Edward F. Owens, Jr., MS, DC

Director of Research Sherman College of Straight

ChiropracticSpartanburg, SC

Vertebral Subluxation Research:

Philosophical Roots to Modern Development

Overview

• Relationships– Philosophy– Art– Science

• Hypothesis formulation

• Experimental methods

• Subluxation measures

• Examples of works in progress

Practice objective dictates application

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

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.

• 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

Vertebral Subluxation

Negative mechanical influences can occur in the area of the spine and interfere with information processing. These are called vertebral subluxations.

Which comes first?

Articular derangement leads to neurological involvement.

Neurological dysfunction leads to

articular derangement.

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.

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

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.

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

RAC-IV Presentation

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

Validation of Measures

• Challenges– No gold standard– Hypothetical nature– Often subjective

• Possibilities– Covariation of

neurological and articular measures

– Fixed Pattern = Stasis, poor adaptation

Subluxation Detection

• Altered neurological function– muscle tone

– leg length difference

– posture/balance

– thermography

• Altered articular function– X-ray Analysis

– palpation

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

Leg Check

Leg Checking Apparatus

Assessment of the modified Prill leg check and Prill Push Test as indicators of vertebral subluxation by

comparison with established indicators. Alan Hartley

Recent developments

Leg Check Force Application

Force profiles

Paraspinal temperature measurement. TyTron dual probe computerized infra-red device.

TyTron Screen Shot

Thermographic Pattern Analysis using Objective Numeric Methods

• Preconditioning– Normalization

– Smoothing

– Sliding

– Clipping

• Congruence Calculations– Area difference

– Slope comparison

– Correlation

– Stewart/Boone methods• Slope

• Amplitude

Screen shot of interface

Muscle Palpation Studies

• Reliability testing• Validity testing• Anatomical structure

location

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