Haymo W Thiel

• DC MSc PhD DipMed
• Professor Emeritus at Health Sciences University

This prospective, community-based, active surveillance study aimed to report the incidence of moderate, severe, and serious adverse events (AEs) after chiropractic (n = 100) / physiotherapist (n = 50) visit in offices throughout North America between October-2015 and December-2017. Three content-validated questionnaires were used to collect AE info...

Objectives: To: 1) develop/adapt and validate an instrument to measure patient safety attitudes and opinions of community-based spinal manipulative therapy (SMT) providers; 2) implement the instrument; and 3) compare results among healthcare professions. Methods: A review of the literature and content validation were used for the survey developm...

Aim of the study/Introduction. Spinal manipulation therapy (SMT) is used throughout the world by chiropractors, osteopaths, physiotherapists and other manual therapists, yet there are no systematic data collection mechanisms in place to monitor and evaluate adverse events (AE) that occur after SMT. We established a reporting and learning system (“S...

Background It is not uncommon for chiropractors to be associated with sports teams for injury prevention, treatment, or performance enhancement. There is increasing acceptance of the importance of sports psychology in the overall management of athletes. Recent findings indicate mental hardiness can be determined reliably using specific self-assess...

Background The literature on chiropractic safety tends to focus on adverse events and little is known about how chiropractors ensure safety and manage risk in the course of their daily practice. The purpose of this study was to investigate how chiropractors manage potentially risky clinical scenarios. We also sought to establish how chiropractors p...

The European Patient Organizations' review.

The "Swiss Cheese Model" of accident causation [16].

Percentage of agreement with the AGREE domains by members of the commission (n = 5).

Summary on person and system approach.

In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU) and the European Academy of Chiropractic (EAC) involved in the European Committee for Standardization (CEN) process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There w...

Augmenting validated paper versions of existing outcome measures with an equivalent online version may offer substantial research advantages (cost, rapidity and reliability). However, equivalence of online and paper questionnaires cannot be assumed, nor can acceptability to respondents. The aim was to test whether online and written versions of the...

But neurology has another very important role in chiropractic, and that is in the minimisation of patient injury following our treatment. While chiropractic is a very safe method of health care, we have to accept that serious injury can occur. Other than sprains, strains, muscle soreness and fractures; the most serious injuries associated with our...

Background: augmenting validated paper versions of existing outcome measures with an equivalent online version may offer substantial research advantages (cost, rapidity and reliability). However, equivalence of online and paper questionnaires cannot be assumed, nor can acceptability to respondents. The aim was to test whether online and written ver...

Objectives The objectives of this study were (i) to identify levels of awareness and understanding of a patient safety incident (PSI) reporting system by members of the British Chiropractic Association (BCA); (ii) to identify BCA members’ attitudes to the reporting of PSIs; (iii) to identify possible barriers to incident reporting and the use of th...

Patients with nonspecific musculoskeletal disorders may vary in their response to treatment. This study set out to identify the predictors for either improvement or worsening in symptoms for which cervical spine manipulation is indicated. A large prospective study recorded details on patients, their presenting symptoms, and type of treatment. At th...

Professor Ernst has published a so-called ‘systematic’ review1 of adverse events following spinal manipulation based on low quality evidence including, for the most part, case reports (JRSM 2007;100:330-338). The whole point of systematic reviews is to get away from an author's often strong prior beliefs and opinions, and instead present an imparti...

Prospective national survey. To estimate the risk of serious and relatively minor adverse events following chiropractic manipulation of the cervical spine by a sample of U.K. chiropractors. The risk of a serious adverse event following chiropractic manipulation of the cervical spine is largely unknown. Estimates range from 1 in 200,000 to 1 in seve...

Objective To design and test a reporting format for patient safety incidents (PSIs) related to chiropractic practice. Design A pilot study of adverse event monitoring. Setting Field chiropractic practice and the teaching clinic of the Anglo-European College of Chiropractic. Subjects Members of the British Chiropractic Association and final year...

The combined extended and rotated cervical spine position has been postulated to affect vertebral artery blood flow by primarily causing a narrowing of the vessel lumen, usually within the artery contralateral to the side of head rotation. The production of brainstem symptoms during the manoeuvre has generally been considered to be a positive test...

Neck pain is a leading cause of morbidity and health care utilisation worldwide, and spinal manipulative therapy (SMT) has become an increasingly popular therapeutic approach for the treatment of mechanical neck disorders and headache. Within the UK, the chiropractic profession is one of the main providers for SMT, however, the frequency with which...

Recent changes in the National Health Service (NHS) in the UK have included a major push towards improving the quality of patient care and the safety of the offered services under the mantle of clinical governance. The various elements that constitute clinical governance are, in the main, just as relevant to the chiropractic profession as they are...

Spinal manipulative therapy to the cervical, and especially the upper cervical, spinehas been linked to stroke of the posterior circulation affecting the cerebellum and brain stem.Two cases are presented in which chiropractors manipulated patients who presented with neck pain and headaches, resulting in post-manipulative stroke in both cases. Analy...

This case report details diagnosis of an apparent compression fracture of the lateral mass of the atlas vertebra with an associated avulsion fracture of the medial portion of the lateral mass. Congenital abnormalities of the posterior arches of both atlas and axis were also noted. The patient, a 59-year-old Caucasian male had two previous incidents...

Manipulation is rapidly gaining acceptance by orthodox practitioners as a valid method of treatment of joint dysfunction and pain syndromes. The first part of this overview will discuss definitions, patient assessment and the application of a typical manipulation (for low back pain) as it is practiced by most modern manipulative practitioners. In t...

To determine the validity of the neck extension-rotation test as a clinical screening procedure to detect decreased vertebrobasilar blood flow that might be associated with dizziness. Secondary analysis of a clinical screening test. Twelve subjects with dizziness reproduced by the extension-rotation test and 30 healthy control subjects had Doppler...

HEPURPOSE OF THIS STUDY was to establish the intra-and interexaminer reliability for assessing relative iliac crest height, palpatory tenderness over the posterior superior iliac spines, and the sitting flex ion test using two examiners and 32 asymptomatic subjects. Tenderness to palpation over the posterior superior iliac spines was the only param...

The purpose of this study was to assess blood flow velocity in the vertebral arteries with duplex Doppler ultrasound during various positions of the head and neck. Vertebral artery morphology and blood flow velocity were assessed in a control group and in a group of subjects who displayed clinical signs and symptoms of vertebrobasilar insufficiency...

This paper reviews the vertebral artery syndrome with respect to the relevant patho-anatomy, aetiology, signs and symptoms and risk factors of cerebrovascular compromise. Studies assessing vertebral artery flow have also been reviewed.

Objectives: The objective of this article is to review the status of side posture manipulation for lumbar intervertebral disk herniation. Data sources, study selection and data extraction: The data presented in this article are from our Back Pain Clinic at the Royal University Hospital and the articles cited are those which we feel are important...

Fracture of the vertebral ring apophysis in the lumbar spine is an uncommon condition that has been reported in adolescent patients presenting with low back pain. The pathophysiology is considered to be a fracture of the posterior ring apophysis in association with a herniated disc. The nature and the extension of the lesion is best established by...

A radiographic study was undertaken to describe the relationship between coupled lumbar motion in lateral bending and the presence of low back pain symptomatology, evaluate trends of coupled motion and determine if these trends were attributable to chance confluence of independent motions. Survey. Chiropractic college student health center and priv...

Cerebrovascular accidents are an uncommon, but well documented, complication of cervical spine manipulation. This paper reviews vertebral artery gross morphology and pathoanatomy as they relate to possible mechanisms of injury to this vessel. Certain positions of the head and neck can lead to vertebral artery compromise and may ultimately lead to a...

Thoracolumbar fractures are sometimes misdiagnosed and treated as mechanical low-back pain. This report describes three such cases following flexion-compression injury to the spine. The characteristic presentation along with appropriate examination of the patient are discussed. It is important to consider the possibility of thoracolumbar fracture i...

Interrater reliability is described for the evaluation of lumbar motion and motion coupling patterns in lateral bending. Upright neutral and lateral bending lumbar films of 58 student volunteers were marked by three examiners. Segmental tilt, segmental rotation and motion categories were computed. The performance of the examiners was evaluated usin...

Subdural hematoma formation should be considered as a diagnosis in the patient who complains of headache and is on long-term anticoagulant therapy. Three such cases are described and the proper medical management is discussed.

Two cases of spinal nerve-root Schwannomas, initially diagnosed as intervertebral disc herniations, are presented. Both were surgically excised after being located using myelography and CT scans. A review of the literature, with emphasis on the differential diagnosis of Schwannoma from herniated intervertebral disc, is included.

A seventy-four year old man presented with a one-year history of low back pain and a long history of osteoarthrosis of both hips. Four months prior to presentation, he developed septicemia following a biopsy for suspected prostatic carcinoma. He seemed to have recovered well from the septicemia, but radiographs of the lumbar spine strongly suggeste...

Two cases of patients with evidence of both vascular and spinal intermittent claudication are presented. When patients present with low back pain and post-exercise lower extremity pain, confusion may arise with respect to the etiology of the symptoms. These cases stress the need for a rational and logical approach to the patient with intermittent c...

This paper reviews three cases in which radiculopathies of the cervical and lumbar spine were successfully managed by the use of transcutaneous electrical nerve stimulation (TENS) in addition to, or instead of, spinal manipulative therapy. Characteristics of TENS, indications for its use, and application procedures are discussed.

This report gives a brief introduction to the characteristics of therapeutic low power laser devices. Absorption, tissue penetration and physiological mechanisms of laser irradiation are discussed. The biological effects of low power laser light are reviewed in the areas of collagen metabolism, woundhealing, inflammation and pain control. Contraind...

A 21 year old oriental male presented with a one month history of neck pain associated with neck stiffness and dysphagia. A five week course of chiropractic treatment relieved most of his symptoms. Due to persistent tenderness in the suboccipital region and substantial weight loss, he was subsequently hospitalized. Further investigations revealed t...

This manuscript’s purpose was to establish a knowledge base of information related to stroke and the cervical spine vascular structures, from both historical and current perspectives. The scientific biomedical literatures both indexed (ie. Index Medicus, CRAC) and non-indexed literature systems were scanned and the pertinent manuscripts were annota...