edward f. owens, jr., ms, dc director of research sherman college of straight chiropractic...
TRANSCRIPT
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Edward F. Owens, Jr., MS, DC
Director of Research Sherman College of Straight
ChiropracticSpartanburg, SC
Vertebral Subluxation Research:
Philosophical Roots to Modern Development
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Overview
• Relationships– Philosophy– Art– Science
• Hypothesis formulation
• Experimental methods
• Subluxation measures
• Examples of works in progress
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Practice objective dictates application
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The scientific method applied to chiropractic questions
• Hypothesis formulation– derived from deductive
philosophy
– asking the right questions
• Hypothesis testing– inductive process
– methods suitable to hypothesis
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Another Vertebral SubluxationHypothesis
Complex organisms depend on the bidirectional flow of information between the central nervous system and the peripheral cells in order to adapt to a changing environment in a coordinated manner.
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• Metabolic demands
• Alcohol
• Inflammation
• Trauma
• Spinal lesion in close Spinal lesion in close proximity to neural tissueproximity to neural tissue
Distortion of Information:Disturbed Function
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Vertebral Subluxation
Negative mechanical influences can occur in the area of the spine and interfere with information processing. These are called vertebral subluxations.
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Which comes first?
Articular derangement leads to neurological involvement.
Neurological dysfunction leads to
articular derangement.
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General Hypotheses
Articular derangement leads to neurological involvement.
Slight disarticulations in spinal joints can restrict nerve transmission by occluding the IVF
Changes in vertebral mobility can alter joint loading and mechanoreceptor output in such as way as to disturb spinal reflexes.
IVD material can encroach on the spinal canal or IVF causing restriction on the volume of neural tissue.
Misalignments of vertebrae can change the course of the spinal cord, producing interference in the transmission of nerve impulses.
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More specific hypotheses
Misalignments of vertebrae can change the course of the spinal cord, producing interference in the transmission of nerve impulses.
Misalignment can be measured on x-ray
Sensory nerve conduction can be assessed with SSEP
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Neurological dysfunction leads to articular derangement.
General Hypotheses: the other limb of the tree
Improper muscle tone leads to fixation and improper instantaneous axis of rotation.
Compression or irritation of efferent tracts leads to loss of muscle control.
Irritation of sensory tracts leads to loss of feedback from joints and muscles.
Poor sense of joint strain leads to improper, or prolonged loading.
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Vertebral subluxations at any segment will effect physical functioning.
Subluxation can be assessed clinically using a well known technique.
Physical function can be evaluated using performance measures.
Protocols Protocols
More global hypotheses
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RAC-IV Presentation
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Experimental Design:VS - Paradigm
1. Test function independent of symptoms
2. Observe structural and articular status
3. Correct structure
4. Re-test function
Using Common VS measures would allow Using Common VS measures would allow comparison of techniques for effectivenesscomparison of techniques for effectiveness
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Validation of Measures
• Challenges– No gold standard– Hypothetical nature– Often subjective
• Possibilities– Covariation of
neurological and articular measures
– Fixed Pattern = Stasis, poor adaptation
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Subluxation Detection
• Altered neurological function– muscle tone
– leg length difference
– posture/balance
– thermography
• Altered articular function– X-ray Analysis
– palpation
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Some Projects Underway
• Dissecting the Prone Leg Check. Alan Hartley
• Thermographic Pattern Analysis. John Hart
• Muscle Palpation Studies. Joe Donofrio
• Maintenance/Wellness Applications of Subluxation-Centered Chiropractic Care. Brian McAulay
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Leg Check
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Leg Checking Apparatus
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Assessment of the modified Prill leg check and Prill Push Test as indicators of vertebral subluxation by
comparison with established indicators. Alan Hartley
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Recent developments
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Leg Check Force Application
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Force profiles
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Paraspinal temperature measurement. TyTron dual probe computerized infra-red device.
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TyTron Screen Shot
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Thermographic Pattern Analysis using Objective Numeric Methods
• Preconditioning– Normalization
– Smoothing
– Sliding
– Clipping
• Congruence Calculations– Area difference
– Slope comparison
– Correlation
– Stewart/Boone methods• Slope
• Amplitude
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Screen shot of interface
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Muscle Palpation Studies
• Reliability testing• Validity testing• Anatomical structure
location
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Where the rubber meets the road
• Do patients who receive care for subluxation correction experience positive clinical outcomes?
• General health measures
• Quality of life surveys
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