FROM: Todays Chiropractic 2002 (Jan); 31 (1): 41–45 ~ FULL TEXT
By Christopher Kent, D.C.
Practicing chiropractors are faced with the challenge of determining when to adjust. Trying to apply examination procedures, such as medical orthopedic tests, which do not indicate the presence or correction of vertebral subluxations, has frustrated many doctors.
The concept of nerve interference is often challenging to patients. Their confusion is compounded when the chiropractor claims to subluxation-based, but bases care on the presence or absence of symptoms.
The ideal clinical examination procedure:
Will provide objective measurements;
Is completely non-invasive;
Provides a reliable and valid assessment of the functional status of the nervous system;
Provides a means of re-examination to track progress;
Is time- and cost-effective;
Uses protocols supported by peer-reviewed publications;
Is applicable to persons of all ages, including infants, toddlers, children, adolescents and adults;
Facilitates patient education by providing easy-to-understand, tangible evidence; and
Is suitable for spinal screening.
Five Key Aspects To Measure
Using proper instrumentation during the clinical examination empowers the chiropractor with objective evidence of nervous system function. One chiropractor-designed system, the Insight Subluxation Station, was developed in consultation with experts in engineering, basic sciences and clinical assessment.
Such a system enables the chiropractor to evaluate five aspects of functional integrity, which are related to the analysis of vertebral subluxation:
Static surface EMG (sEMG) measures the electrical activity in the muscles surrounding the spine. This test enables the chiropractor to objectively evaluate the innate response of the paraspinal muscles to gravity. Tonic muscle activity is assessed with static sEMG.
Dynamic surface EMG allows the chiropractor to graph up to four channels of sEMG activity as the patient goes through ranges of motion. The result is an objective assessment of voluntary motion.
Paraspinal infrared temperature analysis evaluates the integrity of the autonomic nervous system, which controls organs, glands, and blood vessels. It allows the chiropractor to relate vertebral subluxation to autonomic function. The unique rolling thermal scanner allows the doctor to examine infants, children and adult patients in a single pass.
Computerized inclinometry measures ranges of spinal motion. These measurements relate to the biomechanical component of vertebral subluxations.
Pressure algometry evaluates sensory function by measuring the pressure/pain thresholds of tender regions along the spine.
Dramatic color graphics can display this information in a format that is easy to apply clinically and to communicate effectively to patients.
To illustrate subluxation analysis, consider a clinical case study. The patient, Debbi, made an initial visit to a chiropractic office after a medical doctor stated she had six months to live.
History: The patient awoke with a congested feeling in December 1994. She reported to her family M.D., who diagnosed her with indigestion. Symptoms became more severe and constant over the following days, and she was referred to a specialist, who arrived at a diagnosis of asthma. She was placed on various inhalers and sent home. Over the next three months, her condition worsened and she was admitted to the emergency room on three occasions.
Medical Treatment: The patient was treated with a variety of steroids and inhalers over the course of the past several years. Her condition continued to worsen. At the time of consultation in our office, she was taking daily doses of Albuterol, Flovent, Serevent, Prilosec, Paxil, Valium, Maxide, Prednisone and Hycatus.
Chiropractic Findings: On first glance, it was obvious the patient was very ill. Her skin was a gray/blue color, and dark black circles surrounded her eyes. She was unable to carry on a conversation due to a cough she had had for over five years. Palpation of the cervical and upper thoracic spine revealed severe myospasm and decreased motion, indicating subluxation. An exam utilizing the Insight Subluxation Station was performed, including sEMG and thermal testing. Results demonstrated severe effects of vertebral subluxation. Subsequent scans were performed after every 12 adjustments.
Outcome: The patient noted an immediate change in her quality of life. Her breathing eased and her use of inhalers/nebulizers decreased. On March 26, she was re-scanned and demonstrated great progress. She reported that her cough of five years was completely gone, that she was able to sleep through the night for the first time in over five years and that she was off all medications.
Despite her feeling "completely well," her scans, although greatly improved, still demonstrated moderate and severe findings. The patient chose to continue with the care plan until objective data showed she was ready for lifetime wellness care.
Final Note: Debbi was told by her M.D.s that she had six months to live. On her intake form, she wrote as her expectation of care with us to "breathe and enjoy life again." She was referred to this office by her daughter, who knew we had the technology to truly discover what was causing her mothers loss of health. Today, Debbi reports a level of wellness she never dreamed possible. She continues with weekly wellness care and, as her most recent scans reveal, is doing very well.
Saur, P.M., Ensink, F.B., Frese, K., et al.,
Lumbar Range of Motion: Reliability and Validity of the Inclinometer Technique in the Clinical Measurement of Trunk Flexibility
Spine 1996; 21(11):1332.
Whatmore, G.B., Kohi, D.R.
Dysponesis: A Neurophysiologic Factor in Functional Disorders
Behav Sci 1968; 13(2):102.
Surface Electromyography in the Assessment of Changes in Paraspinal Muscle Activity Associated with Vertebral Subluxation: A Review
Journal of Vertebral Subluxation Research 1997; 1(3):15.
Uematsu, S., Edwin, D.H., Jankel, E.R., et al.
Quantification of Thermal Asymmetry.
J Neurosurg 1988; 69:552.
Kent, C., Gentempo, P.
Instrumentation and Imaging in Chiropractic: A Centennial Retrospective
Todays Chiropractic 1995; 24(1):32.
Kelly, S., Boone, W.R.
The Clinical Application of Surface Electromyography As An Objective Measure of Patient Progress: A Pilot Study
Journal of Vertebral Subluxation Research 1998; 2(4):175.
Instrumentation and Imaging," In: Masarsky, C., Todres-Masarsky, M., Somatovisceral Aspects of Chiropractic An Evidence-based Approach
New York: Churchill-Livingstone, 2001.
About the authors: Christopher Kent, D.C., a 1973 graduate of Palmer College of Chiropractic, was named "Chiropractic Researcher of the Year" in 1991 by the International Chiropractors Association. A noted author, researcher, lecturer and consultant, he formerly served as a principal investigator in the PCC research department. A diplomate of the Academy of Chiropractic Radiology, he has served as chairman of the ICA College of Chiropractic Imaging. For additional information, call the Chiropractic Leadership Alliance, Inc., at (800) 892-6463 or (201) 368-9600; visit Web site www.subluxation.com; or send E-mail to email@example.com.
Return to the CHIROPRACTIC SUBLUXATION Page