Post on 16-Jul-2020
Chiropractic and Stroke What you need to know to
protect yourself.
Dr. Stu Hoffman President & Founder
Removing the stress of being in practice.
How to communicate with the public about the stroke topic.
Why an evidence based practice is the new philosophy.
How to lower your risk through proven research.
Making informed consent work for you.
Today’s Topics
Removing the stress of being in practice.
How to communicate with the public about the stroke
issue.
“There is no sound scientific evidence, no epidemiologic study, no biomechanical
study, that proves a causative link between the chiropractic adjustment and
vertebral artery dissection.”
Arterial Dissec,on
“While the weakest form of scientific evidence, case studies, establish an association between
chiropractic adjustments and stroke, that association is common to a hundred trivial
movements that are a part of everyday life. Yet, causation not only remains unproven, the inverse
has been established.”
Arterial Dissec,on
Current thinking holds that the majority of patients who develop frank symptoms of a
vertebral artery dissection following chiropractic care were in the process of dissection when they presented for care.
Arterial Dissec,on Gem
Vertebral artery strains obtained during spinal manipulative therapy are significantly smaller than those obtained during diagnostic and range of motion testing, and are much smaller than failure strains.a. Herzog W, Leonard TR, Symons B, Tang C, Wuest S. Vertebral artery strains during high-speed, low amplitude cervical spinal manipulation. J Electromyogr Kinesiol. 2012;22:740–746.b. Austin N, DiFrancesco LM, Herzog W. Microstructural damage in arterial tissue exposed to repeated tensile strains. J Manipulative Physiol Ther. 2010;33:14–19.c. Piper SL, Howarth SJ, Triano J, Herzog W. Quantifying strain in the vertebral artery with simultaneous motion analysis of the head and neck: A preliminary investigation. Clinical Biomechanics. 2014; 29:1099-1107.
Arterial Dissec,on
Relevant Literature
We were all taught “George’s Test”, “DeKlynes Test” and other tests for Vertebral artery competency.
Regardless of what your teachers, colleagues, professional liability providers, risk management consultants have told you about these provocative tests—DO NOT DO THEM.
Arterial Dissec,on
The 5D’sand the A
and the 3 N’s.
There are no clear-cut predisposing factors suggesting VAD…
There are no testing procedures helpful in ruling out potential VAD patients…
The great majority of VAD-in-progress patients present with musculoskeletal complaints…
Arterial Dissec,on Gem
ChiroSecure promotes the most aggressive defense available based on
the best scientific evidence.
Arterial Dissec,on Gem
How to communicate with the public about the stroke
issue.
Making informed consent work for you.
Informed Consent is living breathing entity which we update regularly at ChiroSecureThe research is in our favor that there is no evidence we cause a VAD with our adjustment.Always follow your individual boards recommendations on how to present Informed Consent, whether that is orally in writing and/or a combination of both.Once explained properly it builds confidence in your relationship with the patient.Always document in your notes that you went over the Informed Consent with the Patient.
How to lower your risk through proven research.
Research Presented on ChiroSecure Live Events
Z-Joint Gapping - pain reduction Pediatric Safety Study ‘Strain is in the brain’ - Study regarding Plasticity Myofascial Pain - reducing DJD Brian Adjustments - connecting body and brain Spine as an Organ - restoring Function and Behavior Chiropractic and LBP - comparison to Medical Care SMT and Biomechanics - why patients respond Back Pain and Pediatrics - how back pain leads to health problems later on Patient Centered Care - respecting patient values
Dr. Dean Smith Show
Spinal manipulation in addressing disordered sensorimotor integration Alterations In Cortical And Cerebellar Motor Processing Effects of Cervical Manipulation on Joint Position Fall Risk Profile in Elderly Patients Neuromodulatory Effects of Subluxation and Chiropractic Care Spinal Manipulation on Central Integration And the list goes on and on
Dr. Heidi Haavik Show
Gait Evaluation Study - Temporal and Spacial Gait Parameters Neuroscience and Cognition Chiropractic Adjustment and Ergonomics Chiropractic Adjustment and Force Profiles Chiropractic Long Term Health Studies.
Dr. Stephanie Sullivan Show
Why an evidence based practice is the new
philosophy.
Useful research is patient centered. It is done to benefit patients or to preserve health and enhance wellness, not for the needs of physicians, investigators, or sponsors.
Useful clinical research should be aligned with patient priorities, the utilities patients assign to different problems and outcomes, and how acceptable they find interventions over the period for which they are indicated.
Why Most Clinical Research Is Not Useful • John P. A. Ioannidis Published: June 21, 2016 • http://dx.doi.org/10.1371/journal.pmed.1002049
Patient Centeredness
Removing the stress of being in practice.
How to communicate with the public about the stroke topic.
Why an evidence based practice is the new philosophy.
How to lower your risk through proven research.
Making informed consent work for you.
Today’s Topics
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Most comprehensive policies!
Free audit coverage!
ChiroSecure is changing the way the public views chiropractic and you need to be part
of that movement.
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