Search results

The purpose of this paper is to examine the outcomes of chiropractic manipulative and manual therapy (MMT) provided to residents experiencing spinal pain in a substance misuse therapeutic community (TC).

Clinical audit to explore the potential benefits of the interventions offered to residents experiencing spinal pain in a TC. Residents seeking care underwent an assessment by either general practitioner or chiropractic intern. Eligible participants could choose one of the four interventions: usual care without any additional treatment (Group 1), usual care with simple analgesics (Group 2), usual care plus MMT without simple analgesics (Group 3), or usual care plus MMT with simple analgesics (Group 4). Outcome measures were the RAND-36-item short form health-related quality-of-life survey and the patient satisfaction questionnaire (PSQ). Data were collected at baseline and after six weeks for each participant, with those participants choosing MMT receiving up to six treatments over the study period. Two cycles of six weeks of data collection was used. Data were analysed for statistically significant (repeated measures ANOVA with Bonferroni correction) and clinically meaningful changes in scores.

Of 71 self-presenting residents seeking care, 68 were eligible to participate. Of these, 32 chose usual care with simple analgesics (Group 2) and 36 chose usual care plus the package of MMT but without simple analgesics (Group 3). None chose usual care without additional treatment or usual care plus the package of MMT with analgesics, thus offering only the data from two groups for analysis. Group allocation was non-random and based on patient choice. Between-group analysis of the cumulative and component RAND-36 data indicated a significant difference between the two groups (p=0.034), particularly in the physical outcomes (p=0.012), indicating that Group 3 had improved scores over Group 2. Group 3 showed a significant change in RAND-36 scores (p<0.01) when compared with Group 2 (p=0.23) over the six-week treatment period. The PSQ scores of the two groups showed a statistically significant difference (p=0.0093), suggesting that Group 3 had greater patient satisfaction with care. The outcomes suggest that the package of MMT in Group 3, delivered by an appropriately trained clinician may have added to therapeutic effect that extended beyond physical outcomes but also influenced psychological outcomes.

The results of this clinical outcome-based audit suggest that the addition of a package of chiropractic MMT to usual care may be of benefit over usual care with simple analgesics for residents of a TC with spinal pain. The results intimate that benefits may extend across both the physical and psychological components of the pain experience, although a confirmatory study is recommended to substantiate these insights.

As far as the authors are aware, this trial is the first of this type in a TC, with the insights and experience gained supporting a definitive trial.

FOR the tenth time our American counterpart, the Industrial Management Society, is holding a contest for methods improvement. The brochure giving the rules shows how thoroughly such a project is undertaken. Its main purpose is to stimulate interest in cost reduction through improved ways of doing something, although the mere replacement of obsolete equipment by new plant which is commercially available is not considered to fall within the ambit of the competition.

This viewpoint article explores how companies can solve the problems of flat sales revenue and customer churn by conducting an honest self‐assessment of corporate culture, then reinventing or refocusing products and services to provide the value that customers want.

Using examples drawn from real businesses facing real problems, the author describes the process companies can use to reenergize their people and their offerings when flat sales and customer churn are symptoms of a flat culture.

Connecting with customers helps a company develop the roadmap it needs to reenergize and reinvent its products, services, sales reps, and marketing and management teams. The only way to remain on target with customer value needs is to develop systems that communicate with internal and external customers and act upon the knowledge gained – and consistently keep the company in touch with its customers.

It is recommended that companies start with a situational assessment that includes an exploration of four key customer value determinants: products and/or services, sales representatives, management, and service quality. Healthy companies listen to their customers' concerns and partnership requirements, and then act accordingly.

This article offers practical recommendations to help managers get their companies back on track if flat sales and customer churn are problems.

In the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a deeply rooted philosophical conflict. This qualitative study works to identify factors that health-care leaders can use, which will build a pathway to greater integrative practice between medical doctors and CAM practitioners – from parallel existence to partnership – by examining the tensions between biomedical medicine and naturopathic medicine. The purpose of this study is to offer short-term suggestions for partnership and long-term recommendations for better understanding.

An original qualitative study using semi-structured with CAM practitioners and biomedical practitioners.

Areas of conflict that are preventing synergy are identified and a pathway for health-care leaders to follow to create greater integration and partnerships is suggested.

This is a qualitative and exploratory study that has significant limitations on generalizability.

This study suggest steps that both types of health-care practitioners can take to increase their success at working together on an individual level, a group level, an organizational level and on an industry-wide basis, as well as provide a specific pathway to create greater integrative practice for health-care leaders.

The results indicate that stronger partnerships between different types of medical practitioners increase patient choice, patient satisfaction and outcomes.

Increasing interested in CAM modalities is driving more contact between CAM practitioners and biomedical practitioners. This contact is best established in partnership between practitioners rather than in parallel. This original research outlines the sources of conflict and provides recommendations for encouraging greater synergy.

The purpose of this study is to analyze research output in the naturopathy field at the global level and to examine the various trends in scientific literature available on naturopathy using bibliometric analysis.

The data was collected from the SciVerse Scopus database published from 2000 through 2019. The search was conducted using Medical Subject headings entry terms, i.e. “Naturopathy” OR “Naturopathic Medicine” using the “Document” search option. The search results comprised of documents that had these above search terms in their article title, abstract and keywords. The retrieved documents were then analyzed concerning different parameters like the growth of publications, authorship patterns, productive countries and institutions, highly cited papers, top prolific authors, funding agencies and document types.

The results of this study reveal that a total of 1,099 documents were published during 20-year time span. The most preferred publication type is research articles 683 (62.14%). Germany, USA, Australia, India and Canada were the most productive countries in terms of the number of scientific documents. The findings also show that the most preferred journal in the field of naturopathy is MMW Fortschritte der Medizin, with 115 documents followed by Journal of Alternative and Complementary Medicine with 58 documents. In contrast, the journal BMC Complementary and Alternative Medicine had the highest citations per paper (17.85). For the 20-year study period, the average value for the degree of collaboration was calculated as 0.57, indicating 54% of the total publications in naturopathy were multi-authored. The value of the collaboration coefficient (CC) signifies the levels of multi-authored papers. CC was highest in the year 2019 (0.55) indicating that the publications were contributed in collaboration rather than in isolation and the number of multi-authored/mega-authored papers outnumbered the single authors in the collection of all authors in the year 2019. Bastyr University, USA was the most productive Institution. Journal articles were the most preferred form of publication.

This study traces various trends in the research behavior and preferences of researchers in the field of naturopathy. It thus can be of immense help to identify strong areas in naturopathy research. Further, this study will help the librarians to identify the core/preferred journals in naturopathy. 

This paper makes an endeavor to carry an extensive bibliometric study that provides an overview of emerging trends in naturopathy research.

This paper aims to propose a pulsing type joint servo driver-based obstacle surmounting method for a humanoid robot according to the whole-body dynamics model, which fully takes into account the relationship between the whole-body stability margin and instantaneous torque.

First, the authors designed a new practical instantaneous large torque strategy for a pulsing type joint servo driver by modeling the whole-body dynamics of the humanoid robot. The work also considered joint angle planning based on the dynamic model for crossing obstacles. Second, in the simulation and experimentation, the instantaneous torque of the driver is used to realize successful crossing of obstacles by the humanoid robot. This verifies the correctness of the whole-body dynamics model and the feasibility of the method for crossing obstacles.

The experimental data and results are described and analyzed, showing that the proposed method is feasible and effective through simulation and implementation.

The main contribution is the humanoid robot’s actuation control technology and humanoid action realization, which could be used for squatting and moving heavy objects to help a humanoid robot adapt effectively.

The purpose of this paper is to present a surgical robot for spinal fusion and its control framework that provides higher operation accuracy, greater flexibility of robot position control, and improved ergonomics.

A human‐guided robot for the spinal fusion surgery has been developed with a dexterous end‐effector that is capable of high‐speed drilling for cortical layer gimleting and tele‐operated insertion of screws into the vertebrae. The end‐effector is position‐controlled by a five degrees‐of‐freedom robot body that has a kinematically closed structure to withstand strong reaction force occurring in the surgery. The robot also allows the surgeon to control cooperatively the position and orientation of the end‐effector in order to provide maximum flexibility in exploiting his or her expertise. Also incorporated for improved safety is a “drill‐by‐wire” mechanism wherein a screw is tele‐drilled by the surgeon in a mechanically decoupled master/slave system. Finally, a torque‐rendering algorithm that adds synthetic open‐loop high‐frequency components on feedback torque increases the realism of tele‐drilling in the screw‐by‐wire mechanism.

Experimental results indicated that this assistive robot for spinal fusion performs drilling tasks within the static regulation errors less than 0.1 μm for position control and less than 0.05° for orientation control. The users of the tele‐drilling reported subjectively that they experienced torque feedback similar to that of direct screw insertion.

Although the robotic surgery system itself has been developed, integration with surgery planning and tracking systems is ongoing. Thus, the screw insertion accuracy of a whole surgery system with the assistive robot is to be investigated in the near future.

The paper arguably pioneers the dexterous end‐effector appropriately designed for spinal fusion, the cooperative robot position‐control algorithm, the screw‐by‐wire mechanism for indirect screw insertion, and the torque‐rendering algorithm for more realistic torque feedback. In particular, the system has the potential of circumventing the screw‐loosening problem, a common defect in the conventional surgeon‐operated or robot‐assisted spinal fusion surgery.

The purpose of this paper is to present the design and experiment of a universal space-saving end-effector for multi-task operations.

The universal end-effector is equipped with capture and actuation transmission capabilities with two corresponding subsystems, which are highly integrated systems of mechanics, electronics and sensors. A trefoil-shaped capture system is developed for closed envelop. The worm gear pair is adopted for self-locking and space-saving, and it is used in a unique manner for three grapple chains’ synchronous motion. The combination of optimal straight path linkage and pantograph mechanism is proposed in the transmission system. The electrical structure and the multi-sensory system provide the foundation for control strategy.

Simulations and experiments demonstrated characteristics of the universal end-effector. The compliance of the manipulator guaranteed the achievement of “soft capture” by the end-effector. Due to the self-locking property, the end-effector and the grapple interface could keep rigid connection when powered off.

The design process takes practical requirements into consideration. Through experiments, it is proved that the proposed end-effector can be used for the multi-task operations with corresponding tools.

Among end-effectors with operation function, the misalignment tolerance (MT) is originally regarded as a key factor. The adoptions of the worm gear pair and the linkage make it space-saving compared to conventional designs.

This paper aims to develop a new robotic ultrasound system for spine imaging with more anthropomorphic scanning manipulation in comparison with previously reported techniques.

The system evaluates the imaging quality of ultrasound (US) B-scans by detecting vertebral landmarks and groups the images with relatively low quality into several sub-optimal types. By imitating the scanning skills of sonographers, the authors defined a set of adjustment strategies for certain sub-optimal types. In this way, the robot can recollect the US images with high quality by adaptively adjusting the pose of the probe like a sonographer.

The results from phantom experiments and in vivo experiments showed that the proposed method could improve the quality of B-scans during the scanning. The 3 D US volume reconstruction has also verified the feasibility of the proposed method.

This paper demonstrates how to adapt a robotic spinal ultrasound scanning using a preliminary anthropomorphic approach.

Human-like musculoskeletal robots can fulfill flexible movement and manipulation with the help of multi joints and actuators. However, in general, sophisticated structures, accurate sensors and well-designed control are all necessary for a musculoskeletal robot to achieve high-precision movement. How to realize the reliable and accurate movement of the robot under the condition of limited sensing and control accuracy is still a bottleneck problem. This paper aims to improve the movement performance of musculoskeletal system by bio-inspired method.

Inspired by two kinds of natural constraints, the convergent force field found in neuroscience and attractive region in the environment found in information science, the authors proposed a structure transforming optimization algorithm for constructing constraint force field in musculoskeletal robots. Due to the characteristics of rigid-flexible coupling and variable structures, a constraint force field can be constructed in the task space of the musculoskeletal robot by optimizing the arrangement of muscles.

With the help of the constraint force field, the robot can complete precise and robust movement with constant control signals, which brings in the possibility to reduce the requirement of sensing feedback during the motion control of the robot. Experiments are conducted on a musculoskeletal model to evaluate the performance of the proposed method in movement accuracy, noise robustness and structure sensitivity.

A novel concept, constraint force field, is proposed to realize high-precision movements of musculoskeletal robots. It provides a new theoretical basis for improving the performance of robotic manipulation such as assembly and grasping under the condition that the accuracy of control and sensory are limited.