January 2022 Asia Pacific Chiropractic Journal
Issue 2.5 'Immunity'
Disclaimer
This journal is a professional journal by chiropractors for chiropractors. Readers not fully trained as a chiropractor should not act on their own on any information published in these pages and should always discuss their situation with their chiropractor.
The papers addressing COVID report current information at their time of writing. The topic is fast moving and readers are encouraged to extract threads from what we publish here and undertake their own searches for the most recent information.
Ebrall: Editorial Great news for segment-specific chiropractors who adjust with intent.
Ierano: In Memoriam: Dr Roy W Sweat.
Schmitt & McCord: Measure, measure, measure: 'Indicator testing' and nutrients for musculoskeletal pain.
Cuthbert and Lindley-Jones: A History of Professional Applied Kinesiology (PAK) Around the World, Part II
Elbert: Clinical Huddle: X-Ray evaluations
Sedar: Clinical Huddle: Pediatric patients
Chu et al: The Scalable Approach to Chiropractic Patient Journey
Masarsky: The Wide-Angle Lens: How many accidents have you prevented?
ASRF writers: Chiropractic Care and Immune Function: What you really need to know from the literature
Force: Reasoning SARS-CoV-2
Cuthbert: Vitamin D and Coronavirus: Not a vaccine, nonetheless nature’s humble natural cure
Ebrall: How chiropractors may influence immunity: Zinc supplementation. A speed update of the literature
Blum series title 'Covid-19 and the role of chiropractic in the healthcare arena with non-pharmaceutical prevention, early treatment, and care for those with long Covid syndromes':
See also
Blum C. Chiropractic and the Immune System: Disentangling Context and Looking at the Big Picture. Asia-Pac Chiropr J. 2020;1:001 URL https://apcj.net/blum-immunity...
Blum C. Covid-19 and the role of chiropractic in the healthcare arena: Omicron Variant: Pre-Publication Update, 27 December 2021. Asia-Pac Chiropr J. 2021;2.4. URL apcj.net/papers-issue-2-4/#BlumOmicron
Kolterman & Martin, et al: Chiropractic management of an 18-yo with Lupus
Steinberg et al: Decrease in allergies, nocturnal enuresis and sleep problems in a 3-year-old under chiropractic care
Hassan et al. Improvement in migraines and chronic neck pain in a 42 year old male under chiropractic care
Leahy et al: Improvement in posture, sleep and energy in a 25 year old female under chiropractic care
Luc et al: Chiropractic Management of chronic sinusitis and breathing difficulty in a 67-year-old male
Marsilla Alarcon et al: Resolution of severe hypoacusia and first degree tinnitus concomitant with chiropractic care
Great news for segment-specific chiropractors who adjust with intent
Abstract: The authors have delivered a paper which actually reinforces the key chiropractic beliefs that specificity matters. It is just that they do not know how to investigate it.
Cite: Ebrall P. Great news for segment-specific chiropractors who adjust with intent. Asia-Pac Chiropr J. 2021;2.5. URL apcj.net/papers-issue-2-5/#EbrallEditorialJan22
Roy W Sweat [In Memoriam]
Abstract: To experience the teaching of Roy Sweat directly was to hear an infallible sequence of verbal instruction that only years of application can ensue, but that hidden magic has no quantifiable ingredient. Within his delivery is the cradle of humour, familiarity and respect that you only find in that of a family elder, a tribal leader, a sociological student of human development, an anthropological master who simply delivers a message contextually. An innovator. A healer.
Cite: Ierano J. Inventor, Atlas Orthogonal Instrument and Program: Roy W Sweat [In Memoriam]. Asia-Pac Chiropr J. 2022;2.5. URL www.apcj.net/papers-issue-2-5/#IeranoSweat
Measure, Measure, Measure:‘Indicator testing’ and nutrients for musculoskeletal pain
Abstract: Precise individualized procedures and nutritional interventions may be determined for patients with musculoskeletal pain by using Indicator Testing.
Indicator testing for nutritional supplements measures pain and/or range of motion before and after the patient tastes a supplement.
The most important nutritional supplements to be measured by Indictor Testing in patients with musculoskeletal pain are essential fatty acids, manganese, and cartilage producing substances including chondroitin sulfate and/or glucosamine sulfate, methylsulfonylmethane (MSM), and the amino acid L-cysteine.
Indexing Terms: chiropractic; AK; Applied Kinesiology; Indicator Testing.
Cite: Schmitt WH, McCord KM. Asia-Pac Chiropr J. 2022;2.5 URL apcj.net/papers-issue-2-5/#SchmittMcCordIndicatorTesting
A history of professional Applied Kinesiology around the world (Part 2)
Abstract: In this history of the growth of Professional Applied Kinesiology (PAK) and the International College of Applied Kinesiology around the world and throughout the healing professions in Part II, thirteen contributing authors and teachers of this chiropractic technique tell the story of PAK’s growth on each of the continents of the world and its penetration into allied natural health care fields, presenting the detailed, colorful story of the permeation of AK manual muscle testing (MMT) methods and philosophy into the daily practice of hundreds of thousands and potentially millions of clinicians. Illustrated throughout with historical pictures covering over 5 decades, this is the first comprehensive history of AK around the world.
Indexing Terms: Chiropractic, Applied kinesiology, Goodheart, AK, chiropractic history, Manual Muscle Testing.
Cite: Cuthbert S, Lindley-Jones C, and contributors. A history of professional Applied Kinesiology around the world (Part II). Asia-Pacific Chiropr J. 2022;2.5. URL https://www.apcj.net/papers-issue-2-5/#CuthbertetalPAK2
X-ray evaluation: A Clinical Huddle.
Abstract: Practice Wisdom is applied to the clinical interpretation of full spine radiographs in the chiropractic clinical situation. A systematic approach is described noting key landmarks and measurements. Notation is made of the clinical findings to guide optimal care of the patient.
Indexing Terms: chiropractic; X-ray; radiograph; full-spine radiograph, radiographic interpretation.
Cite: Elbert R. X-ray evaluation: A Clinical Huddle. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#ElbertHuddleRads
Caring for the pediatric patient and their unique challenges
Abstract: A conversational style is used by the authors to provide an overview of the pediatric consultation in Gonstead-style chiropractic practice. The matters of instrumentation diagnostic imaging are addressed with a conclusion that they provide relevant clinical information to guide the least level of therapeutic intervention. A short pediatric case is given as an example..
Indexing Terms: chiropractic; Gonstead Methods; pediatric; instrumention.
Cite: Sedar BM, Franzluebbers K. Caring for the pediatric patient and their unique challenges: A Clinical Huddle. Asia-Pac Chiropr J. 2021;12.2. URL apcj.net/papers-issue-2-5/#SedarPediatric
The scalable approach to the Chiropractic patient journey
摘要: 許多被傳統醫學制度拒絕的病患尋求脊醫替代傳統治療。從患者的⻆度了解患者的治病旅程可以幫助脊醫解決和滿足患者需求、參與患者對患者自己的護理以及改善他們的護理模式可以改變生活質量和增進治療結果。本研究旨在通過不同支柱創造患者體驗提供理論框架。研究也嘗試提出改善患者旅程的影響因素。最後，該研究建議不同來創造更好的患者治病旅程。
Abstract: Chiropractors have been treating people who had been turned down by standard medical practitioners and who sought chiropractic care as an alternative therapy. Understanding the patient journey from the patient's point of view can help chiropractors improve their care models by addressing unmet patient needs, increasing patient participation in their care, and progressing toward better outcomes and quality of life. This study intends to give a theoretical framework for creating the patient experience by highlighting common pillars. It also tries to examine influential factors for how to improve the patient journey. Lastly, the study makes recommendations on what can be done to create a better patient journey.
索引詞: 脊骨神經醫學; 香港; 脊醫患者治病旅程
Indexing Terms: chiropractic; Hong Kong; chiropractic patient journey
Cite: Chu ECP. The scalable approach to the Chiropractic patient journey. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#ChuPatientJourney
Related papers by Dr Chu
Leung K, Chu ECP. 2021 Hong Kong Chiropractic Survey: Analysis of Data. Asia-Pac Chiropr J. 2021;2.3. URL apcj.net/papers-issue-2-3/#LeungChuHongKong
Chu ECP. Hong Kong poised for rapid healthcare change [Report]. Asia-Pac Chiropr J. 2021;2.2. URL https://www.apcj.net/papers-issue-2-2/#ChuHongKong
How many accidents have YOU prevented? The wide-angle lens
Abstract: To propose that a chiropractor may never really know who many accidents they prevent through their patient-centred care where the adjustment improves a person’s reaction time and situational awareness. Chiropractic care improves how patients see their world.
Indexing Terms: chiropractic; reaction time; situational awareness.
Cite: Masarsky CS. How many accidents have YOU prevented? The wide-angle lens. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#MasarskyAccidents
Chiropractic Care and Immune Function: What you really need to know from the literature
Abstract: The purpose of this literature review is to report the Top Five papers forming the current evidence on chiropractic care and immune function. The paper covers five significant studies, include meta-analyses and systemic reviews, in order to create context and background for the case reports included in this issue of the Journal.
Despite strong debate, it is clear from the included reviews and meta-analyses that evidence for SMT modulating biochemical markers of immune function does indeed exist. This literature review found evidence for improvements in inflammatory cytokines, specifically IL-beta and TNF-alpha, interleukin (IL) 1β and the neurotransmitter Substance P. Other included evidence shows indications that SMT may impact neurotensin, oxytocin and immunological biomarkers.
Further research will be beneficial in terms of raising the quality of evidence, examining asymptomatic and symptomatic patients, and defining the mechanisms behind the observed improvements. However, the current evidence provides a strong starting point for future efforts
Indexing Terms: Chiropractic, Subluxation, Immunity.
Cite: Foote P, Emmanuel L, Postlethwaite R, McIvor C. Chiropractic Care and Immune Function: What you really need to know from the literature. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#ReviewImmuneFunction
Reasoning SARS-CoV-2
Abstract: Objective - To present an overview of the current literature in a form that is easy for chiropractors to use with patients.
Discussion - Some 360 papers were retrieved to address and inform a structure built from Practice Wisdom. A wide gamut of approaches suited to conventional chiropractic are described, each with current evidence.
Conclusion - Chiropractors play a critical role in maintaining the general health of people in their community. While the SARS pandemic has impacted practices in various ways, all chiropractors are able to contribute evidence-based support individualised to their patients.
Indexing Terms: chiropractic; clinical reasoning; immunity.
Cite: Force M. Reasoning SARS-CoV-2. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#ForceReasoningSARS
Vitamin D and Coronavirus: Not a vaccine, nonetheless nature’s humble natural cure
Abstract: Objective - To review the leading relevant research regarding vitamin D’s role in prevention of COVID-19 infection, progression and severity and innate immune function.
Discussion - The chiropractor’s perspective is upheld that vitamin D supplementation may assist with the body’s immune function and anti-viral capacity. It is acknowledged that the formal scientific literature is incomplete but growing rapidly and that it is favourable to the idea. In clinical terms, there is no harm and possibly great benefit for guiding patients to consider vitamin D supplementation in the endemic coronavirus era.
Conclusion - Chiropractors should consider the benefits of vitamin D supplementation in these days of virulent respiratory infection. There is a very little risk of any adverse events related to such a recommendation.
Indexing Terms: chiropractic; immunity; COVID, vitamin D, applied kinesiology, nutritional diagnosis.
Cite: Cuthbert S. Vitamin D and Coronavirus: Not a vaccine, nonetheless nature’s humble natural cure. Asia-Pac Chiropr J. 2022;2.4. URL apcj.net/papers-issue-2-5/#CuthbertVitaminD
How chiropractors may influence immunity: Zinc supplementation. A speed update of the literature
Abstract: Objective - To review the top 6 relevant papers regarding zinc and immune function.
Discussion - The chiropractor’s perspective is upheld that zinc supplementation may assist with the body’s immune function. It is acknowledged that the formal scientific literature remains cautious but is favourable to the idea that in clinical terms, there is no harm and possible benefit for guiding patients to consider zinc supplementation.
Conclusion - Chiropractors should consider the benefits of zinc supplementation in these days of virulent respiratory infection. There is a very little risk of any adverse event related to such a recommendation.
Indexing Terms: chiropractic; immunity; zinc; COVID, Zinc Tally Test.
Cite: Ebrall P. How chiropractors may influence immunity: Zinc supplementation. A speed update of the literature. Asia-Pac Chiropr J. 2022;2.4. URL apcj.net/papers-issue-2-5/#Ebrallimmunity
Covid-19 and the role of chiropractic in the healthcare arena with non-pharmaceutical prevention, early treatment, and care for those with long Covid syndromes (in 3 parts)
Part One: Series Introduction, and Prevention
Abstract: The role of COVID-19 prevention is complex but important for a chiropractor’s place in the wellness healthcare community. With patients that have comorbidities and are in high-risk arenas or exhibiting high-risk behaviors, based on the current evidence, the risk of having COVID-19 may clearly outweigh any risk associated with being vaccinated. As more research is gathered over the ensuing years regarding vaccination side effects this will help further influence decision-making.
Indexing Terms: chiropractic; immunity; COVID; prevention’ comorbidity.
Cite: Blum C. COVID-19 and the role of chiropractic in the healthcare arena with non-pharmaceutical prevention, early treatment, and care for those with long Covid syndromes: Part One - Series Introduction, and Prevention. Asia-Pac Chiropr J. 2021;2.4. URL apcj.net/papers-issue-2-5/#BlumPrevention
Part Two: Early treatment
Abstract: Early treatment of COVID-19 starts with becoming aware of possible patient symptoms and encouraging any patient who may have come in contact with anyone with COVID-19 to be tested since asymptomatic patients are still capable of transmitting the virus.
Patients with comorbidities should be handled very carefully with a discussion that if their symptoms worsen that allopathic co-treatment is immediately considered since waiting for a serious condition to improve is not a viable or optimal option.
However if the patient does not have comorbidities, is asymptomatic or only has mild symptoms then the discussed low-risk (mostly) non-pharmaceutical interventions are worthy of consideration and may prevent worsening of symptoms, improve vaccination response, and limit progression of a possible long hauler COVID-19 syndrome
Indexing Terms: chiropractic; immunity; COVID; early treatment; comorbidity.
Cite: Blum C. COVID-19 and the role of chiropractic in the healthcare arena with non-pharmaceutical prevention, early treatment, and care for those with long Covid syndromes: Part Two - Early Treatment. Asia-Pac Chiropr J. 2021;2.4. URL apcj.net/papers-issue-2-5/#BlumEarlyTreatment
Part Three: Long COVID
Abstract: One huge challenge in treatment of Long COVID disorders in the future will be unraveling the tangled threads of whether a presenting condition is directly related to the virus’ affect on the body or possibly just the social implications of dealing with the pandemic and the ability of a subset of patients to cope. In each stage of coping with COVID-19, prevention, early treatment, and treating Long COVID, there are subtle differences in perspective and goals. One not so subtle difference is that persistent malnutrition appears to be comorbidity factor in all three scenarios so improving a patient’s general nutrition is a basic though crucial first step. There are mixed approaches for treatment of Long COVID which include a multi-nutrient, herbal, and probiotic therapeutic approach (31) and a nutritional supplement based on vitamins, minerals, amino acids and plant extracts
Indexing Terms: chiropractic; immunity; COVID; Long COVID; Long Hauler; comorbidity.
Cite: Blum C. COVID-19 and the role of chiropractic in the healthcare arena with non-pharmaceutical prevention, early treatment, and care for those with Long COVID syndromes: Part Three - Long COVID. Asia-Pac Chiropr J. 2021;2.5. URL apcj.net/papers-issue-2-5/#BlumLongCovid
It happened like this: a case for the case report
Abstract: Case studies allow for in-depth, data-rich explorations of a single participant in their real-life settings. The value of the case study was once well recognised in health and medical research but was supplanted by research higher in the hierarchy of best evidence. However, case studies are still written, so what is a case study, why would one go to the effort of writing one, and what is worth reporting? This paper aims to provide insights into why anyone would still write a case study, what they are useful for, and what makes a good case study.
Indexing Terms: Case report, study, in-depth study, writing, research report.
Cite: Cade A. It happened like this: a case for the case report. Asia-Pac Chiropr J. 2021;2.3. URL apcj.net/papers-issue-2-5/#CadeCaseReports
The Long and Winding Road of Whiplash Associated Disorders: An Applied Kinesiology Chiropractic Case-Report
Abstract: Objective The objective of this case study is to report the long, detailed, and ultimately unsuccessful treatment modalities used (medical, pharmaceutical, physiotherapeutic, and chiropractic) for the victim of a motor vehicle accident (MVA) over 1.5 years. The missing component was then applied for the patient, which involved the evaluation and treatment of the patient’s injured cranio-sacral system, producing resolution of her MVA symptom picture.
Clinical Features A 32-year-old obese female was referred by her neurologist with a 1.5 year history of symptoms after a MVA. Her measurable orthopedic and neuromuscular deficits are described after 47 chiropractic and 9 physiotherapeutic and a dozen medical visits, including 18 months of heavy medication as her treatment.
Intervention In this case, chiropractic cranial, TMJ, and cervical subluxations were addressed in a patient who had suffered a MVA with whiplash associated disorders (WAD) 1.5 years previously, which were resolved through the use of applied kinesiology chiropractic treatment. This case offers the reader a detailed medical and chiropractic history review, showing the many months of unsuccessful treatments victims of MVAs often suffer. The case can also serve as a foundation for a detailed discussion regarding how to effectively incorporate chiropractic cranial treatment into chiropractic practice for patients who present with head or neck pain after MVAs. The patient was placed on a care plan consisting of three times a week for the first two weeks before significant symptom reductions and functional restoration was achieved.
Outcomes At the second week examination on her sixth visit, the patient stated that she had been steadily experiencing significant recovery in mobility, strength, mood, independence, sleep, and energy. For the first time in 1.5 years, her headaches and neck and low back pain were stabilised. All cervical range of motion was improved, as were her visual analog scales (going from 1050 on initial examination to 250 after 2 weeks of treatment), and the Neck Disability Form and Oswestry Low Back Disability Forms each going from the “severe disability” (or 34) rating to “no disability” rating (or 8).
Indexing Terms: chiropractic; AK; Applied Kinesiology; WAD; Whiplash Associated Disorders.
Cite: Cuthbert S. The Long and Winding Road of Whiplash Associated Disorders: An Applied Kinesiology Chiropractic Case-Report. Asia-Pac Chiropr J. 2022;2.4. URL apcj.net/papers-issue-2-5/#CuthbertWADAK
Chiropractic Management of an 18-year old female with lupus: A Case Report
Abstract: An 18 year old female presented with a diagnosis of Lupus, and had been advised to commence medical management of the condition.
Objective/Clinical Features: Her condition was, at that point in time, presenting as chronic neck and joint pain.
Intervention/Outcomes: A week of concentrated care during which she received 56 low level force chiropractic adjustments. The adjusting technique used was the Functional Neurological Technique, a sustained contact low-level force adjusting technique.
Conclusion: Following two courses of concentrated care at the Averio Institute (which included chiropractic care), the Medical Doctor reversed the diagnosis of Lupus.
Indexing Terms: Chiropractic; Subluxation; Lupus; autoimmune conditions; immunity.
Cite: Kolterman S, Martin A, Postlethwaite R, McIvor C. Chiropractic Management of an 18-year old female with lupus: A Case Report. Asia-Pac Chiropr J. 2021;2.3. URL apcj.net/paper-issue-2-5/#AverioLupus
Decrease in allergies, nocturnal enuresis and sleep problems in a 3-year-old under chiropractic care
Abstract: Objective/Clinical Features: A three-year old female presented for chiropractic care, with her mother citing primary concerns of allergies and a stuffy nose for the past two months. Secondary concerns included behavioural issues, poor sleep and a 6-7 month history of bed-wetting.
Intervention/Outcomes: A course of subluxation-base chiropractic care commenced, with torque release technique, toggle board and HVLA adjustments delivered in age appropriate measures. Chiropractic care was concomitant with an improvement in allergies and mood, decrease in temper tantrums and bed-wetting (nocturnal enuresis), and improved sleep.
Conclusion: This case report indicates that chiropractic care to reduce subluxations may result in improved immune system function as seen in the decrease in allergies in this case.
Indexing Terms: Chiropractic; Subluxation; Allerg* Allergy, Allergic, Allergies); Behaviour; Nocturnal Enuresis.
Cite: Steinberg B, Postlethwaite R, McIvor C. Decrease in allergies, nocturnal enuresis and sleep problems in a 3-year-old under chiropractic care: A case report. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#SteinbergAllergies
Improvement in migraines and chronic neck pain in a 42 year old male under chiropractic care
Abstract: A 42-year old male presented for chiropractic care with a chief complaint of migraines and neck pain he believed to be involved with poor posture.
Objective/Clinical Features: A course of chiropractic care (Diversified Technique, combined with Chiropractic Biophysics exercises) was concomitant with a decrease in the frequency and severity of migraine, decrease in pain and pain-related stress, and an increase in range of motion and coping skills.
Conclusion: This case report indicates that chiropractic care may be of benefit for the reduction of stress, pain and migraine. Further research is required.
Indexing Terms: Chiropractic; Subluxation; Migraine; Neck Pain; Headache.
Cite: Hassan F, Postlethwaite R, McIvor C. Improvement in migraines and chronic neck pain in a 42 year old male under chiropractic care: A Case Report. . Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#HassanMigraine
Improvement in posture, sleep and energy in a 25 year old female under chiropractic care
Abstract: A 25-year old female presented for chiropractic care to address her postural concerns. She described herself as ‘healthy but fatigued.’
Objective/Clinical Features: Chiropractic care for the reduction of vertebral subluxations involved special attention to the thoracic and cervical spine, where a forward head carriage was noted, and stabilising of the pelvis which was found to be tilted.
Intervention/Outcomes: Following a course of chiropractic care, objective findings confirmed a reduction in forward head carriage, an increase in pelvic stability, and was concomitant with patient reported increases in sleep quality, energy, vitality, and immune function (i.e. resistance to coughs, colds and flus)
Conclusion: In this case, an improvement in sleep, energy, vitality, and immunity was concomitant with a course of chiropractic care.
Indexing Terms: Chiropractic; Subluxation; Immunity; Fatigue; Sleep Quality.
Cite: Leahy A, Postlethwaite R, McIvor C. Improvement in posture, sleep and energy in a 25 year old female under chiropractic care: A case report. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#LeahyPostureSleep
Chiropractic Management of chronic sinusitis and breathing difficulty in a 67-year-old male
Abstract: A 67 year old male presented for chiropractic care with a chief complaint of chronic sinusitis, post-nasal drip, breathing difficulty and generalised discomfort, from which he had suffered for ten years. ENT Specialists had failed to diagnose an underlying cause.
Intervention/Outcomes: Chiropractic care for the reduction of vertebral subluxations using the Advanced BioStructural Correction technique was concomitant with a significant improvement in sinusitis
Conclusion: Chiropractic care was concomitant with a 50-60% reduction in chronic sinusitis, and a 50% reduction in sinus medication.
Indexing Terms: Chiropractic; Subluxation; Immunity; Sinusitis.
Cite: Luc A, Postlethwaite R, McIvor C. Chiropractic Management of chronic sinusitis and breathing difficulty in a 67-year-old male: A case report. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#LucSinusitis
Resolution of severe hypoacusia and first degree tinnitus concomitant with chiropractic care.
Abstract: A 62-year-old female presented for chiropractic care after a medical diagnosis of severe hypoacusia and first degree tinnitus following weight overload.
Intervention/Outcomes: A four-visit course of care was undertaken, using Diversified Technique for the diagnosis and adjustment of subluxations. After four weeks of care, a 90% increase in hearing was noted on the left side. Her subluxation listings remained consistent.
Conclusion: Chiropractic care may be of assistance in the management of hypoacusia. Further research is required.
Indexing Terms: Chiropractic; Subluxation; Immunity; Hypoacusia.
Cite: Alarcon EM, Postlethwaite R, McIvor C. Resolution of severe hypoacusia and first degree tinnitus concomitant with chiropractic care. A case report. Asia-Pac Chiropr J. 2022;2.5. URL apcj.net/papers-issue-2-5/#Emiliohypoacusia
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