Faculty Scholarship

Background: Low back pain (LBP) is influenced by interrelated biological, psychological, and social factors, however current back pain management is largely dominated by one-size fits all unimodal treatments. Team based models with multiple provider types from complementary professional disciplines is one way of integrating therapies to address patients’ needs more comprehensively.
Methods: This parallel group randomized clinical trial conducted from May 2007 to August 2010 aimed to evaluate the relative clinical effectiveness of 12 weeks of monodisciplinary chiropractic care (CC), versus multidisciplinary integrative care (IC), for adults with sub-acute and chronic LBP. The primary outcome was pain intensity and secondary outcomes were disability, improvement, medication use, quality of life, satisfaction, frequency of symptoms, missed work or reduced activities days, fear avoidance beliefs, self-efficacy, pain coping strategies and kinesiophobia measured at baseline and 4, 12, 26 and 52 weeks. Linear mixed models were used to analyze outcomes.
Results: 201 participants were enrolled. The largest reductions in pain intensity occurred at the end of treatment and were 43% for CC and 47% for IC. The primary analysis found IC to be significantly superior to CC over the 1-year period (P = 0.02). The long-term profile for pain intensity which included data from weeks 4 through 52, showed a significant advantage of 0.5 for IC over CC (95% CI 0.1 to 0.9; P = 0.02; 0 to 10 scale). The short-term profile (weeks 4 to 12) favored IC by 0.4, but was not statistically significant (95% CI − 0.02 to 0.9; P = 0.06). There was also a significant advantage over the long term for IC in some secondary measures (disability, improvement, satisfaction and low back symptom frequency), but not for others (medication use, quality of life, leg symptom frequency, fear avoidance beliefs, self- efficacy, active pain coping, and kinesiophobia). Importantly, no serious adverse events resulted from either of the interventions.
Conclusions: Participants in the IC group tended to have better outcomes than the CC group, however the magnitude of the group differences was relatively small. Given the resources required to successfully implement multidisciplinary integrative care teams, they may not be worthwhile, compared to monodisciplinary approaches like chiropractic care, for treating LBP.

This presentation traced the life of Paul von de Schoeppe, an early (1910 P.S.C.) DC, who practiced in Antigo, WI. Before taking up chiropractic, von de Schoeppe took a sanitarium management course from Bernarr McFadden at his Battle Creek institution.

von de Schoeppe opened a school, then decided to erect a building to house the school, a hotel, his office, and a sanitarium. It opened under the name Hotel Backbone in February of 1913. VDS was bankrupt by September of that year and, soon thereafter, moved to Duluth.

The hotel continued to operate under that name until 1916, when it was re-named Hotel Antigo. It operated as a hotel until the 1960s. It remains in operation as low-income housing for men.

Chiropractic clinical internships at Northwestern Health Sciences University begin early in the program’s curriculum.  It is a hands-on learning experience that enhances students’ technical and patient care skills.  How this internship program was developed was presented.