Joel Alcantara

International Chiropractic Pediatric Association · Research

Background The SF-36 questionnaire is perhaps the most widely used quality of life instrument in the world today, while the PROMIS instruments continue to gain popularity. Given their continued use in chiropractic research and practice, we examined their latent domain structure using exploratory factor analysis (EFA). Methods To uncover latent str...

Objective To assess the attitudes, practices and other contributing factors to patient safety among chiropractors. Methods: In addition to obtaining socio-demographic and practitioner/practice characteristics, we utilized the Safety, Communication, Operational Reliability, and Engagement (SCORE) questionnaire. To identify variables contributing to...

Introduction: Antonovsky's sense of coherence (SOC) has been shown to positively correlate with quality of life (QoL). We examined the relationship between socio-demographic data and clinical covariates along with various QoL domains to SOC in patients presenting for care within a chiropractic practice-based research network. Methods: In additio...

Objective: To quantify the quality of life (QoL) and visit-specific satisfaction of pregnant women. Design: A prospective cohort within a practice-based research network (PBRN). Setting/locations: Individual chiropractic offices. Subjects: Pregnant women (age ≥18 years) attending chiropractic care. Intervention(s): Chiropractic care (i.e., T...

Objectives: To characterize pediatric chiropractic and assess pediatric quality of life (QoL). Design: A prospective cohort. Setting/Locations: Individual offices within a practice-based research network located throughout the United States. Subjects: A convenience sample of children (8-17 years) under chiropractic care and their parents. Exp...

Objective To measure the cross-informant variant of pediatric quality of life (QoL) based on self-reports and parent proxy measures. Methods A secondary analysis of baseline data obtained from two independent studies measuring the QoL based on the pediatric PROMIS-25 self-report and the PROMIS parent-proxy items banks. A scoring manual associated...

Objective: To describe the concomitant chiropractic care of an infant with hydrocephaly. Clinical Features: The parents of a 14-week-old infant presented their child for chiropractic care with a history of hydrocephalus. Intervention and Outcome: The infant was cared for with cranial release work and Modified Diversified Technique involving a susta...

Objective: To describe the care of a patient with spinal subluxations and cranial dysfunctions along with possible conversion disorder. Clinical Features: The patient was a 16-yr-old female presenting for chiropractic care with complaints of neck and upper shoulder pain due to trauma. The patient had a history of fatigue, dizziness and headaches a...

Objective: To describe the attitudes and perceptions of patients introduced to chiropractic through public spinal screening, prior to and following a course of chiropractic care focused on the correction of vertebral subluxation. Methods: Individuals receiving care at a chiropractic teaching clinic, after exposure to a public spinal screening were...

Objective: To describe the care of a 28-year-old pregnant patient Clinical Features: A 32-year-old female with a prior history of failed in-vitro fertilization (IVF) began chiropractic care 2 weeks prior to her second implantation. Upon confirmation of a successful implantation of triplets, the patient elected to receive regular chiropractic care a...

Introduction Although chiropractic care is known to be provided in different types of environments, patient satisfaction on the use of an open plan/multi bedded environment is unknown. The aim of this study was to examine chiropractic patients’ beliefs, experiences and satisfaction with chiropractic care in an open environment and to test the hypot...

Objective: To chronicle a case of infantile Erb’s-Duchenne Palsy that resolved during chiropractic care. Clinical features: A 5-month-old girl medically diagnosed with right-sided Erb’s-Duchenne Palsy and previous physiotherapy presented for care. The infant’s right elbow on flexion/extension, pronation/supination and right shoulder abduction demo...

Objective: To report on the outcomes of a male patient who presented for chiropractic care with hypertension. Clinical Features: 72-year-old male presented with a history of hypertension, arthritis, ringing/buzzing in the ears and numbness/burning in his shoulder. He was on blood pressure medication for one year prior to beginning chiropractic car...

Objective: Chiropractors have long advocated on the benefits of breastfeeding and given the realized and potential role of chiropractors in the care of infants with breastfeeding difficulties, we performed this review of the literature on the subject to inform clinical practice. Methods: For this article, we searched Pubmed [1966-2013], Manual,...

To examine the attitudes and utilization of evidence-based practice by chiropractors. Utilizing a descriptive survey implemented as an online questionnaire, we examined chiropractors׳ perception, skills, and level of training, their engagement in, the barriers and facilitators to, and possible interventions to evidence-based practice. A total of 16...

Our ongoing efforts to demonstrate effectiveness of care examined the quality of life (QoL) and patient satisfaction of chiropractic patients presenting for care in a PBRN. In addition to socio-demographic and clinical care information, we examined visit-specific satisfaction and QoL using the RAND VSQ and PROMIS-29, respectively. Our study populat...

Healthcare systems recognize the need to incorporate patient-reported outcomes as part of their clinical and research measures. We performed this review on the use of validated outcome measures in the chiropractic care of pregnant patients. Pubmed, CINAHL, Medline, Index to Chiropractic Literature and MANTIS were searched for (1) primary investigat...

Obesity is a global problem and places individuals at risk for developing chronic metabolic disorders. The need for investigating simple, effective and sustaining approaches to weight loss cannot be overstated. We performed a retrospective file analysis of patient files attending a 13-week weight loss program. Inclusion for analysis were files of a...

Constipation compromises the health-related quality of life of children. Chiropractic is a popular alternative therapy for children with constipation. We performed this integrative review of the literature to inform clinical practice. Our integrative review of the literature began with an examination of the databases Pubmed [1966-2013], MANTIS [196...

Abstract: Objective: To report positive outcomes in a pediatric patient diagnosed with Autistic spectrum disorder (ASD) who was receiving chiropractic care. Clinical Presentation: The 7-year-old boy diagnosed with ASD presented for chiropractic care with chronic diarrhea and nocturnal enuresis. Intervention and Outcomes: The patient received full s...

Objective: To describe the chiropractic care of an infant female with a medical diagnosis of strabismus. Clinical Features: An 18-month-old female with strabismus and a history of surgical care to correct her visual dysfunction is presented. Neurological examination revealed primitive reflexes with Galant's and Mora retained. No abnormalities were...

Objective To describe the chiropractic care of a pediatric patient with complaints of spinal pain, headaches, motor dysfunction and left leg and left arm twitching concomitant with a diagnosis of conversion disorder.Clinical featuresThree and half months following a fall on her head from the monkey bars, the patient presented for chiropractic care...

Introduction: To decrease health disparity in the care of diverse populations, allopathic and non-allopathic providers will require cultural competency to better serve these populations. We report on the impact in knowledge and confidence to serve diverse populations following a six-hour cultural competency training in two cohorts of third year chi...

Introduction: Wellness is an emerging, multibillion-dollar industry. Many professional services claim to adopt wellness into their business model, including chiropractic. Social networking sites like Twitter have been utilized to promote a variety of services. We report on the usage of the #wellness hashtag as a method of wellness and health promot...

Purpose: Diverse communities require chiropractors to be culturally competent to serve diverse populations. The purpose of this analysis is to describe the effect on knowledge and confidence to serve diverse populations following 6 hours of cultural competency training. Methods: Using a quasi-experimental one-group design, a paired t-test using...

Background and Aims Complementary and alternative medicine (CAM) use by children is predicated upon CAM-use by their parents. Of the various practitioner-based CAM therapies for children, chiropractic is the most popular. This study was undertaken to characterize the chiropractic care of children in Europe in a practice-based research network (PBRN...

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 (1°), secondary (2°), and tertiary (3°) complaints, perceiv...

To describe the care of a patient with spinal and cranial dysfunctions and medically diagnosed with conversion disorder. The patient was an 11-yr-old girl presented by her parents with complaints of uncontrollable tremors of both arms and right leg. Conversion disorder was diagnosed following negative examination findings for an organic etiology. P...

Estimates place some 300 million people worldwide suffer from asthma with 180,000 deaths attributed to the disease. The financial burden from Asthma in Western countries ranges from $300 to $1,300 per patient per year. In the United States, asthma medication costs between $1 billion and $6.2 billion per annum. With an increasing prevalence of 50% e...

Objective: To describe the successful chiropractic care of a toddler with an abnormal crawling pattern and review the literature. Clinical Features: An 11 month female infant was presented by her mother with concerns regarding her daughter's inability to cross-crawl. The infant was described as a "bottom shuffer". The infant's unusual locomotion be...

Objective: To describe the care of a newborn with breastfeeding difficulties and jaundice. Clinical Features: A neonate with difficulty rotating his head and neck and opening of the mouth due to mandibular sway to the left received chiropractic care. The infant was also medically diagnosed with jaundice due to elevated bilirubin levels.

Background: Concerns regarding the safety and effectiveness of complementary and alternative medicine (CAM) therapies have been raised. Of the various practitioner-based CAM therapies, chiropractic remains popular. To address safety concerns, we examined the prevalence and incidence of adverse events in a practice-based research network setting.

In addition to impacting the affected child and his/her family's quality of life, recent estimates place the lifetime cost for an individual with ASD at $3.2 million and $35 billion for the entire birth cohort. Given the clinical heterogeneity of ASD, treatment approaches are multidisciplinary including alternative therapies, particularly when no p...

A survey of midwives' knowledge and views about chiropractic. Cross-sectional descriptive survey. An anonymous on-line self-administered survey. United States midwives. Respondent demographics, professional training, personal and professional clinical experience, opinions on safety of chiropractic, and scope of chiropractic practice. A total of 187...

Background and significance: Cancer is the leading cause of death worldwide and accounted for 7.4 million deaths in 2004. By 2030, deaths from cancer have been estimated at 12 million with 30% being preventable. Complementary and alternative medicine remains popular among cancer patients; particularly with chiropractic services. However, the natur...

To perform a systematic review of the literature on the chiropractic care of patients with infantile colic. The following databases were interrogated: MANTIS [1965-2010]; Pubmed [1966-2010]; Index to Chiropractic Literature [1984-2010]; EMBASE [1974-2010]; AMED [1967-2010]; CINAHL [1964-2010]; Alt-Health Watch [1965-2010], and PsychINFO [1965-2010]...

To describe the successful chiropractic care of two pediatric patients with complaints of "growing pain." A 2¾-yr-old female and 3½-yr-old male were presented by their mothers with complaints of "growing pains" that awakened both patients at night. The girl's problem began 3 months prior to care with awakening due to leg pain at 1-2 nights weekly i...

The objective of this study was to characterize the practice of pediatric chiropractic. The study design was a cross-sectional descriptive survey. The settings were private practices throughout the United States, Canada, and Europe. The participants were 548 chiropractors, the majority of whom are practicing in the United States, Canada, and Europe...

Characterized with hyperactivity, inattention and impulsivity, attention-deficit/hyperactivity disorder (ADHD) has a prevalence in children, ranging from 2.6% to 11.4%. The medical approach is multimodal, with combination therapies of behavioral modification and pharmacotherapy. With growing concerns regarding the safety of both short-term and long...

We described the successful chiropractic care of a pediatric patient with migraine-type headaches. We encourage greater reporting of these types of cases to build the foundation for higher research design studies investigating the effectiveness of alternative approaches for such patients.

Background and significance Vohra and her colleagues recently performed a systematic review of the literature to document adverse events (AE) associated with pediatric spinal manipulative therapy (SMT). Over a period of 100 years and using 8 databases, they found 14 articles documenting AE with SMT. Ten of the 14 cases were associated with chiropra...

The absence of hormone fluctuations and/or the analgesic effects of increased beta-endorphins are thought to confer improvements in headache symptoms during pregnancy. However, for a number of pregnant patients, they continue to suffer or have worsening headache symptoms. The use of pharmacotherapy for palliative care is a concern for both the moth...

With continued popularity of complementary and alternative medicine (CAM) therapies for children, their safety and effectiveness are of high concern for both CAM and conventional therapy providers. Chiropractic is the most popular form of practitioner-based CAM therapies for children. The objective of this study was to describe the practice of pedi...

Objective: To report on three infertile females with vertebral subluxation that responded to the introduction of chiropractic care and review the literature on the topic. Clinical Features: Three females presenting with a chief complaint of infertility and vertebral subluxation. Interventions and Outcomes: Chiropractic care included diversified spi...

The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence-based practice, we describe t...

The mother of a 3-month old girl presented her daughter for chiropractic care with a medical diagnosis of gastroesophageal reflux disease. Her complaints included frequently interrupted sleep, excessive intestinal gas, frequent vomiting, excessive crying, difficulty breastfeeding, plagiocephaly and torticollis. Previous medical care consisted of Pr...

Objective The purpose of this study was to determine the range of presenting complaints by children (<18 years of age) to chiropractors and the reasons leading to attendance at a chiropractic clinic. Methods Chiropractors and parents of children attending for chiropractic care (range 1–12 visits) completed a self-administered questionnaire. Resul...

Background and significance Vohra and her colleagues (Vohra, 2007) recently performed a systematic review of the literature to document adverse events (AE) associated with pediatric spinal manipulative therapy. Over a period of 100 years and using 8 databases, they found 14 articles documenting AE with SMT. Ten of the 14 cases were associated with...

Chronic constipation is a common condition in the very young and the very old. This is reflected in approximately $800 million spent on laxatives in the United States each year. The elimination of food waste from the body is a common and simple daily occurrence for most individuals. Constipation is such a common problem in the pediatric population...

Introduction Chronic constipation is a common condition in the very young and the very old. So much so that approximately $800 million is spent on laxatives in the United States each year. Constipation is such a common problem in the pediatric population that it is the second most referred problem to the pediatric gastroenterologist and accounts fo...

Descriptions of the inability of children to move their arms following birth have been recorded since the days of Hippocrates. In industrialized countries, the incidence ranges from 0.38 to 3.0 per thousand live births, making it a very common injury in neonates and a clinically common presentation. Sentinel observations by Erb (due to injury to th...

To describe the chiropractic care of a patient with a pelvic ring fracture and concomitant subluxations of multiple segments of the spinal column. A 23-year-old male, after falling down a flight of stairs, was initially hospitalized for fractures of the pelvis. Five weeks posthospitalization, the patient initiated chiropractic care with complaints...

To describe the chiropractic care of a geriatric patient with complaints of midthoracic and low back pain. A 74-year-old woman sought chiropractic care with complaints of thoracic spinal pain following a fall. Palpation findings included hypertonicity and tenderness along with painful muscle spasms in the paraspinal musculature of the thoracolumbar...

Objective: To describe the chiropractic care of a pediatric patient with complaints associated with myasthenia gravis. Clinical features A 2-year-old girl was provided chiropractic care at the request and consent of her parents for complaints of ptosis and generalized muscle weakness (ie, lethargy), particularly in the lower extremities. Prior to...

To describe the chiropractic care of a patient medically diagnosed with Bell's palsy and discuss issues clinically relevant to this disorder, such as its epidemiology, etiology, diagnosis, care, and prognosis. A 49-year-old woman with a medical diagnosis of Bell's palsy sought chiropractic care. Her symptoms included right facial paralysis, extreme...

To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group. Randomized controlled-comparison trial with 3 parallel...

To describe the chiropractic care of a patient with cervical subluxation and complaints associated with temporomandibular disorder. A 41-year-old woman had bilateral ear pain, tinnitus, vertigo, altered or decreased hearing acuity, and headaches. She had a history of ear infections, which had been treated with prescription antibiotics. Her complain...

The chiropractic care of a patient with vertebral subluxations, neck pain, and cervical radiculopathy after a cervical diskectomy is described. A 55-year-old man had neck pain and left upper extremity radiculopathy after unsuccessful cervical spine surgery. Contact-specific, high-velocity, low-amplitude adjustments (i.e., Gonstead technique) were a...

Objective: The chiropractic care of a patient with vertebral subluxations, neck pain, and cervical radiculopathy after a cervical diskectomy is described. Clinical Features: A 55-year-old man had neck pain and left upper extremity radiculopathy after unsuccessful cervical spine surgery. Intervention and Outcome: Contact-specific, high-velocity, low...

The chiropractic management of a patient with myasthenia gravis and vertebral subluxation is described. We discuss the pathophysiology, clinical features, and treatment of patients with these diseases. The 63-year-old male patient suffered from complaints associated with the disease myasthenia gravis along with signs of vertebral subluxation. The p...

To describe the chiropractic management of a patient presenting with complaints of low back pain and epileptic seizures. The discussion also addresses epilepsy and the current concepts of this disorder; possible mechanisms for the neurological effects of the chiropractic adjustment at sites of subluxation and its therapeutic implications are propos...

To describe the chiropractic management of a patient suffering from a right lateral meniscus tear concurrent with calcium pyrophosphate dihydrate (CPPD) deposition disease. A 51-yr-old bus driver suffered from right knee pain (7 on a 1-10 pain scale). The onset of the pain was gradual and increased during braking and accelerating. Palpatory tendern...

To discuss the chiropractic management of a patient who sustained a unilateral lamina fracture of the sixth cervical vertebra. The patient had suffered cervical trauma from a motor vehicle accident. Clinical evaluation revealed acute global neck pain with associated left arm radiculitis and approximately 75% loss of useful left-arm motor function....

To document the chiropractic management of a patient who sustained a Chance fracture of the third lumbar vertebra. This case study represents the first report in the scientific literature of such an injury managed through chiropractic methods. An 18-yr-old man complained of low back pain and paresthesia in the lower extremities 10 days after suffer...

Reports of complications after chiropractic adjustments were administered to the lumbar spine and/or pelvis are rare. This case report provides the events associated with a sacral fracture that was not identified before a side-posture sacroiliac adjustment. The patient suffered from blunt, low back trauma as a result of a fall. Clinical evaluation...

Pseudomonas aeruginosa 579 biofilms formed on dialysis membranes retarded piperacillin diffusion. Treatment of biofilms with 5.0 mM CaCl2.2H2O prevented diffusion. Biofilms permitted equilibration of [14C]glucose. Thin-layer chromatography of fluids distal to untreated (viable and nonviable) and viable Ca(2+)-treated P. aeruginosa 579 biofilms and...