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The Contemporary Model of Vertebral Column Joint Dysfunction and Impact of High-velocity, Low-amplitude Controlled Vertebral Thrusts on Neuromuscular Function

By |December 17, 2021|Neurology, Subluxation|

The Contemporary Model of Vertebral Column Joint Dysfunction and Impact of High-velocity, Low-amplitude Controlled Vertebral Thrusts on Neuromuscular Function

The Chiro.Org Blog


SOURCE:   European J Applied Physiology 2021 (Oct); 121 (10): 2675–2720

Heidi Haavik, Nitika Kumari, Kelly Holt, Imran Khan Niazi, Imran Amjad, Amit N Pujari, Kemal Sitki Türker, Bernadette Murphy

Centre for Chiropractic Research,
New Zealand College of Chiropractic,
Auckland, New Zealand.



Purpose:   There is growing evidence that vertebral column function and dysfunction play a vital role in neuromuscular control. This invited review summarises the evidence about how vertebral column dysfunction, known as a central segmental motor control (CSMC) problem, alters neuromuscular function and how spinal adjustments (high-velocity, low-amplitude or HVLA thrusts directed at a CSMC problem) and spinal manipulation (HVLA thrusts directed at segments of the vertebral column that may not have clinical indicators of a CSMC problem) alters neuromuscular function.

Methods:   The current review elucidates the peripheral mechanisms by which CSMC problems, the spinal adjustment or spinal manipulation alter the afferent input from the paravertebral tissues. It summarises the contemporary model that provides a biologically plausible explanation for CSMC problems, the manipulable spinal lesion. This review also summarises the contemporary, biologically plausible understanding about how spinal adjustments enable more efficient production of muscular force. The evidence showing how spinal dysfunction, spinal manipulation and spinal adjustments alter central multimodal integration and motor control centres will be covered in a second invited review.

Results:   Many studies have shown spinal adjustments increase voluntary force and prevent fatigue, which mainly occurs due to altered supraspinal excitability and multimodal integration. The literature suggests physical injury, pain, inflammation, and acute or chronic physiological or psychological stress can alter the vertebral column’s central neural motor control, leading to a CSMC problem. The many gaps in the literature have been identified, along with suggestions for future studies.

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The Chiropractic Vertebral Subluxation Part 1

By |April 19, 2019|Subluxation|

The Chiropractic Vertebral Subluxation Part 1: Introduction

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SOURCE:   J Chiropractic Humanities 2018 (Dec); 25: 146–168

Simon A.Senzon, MA, DC

School of Health and Human Sciences,
Southern Cross University,
Lismore, New South Wales, Australia.


Objective   The objective of this article is to present a rationale for the need of a history of chiropractic vertebral subluxation (CVS) theory based on primary sources.

Discussion   There is a dichotomy in the chiropractic profession around subluxation terminology, which has many facets. The literature around this topic spans social, economic, cultural, and scientific questions. By developing a rationale for a historical perspective of CVS theory, including the tracking of the historical development of ideas throughout the profession, a foundation for future discourse may emerge.

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The Chiropractic Vertebral Subluxation Part 10

By |April 16, 2019|Subluxation|

The Chiropractic Vertebral Subluxation Part 10:
Integrative and Critical Literature From 1996 and 1997

The Chiro.Org Blog


SOURCE:   J Chiropractic Humanities 2018 (Dec);   25:   146–168

Simon A.Senzon, MA, DC

School of Health and Human Sciences,
Southern Cross University,
Lismore, New South Wales, Australia.


Objective   The purpose of this paper is to review and discuss the history of chiropractic vertebral subluxation (CVS) during 1996 and 1997. The literature during this period offered critical and integrative models emphasized by a need for research into operational and functional definitions.

Discussion   Several integrative approaches emerged, from Rome’s 296 synonyms to Bergman’s Pain/Tenderness, Asymmetry/Alignment, Range of Motion Abnormality, Tissue Tone, Texture, Temperature Abnormality, and Special Tests (PARTS) analysis adopted by the profession in the United States. Other noteworthy contributions included Ruch’s Atlas of Common Subluxations, Epstein’s introduction of network spinal analysis, and Kent’s review of CVS models. Boone’s introduction of the Journal of Vertebral Subluxation Research was accompanied by his 3-part model with Dobson. These years also included the paradigm statement of the Association of Chiropractic Colleges, which was adopted by the American Chiropractic Association, International Chiropractors Association, and World Federation of Chiropractic. Two other papers included Nelson’s critique of the CVS paradigm and Keating’s 1996 “Hunt for the Subluxation.”

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The Influence of Neck Pain on Sensorimotor Function in the Elderly

By |January 28, 2019|Neurology, Subluxation|

The Influence of Neck Pain on Sensorimotor Function in the Elderly

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SOURCE:   Arch Gerontol Geriatr. 2012 (Nov); 55 (3): 667–672

Sureeporn Uthaikhup, Gwendolen Jull, Somporn Sungkarat, Julia Treleaven

Department of Physical Therapy,
Faculty of Associated Medical Sciences,
Chiang Mai University,
Thailand.


Greater disturbances in sensorimotor control have been demonstrated in younger to middle aged groups. However, it is unknown whether or not the impairments documented in these populations can be extrapolated to elders with neck pain. The aim of this study was to investigate the influence of neck pain on sensorimotor function in elders. Twenty elders with neck pain (12 women and 8 men) and 20 healthy elder controls (14 women and 6 men) aged 65 years and over were recruited from the general community. Tests for sensorimotor function included; cervical joint position sense (JPS); computerised rod-and-frame test (RFT); smooth pursuit neck torsion test (SPNT); standing balance (under conditions of eyes open, eyes closed on firm and soft surfaces in comfortable stance); step test and ten-meter walk test with and without head movement.

Elders with neck pain had greater deficits in the majority of sensorimotor function tests after controlling for effects of age and comorbidities. Significant differences were found in the SPNT (p<0.01), error in the RFT (frame angled at 10° and 15° anticlockwise) (p<0.05), standing balance (amplitude of sway) – eyes open on a firm surface in the medio-lateral (ML) direction (p=0.03), and total number of steps on the step test, both left and right sides (p<0.01).

Elders with neck pain have greater sensorimotor disturbances than elders without neck pain, supporting a contribution of altered afferent information originating from the cervical spine to such disturbances. The findings may inform falls prevention and management programs.

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Interexaminer Reliability of Cervical Motion Palpation

By |January 10, 2019|Subluxation|

Interexaminer Reliability of Cervical Motion Palpation Using Continuous Measures and Rater Confidence Levels

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2013 (Jun); 57 (2): 156–164

Robert Cooperstein, MA, DC, Morgan Young, DC, and Michael Haneline, DC, MPH

Palmer Center for Chiropractic Research,
San Jose, CA, USA.


INTRODUCTION:   Motion palpators usually rate the movement of each spinal level palpated, and their reliability is assessed based upon discrete paired observations. We hypothesized that asking motion palpators to identify the most fixated cervical spinal level to allow calculating reliability at the group level might be a useful alternative approach.

METHODS:   Three examiners palpated 29 asymptomatic supine participants for cervical joint hypomobility. The location of identified hypomobile sites was based on their distance from the T1 spinous process. Interexaminer concordance was estimated by calculating Intraclass Correlation Coefficient (ICC) and mean absolute differences (MAD) values, stratified by degree of examiner confidence.

RESULTS:   For the entire participant pool, ICC [2,1] = 0.61, judged “good.” MAD=1.35 cm, corresponding to mean interexaminer differences of about 75% of one cervical vertebral level. Stratification by examiner confidence levels resulted in small subgroups with equivocal results.

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A Hypothesis of Chronic Back Pain

By |July 8, 2018|Neurology, Subluxation|

A Hypothesis of Chronic Back Pain: Ligament Subfailure Injuries Lead to Muscle Control Dysfunction

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SOURCE:   European Spine Journal 2006 (May); 15 (5): 668–676

Manohar M. Panjabi

Biomechanics Research Laboratory,
Department of Orthopaedics and Rehabilitation,
Yale University School of Medicine,
New Haven, CT 06520-8071, USA.


Clinical reports and research studies have documented the behavior of chronic low back and neck pain patients. A few hypotheses have attempted to explain these varied clinical and research findings. A new hypothesis, based upon the concept that subfailure injuries of ligaments (spinal ligaments, disc annulus and facet capsules) may cause chronic back pain due to muscle control dysfunction, is presented. The hypothesis has the following sequential steps. Single trauma or cumulative microtrauma causes subfailure injuries of the ligaments and embedded mechanoreceptors. The injured mechanoreceptors generate corrupted transducer signals, which lead to corrupted muscle response pattern produced by the neuromuscular control unit.

Muscle coordination and individual muscle force characteristics, i.e. onset, magnitude, and shut-off, are disrupted. This results in abnormal stresses and strains in the ligaments, mechanoreceptors and muscles, and excessive loading of the facet joints. Due to inherently poor healing of spinal ligaments, accelerated degeneration of disc and facet joints may occur. The abnormal conditions may persist, and, over time, may lead to chronic back pain via inflammation of neural tissues. The hypothesis explains many of the clinical observations and research findings about the back pain patients. The hypothesis may help in a better understanding of chronic low back and neck pain patients, and in improved clinical management.


From the Full-Text Article:

Introduction

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