Ndetan Harrison T, Rupert Ronald L, Bae Sejong, Singh Karan P
Parker College Research Institute, Dallas, Tex, USA.
J Manipulative Physiol Ther. 2009 Feb;32(2):140-8. doi: 10.1016/j.jmpt.2008.12.012.
The purpose of this study was to assess the prevalence, distribution, severity, risk factors of, and response to musculoskeletal injuries to the low back, hand/wrist, and neck/shoulder among chiropractic students while receiving and/or administering adjustments/manipulation while attending a chiropractic college.
The study was an epidemiologic survey of chiropractic students at all levels of training (n = 890) at one chiropractic college. A self-administered anonymous 3-paged questionnaire was used. The questionnaire was divided into sections for collecting data separately on injuries associated with receiving or administering chiropractic adjustments.
The response rate was 64.3% with 62.6% male respondents. The overall prevalence of injuries sustained in college was 31.5%, 44.4% of which was exacerbations of prior complaints. Injuries from receiving adjustments/manipulation were most prevalent to neck/shoulder (65.7%), whereas hand/wrist injuries were most common when administering adjustments (45.6%). The risk difference among students receiving adjustments was 81.6/1000 neck/shoulder injuries, and the etiologic fraction was 76.6%. The risk difference was 170/1000 hand/wrist injuries with etiologic fraction of 96.5% among students administering adjustments. Diversified, Gonstead, and upper cervical adjusting techniques were perceived to be the most injury-related.
Some students enroll in a chiropractic college with preexisting injuries that can easily be exacerbated. Others sustain new injuries of moderate severity from receiving and administering adjustments. Potential risk factors may include height, body mass index, and nonexercising. The risk factors and mechanisms responsible for the high levels of hand/wrist injuries need further examination. This research identifies an important need to design a comprehensive and logical protocol to prevent injury to chiropractic students.
本研究旨在评估整脊专业学生在整脊学院接受和/或进行调整/手法治疗时，下背部、手/腕部以及颈部/肩部肌肉骨骼损伤的患病率、分布情况、严重程度、危险因素及应对措施。
本研究是对一所整脊学院所有培训阶段的整脊专业学生（n = 890）进行的流行病学调查。采用自行填写的3页匿名问卷。问卷分为不同部分，分别收集与接受或进行整脊调整相关的损伤数据。
回复率为64.3%，男性受访者占62.6%。在学院期间遭受损伤的总体患病率为31.5%，其中44.4%是既往病症的加重。接受调整/手法治疗导致的损伤在颈部/肩部最为普遍（65.7%），而在进行调整时，手/腕部损伤最为常见（45.6%）。接受调整的学生中，颈部/肩部损伤的风险差异为每1000人中有81.6例，病因分数为76.6%。在进行调整的学生中，手/腕部损伤的风险差异为每1000人中有170例，病因分数为96.5%。多样化、冈斯特德和上颈椎调整技术被认为与损伤关系最为密切。
一些学生进入整脊学院时就已有易加重的既往损伤。另一些学生在接受和进行调整时遭受了中度严重程度的新损伤。潜在危险因素可能包括身高、体重指数和缺乏运动。导致高水平手/腕部损伤的危险因素和机制需要进一步研究。本研究明确指出，迫切需要设计一套全面且合理的方案来预防整脊专业学生受伤。
