Sidney M Rubinstein

• PhD
• Senior Researcher at Vrije Universiteit Amsterdam

Background Diagnostic imaging is commonly used in the management of low back pain (LBP), with approximately one-quarter of those who present to primary care referred for imaging. Current estimates of imaging frequency commonly exclude older adults; however, pathology detected with imaging (e.g., osteoporosis, cancer) may occur more frequently in ol...

Background To describe the societal costs during one year of follow-up among older adults seeking chiropractic care due to a new episode of low back pain (LBP), and to determine what factors predict high societal costs in this population. Methods Prospective cohort study, within chiropractic private practices (n = 38) in the Netherlands. 223 peopl...

In chronic musculoskeletal conditions, the prognosis tends to be more informative than the diagnosis for the future course of the disease. Many studies have identified clusters of patients who seemingly share similar pain trajectories. In a dataset of low back pain (LBP) patients, pain trajectories have been identified, and distinct trajectory type...

The smallest worthwhile effect (SWE) is the smallest beneficial effect of an intervention that justifies the costs, risks, and inconveniences. The objective is to establish the SWE of spinal manipulative therapy (SMT) for the treatment of low back pain (LBP), and to gain insight into how different attributes of the treatment are traded among each o...

Background: Research waste is defined as research outcomes with no or minimal societal benefits. It is a widespread problem in the healthcare field. Four primary sources of research waste have been defined: (1) irrelevant or low priority research questions, (2) poor design or methodology, (3) lack of publication, and (4) biased or inadequate report...

The world’s elderly population is growing at a rapid pace. This has led to an increase in demand on the health and welfare systems due to age-related disorders, with musculoskeletal complaints driving the need for rehabilitation services. However, there are concerns about health services’ ability to meet this demand. While chiropractic care is gain...

Background Little is known about lived experience of synchronous telehealth in patients with musculoskeletal (MSK) disorders. Objective We conducted a rapid systematic review to answer: (1) what are the lived experiences and/or perspectives of people with MSK disorders receiving non-pharmacological interventions delivered through synchronous teleh...

Background No previous studies have examined the association between attitudes and beliefs of chiropractors and their adherence to low back pain (LBP) guidelines. The aim of this study is: (1) to assess the attitudes and beliefs towards the management of LBP of Dutch and Belgian chiropractors; and (2) to investigate the association of these attitud...

Background: Low back pain (LBP) is the leading cause of disability globally. It generates considerable direct costs (healthcare) and indirect costs (lost productivity). The many available treatments for LBP include exercise therapy, which is practised extensively worldwide. Objectives: To evaluate the benefits and harms of exercise therapy for a...

Background No previous studies have examined the association between attitudes and beliefs of chiropractors and their adherence to low back pain (LBP) guidelines. The aim of this study is: 1) to assess the attitudes and beliefs towards the management of LBP of Dutch and Belgian chiropractors; and 2) to investigate the association of these attitudes...

Background Understanding care seeking behaviour is vital to enabling access to care. In the context of low back pain (LBP), chiropractors offer services to patients of all ages. Currently, geriatric sub-populations tend to be under-investigated, despite the disproportionate effects of LBP on older adults. In the Netherlands, the chiropractic profes...

Background Chiropractors commonly provide care to people with low-back pain (LBP). The aim of this survey was to determine the opinions and beliefs of chiropractors regarding the support and management of LBP. We also investigated whether their management is in accordance with the three most commonly recommended approaches to LBP based upon interna...

Purpose Many systematic reviews have reported on the effectiveness of spinal manipulative therapy (SMT) for low back pain (LBP) in adults. Much less is known about the older population regarding the effects of SMT. Objective To assess the effects of SMT on pain and function in older adults with chronic LBP in an individual participant data (IPD) m...

Objective: To evaluate the effectiveness of motor control training (MCT) compared with other physical therapist-led interventions, minimal/no intervention or surgery in patients with symptomatic lumbar disc herniation (LDH). Design: Systematic review and meta-analysis. Data sources: Eight databases and the ClinicalTrials.gov were searched from...

Objectives: The purpose of this study was (1) to describe diagnostic imaging in Dutch and Belgian chiropractic practice in general, (2) to estimate adherence to the diagnostic imaging guidelines for patients with low back pain (LBP) via vignettes, and (3) to evaluate factors associated with diagnostic imaging and adherence to the guidelines. Meth...

Objective: To examine validity, reliability and responsiveness of three commonly used questionnaires for assessing physical function (i.e. Oswestry Disability Questionnaire (ODI), Quebec Back Pain Disability Scale (QBPDS) and Roland-Morris Disability Questionnaire (RMDQ)) in older patients undergoing chiropractic care for low back pain (LBP). Des...

Objective To assess the costs and cost-effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared with open microdiscectomy among patients with sciatica. Methods This economic evaluation was conducted alongside a 12-month multicentre randomised controlled trial with a non-inferiority design, in which patients were randomise...

Objective To assess whether percutaneous transforaminal endoscopic discectomy (PTED) is non-inferior to conventional open microdiscectomy in reduction of leg pain caused by lumbar disc herniation. Design Multicentre randomised controlled trial with non-inferiority design. Setting Four hospitals in the Netherlands. Participants 613 patients aged...

We developed an algorithm to classify non-specific low back pain patients by their long-term pain fluctuations, known as pain trajectories. This algorithm will be used to perform a large scale multidimensional subgroup analysis to identify moderators and or mediators of low back pain trajectories.

Background A 2019 review concluded that spinal manipulative therapy (SMT) results in similar benefit compared to other interventions for chronic low back pain (LBP). Compared to traditional aggregate analyses individual participant data (IPD) meta-analyses allows for a more precise estimate of the treatment effect. Purpose To assess the effect of...

Background: Low back pain is a common condition among older adults that significantly influences physical function and participation. Compared to their younger counterparts, there is limited information available about the clinical course of low back pain in older people, in particularly those presenting for chiropractic care. Improving our unders...

Background: Predicting ongoing disability for chronic non-specific low back pain (LBP) is important to avoid prolonged disability. Objective: Determine predictors of disability at 6 month follow-up in patients with LBP at medium risk of ongoing disability. Methods: Baseline data was collected from 108 patients with medium-risk chronic non-spec...

Study design: Individual participant data (IPD) meta-analysis OBJECTIVE.: To identify which participant characteristics moderate the effect of spinal manipulative therapy (SMT) on pain and functioning in chronic LBP. Summary of background: The effects of SMT are comparable to other interventions recommended in guidelines for chronic low back pai...

Study design: Systematic review and meta-analysis. Objective: To give a systematic overview of effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared to open microdiscectomy (OM) in the treatment of lumbar disk herniation (LDH). Summary of background data: The current standard procedure for the treatment of sciatica...

Background: To evaluate the cost-effectiveness of a reduction in the number of routine radiographs in the follow-up of patients with ankle fractures. Methods: We performed an economic evaluation alongside the multicentre, randomised WARRIOR trial. Participants were randomised to a reduced imaging follow-up protocol (i.e. radiographs at week 6 an...

Objective To assess the cost effectiveness of a reduced imaging follow-up protocol of distal radius fractures compared with usual care. Design An economical evaluation conducted alongside a multicentre randomised controlled trial (RCT). Setting Four level-one trauma centres in the Netherlands. Participants 341 patients participated (usual care (...

Background: The clinical consequences of routine follow-up radiographs for patients with ankle fracture are unclear, and their usefulness is disputed. The purpose of the present study was to determine if routine radiographs made at weeks 6 and 12 can be omitted without compromising clinical outcomes. Methods: This multicenter randomized controll...

Background: Low back pain (LBP) is prevalent, costly and disabling. A biopsychosocial treatment approach involving physical and cognitive behavioural therapy (CBT) is recommended for those with chronic LBP. It is not known if online psychological coaching tools might have a role in the secondary prevention of LBP related disability. To assess the...

Background: Low back pain is a common condition among older adults that significantly influences physical function and participation. Compared to their younger counterparts, there is limited information available about the clinical course of low back pain in older people, in particularly those presenting for chiropractic care. Improving our underst...

Background: Routine radiography in the follow-up of distal radial fractures is common practice, although its usefulness is disputed. The aim of this study was to determine whether the number of radiographs in the follow-up period can be reduced without resulting in worse patient outcomes. Methods: In this multicenter, prospective, randomized con...

Objective To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Physiotherapy Evidence Database (PEDro), Ind...

Supplementary file: additional information

Background The added value of routine radiography in the follow-up of extremity fractures is unclear. The aim of this systematic review was to create an overview of radiography use in extremity fracture care and the consequences of these radiographs for the treatment of patients with these fractures. Materials and methods Studies were included if...

Rationale, aims, and objectives Studies suggest that routine radiographs during follow‐up of distal radius and ankle fractures result in increased radiation exposure and health care costs, without influencing treatment strategies. Encouraging clinicians to omit these routine radiographs is challenging, and little is known about barriers and facilit...

Background: The natural course of abdominal aortic aneurysms (AAA) is growth and rupture if left untreated. Numerous markers have been investigated; however, none are broadly acknowledged. Our aim was to identify potential prognostic markers for AAA growth and rupture. Methods and results: Potential circulating, biomechanical, and genetic marker...

Currently, the routine use of radiographs for uncomplicated ankle fractures represents good clinical practice. However, radiographs are associated with waiting time, radiation exposure, and costs. Studies have suggested that radiographs seldom alter the treatment strategy if no clinical indication for the imaging study was present. The objective of...

Back Complaints in Elders in Chiropractic Care

Introduction Lumbosacral radicular syndrome is often caused by a disc herniation. The standard surgical technique to remove a disc herniation is open microdiscectomy. An alternative technique is percutaneous transforaminal endoscopic discectomy (PTED), which is less invasive. In the Netherlands, PTED is not currently considered as standard care, an...

Introduction: The value of routine radiographs during follow-up after distal radius fractures is unclear. The aim of this study was to evaluate whether routine radiographs performed during the follow-up period in patients with a distal radius fracture influenced clinical decision making. Methods: This retrospective cohort study included patients...

Background: Information on the course of neck pain (NP) and low back pain (LBP) typically relies on data collected at few time intervals during a period of up to 1 year. Methods: In this prospective, multicentre practice-based cohort study, patients consulting a chiropractor responded weekly for 52 weeks to text messages on their cell phones. Da...

Background: Near-infrared imaging with indocyanine green (ICG) has been extensively investigated during laparoscopic cholecystectomy (LC). However, methods vary between studies, especially regarding patient selection, dosage and timing. The aim of this systematic review was to evaluate the potential of the near-infrared imaging technique with ICG...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The primary objective is to evaluate the effectiveness of orthosis following lumbar spinal surgery for people with degenerative disease on pain reduction and improvement of functional status. Secondary objectives are to examine the effect of the intervention on...

Objective: The aim of the Consensus on Interventions Reporting Criteria List for Spinal Manipulative Therapy (CIRCLe SMT) study was to develop a criteria list for reporting spinal manipulative therapy (SMT). Methods: A Delphi procedure was conducted from September 2011 to April 2013 and consisted of international experts in the field of SMT. The...

Background Chronic low back pain (LBP) is the leading cause of pain and disability, resulting in a major socioeconomic impact. The Cochrane Review which examined the effect of spinal manipulative therapy (SMT) for chronic LBP concluded that SMT is moderately effective, but was based on conventional meta-analysis of aggregate data. The use of indivi...

Low-back pain is the most important non-fatal disease in Europe and is associated with increasing healthcare costs. These costs are likely to become greater as the population becomes older. Low-back pain, particularly in older people, results in reduced quality of life, reduced social participation and increased isolation, as well as being associat...

Purpose: To evaluate the cost-effectiveness of manual therapy according to the Utrecht School (MTU) in comparison with physiotherapy (PT) in sub-acute and chronic non-specific neck pain patients from a societal perspective. Methods: An economic evaluation was conducted alongside a 52-week randomized controlled trial, in which 90 patients were ra...

Treatment of neck pain with manual therapy demonstrated to be more effective and cost-effective than general practitioner (GP) care or physiotherapy in a high quality RCT in the Netherlands in 2002. However, referral to manual therapy for neck pain is still relatively low. This study aims to explore the barriers and facilitators affecting the imple...

Objective: A prospective, multi-center chiropractic practice-based cohort study in Belgium and the Netherlands to determine whether certain psychosocial factors provide added value to predict recovery. Methods: 917 patients, of which 326 with neck pain and 591 with low back pain, completed self-administered questionnaires at baseline and at 3, 6...

Background: Laparoscopic surgery has led to great clinical improvements in many fields of surgery; however, it requires the use of trocars, which may lead to complications as well as postoperative pain. The complications include intra-abdominal vascular and visceral injury, trocar site bleeding, herniation and infection. Many of these are extremel...

Background: Various interventions are available for the treatment of chronic low back pain (LBP), including Manual Therapy and Cognitive Behavioural Therapy (CBT). The purpose of this study is to evaluate whether the addition of an internet-based CBT program leads to better outcomes in patients who are treated with multimodal manual therapy for ch...

Purpose To evaluate the cost-effectiveness of manual therapy according to the Utrecht School (MTU) in comparison with physiotherapy (PT) in sub-acute and chronic non-specific neck pain patients from a societal perspective. Methods An economic evaluation was conducted alongside a 52-week randomized controlled trial, in which 90 patients were randomi...

The purpose of this study was to determine whether direct ambulance transport of ST-elevation myocardial infarction (STEMI) patients to a percutaneous coronary intervention (PCI) hospital (field triage) leads to a lower 30-day mortality compared to transport via a referral non-PCI hospital (referral via a spoke centre) in STEMI patients. We perform...

To determine if psychosocial factors are associated with outcome in patients with neck pain or low back pain. In a prospective, multi-center chiropractic practice-based cohort study in Belgium and The Netherlands, 917 patients, of which 326 with neck pain and 591 with low back pain, completed self-administered questionnaires at baseline, following...

Extremity fractures such as wrist and ankle fractures are a common and costly healthcare problem. The management of these fractures depends on fracture type and loss of congruity of the joint, resulting in cast immobilization or operative treatment. Loss of congruity or displacement leading to uneven joint loading, osteoarthritis and an increased p...

Objective The purpose of this study was to evaluate changes in methodological quality and sample size in randomized controlled trials (RCTs) of spinal manipulative therapy (SMT) for neck and low back pain over a specified period. A secondary purpose was to make recommendations for improvement for future SMT trials based upon our findings. Methods...

Purpose To establish an evidence-based recommendation for the pragmatic use of the Neck Disability Index-Dutch Version (NDI-DV) in primary care based on an assessment of the reliability, the responsiveness, and the interpretability of the NDI-DV. Study design and setting/methods At baseline, the NDI-DV was completed by 337 patients with neck pai...

Objective To determine the comparative effectiveness and safety of current maintenance strategies in preventing exacerbations of asthma. Design Systematic review and network meta-analysis using Bayesian statistics. Data sources Cochrane systematic reviews on chronic asthma, complemented by an updated search when appropriate. Eligibility criteria T...

Research involving chiropractors is evolving and expanding in Europe while resources are limited. Therefore, we considered it timely to initiate a research agenda for the chiropractic profession in Europe. The aim was to identify and suggest priorities for future research in order to best channel the available resources and facilitate advancement o...

Assessing the benefits of surgical treatments for sciatica is critical for clinical and policy decision-making. To compare minimally invasive (MI) and conventional microdiscectomy (MD) for patients with sciatica due to lumbar disc herniation. A systematic review and meta-analysis of controlled clinical trials including patients with sciatica due to...

We aimed to evaluate the available evidence on the effectiveness of surgical interventions for a number of conditions resulting in low back pain (LBP) or spine-related irradiating leg pain. We searched the Cochrane databases and PubMed up to June 2013. We included systematic reviews and randomised controlled trials (RCTs) on degenerative disc disea...

The choice for a specific surgical technique should be based on its benefits and harms. Previous reviews showed that the benefit of surgery over conservative care is not clearly demonstrated in patients with cervical disorders. Also no additional benefit of fusion upon anterior decompression techniques could be found. A clear overview of other surg...

The purpose of this study was to systematically search the literature for studies reporting serious adverse events following lumbopelvic spinal manipulative therapy (SMT) and to describe the case details. A systematic search was conducted in PubMed including MEDLINE, EMBASE, CINAHL, and The Cochrane Library up to January 12, 2012, by an experienced...

PURPOSE: Many systematic reviews have been published on surgical interventions for low back disorders. The objective of this overview was to evaluate the available evidence from systematic reviews on the effectiveness of surgical interventions for disc herniation, spondylolisthesis, stenosis, and degenerative disc disease (DDD). An earlier version...

Objective: To determine the content, structural, and construct validity of the Dutch version of the Neck Disability Index (NDI). Study Design and Setting: To assess content validity, 11 neck pain experts and 10 patients commented on the construct, comprehen-siveness, and relevance of the NDI. Structural validity was assessed by item factor analysis...

Study Design. Systematic review of interventions.Objective. To assess the effects of spinal manipulative therapy (SMT) for acute low-back pain.Summary of Background Data. SMT is one of many therapies for the treatment of low-back pain, which is a worldwide, extensively practised intervention.Methods. Search methods. An experienced librarian searche...

OBJECTIVE: General practitioners refer patients with continued neck pain that do not respond well to conservative care frequently to secondary care for further assessment. Are surgical interventions to the cervical spine effective when compared to conservative care for patients with neck pain? DESIGN: Systematic review. METHOD: The search strategy...