036- Value of Chiropractic Adjustments for Chronic Neck Pain

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. This week we are back with another fantastic episode. If you missed last week, please check it out. We had an interview with Dr. Steve Cape, Obianco Medical Director for Rock Tape and we talked about the research behind Rock Blades, all the tools. It's an awesome episode, one of our most highly downloaded episodes yet. So. So please check that out if you haven't had the opportunity yet. Also on that note, Dr. Steve and I will both be at the California Chiropractic Association Sports Symposium. That's in a couple weeks time at Disney in Anaheim, California. So any California docs or anybody looking to take a nice trip out to California and get some nice research, get some content and get some actionable items to put into practice, check that out. Sports Symposium California Chiropractic Association Dr. Steve, myself and a bunch of other fantastic speakers. I'll put a link in the show. Notes this week we are going to talk about a piece of research that was released in 2014 and it was released from the Journal of Rehabilitation Medicine. It is titled Perceived Value of Spinal Manipulative Therapy and Exercise among Seniors with Chronic Neck A Mixed Method Study. It's a nice piece of research. It highlights chiropractic care, spinal manipulation for seniors and we will dive in momentarily. Before we do, I'll say a few words about our sponsor, Rocktape. Rocktape is proud to be a sponsor of the evidence based Chiropractor. Rock Tape offers the world's best kinesiology tape, pain relief, topicals, mobility tools and functional fitness accessories. New from Rocktape is Rocksauce Chill, a powerfully cool pain relief topical and a convenient roll with with 6% menthol. It's stronger than the freeze competition. They are more than a tape company, they are a movement company. Learn more and get access to your medical discount by visiting rocktape.com and of course as I spoke of last week we talked about Rock Blades, their new soft tissue tools. So this week we are looking at I will repeat the title so you make sure you get it. Perceived Value of Spinal Manipulative Therapy and Exercise Among Seniors with Chronic Neck Pain A Mixed Method study released in 2014. It's a new piece of research so it's nice to have on tap. As we know perception shapes our vision of reality, each one of us in the field of medicine. Perception has historically been analyzed through the use of placebo. Placebo is used as the control, essentially. As research methods have become more refined, the tools which measure and assess the perceived value of an intervention have also become more advanced. This recent study from the Journal of Rehabilitation Medicine examined the patient experience when receiving conservative care for chronic neck pain. So again, chronic neck pain pain that's lasted longer than 90 days or over the three months. The influencing factors and application of these factors provide significant insight into the minds of seniors living with chronic pain. And there are many out there that are living with chronic pain. We see them each and every day in all of our practices. So these factors could and should play a significant role in determining the appropriate referral for these patients. And when I say referral, I mean that by when they go into their primary care office, what is their primary care physician doing? Are they referring them to a chiropractor? Are they referring them to physical therapy or are they treating in house with medications? As everybody who listens to this show knows, chiropractic and the evidence based chiropractor is really we like to place a strong emphasis on functional gains, pain reduction and improvement of quality of life. Those are outcome measures that never get old. And as the reimbursement model shifts more from fee to service to outcome based assessments, the emphasis on functional gains, pain reduction and improvements specifically in quality of life as relate to activities of daily living is going to become more and more important. So let's take a look at what the researchers found. There's a few quotes that I'd like to highlight from this study and one is the researchers found patients perceptions and the individual experience of care are important factors in determining the value of an intervention in healthcare. Patient centeredness responsive to individual patient preferences, needs and values is one of the six dimensions of quality and value in healthcare identified in a seminal report by the Institute of Medicine. So let's dive into that a little bit. Patient centeredness and specifically quote responsive to individual patient preferences, needs and values is one of the six dimensions of quality and value in healthcare. So this is telling us as providers and as chiropractors that we need to be exquisitely in tune with what our patients needs are, what their values are, and also what their preferences for care are. That's going to play a very large role ultimately not only in their outcome, but in their experience of the care in that office. Researchers also found at 94%, the majority of participants considered study treatment worthwhile. So again, they looked specifically at the perceived value of spinal manipulative therapy, the the hallmark of chiropractic care and exercise hallmark of active care among seniors. And they found unequivocally 94% participants found the study treatment worthwhile. That is very, very powerful. That is to say the least, a majority and nearly unanimous as far as the perceived value regarding the treatment. The researchers also found of interest, nothing was indicated as being disliked about chiropractic care by 57% of the patients who were in the adjustment and home exercise group. So the participants in this study who received both spinal manipulative therapy, chiropractic adjustments and home exercise, 57% of those patients said they disliked nothing about the care, so they liked every single attribute of the care that they received. Again, very powerful numbers. Finally, the researchers found clinical focus on these components, interaction, supervision and exercise of musculoskeletal care may enhance the therapeutic management of an important and growing population. As we know and we see every day, more people are being in the United States on Medicare, which is our senior age healthcare delivery system, and basically baby boomer generation is aging into seniorhood. So I don't know the stat off the top of my head, but it was tens of millions of Americans are going to be going into Medicare population, AKA seniors, as each year goes by, literally tens of millions. So their value or their perceived value of care is exceptionally important. And many of them are dealing with chronic complaints, chronic neck pain. These could be arthritic, degenerative changes. A variety of things can play into this. But when they see spinal manipulative therapy or when we see and more specifically, when primary care internal medicine physicians see that spinal manipulative therapy has an exceptionally high perceived value among these patients, and then further research backs up its efficacy and safety, we have a home run in building those relationships. So the interventions that they looked at, if I didn't clearly say where they looked at home exercise, spinal manipulative therapy with home exercise, or supervised rehab exercise with home exercise. So as we touched on with some of those quotes, the best results, the best perceived value, which is what the study was measuring, was found with the group that received spinal manipulative therapy and home exercise. So that is an important part of what happened in this study. Now, what they looked at also there was some influencing factors that they examined and that was how the care was delivered, what care was provided, and of course, those valued results. So the application of how the care was delivered was really leveraging that patient provider relationship, what care was provided. As we talked about, there were three separate interventions and the valued results were overall improvement, pain reduction and enhanced function. Don't forget about that F word function. Function is an extremely important part of how we measure perceived value and how we measure the overall improvement of patients. And that's gonna be more and more important as time goes on. So I love this study. It's fantastic in the fact that it shows what's going on with our senior population. If you wanna learn more about this specific study, please check out the show notes and if you have been listening, I know I've said this a few times, but we have a few thousand chiropractors listening each and every week. If you could do me a huge favor, click down in the show notes, go over to itunes, leave us a rating or review. It would help us. So any feedback is greatly appreciated on itunes or as always you can reach me at jeffeevidencebasedchiropractor.com I'm looking forward to getting out there in California in a few weeks time. I am also looking forward to being back next week with another episode of the Evidence Based Chiropractor Podcast. If you want to learn more how to use this research to grow and build your practice, please learn about our membership program at the Evidence Based Chiropractor. This was a research brief that we provided for our members the month that this research came out. We try to stay timely, we stay very actionable and we stay very focused on helping our members build their practice. So have a great week in practice Doc and I will talk to you soon.

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