Table 4.
Frequency of Therapeutic Approaches by VA Chiropractors for Patients with Prior Lumbar Fusion Surgery (%) (n = 59)
| Intervention | Always | Frequently | Sometimes | Rarely | Never |
|---|---|---|---|---|---|
| Patient History | 59 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Physical Examination | 59 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Healthy Lifestyle Advice | 41 (69.5) | 15 (25.4) | 2 (3.4) | 1 (1.7) | 0 (0) |
| Education on chronic pain and/or pain neurophysiology | 37 (62.7) | 16 (27.1) | 6 (10.2) | 0 (0) | 0 (0) |
| Mobilization | 14 (23.7) | 19 (32.2) | 20 (33.9) | 6 (10.2) | 0 (0) |
| Flexion-Distraction | 11 (18.6) | 21 (35.6) | 9 (15.3) | 4 (6.8) | 14 (23.7) |
| Pelvic Blocking | 0 (0) | 0 (0) | 8 (13.8) | 12 (22.4) | 37 (63.8) |
| Acupuncture/Dry Needling | 1 (1.7) | 19 (32.2) | 12 (20.3) | 1 (1.7) | 26 (44.1) |
| Thoracic HVLA | 5 (8.5) | 29 (49.2) | 24 (40.7) | 0 (0) | 1 (1.7) |
| Lumbar HVLA | 0 (0) | 10 (16.9) | 17 (28.8) | 17 (28.8) | 15 (25.4) |
| Pelvic HVLA | 3 (5.1) | 20 (33.9) | 20 (33.9) | 9 (15.3) | 7 (11.9) |
| Muscle Stretches | 11 (18.6) | 28 (47.5) | 14 (23.7) | 4 (6.8) | 2 (3.4) |
| Myofascial Therapy (Instrument or Manual) | 6 (10.2) | 31 (52.5) | 14 (23.7) | 4 (6.8) | 4 (6.8) |
| Mechanical Diagnosis and Therapy (McKenzie) | 5 (8.5) | 9 (15.3) | 16 (27.1) | 12 (20.3) | 17 (28.8) |
| Lumbopelvic/Abdominal Stabilization Exercises | 10 (16.9) | 28 (47.5) | 15 (25.4) | 5 (8.5) | 1 (1.7) |
| Neurodynamic Mobilizations | 1 (1.7) | 9 (15.3) | 18 (30.5) | 11 (18.6) | 20 (33.9) |
| Cognitive Behavioral Therapy | 1 (1.7) | 13 (22.0) | 18 (30.5) | 7 (11.9) | 20 (33.9) |
| Mindfulness Meditation | 0 (0) | 6 (10.3) | 17 (29.3) | 19 (32.8) | 16 (27.6) |
| Instrument Assisted Manipulation (Activator, etc.…) | 3 (5.2) | 13 (22.4) | 12 (20.7) | 7 (12.1) | 23 (39.7) |
| Advice General Condition and Physical Activity | 36 (61.0) | 21 (35.6) | 2 (3.4) | 0 (0) | 0 (0) |
| Specific Exercise Recommendations | 25 (42.4) | 27 (45.8) | 5 (8.5) | 2 (3.4) | 0 (0) |
Write-in interventions: passive modalities (n = 3), Proprioceptive Taping (n = 1), Home self-traction (n = 1), Aquatic Therapy (n = 1), Complementary and Natural Medicine (n = 1)
HVLA = High Velocity, Low Amplitude Manipulation