KEY TAKEAWAYS
- The study aimed to investigate the prevalence of non-MSK physical examination procedures among Quebec chiropractors and explore the clinical contexts.
- Researchers observed a patient-centric emphasis on vital signs and cranial nerve exams among chiropractors, with infrequent genitourinary exams being the exception.
Low back pain, constituting approximately 1% of cases, may arise from serious systemic diseases such as cancer, infection, or abdominal aortic dissection.
Danikel Giroux and the team aimed to investigate the prevalence of non-musculoskeletal (MSK) physical examinations within the practices of Quebec chiropractors, aiming to discern the frequency of execution and the clinical context guiding their utilization.
They performed an inclusive analysis through a cross-sectional survey comprising 44 questions administered to a random sample of Quebec chiropractors. Utilizing a combination of online, postal, and phone questionnaires, the four-part survey encompassed 6 demographic inquiries, 28 single-choice questions to gauge the frequency of non-MSK physical examination procedures, clinical vignettes prompting selection of necessary non-MSK examinations, and queries about the perceived necessity and adequacy of non-MSK examinations for new patients.
The questionnaire underwent pilot testing, with integrated feedback prior to administration. The analysis incorporated descriptive statistics, Pearson correlations, and an ANOVA to explore the landscape of non-MSK examinations in chiropractic practice comprehensively.
About 182 chiropractors participated in the survey, representing a response rate of 36.4%. The most frequently performed daily non-MSK examinations were blood pressure (12.1%) and cranial nerves (4.9%). Notably, certain examinations were seldom conducted, including oxygen saturation (68.7%), cardiac auscultation (69.2%), tibio-brachial index (71.4%), breast (86.8%), rectal (96.7%), testicular (95.6%), and vaginal (99.9%) exams.
Female chiropractors and graduates from Quebec University in Trois-Rivières reported a significantly higher proportion of new patients requiring non-MSK physical examinations than their counterparts—37.2% versus 28.3% for gender and 33.9% versus 19.9% for alma mater. The primary reason for not performing a physical examination was the belief that another healthcare professional was better positioned to conduct and interpret the relevant tests, accounting for 76.4% of cases.
The study concluded that chiropractors predominantly focused on vital signs and cranial nerve examinations in their non-MSK assessments. With rare exceptions, such as the infrequent performance of genitourinary exams, participants consistently opted for non-MSK examinations aligned with the patient’s specific clinical presentation.
The study is sponsored by the Fondation Chiropratique du Québec (FCQ)
Source: https://pubmed.ncbi.nlm.nih.gov/38419063/
Giroux D, Branconnier C, Bussières A, et al. (2024). “Frequency and indication of non-musculoskeletal examinations: a cross-sectional survey of Quebec chiropractors.” Chiropr Man Therap. 2024 Feb 28;32(1):6. doi: 10.1186/s12998-023-00522-z. PMID: 38419063; PMCID: PMC10903024.
