Table 4 The results in twenty-three articles on the use of primary prevention in chiropractic practice
From: Primary prevention in chiropractic practice: a systematic review
Articles 1st author Yr of publication Country of study [Quality rating] | Chiropractors’ positive opinions on PP | Chiropractors’ use of PP | Patients’ reason for consulting (RfC) | ||||||
|---|---|---|---|---|---|---|---|---|---|
MSK prevention | General public health approach to PP unrelated to adjustments | Wellness likely to include adjustments | MSK prevention | General public health approach to PP unrelated to adjustments | Wellness likely to include adjustments | MSK prevention | General public health approach to PP unrelated to adjustments | Wellness likely to include adjustments | |
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | |
Mootz (2005) [38] USA GOOD [100%] | Primary RfC: 4% ‘wellness’ (Arizona) 10% ‘wellness’ (Massachusetts) | ||||||||
Malmqvist (2008) [35] Finland GOOD [100%] | 48% use ‘wellness’ | ||||||||
French (2013) [39] Australia GOOD [92%] | RfC: 6% for ‘health maintenance or preventive care’ | ||||||||
Allen- Unhammer (2016) [21] Norway GOOD [91%] | RfC: 1% for ‘prophylactic examination’ | ||||||||
Leach (2011) [28] USA GOOD [90%] | 94% positive to physical activity prescription 66% on tobacco cessation advice See Table 6 | 92% were ‘wellness-oriented’ | 86% prescribed physical activity or advised on this topic 60% advised on tobacco cessation See Table 6 | ||||||
Stuber (2013) [19] Canada GOOD [87%] | 82% ‘’recommend dietary supplements (…) for general health and wellness” | ||||||||
McGregor (2014) [20] Canada GOOD [87%] | 19% thought chiropractic subluxation is an obstruction to human health | ||||||||
McDonald (2004) [34] Several countries GOOD [85%] | 94% included periodic MC/wellness care in their clinical routine | ||||||||
Brown (2014) [40] Australia GOOD [85%] | RfC: 21% for ‘general health and well-being’ | ||||||||
Glithro (2015) [29] UK GOOD [85%] | 81%* agreed that screening patients for skin lesions was part of their clinical role *Includes some DC students | Skin lesions: −94% screened each new patient −53% screened regular patients at every visit −73% screened regular patients at visits scheduled specifically for patient re-assessment. | |||||||
Hawk (2004) [17] USA GOOD [80%] | 91% positive to nutritional advice 95% on the prescription of physical activity 69% on tobacco cessation advice 57% on skin lesion screening See Table 6 | 93% had a positive attitude to subluxation screening | 90% of chiropractors provide information on MSK risk reduction | 86% gave nutritional advice 89% prescribed physical activity or advised on this topic 65% advised on tobacco cessation 46% screened for skin lesion See Table 6 | |||||
Hestbaek (2009) [37] Denmark ACCEPTABLE [77%] | RfC: 7% for ‘prophylactic examination’ | RfC: 2% for ‘general well being’ | |||||||
Pohlman (2016) [41] Several countries ACCEPTABLE [75%] | RfC: 18% for wellness | ||||||||
Fikar (2015) [31] UK ACCEPTABLE [70%] | 62 to 97% considered lifestyle issues to be their responsibility to discuss | 96% advised on poor posture 88% advised on ‘faulty movement patterns’ | 79% gave nutritional advice 92% prescribed physical activity or advised on this topic 57% advised on tobacco cessation See Table 6 | ||||||
Blanchette (2015) [36] Canada ACCEPTABLE [69%] | For 59% of patients Maintenance/ Wellness was the main sector of activity | ||||||||
Blum (2008) [18] Several countries ACCEPTABLE [64%] | RfC in asymptomatic patients: 12% for ‘prevention’ See Table 5 | RfC in asymptomatic patients: 16% for being ‘at risk’ See Table 5 | RfC in asymptomatic patients: 14% for ‘wellness’ See Table 5 | ||||||
Walker (2000) [33] USA ACCEPTABLE [62%] | 77% used nutrition for ‘general healthful eating/nutrition’ | ||||||||
Schneider (2015) [30] USA ACCEPTABLE [62%] | 8% focused on ‘wellness/ prevention’ | ||||||||
Allen- Unhammer (2016) [21] Norway (Part 2 – survey) ACCEPTABLE [62%] | RfC: <5% for infants <3 mo <10% for infants 4–23 mo ‘prophylactic examination’ | ||||||||
Adams (2017) [32] Australia ACCEPTABLE [62%] | 73% treated patients for ‘spinal health maintenance/prevention’. | ||||||||
Hawk (2001) [22] Several countries UNACCEPTABLE [57%] | 48% used ‘diet/nutrition counselling for general health’ 46% used ‘exercise counseling’ | RfC: <1% for disease prevention/health promotion through nutrition | RfC: 3% for disease prevention/health promotion through ‘subluxation correction’ | ||||||
Bussières (2015) [27] Canada UNACCEPTABLE [56%] | 9% focused on ‘wellness/ prevention’ | ||||||||
Marchand (2012) [26] Several countries UNACCEPTABLE [55%] | RfC: <1% for ‘posture screening Prevention’ | RfC: <1% for ‘advice/check up birth check up’ Wellness | |||||||
Alcantara (2008) [23] Several countries UNACCEPTABLE [43%] | RfC reported by DC 35% were reported as ‘wellness care’ RfC reported by patients 44% of parents gave ‘wellness care’ as the motivation to consult | ||||||||
Alcantara (2009) [24] Several countries UNACCEPTABLE [43%] | RfC reported by patients 35% ‘were reported as presenting for wellness care’ RfC reported by patients 47% ‘presented for wellness care’ | ||||||||
Alcantara (2010) [25] Several countries UNACCEPTABLE [43%] | 90%: used ‘wellness care’ | RfC: 2% of DC have patients who consult for ‘postural improvement’ | RfC: 17% of DC have patients who consult for ‘wellness care’ | ||||||