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Concussions are increasingly recognized as a public health concern. This paper evaluates Canadian concussion care guidelines, advocating for the inclusion of a broader range of healthcare professionals (HCPs) in concussion assessment, diagnosis, and management. It emphasizes the role of chiropractors, in addition to medical doctors (MDs) and nurse practitioners (NPs), highlighting their extensive training in musculoskeletal and neurological disorders. Chiropractors are adept at managing symptoms like headache, neck pain, and dizziness, and employing evidence-based, comprehensive interventions including patient education, exercise therapy, manual therapy, cervicovestibular rehabilitation, and return-to-sport (RTS) protocols. The paper also addresses regional variations in chiropractors' roles, focusing on Ontario's "Rowan's Law," and argues that limiting aspects of concussion care (assessment, diagnosis, RTS clearance) to MDs and NPs may result in healthcare inefficiencies and inequities. The findings are significant for policymakers and healthcare leaders, indicating a need for updated concussion care guidelines that integrate and utilize diverse HCPs. This could lead to improved patient outcomes, healthcare efficiency, and equity in concussion management across Canada., Competing Interests: The authors have no disclaimers or competing interests to report in the preparation of this manuscript. CC, GC, and HY are supported by the Canadian Chiropractic Guideline Initiative., (© JCCA 2024.)

Introduction: Brief action planning (BAP) is a collaborative tool to support patients' self-management goal setting and action planning. BAP facilitates patient self-reflection, and provides opportunity to establish goals of their own priority., Case Presentation: A 55 year-old female with recentonset low back pain with L5 nerve root distribution, described severe pain in the low back and sharp pain and tingle-sensations down to her right foot. Pain worsened with sitting, coughing, and bending. She was diagnosed with lumbar and other intervertebral disc disorder with radiculopathy (ICD 10: M51.1)., Treatment: Initial treatment included reassurance, education, promotion of movement, and manual therapies. Symptoms worsened at the eighth visit (five weeks) where she also demonstrated pain-catastrophizing behaviours and an over-reliance on passive treatment strategies (i.e., psychosocial factors or yellow flags). BAP was introduced into her treatment plan to set achievable goals for her care., Outcome: Decreased pain and disability were reported after incorporating BAP into care. Reduced pain-catastrophizing and reduced over-dependence on passive strategies were also demonstrated. Clinical gains were sustained at the 10-week follow-up assessment., Key Clinical Message: We describe the utilization of brief action planning as a technique for improving adherence to evidence-based clinical practice guideline recommendations in a patient with acute low back pain and radiculopathy, and late-onset psychosocial factors., Competing Interests: The authors have no disclaimers or competing interests to report in the preparation of this manuscript. This work was supported by the Canadian Chiropractic Research Foundation (CCRF). The funding organization was not involved in the design or conduct of this work., (© JCCA 2021.)

Objective: The 2019 Canadian guideline for physical activity throughout pregnancy provides evidencebased recommendations to promote maternal, fetal, and neonatal health. We aimed to 1) critically appraise the 2019 Canadian guideline for physical activity throughout pregnancy; and 2) develop a guideline summary for clinicians to facilitate the uptake of recommendations into practice., Methods: We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to critically appraise the quality and reporting of this guideline. Four reviewers independently scored between 1 (strongly disagree) to 7 (strongly agree) for 23 items organized into six quality domains., Results: AGREE II quality domain scores ranged from 47%-64% and the overall quality of the guideline was rated as 83% (high quality)., Conclusion: Based on its methodological quality, we recommend the use of this guideline. Our guideline summary includes six recommendations and other safety precautions that are relevant for clinicians in Canada., (© JCCA 2021.)

Objective: The purpose of this commentary was to critically appraise the patellofemoral pain clinical practice guideline published by the Academy of Orthopaedic Physical Therapy in 2019 and to summarize their recommendations for chiropractic practice., Methods: Quality and reporting of this guideline was assessed with the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Three reviewers independently scored between 1-7 (strongly disagree-strongly agree) for 23 items organized into six quality domains., Results: AGREE II quality domain scores ranged between 57%-98%, with overall quality of the recommendation rated 89%. The guideline contained evidence summaries and/or recommendations for three topics: impairment/function-based diagnosis; examination; and interventions., Conclusion: Based on its methodological quality, we recommend the use of this guideline for the examination, diagnosis, and management of patellofemoral pain in chiropractic practice. A summary of recommendations from this guideline is presented for use within the scope of chiropractic practice in Canada., Competing Interests: The authors have no disclaimers or competing interests to report in the preparation of this manuscript. This study was funded by the Canadian Chiropractic Research Foundation., (© JCCA 2020.)

Introduction: Trust is a key component of any therapeutic relationship and correlates with treatment satisfaction. Patients with high levels of trust in their healthcare providers report more beneficial heath behaviours, fewer symptoms, and a higher quality of life. The purpose of this study was to explore how chiropractors in British Columbia (BC) understand the process of building trust with patients., Design: This was a sequential exploratory mixed-methods design. Semi-structured one-on-one interviews informed an online survey that was sent to all BC Chiropractic Association members., Participants: Interviews were completed by six chiropractors from the Vancouver Practice Based Research Network; an online survey was completed by 97 chiropractors., Results: Themes of honesty, communication, perceived competence, and caring emerged during interviews. Survey findings confirmed the importance of honesty, communication, and perceived competence in building trust., Conclusion: Chiropractors can employ a variety of interpersonal strategies to foster trust with patients., Competing Interests: The authors have no disclaimers, competing interests, or sources of support or funding to report in the preparation of this manuscript., (© JCCA 2020.)

Objective: To determine the prevalence and presenting complaints of HIV/AIDS patients attending a chiropractic outpatient teaching clinic in downtown Toronto, and explore their self-reported comorbidities, medications used, and consumption of other complementary health care., Methods: A random sample was drawn from the entire clinic file collection spanning the years 2007 to 2013. Files were anonymized and coded to ensure confidentiality., Results: A total of 264 files were radomly pulled from approxinately 3750 clinic files. The prevalence of HIV positive patients was 5.7% (15/264), predominantly males, with 3 patients having developed AIDS. Co-infection with Hepatitis B and/or C was identified in 5/15 patients. The most common presenting complaint was neck pain (80%), followed by low back pain (47%) compared to 20% and 43% respectively for the general cohort. Eleven of 15 patients were on antiretroviral treatment (ART); The frequency of comorbidities was 8/15 (53%) however, none were identified as being dominant. In addition to chiropractic, 7/15 patients reported receiving other complementary therapies., Conclusions: A relatively small proportion of HIV/ AIDS patients were found to be receiving treatments in this downtown chiropractic clinic situated within a community health clinic setting. The principal presenting complaint was neck pain., Competing Interests: The authors have no disclaimers, competing interests, or sources of support or funding to report in the preparation of this manuscript.