BackgroundWith the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation.MethodsStructured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation.ResultsA total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement.ConclusionsA considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence.

Purpose: This pilot study was designed to investigate the relationship between chiropractic students' learning and study strategies and academic performance. Differences in strategic learning between chiropractic students with higher grade points averages (GPAs) and those with lower GPAs have not been previously reported. Methods: Fifty-seven consenting first-trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Differences between high and low GPA groups were evaluated for 10 subtests and three factors using independent samples t-tests. Results: The high GPA group scored significantly higher (p < .05) on LASSI subtests Anxiety, Attitude, Concentration, Motivation, Test Strategies, and Selecting Main Ideas, and on factors Effort-Related Activities and Goal Orientation. No differences between groups were found for subtests Information Processing, Self-Testing, Study Aids, and Time Management or for the Cognitive Activities factor. Conclusions: The results of this study show that differences in LASSI subtest and factor scores are associated with academic performance. For the participants studied, motivational and affective aspects of strategic learning contributed to higher academic performance, whereas cognitive strategies did not. Higher performing students utilized Effort-Related and Goal Orientation learning strategies at significantly higher levels than lower performing students. The LASSI may be useful in identifying students who could benefit from learning and study skills development. Longitudinal study is recommended to investigate the effects of students' learning and study strategies on different academic content domains as well as the effects of strategic study and learning skills training on academic performance. ( INTRODUCTIONAcademic success in higher education may be affected by many variables such as student ability, academic load, quality of instruction, prior education, and nonschool responsibilities.1 Learning and study strategies, which are students' characteristic ways of approaching a learning task, including "thoughts, behaviors, attitudes, motivation, and beliefs related to successful learning in higher education," may also affect academic success.1 Understanding the relationship between learning and study strategies and academic performance could help identify barriers to learning and create interventions to improve students' learning experiences.Examining the cognitive processes, behaviors, attitudes, and motivations that contribute to strategic learning is important for improving the student learning process, curricular planning, and designing effective, performance-enhancing educational interventions. To date, few studies have focused on strategic learning in graduate health care education, with only one study performed in chiropractic education. 2 The current study investigates this understudied area. The focus of this pilot study is the relationship between academic performance and study and learning strategies including ability to co...

Learning and study strategies are predictive of NBCE Part 1 examination performance in chiropractic students. The current study found LASSI subtests Anxiety, Concentration, Selecting Main Ideas, and Test Strategies, and the Goal-Orientation factor to be significant predictors of NBCE scores. The LASSI may be useful to educators in preparing students for academic success. Further research is warranted to explore the effects of learning and study strategies training on GPA and NBCE performance.

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Objective: This randomized controlled study was designed to determine the pain-relieving effect of Biofreeze (Performance Health Inc., Export, PA) body surface application and chiropractic adjustments on subjects with acute low back pain (LBP). Methods: The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity. Results: A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P b .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P N.05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups. Conclusion: Biofreeze combined with chiropractic adjustment showed significant reduction in LBP.