Brockhusen Simon Sidenius, Bussières André, French Simon David, Christensen Henrik Wulff, Jensen Tue Secher
Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada.
Chiropr Man Therap. 2017 Jun 30;25:17. doi: 10.1186/s12998-017-0148-9. eCollection 2017.
Non-specific neck pain represents a quarter of all chiropractic patient visits in Denmark. Evidence informed practice can help ensure providers use best available treatment, speed up patient recovery rate and reduce healthcare utilization. It is generally believed that Danish chiropractors treat according to best practice, but we do not know if this is true for management of neck-pain. The objective of this study was to investigate how Danish chiropractors treat patients with acute and chronic non-specific neck pain and determine if management is compliant with recent Canadian guideline recommendations.
An online survey was sent to 554 members of the Danish chiropractic association. A three-part questionnaire was administered asking participants to: 1) rank the frequency of use of a list of treatment modalities; 2) rank treatment modalities they normally use for acute and chronic non-specific neck pain cases; and 3) provide demographic data. Treatment modalities ranked as "used often" were considered in further analysis and compared to the Canadian Guideline recommendations for neck pain. Chi-squared test was used to investigate differences between treatment and guideline compliance for chronic and acute patients.
A 65% (362/544) response rate was achieved. The sample demographics were representative of a recent Danish study of the entire chiropractic profession. Danish chiropractors use a wide range of treatment modalities, including spinal manipulation, manual therapy, exercises and information/patient education on most of their acute neck pain patients. The use of other treatment modalities and especially exercises was more commonly used with chronic cases. Guideline compliance was 10% for recommendations for acute patients and 43% for chronic patients.
Danish chiropractors use a wide range of treatment options for managing adult patients with acute and chronic non-specific neck-pain. However, there were important differences in treatments chiropractors offered for acute and chronic patients, particularly for the use of exercise therapy, which was mainly reserved for chronic patients. Danish chiropractors' compliance with guidelines for neck-pain patients was low, but is neither worse nor better than what is seen for other complaints or health disciplines. Our findings suggest a need for active knowledge translation strategies and robust implementation research.
在丹麦，非特异性颈部疼痛占整脊疗法患者就诊病例的四分之一。循证实践有助于确保医疗服务提供者采用最佳可用治疗方法，加快患者康复速度并减少医疗资源的使用。人们普遍认为丹麦的整脊治疗师按照最佳实践进行治疗，但我们并不清楚在颈部疼痛的管理方面是否确实如此。本研究的目的是调查丹麦整脊治疗师如何治疗急性和慢性非特异性颈部疼痛患者，并确定其管理是否符合加拿大最近的指南建议。
向丹麦整脊疗法协会的554名成员发送了在线调查问卷。问卷分为三个部分，要求参与者：1）对一系列治疗方式的使用频率进行排序；2）对他们通常用于急性和慢性非特异性颈部疼痛病例的治疗方式进行排序；3）提供人口统计学数据。在进一步分析中考虑排名为“经常使用”的治疗方式，并与加拿大颈部疼痛指南建议进行比较。采用卡方检验来研究慢性和急性患者在治疗与指南依从性方面的差异。
回复率为65%（362/544）。样本的人口统计学特征代表了丹麦最近一项针对整个整脊疗法行业的研究。丹麦整脊治疗师使用多种治疗方式，包括脊柱推拿、手法治疗、运动疗法以及针对大多数急性颈部疼痛患者的信息/患者教育。其他治疗方式，尤其是运动疗法，在慢性病例中使用更为普遍。急性患者的指南依从率为10%，慢性患者为43%。
丹麦整脊治疗师使用多种治疗选择来管理患有急性和慢性非特异性颈部疼痛的成年患者。然而，整脊治疗师为急性和慢性患者提供的治疗存在重要差异，特别是在运动疗法的使用方面，运动疗法主要用于慢性患者。丹麦整脊治疗师对颈部疼痛患者指南的依从性较低，但并不比其他疾病或健康学科的情况更差或更好。我们的研究结果表明需要积极的知识转化策略和有力的实施研究。
