Search

Background: Chiropractors and chiropractic students commonly report low back pain (LBP). However, the burden of LBP in this occupational group has not been synthesized in the literature. This systematic review aims to describe the epidemiology of LBP in chiropractors and chiropractic students., Methods: We searched MEDLINE, Embase, CINAHL, and PsycINFO from inception to May 1, 2023. Eligible studies were cross-sectional, cohort, or case-control studies investigating the prevalence, incidence, associated factors, or risk factors of LBP in chiropractors or chiropractic students. Reviewers independently screened articles and assessed risk of bias using the appropriate JBI Checklists for the observational study design. We descriptively synthesized studies that were rated as low or moderate risk of bias., Results: Of 2012 citations screened, we included 2 cross-sectional studies in the evidence synthesis (1 study rated as moderate risk of bias on chiropractors, and 1 rated as low risk of bias on chiropractic students). For chiropractors, the 12-month prevalence of work-related overuse injuries to the low back was 35.6% (95% CI 29.1, 42.0) in women and 22.4% (95% CI 16.3, 29.6) in men. The 12-month prevalence of work-related acute physical injuries to the low back in chiropractors were 3.4% (95% CI 1.6, 6.8) for women and 0.7% (95% CI 0.1, 3.7) for men. Among chiropractic students, the 1-week prevalence of LBP was 69% (95% CI 64.8, 73.0). This was higher among female students (72.5%, 95% CI 67.1, 77.4) and lower among male students (64%, 95% CI 57.0, 70.6)., Conclusion: There is limited high-quality evidence on the epidemiology of LBP in chiropractors and chiropractic students. Our systematic review provides a synthesis of the body of literature, highlighting that chiropractors and chiropractic students commonly report LBP. Future high-quality research is needed to address the incidence, associated factors, and risk factors of LBP., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking., Objectives: To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population., Methods: Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach., Results: We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1-2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified., Conclusions: Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed., Trial Registration: CRD42019135009 (PROSPERO)., (© 2024. The Author(s).)

Introduction: The effectiveness of post-surgical rehabilitation following lumbar disc herniation (LDH) surgery is unclear., Research Question: To investigate the effectiveness and safety of rehabilitation interventions initiated within three months post-surgery for adults treated surgically for LDH., Material and Methods: This systematic review searched seven databases from inception to November 2023. Independent reviewers screened studies, assessed and extracted data, and rated the certainty of the evidence using the GRADE approach., Results: This systematic review retrieved 20,531 citations and included 25 randomized controlled trials. The high certainty evidence suggests that adding Pilates exercise to routine care and cognitive behavioral therapy may improve function immediately post-intervention (1 RCT), and that adding whole-body magnetic therapy to exercise, pharmacological and aquatic therapy may reduce low back pain intensity (1 RCT) immediately post-intervention. Compared to placebo, pregabalin did not reduce low back pain or leg pain intensity (1 RCT) (moderate to high certainty evidence). We found no differences between: 1) behavioral graded activity vs. physiotherapy (1 RCT); 2) exercise and education vs. neck massage or watchful waiting (1 RCT); 3) exercise, education, and in-hospital usual care vs. in-hospital usual care (1 RCT); 4) functional or staged exercise vs. usual post-surgical care including exercise (2 RCTs); and 5) supervised exercise with education vs. education (1 RCT). No studies assessed adverse events., Discussion and Conclusion: Evidence on effective and safe post-surgical rehabilitation interventions is sparse. This review identified two interventions with potential short-term benefits (Pilates exercises, whole-body magnetic therapy) but safety is unclear, and one with an iatrogenic effect (pregabalin)., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Carol Cacelliere reports financial support was provided by 10.13039/501100011713EUROSPINE Task Force on Research. Carol Cancelliere reports financial support was provided by Canadian Chiropractic Research Foundation. Andree-Anne Marchand reports a relationship with Canadian Chiropractic Research Foundation that includes: funding grants. Andree-Anne Marchand reports a relationship with Fondation régionale pour la santé de Trois-Rivières that includes: funding grants. Dan Wang reports a relationship with Canadian Chiropractic Research Foundation that includes: funding grants. Dan Wang reports a relationship with Fondation régionale pour la santé de Trois-Rivières that includes: funding grants. Jessica Wong reports a relationship with Canadian Chiropractic Research Foundation that includes: funding grants. Jessica Wong reports a relationship with 10.13039/501100000024Canadian Institutes of Health Research (10.13039/501100000024CIHR) that includes: funding grants. James Young reports a relationship with 10.13039/501100000142Arthritis Society Canada (22–0000000058) that includes: funding grants. James Young reports a relationship with Diana Kerbel Fellowship in Arthritis Integrated Care that includes: funding grants. James Young reports a relationship with Danish Foundation for Chiropractic Research and Post-graduate Education that includes: funding grants. James Young reports a relationship with 10.13039/501100000024Canadian Institutes of Health Research Clinical Trials Fund that includes: funding grants. Margareta Nordin reports a relationship with Canadian Chiropractic Research Foundation that includes: funding grants. Margareta Nordin reports a relationship with Canadian Institute of 10.13039/100005622Health Research that includes: funding grants. Pierre Cote reports a relationship with Canada Research Chair Program that includes: funding grants. Pierre Cote reports a relationship with EUROSPINE that includes: speaking and lecture fees. Pierre Cote reports a relationship with Canadian Protective Chiropractic Association that includes: paid expert testimony. Sheilah Hogg-Johnson reports a relationship with Canadian Memorial Chiropractic College that includes: employment. Silvano Mior reports a relationship with Canadian Chiropractic Association that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Plastic microbeads were widely used as exfoliants in personal care products (PCPs; e.g., hand/body washes) in North America, but restrictions were imposed on their use in PCPs in the U.S. (2017) and Canada (2018). We provide the first assessment of whether restrictions are effectively reducing microbeads entering surface waters. We examined their abundance, character, and trends in wastewater treatment plant (WWTP) effluents in Toronto, Canada, from 2016 to 2019, and in adjacent Lake Ontario surface waters (2015 and 2018), encompassing the period before and after the bans. Microbeads isolated from PCPs purchased in 2015 provided a visual morphological key with "irregular" and "spherical" microbead categories. Median concentrations of irregular microbeads, composed of polyethylene plastic, declined by up to 86% in WWTP effluents from 8.4 to 14.3 particles/m 3 before to 2.0-2.2 particles/m 3 after the bans, while those of spherical microbeads, predominantly synthetic/polyethylene wax, ranged within 0.5-2.3 particles/m 3 and did not differ before and after the bans since, as nonplastic, they were not regulated. Similarly, amounts of irregular microbeads declined relative to spherical microbeads in Lake Ontario, indicating that product changes may be influencing observations in lake waters. The results suggest that the Canadian and U.S. restrictions effectively and rapidly reduced plastic microbeads entering waters via WWTPs., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Objective: The 5-cycle sit-to-stand (5XSTS) test is frequently used to test physical function for different clinical populations, with time to complete as the measured outcome. This study evaluated the similarity of kinematics between a single cycle of the STS movement and individual cycles of the 5XSTS test., Methods: Lower extremity, pelvis, and thorax kinematic data were monitored as 20 participants (aged 18-40) completed 5 trials of the STS movement and 1 trial of the 5XSTS test. Correlations and root mean squared differences assessed the temporal and spatial similarities in kinematic patterns of sagittal plane joint angles at the ankles, knees, hips, and spine between single cycles of the STS movement and individual cycles of the 5XSTS test. Peak joint angles were obtained along with discrete angles at the start, seat off, and end of the movement., Results: Temporal and spatial similarity of kinematics for the ankles and hips were reduced over cycles 2 to 5 of the 5XSTS. Increased hip flexion was observed at the start of cycles 2 to 5 of the 5XSTS test. Increased knee and hip flexion were observed at the end of cycles 1 to 4 of the 5XSTS test., Conclusions: Temporal patterns of sagittal plane joint angles captured in the first cycle of the 5XSTS represented those adopted for an isolated STS movement. Different initial conditions for cycles 2 to 5 of the 5XSTS 58 may have reduced temporal and spatial similarity of sagittal plane joint angles of the ankles and hips., (Copyright © 2021. Published by Elsevier Inc.)