tag:blogger.com,1999:blog-73073532251871000772024-03-12T21:31:03.915-07:00Manual Medicine & Rehab - Chiropractic PortlandChiropractic Physician, Portland OregonDr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comBlogger36125tag:blogger.com,1999:blog-7307353225187100077.post-42835050939599441702011-07-28T19:45:00.000-07:002011-07-28T19:46:40.029-07:00Whiplash: A true storyThe immense forces transmitted through vehicles during a crash do not discern adults from children. One of my younger patients who has recently been suffering from crash related injuries brought me a very special present - a book about her journey to recovery:<br />
<br />
<br />
<center><img alt="Title page about child injured in crash" src="https://lh3.googleusercontent.com/-7Q49-xcTVvU/TjIcsFd8v7I/AAAAAAAAA3U/agg24wHtJHA/s800/1-Title.png" /><br />
<img alt="Child injured in crash page 2" src="https://lh5.googleusercontent.com/-2C4Q7peoSbs/TjIcsORq1WI/AAAAAAAAA3Q/HHkZAVVIzc0/s800/2.png" /><br />
<img alt="Whiplash injury in children Portland OR" src="https://lh3.googleusercontent.com/-pupsZeO9Oh8/TjIcso4eS5I/AAAAAAAAA3Y/0vayqLUxDkg/s800/3.png" /><br />
<img alt="Whiplash injuries in children successfully treated" src="https://lh6.googleusercontent.com/--8o9YcMpneU/TjIctQV-NwI/AAAAAAAAA3c/ZBuBKRKaTFo/s800/4.png" /></center><br />
If you or your children have whiplash from a crash, don't delay your treatment. <a href="http://www.crash-chiropractic.com/p/contact.html">Call us today</a>.Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-1140549405442368702011-04-27T23:05:00.000-07:002011-04-27T23:14:22.000-07:00Do I need a DOT Medical Card?A common question is:<br />
<br />
<b>When do I need a DOT Medical Card? or Who needs a DOT Medical Card?</b><br />
The obvious answer is for people who have and maintain a commercial driver's license (CDL). But there are other situations where a DOT medical card is required, even when a CDL is not.<br />
<br />
<center><img alt="DOT Medical Card at Manual Medicine Portland" src="https://lh6.googleusercontent.com/_mJNjqdajWvk/TbkBuMA8b-I/AAAAAAAAA1s/O24kjNA_zhI/s800/DOT-Medical-Certificate-Card.jpg" /></center><br />
From the Federal Motor Carrier Safety Administration (FMCSA):<br />
Medical certification in accordance with FMCSA physical qualification standards is required when the driver is operating a commercial vehicle in <b>interstate</b> commerce that:<br />
<ul><li>Has a combined gross vehicle weight or weight rating of 10,0001 lbs. or more.</li>
<li>Is designed or used to transport 9-15 passengers (including the driver) for compensation.</li>
<li>Is designed or used to transport 16 or more passengers (including the driver) whether for compensation or not.</li>
<li>Transports hazardous materials in quantities that require placarding under the hazardous materials regulations.</li>
<li>When a driver returns from an illness or injury that interferes with driving ability, the driver must undergo a medical examination even if the medical examiner's certificate has not expired.</li>
</ul>The medical examiner is responsible for certifying only drivers who meet the physical qualification standards. Certification cannot exceed 2 years, and at the discretion of the FMCSA medical examiner, may be less than 2 years. The Federal Vision and Diabetes Exemption Programs require annual medical certification.<br />
<br />
The medical examiner's certificate expires at midnight of the day, month, and year written on the certificate. There is no grace period on the expiration. The driver must be re-examined and recertified to continue to drive legally.<br />
<br />
<b>Other DOT medical card (CDL physical exam) requirements are posted as follows:</b><br />
<ul><li><a href="http://www.crash-chiropractic.com/2010/10/dot-physical-exam-portland-or.html" target="_blank">DOT medical card: Blood Pressure</a></li>
<li><a href="http://www.crash-chiropractic.com/2010/10/dot-physical-exam-portland-or.html" target="_blank"></a><a href="http://www.crash-chiropractic.com/2010/12/dot-medical-card-vision-requirements.html" target="_blank">DOT medical card: Vision</a></li>
<li><a href="http://www.crash-chiropractic.com/2011/01/cdl-hearing-requirements-portland.html">CDL Hearing Requirements</a></li>
</ul>Need a DOT Medical Card in <a href="http://maps.google.com/maps?f=q&source=s_q&hl=en&geocode=&q=Manual+Medicine+%26+Rehab+-+Chiropractic,+5802+SE+Powell+Boulevard,+Portland,+OR+97206-2858&aq=0&sll=37.0625,-95.677068&sspn=37.956457,79.013672&ie=UTF8&hq=Manual+Medicine+%26+Rehab+-+Chiropractic,&hnear=5802+SE+Powell+Blvd,+Portland,+Oregon+97206&ll=45.498099,-122.602701&spn=0.00277,0.004823&t=h&z=18&iwloc=A" target="_blank">Portland</a>? Call us at (503) 774-3778 to schedule your physical exam. We're often able to accommodate walk-ins.Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-26128624652442480072011-03-23T21:25:00.000-07:002011-03-23T23:18:41.077-07:00Chiropractic for Low Back Pain (LBP)<table><tr><td>Findings of recent research: <b>Patients with acute mechanical low back pain enjoy significant improvement with chiropractic care, but little to no improvement with the usual care they receive from a family physician.</b></td><td><img src="https://lh3.googleusercontent.com/_mJNjqdajWvk/TYrgsT8zjWI/AAAAAAAAA0s/s4ebLKTUchA/s800/Research-on-Chiropractic.jpg" alt="Chiropractic Research"/></td></tr></table><br />
From <a href="http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55150" target="_blank">Dynamic Chiropractic</a>:<br />
<blockquote><p>Published in the December 2010 edition of The Spine Journal, the <a href="http://www.ncbi.nlm.nih.gov/pubmed/20889389" target="_blank">study</a> found that after 16 weeks of care, patients referred to medical doctors saw almost no improvement in their disability scores, were likely to still be taking pain drugs and saw no benefit with added physical therapy - and yet were unlikely to be referred to a doctor of chiropractic.</p><p>The study is "the first reported randomized controlled trial comparing full CPG [clinical practice guidelines]-based treatment, including spinal manipulative therapy administered by chiropractors, to family physician-directed UC [usual care] in the treatment of patients with AM-LBP (acute mechanical low back pain)." (Evidence-based clinical practice guidelines have been established for acute mechanical low back pain in many countries around the world, but sadly, most primary care medical doctors don't follow these guidelines.) Researchers found that "treatment including CSMT [chiropractic spinal manipulative therapy] is associated with significantly greater improvement in condition-specific functioning" than usual care provided by a family physician.</p></blockquote>If you're looking for help with low back pain, or suffering from pain related to auto injuries, <a href="http://www.crash-chiropractic.com/p/contact.html" target="_blank">call us</a> to see how we can help.Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-10711639773768625182011-03-23T20:53:00.000-07:002011-03-23T23:35:30.504-07:00Concussions still a concern for NFL<table><tr><td>At Manual Medicine & Rehabilitation we focus primarily on auto injuries and rehabilitating those injuries. Concussions are often a part of car crash related injuries, and we take them seriously - healthy brain function is essential to quality of life.</td><td><img src="https://lh5.googleusercontent.com/_mJNjqdajWvk/TYrlaXtpG-I/AAAAAAAAA0w/PRnPcvRX2Hc/s800/Sport-Injury-Concussion.jpg" alt="SE Portland Chiropractor"/></td></tr></table><br />
A recent NYT article about the prominent problem facing contact sports such as the NFL. I have outlined previous stories ( <a href="http://www.crash-chiropractic.com/2009/11/nfl-players-have-higher-dementia-levels.html" target="_blank">here</a>, and <a href="http://www.crash-chiropractic.com/search/label/brain%20function" target="_blank">here</a>).<br />
<br />
Dave Duerson, a formal NFL player, tragically committed suicide. In the event, he intentionality spared his brain, and left behind a note: "Please, see that my brain is given to the N.F.L.’s brain bank." Read the full story <a href="http://www.nytimes.com/2011/03/15/opinion/15herbert.html?_r=1" target="_blank">here</a>.<br />
<br />
Serious concussions, especially multiple concussions can cause serious compromise of brain function. If you've been in a crash, call us to see how we can help.Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-6460168708019030472011-01-08T11:29:00.000-08:002011-04-27T23:09:11.188-07:00CDL Hearing Requirements<span class="Apple-style-span" style="font-size: large;">What are the hearing requirements for a CDL physical exam?</span><br />
<br />
<center><img alt="Anatomy of a human ear" src="http://lh3.ggpht.com/_mJNjqdajWvk/TSbYT_ixmLI/AAAAAAAAAxA/mfoKebgYD8g/s800/Ear.jpg" /></center><br />
<b>The short answer is:</b><br />
<ul><li>Candidates must first perceive a forced whispered voice from a distance of at least 5 ft., with or without hearing aid, OR</li>
<li>have an average hearing loss in the better ear < 40 dB</li>
</ul><b>DOT regulations further describe this as follows:</b><br />
<b>§391.41(b)(11)</b><br />
A person is physically qualified to drive a commercial motor vehicle if that person:<br />
First perceives a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid, or, if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 1,000 Hz, and 2,000 Hz with or without a hearing aid when the audiometric device is calibrated to American National Standard (formerly ADA Standard) Z24.5-1951.<br />
Since the prescribed standard under the FMCSRs is the American Standards Association (ANSI), it may be necessary to convert the audiometric results from the ISO standard to the ANSI standard. Instructions are included on the Medical Examination report form.<br />
If an individual meets the criteria by using a hearing aid, the driver must wear that hearing aid and have it in operation at all times while driving. Also, the driver must be in possession of a spare power source for the hearing aid.<br />
<br />
<b>What is a forced whisper test?</b><br />
For the whispered voice test, the individual should be stationed at least 5 feet from the examiner with the ear being tested turned toward the examiner. The other ear is covered. Using the breath which remains after a normal expiration, the examiner whispers words or random numbers such as 66, 18, 23, etc. The examiner should not use only sibilants (s sounding materials). The opposite ear should be tested in the same manner. If the individual fails the whispered voice test, the audiometric test should be administered.<br />
If an individual meets the criteria by the use of a hearing aid, the following statement must appear on the Medical Examiner's Certificate "Qualified only when wearing a hearing aid."<br />
(See Hearing Disorders and Commercial Motor Vehicle Drivers at: <a href="http://www/fmcsa.dot.gov/rulesregs/medrports.htm" target="_blank">http://www/fmcsa.dot.gov/rulesregs/medrports.htm</a>)<br />
<br />
<b>Other DOT medical card (CDL physical exam) requirements are posted as follows:</b><br />
<ul><li><a href="http://www.crash-chiropractic.com/2010/10/dot-physical-exam-portland-or.html" target="_blank">DOT medical card: Blood Pressure</a></li>
<li><a href="http://www.crash-chiropractic.com/2010/10/dot-physical-exam-portland-or.html" target="_blank"></a><a href="http://www.crash-chiropractic.com/2010/12/dot-medical-card-vision-requirements.html" target="_blank">DOT medical card: Vision</a></li>
<li><a href="http://www.crash-chiropractic.com/2011/04/dot-physical-portland.html">Do I need a DOT Medical Card?</a></li>
</ul>Call <a href="http://www.crash-chiropractic.com/p/contact.html" target="_blank">Manual Medicine & Rehab</a> today, and come in for your medical card.Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-4135088690363615842010-12-12T14:07:00.000-08:002015-10-14T19:13:11.666-07:00DOT Medical Card - Vision RequirementsDOT medical cards requires testing of major body systems... including vision.<br />
<br />
<b>In short, DOT medical card requirements for vision are:</b><br />
<ul>
<li>20/40 vision in each eye, tested separately on a Snellen chart. This requirement can be met with, or without corrective lenses (glasses, contact lenses).</li>
<li>At least 70° peripheral vision on both sides.</li>
<li>Be able to recognize the traffic colors of green, amber, and red</li>
</ul>
<br />
<center>
</center>
<br />
<b>These requirements are listed under §391.41(b)(10):</b><br />
<i>A person is physically qualified to drive a commercial motor vehicle if that person:</i><br />
<i>Has distant visual acuity of at least 20/40 (Snellen) in each eye with or without corrective lenses or visual acuity separately corrected to 20/40 (Snellen) or better with corrective lenses, distant binocular acuity of at least 20/40 (Snellen) in both eyes with or without corrective lenses, field of vision of at least 70 degrees in the horizontal meridian in each eye, and the ability to recognize the colors of traffic signals and devices showing standard red, green, and amber.</i><br />
<i>The term "ability to recognize the colors of" is interpreted to mean if a person can recognize and distinguish among traffic control signals and devices showing standard red, green and amber, he or she meets the minimum standard, even though he or she may have some type of color perception deficiency. If certain color perception tests are administered, (such as </i><i>Ishihara, Pseudoisochromatic, Yarn) and doubtful findings are discovered, a controlled test using signal red, green and amber may be employed to determine the driver's ability to recognize these colors.</i><br />
<i>Contact lenses are permissible if there is sufficient evidence to indicate that the driver has good tolerance and is well adapted to their use. Use of a contact lens in one eye for distance visual acuity and another lens in the other eye for near vision is not acceptable, nor telescopic lenses acceptable for the driving of commercial motor vehicles.</i><br />
<i>If an individual meets the criteria by the use of glasses or contact lenses, the following statement shall appear on the Medical Examiner's Certificate: "Qualified only if wearing corrective lenses."</i><br />
<i>CMV drivers who do not meet the Federal vision standard may call <span class="gc-cs-link" id="gc-number-2" title="Call with Google Voice">(202) 366-1790</span> for an application for a vision exemption.</i><br />
<br />
<b>Other DOT medical card (CDL physical exam) requirements are posted as follows:</b><br />
<ul>
<li><a href="http://www.crash-chiropractic.com/2010/10/dot-physical-exam-portland-or.html" target="_blank">DOT medical card: Blood Pressure</a></li>
<li><a href="http://www.crash-chiropractic.com/2010/10/dot-physical-exam-portland-or.html" target="_blank"></a><a href="http://www.crash-chiropractic.com/2011/01/cdl-hearing-requirements-portland.html" target="_blank">DOT medical card: Hearing</a></li>
<li><a href="http://www.crash-chiropractic.com/2011/04/dot-physical-portland.html">Do I need a DOT Medical Card?</a></li>
</ul>
Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-83224742176488317362010-11-23T00:33:00.000-08:002010-11-23T08:28:09.014-08:00Portland Weather Hazards<table><tbody>
<tr><td><div style="text-align: left;">For the most part, Portland weather is predictable. Often it rains. But once in a while, weather like we're getting now comes along and causes havoc on the city - traffic accidents. So if you've been in a crash, come talk to us. At Manual Medicine & Rehabilitation, we almost exclusively treat auto injuries. Our passion is helping you get better.</div><div style="text-align: left;"><br />
</div><div style="text-align: left;">If you're heading out and want to check road conditions, try these links to make life easier - and safer:</div><br />
<ul><li> <a href="http://www.tripcheck.com/Pages/CamerasPortland.asp" target="_blank">ODOT Traffic Cameras</a></li>
<li><a href="http://www.oregonlive.com/traffic/pdx_metro/index.ssf?cityofportland" target="_blank">Traffic Cams Portland</a></li>
</ul></td><td><img alt="Caution Sign Portland Weather Hazards" src="http://lh6.ggpht.com/_mJNjqdajWvk/TOt6CwRH43I/AAAAAAAAAtc/8V6QJL0U8zQ/s800/caution.jpg" /></td></tr>
</tbody></table><br />
<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-11181479623792722202010-11-09T21:17:00.000-08:002010-11-09T21:18:21.501-08:00Speeding Causes Auto Crashes - Portland Chiropractor<iframe src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F11%2Fspeeding-causes-auto-crashes-portland.html&layout=standard&show_faces=true&width=500&action=like&colorscheme=light&height=80" scrolling="no" frameborder="0" style="border:none; overflow:hidden; width:500px; height:80px;" allowTransparency="true"></iframe><br />
As a <a href="http://www.crash-chiropractic.com">Chiropractor in Portland</a>, we treat a lot of people in auto injuries. This video released by <a href="http://www.blogger.com/www.nhtsa.gov" target="_blank">NHTSA</a> (National Highway Traffic Safety Administration)<br />
is humerus, but make it's point.<br />
<br />
<center><object classid="clsid:22D6F312-B0F6-11D0-94AB-0080C74C7E95" codebase="http://www.microsoft.com/Windows/MediaPlayer/" height="360" width="480"> <param name="Filename" value="http://trafficsafetymarketing.gov/speed/toolkit/linkfiles/TVspots/English/7162001.wmv"><param name="AutoStart" value="false"><param name="ShowControls" value="true"><param name="BufferingTime" value="2"><param name="ShowStatusBar" value="true"><param name="AutoSize" value="true"><param name="InvokeURLs" value="false"><embed src="http://trafficsafetymarketing.gov/speed/toolkit/linkfiles/TVspots/English/7162001.wmv" type="application/x-mplayer2" autostart="1" enabled="1" showstatusbar="1" showdisplay="1" showcontrols="1" pluginspage="http://www.microsoft.com/Windows/MediaPlayer/" CODEBASE="http://activex.microsoft.com/activex/controls/mplayer/en/nsmp2inf.cab#Version=6,0,0,0" width="480" height="360"></embed> </object></center><br />
If you've got a lead foot, it's time to slow down. If you've been in a crash and are injured, come in and see what our staff can do to help you.<br />
<br />
<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-82265153368344935352010-11-06T16:24:00.000-07:002010-11-06T16:54:27.852-07:00Shoulder Injuries : Auto Injury<iframe src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F11%2Fshoulder-injuries-auto-injury-portland.html&layout=standard&show_faces=true&width=500&action=like&colorscheme=light&height=80" scrolling="no" frameborder="0" style="border:none; overflow:hidden; width:500px; height:80px;" allowTransparency="true"></iframe><br />
Intense physical forces can be transmitted through the shoulder complex during an auto crash. The following information details how those injuries occur, common areas of the shoulder that are injured, and therapy that can be done to get your shoulder back. If you've been in a crash, contact our <a href="http://www.crash-chiropractic.com/p/contact.html">Chiropractic Clinic in SE Portland</a> today to see how we can help.<br />
<br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><b>Part 1 - Shoulder Anatomy Lesson: Simplified</b></span><br />
There are 3 major bones that form the shoulder complex with the ribs forming another part (not illustrated). The view from behind is:<br />
<br />
<center><img alt="Shoulder Anatomy image - labelled bones" src="http://lh4.ggpht.com/_mJNjqdajWvk/TNXfi99nYgI/AAAAAAAAAtM/qE1xaQ4XSpM/s800/Shoulder-Anatomy-bones.jpg" /></center><br />
Added to those bones are 4 major muscles. 3 of them attach to the back of the scapula and connect to the head of the humerus (image below).<br />
<br />
<center><img alt="Posterior view of the shoulder muscles forming the rotator cuff" src="http://lh4.ggpht.com/_mJNjqdajWvk/TNJQyC5lYfI/AAAAAAAAAss/Ae1OVAvRWlw/s800/Shoulder-Anatomy.jpg" /></center><br />
The 4th muscle (not illustrated), subscapularis, attaches to the front of the scapula, and also connects to the humeral head. These 4 muscles (supraspinatus, infraspinatus, teres minor, subscapularis) form a structure around the top of the humerus (upper arm bone) known as the "rotator cuff." They are often referred to as SITS, an acronym to help remember their names.<br />
<br />
There are, of course, other players in the shoulder complex, including but not limited to:<br />
<center><table><tr><td WIDTH=160>biceps (brachii)</td><td WIDTH=160>deltoid</td><td WIDTH=160>rhomboid major</td></tr>
<tr><td>rhomboid minor</td><td>trapezius</td><td>teres major</td></tr>
<tr><td>serratus anterior</td><td>levator scapula</td><td>coracobrachialis</td></tr>
<tr><td>pec major</td><td>pec minor</td></tr></table></center><br />
In future posts, shoulder injuries common in automobile collisions will be discussed, with treatment options.<br />
<br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><b>Injuries:</b></span><br />
Rotator cuff injuries<br />
Labrum injuries<br />
Sprains and strains of the shoulder complex.<br />
Shoulder impingement.<br />
AC joint separation (acromioclavicular joint). <br />
<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-883092852160282342010-10-28T16:09:00.000-07:002010-10-28T16:12:12.467-07:00DOT Drug Test - Randomly selected more than once per year?Ocassionally questions regarding DOT drug testing procedures comes up. Frequently asked questions (FAQs) such as:<br />
<ul><li>Why did I get selected for random drug testing MORE THAN ONCE this year?</li>
<li>I already got selected for random DOT drug tests. I know other people didn't get picked...</li>
<li>Am I more likely to get picked for random drug tests if my name begins with the letter...</li>
<li>Is the boss singling me out? I just did a random last month?</li>
<li>Joe, never gets tested? I don’t think this thing is random at all!</li>
</ul><div><table><tbody>
<tr><td><br />
The Department of Transportation (DOT) drug testing policies are <a href="http://www.dot.gov/ost/dapc/" target="_blank">well outlined</a> in <a href="http://www.dot.gov/ost/dapc/NEW_DOCS/part40.html" target="_blank">49 CFR Part 40</a>, but to clarify the answer:</td><td><img alt="DOT Drug test cup image" src="http://lh3.ggpht.com/_mJNjqdajWvk/TMn_V-_GVHI/AAAAAAAAAsc/RcPAedGTOIs/s800/DOT-Drug-test-cup.jpg" /></td></tr>
</tbody></table><br />
</div><div style="text-align: center;"><b>"EVERYONE in the pool must have an equal chance of being selected and tested in EACH selection period."</b></div><br />
"The reality is that in a truly random selection process, a high probability exists that some employees will be selected several times while others may never be selected.<br />
"Why? Because after each selection, the employee’s name is returned to the same pool, and he or she becomes just as likely as anyone else to be selected next time."<br />
<br />
So while it may feel like you were singled out, it's just the random selection process working like it should. At <a href="http://maps.google.com/maps?f=q&source=s_q&hl=en&geocode=&q=Manual+Medicine+%26+Rehab+-+Chiropractic,+5802+SE+Powell+Boulevard,+Portland,+OR+97206-2858&sll=37.0625,-95.677068&sspn=52.505328,112.587891&ie=UTF8&hq=Manual+Medicine+%26+Rehab+-+Chiropractic,&hnear=5802+SE+Powell+Blvd,+Portland,+Multnomah,+Oregon+97206&t=h&z=16">Manual Medicine & Rehabilitation Chiropractic clinic in Portland OR</a>, we use computer software to randomize the process for our DOT Drug consortium. More answers about the requirements can be found <a href="http://www.dot.gov/ost/dapc/testingpubs/final_random_brochure.pdf" target="_blank">here</a>.<br />
<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-3464995723914822692010-10-24T20:15:00.000-07:002011-04-27T23:10:31.908-07:00DOT Physical Exam : Blood PressureManual Medicine & Rehabilitation is a chiropractic clinic offering a wide variety of services. Walk in DOT Physical Exams are often available at <a href="http://www.crash-chiropractic.com/p/contact.html" target="_blank">Manual Medicine & Rehabilitation</a>.<br />
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Many ask about the medical requirements for CDL physicals. The most prohibitive requirement for commercial truck drivers getting DOT Physical Medical cards is high blood pressure (hypertension).<br />
<br />
Below are the FMCSA's blood pressure requirements for first time exams, and recertification.<br />
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<center><img alt="DOT Physical Exam Requirements for Blood Pressure - First Time" src="http://lh3.ggpht.com/_mJNjqdajWvk/TMTxmz8v3hI/AAAAAAAAAsI/2QqkSMETRcI/s800/DOT-Physical-blood-pressure1.jpg" /><br />
<img alt="DOT Physical Exam Requirements for Blood Pressure - Recertification" src="http://lh5.ggpht.com/_mJNjqdajWvk/TMTxnMrczDI/AAAAAAAAAsM/riPZ_AWVMO4/s800/DOT-Physical-blood-pressure2.jpg" /></center><b>Other DOT medical card (CDL physical exam) requirements are posted as follows:</b><br />
<ul><li><a href="http://www.crash-chiropractic.com/2010/12/dot-medical-card-vision-requirements.html" target="_blank">DOT medical card: Vision</a></li>
<li><a href="http://www.crash-chiropractic.com/2011/01/cdl-hearing-requirements-portland.html" target="_blank">DOT medical card: Hearing</a></li>
<li><a href="http://www.crash-chiropractic.com/2011/04/dot-physical-portland.html">Do I need a DOT Medical Card?</a></li>
</ul> Call today, and come in for your medical card.Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-2148206894176045462010-10-15T23:35:00.000-07:002010-10-15T23:35:44.692-07:00Is crash prevention black and white?<iframe src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F10%2Fis-crash-prevention-black-and-white.html&layout=standard&show_faces=true&width=500&action=like&colorscheme=light&height=80" scrolling="no" frameborder="0" style="border:none; overflow:hidden; width:500px; height:80px;" allowTransparency="true"></iframe><br />
An interesting <a href="http://www.monash.edu.au/muarc/reports/muarc263.pdf" target="_blank">study</a> has come out of the accident research center at Monash University regarding the relationship between vehicle color and crash frequency.<br />
<br />
Before getting the answers... What do you think is the safest?<br />
<br />
<ul><li>Red</li>
<li>White</li>
<li>Silver</li>
<li>Yellow</li>
<li>Black</li>
</ul><div>And what do you think is the most likely to be involved in a crash?</div><div><br />
</div><div><span class="Apple-style-span" style="font-family: 'Times New Roman', serif; font-size: 16px;">Black colored cars, according to the study, are 47% more likely to be involved in a collision compared to cars that are white, gold, or yellow during dawn or dusk hours. The researchers looked at data from more than 850,000 MVCs over a period of 20 years. Surprisingly, gray, silver, blue, and red were also crash prone colors. Even in daylight, black cars were 12% more likely to crash than white cars (the safest).</span></div><div><br />
</div><div>While visibility of your vehicle is a major player in causing crashes, it can't be denied that certain personality types (and drivers) gravitate toward certain car colors. Have you ever seen an old granny driving a cherry red sports car? How many black cars have tinted windows?</div><div><br />
</div><div>So one factor of crash prevention, might just be black and white. At<a href="http://www.crash-chiropractic.com/"> Manual Medicine & Rehabilitation Center</a>, we understand crash factors, and put that understanding to work helping you. If you've been in a recent auto crash, come visit our chiropractic clinic in SE Portland, or call to make an <a href="http://www.crash-chiropractic.com/p/contact.html">appointment</a>.</div><br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-85334657310827455002010-10-08T14:10:00.000-07:002010-10-08T14:19:53.215-07:00Avoid injury in car crashes<iframe src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F10%2Favoid-injury-in-car-crashes-portland-or.html&layout=standard&show_faces=true&width=500&action=like&colorscheme=light&height=80" scrolling="no" frameborder="0" style="border:none; overflow:hidden; width:500px; height:80px;" allowTransparency="true"></iframe><br />
While many of us like to avoid the thought of auto injuries, they are a reality. And though not very prevalent, fatalities do occur in crashes. Understanding the factors that lead to fatal auto injuries may be the difference between life and death. <br />
The latest data has been released from the Bureau of Transportation Statistics (BTS) regarding factors that cont<span class="Apple-style-span" style="font-family: inherit;">ribute to fatal crashes from 2004-2008.</span><br />
<span class="Apple-style-span" style="font-family: inherit;"></span><span class="Apple-style-span" style="font-family: inherit;">This report examines factors that contribute to fatal crashes involving a motor vehicle (e.g., car, truck, or bus)</span><a href="http://www.bts.gov/publications/bts_technical_report/2010_008/html/entire.html#_ftn2" style="color: blue; text-decoration: none;"><sup style="line-height: 1.5em; vertical-align: super;"><span class="Apple-style-span" style="font-family: inherit;"><span class="Apple-style-span" style="font-size: medium;">1</span></span></sup></a><span class="Apple-style-span" style="font-family: inherit;">. Accident level data was obtained from the National Highway Traffic Safety Administration's (NHTSA's) Fatality Analysis Reporting System (FARS) database for 2004-2008</span><a href="http://www.bts.gov/publications/bts_technical_report/2010_008/html/entire.html#_ftn3" style="color: blue; text-decoration: none;"><sup style="line-height: 1.5em; vertical-align: super;"><span class="Apple-style-span" style="font-family: inherit;"><span class="Apple-style-span" style="font-size: medium;">2</span></span></sup></a><span class="Apple-style-span" style="font-family: inherit;">. Analysis of the FARS database shows:</span><br />
<ul class="btsfont" style="list-style-type: disc;"><li><span class="Apple-style-span" style="font-family: inherit;">Single-vehicle crash fatalities are the most prevalent.</span></li>
<li><span class="Apple-style-span" style="font-family: inherit;">The main factors in single-vehicle fatal crashes involve the functionality of traffic controls and the first harmful event in a crash (e.g., rollover, traffic barrier, or ditch).</span></li>
<li><span class="Apple-style-span" style="font-family: inherit;">With regard to two-vehicle fatal crashes, main factors are traffic controls and the characteristics of the roadway (e.g., roadway alignment or surface type).</span></li>
<li><span class="Apple-style-span" style="font-family: inherit;">In multi-vehicle (three or more) fatal crashes, road characteristics, vehicle speed, and road type (e.g., interstate or country road) are the main factors involved.</span></li>
</ul>Want to know more about how to make your vehicle the safest? Follow these easy guides:<br />
<ul><li><a href="http://www.crash-chiropractic.com/2010/05/head-restraint-geometry-chiropractor.html" target="_blank">Adjust your head restraint.</a></li>
<li><a href="http://www.crash-chiropractic.com/2010/07/preventing-auto-injuries-with-child.html" target="_blank">Quick Reference: Child Restraint Systems</a><br />
</li>
</ul><span class="Apple-style-span" style="font-family: inherit;">As a chiropractor in SE Portland, understanding factors</span> such as these helps me every day in working with patients who have been in car crashes, and working with attorneys and insurance companies to make sure the needs or my patients are being me. If you've been in a crash, please give us a <a alt="Manual Medicine & Rehabilitation contact page" href="http://www.crash-chiropractic.com/p/contact.html" target="_blank">call</a> to see how we can help.<br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-72870090929733430072010-10-05T14:20:00.000-07:002010-10-05T14:22:35.766-07:00New Changes to DOT Drug Testing - Portland ORFor those of you in the transportation industry, including truck drivers, trucking company owner/operators the following information may be important for you:<br />
<br />
As of October 1st, 2010, the Department of Transportation (DOT) has new mandatory guidelines that will be affecting future drug testing as per 49 CFR Part 40.<br />
<br />
<ul><li>MDMA (Ecstasy) and 6-Acetylmorphine (Heroin) will become required screens in the DOT drug testing panels. This is in addition to the THC (Marijuana), COC (Cocaine), PCP, OPI, and AMP (Amphetamines).</li>
<li>Initial screening and confirmation cutoff levels for cocaine and amphetamines will be lowered (i.e. testing is more stringent).</li>
</ul><div>New Federal Drug Testing Custody and Control Forms will be implemented as well. If you have any questions regarding these changes, or DOT drug and alcohol testing please contact us at our Portland chiropractic clinic. Information also available at: <a href="http://www.dot.gov/ost/dapc/">http://www.dot.gov/ost/dapc/</a></div><div><br />
</div><div>Manual Medicine & Rehabilitation PC offers DOT drug and alcohol consortium services for the transportation industry. We also provide walk-in DOT medical exams for CDL driver's licenses. 503-774-3778.</div><br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-34993538066800537132010-08-11T16:59:00.000-07:002010-09-27T23:39:39.241-07:00What percentage of car crashes are rear end?<iframe src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F08%2Fwhat-percentage-of-car-crashes-are-rear.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" scrolling="no" frameborder="0" style="border:none; overflow:hidden; width:450px; height:80px;" allowTransparency="true"></iframe><br />
Ever wonder which from direction most car crashes happen. You might be surprised.<br />
<img alt="Most common vectors for car crashes" src="http://lh3.ggpht.com/_mJNjqdajWvk/TGNAfknhLsI/AAAAAAAAAq4/wld7AoWNXJ4/s800/Crash-Vectors-by-percent.jpg" /><br />
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Adding it up, frontal or offset frontal vehicle crashes make up approximately 72% of all crashes. Not surprising, since such a large percentage are due to driver error. Only about 4% of car crashes are rear or offset rear in nature.<br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-10340320381648583012010-07-21T21:32:00.000-07:002010-09-27T23:34:02.840-07:00Call it a CRASH not an ACCIDENT<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crashchiro.com%2F2010%2F07%2Fcall-it-crash-not-accident.html&layout=standard&show_faces=true&width=500&action=like&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 500px;"></iframe><br />
<div>If you are a patient of my chiropractic clinic in SE Portland, you will notice that the term “<b>car accident</b>” is not used as often in conversation or medical reports as you might expect. Ever wonder why?<br />
<div><br />
To many of us, the terms car “<i>accident</i>,” “<i>crash</i>,” and “<i>collision</i>” are synonymous. Yet <a alt="National Highway Traffic Safety Administration" href="http://www.nhtsa.gov/" target="_blank">NHTSA</a> (the National Highway Traffic Safety Administration) has recommended those in the safety community abandon the use of the term “accident.”<br />
<div><br />
While still used frequently, the term “car accident” may carry with it the connotation that an event was not only unintentional, but unavoidable. It distances the party responsible for the crash from the culpability. “After all, it was just an accident.” In the medicolegal realm, this may have large implications.<br />
<img alt="car crash image" src="http://lh3.ggpht.com/_mJNjqdajWvk/TEfjaTFybaI/AAAAAAAAAqQ/-fvKImIbcpM/s800/Crash-Not-Accident.jpg" /><br />
The term “crash” or “collision” may be a more accurate description of the event. While there may be several factors contributing to the collision between two vehicles, at least one report has shown that 93% of all MVC (Motor Vehicle Crashes) were found to be the result of human error – such as inattention or recognition delays – rather than environmental factors - such as road conditions.<br />
<div><br />
So while some may pass off your injuries as the result of “just an accident,” to us at Manual Medicine & Rehabilitation Chiropractic in SE Portland they are as serious to us as they are to you. Call us at <span class="gc-cs-link" id="gc-number-1" title="Call with Google Voice">(503) 774-3778</span> to set up an appoinment.<br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center></div></div></div></div>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-76616124644156464482010-07-06T22:24:00.000-07:002010-09-27T23:30:21.491-07:00Preventing Auto Injuries with Child Restraint Systems<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F07%2Fpreventing-auto-injuries-with-child.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 450px;"></iframe><br />
In the State of Oregon, there are specific laws regulating the use of Child Restraint Systems (CRS) such as car seats and booster seats to help prevent auto injuries in children.<br />
<br />
<b>Oregon Regulations:</b><br />
<ul><li>younger than 1 year or 20 pounds or less must be in a rear facing child safety seat;</li>
<li>7 or younger: 40 pounds or less must be in a child safety seat; more than 40 pounds but 4 feet and 9 inches or less must be in a safety system that elevates the child so that an adult seat belt fits properly</li>
<li>Adult safety belts are permissible for children taller than 4 feet and 9 inches; 8 through 15 years old.</li>
</ul><div style="text-align: center;"><b>Age at which children must be in a restraint or booster seat</b> (clickable)<b>.</b></div><br />
<br />
<br />
<center><a href="http://www.iihs.org/laws/childrestraint.aspx" target="_blank"><img alt="Map of USA with Link to Insurance Institue of Highway Safety" src="http://lh6.ggpht.com/_mJNjqdajWvk/TDQPY1EKf3I/AAAAAAAAApQ/xGFN6P8ti_A/s400/CRS-Laws-Map-of-USA.jpg" /></a></center>Please note, however, that these laws do not necesarily represent optimal restraint for children. It has been <a href="http://www.ncbi.nlm.nih.gov/pubmed/12214362" target="_blank">reported</a> that 80% of children are improperly restrained in vehicles. This is due in part to a lack of knowledge on the part of parents as to what constitutes the optimal child seat/restraint system as well as a poor understanding of how to place and secure them properly. <br />
<div><br />
</div><div><b>The following are recommendations for child seat systems:</b><br />
<div><ol><li>Rear-facing seats, which include infant and convertible seats, are used from birth to one year and 9.07 kg (20 lb). Forward-facing seats, which include 5-point harness, T-Shield, Tray-Shield, Toddler/Booster combinations, and integrated seats, are recommended for children over 1 year of age, weighing 9.07 to 18.1 kg (20 to 40 lb) and up to 101.6 cm (40 inches) or taller, as long as the child is comfortable.</li>
<li>Rear-facing convertible seats can be converted to forward facing seats. These include the 5-point harness, T-Shield or the Tray Shield.</li>
<li>Toddler/Booster combinations are considered forward facing seats while the internal harness components are used. When the child reaches the weight limits for the internal harness, the harness is removed and the seat is used to boost the child high enough so the vehicle safety belt is positioned correctly. At this point this combination seat is considered a booster seat.</li>
<li>Booster seats, belt positioning high or no back seat and shield booster seat (which is no longer recommended due to lack of upper body protection), are designed for children 18.1 kg (40 lb) and over, up to 139.7 em (4 '7" or 55 inches) tall, and able to sit still and wear the lap/shoulder belt correctly (Safety Belt Safe, 2000). The correct seat type for a specific child cannot be determined based on age alone since children grow and develop at different rates. Weight, height and developmental stage must also be considered.</li>
</ol></div></div><div><br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center></div>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-13416983169788750172010-07-06T21:58:00.000-07:002010-09-27T23:28:11.624-07:00Auto Injuries and Blind Spots<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F07%2Fauto-injuries-and-blind-spots.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 450px;"></iframe><br />
All vehicles have blind spots, and unfortunately, these can lead to crashes and injuries.<br />
One of the most preventable auto related injuries occurs when children are hurt due to vehicles backing up, estimated at 50 cases per week nationally in the US. Most often these auto injuries occur around the home, and in 70% of the cases involves parents, grandparents, aunts/uncles, or sibling drivers backing into small children.<br />
As a preventable auto injury, there are some precautions that can be taken to reduce the risk:<br />
<ul><li>Prior to backing up, walk around the vehicle.</li>
<li>Educate your children to avoid playing or hiding around vehicles</li>
<li>Back up camera</li>
</ul><div>According to <a href="http://www.consumerreports.org/cro/cars/car-safety/car-safety-reviews/mind-that-blind-spot-1005/overview/index.htm" target="_blank">Consumer Reports</a> and <a href="http://www.kidsandcars.org/?gclid=COa4x6XC2KICFSFciAodNCi8yA" target="_blank">KidsandCars.org</a> smaller cars typically have smaller blind spots.<br />
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<center><img alt="Graph/diagram of vehicle blind spots when reversing" src="http://lh6.ggpht.com/_mJNjqdajWvk/TDQI3JnVVUI/AAAAAAAAApM/1gOUX7i2NJg/s800/Blind-Spots.jpg" /></center><br />
More details and specific cars listed on those websites.<br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center></div>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-86059969988273711392010-06-26T13:50:00.000-07:002010-09-27T23:24:48.744-07:00Traffic control helps avoid car crashes<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F06%2Ftraffic-control-avoid-car-crashes.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 450px;"></iframe><br />
<table><tbody>
<tr><td>Have you ever had one of those days where you hit EVERY red light on the way home. Hopefully this video makes you more grateful to live in a country where traffic control is well planned, if not always observed.</td><td><img alt="animated traffic light image" src="http://lh3.ggpht.com/_mJNjqdajWvk/TCbxh5y9sXI/AAAAAAAAAo8/AC1zkaj4YHY/s800/Animated-Traffic-Light100.gif" /></td></tr>
</tbody></table><br />
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<center><object height="304" width="500"><param name="movie" value="http://www.youtube-nocookie.com/v/QESfEd180rQ&hl=en_US&fs=1&rel=0"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube-nocookie.com/v/QESfEd180rQ&hl=en_US&fs=1&rel=0" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="500" height="304"></embed></object></center><br />
<b>And what can we learn from this?</b><br />
<div><div><ul><li>There is no substitute for defensive driving - Stay Alert.</li>
<li>When cars hit bikes, the cars always win. Helmets protect your head, and your brain.</li>
<li>Even these seemingly "minor" <a alt="you were in a crash not an accident" href="http://www.crashchiro.com/2010/07/call-it-crash-not-accident.html" target="_blank">crashes</a> can have some long term consequences. In the US, nearly 50% of the population with chronic neck pain attribute it to a prior crash.</li>
</ul></div><br />
<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBkD2VQAjqI/AAAAAAAAAoI/K9MGXh1Mchs/s800/post-border.png" /></center></div>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-46513171321756060592010-06-09T11:35:00.000-07:002010-09-27T23:18:21.019-07:00How well do you understand car crash dynamics?<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F06%2Fhow-well-do-you-understand-car-crash.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 450px;"></iframe><br />
When you're heading down the highway, ever stop to think what a <a alt="you were in a crash not an accident" href="http://www.crashchiro.com/2010/07/call-it-crash-not-accident.html" target="_blank">crash</a> would be like if someone crossed over the median causing a head on <a alt="you were in a crash not an accident" href="http://www.crashchiro.com/2010/07/call-it-crash-not-accident.html" target="_blank">crash</a>?<br />
Most people would think it would be worse than just hitting a wall.<br />
Assuming both vehicles are about the same mass, which scenario is worse?<br />
<br />
<b>Situation A?</b><br />
<img alt="Car crashing into wall" src="http://lh4.ggpht.com/_mJNjqdajWvk/TBRz_DdLCFI/AAAAAAAAAmc/2eegUOWCohk/s800/Crash-Math1a5.jpg" /><br />
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<b>Or Situation B?</b><br />
<img alt="Car crashing other car" src="http://lh3.ggpht.com/_mJNjqdajWvk/TBRz_Wr5a3I/AAAAAAAAAmg/q_FqhBlJnl0/s800/Crash-Math1b5.jpg" /><br />
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<b>Email this to your friends and ask them before you watch the video to find out:</b><br />
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Understanding <a alt="you were in a crash not an accident" href="http://www.crashchiro.com/2010/07/call-it-crash-not-accident.html" target="_blank">crash</a> dynamics is an important part of what I do as a chiropractor in SE Portland. Whether it is helping attorneys, insurance companies, or patients - factors like this make a difference. They need to be understood by your doctor, and communicated to the appropriate parties. See the "<a href="http://www.crash-chiropractic.com/p/about-me.html">about me</a>" section to learn about some of the advanced chiropractic training I've had on these subjects.<br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/S_jFGAMuUNI/AAAAAAAAAdM/eWT4D5_4v7s/s800/Blog-Divider.jpg" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-32633742208122123192010-05-29T11:01:00.000-07:002010-09-27T23:12:23.981-07:00Is Chiropractic Effective?<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F05%2Fis-chiropractic-effective.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 450px;"></iframe><br />
Giles et al. compared 3 treatment groups for low back pain: Chiropractic, Acupuncture, and Medication.<br />
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<span style="font-weight: bold;">Interesting Outcomes:</span><br />
The results of this efficacy study suggest that spinal manipulation, if not contraindicated, may be superior to needle acupuncture or medication for the successful treatment of patients with chronic spinal pain syndrome.<br />
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<div>This was a very interesting study, comparing what is often considered the “standard approach” by M.D.s to the approach of chiropractors and acupuncturists. In this study, not only did chiropractic have the best results, it also had the:<br />
<ul><li>quickest results (8 early recovery patients vs. 1 for medication, and 1 for acupuncture)</li>
<li>no side effects experienced (vs. 7 cases with the medication group)</li>
<li>lowest “no-effect” response (8 patients vs. 10 in the acupuncture group and 11 in the medication group)</li>
<li>highest patient satisfaction (2 patients changed treatment groups vs. 9 from the medication group and 5 from acupuncture)</li>
<li>patients felt it helped their general well being (SF-36 results showed 47% improvement for chiropractic group, vs. 18% for the medication group, and 15% for the acupuncture group</li>
</ul></div><div>Considering that the patients in this study had experienced chronic spinal pain syndrome for an average of:<br />
<ul><li>4.5 years in the medication group</li>
<li>6.4 years in the acupuncture group</li>
<li>8.3 years in the spinal manipulation group</li>
</ul>It is notable that manipulation, during a maximum treatment duration of 9 weeks, achieved asymptomatic status for every fourth patient (27%). This result is superior to the percentages for acupuncture (9.4%) and medication (5%) for short-term outcomes.<br />
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Medication apparently did not achieve a marked improvement in chronic spinal pain and caused adverse reactions in 6.1% of the patients. Interestingly, although “new” medication (i.e., not previously tried by patients) showed no significant improvement for the subjective pain and disability measures or the objective measures, the Short-Form-36 Health Survey questionnaire did show an improvement of 18% for general health status, as compared with 15% for acupuncture and 47% for spinal manipulation.</div><div><br />
Spinal manipulation appears to provide the best short-term benefit for some patients with chronic spinal pain syndrome.</div><div><br />
<b>The summary is as follows:</b><br />
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</div><div>115 patients with criteria of being over 17 years age.</div><div><ul><li>Patients were randomized to one of three groups, with the other treatments acting as controls.</li>
<li>The patients randomized to medication normally were given Celebrex (200–400 mg/day) unless it had previously been tried. The next drug of choice was Vioxx (12.5–25 mg/day), followed by paracetamol (up to 4 g/day).</li>
<li>Because the patients randomized to medication had previously tried medication without success, an attempt was made to overcome lower expectation bias by telling them that a very promising “new” medication would be tried.</li>
<li>Chiropractic treatment included high-velocity, low-amplitude thrust spinal manipulation to a joint. Two treatments per week defined this intervention.</li>
<li>Acupuncture was performed during 20-minute appointments, and included 8 to 10 needles in local paraspinal intramuscular maximum pain areas, and approximately 5 needles were placed in distal acupuncture point meridians according to the “near and far” technique. Two treatments per week defined this intervention.</li>
</ul><img alt="Is Chiropractic effective?" src="http://lh3.ggpht.com/_mJNjqdajWvk/TAFP-hgH7LI/AAAAAAAAAeE/zJY93tW25OQ/s800/CMT-vs-MD-graph.png" /><br />
<i>*Recovery means patient reached an “Asymptomatic status.”</i><br />
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1. Giles, L.G. and R. Muller, Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine, 2003. 28(14): p. 1490-502; discussion 1502-3.<br />
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</div></div>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-71083665960187536922010-05-21T22:54:00.000-07:002010-05-22T23:28:57.269-07:00Research on ChiropracticNumerous studies have shown that chiropractic treatment is both safe and effective. The following are excerpts from a few of the more recent studies. By examining the research supporting chiropractic care, you will find that chiropractic offers tremendous potential in meeting today’s health care challenges.<br /><br /><div style="text-align: center;"><span class="Apple-style-span" style="font-weight: bold; ">For Acute and Chronic Pain</span></div><br />“Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">– Nyiendo et al (2000), Journal of Manipulative and Physiological Therapeutics</span></span><br /><br />In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;"> -- Korthals-de Bos et al (2003), British Medical Journal</span></span><br /><br /><div style="text-align: center;"><span class="Apple-style-span" style="font-weight: bold; ">In Comparison to Other Treatment Alternatives</span></div><br />“Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically important differences in pain and disability improvement were found for chronic patients.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">– Haas et al (2005), Journal of Manipulative and Physiological Therapeutics</span></span><br /><br />“In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain. The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent) as for the continued care group (general practitioner). Manual therapy scored better than physical therapy on all outcome measures. Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physical therapy each resulted in statistically significant less analgesic use than continued care.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">– Hoving et al (2002), Annals of Internal Medicine</span></span><br /><br /><div style="text-align: center;"><span class="Apple-style-span" style="font-weight: bold; ">For Headaches</span></div><br />“Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">-- Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001)</span></span><br /><br />“The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” ‘<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">-- Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)</span></span><br /><br /><div style="text-align: center;"><span class="Apple-style-span" style="font-weight: bold; ">Cost Effectiveness</span></div><br />“Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">– Haas et al (2005), Journal of Manipulative and Physiological Therapeutics</span></span><br /><br /><div style="text-align: center;"><span class="Apple-style-span" style="font-weight: bold; ">Patient Satisfaction</span></div><br />“Chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients. Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care. Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">-- Hertzman-Miller et al (2002), American Journal of Public Health</span></span><br /><br /><div style="text-align: center;"><span class="Apple-style-span" style="font-weight: bold; ">Popularity of Chiropractic</span></div><br />“Chiropractic is the largest, most regulated, and best recognized of the complementary and alternative medicine (CAM) professions. CAM patient surveys show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high. There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades.”<br /><br /><span style="font-style:italic;"><span class="Apple-style-span" style="font-size: small;">– Meeker, Haldeman (2002), Annals of Internal Medicine</span></span><br /><p><center><img src="http://lh3.ggpht.com/_mJNjqdajWvk/S_jFGAMuUNI/AAAAAAAAAdM/eWT4D5_4v7s/s800/Blog-Divider.jpg" alt="post signature" /></center></p>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-65888555556868936002010-05-14T20:30:00.000-07:002011-05-16T11:25:18.874-07:00Head Restraint Geometry<iframe allowtransparency="true" frameborder="0" scrolling="no" src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2010%2F05%2Fhead-restraint-geometry-chiropractor.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" style="border: none; height: 80px; overflow: hidden; width: 450px;"></iframe><br />
As a chiropractor in SE Portland, knowing more about auto safety is important. One important factor in preventing injuries associated with rear impact crashes is head restraint geometry. The <a href="http://iihs.org/">Insurance Institute of Highway Safety</a> has published its recommendation for <span style="font-weight: bold;">backset</span> (horizontal distance between back of head and the headrest), and <span style="font-weight: bold;">topset</span> (vertical distance from the top of the head to the top of the headrest)summarized by the following diagram:<br />
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<img alt="Safe Position for Headrest" src="https://lh4.googleusercontent.com/_mJNjqdajWvk/TdFrpaEdEfI/AAAAAAAAA2o/lPxXqUAyig4/s800/IIHS-Head-Restraint-Rating.jpg" /><br />
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And in the following video Adrian Lund (president of the IIHS) explains testing done to evaluate seats, seat backs, and head restraints: <a href="http://www.blogger.com/%E2%80%9Dhttp://www.iihs.org/video.aspx/releases/pr010806%E2%80%9D" target="_blank">LINK</a><br />
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The implications of this are a) medical: inadequate or improperly adjusted head restraints being a prognostic factor in the recovery of an injured occupant, and b) legal: having a knowledgeable chiropractic doctor who fully understands these concepts and can explain them in the event that a patient does not fully recover (See <a href="http://www.crash-chiropractic.com/2010/05/recovery-rates-from-whiplash.html">Prognosis</a>).<br />
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<span style="font-weight: bold;">The take home message? Prevent or reduce injuries in your family and friends by adjusting the head restraint in your vehicles.<br />
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Adjust the top of the head restraint so it is at least the height of the ear-top, and with restraints that have further ability, adjust it so less than 3 inches behind the head.</span><br />
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<span style="font-weight: bold;">And finally, if you're in a crash, come see a chiropractor in SE Portland with a passion for auto injuries. </span><br />
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<center><img alt="post signature" src="http://lh3.ggpht.com/_mJNjqdajWvk/S_jFGAMuUNI/AAAAAAAAAdM/eWT4D5_4v7s/s800/Blog-Divider.jpg" /></center>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-92054784053820320452010-05-13T22:00:00.000-07:002010-05-22T23:28:30.707-07:00Recovery Rates from Whiplash - PrognosisYour prognosis for recovery from a car crash is influenced by several factors. Of them, those with the most value are:<br /><ul><li>Head turned at time of impact</li><li>Prior injury</li><li>Prior headaches</li><li>Prior neck pain</li><li>Inadequate head restraint</li><li>Poor position in car</li><li>Arthritis</li><li>Advanced age</li><li>Disc disease</li><li>Shoulder restraint use (seatbelt) in lower velocity crashes</li><li>Rear impact</li><li>Non-failure of seat back</li><li>Female gender</li><li>Non-awareness</li></ul><br /><img src="http://lh3.ggpht.com/_mJNjqdajWvk/S-4hjuSyE9I/AAAAAAAAAVc/tBbGhXm59sc/s800/Recovery-rates-pie-chart.jpg" /><br /><br />This website is under constant construction.<br /><br /><p><center><img src="http://lh3.ggpht.com/_mJNjqdajWvk/S_jFGAMuUNI/AAAAAAAAAdM/eWT4D5_4v7s/s800/Blog-Divider.jpg" alt="post signature" /></center></p>Dr. Wagnerhttp://www.blogger.com/profile/00958102823480216974noreply@blogger.comtag:blogger.com,1999:blog-7307353225187100077.post-84775068675428394742009-11-01T23:50:00.000-08:002010-09-27T23:03:43.133-07:00NFL players have higher dementia levels<iframe src="http://www.facebook.com/plugins/like.php?href=http%3A%2F%2Fwww.crash-chiropractic.com%2F2009%2F11%2Fnfl-players-have-higher-dementia-levels.html&layout=standard&show_faces=true&width=450&action=like&font=arial&colorscheme=light&height=80" scrolling="no" frameborder="0" style="border:none; overflow:hidden; width:450px; height:80px;" allowTransparency="true"></iframe><br />
This article isn't really surprising, other than the fact that the evidence is even more difficult to deny now.<br />
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<blockquote>A study commissioned by the National Football League reports that Alzheimer’s disease or similar memory-related diseases appear to have been diagnosed in the league’s former players vastly more often than in the national population — including a rate of 19 times the normal rate for men ages 30 through 49.<br />
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The N.F.L. has long denied the existence of reliable data about cognitive decline among its players. These numbers would become the league’s first public affirmation of any connection, though the league pointed to limitations of this study.<br />
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The findings could ring loud at the youth and college levels, which often take cues from the N.F.L. on safety policies and whose players emulate the pros. Hundreds of on-field concussions are sustained at every level each week, with many going undiagnosed and untreated.</blockquote><br />
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<a href="http://www.nytimes.com/2009/09/30/sports/football/30dementia.html?_r=1" target="_blank">NYT Source/More</a><br />
<a href="http://www.crash-chiropractic.com/2010/07/nfl-admits-to-greater-risk-of-head.html">Follow up article</a><br />
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