Nursing: Spinal manipulative therapy essay.
Category: Nursing
Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.
INTRODUCTION
PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.
It stands for:
- P – Patient/population/problem.
- I – Intervention.
- C – Comparison (of potential interventions, typically).
- O – Outcome(s).
- T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search.
SCENARIO
For this assessment, please use an issue of interest from your current or past nursing practice.
If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.
INSTRUCTIONS
For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.
Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.
If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.
In your submission, make sure you address the following grading criteria:
- Define a practice issue to be explored via a PICO(T) approach.
- Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
- Explain the findings from articles or other sources of evidence.
- Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
- Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
- Additional Requirements
Your assessment should meet the following requirements:
- Length of submission: Create a 3–5-page submission focused on defining a research question and interpreting evidence relevant to answering it.
- Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
- APA formatting: Format references and citations according to the current APA style.
COMPETENCIES MEASURED
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
- Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
- Explain the findings from articles or other sources of evidence.
- Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
- Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
- Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
- Competency 3: Apply an evidence-based practice model to address a practice issue.
- Define a practice issue to be explored via a PICO(T) approach.
- Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
- Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
- Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Requirements: 3 pages
PICO(T) Question
Students Name
University’s Name
Course
Professor’s Name
Date
PICO(T) Question: In adults above 18 years (P), is spinal manipulative therapy (I) more effective than medication treatment (C) at reducing the rates of chronic back pains (O)within a year(T)?
Back pain is highly prevalent in adults between 18 and 60 years and can lead to significant consequences. The adults are among the most affected since they involve themselves in activities that require them to bend while working or involve themselves with tiresome movements. The lower back pains are standard but are largely self-limiting since they can be treated quickly when the aches are still minor. The condition is considered chronic when the lower back pains do not resolve beyond the expected healing time. Chronic back pains last longer than 90 days for the patients such that the pain does not subside even with the various medication recommended by the doctors and clinicians. I have experienced adults with chronic back pains in my practice, limiting them from performing multiple activities when it is more intense. The condition requires advanced treatment; hence with the continued research, the clinicians have come with Spinal manipulative therapy, which aims to reduce the number of patients suffering from chronic back pains. They are expected to undergo therapy to heal entirely or reduce the rates of the pain. The therapy consists of treatment options referred to the patients by the clinicians to manage the spinal pains. The treatment is characterized by the delivery of force to the affected intervertebral articulation, causing neurophysiological effects and reducing back pains. The paper will present findings of whether spinal manipulative therapy is more effective than medication treatment in adults above 18 within a year.
According to Page and Descarreaux (2019), a single spinal manipulative therapy was delivered to the patient during the intervention through an advanced linear actuator motor. The device had a twin tip padded rod, which targeted the spinal level of the patients, although they had to were supposed to report pain in the targeted area so it could be included in the study. The therapy was characterized by a specific force applied to the affected area. The magnitude of the force, impulse, and rate at which the force was applied varied between the different patients. The force determined the range of the dose being administered to the patients as done by manual therapists, where the dosage was given in intervals and at different peak forces. The research outcomes were pain intensity and disability questionnaire whereby the patients’ records of pain were kept before and after the therapy so they could be evaluated. The clinicians prepared a disability questionnaire to ask the patients about the effects they experienced after the therapy. Pasquier et al. (2019) explains that spinal manipulative therapy also monitored muscle activity and spinal stiffness. as per the research, the patients’ muscles who underwent therapy were quite active and strong during the spinal stiffness procedure.
According to Oliveira et al., (2018), back pains can get better within a month of treatment by using medications and injections depending on how intense the patient experiences the pain. Therefore, clinicians in this condition recommend over-the-counter drugs that are to be taken as prescribed by the doctor. Taking the full dose of the prescribed drugs is supposed to reduce the pains within the shortest period. After monitoring the patient taking the OTC drugs, the doctors and clinicians realized that some of the patients still complained of pain and so they went ahead and prescribed a muscle relaxant. The use of cortisone injections also played a part in relieving the pain, but the patient was not still contented with the healing process (Brennan et al., 2017). They had to go through various injections and take different over-the-counter drugs to achieve the relieve the pain. Although the pain reduced for some time after taking the drugs, it kept coming back days after the patients completed the dosage, meaning they had to keep replacing the dose to do away with the pain completely. In the clinical trial of using over-the-counter drugs and cortisone injections, there was no difference in the reduction of the back pain since they all appeared to be less effective.
Patients who undergone the therapy reported healing cases in less than a year, while those using over-the-counter drugs and injections kept visiting the health institution to get more drugs to reduce the pain. Those who had undergone therapy within the first session were given time to evaluate results obtained at the beginning of the intervention and improvement at the last sessions of therapy. The spinal stiffness was accessed four times before and after the intervention by the same device used to deliver the spinal manipulative therapy. For every spinal stiffness assessment, the clinician would order the patient to breathe in, out, and later hold their breath during measurement to record the required results. The findings revealed a change in the back pains where the patients using the therapy treatment healed faster and got back to their activities on time. On the other hand, in the clinical trial of using over-the-counter drugs and cortisone injections, there was no difference in reducing back pain.
The research findings indicated that the therapy was more effective in reducing back pain in adults compared to injections and OTC drugs. In conclusion, spinal manipulative therapy can be recommended to patients with chronic back pains to reduce the pains and deal with the problem ultimately.
References
Brennan, K. L., Allen, B. C., & Maldonado, Y. M. (2017). Dry needling versus cortisone injection in the treatment of greater trochanteric pain syndrome: a no inferiority randomized clinical trial. journal of orthopedic & sports physical therapy, 47(4), 232-239.
Oliveira, C. B., Maher, C. G., Pinto, R. Z., Traeger, A. C., Lin, C. W. C., Chenot, J. F., … & Koes, B. W. (2018). Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. European Spine Journal, 27(11), 2791-2803.
Page, I., & Descarreaux, M. (2019). Effects of spinal manipulative therapy biomechanical parameters on clinical and biomechanical outcomes of participants with chronic thoracic pain: a randomized controlled experimental trial. BMC musculoskeletal disorders, 20(1), 1-14.
Pasquier, M., Daneau, C., Marchand, A. A., Lardon, A., & Descarreaux, M. (2019). Spinal manipulation frequency and dosage effects on clinical and physiological outcomes: a scoping review. Chiropractic & manual therapies, 27(1), 1-12.