+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews



Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews



Journal of Chiropractic Medicine 4(3): 144-151



Conditions of the hand and wrist often occur in older patients, but decision-making algorithms and manual treatment protocols for this age group have not been developed or assessed. Further, effects of age-related co-morbidities are poorly understood. To build an understanding of an appropriate treatment protocol from the ground up that does not assume that generic spinal or extremity manipulative therapy is indicated. The project was conducted in two phases, involving (1) interviews with chiropractors (reported here) and (2) a single cohort, longitudinal design, identifying the conditions of the hand and wrist and concomitant comorbidities as well as promising accommodations and chiropractic treatments of these symptoms in older people. In the first phase, data were gathered, through in-person focus group and telephone interviews, from 58 chiropractors treating older patients presenting with hand and wrist symptoms. Chiropractors indicated they accommodated treatments to the health status and co-morbidities of their older patients and considered "management," rather than "cure," a more realistic concept in treating chronic conditions. With older patients, chiropractors recommended using a lighter touch, rehabilitative passive stretching, traction, nutritional counseling, soft-tissue work, and home exercises. Chiropractors also cautioned providers to take extra time in history-taking and extra diligence with older patients, identifying use of medications, and conducting blood pressure, bone density, blood clotting assessments, if indicated, before treatment. Chiropractors provided valuable orientation, indicating that caring for older patients requires careful history-taking and treatment plans that accommodate to presenting co-morbidities and the patients' general health statuses.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052064629

Download citation: RISBibTeXText

PMID: 19674656

DOI: 10.1016/S0899-3467(07)60123-2


Related references

Chiropractic treatment of hand and wrist pain in older people: systematic protocol development Part 2: cohort natural-history treatment trial. Journal of Chiropractic Medicine 6(1): 32-41, 2007

Patient-Reported Outcomes In Rare Lysosomal Storage Diseases: Key Informant Interviews And A Systematic Review Protocol. International Journal of Technology Assessment in Health Care 32(6): 393-399, 2016

Development of hand phenotypes and changes in hand pain and problems over time in older people. Pain 157(3): 569-576, 2015

Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol. Systematic Reviews 4(): 30-30, 2016

Chiropractic treatment including instrument-assisted manipulation for non-specific dizziness and neck pain in community-dwelling older people: a feasibility randomised sham-controlled trial. Chiropractic & Manual Therapies 26: 14-14, 2018

Hand exercise leads to modest improvement in grip and pinch strength, but no difference in hand function, pain, stiffness or dexterity in older people with hand osteoarthritis. Australian Occupational Therapy Journal 57(1): 68-69, 2010

Treatment of hand and wrist pain. A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint. Aaohn Journal 46(5): 233-236, 1998

Altered pain processing in people with type I and II diabetes: a protocol for a systematic review and meta-analysis of pain threshold and pain modulation mechanisms. Systematic Reviews 7(1): 222-222, 2018

Anxiety in patients with breast cancer undergoing treatment; The use of the Visual Analogue Scale for the assessment of labour pain: a systematic review; A systematic review on the factors affecting effective communication between Registered Nurses and oncology adult patients in an inpatient setting; The development and maintenance of constructive stafffamily relationships in the care of older people. Journal of Advanced Nursing 67(1): 19-25, 2011

Qualitative studies using in-depth interviews with older people from multiple language groups: methodological systematic review. Journal of Advanced Nursing 68(1): 22-35, 2012

Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial. Trials 14: 18-18, 2013

Laterality judgment performance between people with chronic pain and pain-free individuals: a systematic review protocol. Jbi Database of Systematic Reviews and Implementation Reports 16(8): 1621-1627, 2018

Short-term effects of self-mobilization with a strap on pain and range of motion of the wrist joint in patients with dorsal wrist pain when weight bearing through the hand: a case series. Manual Therapy 18(6): 568-572, 2014

Rapid diagnostic tests for determining dengue serostatus: a systematic review and key informant interviews. Clinical Microbiology and Infection 2019, 2019

Effectiveness of ondansetron as an adjunct to lidocaine intravenous regional anesthesia on tourniquet pain and postoperative pain in patients undergoing elective hand surgery: a systematic review protocol. Jbi Database of Systematic Reviews and Implementation Reports 13(1): 27-38, 2015