Clinical Benchmarks

The GenitoUrinary system in chiropractic: The neuroanatomy of the muscle-organ-gland correlation

To be loaded - ready in October

Best Practice Guidelines for Diagnosing Muscle Imbalance: Chiropractic versus Physiotherapy

Abstract: Professor Vladimir Janda, an accomplished physiotherapist and neurologist, was a key figure in the 20th Century rehabilitation and manual therapy movement. Janda founded the rehabilitation department at Charles University Hospital in Prague, Czechoslovakia. 

He was one of the seminal members of the Prague school of manual medicine and rehabilitation that expanded its influence throughout Central and Eastern Europe. Janda published over 16 books and more than 200 publications about muscle function, and has had a major influence over the physical therapy profession around the world. A review of Janda’s published works demonstrates the breadth of his clinical interest and influence. His published papers varied greatly in their focus: from pediatrics to geriatrics, in addition to the lasting effects of pediatric conditions upon the adult, from postural to neurologic disorders, and from ankle conditions to obscure facial pain. His 1964 college thesis paper was on the association between sacroiliac pain and gluteus maximus weakness. (Janda, 1964) 

In addition to publishing several texts in Czech, Janda subsequently published books in German and English. Janda’s approach has been discussed in many text books, often in chapters that he authored. Many years ago, Janda published a manual muscle testing book in English that is now out of print. (Janda, 1983) Many leaders in the manual therapy world, like Drs. Chaitow and Liebenson, have depended upon the work of Vladimir Janda for their concepts of muscular imbalances and the use of the manual muscle test (MMT). These leaders interact and write in one another’s books spreading the Janda-model far and wide.

This is unfortunate because of 5 PROBLEMS in Dr. Janda’s view of muscle inhibitions … and fortunate as well because it has increased the worldwide understanding of the significance of MMT’s diagnostic potential of muscle imbalances in human health.It may be that an entire generation of manual therapists has abandoned the diagnostic gold-mine of the MMT in part because of Janda’s approach to the assessment of ‘muscular imbalance’. This paper explores this contention. 

Indexing Terms: manual muscle test; muscle imbalance; Applied Kinesiology (AK); diagnosis; physical therapy profession; Goodheart; Janda.

Cite: Cuthbert S. Best Practice Guidelines for Diagnosing Muscle Imbalance: Chiropractic versus Physiotherapy. Asia-Pac Chiropr J. 2022;3.1. URL apcj.net/papers-issue-3-1/#CuthbertBestPractice


The meaning and value of vitalism in chiropractic

Abstract: Vitalism has a long history of guidance and controversy in the chiropractic profession, yet there is little clear understanding of its meaning or value in chiropractic. This study therefore sought to answer two research questions. The first asked what chiropractors mean when they speak about vitalism. The second asked what value do chiropractors believe that chiropractic thinking and practices based on vitalism might offer in addressing current global prevalence of non-communicable lifestyle-related conditions. 

This study used a constructivist approach, a predominant research stance of descriptive phenomenology, and a mixed methodology design of exploratory sequential qualitative and quantitative research methods. In Phase I data collection, semi-structured interviews of 18 key informants from eight countries explored the research questions. 

Phase I findings informed the development of an 82-question online survey which was used for data collection in Phase II (composed of closed-ended questions) and Phase III (composed of open-ended questions). Phases II and III explored the generalisability of the findings of Phase I to a wider sample of the profession. Chiropractor members of the Chiropractors’ Association and Australia (CAA) and of the New Zealand Chiropractors’ Association (NZCA) were invited to participate in the survey. Data from a total of 307 respondents were analysed. This represented 9.6% of CAA members and 16.8% of NZCA members. 

Synthesis of data from all three phases revealed that participants attributed multiple meanings to vitalism. To a majority, vitalism meant innate intelligence, a traditional form of vitalism, a guide to a good life, and an essence of the identity of chiropractic. To a minority, vitalism meant an obsolete and unscientific doctrine. To a smaller minority, vitalism meant a neo-vitalism. These differences of opinion presented a marked division over vitalism within the sample. Very few participants occupied the middle ground between the pro- and anti-vitalism groups. A majority of participants believed that chiropractic thinking and practices based on vitalism could offer great value in addressing prevalence of non-communicable lifestyle related conditions. To address this prevalence, the majority proposed a vitalistic practice model composed of chiropractic adjustive care and healthy lifestyle advice. A minority proposed a non-vitalistic practice model of manipulative therapy for the treatment of musculoskeletal pain. 

This study’s findings offered the first empirical data concerning the meanings and value that a sample of chiropractors attributed to vitalism. Future research could explore the potential of this knowledge to add value to the profession’s activities. 

Indexing Terms: Vitalism, health, non-communicable disease, non-communicable disorder, chiropractic, philosophy.

Cite: Richards DM. The meaning and value of vitalism in chiropractic [Thesis]. Asia-Pac Chiropr J. 2021;1.3. URL https://apcj.rocketsparkau.com/richards--mc-vitalism/

Clinical efficacy of Guasha Therapy for shoulder pain [Thesis].

About the candidate: Professor Santos is Executive Director, Graduate and New Program, College of Allied Health Studies, University of Makati. His Technical Competencies include: 

Abstract: Traditional and alternative forms of medicines have been utilized in the Philippines long before the wide spread use of pharmaceutical products. This is not limited to the use of herbal plants, but is also involved in the growing scope of the alternative medicines including the guasha therapy, acupuncture, ventosa, chiropractic medicine and taping medicines. This study aims to determine the clinical efficacy of the Philippine carabao horn used in guasha therapy in reducing the level of shoulder pain experienced by the athletes of University of Makati as compared to the use of spoon for the spoon therapy. 

Guasha therapy can be applied to virtually any part of the body; however, there are certain strokes for each muscle and joint for it to become effective. The guasha therapy has gained popularity in the recent years, but there is paucity of studies and evidences of its use. The limited information available on the guasha therapy suggests improved function and decrease in the level of pain. Guasha therapy appears to have been proven effective and useful in other countries, despite these, the Philippines still lack knowledge, researches and clinical trials about the therapy. 

Scraper tools from other countries are made up of ceramic plates, jade and ox horn. As observed by the researcher these raw materials are composed of protein called the keratin. The researcher performed a thorough study to find a material that is closely related to the composition of other scraper tool, wanting to utilize the available raw materials in the Philippines, the researcher decided to use the Philippine carabao horn.

Indexing Terms: Guasha Therapy; carabao horn; community health; Philippines.

Cite: Santos E. Clinical efficacy of Guasha Therapy for shoulder pain [Thesis]. Asia-Pac Chiropr J. 2020;1.2:online only. URL apcj.net/clinical-benchmarks/#Santos

Integration of Post-Concussion Support Strategies into chiropractic practice

This is a clinically orientated paper which explores an evidence-based rationale for the inclusion of concussion screening protocols and clinical support of the concussion patient in a general chiropractic practice. It includes topics such as: definitions of concussion, concussion screening, clinical assessment, development of an interdisciplinary referral protocol and network, a description of some in-office clinical treatment and support strategies and a discussion of how to enhance patient and community awareness of the illness burden of undetected post concussion syndrome. This document is not a clinical training or certification document or manual; it is recommended that chiropractors wishing to implement the strategies in this paper undergo clinical training in basic concussion diagnostic and treatment protocols. 

Indexing Terms: Chiropractic, Concussion, Post Concussion Syndrome, Vestibular Rehabilitation, Chiropractic Manipulative Therapy

Cite: Noone P. Integration of Post-Concussion Support Strategies into chiropractic practice [Clinical Benchmark]. Asia-Pac Chiropr J. 2020;1:014 URL  apcj.net/clinical-benchmarks/NooneConcussion

Leon Chaitow: Fascial Dysfunction: Adaption as a major feature

In 2014 Dr Leon Chaitow gathered some of the most distinguished practitioners and researchers from across the spectrum of the bodywork professions to produce the first edition of this book; a multidisciplinary array of evidence-informed approaches at the cutting edge of new knowledge about fascia. In his own words: ‘This book should be seen as work in progress – a translation of current research-based knowledge, designed to counterbalance the plethora of misinformation related to fascial function, dysfunction, and treatment.’ () 

He completed the draft revision of the second edition just days before becoming critically ill in February 2018. I helped him to complete the proofs and images in his final days. Fascial Dysfunction: Manual Therapy Approaches 2e represents the culmination of his exploration of musculoskeletal function and dysfunction that had concerned him from the beginning of his career, and combines the two aspects that he considered most important: translational research and multidisciplinary clinical perspectives. 

This excerpt summarises the spirit of the book, demonstrating its breadth and potential for practitioners in all fields.

Sasha Chaitow, PhD


Cite: Chaitow S. Fascial Dysfunction: Adaption as a major feature. Introduction to: Except from Chaitow L. Fascial Dysfunction: Manual Therapy Approaches 2e, presented as Clinical Benchmark. Asia-Pac Chiropr J. 2020;1:018 URL apcj.net/clinical-benchmarks/#Chaitow

 

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