Utilization of Chiropractic Care at the World Games
Written by Editor   
Tuesday, December 27, 2016 12:00 AM

News Bite:  A research study of the 2013 World Games results in interesting stats.  18% of athletes and 10% of non-athletes sought care at the games. Sports with the largest proportion of total treatments were flying disk, roller inline hockey, speed roller skating, and water skiing. The most frequently treated regions were the thoracic spine, 57%; lumbar spine, 49%; cervical spine, 39%; and sacroiliac joint 23%. The most frequently used treatment method was myotherapy, 81%, followed by manipulation 79%,  taping, 38% and mobilization, 25%. 

This retrospective descriptive study evaluated chiropractic treatment forms at an international sporting event. The International World Games Association (IWGA) contracted with Fédération Internationale de Chiropratique du Sport (FICS) to provide free chiropractic care to any persons accredited at their events. The Cali Local Organizing Committee executed this agreement for The World Games 2013 (TWG2013) by accrediting 40 doctors of chiropractic (DCs) and 6 researchers. The treatment team then provided chiropractic care to athletes and volunteers at the event. The research team reviewed treatment characteristics.

Patients voluntarily sought care over the 10-day event occurring from July 25 through August 4, 2013. Doctors of chiropractic completed a paper treatment form each time a patient sought care. This form included demographic characteristics, chiropractic treatments performed (including the type of treatment and body region treated), and patient pretreatment and posttreatment visual analog scale (VAS) pain scores.

The FICS delegation recorded a total of 1583 treatments; 7.6% of the treatment forms were excluded because of an incomplete treatment record or because the patient was below 18 years of age. Our final analysis included 1463 treatment records representing 940 individuals.

A physical examination was performed to determine the treatment method necessary for that patient. The DCs selected which body regions required treatment from a list of 17 body regions on the treatment form. For treatment type, the DCs indicated whether they applied manipulation (high-velocity low-amplitude), mobilization (passive movement of a joint within its physiological range of motion), myotherapy, or taping. Myotherapy included the use of effleurage, petrissage, tapotement, cross-friction massage, and percussion. Taping was done by applying rigid, elastic, and/or functional tape to the affected joints and muscles.

Patients who requested chiropractic care completed a consent form and agreed to participate in this study. Of the 1463 treatment forms that met the inclusion criteria, a total of 897 (61%) were for athletes and 566 (39%) were for non-athletes. A total of 940 individuals sought care, with 523 treatments (36%) for follow-up care. Of the 2964 accredited athletes, 537 sought treatment; 403 of 4131 accredited non-athletes sought treatment. Utilization rates were 18% and 10% for athletes and non-athletes, respectively.

Analyses of non-athlete utilization rates revealed that a large proportion of accredited medical staff (30%) and IWGA staff (12%) sought treatment. However, the patients who received the greatest number of treatments (athlete or non-athlete) were native Colombian volunteers (307 treatments; 54% of non-athlete treatments and 21% of all treatments).

The sports with the largest utilization rates were bowling (48%), water skiing (42%), fistball (41%), and wushu (41%). The sports with the lowest utilization rates were duathlon (1%), korfball (5%), gymnastics (6%), and climbing (6%). Athletes of 3 sports—air sports, boules, and orienteering—did not seek chiropractic care. The pattern of results shifted when we computed the percentage of total treatments per each sport. The sports with the largest proportion of total treatments were flying disk (11%), roller inline hockey (8%), speed roller skating (8%), and water skiing (8%). The sports with the lowest proportion of total treatments were climbing (6%), gymnastics (6%), korfball (5%), and duathlon (1%).

A greater proportion of athletes (44%) compared with non-athletes (31.5%) returned for follow-up care.  Of athletes presenting for treatment, 201 (37%) presented with acute conditions, 293 (55%) presented with chronic conditions, and 43 (8%) presented with both acute and chronic conditions. However, only 80 (20%) non-athletes presented with acute conditions, 307 (61%) presented with chronic conditions, and 16 (4%) presented with both acute and chronic conditions. When coded dichotomously, the prevalence of acute conditions was greater for athletes (45%) than for non-athletes.

The most frequently treated regions were the thoracic spine (513 treatments; 57%), lumbar spine (437 treatments; 49%), cervical spine (349 treatments; 39%), and sacroiliac joint (209 treatments; 23%). For extremities, the most frequently treated regions were the shoulder (159 treatments; 18%) and the thigh (121 treatments; 14%). We also tabulated the number of treatments applied to each body region for each sport.  

The most frequently used treatment method across all patients (combining athletes and non-athletes) was myotherapy (1183 treatments; 81%), followed by manipulation (1148 treatments; 79%), taping (556 treatments; 38%), and mobilization (360 treatments; 25%. Patterns of treatment type were similar for athletes and non-athletes, although non-athletes received a slightly larger proportion of treatments by manipulation. 

Source:  http://www.jmptonline.org/article/S0161-4754(16)30215-9/fulltext?elsca1=etoc&elsca2=email&elsca3=0161-4754_201611_39_9_&elsca4=Physical%20Medicine%20and%20Rehabilitation%7CHealth%20Professions