Chiropractors earn High Marks

Great article published by the Centers for Medicare and Medicaid services. Just another example of how well Chiropractors due with their customer service.

-Eric Clements

Patients in Medicare Demonstration Project Give Chiropractors High Marks

Published Wednesday, January 27, 2010

Patients in Medicare Demonstration Project Give Chiropractors High Marks

According to long-awaited results from a congressionally mandated pilot project testing the feasibility of expanding chiropractic services in the Medicare program, patients have a high rate of satisfaction with the care they receive from doctors of chiropractic.

When asked to rate their satisfaction on a 10-point scale, 87 percent of patients in the study gave their doctor of chiropractic a level of 8 or higher. What’s more, 56 percent of those patients rated their chiropractor with a perfect 10.

Contributing to that satisfaction was the attention given to patients’ needs and the accessibility of chiropractic care. Patients reported that doctors of chiropractic listened to them carefully and spent sufficient time with them. Some 95 percent said they had to wait no longer than one week for appointments.

“Doctors of chiropractic everywhere should feel pride in these patient satisfaction results and in being part of a profession that still sees the great need for spending time with patients and truly listening to them,” said Dr. Rick McMichael, president of the American Chiropractic Association (ACA). “It’s clear that patients deeply value the time their chiropractic providers spend with them and the expert care that DCs offer.”

The pilot, known as a “demonstration project” in Congress, was conducted from April 2005 to March 2007 throughout the states of Maine and New Mexico, and also in Scott County, Iowa, 26 counties comprising the Chicago metropolitan area, and 17 counties in central Virginia.

Current chiropractic coverage under Medicare is limited to spinal manipulation. Under the demonstration project, however, chiropractic care was expanded to include diagnostic and other services, such as X-rays, examinations, physical therapy and rehabilitation services.

The final report to Congress also includes information on the costs of expanding chiropractic services in the demonstration sites. The report indicates that in all but one of the demonstration sites, patients’ health care costs were not significantly changed by expanding coverage of chiropractic services. In contrast, a cost increase was found in the Chicago metropolitan area. Further research into the reasons why the results in Chicago differ from the rest of the demonstration project sites is needed to better understand these findings.

“We already know that Medicare costs in general tend to be higher in Chicago than other similar areas of the country. We must find the underlying cause of the cost difference found in the chiropractic demonstration project and determine whether it had anything at all to do with the expansion of chiropractic services,” Dr. McMichael noted.



To further analyze the results of the demonstration project, ACA is creating a taskforce of Medicare experts and researchers who will review the report and develop a response for the



Centers of Medicare and Medicaid Services.

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Low back pain sufferers and back muscle weakness

Nice research article linking weakness in back muscles with chronic low back pain. Just another reason to stay active and try to stimulate/exercise those muscles.

Less Activity in Multifidus of LBP Sufferers

Smooth and correct torso movements depend on the coordination of some trunk muscles that produce torque combined with the fine-tuned variations from other muscle groups. Studies have shown that the back extensor muscles are not simply a muscle group, but instead have specific functions for strength or control.

The multifidus appears to be a primary contributor to control and stabilization, while the iliocostalis lumborum pars thoracis (ICLT) produces torque forces in the lumbar region.

This study determined back muscle activity in three groups (77 healthy controls, 24 subacute back-pain patients, and 51 chronic back-pain patients) during strength, coordination, and stabilization exercises. Subacute pain was considered back pain of less than one year. Subjects performed 15 exercises involving kneeling/standing, loading, and lifting. Electromyographic (EMG) activity was recorded for the multifidus and the ICLT at maximum voluntary contraction. The results of the study were as follows:

* During coordination exercises, there was a significant decrease in EMG activity of the multifidus in the chronic-pain group compared to the control group, in post-hoc tests.

* Tests revealed significantly lower activity in both muscles in the chronic-pain group during strength exercises.

* Regarding stabilization exercises, muscle activity was similar for all three groups.

In the long run, low-back-pain patients may have more difficulty recruiting the multifidus for neutral lordosis. The authors conclude, "The possible dysfunction of the [multifidus] during coordination exercises and the altered activity of both muscles during strength exercises may be important in the symptom generation, recurrence or maintenance of low back pain."

Danneels LA, Coorevits PL, Cools AM, et al. Differences in electromyographic activity in the multifidus muscle and the iliocostalis lumborum between healthy subjects and patients with sub-acute and chronic low back pain. European Spine Journal 2002:11(1), pp. 13-19.