Safety of chiropractic interventions: a systematic review

^^Interesting story to go with the above picture^^

Please note, this is far from an attack on the chiropractic profession. I know and respect a number of chiro's and look forward to the positive interplay between our two professions through my career.

McMaster Plus has a great FREE service called Rehab+ where you can subscribe to topics of interest. The interaction and unique relationship between Physical Therapists and chiropractors is one that appears very often especially in outpatient therapy practices. This systematic review throws out a pretty significant statistic that made me cringe a little when reading it:

The frequency of adverse events varied between 33% and 60.9%, and the frequency of serious adverse events varied between 5 strokes/100,000 manipulations to 1.46 serious adverse events/10,000,000 manipulations and 2.68 deaths/10,000,000 manipulations.

Physical Therapy on the other hand has been shown to be much more cost-effective and safer than many alternatives including chiropractic. One example of this is how much malpractice insurance I receive for the low amount I pay... are you ready for this... $3 million in coverage for about $175.00 a year. Some (if not most) doctors pay 6 figures a year. I wonder how much Chiropractors pay?


Addendum to original post: I also stumbled upon this website: http://www.chiropracticstrokeawarenessblog.org/

100th post, what not to do

I came across this picture in Ski magazine discussing injury risk (click on pic for clearer version). I went ahead and added lines to the thighs and highlighted that the foot is compensating by the outside of it lifting off the ground. This picture is what you should not be doing! The magazine was in fact trying to point this out and offers the following solution if you display this increased hip adduction with squatting: Link Here.

You Tube PT Vid

Thanks Doc Denniger:

StreetWars

Non-PT related but I wanted to share this game crazy enough I may have to participate:
http://www.streetwars.net/

StreetWars is a 3 week long, 24/7, watergun assassination tournament that has already taken place in New York City, Vancouver, Vienna, San Francisco, Los Angeles, London, Chicago, and Paris.

At the start of the game you will receive a manila envelope containing the following:

* A picture of your intended target(s)
* The home address of your intended target(s)
* The work address of your intended target(s)
* The name of your intended target(s)
* Contact information of your intended target(s)

Upon receipt of these items, your (or your team's) mission is to find and kill (by way of water gun, water balloon or super soaker) your target(s).

You can hunt your target down any way you see fit; you can pose as a delivery person and jack them when they open the door, disguise yourself and take them out on the street, etc.

If you are successful in your assassination attempt, the person you killed will give you their envelope and the person they were supposed to kill becomes your new target. This continues until you work yourself through all the players and retrieve the envelope with your (or your team's) picture(s) and name(s). Then you win. Cash…but first live in fear.

APTA Virtual Rally This Wednesday

Save the date for APTA's FREE virtual rally, to be held Wednesday, June 24, from 7:30 pm-9:00 pm ET, and participate in the national health care reform debate from your home, classroom, or office. The rally will include messages from APTA leaders, a presentation on reform proposals, and an interactive town hall session in which participants can ask questions.

The Association supports a number of themes that coincide with the broader health care reform debate, including expanded coverage, payment reform, guaranteed issue, workforce, research, health information technology, and prevention. Join the rally and help strengthen the profession's influence during this important and historic time in health care reform.

To participate in the rally, you will need to complete a free registration. Registration opens Monday, June 22, and can be completed until the start of the rally. If you do not register early, please join the rally on Wednesday, June 24, between 7:00 pm and 7:15 pm. The registration process takes approximately 3-5 minutes.

If you have any questions, please visit the Virtual Rally page on the APTA website or email advocacy@apta.org

For more resources on Healthcare Reform, visit the APTA Healthcare Reform Resource Page at http://www.apta.org//healthcarereform

Thank you all for participating!

(I finish up at 8 pm with patients so I will have to join late but think this is a great idea and look forward to what comes out of it)

Web Anatomy!

Test your knowledge, have some fun with it:
http://msjensen.cehd.umn.edu/Webanatomy/

Bonus points if you can point out some common workout errors in the pic be-low.

Floyd Landis

In the defense of the tour de France winner, this article: (being lazy and posting the entire pubmed abstract, sorry... bottom line is science isn't exactly an "exact science")

Clin Chim Acta. 2009 May 22. [Epub ahead of print] Links
Bad Science: The instrumental data in the Floyd Landis case.Blackledge RD.
8365 Sunview Dr., El Cajon, CA 92021, United States.

BACKGROUND: In 2006 Floyd Landis won the world's most prestigious bicycle race, the Tour de France. However, not many days after the race's conclusion it was released to the press that the Laboratoire National de Dépistage du Dopage (LNDD) had found Landis' urine after stage 17 positive for synthetic testosterone. METHODS: This review examines the instrumental data and methodology used by LNDD in the Landis case. The conclusions reached by LNDD were based on results of 2 separate instrumental methods. Subsequent to urine extraction and possibly derivatization, samples were initially screened via gas chromatography/mass spectrometry (GC/MS) using selected ion monitoring (SIM) to measure the ratio of testosterone to epitestosterone (T/E). Final confirmation of exogenous testosterone was determined by measuring the (13)C/(12)C stable isotope ratios in 4 metabolites of testosterone via gas chromatography combustion stable isotope ratio mass spectrometry (GC-C-IRMS). CONCLUSION: T/E ratios determined by LNDD in Landis' stage 17 urine were unreliable due to the combined factors of an unsatisfactory extraction, high GC background, failure to obtain baseline peak separation for epitestosterone, unreliable quantization of the epitestosterone peak due to both peak overlap and because it was barely above background noise, and because only a single ion mass (432) rather than a minimum of 3 was used for SIM (in violation of both LNDD's SOP and WADA procedures). GC-C-IRMS methodology is less well known to the analytical chemistry community, but here too the results obtained by LNDD were unreliable. GC-C-IRMS errors can be briefly summarized as uncertain peak identification, unsuitable standards, and unreliable (and possibly biased) calculation of (13)C/(12)C ratios due to peak overlap as well as LNDD's usage of manual peak integration rather than use of the instrument system software.

PMID: 19465014