• Funabashi M
• Pohlman KA
• Goldsworthy R
• Lee A
• Tibbles A
• Mior S
• Kawchuk G

• Affiliation / Canadian Memorial Chiropractic College (CMCC)
• Affiliation / Parker University
• Affiliation / Université du Québec à Trois-Rivières (UQTR). Département de chiropratique
• Affiliation / University of Alberta
• Affiliation(G) / Canada / Alberta / Edmonton
• Affiliation(G) / Canada / Ontario / Toronto
• Affiliation(G) / Canada / Quebec / Trois-Rivières
• Affiliation(G) / United States / Texas / Dallas
• Manipulation, Spinal
• Manipulation, Spinal / adverse effects
• Open Access Document
• Patient Safety
• Quality Assurance, Health Care
• Surveys and Questionnaires

Background: Approximately 50% of patients who receive spinal manipulative therapy (SMT) experience some kind of adverse event (AE), typically benign and transient in nature. Regardless of their severity, mitigating benign AEs is important to improve patient experience and quality of care. The aim of this study was to identify beliefs, perceptions and practices of chiropractors and patients regarding benign AEs post-SMT and potential strategies to mitigate them.

Methods: Clinicians and patients from two chiropractic teaching clinics were invited to respond to an 11-question survey exploring their beliefs, perceptions and practices regarding benign AEs post-SMT and strategies to mitigate them. Responses were analyzed using descriptive statistics.

Results: A total of 39 clinicians (67% response rate) and 203 patients (82.9% response rate) completed the survey. Most clinicians (97%) believed benign AEs occur, and 82% reported their own patients have experienced one. For patients, 55% reported experiencing benign AEs post-SMT, with the most common symptoms being pain/soreness, headache and stiffness. While most clinicians (61.5%) reported trying a mitigation strategy with their patients, only 21.2% of patients perceived their clinicians had tried any mitigation strategy. Clinicians perceived that patient education is most likely to mitigate benign AEs, followed by soft tissue therapy and/or icing after SMT. Patients perceived stretching was most likely to mitigate benign AEs, followed by education and/or massage.

Conclusions: This is the first study comparing beliefs, perceptions and practices from clinicians and patients regarding benign AEs post-SMT and strategies to mitigate them. This study provides an important step towards identifying the best strategies to improve patient safety and improve quality of care.

Author keywords:  Spinal manipulation — Adverse events —  Mitigation —  Survey —  Patient safety —  Quality assurance

Author affiliations: MF: Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada; MF, RG, AL, AT, SM: Canadian Memorial Chiropractic College, Toronto, Ontario, Canada; KAP: Parker University, Dallas, Texas, United States; GK: University of Alberta, Edmonton, Alberta, Canada

This abstract is reproduced with the persmission of the publisher; click on the above link for free full text. PubMed Record | PDF