|
|
Re: The Final Word: ALL DC education in Canada is UNIVERSITY based as of 2005
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 2:13:00 AM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
On student posts:
[QUOTE]Here is some evidence to show the lack of quality research available in chiropractics..this is a systematic review ..level 1A evidence
: J Manipulative Physiol Ther. 2006 Oct;29(8):658-71. Links
Chiropractic treatment of lower extremity conditions: a literature review.Hoskins W, McHardy A, Pollard H, Windsham R, Onley R.
Macquarie Injury Management Group, Department of Health and Chiropractic, Macquarie University, Australia. waynehoskins@optusnet.com.au
OBJECTIVE: The purpose of this study was to document the quantity and type of research conducted on the chiropractic management of lower extremity conditions. METHODS: A review of the literature was conducted using the CINAHL, MEDLINE, MANTIS, and Science Direct databases (each from inception to December 15, 2005). Search terms included chiropractic, hip, knee, ankle, foot, with Medical Subject Heading terms for each region. Inclusion criteria included studies with a lower extremity diagnosis, and the treatment was performed by doctors of chiropractic. Articles were excluded if pain was referred from spinal sites and if there was a duplicate publication; articles published in non-peer-reviewed literature and abstracts in conference proceedings were also excluded. Of the articles identified, an analysis was conducted assessing those including peripheral and/or spinal treatment. Clinical trials were assessed for quality using the Physiotherapy Evidence Database scale. RESULTS: There was a total of 1652 citations. Of these, 76 were deemed relevant; 24 were related to the foot, 10 to the ankle, 25 to the knee, and 17 to the hip. Twenty-nine citations included spinal treatment, 47 solely peripheral, and 2 solely spinal. Ten citations were clinical trials and scored on the Physiotherapy Evidence Database scale.
CONCLUSIONS: Literature on the chiropractic management of lower extremity conditions has a large number of case studies (level 4 evidence) and a smaller number of higher-level publications (level 1-3 evidence). Future chiropractic research should use higher-level research designs, such as randomized controlled trials. [/QUOTE]You declare: "Here is some evidence to show the lack of quality research available in chiropractics.." Yet, from what you have provided above, I cannot find any discussion of the " quality " of the 76 relevant studies (which were of various levels of evidence)in this literature review.
Please provide, from the text of the review, the discussion of the " quality " of studies reviewed.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 2:36:00 AM
|
|
|
dfjpt
Posts: 238
Joined: April 9, 2006
Status: offline
|
[QUOTE]If you look at the number of PT schools in North America I'm sure it's more than 19 although I could be wrong.[/QUOTE]Yup, you're wrong.
In Canada alone there are [URL=http://72.14.253.104/search?q=cache:un4IdxrpHXcJ:www.opa.on.ca/pdfs/physio_education_programs.pdf+Number+of+physiotherapy+programs+in+Canada&hl=en&gl=ca&ct=clnk&cd=1]fourteen[/URL]. Since the US is ten times the population, I would guess something like 140 programs, for a total of over 150 in North America. Slightly more than 19. Does this help your sense of proportion any?
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 3:56:00 AM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
Using the information above(provided by dfjpt):
One would/should expect:
10-15 PT produced research studies for every 1 chiropractic produced research study.
Is this the case?
AND:
I have been trying to locate any(of ANY "quality") peer-reviewed, pub-med indexed, research studies, of any level of evidence, on this "skin-stretching" technique, and am finding nothing.
dfjpt- Please provide the links to these studies.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 4:21:00 AM
|
|
|
drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
Status: offline
|
dfj,
You tell him he's wrong for saying there are more than 19, then you go on to say they are over 150. That was his whole point. There are a significant number of PT schools compared to DC schools.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 4:27:00 AM
|
|
|
ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
|
Marc,
I should have said quality research .. could you point out which of those studies on the CMCC website are high quality treatment studies at level 1A or B..perhaps I missed one.
Jeep,
If you understand EBM and levels of evidence .. you would have known that the study I posted was systematic review.. which is the highest level of evidence (level 1A).. and it showed that there was a lack of quality evidence available available in chiropractic research.
Did you not read the conclusion .. it mentioned quality:
"CONCLUSIONS: Literature on the chiropractic management of lower extremity conditions has a large number of case studies (level 4 evidence) and a smaller number of higher-level publications (level 1-3 evidence). Future chiropractic research should use higher-level research designs, such as randomized controlled trials. "
lower levels = lower quality
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 4:34:00 AM
|
|
|
Marc Bronson
Posts: 113
Joined: January 13, 2007
From: Toronto
Status: offline
|
[QUOTE] If you look at the number of PT schools in North America I'm sure it's more than 19 although I could be wrong.
Yup, you're wrong.
In Canada alone there are fourteen. Since the US is ten times the population, I would guess something like 140 programs, for a total of over 150 in North America. Slightly more than 19. Does this help your sense of proportion any? [/QUOTE]D
This just proves again, that you seem to go out of your way to antagonize me. I said I was sure it was more than 19 and you said it was close to 150. So, I was RIGHT that there was way more than 19.
But, you've kinda proved my point that just by sheer volume alone, research performed at chiropractic schools would never reach the quantity of PT research. That being said, we all know that it's about the QUALITY of the research anyways. If you look at the link to CMCC's most recent research report you will see how many studies don't involve manipulation (your self-admitted pet peeve).
It all comes back to how "chiropractic" is defined, and clearly the chiropractic educators in Canada aren't concerned really with bone of out place/pinched nerve causing disease angle but rather a NMSK specialist who is for the most part hands on. I would even argue that in large part, the Canadian chiropractic education scene is akin to the Australian physio scene in that they are largely different than most of their counterparts, tend to produce research that is out of the norm for their profession and have seemed to raised the bar in educational standards. Ironic in some ways.
_____________________________
BSc (Hon), DC, Dipl. Med. Ac. CSCS
Integrative Manual Medicine
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 5:28:00 AM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
Onstudent declares:
"lower levels = lower quality"
Really?------I have read many "Low quality" and also many "high quality" RCTs.
From your posts, I get the impression that you consider ALL RCTs "high quality"?
I have also read many "low quality" case studies and many "high quality" case studies.
Your definition of "quality" is totally confused.
It is YOU that does not understand the difference between "levels of evidence" and "quality" of levels of evidence.
The "conclusion" of this review commented on the studies in "levels of evidence" NOT the "QUALITY" of the studies within those levels.
AGAIN:
To properly, and objectively consider your assertion of this literature review as demonstrating---- "Here is some evidence to show the lack of quality research available in chiropractics"......------
Please provide the text(discussing the QUALITY of the 76 studies) from this review to support your declaration.
I am sure, as an "evidence based" student, you are well aware of the importance of the information requested to an academically valid discussion of this study.
I await your provision of the requested text.
Thank-you
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 5:50:00 AM
|
|
|
ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
|
I think you are really confused about your understanding of levels of evidence ..
for example ..
a low quality RCT would be level 2 evidence which the study says even low quality RCTs is lacking
high quality RCT would be level 1B
a case study would be level 4 a lower standard/quality/level evidence
if the study says that chiropractic research is lacking higher levels of research design ... that would mean it is lacking high quality and even low quality RCTs and systematic reviews...
I think you need to review what levels of evidence means. Look up oxford's EBM levels of evidence.
I hope I cleared up a bit of the confusion for you. If not then its really a waste of time to debate on this topic with you .. the study I posted is very clear to anyone who understands research.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 6:19:00 AM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
There is no confusion-
Sofar- You have failed to support your "position/declaration" per the information you provided.
Please provide the text of the study (you quoted) discussing the "QUALITY" of the 76 studies.
I offer that it is you that is confused.
"Quality" and "Level of evidence" are NOT synonomous.
---------------------
ANY PTs here that want to bail out one of your future collegues?------Please post.
This "student" wants to make everything into a DC/PT pissing match.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 8:30:00 AM
|
|
|
savela
Posts: 63
Joined: October 7, 2004
From: toronto
Status: offline
|
ON student,
I am PT who graduated from an EBM structured school.
I have a very good friend and mentor that graduated from CMCC, is a preceptor for students and teaches post grad courses for all health professionals.
It is of my understanding, that CMCC also teaches EBM and have the access to the same Journals as PT's (in fact he has leant me many great articles).
In the past Chiro's in Canada, may have been subluxation non EBM based, but that is rapidly changing.
Multi-disciplinary clinics are very popular in Ontario. We can all work together and hopefully learn from each others professional experience.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 8:41:00 AM
|
|
|
james097
Posts: 178
Joined: January 27, 2005
From: West Vancouver BC
Status: offline
|
Multi-disciplinary clinics other than chiro+ massage+naturopathic don't seems to exist here.
Do you know how much ping ponging happens in such clinics and do patient have a better outcome.
Jim McGregor
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 8:46:00 AM
|
|
|
dfjpt
Posts: 238
Joined: April 9, 2006
Status: offline
|
OK, right on this one point, and wrong on so many others I've lost track.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 9:02:00 AM
|
|
|
savela
Posts: 63
Joined: October 7, 2004
From: toronto
Status: offline
|
James,
Currently where I work, we do not ping pong pts. often.
Occassionally, if what I am doing as a PT is not working I will refer off to another health professional. We do have case discussions which I find interesting.
The Jan/Feb/o7 Interdivisional Review has a current article about multidisciplinary clinics and it's benefits.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 9:49:00 AM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
dfjpt posts:
[QUOTE] OK, right on this one point, and wrong on so many others I've lost track [/QUOTE]This is ambiguous/meaningless as is. Please clarify/attach a reference, to the "point"(s) in your above statement.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 1:40:00 PM
|
|
|
Marc Bronson
Posts: 113
Joined: January 13, 2007
From: Toronto
Status: offline
|
Jim,
I work in one of the multidisciplinary clinics you've described. DC, PT, RMT, ND as well as a psychotherapist. Basically, we refer patients to other practitioners when there's either been an
(a) plateau in improvement
(b) a different clinician has a different skill set that would be complementary to the initial clinician (referrals for ACU/IMS, different techniques (Active Release Technique, Graston Technique or Trigenics sensorimotor) etc.
(c) the patient has improved and is ready to take the next step in care (i.e. acute pain that is resolving following manual care and a progression to more active measures
(d) a certain clinician has more experience or good success with particular cases and the initial clinician refers the patient
I've heard great feedback from the patients of my workplace, how that the health care team is competent, checks their egos at the door and does whats best for the patient in terms of co-management. IMO, the only thing missing would be a level-headed MD to work with us since ultimately they have the power to order any imaging/lab tests under the sun. We have some sports medicine MD across the street we refer to, so the professional network is fairly complete.
I guess the trick is to have good, caring, ethical competent health care providers that don't have too much duplication of services, and enough variety in approaches/techniques/skills that patients and clinicians can benefit from.
Diane
Your posts in this thread contain so much hot air you could have your very own balloon service.
_____________________________
BSc (Hon), DC, Dipl. Med. Ac. CSCS
Integrative Manual Medicine
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 1:42:00 PM
|
|
|
dfjpt
Posts: 238
Joined: April 9, 2006
Status: offline
|
Marc, no truce for you. Jeep, the title of this thread for one.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 2:05:00 PM
|
|
|
rwillcott
Posts: 436
Joined: March 20, 2006
From: Canada
Status: offline
|
Marc,
The Canadian chiropractic education and research is not even close to the level of education and research of Australian PT's. The recent research performed on multifidus and transversus abdominus has been cutting edge and performed by PT's.
I don't know how you see how the chiropractic research even compares? Many within the PT field know that the Australian level of education is very similar to Canadian PT's especially in terms of manual therapy.
Rob
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 3:11:00 PM
|
|
|
Marc Bronson
Posts: 113
Joined: January 13, 2007
From: Toronto
Status: offline
|
Rob,
I should clarify: Aussie PT's seem to be the gold standard in PT education and I would argue that recent CMCC/UQTR DC's are likely the gold standard in chiropractic education.
Regarding chiropractic research, I assume you mean research on manips. Ross, Bereznik, and Herzog have all recently done some good studies looking at SMT kinematics including publishing a study that refutes the specificity of SMT in the lumbar spine. I wouldn't call it groundbreaking in the big picture, but it is a dagger to the heart to many subluxation DC's who claim their technique allows for so much more specificity than "competing" manipulative techniques.
I don't know how you can make flat out comments that CMCC/UTQR education "isn't even close" to Aussie PT ed since our education seems to differ with respect to certain courses (microbiology, immunology, pathology, differential diagnosis, etc). I would be curious to see the curriculum of a an Aussie PT school. I would assume the CMCC curriculum probably falls in between MD type courses and more PT type courses.
Anyways, I'm sure that we can all agree here that Richardson, Jull, Hodges, Hides TrA and multifidi stuff is good, but remember that McGill pretty much says the opposite. What they both probably have in common is that they are teaching chronic LBP patients to develop better motor control which is preventing excessive segmental motion resulting in nociception and eventually pain.
Diane
Had I known you were going to truce I wouldn't have posted that comment. Sorry.
_____________________________
BSc (Hon), DC, Dipl. Med. Ac. CSCS
Integrative Manual Medicine
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 3:15:00 PM
|
|
|
ONstudentPT555
Posts: 224
Joined: July 25, 2006
Status: offline
|
Savela,
My point was that there is a lack of high level chropractic research.. this can be seen easily by doing a search for RCTs and systematic reviews on pubmed, cochrane, medline, embase,..etc.
Although I respect your decision to work in a mult-disciplinary setting with DCs. I have confidence in the physiotherapy profession that I dont see the need to have to work with DCs.. if I ever wanted to clearify something I was not sure of .. I would rather consult an experienced PT. Maybe I am alone with this view but this is just my opinion. I say let us do what we do and let them to what they do... our profession has done the research to back up what we do.
|
|
|
|
|
Re: The Final Word: ALL DC education in Canada is UNIVE... - January 18, 2007 3:18:00 PM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
Onstudent-
Your ad hom is noted---
However-
That does NOT address or answer my request to you to provide the TEXT from your above chosen/quoted review abstract to support your position.
I repeat(for the third time):
[QUOTE] Please provide the text of the study (you quoted) discussing the "QUALITY" of the 76 studies
[/QUOTE]Is there a reason you have not provided this?
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
 Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.109
|
Printable Version
All Forums >> [RehabEdge Forum] >> Open Forum >> Re: The Final Word: ALL DC education in Canada is UNIVERSITY based as of 2005 
