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Table 4 Frequency of Therapeutic Approaches by VA Chiropractors for Patients with Prior Lumbar Fusion Surgery (%) (n = 59)

From: Management of patients with prior lumbar fusion: a cross-sectional survey of Veterans Affairs chiropractors’ attitudes, beliefs, and practices

Intervention

Always

Frequently

Sometimes

Rarely

Never

Patient History

59 (100)

0 (0)

0 (0)

0 (0)

0 (0)

Physical Examination

59 (100)

0 (0)

0 (0)

0 (0)

0 (0)

Healthy Lifestyle Advice

41 (69.5)

15 (25.4)

2 (3.4)

1 (1.7)

0 (0)

Education on chronic pain and/or pain neurophysiology

37 (62.7)

16 (27.1)

6 (10.2)

0 (0)

0 (0)

Mobilization

14 (23.7)

19 (32.2)

20 (33.9)

6 (10.2)

0 (0)

Flexion-Distraction

11 (18.6)

21 (35.6)

9 (15.3)

4 (6.8)

14 (23.7)

Pelvic Blocking

0 (0)

0 (0)

8 (13.8)

12 (22.4)

37 (63.8)

Acupuncture/Dry Needling

1 (1.7)

19 (32.2)

12 (20.3)

1 (1.7)

26 (44.1)

Thoracic HVLA

5 (8.5)

29 (49.2)

24 (40.7)

0 (0)

1 (1.7)

Lumbar HVLA

0 (0)

10 (16.9)

17 (28.8)

17 (28.8)

15 (25.4)

Pelvic HVLA

3 (5.1)

20 (33.9)

20 (33.9)

9 (15.3)

7 (11.9)

Muscle Stretches

11 (18.6)

28 (47.5)

14 (23.7)

4 (6.8)

2 (3.4)

Myofascial Therapy (Instrument or Manual)

6 (10.2)

31 (52.5)

14 (23.7)

4 (6.8)

4 (6.8)

Mechanical Diagnosis and Therapy (McKenzie)

5 (8.5)

9 (15.3)

16 (27.1)

12 (20.3)

17 (28.8)

Lumbopelvic/Abdominal Stabilization Exercises

10 (16.9)

28 (47.5)

15 (25.4)

5 (8.5)

1 (1.7)

Neurodynamic Mobilizations

1 (1.7)

9 (15.3)

18 (30.5)

11 (18.6)

20 (33.9)

Cognitive Behavioral Therapy

1 (1.7)

13 (22.0)

18 (30.5)

7 (11.9)

20 (33.9)

Mindfulness Meditation

0 (0)

6 (10.3)

17 (29.3)

19 (32.8)

16 (27.6)

Instrument Assisted Manipulation (Activator, etc.…)

3 (5.2)

13 (22.4)

12 (20.7)

7 (12.1)

23 (39.7)

Advice General Condition and Physical Activity

36 (61.0)

21 (35.6)

2 (3.4)

0 (0)

0 (0)

Specific Exercise Recommendations

25 (42.4)

27 (45.8)

5 (8.5)

2 (3.4)

0 (0)

  1. Write-in interventions: passive modalities (n = 3), Proprioceptive Taping (n = 1), Home self-traction (n = 1), Aquatic Therapy (n = 1), Complementary and Natural Medicine (n = 1)
  2. HVLA = High Velocity, Low Amplitude Manipulation