Archive for category Research

Abstract

This paper illustrates the role cervical spine dysfunction  plays as an important aetiological factor in the clinical presentation  of various pain syndromes and the application of spinal manipulative  therapy as a therapeutic procedure. Specific manipulative skills and  application of these skills to help reduce the possibility of  post-manipulative cerebrovascular complications are presented.


Eur J Chiropr.  1991: 39: 45-52.

Author information: Byfield D.  Anglo-European College of  Chiropractic, Bournemouth, Dorset, UK.

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Abstract

An overview of Activator Methods Chiropractic Technique (AMCT) theory and training is provided. The Kaminski model includes an outline for formal evaluation of current hypotheses and practices advocated and taught by Activator Methods, Inc. On this basis, we consider AMCT assessment procedures to show some promise of reproducibility within, and among, practitioners. Although AMCT procedures are among the most widely studied chiropractic procedures in the scientific literature, and although some quantitative outcome data concerning Activator instrument adjusting are available, few controlled trials have been conducted. Consequently, no strong claims for the clinical effectiveness of these (or other chiropractic) intervention strategies are currently justified. Theories and rationales for AMCT procedures are incomplete, and require further elaboration. Recommendations for further research, and for improvement in AMCT instruction are provided.


Chiropr Tech November 1990; 2(4)168-175.

Author information: Osterbauer P, Fuhr AW. Activator Methods, Inc. Phoenix, AZ.

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Abstract

The interexaminer reliability of noninvasive methods of examining lumbar spinal segments is not well established. In this project the interexaminer reliability of three experienced chiropractic examiners, who evaluated 21 symptomatic and 25 asymptomatic subjects, was explored. Eight noninvasive segmental examination strategies (dimensions) were employed at each spinal segment from T11/T12 through L5/S1. Marginal to good agreement beyond chance was noted for palpatory pain over osseous structures and in paraspinal soft-tissues. Weaker and less frequently, significant concordance between examiners was noted for detection of temperature differences (greater than or equal to 1.5 degrees F) between adjacent segments and for visual inspection for segmental abnormality. Little significant agreement between examiner was found for active and passive motion palpation, muscle tension palpation and misalignment palpation. This study suggests that “subjective” findings (pain) may be among the most reliable of conservative spinal observations. Weak but significant correlations were found when positive findings for the eight dimensions at each lumbar segment were summed to form a composite joint abnormality index. When the multidimension index was developed using the four most reliable dimensions, slightly stronger correlations were found. The strongest agreement between examiners tended to be found in the lower lumbar spine.


J Manipulative Physiol Ther. 1990 Oct;13(8):463-70. [PMID:2146357]

Author information: Keating JC Jr, Bergmann TF, Jacobs GE, Finer BA, Larson K. Palmer College of Chiropractic/West, Sunnyvale, CA 94087.

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Abstract

The influence of nociceptive peripheral input on the response characteristics of spinal interneurons may result in long-term alterations of interneuronal excitability and modify their responses to subsequent stimuli. Such neuromodulation has been found to result in physiological changes including hyperalgesia, lowering of pain thresholds, expansion of receptive fields and changes in response behaviors of muscles. These types of alterations may contribute to clinically significant findings including muscle spasm, hypomobility, edema, chronic pain, recurrences in areas of previous injury and resistance to treatment. This article reviews studies concerning plasticity of response behaviors of interneurons including habituation, spinal learning, spinal fixation, neuromodulation and the effects of substance P. Potential clinical and chiropractic application are discussed and a brief review of clinically relevant studies of chiropractic adjustments are cited.


J Manipulative Physiol Ther. 1990 Jul-Aug;13(6):326-36. [PMID:1697616]

Author information: Slosberg M. Department of Research, Life Chiropractic College-West, San Lorenzo 94580.

 

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Abstract

Two patients with sciatic neuropathy and confirmed disc  herniation were treated with a low force treatment regimen consisting of the Activator instrument adjusting, pelvic blocking, high voltage  galvanic current and exercises. CT scans with multiplanar data imaging  (MPDI) and clinical observation were used to monitor the cases both in  diagnosis and as treatment progressed. The results of the follow up CT  scans in the first case included complete absence of disc herniation.  The second case follow up scan revealed the continued presence of a silent disc bulge at the L3-4 level and partial decrease in a herniation  at the L4-5 level. The bulge appeared to have shifted away from the nerve root. Both patients’ pain levels decreased from severe to  minimal. The patients gained the ability to stand, sit and walk for  longer periods without discomfort; lifting tasks also became easier. The  patients were able to return to full work capacity at three and nine  months respectively. This case study is unique to the literature since it documents the use of a treatment regimen which included low force  adjustments. While no conclusions may be made concerning efficacy of  anyone type of treatment, the favorable patient outcomes are somewhat  encouraging.


Am J Chiropr Med. 1990; 3(1): 25-32.

Reference: Richards GL, Thompson JS, Osterbauer PJ, Fuhr AW. Private practice of chiropractic, Mentor, OH.

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Abstract

A series of blinded studies to determine the feasibility of documenting functional leg length inequalities and changes in functional leg length in normal and non-normal patients were performed. A new apparatus designed to minimize or eliminate subjective components of inequality assessment, while attaining high levels of precision, was developed. Subjects were evaluated for presence of cervical spine lesion by five independent examiners and grouped into “lesioned” and “nonlesioned” categories. Subjects’ leg length inequalities were measured by different evaluators as well as multiple measurements by a single evaluator to determine interrater and intrarater reliability coefficients. Measurements were taken on both flat and hi-low tables for changes during active cervical spine rotation. In addition, leg length measurements were taken during induced tetanic contraction by ipsilateral galvanic paravertebral muscle stimulation. Results indicated an absence of any significant effect of head rotation, type of table, galvanic stimulation, or any difference between persons classified as cervically lesioned or not cervically lesioned. Interrater and intrarater reliability coefficients for the measuring apparatus were statistically significant with small error variances. Failure to obtain subjects with frank pain as well as absence of an applied cephalad pressure (as is performed clinically) during leg length evaluation were considered as possible explanations for the failure to detect an effect of head rotation in the leg lengths. Discussion addresses the need for sensitive leg length inequality assessment techniques which eliminate subjectivity and contribute to decreased error variances.


J Manipulative Physiol Ther. 1989 Oct;12(5):364-8. [PMID:2607227]

Author information: Falltrick DR, Pierson SD. Research Department, Life Chiropractic College-West, San Lorenzo, CA 94580.

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Abstract

A reliability study was conducted to determine whether prone leg length analysis in association with an isolation test maneuver was reproducible. Seventy-two subjects were evaluated by two examiners on separate occasions for the presence of C1 subluxation. Concordance was assessed by the Kappa statistic, and interexaminer percentage of agreement was compared. Agreement beyond chance for the two groups was K = 0.52, p less than 0.01 and 0.55, p less than 0.001, respectively. The results indicate good reliability using this method of analysis for putative upper cervical subluxation in this patient population. Further investigation is necessary to correlate this method of analysis with the empirical evidence of manipulable lesions or subluxations.


J Manipulative Physiol Ther. 1989 Apr;12(2):93-7. [PMID:2715743]

Author information: Youngquist MW, Fuhr AW, Osterbauer PJ. Activator Methods, Inc., Phoenix, AZ 85060-0317.

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Abstract

The interexaminer reliability of relative  leg-length evaluation was studied on a sample of 30 subjects by  examiners. Prone leg length was examined categorically, whether heels  were even or whether there was a relative shortness to either side.  Relative leg-length differences were estimated by using a ruler.  Concordance was computed using Kappa and intra-class correlation  coefficients. The Kappa statistic yielded “fair” to “good” concordance  (ranges: 0.31-0.75) among the 6 combinations of examiner pairs. The  results support the reliability of observing and measuring relative leg-  length inequality in the prone position, and are intended to establish a  baseline for future investigation.


Chiropr Tech 1989; 1(1):13-8.

Author information: Fuhr AW, Osterbauer PJ. Activator Methods, Inc. Phoenix, AZ 85060.

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Abstract

The authors studied relative bone movements in response to manipulative light taps to the spine. Piezoelectric accelerometers attached to bone of an anesthetized dog measured transverse, X-Z plane, movements of L2-L3 adjacent vertebrae while percussion thrusts of an instrument used for manipulation made inputs three vertebrae above and five vertebrae below the L2-L3 joint interface. Small, relative 1-mm translations and 0.5 degree rotations occurred during the first 19 msec. When one set of accelerometers were stabilized on the skin surface, half of the skin-bone translation maxima erred less than 2%. However, skin translations averaged 77% (SD = 2%) of bone translations and skin rotations averaged 95% (SD = 26%) of bone rotations. The results suggest the possibility that, with further development, piezoelectric accelerometers can be a noninvasive tool to study dynamic, relative, bone movement.


J Manipulative Physiol Ther. 1989 Feb;12(1):26-37. [PMID:2926284]

Author information: Smith DB, Fuhr AW, Davis BP. Activator Methods, Inc., Phoenix, Arizona 85060-0317.

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Abstract

This study examined the effects of chiropractic adjustments of the thoracic spine (T1-T5) on blood pressure and state anxiety in 21 patients with elevated blood pressure. Subjects were randomly assigned to one of three treatment conditions: active treatment, placebo treatment, or no treatment control. The adjustments were performed by a mechanical chiropractic adjusting device. Dependent measures obtained pre- and post-treatment included systolic and diastolic blood pressure, and state anxiety. Results indicated that systolic and diastolic blood pressure decreased significantly in the active treatment condition, whereas no significant changes occurred in the placebo and control conditions. State anxiety significantly decreased in the active and control conditions. Results provide support for the hypothesis that blood pressure is reduced following chiropractic treatment. Further study is needed to examine the long-term effects of chiropractic treatment on blood pressure.


J Manipulative Physiol Ther. 1988 Dec;11(6):484-8. [PMID:3075649]

Author information: Yates RG, Lamping DL, Abram NL, Wright C. Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.

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