Association of Chiropractic Colleges Educational Conference and Research Agenda Conference 2025: Transformative Trends in Healthcare

The Association of Chiropractic Colleges Education and Research Agenda Conference (ACCRAC) addresses the needs of the chiropractic academic and research community by providing an outlet for educational, scholarly, and research-related dialogue. This meeting offers educators and researchers the opportunity to present new findings from the educational, clinical, and basic science domains.

This conference was convened by the Association of Chiropractic Colleges in New Orleans, Louisiana, March 20–22, 2025. The theme for this ACCRAC program was Transformative Trends in Healthcare. The purpose of this proceedings document is to publish the names of the Peer Review Committee members and all platform and poster abstracts presented at the 2025 ACCRAC.

For the 2025 conference, the call for peer reviewers was widely distributed in July 2024. The 124 peer review committee members submitted their ratings and formative comments on time. The ACC commends the peer review committee members and the peer review committee chair for their excellent scholarly work and steadfast professional service.

The ACC thanks all participants for their hard work, perseverance, and dedication to advancing education and research for the chiropractic profession. Following are the volunteers who provided peer review services for the 2025 ACCRAC, listed alphabetically by last name:

Andrea Albertson, Whitney Amos McNary, Brian Anderson, Ilija Arar, Kira Baca, Tyler Barton, Jessica Billham, Charles Blum, Gina Bonavito-Larragoite, Patrick Boylan, Renee Broughten, Kathryn Brown, Paul Bruno, Casey Buns, Kara Burnham, Robert Butler, Marni Capes, Matthew Carinci, Beth Carleo, Joel Carmichael, Cynthia Chapman, John Cho, Zachary Cupler, Loik de Tienda, Irina Dedova, Kaitlin Dick, Callyn Dittmar, Scott Dunham, Brennan Dynes, Jonathan Emlet, Roger Engel, Amberly Ferguson, Leslie Fuller, Matthew Gajkowski, Geoff Gelley, Brian Gleberzon, Jordan Gliedt, Christopher Good, Lindsay Gorrell, Whitney Graff, Brett Guist, Billie Harrington, Shawn Hatch, Navine Haworth, Shawn He, Charmaine Herman, Kathryn Hoiriis, Dana Hollandsworth, Karmen Hopkins, Ronald Hosek, Marius Hossu, Adrian Hunnisett, Fiona Jarrett-Thelwell, Edward Johnnie, Theodore Johnson, Amanda Jones-Harris, Jane Joyce, Sarah Kelly, Stuart Kinsinger, Suzanne Lady, Misty Lagasse, Alexander Lee, Joy Lewis, Craig Little, Ashley Long, Christine Major, Barbara Mansholt, Aurelie Marchand, Alexander Margrave, Emile Marineau, Heather Meeks, Hiwot Melka, Kevin Meyer, Meredith Meyers, Michael Moore, Vanessa Morales, Ryan Muller, Lia Nightingale, Laura O’Connor, Anjum Odhwani, James Oldham, Brittni Partridge, Steven Passmore, Kevin Percuoco, Kristina Petrocco-Napuli, Katherine Pohlman, Morgan Price, Mohsen Rapasand, Muhamad Faizzuddin Razali, Katherine Reckelhoff, Anthony Rosner, Robert Rowell, Brent Russell, Nathan Schilaty, Gary Schultz, Samuel Schut, Margaret Sels, Mayda Serrano, Christine Silverman, Dana Sims, Monica Smith, Christopher Smoley, Timothy Stecher, John Stites, Kent Stuber, Stephanie Sullivan, Gary Tam, Aaron Teitelbaum, Lauren Tollefson, Lauren Tollefson, Elissa Twist, Desiree Varatharajullu, Robert Vining, Amanda Vozar, Amanda Vozar, Breanne Wells, Adrian Wenban, Bret White, Michael Wiles, Cortny Williams, Yi Kai Wong, Shari Wynd, Niu Zhang, Nicole Zipay. Peer Review Chair: Claire Johnson. Journal of Chiropractic Education Editor-in-Chief: Bart Green.

The results of the peer review process are the accepted abstract presentations. Below, the accepted abstracts are listed in platform and poster presentation categories. In each category, the abstracts are listed in alphabetical order by the first author’s last name.

Objective: Federally Qualified Health Centers (FQHCs) provide affordable healthcare to underserved populations. This study describes the professional qualities, skills, and experience of chiropractors (DCs) working in FQHCs. Methods: FQHC-employed DCs were surveyed about their practice, with a subset participating in qualitative interviews about their experience. FQHC administrators and colleagues were interviewed about the skills DCs need to work effectively in FQHCs. Survey analysis utilized descriptive statistics and content analysis, while interviews used thematic analysis. Results: Out of 206 DCs invited, 101 responded (49.0%). Their average years in practice was 18.2 (range: 1–48), and 44% participate in Public Services Loan Forgiveness. Some DCs reported prior multidisciplinary experience (47.4%) and additional training through certificates (43.0%) and advanced degrees (28.1%). Interviews involved 12 DCs, 10 administrators, and 7 colleagues. Prioritized qualities in DCs included strong communication, collaborative, and interpersonal skills. DCs valued providing chiropractic access to underserved communities and focusing on patient care over business practices. Many (41.8%) use a non-English language with FQHC patients, predominantly Spanish (80.5%). DCs frequently perform joint manipulation and soft tissue therapies for spinal and chronic pain. Conclusions: This study offers insights into the qualities, skills, and experiences of DCs working in FQHCs. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Although there is growing literature on the safety and effectiveness of chiropractic care for older adults, specific information about those from medically underserved communities is limited. This study describes the characteristics, clinical management, and patient-reported outcomes of older adults with spinal pain who present for chiropractic care at a publicly funded community health center serving marginalized populations. Methods: This retrospective analysis utilized quality assurance data from chiropractic encounters at Mount Carmel Clinic between January 2011 and June 2020 of adults aged 45 and older. Descriptive statistics summarized the study population and their self-reported pain severity scores. Student t tests and repeated-measures analysis of variance explored relationships between pain outcomes, age, and clinical characteristics. Results: The sample included 240 middle-age (45–59 years) and older adults (>60 years) who recorded baseline and discharge pain scores after chiropractic treatment. Over half of middle-aged participants self-identified as indigenous or disabled. Statistical and clinically important improvements in pain were noted across spinal regions and extremities for both age cohorts. Participants overwhelmingly indicated the chiropractic visit prevented additional primary care visits. Conclusion: Adults (45+ years) from medically underserved communities experienced significant benefits from chiropractic care in managing spinal and extremity pain. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To examine the safety attitudes of chiropractors in the care of pregnant women. Methods: As part of the characterization of chiropractic pregnancy care, respondents were asked about their safety attitude (0 = not very safe; 10 = very safe) on the use/application of a number of chiropractic techniques and their professional opinion (i.e., absolute vs relative contraindication to care) to a number of morbidities associated with pregnancy. Results: Respondents were comprised of 247 chiropractors (i.e., 196 females; 51 males; average age of 39.02 years). Pregnancy care was assessed as very safe (i.e., mean score = 9.91). The Webster Technique and manually assisted instruments were rated as the safest (i.e., mean = 9.9/10) while manual spinal manipulative therapy (SMT) were rated lowest (mean score = 8.7/10). The majority of chiropractors indicated as performing a clinical work-up, provide SMT care and refer to a specialist for a majority of the comorbidities. Spotting, premature labor, appendicitis, ectopic pregnancy, ruptured membrane, and placenta abruptio were indicated as an absolute contraindication to care and necessitated immediate referral. Conclusion: Overall, chiropractors are of the opinion that chiropractic is safe for pregnant women with certain comorbidities requiring immediate referral to a medical specialist. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To establish a needs assessment of the research capacity and culture (RCC) of 1 chiropractic academic institution. Methods: An electronic survey of chiropractic college faculty was conducted across 3 campuses. RCC instrument domains were categorized into low, moderate, or high scores. Adjusted differences in median scores across RCC domains were analyzed using linear regression. Results: 95 respondents completed the RCC. Median scores were moderate (4) for Individual (personal research skills) category, while Department (team level success) and Organization (institutional resources/initiatives) were both low (2, 3 respectively); the latter two categories also included more “unknown” responses. Individual category adjusted scores were highest for professors (reference group), subjects aged 35–49 (reference group) and those with academic doctorates (0.46, 95% CI: 0.07, 0.85). Predictors of higher scores in the department category included: associate professor (0.40: 0.00, 0.81); branch campus 1 faculty (0.72: 0.53, 0.98); research role (1.07: 0.41, 1.73); and doctor of chiropractic (0.57: 0.03, 1.11). Professors (reference group) and main campus faculty (reference group) scored highest in the organization category. Conclusion: Understanding key variables of research culture and capacity for individuals, departments, and organizations is paramount to the advancement of chiropractic education and practice. Findings from this study inform this vital imperative. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The purpose of this study was to determine if AI-generated discussion posts within an online chiropractic course offering satisfy criteria for submission. A secondary purpose was to determine if faculty can identify AI-generated work. Methods: A sample of 11 faculty volunteers evaluated 10 anonymized discussion posts using a rubric. Nine submissions were authored by third trimester Doctor of Chiropractic students enrolled in an ethics course and one was generated in ChatGPT 3.5 using identical instructions given to students. Faculty were made aware that one of the discussion posts was generated using AI and were prompted to indicate which of the 10 discussion posts was generated using AI. Faculty were given the opportunity to provide open-ended feedback. Results: The AI-generated submission scored highest among randomly sampled discussion posts. A total of 45% of faculty were able to correctly identify the submission as being AI-generated. Fleiss’ Kappa was calculated. There was slight agreement between raters with κ = 0.11, p = .009. Conclusion: ChatGPT can generate output satisfying or exceeding requirements for discussion posts in a chiropractic context. Some faculty can identify AI-generated content. Output is sufficiently nuanced to evade detection by most faculty. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To identify chiropractic college faculty perceptions and determinates of work–life balance (WLB). Methods: Data from electronic surveys and qualitative interviews with chiropractic college faculty/administrators were analyzed. We utilized frequency, correlation, and backward multivariate regression on SPSS, using hours worked against demographics. Qualitative content analysis identified WLB themes. Results: Sample characteristics were primarily age 35–49 years, partnered, employed <10 years, and worked 35–50 hours/week. Many participants consider WLB a barrier to scholarship (48%). Longer weekly hours worked were reported by younger (r[88] = −0.222, p < .05) and more recently employed faculty (r[88] = −0.192, p < .05). Age and caregiving status (Model 4: adjusted R2 = 0.06, FΔ = 0.353, p = .026) weakly predicted total hours worked, with age predicting total hours worked (ß = −0.251, t = −2.410, p < .05). Positive WLB was defined in interviews as working less to focus on personal life. Poor WLB most commonly included work time constraints, divided attention (work/home life), and encroachment on personal time, but also burnout, using overage to pay bills, and overworking to complete primary work-role activity and scholarship. Conclusion: Hours worked per week and perceived time constraints may negatively impact WLB, especially in younger/newer hires and noncaregivers who work long hours. Chiropractic colleges might adopt employment interventions to address hours worked to prevent early career burnout, especially among newer hires. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Raise awareness of subtle/atypical red flags for vertebral artery tears that may present to a chiropractic office. Clinical Features: The patient presented with acute neck pain 4 days after falling while waterskiing. Pain extended from the suboccipitals to the cervicothoracic junction, with visual disturbances described as “fans” in their periphery, bilaterally. There were no red flags, palliative or provocative factors. Orthopedic and neurological examination was unremarkable except for the inability to reproduce the symptoms, and guarded range of motion. Intervention/Outcome: Initial chiropractic treatment consisted of manual soft tissue massage of the upper trapezius, kinesiotape, and referral for medical evaluation. Four days later, the patient went to the emergency department, where a computed tomography (CT) scan was performed and identified a tear in the vertebral artery at C3/C4 on the left and C4/C5 on the right. Anticoagulants were administered and referral to a specialty clinic, where they reperformed the CT scan and prescribed Plavix for 6 months and aspirin for life. Conclusion: Not all cases will present as a classic stroke, which emphasizes the importance of history, physical examinations, abstention from spinal manipulation, and referral to an appropriate provider for management, which mitigates risk for all providers. (This is a conference presentation abstract and not a full work that has been published.)

Objective: There has been myriad research on academic performance and how it correlates with standardized test success across various disciplines. Numerous sources have found a statistically significant positive correlation between grade point average (GPA) and therefore classroom achievement, and performance on National Board of Chiropractic Examiners (NBCE) exam domains among students in chiropractic programs. Although research on academic performance and performance on Part I of NBCE exams is plentiful, there is a lack of research on Part II. As it currently stands, two of the four parts of the NBCE exams include domains related to diagnostic imaging: Parts II and III. This study focuses on the Part II NBCE examinations, in particular, the diagnostic imaging modalities (DIM) domain. In this retrospective analysis of a cohort of chiropractic students enrolled at Northeast College of Health Sciences (n = 172), a statistically strong positive correlation (r = 0.70, ρ = 0.71, p = <.001) was discovered between academic performance in a diagnostic imaging course, RAD6504 Bone and Joint imaging, and success on the DIM domain of Part II NBCE exams. This information adds to the body of literature regarding standardized test and academic performance and can aid in course planning and curriculum development. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To evaluate the factors considered by Veterans Health Administration (VHA) chiropractors that inform the frequency and duration of an initial trial of care for low back pain (LBP) patients. Methods: An electronic survey distributed to all 384 VHA chiropractors. Data on clinical decision-making, optimal trial visit scheduling, and perceived facilitators/barriers were analyzed with descriptive statistics. Results: We received 181 (64%) complete responses. The mean reported ideal trial duration was 5.7 weeks (95% CI [5.4, 6.0]), with 6.4 visits (95% CI [6.1, 6.7]) per trial. Optimal scheduling was reported as achievable in 42.5% of cases. Factors increasing trial duration and visit frequency included higher pain intensity, positive prior treatment responses, and comorbid anxiety, depression, or rheumatological conditions. Factors decreasing trial duration and frequency included significant symptom reduction after initial visits and less severe examination findings. Rural clinics reported more barriers to achieving ideal trial parameters than suburban/urban clinics. Conclusion: Key factors influence VHA chiropractors’ selection of initial trial visit frequency/duration, though optimal trial delivery is reported to occur in less than half of cases. More work is needed to explore clinical, organizational, and geographical barriers to care. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe the clinical presentation of a patient with neurosarcoidosis (NS) causing dysautonomia. Clinical Features: A 49-year-old male presented with diffuse spinal pain to a chiropractor in 2024. His medical history included systemic sarcoidosis diagnosed in 2013. Beginning in 2020, the patient experienced daily episodes of syncope and collapse diagnosed as transient ischemic attacks due to negative stroke imaging in the emergency department. These episodes persisted through 2024 and were exacerbated by postural changes. These episodes were accompanied by other chronic symptoms including fatigue, diarrhea, nausea, and vomiting. Interventions and Outcomes: The patient scored 51 on the COMPASS-31 autonomic dysfunction questionnaire. The patient was referred to cardiology for tilt table testing and was diagnosed with postural orthostatic tachycardia syndrome. Further referral and evaluation by a neurologist led to the diagnosis of dysautonomia hypothesized to be caused by NS involving the vagus nerve. Co-management involved a combination of medication and exercise-based rehabilitation. Conclusion: Neurosarcoidosis and dysautonomia are uncommon manifestations of systemic sarcoidosis. This case highlights the diagnostic challenges and the importance of screening for dysautonomia in NS patients. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Spinal manipulative therapy (SMT) may positively impact balance, but its association with fall risk remains unclear. We hypothesized that older adults receiving chiropractic SMT for spinal pain would have a lower fall risk over 13 months compared to matched controls. Methods: We searched over 116 million de-identified patient records from TriNetX, Inc. (2013–2023) to identify adults ≥65 years with spinal pain. After excluding individuals with major fall risk factors, SMT and non-SMT cohorts were formed, and propensity score matched. Risk ratios (RR) with 95% confidence intervals (CI) and p values were calculated for primary (falls) and secondary (limb fractures) outcomes. Negative control outcomes were explored (i.e., colonoscopy, vital signs, diabetes, nicotine/tobacco screening). Results: Each matched cohort contained 1666 patients (mean age: 72). The SMT cohort exhibited a lower fall incidence than the non-SMT cohort (3.8% vs 5.4%), with a RR [95% CI] of 0.71 ([0.52, 0.97]; p = .0319). No significant difference was observed in limb fractures (1.16 [0.87, 1.54]; p = .3153). Negative control outcomes were similar between cohorts. Conclusion: Older adults undergoing SMT for spinal pain had reduced risk of falls. However, due to limitations in exploring fall-related injuries and similar limb fracture risk, the clinical significance remains uncertain. (This is a conference presentation abstract and not a full work that has been published.)

Objective. To assess prevalence, intensity and source of stress in chiropractic students and compare full-time (FT) and full-time equivalent (FTE) students. Method: After ethical approval, a cross-sectional study was undertaken. A previously validated survey instrument was distributed to all student groups at the end of a lecture session at 2 separate campuses of a UK chiropractic college. The study instruments were constructed as a sociodemographic questionnaire coupled with the perceived stress scale. Sample size was calculated as 180 respondents. Completed questionnaires were analysed descriptively. Results: A total of 205 responses were received, mixed across FT and FTE pathways in both campuses. Across both campuses, the FT and FTE students found their well-being to be negatively affected as they progressed through the course, with final-year FTE students (Yr5) being the most stressed. The least stressed groups were FTE Yr3 and FT Yr2 students, prior to commencing the major clinical modules. Sources of stress tended to be a mixture of workload and financial stressors. Conclusion: The final year of chiropractic students were found to be the most stressed. The findings enabled the college to redesign strategies to provide more support to this group of students. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To investigate the effects of chiropractic and sports massage on athletes. Methods: After ethical approval, a mixed-methods trial was undertaken on 73 athletes across several sports disciplines. Participants were randomized into 3 groups, chiropractic, sports massage or “care as usual” (rest & physiotherapy); and were followed weekly over a 12-week period for quantitative physiological (range of motion, muscle strength, and pain assessment) and performance measurements (sprint times, jump height, and endurance tests). A subset of the group was randomly chosen to participate in qualitative focus groups to investigate personal perspectives and experiences of the therapies. Results: Using Kruskal-Wallis testing, quantitative improvements were shown in all physiological measures across the chiropractic and massage groups compared with the control group (p = .025 and p = .041, and p = .02 and p = .038, respectively). The chiropractic group showed better outcomes compared with the massage groups (p = .033). Qualitatively, both chiropractic and massage groups reported improved benefits across recovery times, perceived performance, and psychological benefits. Conclusion: Quantitative and qualitative results demonstrate that chiropractic care and sports massage significantly enhance athletic performance, recovery, and psychological well-being. Both modalities are perceived positively. Further research is needed to assess effects in individual sports disciplines. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This report describes the framework, design, implementation, and assessment of a Year IV clinical internship program to meet the CCE 2025 Meta-Competency 6. Methods: During the 2024–2025 academic year, faculty met to develop a new, focused cultural competency program to meet the needs of patients, learners, and accreditors. Based on the Culturally Connected framework, interns participated in 3 one-hour learning activities exploring their own cultures through the Hofstede model, understanding relationships between cultural safety and health literacy, and considering practical strategies for creating culturally safe environments, including the use of interpretive services. Interns, in small groups, then participated in a workshop reviewing a culturally unsafe clinical interaction video and engaged in a facilitated discussion. Pre- and post-workshop program evaluation satisfaction surveys were administered and analyzed. Two follow-up Gibbs format self-reflective exercises linked to authentic clinical experiences allowed a deeper exploration of intern experiences. Results: Intern participation rates were high and outcomes revealed a high satisfaction score of 9.29/10. Conclusion: We successfully implemented a cultural competency program that addressed, in part, the 2025 CCE Meta-Competency 6. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe a patient with aromatase inhibitor-induced bilateral carpal tunnel syndrome (CTS) who experienced durable relief of pain and paresthesia through chiropractic management. Clinical Features: A 42-year-old female veteran developed pain and paresthesia consistent with bilateral CTS after initiation of aromatase inhibitor medication as part of her breast cancer treatment. CTS was confirmed with electromyography/nerve conduction study. Conservative treatment of physical therapy and splinting yielded minimal benefit, with surgery recommended if physical therapy failed. The patient was referred to the Veterans Affairs chiropractic clinic by primary care. Initial evaluation revealed constant paresthesia in the bilateral median nerve distribution with aching into the forearms; severity of numeric pain rating scale: 6–8/10; positive Tinel’s sign, Phalen’s, and Reverse Phalen’s bilaterally. Intervention/Outcome: For 6 visits over 6 weeks, the patient received manual myofascial release and chiropractic manipulation to the hands, wrists, and elbows, combined with a home exercise program of stretching, strengthening, and self-myofascial release. By visit 6 she reported 85% reduction in symptoms, allowing her to perform her desk job comfortably. Conclusion: This case suggests that a multifaceted chiropractic care plan may offer significant symptom relief for patients with aromatase inhibitor-induced bilateral CTS, avoiding surgical intervention and changes in pharmaceutical regimen. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To determine the motivators and barriers to research and scholarship experienced by faculty and administrators at a chiropractic college. The RAISE committee developed and administered an electronic survey to assess the views of research and scholarship among faculty and administrators at 3 chiropractic campuses. Data were collected via SurveyMonkey and analyzed using SPSS software to determine key motivators and barriers to research. A total of 110 respondents completed the survey. Associate and assistant professors selected the following motivators and barriers at greater frequencies than instructors or professors. Career advancement (65.5%), developing skills (50%), increased credibility (41.8%), mental stimulation (40.9%), or job satisfaction (35.5%) were the top motivators to participate in research. The main barriers were lack of time (70.9%), other work-role priorities (58.2%), desire for work–life balance (47.3%), lack of skills (40.9%), and insufficient faculty coverage to allow dedicated time for research (38.2%). The most common open-ended responses for scholarship motivators were professional growth, compensation, and enjoyment of research. Lack of skills, direction, and mentorship were the most mentioned open-ended responses for barriers to research participation. To support chiropractic faculty scholarship, institutional resources such as training, mentorship, and dedicated time for research and scholarship are needed. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Using functional magnetic resonance imaging (fMRI), dysfunctional large-scale intrinsic brain networks (salience, default mode, frontoparietal) may display abnormal connectivity between sensory inputs, cognitive processing, and behavioral outputs, resulting in chronic pain. Spinal manipulation has been shown to modulate the salience network in chronic low back pain. We hypothesize these functional resting state networks, particularly the salience network, modulates the experience of chronic pain. Methods: Databases were searched in August 2024. They included PubMed, EBSCOhost, Google Scholar, and CINAHL Complete using search terms: salience network, resting-state network, fMRI, chronic pain, functional connectivity, and neuromodulation for inclusion in final synthesis. Duplicates, nonfull texts, and articles not regarding the search terms were excluded. Results: 16 papers out of 41 were identified referencing the altered functional connectivity of the salience network and an altered likelihood of chronic pain. Conclusion: Synthesis of this narrative review supports resting-state intrinsic brain network activity, such as the salience network, is altered when perceiving chronic pain. Identification of these networks will facilitate individualized treatments using neuromodulation in chronic pain. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This study rigorously examines the alignment between the National Board of Chiropractic Examiners (NBCE) prelicensure exams and the Council on Chiropractic Education (CCE) meta-competencies through a qualitative analytic approach. Employing thematic analysis, the research utilizes a detailed coding framework based on the CCE meta-competencies to methodically evaluate the coherence between exam content and the essential skills and knowledge required for effective chiropractic practice. The research involved a 2-phase methodology: the first phase focused on the alignment of the NBCE exams with CCE Meta-competencies, while the second phase involved a comprehensive document analysis of chiropractic college curricula to confirm curricular alignment with the NBCE exam content and CCE competencies. Results reveal a substantial alignment, indicating that the NBCE exams thoroughly assess critical competencies such as clinical reasoning, diagnostic evaluation, patient management, professionalism, and interprofessional collaboration. The findings demonstrate that the NBCE exams are adept at evaluating critical thinking, clinical reasoning, and practical skills, thus ensuring that chiropractic students are well-prepared to meet the complex demands of real-world clinical practice. The study emphasizes the necessity for ongoing assessment and refinement of both chiropractic curricula and prelicensure exams to ensure they remain relevant and effective. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Peer mentoring has emerged as a valuable tool for advancing professional skills in healthcare education. At our institution, the chiropractic program has integrated force-sensing technology to enhance manual therapy techniques. Building on this, the CHIRO-Force Peer-Assisted Learning (PAL) program was launched to improve practical skills through student collaboration. This paper introduces the CHIRO-Force PAL program and presents findings from its inaugural year. Methods: The program was structured and evaluated using the framework by Balilah et al on PAL educational programs. After obtaining pilot funding, 2 fourth-year students were recruited and trained during summer 2023. The mentors developed 5 mentoring protocols, a scheduling system, and an online feedback survey. The program commenced in September 2023, initially focusing on fifth-year students and expanding to include first-year students by December. Results: Mentors provided an average of 5 hours of mentoring weekly. Over 8 months, more than 100 sessions were conducted with over 70 students, including group sessions during clinical internships. Feedback was overwhelmingly positive, with 97% of sessions rated “highly appreciated.” Conclusion: Due to its success, the program has secured annual funding, and 3 new mentors were recruited and trained in spring 2024 to sustain its impact. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Investigate demographics, professional traits, and practice habits among chiropractors employed by a large private integrated healthcare system. Methods: An institutional review board approved cross-sectional survey with questions on demographics, professional traits, and practice habits was sent via REDCap to chiropractors within our institution between April and July 2024. Data was de-identified and analyzed using descriptive statistics. Results: Surveys were distributed to 23 chiropractors and 17 responded (74%). Respondents were primarily white (94%), male (82%), and had greater than 10 years of clinical experience (82%) with no prior hospital-based training (82%). During patient examinations range of motion, palpation, and posture assessment were frequently utilized. Commonly utilized treatment modalities included diversified manipulation, flexion–distraction, and manual myofascial techniques. Patient education on exercise, lifestyle modification, and pain neuroscience were regularly practiced. New patient consults largely originated from primary care and pain management departments. Most referrals out of chiropractic clinics were sent to pain management, orthopedic surgery, and neurosurgery departments. Conclusion: Most chiropractors within this system currently are white males with guideline consistent practice habits that deliver co-managed care with other disciplines. Results were similar to data published by the US Veterans Health Administration except for having less prior hospital-based training. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Explore ethical congruity between educational curricula, licensing examinations, and regulatory discipline for professional misconduct. Methods: Disciplinary reports for 4 licensing entities (Physical Therapy and Chiropractic in Ontario and New Jersey) were examined. Between 2018 and 2023 the Ontario Colleges of Chiropractors reported 43 discipline cases, and physiotherapists 51; the New Jersey Board of Chiropractic Examiners, 47 and the NJ board of Physical Therapists 22, totaling 163. Practitioner misconduct was categorized as either clinical (direct patient care) or nonclinical, i.e., ethical violations. An analysis of the amount of nonclinical professional values content on respective licensing exams demonstrated an inverse relationship to regulatory complaints and discipline. Results: Between 2018 and 2023, 24 out of 163 (14.8%) constituted practitioner misconduct reflecting lapses in clinical judgment and patient care incompetence. 85.2% of practitioner misconduct resulting in discipline were lapses in professional behaviors including insurance fraud, boundary violations, misrepresentation, and other ethical infractions. Current regulatory discipline contrasts sharply with educational curricula that emphasize knowledge and clinical skills. Licensing examinations offer few questions on ethics and professionalism. Conclusions: We note significant incongruity between the educational support for clinical decision-making compared with professional decision-making and behaviors. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This study aims to describe the development of the accredited Aurora Healthcare Integrated Clinical Practice Chiropractic Residency Program, focusing on its structure, curriculum, and implementation challenges. Methods: A descriptive research design was used, involving qualitative analysis of program documents, including planning reports and accreditation reviews. Interviews with key stakeholders—program developers, faculty, and initial residents—were conducted to gather insights. The data were thematically analyzed to identify major development phases and challenges. Results: The Aurora Chiropractic Residency Program’s development included several phases: conceptualization, curriculum design, accreditation, and implementation. Achievements involved integrating evidence-based practices, establishing clinical training sites, and navigating the accreditation process. Challenges such as securing funding, aligning with accreditation standards, and recruiting faculty were addressed through strategic planning and stakeholder engagement. Conclusion: The Aurora Integrated Clinical Practice Chiropractic Residency Program has effectively developed an accredited chiropractic residency program within a large private-sector, integrated healthcare delivery system. Its structured approach and adaptive strategies offer a model for similar programs. The study provides valuable lessons on planning, stakeholder involvement, and overcoming developmental challenges, offering guidance for institutions aiming to establish or improve residency programs. (This is a conference presentation abstract and not a full work that has been published.)

Objectives: Musculoskeletal (MSK) conditions are the leading cause of disability. Predictions indicate a significant shortfall of family physicians while up to 40% of visits are for MSK conditions. A proposed strategy is to maximize use of nonphysicians with MSK expertise by integrating them into funded primary care. (1) Develop, deliver, and evaluate synchronous education to primary care teams and their readiness to integrate a MSK provider (chiropractor). (2) Deliver and evaluate asynchronous education for primary care providers on MSK health. Methods: Mixed-methods observational design with pre- and post-intervention evaluations. Educational modules were delivered to primary care teams (synchronously) and primary care providers in Canada (asynchronously). Participation included questionnaire completion and focus group or key informant interviews. Research Ethics Board approval from 5 academic institutions. Results: 33 interdisciplinary members from 5 teams participated in the synchronous phase. A total of 361 healthcare professionals completed the asynchronous modules. Synchronous education improved team knowledge on team-based care, collaborative competency, and assisted in readiness to integrate the chiropractor. Asynchronous results indicated a high rating of collaborative competency. Conclusion: The educational programs enhanced team knowledge about optimizing team-based care and competencies to collaborate and facilitated readiness to integrate chiropractors onto teams. (This is a conference presentation abstract and not a full work that has been published.)

Objectives: Musculoskeletal (MSK) conditions are the leading cause of disability in Canada. Predictions indicate a significant shortfall of family physicians (FP) while up to 40% of FP visits are for MSK conditions. A proposed strategy is to maximize use of nonphysicians with MSK expertise by integrating them into funded primary care. Objectives included: (1) Integrating chiropractors as expert MSK care providers onto primary care teams. (2) Evaluating the knowledge, attitudes, and experience of the teams during the integration process. Methods: Pre-/post-mixed methods observational design. Teams were educated about team-based care, collaborative competency and the need for economic barrier-free MSK care. Chiropractors were integrated into 3 teams and enhanced on 1 team with a pre-existing chiropractor. REB approval from 5 academic institutions. Results: In all settings chiropractors were successfully integrated. Teams employed unique approaches to integration. Success was described by team members and seen by demand for (team referrals) and high use of the services by patients. Conclusion: The results of this study indicate that provision of MSK care without economic barrier is desirable and highly utilized by teams and that chiropractors are well suited to participate on funded primary care teams in Canada. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Evaluate long-term care escalation encounters for Medicare beneficiaries with new episodes of neck pain measuring three care patterns. Methods: Medicare claims from 2019 to 2023 were analyzed for beneficiaries aged 65–99 enrolled in parts A, B, and D with new episodes of neck pain. We calculated the cumulative frequency and propensity-weighted rate ratios of escalated care encounters across three distinct, index-visit related neck pain treatment cohorts: (1) spinal manipulative therapy (SMT); (2) primary care without prescription analgesics within 7 days; (3) primary care with prescription analgesics within 7 days. Results: SMT was linked to a 64% lower rate of care escalation compared to primary care without analgesics (RR: 0.36, 95% CI: 0.35–0.37). Conversely, primary care with analgesics showed an 8% higher escalation rate (RR: 1.08; 95% CI: 1.05–1.10). Conclusion: Initial treatment with spinal manipulative therapy significantly reduced long-term care escalation in Medicare beneficiaries with new neck pain. Our study contributes to a growing body of evidence supporting the integration of nonpharmacological care strategies for neck pain management. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This research examined the association between the Learning and Study Strategies Inventory (LASSI) scores of chiropractic students and their academic performance, as measured by their gross anatomy lecture and lab final exam grades, term GPA, and their General Anatomy and Spinal Anatomy domain scores from Part I of the National Board of Chiropractic Examiners (NBCE). Methods: 113 first-year chiropractic students enrolled in one of three gross anatomy courses completed the LASSI survey and consented to collection of their academic performance data. Pearson product-moment correlation analyses and multiple regression models were performed. Results: The LASSI scale score for Test Strategies was found to have a statistically significant (p < .05) moderate correlation with gross anatomy lab (r = .45) and lecture (r = .44) exam grades, as well as term GPA (r = .64). Additionally, Test Strategies, gross anatomy lab, and lecture final exam grades and term GPA were all moderately correlated with NBCE General Anatomy and Spinal Anatomy scores. Conclusion: Chiropractic educators may consider using students’ LASSI scores, especially the scale Test Strategies, as an indicator for their student’s academic performance, notably gross anatomy grades, term GPA, and related domains of NBCE Part I. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Federally Qualified Health Centers (FQHCs) offer a unique opportunity for Doctors of Chiropractic (DCs) to provide care to medically underserved communities. This study explored factors motivating chiropractic employment and service lines within FQHCs. Methods: Semistructured qualitative interviews were conducted virtually with FQHC-employed DCs and their administrators. Interviews were transcribed and thematic analysis was performed. Results: Interviews were conducted with 12 DCs and 10 administrators, including chief executive officers, medical directors, and development officers. DCs frequently cited relationships with FQHC administrators or colleagues for initiating employment. Many were driven by the desire to provide chiropractic care to underserved communities, with some viewing it as a way to “give back” due to personal experiences with poverty or FQHCs. Other motivating factors included working in a multidisciplinary environment, focusing on patient care rather than business, and expanding integrative care experience. Both DCs and administrators emphasized the need for “in-house” nonpharmacological treatment options to prevent opioid use, with administrators highlighting high patient demand and the need for increased access, particularly for chronic pain patients. Conclusions: Employment in FQHCs offers DCs a unique career path while supporting FQHCs in delivering essential nonopioid pain management to underserved communities. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To report on the implementation and use of a focused-visit ongoing chronic pain management chiropractic clinic for Veterans Health Administration (VA) patients. Methods: We created a weekly 4-hour clinic session for one VA chiropractor with shortened (15- vs the standard 30-minute) followup visits for patients receiving ongoing chiropractic pain management, at the discretion of the treating chiropractor. We analyzed the initial year of clinic use and provider productivity data compared with the previous year. Results: In the project year (7/12/23–7/11/24) we deleted 393 routine followup and 13 (60-minute) consult slots to add 797 chronic followup slots, of which 600 were used. Concurrently, 895 routine followup visits were completed including 14 overbooked, while in the previous year (7/12/22–7/11/23) 1586 were completed, including 312 overbooked. During the project year, 1935 total visits were completed compared to 2045 in the previous year. The provider productivity measure was essentially unchanged in project and preceding years (2685 vs 2731). Conclusions: A shortened-duration VA chiropractic chronic pain clinic session was used by patients and accompanied by a decrease in the amount of routine clinic followup overbookings, with essentially unchanged provider productivity. Future work should assess patient-level outcomes associated with such clinic visits. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The aim of this study is to describe a case study regarding positive response to chiropractic care in a patient with seizures. The published research regarding chiropractic and seizure management was reviewed. Clinical Features: A 25-year-old male reported for chiropractic care with complaints of frequent absence and tonic-clonic seizures during the last several years. Complaints included frequent headaches and neck pain with history of concussion and neck injury preceding the initial onset of seizures. The patient complained of experiencing numerous side effects associated with taking anticonvulsant medications. Outcome: After 3 months of chiropractic spinal manipulation (CSM) focusing on cervical spine joint dysfunction and exercise recommendations, the seizure and headaches are resolved now for 6 months. The patient has returned to driving a car. A search was conducted of medical literature using MEDLINE, CINAHL, Cochrane database, and Index to Chiropractic Literature, which yielded only case reports and expert opinion (levels of evidence from IV to V). Conclusion: Current literature on chiropractic care for treatment of seizures is limited. We describe and review the plausible effects of chiropractic care in patients with seizures, especially when associated with cervical spine dysfunction/trauma and concussion. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Over 8 years, we assessed self-perceived attitudes toward the importance and skills of evidence-based practice competencies among students and faculty at a chiropractic training program, conducting evaluations every 2 years. Methods: Survey questions asked about 8 EBP competencies based on a 0- (minimal) to 10 (optimal) rating scale. The surveys were administered to a range of 45–128 faculty and 694–1298 Doctor of Chiropractic students from 2016 to 2024. Results: Average response rates were: 59.0% faculty and 51.2% students. The importance of the 8 EBP competencies remained consistently high over the years, with slight increases observed, and showed similar patterns for both students and faculty. The trend for self-perceived skills in the EBP competencies differed. Students showed improvement in 3 competencies, faculty in 2, while 3 competencies saw similar skill increases for both groups over the years. The competencies where students improved were generally less complex, whereas faculty showed gains in the more complex areas. Overall, importance was higher than skills for all competencies and years. Conclusion: Tracking self-perceived changes and trends in competencies can help to identify the need or effectiveness of educational interventions and provides insights into how perceptions evolve over time. Caution needs to be taken in interpreting as surveys were cross-sectional. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe complementary and integrative health (CIH) services utilization among pregnant and postpartum veterans and assess factors associated with CIH service use. Methods: Participants were identified from a cohort study of pregnant and postpartum veterans (01/2016–07/2022; n = 1174) at 15 Veterans Health Administration (VHA) facilities. Study survey and electronic health record data were used to obtain demographic and clinical characteristics of participants. Visits to CIH services during pregnancy, 9 months prepregnancy, and 9 months postpartum were identified. Relationships between CIH service utilization during pregnancy and/or postpartum and participant characteristics were assessed using bivariate analyses. Results: A total of 107 (9.1%) veterans utilized CIH services during pregnancy and/or postpartum with 21 (19.6%) percent of these participants also utilizing CIH services prepregnancy. In total, 337 visits to CIH services were identified, with chiropractic (50.1%), acupuncture (15.7%), and massage therapy (7.1%) visited most frequently. Presence of depression (p = .01), post-traumatic stress disorder (p = .009), anxiety (p = .06), service-connected disability (p = .005), and a musculoskeletal diagnosis 1 year prior to pregnancy (p < .001) were associated with CIH service utilization during pregnancy and/or post-partum while participant demographics were not. Conclusions: VHA CIH service utilization was low among pregnant and/or postpartum veterans and associated with participants’ clinical characteristics. (This is a conference presentation abstract and not a full work that has been published.)

Objective: We tested the feasibility of tracking neural dynamics before, during, and immediately after cervical force-based manipulations (FBMs). Methods: Eleven participants (mean age: 31.9 ± 4.6 years; 6 females) were randomly allocated to an FBM or control group. The FBM group received instrument-assisted lower and upper cervical adjustments, while controls received sham adjustments. High-density (64-channel) electroencephalogram (EEG) data was acquired before, during, and immediately after each intervention. We employed a novel mechanical trigger allowing instantaneous, synchronized digital markers within the EEG amplifier and oscilloscope recordings of instrument-delivered forces. Primary outcomes of interest included trigger/marker reliability, sham zero-force fidelity, preload standardization, sensor resilience, and data quality. Additionally, EEG source localization and the phase lag index were used to explore connectivity dynamics. Results: Overall, we found the technical aspects of our protocol are feasible. Additionally, exploratory data suggests that FBM may enhance connectivity with a temporal progression within the frontal, parietal, and cingulate cortices. Conclusion: We introduced new methodologies for tracking neural dynamics during and immediately after FBMs. Further, FBM potentially induces progressive neural network modulation. Informed by the results from this trial, a larger pilot randomized controlled trial has been planned. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To develop a short prematriculation course to introduce foundational organic chemistry and biochemistry concepts and assess its impact on Biochemistry I (BCI) course performance. Biochemistry Boot Camp (BBC) consists of 20 asynchronous interactive videos, 4 self-assessments, and 4 quizzes divided among 4 modules utilizing progressive conditional release rules. At-risk students identified by admissions were enrolled in BBC. Retrospective data was extracted from the learning management system (LMS) and feedback gathered through a post-course survey. Descriptive statistics, Pearson’s correlation, and t tests were analyzed using SPSS. A small cohort (n = 27) was enrolled in BBC, with 56% completing Module 1 and 33% completing all 4 modules. All students (100%) completing Module 3 or above passed BCI. BBC completers had significantly higher BCI Exam 1 scores (80.5%) compared to noncompleters (69.1%; R = 0.414; p = .032). Survey response rate was 70% with students reporting a completion time range of 4–20 hours. Lack of completion was mainly due to time constraints. All respondents expressed increased understanding of biochemistry concepts. Student feedback requested earlier BBC access and a video tutorial navigating the LMS. BBC was successfully developed and implemented. Students with less chemistry background may benefit from completing BBC before enrolling in Biochemistry. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe the use of artificial intelligence (AI) assisted educational video for chiropractic clinical clerkship orientation. Methods: The orientation content from a traditional classroom presentation was transformed with AI to create a video narrative, supplemented by visuals and AI voiceover. The video link and a 20-item quiz developed with GPT-4 were sent to 35 students in the chiropractic program. Students were given a week to view the video and complete the quiz. Viewing behavior was measured with Google Analytics, and test scores were analyzed. Verbal feedback was collected during an in-person debrief session to identify recurring themes. Results: Of the 35 students who received the email, 28 viewed the video. Of the 28 viewers, 24 completed the quiz, or 85.7% of participating viewers, and 68.6% went from email reception to quiz completion. The mean score for those who watched the videos was 96.7%. Qualitative feedback noted the appreciation for the video format as a preferable alternative to traditional in-person training and the perceived realism of the AI-narrated content. Conclusion: We used artificial intelligence to generate an orientation video, providing students with standardized content without disrupting their clinical experience. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To explore faculty perceptions of the institutional emphasis placed on faculty activities to support academic promotion. We developed an electronic survey to assess faculty characteristics and perceptions of institutional expectations required for promotion at 3 campuses of a chiropractic college. Data were collected using SurveyMonkey and descriptive statistics were analyzed using SPSS. Of 110 respondents, most felt moderately to strongly informed about promotion requirements (60.0%), which was similar across campuses. Half (47.3%) are actively pursuing promotion, 23.6% are not, and 20.9% are not eligible due to part-time status or highest rank. Of activities from the faculty promotion rubric, those perceived institutionally emphasized included primary role (90.9%), college service (63.7%), peer-reviewed publications (57.3%), peer-reviewed presentations (55.4%), and professional service (48.1%). Grant writing (67.3%), public service (67.3%), non-peer-reviewed publications (63.6%), non-peer-reviewed presentations (51.9%), and professional development (48.1%) had perceived weak or no emphasis by the institution. Teaching and clinic faculty (52.4%) report weak to no emphasis on professional development. Faculty perceived promotion metrics as disproportionally emphasized by the institution. Primary role, college service, and peer-reviewed scholarship were perceived as more important than non-peer-reviewed activity and professional development/service. Supervisor guidance and research on faculty work effort is recommended. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe the response to spinal manipulation (SM) and neurologic rehabilitation for a patient with chronic tension type headaches (TTH) complicated by concussion history. Clinical Features: 44-year-old male presented to a chiropractic teaching clinic with over 15 years of daily headaches, lasting about 7 hours, and rating 5/10 on a visual analog scale. The patient recalled no single causal event. Several years prior to headache onset, the patient had multiple concussions from football and military/police force occupation. Baseline findings included nystagmus, unsteady gaze holding, and latency and fatigue with saccades in all directions. Interventions/Outcomes: Over the course of 7 months, the patient received 24 visits of SM and 17 treatments of transauricular vagus nerve stimulation, repetitive peripheral somatosensory stimulation, photobiomodulation, and gaze stabilization exercises. The patient reported 50% headache improvement after 7 weeks and 90% improvement at 20 weeks at which point headache frequency was 1 time/wk for 1 hour or less. No nystagmus was observed in the 27-week exam. Conclusion: Chronic TTH improved with SM and neurologic rehabilitation. Past clinical trials document similar TTH improvement with SM. Additional research is needed on neurological rehabilitation treatments for TTH. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The aim of this study is to conduct an evidence-based umbrella review of recently published literature regarding the effectiveness of yoga intervention in patients with back pain. Methods: A search was conducted of medical literature using MEDLINE, CINAHL, Cochrane database, and Index to Chiropractic Literature. All eligible articles were reviewed and then scored using the methodology for Joanna Briggs Institute (JBI) Umbrella Reviews. Two independent reviewers performed the scoring of articles. Results: Ultimately, 20 articles with over 2000 participants were considered eligible for this review. Yoga was associated with short-term improvements in pain intensity, pain-related disability, mental health, and physical functioning. Evidence ranged from low to moderate quality with mixed results when yoga was compared to exercise or when physical and mental quality of life was assessed. Conclusions: Low to moderate quality evidence exists demonstrating the effectiveness of yoga with low back pain. Yoga likely decreases pain from short term to intermediate term and improves functional disability compared with no exercise. Yoga has similar effects as exercise so patient preference should be considered with the recommendation of yoga. Future research should assess combining yoga with chiropractic care in patients with spine-related pain. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Providing patient education aligns with best practice and the biopsychosocial model. Recent literature suggests pain neuroscience education (PNE) improves patient outcomes. This scoping review purpose is to assess the state of literature, and identify education themes and delivery methods utilized by chiropractors with focus on PNE. Methods: Preferred Reporting of Systematic Reviews and Meta-Analysis (PRISMA) extension for scoping reviews was utilized. Peer-reviewed and grey literature written in/translated to English was included from journal inception to January 2024. After title and abstract screening, full text reviews were performed by two investigators, and conflicts adjudicated by a third. Findings were qualitatively analyzed using thematic analysis. Results: 1904 articles were identified, with 66 articles eligible for inclusion. There was some heterogeneity in the content of patient education and delivery method. Chiropractors primarily performed lifestyle education followed by ergonomics/biomechanics, diagnosis education, CBT strategies, self-management, and PNE. Delivery is predominately 1:1 instruction, followed by written materials. Conclusion: PNE frequency was half that of lifestyle education, potentially due to lack of awareness or comfortability in delivery. Further research could help to understand opportunities for provider education and barriers to implementation of pain neuroscience education in the chiropractic setting. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The goal of this project is to describe history, development, and feasibility of a program to integrate chiropractic care with a group of inpatient drug addiction recovery programs. The goal of providing chiropractic care is to support physical and emotional well-being. Methods: Before initiation of chiropractic services, a needs assessment was done to identify the needs of the recovery participants. Ways to identify how chiropractic care could benefit participants were explored, ensuring that chiropractic care did not overlap with existing services. Results: Chiropractic services were initiated within 15 inpatient drug recovery facilities. Over 4 years, chiropractors provided over 36,000 visits to clients in recovery centers across Kentucky. Mean 47% pain reduction was observed for participants who completed 12 visits with the chiropractor. Additionally, clients demonstrated at least 30% improvement in quality of life, activities of daily living, and improvement in program compliance. Conclusion: Chiropractic care within an inpatient drug treatment facility complements existing therapies and leads to lees reliance on pain medication and enhances overall quality of life. Prospective research is planned to explore objective changes in pain, length of stay, and quality of life among this group of patients. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This study aimed to examine accelerated programs for MD, DPT, OTD, DDS, and DC degrees, with a focus on evaluating the potential for implementing an accelerated chiropractic education program. Method: A comprehensive review of existing accelerated programs was conducted, analyzing curriculum structures, admission requirements, and program outcomes. Data was collected from accredited institutions offering accelerated pathways in medicine, physical therapy, occupational therapy, dentistry, and chiropractic care. Comparisons were made between traditional and accelerated programs in terms of duration, content coverage, and student performance. Results: Accelerated programs were identified in MD (3-year), DPT (2-year), OTD (2-year), and DDS (3-year) disciplines. These programs demonstrated successful outcomes in terms of board exam pass rates and residency placements. No widespread accelerated DC programs were found, though some Caribbean medical schools offer 2-year MD programs for individuals with advanced healthcare degrees. Conclusion: Although accelerated programs exist and show promise in various healthcare fields, chiropractic education lacks a standardized accelerated pathway. Given the success of accelerated programs in other disciplines, there is potential for developing a condensed DC curriculum. Further research is needed to design and implement an accelerated chiropractic program that maintains educational quality and meets accreditation standards. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Expanding chiropractic services under Medicaid may improve patient outcomes for musculoskeletal conditions. Expanded chiropractic coverage may be cost-effective and reduce the use of opioids. There are barriers for people of low socioeconomic status to use nonpharmacological providers for back pain. The aim of this study is to review which US states allow coverage of Medicaid for chiropractic visits. We also review current status and barriers to Medicaid expansion for chiropractic coverage. Methods: A systematic review was conducted of regional and state websites as well as additional manual searches of databases for states regarding Medicaid coverage. In addition, a review of recent published articles was conducted regarding issues related to Medicaid coverage for chiropractic services and barriers to Medicaid expansion. Results: Unlike Medicare, many US states have minimal or no coverage of chiropractic services under Medicaid. Barriers regarding inclusion of chiropractic services include concerns about cost and lack of understanding or awareness of evidence regarding benefits of chiropractic care for musculoskeletal problems. Conclusion: Expanding chiropractic services under Medicaid presents opportunities to improve outcomes for musculoskeletal conditions, use less opioids, and potentially reduce overall costs compared to traditional medical care. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To evaluate the longitudinal cost outcomes of different initial treatment strategies for neck pain among Medicare beneficiaries. Methods: A retrospective cohort study was used to analyze claims data from Medicare beneficiaries aged 65–99 years with a new episode of neck pain in 2019. Participants were categorized into 3 cohorts based on the initial management. The chiropractic cohort received only spinal manipulative therapy (SMT). Two primary care cohorts either received analgesics (PCP-A) or did not receive analgesics (PCP-NA) within 7 days of their visit. Results: Among the 291,604 older adults with neck pain, the SMT cohort demonstrated a 6% lower cost for Medicare Part A claims and a 36% lower cost for neck pain-related Medicare Part B claims compared to the PCP-NA cohort. The PCP-A cohort demonstrated 7% lower cost for Medicare Part A neck pain-related claims and 14% lower cost for Part D analgesic claims compared to the PCP-NA cohort. Conclusion: Initial spinal manipulative therapy for neck pain is associated with reduced healthcare costs compared to primary care physician visits among Medicare beneficiaries. These findings highlight the potential for substantial healthcare savings with specific initial treatment patterns. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Accreditation agencies are demanding that a valid method of standard setting be used to determine pass thresholds for competency-based examinations (as opposed to an arbitrary fixed value). The data used in this paper was generated for the purpose of determining if borderline regression would generate reasonable pass thresholds for OSCE. Methods: Scores were compiled across 4 separate OSCE exams. The evaluators scored the students using a rubric that generated a numeric score, as well as by assigning an overall score using a global scale (ranging from clear fail to clear pass). Global scores were converted numerically and were plotted against numeric rubric generated scores. Borderline regression was completed to determine the pass threshold for each station and the OSCE overall. Cronbach’s alpha was also calculated to assess the reliability of each OSCE. Results: Station pass thresholds for the exams ranged from 49%–73%. Entire OSCE thresholds ranged from 60%–63%. R2 values for station borderline regression ranged from 0.31 to 0.77. Cronbach’s alpha ranged from 0.01–0.78. Cronbach’s alpha improved with each subsequent OSCE. Conclusion: Borderline regression yielded reasonable pass thresholds with acceptable reliability and will be used to set pass thresholds for future OSCEs. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Explore the perceptions of chiropractic students toward caring for older adults. Methods: Qualitative analysis of written feedback after a brief educational intervention to introduce second-year chiropractic students to the 4Ms of age-friendly healthcare. Results: Of 300 students who received in-class training, 182 provided feedback on how they might implement the 4Ms framework in their future clinical practice. Chiropractic students described key components of patient-centered care, including listening, rapport building, making time, sharing information, goal setting, and tailoring care for individual needs and preferences. However, tensions in student perceptions of older adults were noted in comments that used nonpreferred terminology or ageism-related language, such as geriatric, elderly, or old. Othering was indicated in frequent “they/them” phrases that categorized older persons as different or lesser than. Paternalism was revealed in “my patient” language and statements in which the chiropractor would manage the health of an older adult “for them.” Invisibility was coded when students described 4Ms-aligned clinical activities with no mention of an older adult or actively-engaged patient. Many statements included both patient-centered and ageism-related language. Conclusions: Chiropractic students demonstrated complex perceptions about older adults that may impact their clinical learning experiences and future clinical practices. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe chiropractic faculty perceptions about their training needs to support research and scholarship. An electronic survey was developed by a team of faculty to assess aspects of research among faculty and administrators across 3 chiropractic campuses. Research training needs was a topic addressed. Data were collected with SurveyMonkey and analyzed with SPSS software. A total of 110 respondents completed the survey. Respondents were somewhat likely (37.3%) and very likely (37.3%) to utilize research training, if offered. Clinical faculty and academic faculty were highly interested in training opportunities (90%+) compared to research faculty (60.0%). Qualitative questions identified lack of confidence in skills and intimidation of the research process, but strong desires to learn and improve as reasons for desiring training. Faculty preferred online training (52.7%) more than in-person workshops (43.6%). Writing a research protocol, conducting a literature review, and writing grant applications were of moderate interest (37.3%, 33.6%, and 32.7%, respectively). Training in participant recruitment, questionnaire development, data management, and statistical analysis were requested by at least 30% of faculty. Faculty are highly interested in training, preferring asynchronous delivery to build confidence and improve research skills. Initial training should focus on information literacy, research process, and writing strategies. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Individuals between the ages of 50 and 70 represent the largest demographic undergoing spinal surgery (SpS). As the population continues to age, the incidence of SpS is expected to increase. The purpose of this study was to identify demographics and incidence of SpS and spinal injections (SpI) for nontraumatic/neoplasm related musculoskeletal conditions. Methods: De-identified patient records were requested from the OneFlorida Research Consortium for patients with diagnosed spinal pain who underwent SpI or SpS. Data was analyzed within JMPPro 17 statistical software. Results: 12,450 patients (57.5% female) were identified. White was the most common race identified (74.9%; Black: 20.1%; Other: 5.1%). The most frequently observed age groups were 51–60 years (25.7%), 61–70 years (25.3%), and 71 years+ (22.1%). The incidence of SpI was higher among females at 60.6%, whereas males exhibited a higher incidence of SpS at 51.6%. Radiculopathy was the most prevalent diagnosis associated with SpI, and spinal stenosis was frequently linked with SpS. The number of procedures reported for Black patients was greater (2 [1, 4]) than the other groups (1 [1, 2]). Conclusion: Demographic information on interventions for musculoskeletal related spinal pain can help guide future intervention and referrals, especially conservative, and advise insurance reimbursements. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Diabetes has a high prevalence in the United States and is a common comorbidity with musculoskeletal pain. Our objective was to summarize the literature on chiropractic management of patients with diabetes. Methods: We used Covidence software to conduct a scoping review after a preregistered protocol, searching PubMed/MEDLINE, CINAHL, Index to Chiropractic Literature, Alt HealthWatch, Cochrane, and Ovid Journals. We used librarian-developed search terms to identify articles describing management, diagnosis, or treatment by a doctor of chiropractic of patients/participants of any age with diabetes of any type and/or metabolic syndrome. Reviewers screened articles and extracted data independently. Extracted information was categorized by article type to identify trends and gaps. Results: The initial search retrieved 442 articles with 92 articles meeting the inclusion criteria. Of the articles included, 57 were from journals and 35 were trade/professional articles. Articles commonly discussed nutrition recommendations with few discussing diagnosis and co-management or reporting pain, disability, or diabetes-specific outcomes. Conclusion: There is limited reporting of outcomes of chiropractic management of patients with diabetes. Given the high prevalence of musculoskeletal pain and diabetes, study of pain and chiropractic disease-specific outcomes is needed to better understand chiropractic care for patients with diabetes. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To assess blinding after a single session of genuine/real or simulated/sham high velocity, low amplitude (HVLA) manual chiropractic adjustments. Methods: 30 participants were randomly allocated to either a genuine manipulation (n = 14; diversified in cervical, double hypothenar in thoracic, prone drop, or side posture push in lumbopelvic region) or a sham manipulation (n = 16; supine with drop in cervical and prone with drop in thoracic and lumbopelvic regions, all without spinal contact). Immediately after the session and 48 hours post-session, blinding was assessed via electronic survey. The primary blinding measurement used was the Bang Blinding Index (Bang BI). Results: 29 participants’ surveys were analyzed (1 participant excluded due to exam findings). Immediate post-session data showed a high level of unblinding in the real intervention (n = 13) (Bang BI: 0.62 [95% CI: 0.21 to 1.00]), but successful blinding in the sham intervention (n = 16) (Bang BI: 0.06 [95% CI: −0.34 to 0.47]). 48 hours post-intervention showed a high level of unblinding in the real intervention (Bang BI: 0.62 [95% CI: 0.21 to 1.00]), but successful blinding in the sham intervention (Bang BI: 0.19 [95% CI: −0.24 to 0.62]). Conclusion: Our sham intervention was successful in blinding participants to their treatment allocation. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To present cross-sectional data of second year chiropractic students’ self-identification of belonging to special population groups (SPG) and their comfort and confidence levels modifying care for these groups. Methods: 113 enrolled students in a new “Special Populations” course were invited to complete a voluntary survey. Respondents (n = 35; RR = 31%) selected SPG to which they identified belonging. They then rated their comfort with, and confidence levels modifying care for, each SPG on a 5-point Likert-like scale. Responses were grouped by those expressing a level of confidence/comfort, a lack of confidence/comfort, or being unsure/neutral. A general patient group (GPG), representing patients not belonging to any SPG, served as a benchmark. Results: Descriptive analysis found that 38% of respondents identified as belonging to one or more SPG, “trauma influenced” being most frequent. Overall, comfort and confidence levels (89%/75% of respondents, respectively) were higher for GPG than across all SPG (63%/53%). The greatest lack of comfort was “pediatric” (35%) and lack of confidence “mentally disabled” (31%). Unsure/neutral was highest for “physically disabled” (42%). Conclusion: Second-year chiropractic students were more comfortable and confident treating GPG than SPG patients. Overall, comfort levels were higher than confidence levels. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Evaluate differences in network-based functional connectivity (FC) patterns using resting-state electroencephalography (rEEG) for individuals receiving force-based or simulated chiropractic care. Methods: Using a quasi-experimental design, rEEG data were obtained from 30 (33.1 ± 8.7 yoa; 16F) adults before, immediately post-, and 1-week post a single, full-spine instrument-assisted force-based (n = 15) or simulated and segmentally matched (n = 15) chiropractic care session. Robust to multiple comparisons, the network-based statistic method (5000 permutations; threshold for significance p < .05) was used to isolate subnetworks within the triple-network (default mode; salience; central executive) that differed in FC between groups. Results: Immediately post, the force-based group demonstrated (1) increased FC in delta band (1–4 Hz) in 25-node subnetwork within bilateral prefrontal cortex (PFC) extending into areas such as the right inferior parietal and bilateral insula and (2) decreased FC in theta band (4–8 Hz) in 18-node subnetwork concentrated within PFC extending into bilateral insula and right superior parietal cortex. At 1 week, the force-based group showed increased FC in beta band (13–30 Hz) in 21-node bilaterally distributed anterior-to-posterior subnetwork. Conclusion: Network-based FC changes were observed within PFC subnetworks and other regions of interest immediately after and 1-week post force-based chiropractic care compared to simulated chiropractic care. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Artificial intelligence (AI) is a transformative trend in healthcare and education, yet its utility remains uncertain. This ethnographic study explores the experience of creating an experiment where AI was employed in the methods of a research study. Methods: AI was used to design stimuli to modulate contextual factors in evaluating chiropractic spinal manipulation dosage. We utilized researcher narratives, journals, and documented interactions with AI tools over 6 months. Thematic analysis identified patterns in AI’s ability to create stimuli for clinical contexts. Reflexivity was key, as the researcher critically assessed biases and assumptions about AI’s ethical and practical capabilities. Results: The study found that AI’s output quality depends heavily on the quality of the input prompt. Poor or contradictory prompts lead to AI errors, hindering effectiveness. Stereotypes and biases proved problematic. However, AI can learn and improve through feedback, becoming more adept at generating quality content aligning with user intentions, though this may not always reflect objective reality. Conclusion: AI is a potential tool for creating contextual factor stimuli in human research, leading to significant implications for chiropractic education and training. Its effectiveness is contingent on human input, which presents ethical considerations surrounding its use. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Review the literature for evidence of self-myofascial release (SMR) effectiveness and protocols. Methods: PubMed database search keywords self-massage, self-myofascial release, musculoskeletal, massage tool, symptom management, outcome measure, pain, flexibility. Data and methodologic quality captured using data extraction template, PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist, and Scottish Intercollegiate Guidelines Network (SIGN). Results: 918 studies screened resulting in 7 studies (n = 305) for inclusion. Sample sizes ranged 16 to 94. SIGN quality varied widely from low to high. Five studies resulted in statistically significant improvement in at least one outcome measure in SMR groups. The other studies reported similar outcomes for both SMR and comparison group. Five study protocols utilized a foam roller for SMR of the lower extremity and demonstrated improved tissue stiffness, hamstring flexibility, ankle range of motion (ROM), knee ROM, pain pressure threshold (PPT), stretch sensation and fascial sliding. Another study demonstrated improved visual analogue scale, PPT, and cervical ROM with SMR using cervical ischemic compression device. A final study demonstrated improved ROM and function with SMR for knee osteoarthritis. Conclusion: The literature suggests similar benefits for a variety of musculoskeletal regions using SMR compared to therapist-provided myofascial release and greater benefits compared to placebo, and/or no intervention. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To report current limitations in chiropractic education syllabi related to the prescription of assistive devices, such as canes and walkers, within the context of patient rehabilitation. Methods: We reviewed syllabi across 16 colleges in the United States offering Doctor of Chiropractic programs accredited by the Council on Chiropractic Education. The review focused on the inclusion of content related to assistive devices in the core curricula as published on the colleges’ websites. Results: None of the college websites suggested or explicitly stated that their core curriculum included the prescription of assistive devices. Although several institutions offered courses such as Passive Care, Active Care, Orthoses, Physical Rehabilitation, and Ergonomics, the course syllabi did not mention assistive devices. Assistive devices are well established as evidence-informed supportive therapy approaches that are crucial for enabling individuals with physical disabilities to enhance their independence by addressing specific needs. Chiropractors may use these devices as adjunctive therapy to support patient care and manage certain conditions within the chiropractic scope of practice. The absence of assistive device education in chiropractic curricula suggests a gap that needs to be addressed to ensure comprehensive training and effective patient management. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The prevalence of neck pain (NP) increases with age, and older adults are vulnerable to the use of high-risk analgesics. Clinical practice guidelines discourage use of prescription drug therapy (PDT) in favor of nonpharmacological therapies including spinal manipulative therapy (SMT). We designed a cohort study of Medicare claims data to compare the risk of adverse outcomes for adults aged 65–99 with a new episode of NP. Methods: The SMT cohort received spinal manipulation from a chiropractic physician and no primary care. Patients in the PDT cohort visited a primary care physician, filled a prescription for an analgesic within 7 days of the initial visit, and received no SMT. The primary care only (PCO) cohort was defined identically to the PDT cohort, except that the patient did not fill a prescription for an analgesic within 7 days. We calculated incidence rates ratios for adverse outcomes over 24 months. Results: Compared to PCO, the risk of any adverse outcome was 14% lower for SMT and 8% higher for PDT. Conclusion: For Medicare Part B beneficiaries with new onset NP, initial care with spinal manipulative therapy is associated with lower risk of adverse outcomes than primary medical physician care. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To evaluate the relationship of transitioning from passive provider driven therapies to active interventions within Whole Health for Veterans experiencing chronic low back pain. Methods: An institutional review board approved retrospective cohort study was undertaken querying records of veterans receiving treatment in chiropractic or acupuncture clinics. Included participants attended 2 or more chiropractic or acupuncture visits, were experiencing chronic low back pain, and not actively attending yoga or tai chi prior to engaging in care. Extracted variables included demographics, visit count, transitioning from passive to active therapies, whole health coaching, medications, and comorbidities. Descriptive statistics and logistic regression analysis were performed utilizing SAS. Results: Of 100 included veterans the average age was 57 years old (range: 23–82), majority were male (n = 85), identified as White (n = 58), and had mean body mass index (BMI) of 30.84 (range: 16.65–51.18). Twenty-three veterans transitioned to active care services. Whole health coaching (OR: 7.807; CI: 2.55–23.86), BMI (OR: 1.11; CI: 1.02–1.21), and opioid use (OR: 0.157; CI: 0.03–0.9) were statistically significant for transition. Conclusion: This study demonstrates limited transition between provider driven therapies and active interventions within Whole Health. While coaching, BMI and opioid usage predicted that transition, a larger sample size, and qualitative studies are required. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To assess Veterans Health Administration (VHA) chiropractic consultation visits for the documentation of key history and examination elements. Methods: A manual chart review of VHA electronic health record data from a random sample of 1000 on-station chiropractic consultation (new patient) visits between 10/01/2017 and 09/30/2018 identified the presence of select history and examination elements. Associations between patient characteristics and those elements were assessed. Results: Data were obtained from 978 visit notes, with low back pain (LBP) (75.6%), neck (39.9%), and thoracic (25.5%) conditions most common. The most frequently documented history elements were quality/characteristics of symptoms (75.5%), provocative/palliative factors (71.0%), and symptom severity (70.0%). Range of motion (77.3%), observation (76.6%), and orthopedic testing (67.0%) were the most frequently documented examination elements. The presence of no documented free text diagnosis was associated with fewer total examination elements (mean: 2.53; p < .001), but not history elements. LBP with radiculopathy was associated with a greater number of history (mean: 4.32; p = .009) and examination (mean: 4.20; p = .023) elements; however, these differences are of unclear clinical significance. Conclusion: Documentation of history and examination elements in VHA chiropractic consultation visits is variable. More work is needed to inform quality improvement efforts. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To examine the latent domain structures of the PROMIS-25 pediatric self-report and PROMIS-25 parent-proxy instruments using exploratory factor analysis (EFA). Methods: EFA models were constructed using Pearson and Polychoric correlations between the measured quality-of-life domains (i.e., mobility, anxiety, depression, fatigue, peer relationships, and pain interference). Unlike confirmatory factor analysis, relations between all measured variables and latent factors were considered in factor extraction. To improve the simplicity and clarity of the latent structure, varimax rotations were performed. Results: A clear domain separation across three latent variables was observed. In the parent–proxy EFA, Factor 1 pertained to Anxiety and Depression, assumed to be a latent mental health factor. Pain Interference, Pain numerica rating scale, and Mobility items were with Factor 2, a latent physical health factor. Peer Relationships items correlated with Factor 3, a latent social health factor. In the pediatric self-report, Factor 1, Factor 2, and Factor 3 similarly corresponded similarly to physical, mental, and social health domains. Conclusion: Distinct separation in the latent factors between presumed physical, mental, and social health domains were found with the PROMIS-25 pediatric self-report and parent–proxy. We encourage continued efforts in this area of research to improving patient reported outcomes. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Idiopathic toe walking (ITW) is an exclusionary diagnosis given to healthy children who persist in walking on their toes after they should have achieved a heel–toe gait. The aim of this study is to provide a narrative review of the topic and to present a case involving a patient with persistent ITW and her response to multimodal chiropractic care. Clinical Features: A 23- year-old otherwise healthy female presented for chiropractic care. History includes persistent toe walking beyond the age of 5, with conservative treatment followed by surgical intervention, which was ineffective. She currently presents with continued toe walking, pain and tightness bilaterally in the calves, and less than 5 degrees of active or passive dorsiflexion of the ankles. Intervention/Outcome: Intervention included chiropractic manipulation of the spine and lower extremities, instrument-assisted soft tissue mobilization, and adjunctive modalities. Treatment was well-tolerated, and the patient had improved to 12-degrees dorsiflexion, with a more normal gait appearance. Conclusion: There are 8 published reviews, mostly discussing outcomes associated with conservative or surgical interventions, but no evidence to guide the use of chiropractic care. Thoughtful use of multimodal chiropractic care may be useful in chronic ITW. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe conservative management with short- and long-term outcomes in an adult athlete with inversion ankle injury, complicated by involvement of medial ankle stabilizers. Clinical Features: A 26-year-old male sustained a lateral ankle sprain while playing basketball. The ankle was supinated, inverted, and plantar flexed when landing from a jump. Intervention/Outcome: Radiographs obtained in the emergency department 2 days post-injury revealed soft tissue swelling, but no fractures. Two weeks later, magnetic resonance imaging demonstrated tears of the anterior talofibular ligament, deltoid ligament, and spring ligament, sprain of the calcaneofibular ligament, strain of the posterior tibialis tendon, multifocal tenosynovitis, and bone marrow edema. The patient was evaluated by a physiatrist and received 8 visits of physical therapy, followed by 11 visits of chiropractic care. Foot and ankle disability index score was 10/104 (9.6%) on the day of the injury, 62/104 (59.6%) at 2 months, and 96/104 (92.3%) at 3 months. The patient has returned to his usual sporting activities with mild pain. Conclusion: Lateral ankle sprains may be complicated by involvement of the medial ankle stabilizers. The treatment should be tailored to address the needs of each patient, which may be optimized with a multidisciplinary approach. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Sharing treatment and outcome of a patient, 2 years post brain surgery that received chiropractic care for her refractory secondary symptoms. Clinical Features: A 57-year-old female presented with unremitting pain, weakness, lower-extremity neuropathies, reduced lower-extremity circulation, and lack of mental clarity after brain surgery. Over the 2 years post-surgery she had made good progress but her presenting symptoms had not changed since the surgery. Intervention and Outcome: She was treated with SOT and cranial protocols to balance meningeal membrane tensions and improve CSF pulsations. After her first visit, she noted on her way home in the car that “for the first time since her surgery she had improved circulation and no numbness in her left leg/foot.” The following morning she noted that she “felt more centered on her feet and her brain was clear.” Although this outcome was remarkable and she will continue with care, she was referred for collaborative care to a chiropractic neurologist to facilitate adding some specific neurological exercises to help sustain and maximize her recovery. Conclusion: When patients reach a plateau or possibly even beforehand, a trial of chiropractic care including SOT and cranial techniques to facilitate rehabilitation may be indicated. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe a inter/intra-disciplinary chiropractic collaborative care of a temporomandibular disorder (TMD) patient presenting with head and neck pain, and right-sided cormiosis. Clinical Features: A 35-year-old female was referred by her dentist treating her TMD for complementary sacro occipital technique (SOT) and cranial technique care. Intervention and Outcome: The patient was treated at this office with SOT protocols to treat kinematic postural imbalances affecting her cranium and dental occlusion. Craniofacial techniques were utilized to facilitate any palatal expansion occurring from wearing her dental appliance. She was also given specific exercises to improve her dental vertical occlusal dimension and nasal strips to improve nasal airflow. She was reporting consistent improvement but a relationship was noted between her right temporomandibular joint, upper cervical region, and ipsilateral pupillary constriction. Since it was postulated that this might be contributory to her presentation she was referred to a chiropractic neurologist who assessed/treated her and gave her exercises. She reported that the conjoint dental, chiropractic, and chiropractic-neurology interventions have vastly improved her quality of life and ability to function. Conclusion: Although it is ideal for chiropractors to seek interdisciplinary care, as more chiropractors develop advanced specific training intradisciplinary referrals should be considered. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To define dual-task function differences in chronic low back pain (CLBP) patients compared to controls. Methods: A search via PubMed, Scopus, and CINHAL was performed for data published between 2014 and July 2024 in the English language using the terms “dual task*” AND “chronic low back pain.” Included studies measured at least 1 dual task and compared CLBP participants to controls. Articles were appraised via National Institutes of Health quality assessment tools. A total of 10 studies were included. Results: In CLBP patients, studies demonstrated increased gait variability, particularly under dual task conditions, with some showing reduced stride length and lower cadence. Balance and posture assessments reveal heightened postural sway and trunk variability, especially under cognitive load. Electromyography findings indicate delayed muscle activation during dual tasks, with significant differences in anticipatory postural adjustments. However, some studies found no differences in stride parameters or balance metrics for CLBP patients but this can be explained by differences in methodologies. Conclusions: Neurocognitive function differences appear to exist for those with CLBP in both physical and cognitive tasks. Future research is needed that incorporates new forms of neurocognitive tasks, standardizes methods, and applies neurocognitive tasking to rehabilitation protocols to evaluate pain and function outcomes. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To assess the effectiveness of artificial intelligence (AI) in applying the PEDro (Physiotherapy Evidence Database) scale and CASP (Critical Appraisal Skills Programme) tool for literature evaluation. Methods: Peer-reviewed literature was evaluated by 2 independent reviewers and OpenAI’s ChatGPT. The human reviewers assessed the literature before the AI was prompted for a review to prevent influence on assessment. The AI was instructed to provide a PEDro scale score with explanations for each of its 11 components. Afterward, the AI was prompted to evaluate the article using the CASP tool. The literature article was attached for the AI to review. Results: The AI and human reviewers returned matching PEDro scale scores for each article. The AI and human reviewers all confirmed the validity, precision, and applicability of the results using the CASP tool with identical scores. Conclusion: AI can be an effective tool for quickly and accurately evaluating the validity of literature using the PEDro scale and CASP tool. This capability could help clinicians rapidly determine literature quality. Future studies should include a larger number of articles, various types of research, and additional validity tools. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The objective of this ongoing program is to create, curate, and analyze a corpus of chiropractic research globally over all time. Methods: The initial corpus of chiropractic peer-reviewed articles was created from the 2011–2020 publication lists submitted by 19 participating chiropractic research performing organizations (RPOs) and 15 highly productive researchers outside of chiropractic RPOs. This corpus was supplemented by searches over all time in PubMed, Web of Science, the Chiropractic Research Archives Collection, and the Index to Chiropractic Literature, supplemented by hand-searching of journals. Results: The numbers of publications (currently ∼3,500), numbers of contributing authors (∼10,000) and numbers of unique journals publishing chiropractic research (∼500) all appear to be in an exponential phase of growth. Interinstitutional and international collaborations are now the norm, rather than the exception. Distributions of genres and themes vary by nation and institution. Citations, one indirect measure of quality, stand at approximately 33,000. Conclusion: In one generation, the global chiropractic research enterprise has been turned on its head. Network analysis reveals intensive collaborative behavior, but no one “secret formula” as different RPOs find different roads to success. However, funding mechanisms and social behaviors may be good predictors of growth. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To discuss the management of lead ankle pain and decreased hip mobility. Clinical Features: A 51-year-old male with chronic left ankle pain while golfing and walking. Symptom intensity and frequency increased during his golf season, then decreased in his off-season. Previous treatments focused on ankle mobility and myofascial release yielded short-term relief, with symptoms returning upon golfing or walking. Intervention and Outcome: Initial treatment focused on soft-tissue mobilization, chiropractic manipulation, and therapeutic exercises to improve ankle dorsiflexion. Eccentric loading after soft-tissue mobilization led to the elimination of the patient’s symptoms except during golf swing activities. The next golf season, symptoms returned and worsened. Modification of his golf swing focused on stabilizing his lead foot, eliminating symptoms once again. Treatment aimed at increasing internal rotation of his lead hip improved ability to stabilize lead foot in his golf swing, leading to a lasting elimination of symptoms in season. Conclusion: This case discusses an athlete with activity-specific ankle pain and dysfunction failing to respond long term with local interventions. After a soft tissue mobility disfunction at the lead hip was identified, treatment focused on hip rotation with improved symptoms in season and long term. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Access to various healthcare professionals (MD, DC, DPT) in an integrative setting to increase postoperative patient outcomes after a medial patellofemoral ligament reconstruction in a collegiate baseball pitcher. Clinical features: 02/23/2024 patella dislocation, lateral displacement. 8/10 VAS, impaired gait, swelling palpable, + sweep test. Torn medial patellofemoral ligament upon diagnostic imaging. Interventions/outcomes: X-ray and magnetic resonance imaging diagnostic imaging. Hospital for Special Surgery (HSS) orthopedic surgery, HSS outpatient physical therapy, Keiser University Spine Care Clinic, patient education, passive modalities, progressive rehabilitation, chiropractic manipulations to segments negatively impacted in the kinetic chain due to compensations. Lower extremity (LE) active range of motion and passive range of motion. Current activity level/demands on LE being a collegiate baseball pitcher. Conclusion: Access to various healthcare professionals (MD, DC, DPT) provides an array of treatments focused on improving patient outcomes. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This case describes the chiropractic management of pubic symphysis pain and dysfunction in a pregnant patient utilizing Webster technique. Clinical Features: A 28-year-old at 21 weeks gestation presented to the clinic on crutches with pubic symphysis pain, which worsened while weight bearing and walking. An exam revealed palpatory tenderness over the right pubic symphysis, decreased right sacroiliac fluid motion, and hypertonicity of the right psoas muscle. Interventions and Outcomes: Given the patient’s pregnancy and presentation Webster technique was used to address the misalignment of the sacrum, pubic bone, and associated muscular hypertonicity. A total of 10 adjustments were performed over a 3-week period during which the patient stopped using the crutches to walk and reported less pain. A re-evaluation examination showed resolution of the patient’s pubic symphysis pain and return to activities of daily living. After the exam, it was determined that weekly adjustments were appropriate to assess the patient for misalignments as her pregnancy progressed. Conclusion: This case suggests that chiropractic care and in particular Webster technique should be considered as a conservative intervention for pregnant women suffering from pubic symphysis pain and dysfunction. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The purpose of this study is to describe the chiropractic management of chronic radicular low back pain. Clinical Features: A 68-year-old white male veteran presented to the clinic with complaints of radicular low back pain. The pain traveled down his right leg into his foot, was chronic in nature, and getting worse. He described the pain as sharp, deep, aching, and radiating. Interventions and Outcomes: A treatment plan consisting of manual chiropractic manipulation of the pelvic and lumbar spines as prescribed at a frequency of 2 times per week for 4 weeks and 1 time per week for 8 weeks. During that time the patient reported improvement in his symptoms both in intensity and decreased radicular pain. An updated outcome measure was performed on the 10th visit showing quantitative improvement in the patient’s symptomatology. Conclusion: This case suggests that chiropractic manipulation of the pelvis and lumbar spines can have a positive effect on chronic radicular low back pain and should be considered as a primary conservative intervention. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Chiropractic continues to be overlooked as top option for management of chronic pain, resulting in increased cost while delaying relief and increased functionality. Clinical Features: A 34-year-old male veteran firefighter with chronic back pain post improvised explosive device injury in 2012 has been referred to chiropractic clinic. He underwent years of physical therapy, back school, medication, and interventional procedures. He continues to experience pain with radiculopathy and spasms. Pain is rated 4 to 5, aggravated by prolonged activities, physical demands of being a firefighter, and training for the New York City marathon. Recently, the pain has been aggravated by changing diapers of his first newborn. A previous magnetic resonance imaging revealed disc desiccation. Outcomes: With 4 visits, the veteran has experienced significant relief, minimal pain when changing a diaper and also while increasing marathon training. Treatment involved chiropractic manipulative therapy, therapeutic exercises, and manual therapy. Daily foam rolling, resistance bands use, and placing a pillow between knees when side sleeping was also suggested. Proper ergonomics were prescribed. Conclusion: Chiropractic care should be a top option for the population as studies are showing efficiency with minimal side effects. This type of care has the potential to give the functional life people want and deserve to live. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This case report outlines the use of extracorporeal shockwave therapy (ESWT) for treatment of calcium pyrophosphate deposition disease (CPPD) of a 59-year-old male’s bilateral knees. Documenting this treatment was done to advance research of therapeutic benefit of ESWT for CPPD. Clinical Features: Patient presented with bilateral knee pain. After examination and radiographs, he was diagnosed with bilateral CPPD. Patient was treated with low-level laser, interferential therapy, and therapeutic ultrasound with minimal improvement. After finding literature suggesting ESWT as a potential option (1), patient was approached about a course of ESWT. Intervention/Outcome: Patient received an 8-week treatment of ESWT to bilateral knees. The primary endpoint was pain reduction. After completing treatment, he had a decreased pain bilaterally that was statistically significant (p = .006) as well as increased range of motion bilaterally. Patient also experienced improvements in functional ability as reflected by higher Lower Extremity Functional Scale scores. Conclusion: ESWT shows promise as a viable treatment for CPPD. Treatment duration is dependent on the stage of CPPD. Further research is necessary for optimal ESWT treatment plans, to explore post-ESWT treatment, and understand short- and long-term effects of ESWT on CPPD. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Complex Regional Pain Syndrome (CRPS) is an often-overlooked pathology with an occurrence of 6.28 cases per 100,000, though other sources indicated an occurrence of 26.2 per 100,000. Previously, a clinician within our office found a 5.06% 1-year occurrence. Method: In 2023, our office had 249 new patient interactions, predominantly first responders, who experience a higher incidence of trauma compared to the “general population.” Of the 249 patients, 14 patients either presented with a suspected primary diagnosis of CRPS or developed it during postoperative management. Results: Patients with suspected CPRS was referred to a specialist, who performed a diagnostic peripheral sympathetic block. Patients who had a decrease in, or resolution of, symptomatology post-intervention, had a confirmed diagnosis of CRPS. Each patient then underwent specialized care for this disease, which included the sympathetic blockade and adjunct therapy. Adjunct therapy included topical gabapentin–ketamine, oral alendronate, clonidine patches, and oral ketamine. Conclusion: The occurrence of CRPS in our office is 5.6%, which corroborates the previous findings of 5.06%. The incidence of CRPS may be higher in our office compared to a standard chiropractic office due to the high incidence of trauma in our population. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Evaluate tolerance and response to chiropractic care in a paraplegic veteran with complex chronic pain with history of a traumatic spinal cord injury. Clinical Features: A 49-year-old male veteran with paraplegia, resulting from a traumatic spinal cord injury (TSCI) sustained in Afghanistan, experienced surgical complications after a multilevel laminectomy decompression. He presented with chronic neck and low back pain spanning over a decade. The TSCI led to syringohydromyelia and degenerative scoliosis, likely worsened by the multilevel decompression laminectomy performed without spinal fusion, resulting in additional health complications, including persistent urinary and fecal incontinence. The veteran had no previous experience with chiropractic care. Intervention/Outcome: The veteran underwent a trial of chiropractic care within a Veterans Affairs chiropractic clinic. Treatment included mechanical traction, instrument-assisted soft tissue mobilization, spinal mobilization, and manipulation. Despite the veteran’s good tolerance, significant clinical improvements were not apparent in outcome measures. However, treatment was well tolerated and did provide transient relief. Conclusion: This case underscores the complexities of managing chronic pain in paraplegic veterans, highlighting the need for specialized outcome measures and the potential expansion of chiropractic services for patients with severe physical limitations. (This is a conference presentation abstract and not a full work that has been published.)

Objectives: Utilizing cadaveric dissection and wet prosection is essential for student engagement and learning strategies in understanding human gross anatomy at the Doctor of Chiropractic school level. Dissection not only aids in learning anatomy and its clinical correlations but also promotes discipline and critical thinking skills. However, combining dissection with prosections, plastinations, and computer-aided technology is more effective and efficient. This study aimed to evaluate student preferences and retention efficacy between dissection and prosection methods of students enrolled at a chiropractic school. Methods: A Likert-scale survey was prepared with 4 questions and one comment section related to gross anatomy dissection and prosection preference and retention. Survey Results: From 51 subjects indicated a significant preference for cadaveric dissection (67%) over prosection (53%) and a belief in better retention through dissection (57%) compared to prosection (55%). Conclusion: The findings suggest educational programs should emphasize cadaveric dissection while integrating prosection to cater to diverse learning preferences and enhance anatomical education outcomes. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Objective of this case report was to discuss the potential benefit of accurately monitoring manipulative forces and clinical improvements in treating a sciatica patient. Clinical Features: Patient presented with complaints of left lumbar spine pain, which radiated into the left buttock, down the left leg, accompanied by an inability to dorsiflex the left foot and limiting activities of daily living and work. A diagnosis of sciatica with a sequestered disk fragment and left lower extremity motor deficit was rendered through objective physical examination results and a review of a lumbar magnetic resonance imaging study. Intervention/Outcome: The treatment plan, in this case, was primarily force-based Cox technique flexion distraction decompression (CTFDD), equal-force bidirectional traction, premodulated electrical muscle stimulation (EMS), infrared light therapy (ILT), and a home stretching and strengthening program. This patient had a positive clinical outcome from a force-based CTFDD treatment plan along with other modalities consisting of premodulated EMS, ILT, and a home stretching and strengthening program. Conclusion: Force-based CTFDD spinal manipulation, along with other modalities has been found to be an alternative, nonsurgical treatment for discogenic sciatica in improving pain and quality of life. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe an adult male with focal nodular hyperplasia (FNH) of the liver mimicking right lower rib pain. Clinical Features: A 42-year-old male presented with right lower rib pain extending from the midsternal to the midaxillary line. The pain was sharp, aching, and radiating. He had a history of liver laceration after blunt abdominal trauma ∼34 years prior. Interventions/outcomes: Murphy’s sign was positive, and there was reduced and painful right lateral thoracic bending. Palpation of the anterior right lower ribs elicited epigastric pain. An Activator instrument-assisted adjustment was performed on rib 8, which did not relieve the pain. The working diagnosis was intercostal neuralgia. The patient was referred for a sonographic examination of the gall bladder to discard acute cholecystitis. The sonogram revealed an incidental large hypervascular liver mass. Multiphase contrast abdominal computed tomography was performed to further characterize the lesion, demonstrating a mildly hyperattenuating, and moderately enhancing 8.8 cm mass in the left lobe of the liver, with hypoattenuating central scar, consistent with FNH. Conclusion: Remote trauma may predispose patients to developing painful visceral lesions that mimic musculoskeletal pain. Diagnostic imaging plays a crucial role in securing the diagnosis and directing appropriate management. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To discuss chiropractic management of a patient presenting with suboccipital headaches and chronic allergy-induced sinusitis. Clinical Features: A 50-year-old female with a history of chronic sinus headaches presented with constant bilateral suboccipital pain for 3 weeks. The patient has had sinus headaches 1 time per week for most of her adult life. She managed the symptoms with daily over-the-counter medications. The physical examination was unremarkable, revealing no red flags. This episode of suboccipital headaches was previously treated with stretching and massage without resolution; she received diversified-type chiropractic care 6 months previously without change to conditions. Intervention and Outcomes: Upper cervical specific radiographs were used for Atlas Orthogonal (AO) biomechanical analysis. The patient was scheduled once/wk for 4 weeks and adjusted as indicated using AO, Thompson, and sacro-occipital technique assessments. Suboccipital headaches resolved after 3 treatments. The patient noted that sinus headaches had also ceased. She chose to discontinue her routine antihistamine use; her allergy symptoms have not returned. Conclusion: Chiropractic care is a validated option for management of cervicogenic and tension-type headaches. This patient experienced improvement in concurrent allergies and/or sinus headaches. Further research is needed regarding upper cervical specific correlation. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Whole-body photobiomodulation using 650 nm low-level red-light therapy (LLLT) and 850 nm near infrared (NIR) is a promising emerging treatment for multiple sclerosis (MS), a condition known for its complications with demyelination and neuroinflammation. This whole-body therapy applies LLLT and NIR photobiomodulation to enhance cellular repair and reduce inflammation. Recent studies indicate that LLLT may improve neurological function and quality of life in patients with MS by boosting mitochondrial activity and modulating oxidative stress. Clinical Features: A 62-year-old African American woman with MS presented to a chiropractic clinic with right-sided paresis with pain and stiffness of her neck and back. The patient was ambulatory via an electric wheelchair and a walker. Intervention and Outcome: Weekly treatments of whole-body LLLT and NIR utilizing 203.8 J/Wcm² along with other manual therapies were applied. Progress was tracked via the PROMISE-29 and Pain Detect questionnaires. At 6 months, she reported improvements in physical function, anxiety, sleep quality, social participation, and pain interference. No worsening of symptoms was seen in any category. Conclusion: Whole-body photobiomodulation with LLLT and NIR is promising for MS. Further clinical trials are necessary to determine effectiveness and generalizability in this patient population. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To discuss the presentation, imaging, and laboratory findings, and management of a rare case of low back pain and postsurgical complications along with appropriate differential diagnosis. Clinical Features: Patient presented with severe unrelenting low back pain 1 day after shoulder surgery that was not responding to medications or other attempted pain-relieving remedies. Imaging was ordered and showed computed tomography and magnetic resonance imaging features consistent with infection and abscess or intramuscular necrosis. Culturing showed no evidence of microbe or infection. Diagnosis of paraspinal compartment syndrome was made. Blood work showed creatine kinase as 13,000 U/L consistent with compartment syndrome. Surgery was scheduled for paraspinal compartment release fasciotomy. Intervention/Outcome: Thoracolumbar paraspinal release was performed surgically. Patient went on to have improvement of their low back pain and compartment syndrome. Postsurgical complications including delayed wound healing and weeping as a complication of patient history of Factor V deficiency and medication interactions. Even though the wound has had several discharges over the healing phase, the collection has always tested negative for infection. Conclusion: Resolution of the severe low back pain was achieved, although patients still have some residual low back pain and noticeable scar from the surgery. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The introduction of the new format for the National Board Of Chiropractic Examiners (NBCE) computer-based testing (CBT) exams Part I marks a significant shift in how student performance will be assessed and scored. Under this new model, the NBCE eliminated domain-level scoring and instead provides a single comprehensive score for each exam. This change is designed to assess a candidate’s overall competency across all tested domains, allowing for compensation of minor deficiencies in one domain by stronger performance in others. This study focuses on examining the actual performance of students under the new scoring format, specifically analyzing whether their real-world outcomes align with the predictions made during the scoring model’s development. The study compared the average performance in each domain of the exam under the new scoring model to that of the previous format. Additionally, item resource theory-based pass rates were analyzed and compared to the pass rates from the old exam format, providing insight into how the new scoring system impacts overall success rates for examinees. This study helps understand the real impact on students and enables chiropractic programs and the NBCE to effectively support student success while upholding the standards of the profession. (This is a conference presentation abstract and not a full work that has been published.)

Objective: As the National Board of Chiropractic Examiners (NBCE) transitions to a centralized testing model for the Part IV exam in 2026, significant changes will also be made to the scoring process. The revised exam structure aims to more accurately reflect real-world patient encounters and to incorporate the latest in testing technology, including video recording for enhanced scoring reliability. This new model necessitates a shift in scoring protocols to ensure score continuity, fairness, and consistency. The use of video recording will be used for standardized patient training and allow for the identification and correction of possible grader bias, promoting more accurate assessments of examinee performance. In light of these changes, the scoring for the Part IV exam will now focus more on the evaluation of each examinee’s competency within a complete patient encounter. With the introduction of this centralized model, the NBCE anticipates greater standardization and consistency across all examinees. This study presents the logic and rationale for the new scoring model. The new scoring method will streamline the process, utilizing both technology and refined protocols to ensure the exam maintains its rigor while adapting to the evolving standards of healthcare licensure examinations. (This is a conference presentation abstract and not a full work that has been published.)

Clinical Features: A 50-year-old male presenting in the chiropractic clinic with bilateral upper extremity (BL; UE) weakness and neck pain. Prior plastic surgery evaluation lead to diagnosis of BL carpal tunnel syndrome with pending electromyograph and nerve conduction velocity test. Neurological exam performed by chiropractor revealed BL hyperreflexia of UE, clonus with ankle jerk, finger escape, Hoffman’s sign, and severe atrophy and weakness in BL hand muscles. Intervention: Cervical magnetic resonance imaging (MRI) ordered, revealing moderate, multilevel degenerative changes with no abnormal cord signal. Evaluation by neurosurgery department prompted an urgent neurology referral due to significant UE weakness, abnormal neurological exam, and lack MRI findings suggesting cervical myelopathy. Outcome: Patient seen in chiropractic clinic for period 4 months with thoracic and lumbar spine pain evaluated and treated with spinal manipulation and a therapeutic exercise program. Evaluation by neurology eventually lead to a diagnosis of amyotrophic lateral sclerosis. Conclusion: Although patient’s spinal complaint was managed in the chiropractic clinic, care was coordinated by the chiropractor between neurosurgery, neurology, occupational therapy, and social work leading to improved patient outcomes and quality of life. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To compare thrust forces applied to mannequin thoracic spine, as measured with a novel loadpad sensor, to forces transmitted through the mannequin as measured by a Bertec force plate. We hypothesized that the ratio of transmitted to applied forces would be less than one and that the two force profiles would be moderately correlated. Previous studies showed conflicting results. Methods: Two DCs and 7 students each performed 12 thrusts at the T6 level: 3 “normal” force, 3 “heavy,” 3 “light,” and 3 slow. Data were recorded simultaneously from the two sensors. Analyses of force patterns, intraclass correlation, and peak normality were performed in R. Results: Transmitted peak values were higher for 69 of 108 recordings (64%, similar to other studies), with no obvious trend. Transmitted to applied mean peak ratios ranged from 0.78 to 0.94. “Normal” thrusts showed good agreement (ICC = 0.71, p = .04); other thrust types were not statistically significant. Peak value distributions were normal except for light thrusts. Conclusion: The loadpad is best suited for “normal” force levels. We plan to do additional analysis, e.g., relationship of peak ratio to rate of force application, to investigate lack of consistency. (This is a conference presentation abstract and not a full work that has been published.)

Objectives: Recent research demonstrated that many nonsensory cells can monitor and respond to mechanical cues in their surroundings through multiple mechanotransduction receptors and pathways. Since chiropractic manipulative therapies (CMT) directly alter the mechanical environment of treated tissue, this work identifies and reviews various classes of cells affected by mechanical stimuli as they participate directly and locally in tissue response to CMT. Methods: Review published research related to mechanoreceptors and mechanotransduction in cells and tissues excluding sensory cells. Results: Most cells in the tissues receiving CMT including fibroblasts, chondrocytes, tenocytes, synoviocytes, muscle fibers, and tissue resident macrophages, endothelial cells respond to mechanical cues independent of chemical, hormonal, or neurological signals. In addition, fibroblasts, chondrocytes, macrophages, and endothelial cells were discovered to switch from a pro-inflammatory state to a repairing/remodeling state based on mechanical tension in their environment. The absence or overstimulation of mechanoreceptors was also demonstrated to be deadly for the involved cells, and the extension of therapeutic effect is currently extensively investigated. Conclusion: There is growing evidence that mechanotransduction is an independent parameter in musculoskeletal tissue and associated connective, vascular, and immune homeostasis and is directly involved in tissue health and response to local mechanical therapies. (This is a conference presentation abstract and not a full work that has been published.)

Objectives: To assess the effects of chiropractic intervention on activities of daily living (ADL) and pain scales in patients suffering with chronic low back pain (cLBP). Methods: Following ethical approval, a pilot study was conducted using 12 participants with cLBP attending the college chiropractic clinic. Changes in pain scales and ADLs were assessed at the start and the end of a 6-week, once-weekly course of chiropractic interventions. Pain scales were measured using the McGill Pain Questionnaire, and ADLs were measured using the Oswestry Disability Index. A comparison of pain scales and ADLs were assessed using appropriate inferential statistics. Results: Over the 6-week period, there were improvements in both pain and ADLs. The mean scores for both McGill and Oswestry indices fell by 24% (39 [SD: 12] to 30 [SD: 8] and 21 [SD: 12.5] to 16 [SD: 12]), respectively. Paired t test statistics indicated the improvements to be statistically significant with p = .004 (pain) and p = .021 (ADLs). Conclusion: This pilot study provides valuable insights into chiropractic as a viable treatment for patients diagnosed with cLBP. Reproducing this study on a larger scale, over a longer period as an randomized controlled trial, would further strengthen the validity of this data. (This is a conference presentation abstract and not a full work that has been published.)

Objective. To critically appraise current evidence on clinical effectiveness of chiropractic for temporomandibular joint dysfunction (TMJD). Method: A comprehensive literature search was conducted using Elsevier, CINAHL, Medline, and Royal Society of Medicine databases to identify relevant studies published between 2012 and 2024. Simple inclusion criteria covered chiropractic interventions for TMJD, all literature levels, written in English and freely available full text. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tools. Results: A total of 5 studies met inclusion criteria, comprising 2 case reports, 1 case series, and 2 randomized controlled trials (RCTs). The case reports and case series suggest that chiropractic interventions, either alone or in combination with other therapies, can effectively manage TMJD symptoms. The RCTs demonstrated the superiority of intraoral myofascial therapy combined with education and self-care, as well as activator method chiropractic technique. Limited number of studies, small sample sizes, and variations in diagnostic criteria and outcome measures among the studies limit the generalizability of the findings. Conclusion: The evidence suggests chiropractic interventions offer a valuable treatment option for TMJD. Future larger RCT studies should focus on standardized diagnostic criteria, and long-term follow-up assessments. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe a chiropractor’s application of musculoskeletal (MSK) expertise in the management of MSK pain for an inpatient veteran. Clinical Features: An 83-year-old white male veteran was hospitalized for pulmonary embolism and experienced MSK pains. A Veterans Affairs chiropractor responded to a request for consultation from the inpatient ward for management of pain per patient request. Intervention/Outcome: The chiropractor evaluated and treated the patient four times over the course of 15 days in an inpatient setting using manual and instrument assisted joint mobilization, positional modifications, pain science, and rehabilitative exercise. The patient reported a reduction in pain with improvement in function and quality of life. Future studies may provide insight into how chiropractors can be integrated in inpatient settings for management of MSK pain or functional challenges. Conclusion: An inpatient experiencing pain and functional limitations was aided by a staff chiropractor, providing a unique conservative approach to inpatient pain management. Chiropractors may benefit patients experiencing acute or chronic pain or functional limitations related to hospitalization. This case report highlights low-tech, low-cost, and low-risk techniques implemented in an inpatient setting, incorporating pain science education and self-care strategies to empower and equip the patient. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe an example of chiropractor musculoskeletal expertise being utilized to assist interventional pain procedures to improve patient satisfaction and reduce aborted procedure attempts. Clinical Features: A 75-year-old white male veteran presented for computed tomography-guided bilateral L5-S1 radiofrequency ablation (RFA) after two prior failed attempts due to patient intolerance to side lying position, resulting in severe hip, back, and shoulder pains. The procedure was rescheduled over the course of multiple months, resulting in a protracted pain experience for the patient. A Veterans Affairs chiropractor responded to a request to aid in positioning for the procedure. Intervention/Outcome: The chiropractor was able to position the patient comfortably using pillows and bolsters, facilitating successful completion of the RFA procedure. Future studies may provide insight into how chiropractors and other spine specialists may be utilized in hospital-based clinical settings, including pain interventions. Conclusion: Challenges with patient positioning for an interventional pain procedure were met by offering a unique approach, incorporating a staff chiropractor. Chiropractors have expertise in spinal and skeletal alignment, and functional biomechanics, making them excellent candidates to provide support to pain management teams. Incorporating chiropractors into CT-guided procedures has potential to reduce the number of failed attempts. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe an uncommon anatomical variation of the ulnar artery, known as the superficial ulnar artery (SUA), observed during the dissection of a cadaver, and to discuss its clinical implications. Methods: A 52-year-old male cadaver underwent routine dissection of the upper extremity, during which an SUA was identified. The artery’s course was traced, noting its origin, path through the forearm, and connection to other vascular structures. Observations were compared with known anatomical literature, and the embryological development of the artery was reviewed. Results: The SUA was found originating from the brachial artery, coursing superficially through the anterior compartment of the forearm, anterior to the medial epicondyle, and traveling through the Guyon canal alongside the ulnar nerve. It terminated in the hand as the incomplete superficial palmar arch, without contribution from the radial artery. This variation highlights the complexity of arterial development and potential clinical relevance, particularly in surgical and diagnostic contexts. Conclusion: Understanding variations like the SUA is crucial for clinicians to avoid complications during medical procedures involving the forearm and hand. Recognition and documentation of such anomalies enhance anatomical knowledge, guiding surgical interventions and improving clinical outcomes. Further studies are needed to explore these variations and their implications. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Chiropractic clinicians need to be able to recognize inflammatory myopathies. In this case, after a failed chiropractic treatment trial, a patient was given the proper referral to rheumatology for an ultimate diagnosis of dermatomyositis. Clinical Features: An 87-year-old male veteran presented to a Veterans Health chiropractic clinic with chief complaint of bilateral hip pain and low back pain of sudden onset after playing golf. After 2 weeks, he complained of a rash on his scalp, neck, arms, and back. One month after onset, he developed new onset of weakness in the legs and arms. Intervention/Outcome: The patient underwent 8 chiropractic visits and 7 acupuncture treatments, which fully relieved his pain. Unfortunately, he reported increased weakness. He was referred to primary care and dermatology, ultimately being diagnosed with dermatomyositis and subsequently sent to rheumatology. Conclusion: Patients often seek chiropractic care for muscle pain and joint aches, but when other symptoms such as skin rashes and weakness present, it is important for the clinician to quickly re-assess and refer the patient to the proper specialist for prompt diagnosis and treatment. This patient with dermatomyositis was able to receive the appropriate treatment for his condition, which included rheumatology and rehabilitative exercise. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Review the return-to-play process for a rugby athlete with a partial patellar tendon tear, emphasizing the role of ultrasound in guiding treatment. Clinical Features: A 25-year-old male collegiate rugby athlete suffered a partial patellar tendon tear, which was treated conservatively and managed by the patient who independently completed a rehab program. Six months later, the athlete faced re-injury with marked functional impairment and diminished performance capacity. The re-injury underscored the need for a more structured rehabilitation approach, incorporating both physical and psychosocial aspects of recovery. Intervention/Outcome: Treatment involved instrument-assisted soft tissue mobilization combined with a graded progression of functional movements through sagittal and coronal planes to meet the demands of rugby. Diagnostic ultrasound was used methodically to assess the extent of injury, progression of tendon healing, and adjust the rehabilitation strategy. After rehabilitation, the patient returned to sport for the rest of the season and recreational sporting activities thereafter. Conclusion: A nonsurgical treatment strategy effectively managed the partial patellar tendon tear, allowing the athlete to return to full rugby participation. This case highlights the importance of diagnostic ultrasound in tracking recovery and tailoring treatment, as well as the value of sport-specific rehabilitation in achieving optimal return-to-play outcomes. (This is a conference presentation abstract and not a full work that has been published.)

Objective. Low back pain (LBP) is a common chronic pain causing disability and suffering. Spinal manipulative therapy has been shown to benefit LBP patients, but the biomechanical effects resulting in clinical improvement are not well understood. The purpose of this study was to document the spinous process movement in the lumbosacral spine (L3–S1) during flexion distraction spinal manipulation, using diagnostic ultrasound imaging. Methods: Thirty asymptomatic volunteers were asked to lie prone on a specialized flexion distraction chiropractic table. An ultrasound imaging sonographer performed scanning to image the spinous processes from L3–S1 under no traction and during flexion distraction utilizing standard protocol I. Ultrasound measurements were made and recorded by identifying the tips of the spinous processes and distances between L3–L4, L4–L5, and L5–S1, before, during, and after flexion distraction. Results: Descriptive statistics of distance between the spinous processes during flexion distraction revealed a mean (SD) separation of 1.26 (1.06) mm at L3–4, 1.34 (1.30) at L4–L5, and 1.62 (.81) at L5–S1. Conclusion: Our study found a separation of the spinous process at L3–L4, L4–L5, and L5–S1 during Cox Flexion Distraction Protocol I. This separation was not significantly maintained after the treatment was complete. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This study aims to explore providers’ perceptions of artificial intelligence’s (AI) impact on their practice efficiency and patient outcomes, as well as the correlation between these perceptions and the effects on patient outcomes. Methods: A self-administered questionnaire was mailed to 38 providers at a rural medical center in north Texas, with a 70% percent response rate (n = 27). Besides descriptive statistics, multivariable logistic regression test was conducted to discern the relationship between their perceptions of AI and its impact on patient outcomes. Results: The findings revealed that a majority of providers perceived AI to still be in its early stages, posing challenges for practice and having a limited impact on patient outcomes. Additionally, various factors such as age, gender, a user-centered design approach, AI experience, along with perceptions of workplace support and stress, significantly shape providers’ attitudes toward AI and ultimately affecting patient outcomes. Conclusion: Before AI technology can fulfill its promise of transforming healthcare through integration with other technologies, it is crucial to approach the development and testing of intricate systems like AI-integrated electronic health record systems with caution to ensure their reliability and dependability in clinical decision-making. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe the chiropractic management of a 66-year-old male veteran with chronic low back pain (LBP) with an incidental magnetic resonance imaging finding of a heterogeneous bone marrow (BM) signal. Clinical Features: The patient presented with a 10-year history of intermittent, sharp LBP, exacerbated by forward flexion and relieved by chiropractic care. Magnetic resonance imaging (MRI) findings included lumbar spondylosis, mild disc desiccation from L3–L4 to L5–S1, Schmorl’s node formation at L4, mild facet arthrosis, and a nonspecific heterogeneous BM signal throughout the lumbar spine. A heterogeneous BM signal is a common finding but can be challenging as a small minority can be associated with serious conditions such as multiple sclerosis, metastatic cancer, or bone marrow disorders. Recent bloodwork proved to be noncontributory. Intervention/Outcome: Initial treatment involved conservative chiropractic care, Cox flexion–distraction, manual therapy, and patient education. Consultation with the radiologist ruled out serious pathology. The patient demonstrated a consistent response to chiropractic management strategies. Conclusion: This case underscores the importance of considering differential diagnoses when evaluating MRI findings in chronic LBP. Despite the heterogeneous BM signal finding, conservative chiropractic care effectively managed the patient’s symptoms and improved function. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The goal of this case report is to describe the effects of chiropractic care in a patient with Ehlers-Danlos syndrome. Clinical Features: A 24-year-old female presented with a history of migraine, recurrent dislocations of the hips bilaterally, cervical pain, and low back pain. A prior diagnosis of Ehlers-Danlos syndrome had been made using Villefranche criteria and the Beighton scale. Intervention and Outcome: The patient reported a history of increased pain and inflammation after forceful chiropractic manipulation in the past. A treatment strategy using gentle low-force manipulative techniques, soft-tissue therapies, and exercise was implemented. The patient responded favorably, reporting notable albeit temporary relief of symptoms. Conclusion: Hypermobile Ehlers-Danlos is a condition in which repeated compromise of the structural integrity of affected regions can create more chronic issues. Practitioners must be aware of the potential for further complications, including tears, muscle strains, and joint dislocations, to tailor an individualized treatment pain that considers underlying health factors. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Emerging chiropractic services within multidisciplinary settings raises questions of value, integration, and optimization, particularly for marginalized populations. This study describes the value of chiropractic services within federally qualified health centers (FQHCs), through the perspective of chiropractic doctors (DCs), colleagues, and administrators employed there. Methods: Semistructured qualitative interviews were conducted via Microsoft Teams. Questions focused on the practice environment, demand for chiropractic services, value, and professional relationships. Thematic analysis was used to code themes, which were iteratively refined and organized into an analytic narrative. Results: Interviews were conducted with 12 DCs, 10 administrators, and 7 colleagues. Most noted chiropractic care as an effective, conservative care option for pain among both communities and FQHC staff, and as an important component of their opioid crisis response. Referral and co-management were common, made convenient by proximity and integrated electronic health records. Several administrators indicated a positive revenue impact; providers noted decreased burden on primary care and patient wait times. Demand for chiropractic was high, with general support and optimism for growth of chiropractic within FQHCs as resources allow. Conclusion: Chiropractic services within FQHCs were generally viewed as an asset, especially for pain management among communities typically lacking access. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe advanced professional training and recent research experiences among chiropractic college faculty. Methods: An anonymous electronic survey of chiropractic college faculty and administrators was conducted across 3 campuses. The survey included self-reported advanced training and recent research/scholarship experiences. Data were collected using SurveyMonkey and analyzed with SPSS. Results: Of 110 responses, nearly half (46.4%) reported diplomates/certificates, mostly in sports/rehabilitation (n = 31). Several faculty members completed masters (18.2%) and doctoral research degrees (10.9%). In the last year, <30% of faculty planned/conducted research, analyzed data, or presented results, although 40.9% critically reviewed literature. Exactly 25.5% reported journal peer-reviewing, 21.8% conference peer-reviewing, 10% mentored students, and 16.4% mentored colleagues. More faculty attended conferences (29.1%), used reference managers (21.8%), wrote case reports (23.6%), and submitted papers for peer review (31.8%). Publications in the past 5 years ranged from 0–29, with many faculty reporting 0 (19.4%), 1 (26.9%), or 2 (19.4%) publications. Research faculty (n = 5) contributed highly to overall publications (41.6%) and conference presentations (31.0%). Conclusion: Despite self-reported increases in scholarly activity, most faculty and administrators did not conduct research over the last year. Institutional initiatives to engage and incentivize collaboration among highly trained faculty in peer-reviewed scholarship are warranted. (This is a conference presentation abstract and not a full work that has been published.)

Objective: A 43-year-old patient with a history of intravenous (IV) drug use presented with persistent neck pain. Initial assessments suggested a musculoskeletal origin; however, due to the patient’s complex medical history, further investigation was necessary. Objective: To report an incidental finding of silent sinus syndrome (SSS) in a patient undergoing cervical spine imaging for neck pain and emphasize the importance of comprehensive radiological evaluation and comparison with previous imaging in patients with complicating medical histories. Methods: A cervical spine X-ray revealed unexpected opacification of the maxillary sinus. Review of previous imaging from 7 years earlier showed well-maintained sinus structures, while a computed tomography scan from 2 months prior noted depression of the orbital floor, indicating an interval change. Recent imaging showed significant collapse of the maxillary sinus, consistent with silent sinus syndrome. Results: The findings of collapsed maxillary sinus and inward bowing of the orbital floor were consistent with SSS. Prompt consultation with an ear, nose, and throat specialist was recommended to combat potential complications like enophthalmos and hypoglobus. Conclusion: This case underscores the need for thorough imaging review and highlights the importance of the use of available previous imaging when managing patients with complex medical backgrounds. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The purpose is to describe an anatomical variant discovered incidentally upon review of imaging, and subsequent chiropractic management of pain in the involved region. Clinical Features: A 60-year-old white male presented to a Veterans Affairs chiropractic clinic with chief complaint of chronic low back pain and intermittent pain of the anterior thighs bilaterally. Lumbar magnetic resonance imaging (MRI) reports described probable venous lake with prominent draining vein associated with the L1 vertebral body. Lumbar computed tomography scan report confirmed a well-corticated curvilinear tract in the L1 vertebral body that appeared to contain a duplicated left renal vein. Imaging reports were available for several additional body regions with no other signs of anatomical anomaly. Neurological examination was unremarkable. Intervention/Outcome: Dilated veins extending through a vertebral body are likely developmental, and less likely to be of a posttraumatic origin. The presence of this anomaly appeared to be incidental without significant impact on the clinical presentation of the patient. Trial of chiropractic care was initiated consisting of myofascial release, lumbar flexion-distraction, and exercise prescription. Conclusion: This case describes a rare example of renal vein duplication that transverses a vertebral body. The clinical implications of renal vein anomaly to chiropractic practices are unclear. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Case studies suggest that self-manipulation of the cervical spine may result in adverse events (AEs). This subject is understudied and we aimed to identify and characterize individual cases of AE after cervical self-manipulation. Methods: Multiple databases were searched for observational studies describing AEs after cervical self-manipulation from inception to June 2024. Screening and data extraction were performed in duplicate. Extracted data included time between self-manipulation and AE, preceding symptoms, and AE diagnosis and description. Adverse event severity was graded from 1 to 4 (4 most severe) using a classification system for manipulation/mobilization procedures. Results yielded 5714 articles after deduplication, 38 articles for full-text screening, and 24 articles met inclusion criteria. The majority (93%) of AE cases occurred within 0–2 days of self-manipulation and 83% were vascular in nature. Over half of AEs reported were grade 3 (n = 10, 42%) or 4 (n = 4, 17%). Conclusion: Only 24 cases with AEs have been reported after cervical self-manipulation. Cervical self-manipulation has the potential for serious AEs; however, it is likely very rare, and further research is needed on the topic. (This is a conference presentation abstract and not a full work that has been published.)

Objectives: The goal of this presentation is to share the unique bony abnormalities, congenital anomalies, and other features of a cadaver with dwarfism from our anatomy lab. In this presentation, we will share radiographical features displaying the impact that thrombocytopenia absent radius syndrome (TARS) had on the musculature in relationship to the upper extremity bony anatomy. Supported literature reviews will be presented displaying the similarities between our findings and the findings of other cadavers or live patients, regarding the abnormalities of muscle attachment sites in cases of TARS. Clinical Features: Absent radii, clinodactyly, opposable thumbs, hypoplastic patella, arthritic changes of knee, status post apparent repair of tetralogy of Fallot with right-sided aortic arch, polycystic horseshoe kidney, subhepatic cecum, necrosis, and hemorrhages of the brain were some features noted in this case. Outcomes: Chiropractic modalities can possibly help in the patient management of those with dwarfism, including those with TAR syndrome, who present with arthritic changes and bony abnormalities. Conclusion: The uniqueness of these findings in this rare case could potentially provide a starting point for treatment in clinical settings for patients who have dwarfism in general. Research and additional data collected from similar cases may support the relevancy of thrombocytopenia and its effect on potential therapeutic strategies for these patients. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Diagnosis and management of os odontoideum versus odontoid fracture. Clinical Features: A 40-year-old male with low back pain was referred to Veterans Affairs chiropractic service to determine appropriateness of chiropractic care in the community. The review of systems also revealed complaints of chronic headaches. Screening cervical spine x-rays revealed congenital variant os odontoideum versus old nonunited odontoid fracture. Further evaluation with computed tomography scan and magnetic resonance imaging confirmed these findings along with posterior and lateral subluxation with angulation of the odontoid and significant radiographic instability. Intervention/Outcome: The patient had been receiving chiropractic manipulative therapy to the cervical and lumbar spine in the private sector and requested ongoing care. After a neurosurgical consultation, nonsurgical care including avoidance of cervical manipulation and surveillance consisting of clinical evaluation of neurological status and serial imaging every 3 months was recommended. Conclusion: Os odontoideum is a rare anatomic variant of the odontoid process and should be differentiated from odontoid fracture, which can result in atlantoaxial instability. Management of os odontoideum remain vague due to poorly understood natural history. Symptomatic and unstable odontoid lesions should be treated surgically. Early identification of os odontoideum takes on additional significance for healthcare providers utilizing manual therapy techniques. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe how mechanical diagnosis and therapy identified the lumbar spine as a likely pain generator in a case of chronic postpartum isolated coccygeal pain. Clinical Features: A 30-year-old female presented with isolated coccygeal pain that began after a vaginal birth 4 months prior. Aggravating factors included sitting, standing up, and glute contraction. She expressed fear of standing after sitting and described the pain as if her sacrum were being pulled apart. Alleviating factors included bending forward. Intervention/Outcome: Initial assessment revealed a directional preference for lumbar extension with right lateral flexion, leading to a diagnosis of lumbar derangement and initiation of reductive forces. At follow-up, reduction was maintained and she reported periods of being pain free with less fear of movement. Subsequently, force progressions and a functional recovery plan were implemented. By visit 6, she was discharged with improved scores on the numerical pain rating scale (7/10 to 0/10) and the patient-specific functional scale (50% to 10%). Conclusion: This case suggests that lumbar derangements may cause isolated coccygeal pain. Given that lumbar derangements have been shown to cause isolated pain in peripheral joints, further research is needed to explore their potential link to coccygeal pain. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe the additional therapeutic benefit a patient with phantom limb pain (PLP) experienced while being treated for low back pain (LBP) with radicular symptoms into the residual limb. Clinical Features: A 66-year-old male with a left-sided below-knee amputation presented with LBP and radicular symptoms to the left residual limb. Aggravating factors included standing, walking, and sleeping. Alleviating factors included pain medications. He also reported PLP that began 2 days after amputation 5 years ago. Intervention/Outcome: Lumbar long-axis distraction and soft-tissue therapy were initiated to address the LBP and radicular symptoms. He self-reported 2 weeks of complete symptomatic relief from PLP at visit 5. A flareup of LBP and PLP was reported at visit 6. However, he chose to discontinue care, citing insurance limitations. At discharge from care, scores on the numeric pain rating scale improved from 8/10 to 4/10 and the Department of Defense/Veterans Affairs Pain Supplemental Questions score improved from 32/40 to 18/40. Conclusion: This case illustrates an unexpected favorable response to the patient’s PLP while being treated with chiropractic care for low back and radicular symptoms. Further investigation into the effects of lumbar spine long-axis distraction and soft-tissue therapy on PLP is warranted. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe the use of structured Force Sensing Table Technology (FSTT) for clinical skills remediation for 1 student. Methods: A chiropractic student with manipulation skill gaps participated in a structured 1-hour remediation regimen using FSTT for 4 months. Pre- and post-remediation FSTT records for 4 corrective high-velocity low-amplitude spinal manipulation techniques were analyzed. Side-lying hypothenar illum push left (Technique 1) and right (Technique 2), bilateral hypothenar SP-TP push (Technique 3), and unilateral hypothenar TP push (Technique 4). Average force of thrust in newtons (N) was calculated from the FSTT software. The student’s clinical performance scores in manipulation skills were graded using the Dreyfus model of skill acquisition (0: absolute beginner; 4: proficient). Pre- and post-remediation skills scores were analyzed. Results: FSTT data sessions showed increased force of thrust post-remediation for all 4 techniques. Technique 1 (422N to 665N), Technique 2 (371N to 705N), Technique 3 (228N to 246N), and Technique 4 (211N to 252N). The student’s clinical skills performance increased from 1.88 to 2.52 post-remediation. Conclusion: We used FSTT to obtain quantitative force data for targeted manipulation skill development and remediation for a student. Use of FSTT for manipulation skill remediation benefited this student. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To assess the impact of a 21-day purification program on porphyrin levels, oxidative stress, and age-related health markers. Methods: A randomized, controlled, double-blind, cross-over study involved 40 healthy subjects (aged 21-64) undergoing either a 21-day purification program or a control diet. The program aimed to purify and nourish the body using whole food ingredients like buckwheat, Brussels sprouts, and kale. Urine and blood biomarkers were measured at baseline, day 22, 36, and 58. Statistical analyses included ANOVA and Wilcoxon/Kruskal-Wallis tests. Results: The intervention group showed significant improvements in hepatic detox and renal clearance markers (p < 0.05). Mean total porphyrin level was 103.6 ± 30.8, with average participant age of 33 ± 11 years. A weak positive correlation between age and porphyrin levels was observed (r = 0.27, p = 0.01). Regression analysis revealed the intervention slowed age-related increases in porphyrin levels. The intervention group consistently demonstrated lower relative fluorescence unit values, indicating reduced oxidative stress (p < 0.05). Conclusion: The 21-day purification program effectively reduced porphyrin levels and oxidative stress while mitigating age-related increases in porphyrin levels. These findings suggest potential clinical implications for oxidative stress management and healthy aging. Larger robust studies are required for validation. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe the influence of maladaptive coping behaviors on the clinical presentation and management of an acute lumbar lateral shift. Case Description: A 39-year-old male sought chiropractic care for acute low back pain with an associated lumbar lateral shift of 3 days’ duration. The symptoms had remained refractory to chiropractic care and medication provided by visits to the emergency room and an orthopedist. In response to the severity of symptoms, heightened cognitive and emotional factors propagated passive coping that resulted in bedrest and work absenteeism. Outcome: Providing an understanding of pain from a biopsychosocial perspective combined with self-management strategies involving the method of manual shift correction and graded exposure exercises decreased pain and catastrophizing in 4 visits over 5 days. The revised low back Oswestry scored 82%, 0%, and 2% disability and the Yellow Flag Risk Form scored 96, 8, and 34 at intake, discharge, and 6-month followup. Conclusion: The method of manual shift correction is discussed as a favorable biomedical procedure for lumbar lateral shift, with little attribution to the multidimensional nature of low back pain. This case depicts the influence of pain-related cognitions and behaviors on nociceptive symptoms. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The biopsychosocial model (BPSM) is a comprehensive, interdisciplinary framework that examines how the interaction of biological, psychological, and social factors influence an individual’s health and well-being. This single-arm feasibility study sought to test a multidimensional, BPSM-based assessment battery in school-age children (5–17 years old) receiving chiropractic care in March 2024 within a United States-based school district. Methods: Twenty-five parent/student pairs were approached, and 17 students (mean age: 11.0 ± 3.5 years; 10 males) were enrolled in the trial. Assessments consisted of electroencephalography, electrocardiography, cognitive functioning, school-related behavior, health-related quality of life, daily activity, and sleep quantity/quality. Primary outcomes of interest included recruitment rate, tolerability, compliance, efficiency, data quality, responsiveness, and pain levels with progression criteria based on the traffic light (i.e., green, amber, red) approach. Results: Overall, point estimates suggest that our battery is feasible with minor revisions although 95% confidence intervals indicated considerable uncertainty due to limited sample sizes. Conclusion: Informed by the results from this trial, a modified version of this assessment battery has been developed in anticipation of a future pilot cluster randomized controlled trial. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Nutritional ergogenic aids are substances included within the overall group of sports supplements with the goal of improving sports performance and recovery. Although they are widely used by athletes of various levels, evidence-based analysis should be used to evaluate effects and harms. Chiropractors commonly consult with athletes at various ages and levels of ability and should have current knowledge regarding common ergogenic supplements that are in use. Chiropractors working with high level athletes need to be mindful of the World Anti-Doping Agency resources to help athletes avoid use of banned substances. Methods: A systematic search was conducted of online medical and chiropractic literature. Instruments developed by the Scottish Intercollegiate Guideline Network were used to evaluate randomized controlled trials and systematic reviews. Results: Overall, 515 publications were identified. Of those, 96 systematic review publications were included (published within the last 5 years). Creatine and caffeine are among the most researched ergogenic supplements. Conclusion: Creatine and caffeine demonstrate efficacy in enhancing athletic performance through various mechanisms including increases in muscle strength and endurance. There has been a steady increase in substances tested for ergogenic potential. Common substances studied include vitamins, amino acids, caffeine, and various herbal extracts. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This case study reports the positive outcome of chiropractic management for a patient with trigeminal neuralgia (TN). Clinical Features: A 41-year-old female presented with facial numbness affecting the right trigeminal nerve’s V2 and V3 branches that started 7 months prior. Physical examination revealed point tenderness of the right trapezius, muscle spasms in the right levator scapulae, and right greater suboccipitals. Cervical compression caused local pain in the suboccipitals of the right side. Trigger points with reproduction of migraine symptoms were found in the right suboccipitals and right anterior scalenus. Intervention/Outcome: Treatment protocol included cervical high velocity and low amplitude manipulation, trigger point therapy to the right suboccipitals and right anterior scalenus, and a home exercise program including cervical retractions, deep neck flexors strengthening, trapezius stretch, and levator scapulae stretch. An evaluation with neurology confirmed the diagnosis of trigeminal neuralgia. Symptoms of facial numbness associated with trigeminal neuralgia were relieved by chiropractic management. Patient continued with neurology for management of persistent symptoms of migraine and trapezius spasms. Conclusion: The positive outcome with chiropractic management of TN in this case supports further research for similar presentations of this condition. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This case study details chiropractic treatment resulting in long-term improvement for pubic symphysis dysfunction in a female patient. Clinical Features: A 35-year-old female with pelvic girdle and low back pain, worsened by running and driving, and a history of unresolved post-partum pubis symphysis dysfunction of 10-year duration, diagnosed by a gynecologist as Lightning Crotch, was referred for chiropractic evaluation. Initial examination revealed right-sided pain provoked when performing Yeoman’s, Kemp’s, and Nachlas’ and a positive sacral apex test. Palpatory findings were point tenderness of the right gluteus medius, right piriformis, and right hamstring. Intervention/Outcome: Chiropractic treatment including pin and stretch of the hypertonic muscles, side posture manipulation, and supine lumbar long-axis distraction to address lumbar, sacral, and pelvic somatic dysfunction along with a home exercise program was initiated. Pubic symphysis dysfunction and low back pain were resolved after 9 visits and patient was discharged after 12 visits, having adhered consistently to the care plan. Conclusion: Unintended relief of chronic pubis symphysis dysfunction and correlating pain via chiropractic management of low back pain, which continued to be resolved at 7-month follow-up, noted in this case warrants further exploration in patient populations with this condition. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This single-arm trial employed a repeated measures design to assess the test-retest reliability of a neuropsychological assessment. The purpose of the trial was to develop a test battery that was sensitive to change induced by interventions designed to improve or remediate movement control and decision-making aberrations. Methods: 19 participants (5 males, mean age: 23.11 ± 3.13 years) were enrolled in the trial and individually assessed across two laboratory sessions separated by 14 days. During each session, participants completed a cognitive switch task, which assessed their response times on task set reconfiguration. The interclass correlation coefficient (ICC) was then assessed between the two testing sessions. Results: A good degree of test-retest reliability was found between repeated-measures of response time outcomes on the switch task. The average interclass correlation was 0.799 ([95% CI: -0.098 to 0.944], F(18, 18) = 11.068, p < .001). Conclusion: The results of this trial support the test-retest reliability of the present assessment. We aim to utilize this neuropsychological test battery to assess the effects of chiropractic interventions in future randomized controlled trials. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Chiropractic management of knee pain includes various nonpharmacological interventions aimed at improving function and symptoms. The aim of this study is to review chiropractic and manual therapy interventions for knee pain associated with osteoarthritis (OA) and patellofemoral pain syndrome (PFPS). Methods: A systematic search was conducted of online medical and chiropractic literature. Instruments developed by the Scottish Intercollegiate Guideline Network were used to evaluate randomized controlled trials and systematic reviews for this narrative review. Results: Twelve studies were included in this review. A majority of studies may not be generalizable and have a risk of bias. Improvement in short-term outcomes regarding function and pain in individuals with PFPS are reported. Limited research is available regarding outcomes associated with OA of the knee. Conclusion: An innovative nonrandomized study was promising for general knee pain in adults treated with flexion-distraction knee manipulation. Manual therapy approaches, which are commonly used by chiropractors are likely helpful in the short term for decreasing pain in patients with PFPS. More research is needed to determine optimal manual therapy and chiropractic interventions or combinations of interventions. Future treatment with longer follow-up is also needed. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The purpose of this study is to examine the correlation between student performance on the NBCE (National Board of Chiropractic Examiners) Part I and their performance in courses related to the same exam components. The School of Chiropractic at Universidad Central del Caribe, Puerto Rico, is the first and only chiropractic school on the island, offering an innovative, evidence-based approach. The school is part of a larger institution that includes a medical school and other academic programs with an interprofessional focus. Basic sciences constitute a significant component during the first 2 years of the chiropractic students’ academic preparation. The curriculum is aligned with the topics covered by the NBCE Part I examination to ensure student success. As a longitudinal study, data will be updated after each exam. Methodology: A Pearson correlation was conducted to determine the relationship between students’ final grades in specific courses and their performance in the corresponding components of the NBCE Part I exam. Conclusion: Understanding this correlation provides insights for course improvements as part of the school’s continuous quality improvement efforts. Moreover, analyzing these correlations helps identify student needs and resources to support their success as future graduates. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Students appear to sacrifice exam performance to prioritize studying for exams that are more significant to their success in a chiropractic program. The purpose of this paper is to document unexpected changes in student performance between early assessments and final exams. Methods: Scatter plots of Student Accumulated Mark going into the Final Exam vs Final Exam Performance and performance between exams at different course timepoints were constructed. Correlation coefficients were calculated for each scatterplot and a frequency count of students who declined in exam performance by 20% or more was conducted. Results: There were weak relationships between Accumulated Mark going into a Final exam and Final Exam Performance. Secondly, the percentage of students who dropped by 20% or more in the last exam ranged from 0.5% to 53%. There were strong correlations between exam performance early in a course, but weak relationships between early and final exam performances. Conclusion: These methods of analysis support the notion that students strategically prioritize preparing for certain exams as a tactic for success in the overall educational program. (This is a conference presentation abstract and not a full work that has been published.)

Objective: From an ongoing project of kinematic analysis of chiropractic adjustments, we present a case from our exploration of research-based content for technique education. Methods: A senior-year DC student wore 16 inertial measurement units (IMUs) to track motion while performing a supine cervical thrust on a Palpation and Adjustment Trainer mannequin. From the data we identified angular positions at prethrust setup and peak of thrust for the spinal regions, shoulders, elbows, wrists, hips, knees, and ankles. We also generated a 5-viewing-angle “skeletal avatar” video from the IMU’s software. Our primary interest was change in angular positions during the thrust. Results: Motion changes during the thrust were small. Of 37 values, only 12 were larger than 2.5°; the largest was a 12.7° decrease in left wrist pronation. Some video observations disagreed with the data. Notably, left elbow extension was judged to be a major thrust element, but the IMU data indicated only 1° of extension, supplemented by multiple body motions. Conclusion: Small movement amplitudes were difficult to see and there were discrepancies between the data and observational analysis. IMU data and videos would be useful complements to observations and instructor feedback in chiropractic technique education. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Complex regional pain syndrome (CRPS) is a broad term describing a chronic pain syndrome that can occur after injury or surgery. The aim of this project is to describe a patient with CRPS and review challenges in management. We also review diagnosis and current treatment approaches for CRPS. Features: A 33-year-old male with combat-related injuries secondary to blast exposure was treated by Veterans Affairs (VA) surgeons for an upper extremity complaint. The symptoms worsened and eventually consulted the VA chiropractic service for subsequent back pain. Intervention/Outcome: The patient’s neuropathic symptoms did not improve after cubital tunnel release with ulnar nerve transposition. Surgical excision of a neuroma on the medial antebrachial cutaneous nerve proved ineffective. Post-surgery, the patient developed subsequent upper back and neck pain. A triple-phase bone scan of the left upper extremity substantiated CRPS diagnosis. Physical medicine intervention included a stellate ganglion block, which was ineffective. The patient also had back and neck pain, which prompted consultation for chiropractic care. Chiropractic care was effective for spine-related pain. Conclusion: This is an example demonstrating the advantage of inclusion of chiropractic care within multidisciplinary settings to improve outcomes for complex pain syndromes. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe information technologies used by a faculty workgroup to support research activities. Methods: RAISE (Recognize, Assist, Include, Support, & Engage) workgroup engaged in faculty development and skill building to support educational research. Analysis of meeting minutes identified technologies used to support research activities. Team reflections outlined adoption challenges and successes. Results: Eighteen faculty from 2 campuses of 1 chiropractic college implemented 18 communication and information technologies over 24 months. Technologies were adopted if faculty had current access/proficiency or to enhance cross-campus collaboration, increase research rigor, and support group-writing projects. Faculty were proficient in office management software and research databases. Novice faculty completed training for CITI research ethics (n = 6), Covidence review software (n = 14), and SPSS statistical software (n = 14). Experienced faculty programmed SurveyMonkey and trained others on statistical and qualitative research technologies. Many technologies (Zotero, Covidence, OpenScienceFramework, SurveyMonkey, SPSS, NVIVO, CITI) required registration/paid subscriptions. Challenges included lack of experience with research software, novice data analysis knowledge, budget constraints leading to less-than-optimal options, and difficulty with file-sharing and virtual meeting technology. Conclusion: Successful implementation of chiropractic educational research may require institutional investment in research software and training by experienced users. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe atlanto-occipital assimilation in an adult female that was initially missed on a plain radiographic exam, and the adverse reactions observed after a manual upper cervical spinal manipulation. Clinical Features: A 37-year-old female presented to a chiropractic clinic with chronic neck and back pain. Twenty years prior, she fell headlong onto the grass after doing a mid-air pirouette in a cheerleading maneuver. Intervention/Outcome: After the initial evaluation, the patient received a manipulation of the cervical spine using an Activator instrument and was referred for cervical radiographs. The imaging report described minimal degenerative changes and no other abnormalities. On the second visit, the chiropractor reviewed the report and radiographs and identified atlanto-occipital assimilation. They proceeded to manipulate the cervical spine with a drop-assisted method. In the first two visits the patient’s symptoms improved, and no adverse reactions were observed. On the third visit, the cervical spine was manipulated using diversified technique. Immediately after, the patient experienced dizziness and nausea, which was severe for 1 to 2 minutes. Conclusion: Atlanto-occipital assimilation may be associated with other visceral, vascular, and bony anomalies; symptoms may include headaches, neck pain, paresthesias, weakness, and tinnitus, among others. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Investigate chiropractic healthcare (CHC) section leaders’: (1) motivations to engage with the section; (2) perceptions of barriers and facilitators to member recruitment and engagement; and (3) perceptions of section public health priorities. Methods: Past and present CHC section leaders were invited via convenience sampling to complete an online 17-item survey. A qualitative thematic analysis was conducted between June and July 2024. Results: Of 19 respondents, the mean age was 54 (range: 30–74) years and the majority were non-Hispanic White (89%), male (53%), chiropractors (100%), and current CHC section members (74%). In summary, the three overarching themes developed included CHC section leaders: 1. Have primarily had positive experiences with the section; 2. Reported a belief that membership growth will contribute to enhancing section productivity and leadership; 3. Believe the section has the opportunity to lead the chiropractic profession in the public health field. Conclusion: CHC section leaders see value in guiding the chiropractic profession in public health, growing membership, and believe future efforts should focus on research, education, and policy. Reflecting on past and present section leadership motivations, attitudes, and accomplishments may aid future strategic CHC section planning. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Whole Health (WH) empowers veterans in actively managing their health by focusing on what matters most. This case series, documents and shares three successful stories demonstrating transformed lives and goal achievement through engaging in Whole Health. Clinical Features: Patient 1: 49-year-old Caucasian male with remote polysubstance abuse, unemployment, homelessness, psychotic disorder, Charcot foot, osteomyelitis, and chronic mid and low back pain (LBP). Patient 2: 91-year-old Caucasian male whose WH journey started 7 years prior with hyperglycemia, spine pain, and social disengagement. Patient 3: 75-year-old Caucasian male actively participating in WH since 2019, 7 years of opiate analgesic and Percocet use, CLBP, discitis, and psychological distress. Intervention/Outcome: Patient 1 engaged in WH coaching, tai chi, yoga, meditation, Battlefield acupuncture, chiropractic, and biofeedback. He obtained goals of independence, stable transportation, and employment, helping him take control of his life. Patient 2 found social connection, reduced Hgb A1C levels, continues participating in chiropractic care, and increased regular activity. Patient 3 created a support group within WH aiding in processing his daughter’s disease and loss and facilitating opioid tapering. Conclusion: This case series empowers health professionals to encourage veterans’ active participation in their health, and demonstrates inclusion of chiropractic care as part of WH. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The objective of this report is to demonstrate the practical consideration of a veteran’s social determinant of health (SDOH) and the subsequent care coordination between Veterans Health Administration (VA) Chiropractic and Social Work services. Clinical Features: An Army veteran presented to a VA chiropractic clinic for evaluation and care for a working diagnosis of mechanical neck and associated cervicogenic head pain due to cervical derangement and secondary myofascial pain. At the fourth visit, he reported increased headache frequency and concerns of housing instability due to failure of his apartment building’s heating system, below freezing outside temperatures, and a potential carbon monoxide leak. Intervention/Outcome: On evaluation, a care plan of end range loading and acupuncture was recommended for his neck pain and cervicogenic headache. At visit 4, he reported degradation in symptoms and acute housing instability. The chiropractor considered this veteran’s SDOH and performed care coordination to address the housing instability. Through care coordination with social work, the veteran was provided with resources for his unstable housing situation resulting in reported symptomatic improvement. Conclusion: This case highlights the ability of chiropractors in integrated care settings to play critical roles in identifying and addressing SDOHs. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To investigate knowledge of scientific publishing, with a focus on predatory publishing, among chiropractic education stakeholders. Methods: An anonymous, online survey was administered to a convenience sample of 2476 faculty, staff, and students at a chiropractic college. Respondents indicated their knowledge of predatory publishing practices, perceptions of chiropractic journals and information resources, and publication history. Results: Respondents (n = 210; response = 8.4%) included 111 chiropractic students, 35 faculty, 16 administrators, and 42 staff members. A total of 26% of respondents had published 1 or more peer-reviewed publications. When asked if they were familiar with predatory journals, 43% said yes, 42% said no, and 15% were unsure. Although 51% were not confident in identifying predatory journals, many respondents identified their key features such as no/insufficient peer review (71%), no/fake editorial board (68%), promise of fast publication process (59%), high publication fees (55%), no/use of fake impact factors (53%), publication of plagiarized articles (53%), and unsolicited request for articles (52%). A total of 61% indicated they would like training or resources on identifying quality academic journals for publication or research. Conclusion: Chiropractic faculty, staff, and students are familiar with predatory publishing, but most respondents seek more training on identifying quality academic publications. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This study examines the effectiveness of shockwave therapy in treating a patient with Dupuytren’s contracture after limited success with passive modalities. Clinical Features: The patient presented with palpable nodules proximal to the second through fourth metacarpophalangeal joints, causing pain and difficulty with activities involving the flexor tendons. The patient’s index finger “locked” or “caught” during flexion-extension motions, particularly when using a computer mouse. The patient also has diabetes mellitus, a known risk factor for Dupuytren’s contracture. Intervention/Outcome: Initial treatments with instrument-assisted soft tissue mobilization (IASTM) and therapeutic ultrasound provided modest relief. The patient then underwent shockwave therapy targeting the palmar nodules. This intervention led to significant pain reduction and improved hand functionality, enabling easier performance of daily activities. The Upper Extremity Functional Index (UEFI) scores improved from 58/80 at baseline to 75/80 midtreatment, indicating a substantial improvement. Clinically, the fibrous tendons softened, nodularity decreased, and range of motion improved. Conclusion: Shockwave therapy effectively managed Dupuytren’s contracture, showing substantial improvements where other non-surgical methods had limited success. This case suggests shockwave therapy as a viable alternative for patients seeking nonsurgical intervention, enhancing hand function and reducing pain. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Documentation and assessment of human osteological collections have scientific value, providing opportunities for research and pedagogy. Knowledge of normal and abnormal osteology has been an essential part of chiropractic training. The study of bones can provide a record of sex, age, stature, trauma, in addition to variation and pathologies. This preliminary study of skulls from the large osteological collection of a chiropractic college recorded both morphometric and nonmorphometric characteristics of the studied skulls. The emphasis of this study was on the variations and pathologies of the skull and their importance to teaching and research. Methods: During a morphometric analysis of 29 human skulls, nonmetric variations were documented and photographed. A literature review was conducted on nonmorphometric characteristics. Results: A wide variety of skull anomalies were noted. These included but were not limited to: atlas assimilation, enlarged foramen magnum, elongated styloid process, asymmetrical mastoids, unfused sutures in adults, enlarged pterygoid hamulus, and others. Conclusion: Documentation of human osteological variations is a vital resource for teaching and research in the health sciences. This osteological collection documents a broad range of abnormalities making it an invaluable resource for study. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The purpose of this study was to develop an assessment rubric for direct observation of the 31 metacompetency outcomes. Methods: The metacompantency outcomes in the 2025 standards from the Council on Chiropractic Education were revised with actionable verbs for a clear and reliable objective measurement. We established a design process by first defining criteria for the descriptors, and applying each criteria to each of the metacompantency outcomes in an effort to identify the desired behavior expected in each of the levels of the scale. Artificial intelligence was consulted to establish the first draft and inspire the discussions for refinement. This was placed in a table for organization. Once established, the table was shared with internal and external educators for feedback and validation. After revisions, the rubric was tested with video encounters for level setting. Our collection of data from usage of the assessment combined with observed behaviors is expected to define a scale for use throughout the curriculum where direct observation is used. (This is a conference presentation abstract and not a full work that has been published.)

Objective: The objective of this report is to share novel treatment for a toe walking in a 33-year-old female presenting with a lifelong toe walking condition. Clinical Feature: A 33-year-old female (now 35 years old) presenting for chiropractic care with unresponsive bilateral toe walking and mild scoliosis in her entire spine due to gait disturbances, to an interdisciplinary clinic having given up on other options (e.g., surgery, physical therapy, etc). Intervention and Outcome: Treatment consisted of sacro-occipital technique, cranial techniques, and one visit to a pelvic floor physical therapist to address spinal/coccyx, lower extremity, and postural imbalances, likely related to the patient’s lifelong toe-walking. After 2 months of one-two chiropractic treatments per week, the patient was able to stand flat footed with some forward torso bending for the first time in her life. Her gait still consisted of toe-walking but had some intervals of heel-toe walking as well. After 8 months of chiropractic treatments, approximately one treatment per week, she has attained proper gait mechanics and only toe-walks out of habit on occasion. Conclusion: This case demonstrates a conservative treatment for an adult patient presenting with toe-walking/gait disturbance when other methods were not effective. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe chiropractic patient using assistive mobility device to reduce pain deferring possible need for hip replacement surgery. Clinical Features: Older female patient osteoarthritis, hip pain, reduced range of motion (ROM), difficulty walking for exercise. Patient’s orthopedic surgeon offered hip arthroplasty and/or corticosteroid injection as elective options at patient’s discretion. Patient concerned about risks of medical/surgical options and recovery time, sought alternative, nonsurgical treatment options. Intervention/Outcome: Patient’s 12-week chiropractic care included spinal and extremity adjustments, soft tissue mobilization, rehabilitative exercises to enhance joint function and reduce pain. Assistive mobility device (cane) introduced to alleviate joint pressure and support ambulation. Post: Reduction pain (visual analogue scale), improved hip ROM, enhanced ability for daily activities. Patient postponed hip replacement surgery, opting for conservative management for the time being. Conclusion: Evidence-informed chiropractic management, including prescription and patient education on proper use of assistive mobility device to alleviate pressure in weight-bearing joints, offers effective comprehensive conservative treatment option for improving mobility in patients with painful ambulation. Reducing pain and improving patient quality of life in the near term, gives patient more time and less stress to fully consider their preferences and options for care over the longer term, such as elective non-urgent joint replacement surgery. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Interest in nonpharmacological pain management options is growing, likely due to the high incidence of pain and problems associated with using opioids to manage that pain. Pain is a common complaint within chiropractic offices and many chiropractors use acupuncture as an adjunctive pain management approach. Battlefield acupuncture (BFA) is a form of auricular acupuncture that is quick and easy to apply and has been used primarily for pain management in military and emergency departments. The aim of this study is to review published articles regarding implementation and effectiveness of battlefield acupuncture. Methods: A systematic search was conducted of online medical and chiropractic literature. Instruments developed by the Scottish Intercollegiate Guideline Network were used to evaluate randomized controlled trials and systematic reviews. Results: Seven articles were included in this narrative review. Both randomized and nonrandomized trials were included. Most nonrandomized trials report positive findings while not all randomized trials achieved statistical significance. Class 1 evidence is lacking. Conclusion: Evidence exists that BFA is potentially effective immediate and short term, nonpharmacological pain management tool. Published studies are limited and underpowered, which limits generalizability of results. BFA interventions should be used thoughtfully, with a recognition of its limitations. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To describe a research elective in collaboration with Stanford University School of Medicine for the Integrated Clinical Practice Chiropractic Residency Program at the VA Palo Alto. Methods: Through an iterative process, faculty developed a learner-centered curriculum to build research competencies though mentored training in clinical pain. Key milestones include the completion of an independent research project, presentation of findings at scientific conferences, and acceptance of a first-author publication. Achievements are assessed using validated tools to track health care knowledge specific to interdisciplinary pain research. Results: The first chiropractic resident has begun the elective, and we have identified an independent research project and an interdisciplinary research mentorship team. The elective will advance the research training of chiropractic residents, develop interinstitutional research collaborations, and contribute to the development of a robust VA chiropractic research program. The anticipated outcomes will include chiropractic residents with greater competency in research methods, improved ability to translate research to clinical practice, and high-quality research outputs. Conclusion: The long-term plan for this elective includes collaboration with other academic institutions and expansion to other VA locations to provide novel research training opportunities for VA chiropractic residents. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This study investigated the relationship between chiropractic students’ use of a clinical education wiki site (CEWS) and practical exam performance. Methods: An institutional review board-approved survey and cross-sectional study of trimester 1 through 7 students was conducted. Questions included frequency of use, experience level with online technology, gender, perception of how usage impacted their overall education, and performance on practical exams. The survey was pretested for face validity prior to administration. Practical exam data was collected from our leaning management system. Results: The survey was distributed to 348 students and 150 responded: a response rate of 43%. There were no statistically significant differences in exam scores between users and nonusers, based on frequency of use, between gender, or between students’ perception of using the site and their practical exam scores. Seventy-five percent of users reported being satisfied or very satisfied with the overall ease of use of the CEWS. Conclusion: There was no statistically significant evidence to support the hypothesis that increased engagement with the CEWS improves practical exam performance. Further research with larger sample sizes and refined methodologies is recommended to better understand the potential benefits of digital learning tools in chiropractic education. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Determine the relationship between hip flexion-extension range of motion (ROM), ankle plantar flexion-dorsiflexion ROM, low back pain level, activities of daily living disability level, and standing 30-second static balance of individuals with low back pain (LBP). Methods: Fifty-two individuals with LBP stated their pain level on a 0–10 numeric rating scale and completed a 24-item Roland-Morris Disability Questionnaire. Next participants were outfitted with standardized form fitting clothing and silver reflective motion analysis markers on their right lateral torso rib 10, greater trochanter, lateral femoral epicondyle, tibial tuberosity, lateral malleolus, and fifth metatarsal head. Participants’ active ROM for hip flexion-extension and ankle plantar flexion-dorsiflexion were measured using Vicon infrared cameras. The transformed dot product equation was used to calculate relevant joint angles 3 dimensionally. Lastly, participants’ standing eyes-closed balance was recorded for 30 seconds while participants engaged in serial 7s (counting backwards by 7s from 500 to mentally tax their cognitive and vestibular systems further). Next, Pearson correlations were performed to analyze the relationship between variables. Results: Participants with LBP expressed unique relationships among the measured variables. Conclusion: LBP is associated with impairments in varied attributes that demonstrated correlations with balance parameters. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Describe development and evaluation of a doctor of chiropractic program preceptorship program. Methods: Between 2019 and 2022, a DCP greatly increased the percentage of students precepting with chiropractors (DCs). In 2023, the authors developed a preceptorship evaluation including an intern questionnaire on opportunities, confidence growth, and post-graduate plans and a DC questionnaire about interns’ skills and preparedness. Between November 2023 and July 2024, 221 intern and 158 DC surveys were distributed. Descriptive statistics were used to analyze ordered scale and discrete question responses, and word clouds were used to summarize replies to 2 open-ended questions. Results: Seventy-four DC and 44 intern surveys were received. The majority of DC surveys ranked 8 assessed student skills as strong although a need to increase intern preparation in adjusting, business, and patient communication skills was identified. The majority of interns strongly agreed with receiving adequate opportunities and increasing their confidence skills in assessed areas including adjusting. Over half of interns reported receiving an offer to continue working at the preceptor location. Conclusion: Interns and DCs value external clinical placements, as observed in previous research. Survey responses will guide intern and preceptor training and future evaluation questions. (This is a conference presentation abstract and not a full work that has been published.)

Objective: This report demonstrated how to use a rubric to assess the progression of case assessment skills during pre-clinical and clinical years of a Doctor of Chiropractic program. Methods: A case report about viscerosomatic pain was presented to pre-clinical students in a gastrointestinal course and to clinical internship students during case conferences. The level of performance in generating a conclusion and related outcomes for the case was assessed using the critical thinking value rubric produced by the Association of American Colleges and Universities (AAC&U). The initial case presentation included clinical internship students with no prior exposure to the case and subsequent presentations measured the progression of reasoning skills over time. Results: Preclinical students score 2/4 and include viscerosomatic pain while clinical internship students without prior exposure did not include viscerosomatic pain scoring 3/4 on the rubric. Sixty percent of clinical internship students with prior case exposure included viscerosomatic pain in their case assessment, producing a 4/4 rubric score. Conclusions: Preclinical students applied knowledge of viscerosomatic pain from their coursework while clinical internship students retrieved preclinical knowledge and experience to assess the case. Increased exposure to the same case enhances retrieval of knowledge and reasoning. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To discuss chiropractic management, specifically Logan technique, of a patient with severe menstrual symptoms. Clinical Features: A 28-year-old female with a history of debilitating menstrual symptoms to include severe cramping (10/10 on the visual analogue pain scale), headaches, and heavy menstrual flow lasting around 9 days each cycle. She sought chiropractic care in December 2023 inquiring about Logan technique for her symptoms. Initial quadruple visual analogue score (QVAS) showed high intensity for menstrual symptoms with a 76.6. Intervention/Outcome: The patient was treated with Logan technique for 6 months. Her symptoms significantly reduced after 2 visits involving Logan technique and continued to make progress with consistent care. Her follow-up QVAS score 3 weeks later was low intensity for menstrual symptoms with a 33 and then again at 8 weeks, a QVAS score of 36. After a 1-week break in care prior to her next cycle, her symptoms returned but with less intensity than before treatment. Conclusion: The case report demonstrated improved menstrual symptoms for a patient receiving chiropractic care with Logan technique. Case series and controlled research studies to evaluate the effectiveness of Logan technique for patients with severe menstrual symptoms may be warranted. (This is a conference presentation abstract and not a full work that has been published.)

Objective: Microgravity has been suggested to cause both short- and long-term detriments to physiological systems, including musculoskeletal, cardiovascular, and neurophysiological functions. These issues are particularly relevant to chiropractic care, which aims to maintain and improve overall health. The objective of the study was to review the current literature on the roles of alternative medicine including chiropractic care on the management in preventing and mitigating musculoskeletal ailments in astronauts and others exposed in low-gravity environments. Methods: A literature review was conducted using databases such as PubMed, ScienceDirect, TRIP, Google Scholar, Medline, and CINAHL. The review focused on peer-reviewed articles published in the last 20 years, using keywords like “Microgravity,” “chiropractic,” and “manual therapy.” The selected articles were analyzed to assess the effectiveness of chiropractic care in addressing microgravity-induced musculoskeletal issues. Results: Among 96 initial searched papers, 30 qualified for analysis; 66.7% of them focused on exercise as a countermeasure, while 33.3% of them examined wearable equipment, nutrition, pharmacology, electrical stimulation, and artificial gravity. No study related to chiropractic care was found. Conclusion: Future research on the potential advantages of chiropractic care in managing microgravity conditions is warranted given the paucity of existing literature on the subject. (This is a conference presentation abstract and not a full work that has been published.)

Objective: To conduct a bibliometric analysis of global research trends in chiropractic treatment for musculoskeletal conditions, using multiple databases to provide a comprehensive overview. Methods: This study analyzed 1123 articles from Web of Science, PubMed, and Index to Chiropractic Literature spanning January 1978 to June 2024. Results: Publication volume has grown significantly since 1995, with a peak in 2021 to 2022. The United States (95 documents) and Canada (38 documents) led contributions, with strong collaborations in Europe and Oceania. Jan Hartvigsen, from the University of Southern Denmark, was the most prolific author with 12 citations per document, while his institution led with 15 publications. Influential researchers like Scott Haldeman (43 citations) and key works such as Chou’s low back pain guidelines (12 citations) were widely referenced. Leading journals included the Journal of Manipulative and Physiological Therapeutics (126 citations) and Spine (113 citations). Keywords like “low-back pain” and “spinal manipulation,” identified through the co-occurrence network, indicated a shift towards specific conditions and integrated care. Conclusion: This analysis underscores the growth of chiropractic research, key contributors, and emerging trends, highlighting the importance of international collaboration. (This is a conference presentation abstract and not a full work that has been published.)

Publication of the proceedings was funded by the Association of Chiropractic Colleges. No conflicts of interest were reported for the publication of these proceedings.