First Quarter January 2023 Asia Pacific Chiropractic Journal

Issue 3.3

Subluxation

Case Report Project

An ASRF Research Project

Case Report Project - An ASRF Research Project
Case Reports

Our profession is is great shape

Case Reports - Our profession is is great shape

Chiropractic Lexicon: Useful or not?

Abstract: Obtaining an ultimate definition of this ‘something’ we have been addressing, successfully, for over 125 years is elusive, yet this allows flexibility when defining it within different contexts. This provides space for chiropractors to do this (both consciously and subconsciously) every day in practice, and over time to use their growing experience to add complexity and subtlety to their conceptual framework, and their application of their science and art. Millions of patients over the years would attest to the value in that. 

Indexing Terms: chiropractic; subluxation; definition; lexicon; rhetoric

Cite: Cahill D. Chiropractic Lexicon: Useful or not? URL Asia-Pac Chiropr J. 2023;3-3. URL apcj.net/Papers-Issue-3-3/#CahillLexicon


Preserving the chiropractic subluxation: A narrative literature review of research for and against the controversial diagnostic term

Abstract: Background For decades the chiropractic profession has faced internal and external conflicts surrounding the scope, beliefs, techniques, and ideologies of practitioners. Most literature discussing these facets of the profession have defined two specific groups that are either practicing ‘orthodox’ or ‘unorthodox’. Previous gaps in research and conflicting evidence have suggested an inquiry into whether using the term ‘subluxation’ still valid for the future of chiropractic diagnosis, treatment, and management. And what impact does the term have on solidifying the profession’s unique identity within the medical model and demand for patient-centred care. 

Design A narrative literature review.

Methods A review of available literature was conducted and produced 317 results across multiple databases. 146 articles where then identified and a collection of 515 articles then met the inclusion and exclusion criteria for answering the clinical question. A Narrative Review Checklist and Summary of Significance were assessed on the strengths and limitations of these articles in forming an objective discussion on the validity of chiropractic vertebral subluxations. 

Results Narrative reviews have been the main form of research on the topic of vertebral subluxation. Whilst this has allowed for very interesting insights and strengths of literature progression, it has limited the tangible progression of the chiropractic subluxation premise. 

Conclusion Whilst there is discouraging research available that aims to invalidate the chiropractic subluxation, there is also robust evidence in favour of this term. It seems reasonable to say that assessment and treatment of subluxations hold a significance in this identity of chiropractic and should not be dismissed as archaic but celebrated as unique and cause for further research.

Indexing Terms: Chiropractic; subluxation; vertebral subluxation; evidence-based practice; chiropractic philosophy; chiropractic curriculum

Cite: Eldemire J. Preserving the chiropractic subluxation: A narrative literature review of research for and against the controversial diagnostic term. Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#EldemireSubluxation

The Chiropractic Subluxation: Medical evidence in support of the subluxation construct

Abstract: This presentation serves to demonstrate the widespread use and acceptance of the term subluxation. It acknowledges the broader chiropractic interpretation by recognition and adoption of the term outside the profession. In particular, it also emphasises the medical recognition supported by some of the medical evidence incorporating the construct of a chiropractic vertebral subluxation complex, and its utilisation in practice.

The vertebral subluxation concept is similar to the terms spinal dysfunction, somatic dysfunction, segmental dysfunction or the vague vertebral lesion. These terms are primarily used by osteopaths, physiotherapists and medical doctors to focus their manipulative techniques, but they relate primarily to the physical-mechanical aspects. In this respect, these terms are limited in what they signify. The implication of just plain osseous biomechanical dysfunction does not incorporate the wider ramifications of integrated neural, vascular, and internal associations which may involve greater ramifications, and should be more appropriately referred to as a vertebral subluxation complex (VSC).

Indexing Terms: Medical Terminology; Vertebral Subluxation; Vertebral Subluxation Complex

Cite: Rome PL, Waterhouse JD. The Chiropractic Subluxation: Medical evidence in support of the subluxation construct. URL Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#RomeWaterhouseMedicalEvidence

Changing chiropractic’s subluxation rhetoric: Moving on from ‘deniers’, ‘vitalists’, and ‘unorthodox’, to realists, post-realists, and absurdists

Abstract: Chiropractic rhetoric must advance beyond vitalists attacking subluxation deniers, and deniers holding firm to eminence over evidence. I am calling for clear and strong debate in which the issues and their evidence are examined in the manner of traditional philosophical debate.

The purpose of this paper is to present two behaviours that will each change the profession and discipline’s narrative about subluxation, scilicet: (i) that an active, intellectual discussion occur and (ii) that it be published in any author’s preferred journal of record, indexed by the Chiropractic Library Collaboration with terms that will connect the papers, and be open access for all.

To facilitate this change I present a palette of three terms with exposition to show how we can build our rhetoric into constructive argument from either a realist, a post-realist, or an absurdist view-point.

For the reason the post-realist and absurdist’s positions are opinion, have not been thought-through, and show no appreciation of the paradox that they have no evidence at all supportive of that opinion, they should cease gaslighting the realists and anyone who opposes their position.

Chiropractic realism is the conventional position of the majority of the profession and of the discipline. The realists quite rightly demand to see and discuss the evidence held by the post-realists. 

Indexing Terms: Chiropractic; subluxation; realism; post-realism; absurdism; orthodox; rhetoric

Cite: Ebrall P. Changing chiropractic’s subluxation rhetoric: Moving on from deniers and vitalists to realists, post-realists, and absurdists. URL Asia-Pac Chiropr J. 2022;3.3. URL apcj.net/Papers-Issue-3-3/#EbrallRhetoric


Case Report 1

Abstract: Objective/Clinical Features: Four cases addressing chiropractic care and sleep, energy and behaviour are presented, with diversified technique as the primary method of reducing subluxations.

Intervention/Outcome: Subluxation-based care was delivered via diversified technique with care plans tailored to meet parent and chiropractor recommendations. 

Conclusion: Chiropractic care for the reduction of subluxations may contribute to enhanced nervous system coherence, thus allowing the child to better adapt to their environment, resulting in better sleep and behaviour. In terms of the research agenda of the ASRF these cases demonstrate an improvement is patient adaptability seems associated with subluxation correction. Further research is required to understand the mechanisms behind these improvements. 

Indexing Terms: Chiropractic; Subluxation; breastfeeding; case report; case series; adaptability

Cite: Dukovac N, Postlethwaite R, McIvor C. Improvement in adaptability concomitant with paediatric chiropractic care: A series of 5 cases. Asia-Pac Chiropr J. 2022;3.2. URL apcj.net/Papers-Issue-3-2/#DukovacAdaptability


Diversity Beliefs as a bridge for the future

The future is good

Abstract: Chiropractic practitioners have the potential to help create space and acceptance for their patients, but what about each other? Chiropractic has a large spectrum when it comes to defining what is chiropractic. One side has a vitalistic view while the other is mechanistic, plus everything in between. The vitalistic chiropractors use the term vertebral subluxation and depending on how deep you want to take it, some have a more spiritual viewpoint. While the mechanistic viewpoint mainly focuses on the physical body and uses the term manipulation or moving a segment in space.

What if diversity is a key for improving the future of humanity, even chiropractic?

Indexing terms: chiropractic; WCCS; diversity; vitalism; mechanism

Cite: Paul C. Diversity Beliefs as a bridge for the future. Asia-Pac Chiropr J. 2022;3.2. URL apcj.net/papers-issue-3-2/#PaulWCCS



Wide angle lens: Complex Circuitry for Complex Machinery

Abstract: Practitioners who adjust the upper cervical area are generally aware of the potential benefit of this service in terms of vagal function. This is because of the proximity of the vagus n to the occipital condyles as it exits the jugular foramen. What is not always appreciated is the potential for mid-cervical and lower thoracic adjustments to benefit the vagus as well, due to the relation of that nerve to the diaphragm. If the chiropractic adjustment did nothing but improve diaphragm function, the whole-body benefits of our service would already have ample explanation.

Indexing Terms: chiropractic; diaphragm; adjustment; subluxation

Cite: Masarsky CS. Complex Circuitry for Complex Machinery [The wide-angle lens]. Asia-Pac Chiropr J. 2022;3-2. URL apcj.net/Papers-Issue-3-2/#MasarskyDiaphragm

Long COVID: A Risk Factor for Scoliosis Incidence and Exacerbation? [Hypothesis]

Abstract: With long COVID beginning to overtake acute COVID-19 infection as a public health concern, we hypothesize that long COVID is a risk factor for scoliosis incidence and exacerbation. We suggest mechanisms for this risk. 

Emerging research suggests mitochondrial hijacking is a component of long COVID. This phenomenon can disturb osteoblast function. The resulting loss of structural integrity of the vertebra is expected to worsen scoliosis.

Reduced lung capacity due to both scoliosis and long COVID is expected to be mutually exacerbating. Breathing exercises are frequently part of the regimen of care for scoliosis patients, not only to improve lung capacity, but to help address the scoliosis itself by preserving rib cage flexibility. Reduced lung capacity due to long COVID would be expected to make this aspect of scoliosis care more difficult. 

‘Brain fog’ and fatigue due to long COVID could reasonably be expected to increase the incidence of whiplash, slip-and-fall injuries, sports injuries, work-related accidents, and other forms of accidental trauma. Traumatic scoliosis could create new cases as well as exacerbating pre-existing scoliosis. 

Methods of testing the hypothesis by standard epidemiological techniques, controlled clinical observational trials, and case reports are discussed. If the null hypothesis is found to be rejected, and this hypothesis accepted, the importance of intensified screening for both scoliosis and long COVID are discussed. We discuss the possible role of dietary interventions and chiropractic adjustments in the clinical care of scoliosis patients also suffering from long COVID. 

Indexing Terms: chiropractic; Long COVID; scoliosis; mitochondria; hypothesis

Cite: Masarsky CS, Todres-Masarsky M. Long COVID: A Risk Factor for Scoliosis Incidence and Exacerbation? [Hypothesis]. URL Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#MasarskyLongCovidScoliosis


Etiopathogenetic significance of hidden compression syndromes in chronic low back pain syndrome development

Abstract: Pain syndrome is the leading clinical manifestation of dense connective tissue involutive degenerative changes. At the same time, the use of drugs that have a depressing effect on dense connective tissue regeneration contributes to an even greater metabolic disorder in the affected segment. Some NSAIDs can disrupt the chondrocytes metabolism and inhibit proteoglycans synthesis.

This paper investigates the reflectory interaction and tone-strength characteristics of the antagonist muscles of the lumbar and pelvic regions and their influence on the pain formation in LBP patients.

The additional aim of the study is to develop a rehabilitation technique. 

Indexing Terms: chiropractic; low back pain; syndrome development; rehabilitation; dynamic EMG

Cite: Kirdoglo GK. Etiopathogenetic significance of hidden compression syndromes in chronic low back pain syndrome development. URL Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#KirdogloLBP


ЭТИОПАТОГЕНЕТИЧЕСКОЕ ЗНАЧЕНИЕ СКРЫТЫХ КОМПРЕССИОННЫХ СИНДРОМОВ В ФОРМИРОВАНИИ ХРОНИЧЕСКОГО БОЛЕВОГО СИНДРОМА НИЖНЕЙ ЧАСТИ СПИНЫ

Резюме: Болевой синдром является ведущим клиническим проявлением инволютивных дистрофических изменений плотной соединительной ткани. В то же время применение препаратов, угнетающе влияющих на регенерацию плотной соединительной ткани, способствует еще большему нарушению обмена веществ в пораженном сегменте. Некоторые НПВП могут нарушать метаболизм хондроцитов и ингибировать синтез протеогликанов.

В данной работе исследуются рефлекторное взаимодействие и тонусно-силовые характеристики мышц-антагонистов поясничного и тазового отделов и их влияние на формирование боли у больных БНС.

Дополнительной целью исследования является разработка методики реабилитации.

Термины индексации: хиропрактика; боль в пояснице; развитие синдрома; реабилитация; динамическая ЭМГ

Cite: Глеб КИРДОГЛО [Kirdoglo GK]. ЭТИОПАТОГЕНЕТИЧЕСКОЕ ЗНАЧЕНИЕ СКРЫТЫХ КОМПРЕССИОННЫХ СИНДРОМОВ В ФОРМИРОВАНИИ ХРОНИЧЕСКОГО БОЛЕВОГО СИНДРОМА НИЖНЕЙ ЧАСТИ СПИНЫ [Russian] [Etiopathogenetic significance of hidden compression syndromes in chronic low back pain syndrome development]. URL Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#KirdogloLBPRussian

ЭТИОПАТОГЕНЕТИЧЕСКОЕ ЗНАЧЕНИЕ СКРЫТЫХ КОМПРЕССИОННЫХ СИНДРОМОВ В ФОРМИРОВАНИИ ХРОНИЧЕСКОГО БОЛЕВОГО СИНДРОМА НИЖНЕЙ ЧАСТИ СПИНЫ

Резюме: Болевой синдром является ведущим клиническим проявлением инволютивных дистрофических изменений плотной соединительной ткани. В то же время применение препаратов, угнетающе влияющих на регенерацию плотной соединительной ткани, способствует еще большему нарушению обмена веществ в пораженном сегменте. Некоторые НПВП могут нарушать метаболизм хондроцитов и ингибировать синтез протеогликанов.

В данной работе исследуются рефлекторное взаимодействие и тонусно-силовые характеристики мышц-антагонистов поясничного и тазового отделов и их влияние на формирование боли у больных БНС.

Дополнительной целью исследования является разработка методики реабилитации.

Термины индексации: хиропрактика; боль в пояснице; развитие синдрома; реабилитация; динамическая ЭМГ

Cite: Kirdoglo GK. Етіопатогенетичне значення прихованих компресійних синдромів у розвитку синдрому хронічного болю в попереку. [Ukrainian][Etiopathogenetic significance of hidden compression syndromes in chronic low back pain syndrome development]. URL Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#KirdogloUkrainian

k Factor for Scoliosis Incidence and Exacerbation? [Hypothesis]

Abstract: With long COVID beginning to overtake acute COVID-19 infection as a public health concern, we hypothesize that long COVID is a risk factor for scoliosis incidence and exacerbation. We suggest mechanisms for this risk. 

Emerging research suggests mitochondrial hijacking is a component of long COVID. This phenomenon can disturb osteoblast function. The resulting loss of structural integrity of the vertebra is expected to worsen scoliosis.

Reduced lung capacity due to both scoliosis and long COVID is expected to be mutually exacerbating. Breathing exercises are frequently part of the regimen of care for scoliosis patients, not only to improve lung capacity, but to help address the scoliosis itself by preserving rib cage flexibility. Reduced lung capacity due to long COVID would be expected to make this aspect of scoliosis care more difficult. 

‘Brain fog’ and fatigue due to long COVID could reasonably be expected to increase the incidence of whiplash, slip-and-fall injuries, sports injuries, work-related accidents, and other forms of accidental trauma. Traumatic scoliosis could create new cases as well as exacerbating pre-existing scoliosis. 

Methods of testing the hypothesis by standard epidemiological techniques, controlled clinical observational trials, and case reports are discussed. If the null hypothesis is found to be rejected, and this hypothesis accepted, the importance of intensified screening for both scoliosis and long COVID are discussed. We discuss the possible role of dietary interventions and chiropractic adjustments in the clinical care of scoliosis patients also suffering from long COVID. 

Indexing Terms: chiropractic; Long COVID; scoliosis; mitochondria; hypothesis

Cite: Masarsky CS, Todres-Masarsky M. Long COVID: A Risk Factor for Scoliosis Incidence and Exacerbation? [Hypothesis] URL Asia-Pac Chiropr J. 2023;3.3. URL apcj.net/Papers-Issue-3-3/#MasarskyLongCovidScoliosis


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.

 

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