JMPT HIGHLIGHTS

Unexpected Outcomes

Lewis (p 715) reports on apatientwith life-long scoliosiswho gains postural improve-ment using a noninvasiveexercise–centered active ther-apeutic movement device.This treatment should beevaluated further to determineif this protocol has an impacton physical dysfunction andpsychosocial aspects forpatients with scoliosis andspinal deformities.

Dimensions of SocialCommunication Skills

Marchiori et al (p 682) eval-uated practice-based predic-tors of social communicationskills of practicing chiro-practors. Although someaspects of communicationwere predicted by the provi-der's practice arrangement

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and sex, the weekly volumeof patient to the practice wasthe strongest predictor ofoverall communication skillsof providers. This study sug-gested associations betweendimensions of social com-munication skills, practicecharacteristics, practice ar-rangements, and sex thatmay inform the efforts ofeducators as they endeavorto better prepare health pro-fessionals for practice in awide spectrum of settings.

Literature SynthesisMethods

Triano (p 645) describes theinitiation of an iterative pro-cess for systematic review ofthe literature involving abroad spectrum of indivi-duals with experience acrossmultiple domains within thechiropractic profession.

ChiropracticManagement ofLow Back DisordersGlobe et al (p 651) report on aproject that incorporated abroad-based consensus ofchiropractic research andinput from clinical expertsrepresentingmainstream chir-opractic practice into a prac-tical document designed toprovide standardized para-

meters of care. A broad-based panel of experiencedchiropractors reached a highlevel (80%) of consensusregarding specific aspects ofthe chiropractic approach tocare for patients with lowback pain, based on both thescientific evidence and theirclinical experience.

A Literature Synthesison Low Back PainLawrence et al (p 659) reviewthe literature for the use ofspinal manipulation for lowback pain. Evidence exists forthe use of spinalmanipulationto reduce symptoms andimprove function in patientswith acute, subacute, andchronic low back pain. Exer-cise in conjunction withmanipulation is likely tospeed and improve outcomesand minimize recurrence.

Connection betweenCurve and Health?

Christensen et al (p 690)systematically reviewed theepidemiologic literature pub-lished between 1942 and2008 for any evidence sup-porting an association bet-ween sagittal spinal curvesand health, including spinalpain. No association wasfound, however; no firm con-

clusions could be drawnbecause of the low methodo-logical quality of the includedstudies.

Cervical SpineManipulation

Fernández-Carnero et al(p 675) analyzed the immedi-ate effects of a cervical spinethrust manipulation and asham-manual therapy inter-vention on pain and thermalpressure thresholds over theelbow region, as well aspain-free grip force inpatients with lateral epicon-dylalgia. Cervical manipula-tion increased pain-free gripon the affected side, but notthe maximum grip force onthe unaffected arm.

What ConstitutesEvidence for BestPractice?Triano (p 637) describes inthis editorial the guidingprinciples, methods, andcommon factors that serveas the foundation for theCommission of the Councilon Chiropractic Guidelinesand Practice Parameters bestpractices initiative in thecontext of the chiropracticpractice environment.