Biostatistics).  So maybe they got in the journal because they "carefully" placed an MD on the list of authors? Still, the head authors are DC's and the journal accepted the research and published it.
Anyway, let me tell you how difficult this is:  Medical journals have a board of "peer" reviewers who read over submissions to the journal, slice it up with comments, and often times, stamp a big denial on the paper and send it back to the author.  In other words, just because you can write well and you are articulate, and you can back up your paper with actual results and referenced research at the end of your manuscript, these distinguished doctors who make up the peer reviewers and editors often times deny your paper if they simply don't like you or don't agree.
So, I think this is a significant event.  Medscape's subscribers are made up mainly of medical doctors and specialists.  Maybe more than 100,000 doctors read this paper.  
When you try and subscribe to Medscape, you will see that "DC" is not even on the dropdown list where it asks, what your specialty is.   Hint:  pick another specialty when you become a subscriber--maybe someone you have always wanted to be like a Neurobiologist.  



Original Research | 16 September 2014

Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain: A Trial With Adaptive Allocation

Gert Bronfort, DC, PhD; Maria A. Hondras, DC, MPH; Craig A. Schulz, DC, MS; Roni L. Evans, DC, PhD; Cynthia R. Long, PhD; and Richard Grimm, MD, PhD
[+] Article and Author Information
Ann Intern Med. 2014;161(6):381-391. doi:10.7326/M14-0006
Text Size: A A A
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Background: Back-related leg pain (BRLP) is often disabling and costly, and there is a paucity of research to guide its management.

Objective: To determine whether spinal manipulative therapy (SMT) plus home exercise and advice (HEA) compared with HEA alone reduces leg pain in the short and long term in adults with BRLP.

Design: Controlled pragmatic trial with allocation by minimization conducted from 2007 to 2011. (ClinicalTrials.gov: NCT00494065)
Setting: 2 research centers (Minnesota and Iowa).
Patients: Persons aged 21 years or older with BRLP for least 4 weeks.
Intervention: 12 weeks of SMT plus HEA or HEA alone.
Measurements: The primary outcome was patient-rated BRLP at 12 and 52 weeks. Secondary outcomes were self-reported low back pain, disability, global improvement, satisfaction, medication use, and general health status at 12 and 52 weeks. Blinded objective tests were done at 12 weeks.
Results: Of the 192 enrolled patients, 191 (99%) provided follow-up data at 12 weeks and 179 (93%) at 52 weeks. For leg pain, SMT plus HEA had a clinically important advantage over HEA (difference, 10 percentage points [95% CI, 2 to 19]; P = 0.008) at 12 weeks but not at 52 weeks (difference, 7 percentage points [CI, −2 to 15]; P = 0.146). Nearly all secondary outcomes improved more with SMT plus HEA at 12 weeks, but only global improvement, satisfaction, and medication use had sustained improvements at 52 weeks. No serious treatment-related adverse events or deaths occurred.
Limitation: Patients and providers could not be blinded.
Conclusion: For patients with BRLP, SMT plus HEA was more effective than HEA alone after 12 weeks, but the benefit was sustained only for some secondary outcomes at 52 weeks.
Primary Funding Source: U.S. Department of Health and Human Services.

Topics

back pain ; exercise ; lower limb pain ; manipulation, spinal
Posted by Alan Himmel at 12:07 PM
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