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Chiropractic Journal of Australia : CJA June 2012
60 Chiropractic Journal of Australia Volume 42 Number 2 June 2012 INTRODUCTION A myriad of changes take place during pregnancy. Maternal stress from a biopsychosocial point of view has been linked to adverse health outcomes for both the mother and fetus.1,2 With the well-known biomechanical changes that take place in a woman’s body, approximately 25% of pregnant women have disabilities that compromise their performance in the workplace and their activities of daily living.3 Although low back pain is the most common complaint, the pregnant woman may also suffer from other neuromusculoskeletal (NMS) complaints such as peripheral neuropathy, nausea and vomiting, problems with labor, postpartum perineal discomfort, and lactation disorders to name a few.4 Both allopathic and complementary and alternative medicine (CAM) treatment approaches have been offered to address these complaints. However, due to the intimate maternal-fetal relationship, concerns regarding adverse events associated with pharmacological interventions motivate the pregnant woman’s willingness to try CAM therapies. The effectiveness of chiropractic spinal manipulative therapy (SMT) in treating NMS conditions5,6 and its overall popularity among CAM users7 makes chiropractic an attractive CAM option for the pregnant woman. Based on our review of the literature8-60 no study has examined the presenting complaints and perceived effectiveness of pregnant patients to chiropractors within a practice-based research network (PBRN). A relatively recent systematic review of the literature by Stuber and Smith49 admonished that there is a need for the chiropractic profession to elicit more epidemiologic and clinical information about the pregnant patients who access chiropractic services in terms of their demographics, reasons for seeking chiropractic care, and The Characterisation and Response to Care of Pregnant Patients Receiving Chiropractic Care within a Practice-based Research Network JOEL ALCANTARA, JEANNE OHM, KURT KUNZ, JOEY D ALCANTARA and JUNJOE ALCANTARA Abstract: Objectives: To characterise the chiropractic care of pregnant patients in a practice-based research network (PBRN). Main Outcome Measures: Patient demographics (i.e., age, gender, level of education) and weeks of gestation, presenting complaints based on hierarchical designation of primary (10), secondary (20), and tertiary (30) complaints, perceived effectiveness of care and the specifc effects of care. Results: One hundred and twenty six pregnant patients participated in our PBRN survey. Their average age was 30.56 years and presented for chiropractic care at an average gestational age of 29.42 weeks. Approximately 25% of the patients indicated presenting for "wellness care." A total of 241 complaints were documented by the patient population and designated as 10 (N=118), 20 (N=91) and 30 (N=32). A majority of the specifc complaints were musculoskeletal in nature with low back pain specifc to the lumbar spine as the most common site. A majority of the patients reported a high perceived effectiveness in 98% of patients with 10 complaints, 97% of patients with 20 complaints and 100% of patients with 30 complaints. Response to specifc effects of the chiropractic spinal manipulative therapy were categorized to 3 main domains as "decreased pain", "improved function and "other" due to heterogeneity of indicated responses..Conclusions: Pregnant patients present for chiropractic care for musculoskeletal complaints in addition to wellness care with high-perceived effectiveness. We support further research to examine the safety and effectiveness of this popular non-allopathic approach to women's health. INDEX TERMS: (MeSH): CHIROPRACTIC; PREGNANCY; MANIPULATION, SPINAL. Chiropr J Aust 2012;42: 60-7. Joel Alcantara, BSc, DC Research Director, International Chiropractic Pediatric Association, Media, PA, USA Adjunct Assistant Professor, Life Chiropractic College West, Hayward, CA,USA Jeanne Ohm, DC Executive Director, International Chiropractic Pediatric Association, Media, PA, USA Kurt Kunz, BS Research Associate, International Chiropractic Pediatric Association, Media, PA, USA Joey D Alcantara, DC Private Practice of Chiropractic Calgary, AB, Canada Junjoe Alcantara, DC Private Practice of Chiropractic San Jose, CA, USA Received: 7 January 2011, revised version accepted: 31 January 2012 This study was funded by the International Chiropractic Pediatric As- sociation, Media, PA, USA
CJA March 2012
CJA September 2012