Kent Stuber

University of South Wales, Faculty of Life Science and Education, Graduate Student

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George Perry

University of Texas at San Antonio

Gillian Ray-Barruel

The University of Queensland, Australia

Tomasz Komendzinski

Nicolaus Copernicus University

Siriphan Sasat

Chulalongkorn University

Christopher Groves

Cardiff University

Vulca Fidolini

Université de Lorraine

Jim Hopkins

University College London

Thomas Völker

University of Bergen

Dian Perdana Mandasari

Universitas Airlangga

Miquel Pujol

Bellvitge Institute of Biomedical Research (IDIBELL)

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Papers by Kent Stuber

Quality of Reporting in Chiropractic Mixed Methods Research: A Methodological Review

The purpose of this methodological review is to examine the reporting quality of chiropractic mix... more

The Journal of the Canadian Chiropractic Association's 60th Anniversary Issue: Time to consider the future

The Journal of the Canadian Chiropractic Association, 2017

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Inheriting the Journal

The Journal of the Canadian Chiropractic Association, 2015

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Gender diversity in chiropractic leadership: a cross-sectional study

The Journal of the Canadian Chiropractic Association, 2021

Background The purpose of this cross-sectional study was to compare the number of males and femal... more Background The purpose of this cross-sectional study was to compare the number of males and females in leadership positions, and whether there is a relationship between gender and degrees held in those positions, within chiropractic academic institutions, national regulatory bodies and the most widely representative national professional associations in the United States and Canada. Methods Publicly accessible websites from chiropractic institutions and organizations were used to collect data. Pearson χ2 tests of independence were conducted to determine the relationship between gender (male vs. female) and other variables, including position (principal vs secondary), and chiropractic and other advanced professional degrees. Results A total of 107 leaders were identified across institutions and organizations. Under one-third of leaders (30.8%) were identified as female. Males were more likely to be in principal leadership roles (86.2%) and more likely to be in a secondary leadership ...

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The Efficacy of Instrument-Assisted Soft Tissue Mobilization for Musculoskeletal Pain: A Systematic Review

Background: Instrument-Assisted Soft-Tissue Mobilization (IASTM) is a common form of manual thera... more Background: Instrument-Assisted Soft-Tissue Mobilization (IASTM) is a common form of manual therapy involving rigid instruments of various shapes and materials to locate and treat soft tissue disorders. The therapeutic mechanism of IASTM is not clearly understood, but there is some evidence that the technique may support the breakdown and absorption of scar tissue, mobilization of fascia, and improved tissue healing. Currently, there are no systematic reviews that have specifically investigated the effects of IASTM on pain intensity of soft tissue disorders. Objective: The purpose of this study was to systematically appraise the current evidence assessing the effects of IASTM on pain intensity in the treatment of musculoskeletal conditions. Methods: A search of the literature was conducted during the Fall of 2017 which included the following electronic databases: PubMed, CINAHL, MEDLINE, PEDro, and SPORTDiscus. The search terms included individual or a combination of the following: ...

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Adverse events from spinal manipulations in the pregnant and postpartum periods: a systematic review and update

The Journal of the Canadian Chiropractic Association, 2021

Background The purpose of this study is to update a previous critical review of adverse events in... more Background The purpose of this study is to update a previous critical review of adverse events in pregnant and postpartum populations. Methods The following databases were searched: PubMed, CINAHL, Index to Chiropractic Literature, Cochrane Database of Systematic Reviews/Cochrane Central Register of Controlled Trials and MEDLINE. We included all study design types as it was determined a priori that there would not be enough high-quality research on spinal manipulative therapy (SMT) in these populations to make any determinations. The Scottish Intercollegiate Guidelines Network (SIGN) and CARE (CAse REport) checklists were used for quality rating. Results This update found one case study that demonstrated a serious adverse event in the cervical spine following SMT and a handful of minor and transient adverse events in the low back following SMT. Conclusions There was limited evidence of adverse events following SMT in these populations. Although we are calling for improved reporting ...

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An online survey of chiropractors' opinions of Continuing Education

Chiropractic & osteopathy, Jan 21, 2005

Continuing Education (CE) for chiropractors is mandatory for licensure in most North American jur... more Continuing Education (CE) for chiropractors is mandatory for licensure in most North American jurisdictions. Numerous chiropractic colleges have begun collaborating with universities to offer master's degree programs. Distance education master's degree programs may be desirable to allow full-time practicing doctors to further their post-graduate education. The present survey sought to answer three questions. First, what is the level of satisfaction of chiropractors with their continuing education? Second, what is the level of interest of chiropractors in online master's degree programs? Lastly, what is the response rate of chiropractors to an online survey? An online survey consisting of 22 multiple choice questions was e-mailed to 1000 chiropractors randomly selected from the mailing list of an online chiropractic newsletter. Upon completion of the questionnaire, participants' answers were saved on a secure site. Data analysis included evaluation of the demographic ...

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Chiropractic treatment of lumbar spinal stenosis: a review of the literature

Journal of Chiropractic Medicine, 2009

The objective of this article was to review the literature on the use of chiropractic for the tre... more The objective of this article was to review the literature on the use of chiropractic for the treatment of lumbar spinal stenosis. Methods: A literature search was conducted on 4 electronic databases (Medline, Index to Chiropractic Literature, Cumulative Index to Nursing and Allied Health Literature, and Allied and Complementary Medicine Database) for clinical research pertaining to chiropractic treatment of lumbar spinal stenosis. Retrieved articles were hand searched for relevant references. Inclusion criteria consisted of any clinical study design (including case reports) using chiropractic care on patients with lumbar spinal stenosis published in English in the past 25 years. Results: Six articles on a total of 70 patients met the inclusion criteria for the review. These articles included 4 case studies, a case series, and an observational cohort study. Treatments included spinal manipulation and, most often, flexion-distraction manipulation. Numerous other interventions including exercise, activity of daily living modifications, and various passive care modalities were selectively used in the included studies. Conclusions: There is a paucity of evidence available with respect to chiropractic treatment of spinal stenosis. The limited evidence that is available points toward chiropractic care being potentially beneficial in the treatment of patients with lumbar spinal stenosis, but further clinical investigations are necessary.

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Pseudomonas aeruginosa Quorum-Sensing Systems May Control Virulence Factor Expression in the Lungs of Patients with Cystic Fibrosis

Infection and Immunity, 2002

Individuals with cystic fibrosis (CF) are commonly colonized with Pseudomonas aeruginosa . The ch... more Individuals with cystic fibrosis (CF) are commonly colonized with Pseudomonas aeruginosa . The chronic infections caused by P. aeruginosa are punctuated by acute exacerbations of the lung disease, which lead to significant morbidity and mortality. As regulators of virulence determinants, P. aeruginosa quorum-sensing systems may be active in the chronic lung infections associated with CF. We have examined the levels of autoinducer molecules and transcript accumulation from the bacterial populations found in the lungs of patients with CF. We detected biologically active levels of N -(3-oxododecanoyl)- l -homoserine (3-oxo-C12-HSL) and N -butyryl- l -homoserine lactone (C4-HSL) in sputum from CF patients. Interestingly, it appears that C4-HSL is less frequently detected than 3-oxo-C12-HSL in the lungs of patients with CF. We also examined the transcription of the autoinducer synthase gene lasI and showed that it is frequently expressed in the lungs of patients with CF. We observed a si...

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CCA young investigator award

Clinica Chimica Acta, 1992

Response of Practicing Chiropractors during the Early Phase of the COVID-19 Pandemic: A Descriptive Report

Journal of Manipulative and Physiological Therapeutics, 2020

Objective: The coronavirus disease-2019 (COVID-19) pandemic has strained all levels of healthcare... more Objective: The coronavirus disease-2019 (COVID-19) pandemic has strained all levels of healthcare and it is not known how chiropractic practitioners have responded to this crisis. The purpose of this report is to describe responses by a sample of chiropractors during the early stages of the COVID-19 pandemic. Methods: We used a qualitative-constructivist design to understand chiropractic practice during the COVID-19 pandemic, as described by the participants. A sample of chiropractic practitioners (doctors of chiropractic, chiropractors) from various international locations were invited to participate. Each described the public health response to COVID-19 in their location and the actions that they took in their chiropractic practices from April 20 through May 4, 2020. A summary report was created from their responses and common themes were identified. Results: Eighteen chiropractic practitioners representing 17 locations and 11 countries participated. A variety of practice environments were represented in this sample, including, solo practice, mobile practice, private hospital, US Veterans Administration health care, worksite health center, and group practice. They reported that they recognized and abided by changing governmental regulations. They observed their patients experience increased stress and mental health concerns resulting from the pandemic. They adopted innovative strategies, such as telehealth, to do outreach, communicate with, and provide care for patients. They abided by national and World Health Organization recommendations and they adopted creative strategies to maintain connectivity with patients through a people-centered, integrated, and collaborative approach. Conclusion: Although the chiropractors in this sample practiced in different cities and countries, their compliance with local regulations, concern for staff and patient safety, and people-centered responses were consistent. This sample covers all 7 World Federation of Chiropractic regions (ie, African, Asian, Eastern Mediterranean, European, Latin American, North American, and Pacific) and provides insights into measures taken by chiropractors during the early stages of the COVID-19 pandemic. This information may assist the chiropractic profession as it prepares for different scenarios as new evidence about this disease evolves.

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Quality of reporting in chiropractic mixed methods research: a methodological review protocol

Chiropractic & Manual Therapies

Background Mixed methods designs are increasingly used in health care research to enrich findings... more Background Mixed methods designs are increasingly used in health care research to enrich findings. However, little is known about the frequency of use of this methodology in chiropractic research, or the quality of reporting among chiropractic studies using mixed methods. Objective To quantify the use and quality of mixed methods in chiropractic research, and explore the association of study characteristics (e.g., authorship, expertise, journal impact factor, country and year of publication) with reporting quality. Methods We will conduct a systematic search of MEDLINE, EMBASE, CINAHL, and the Index to Chiropractic Literature to identify all chiropractic mixed methods studies published from inception of each database to December 31, 2020. Articles reporting the use of both qualitative and quantitative methods, or mixed qualitative methods, will be included. Pairs of reviewers will perform article screening, data extraction, risk of bias with the Mixed Methods Appraisal Tool (MMAT), ...

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Chiropractic Care of Adults With Postpartum-Related Low Back, Pelvic Girdle, or Combination Pain: A Systematic Review

Journal of Manipulative and Physiological Therapeutics

Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review

Journal of Manipulative and Physiological Therapeutics

Assessing attitudes of patient-centred care among students in international chiropractic educational programs: a cross-sectional survey

Chiropractic & Manual Therapies

Background Patient-centred care is internationally recognized as a foundation of quality patient ... more Background Patient-centred care is internationally recognized as a foundation of quality patient care. Attitudes of students towards patient-centred care have been assessed in various health professions. However, little is known how chiropractic students’ attitudes towards patient-centred care compare to those of other health professions or whether they vary internationally, and between academic programs. Objective To assess the association of select variables on student attitude towards patient-centred care among select chiropractic programs worldwide. Methods We conducted a cross-sectional study using the Patient-Practitioner Orientation Scale (PPOS) to assess students’ patient-centred attitudes towards the doctor-patient relationship. Eighteen items were scored on a 1 to 6 Likert scale; higher scores indicating more patient-centredness. All students from seven chiropractic educational programs worldwide were invited to complete an online survey. Results were analyzed descriptivel...

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Obstetrician's Attitudes Towards Chiropractic Questionnaire

PsycTESTS Dataset, 2016

Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review

BMC Complementary and Alternative Medicine, 2016

Background: Evidence-based practice (EBP) gaps are widespread across health disciplines. Understa... more Background: Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. Methods: A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Results: Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Conclusion: Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for chiropractors to routinely apply evidence into clinical practice. Educational strategies aimed at practicing chiropractors can lead to more EBP and improved patient care. The chiropractic profession requires more robust dissemination and implementation research to improve guideline adherence and patient health outcomes.

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Psoas Major: a case report and review of its anatomy, biomechanics, and clinical implications

Jcca Journal of the Canadian Chiropractic Association Journal De L Association Chiropratique Canadienne, Dec 1, 2009

A 25-year-old male professional hockey player with right sided hip pain was diagnosed with myofas... more A 25-year-old male professional hockey player with right sided hip pain was diagnosed with myofascopathy of the right psoas major and rectus femoris. The patient maintained a conservative treatment regimen and was prescribed a four week active strengthening program. The program progressed from resisted concentric exercise to eccentric abduction/adduction exercises along with balance training, core stabilizing and endurance exercises in the first two weeks. In the final two weeks the program progressed to include sport specific exercises. At three weeks the patient was able to participate in non-contact practice and was clear for full contact at five weeks. The anatomy, biomechanics, and function of the psoas major muscle are discussed as is its influence on lumbar spine stability. Evidence-based evaluation and management strategies for psoas dysfunction are presented.

Assessing patient-centered care in patients with chronic health conditions attending chiropractic practice: protocol for a mixed-methods study

Chiropractic & manual therapies, 2016

The management of chronic health conditions increasingly requires an organized, coordinated, and ... more The management of chronic health conditions increasingly requires an organized, coordinated, and patient-centered approach to care. The Chronic Care Model (CCM) has been adopted in primary care to improve care delivery for those with chronic health conditions. Chiropractors manage chronic health conditions; however, little is known if such care is patient-centered. The primary aim of this study is to determine to what extent chiropractic patients with chronic health conditions perceive their care is patient-centred. We will assess concordance with the CCM using the Patient Assessment of Chronic Illness Care (PACIC) survey in study patients. We will also explore perception of how patient-centered the care provided by chiropractors is for those with chronic health conditions according to patients and chiropractors. We will use a sequential mixed methods design with quantitative priority. In the quantitative component patients will complete a written questionnaire providing sociodemogr...

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