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Subluxation

Joint Assessment – P.A.R.T.S.

By |November 12, 2023|Joint Dysfunction, Motion Palpation, Subluxation|

Joint Assessment – P.A.R.T.S.

The Chiro.Org Blog


SOURCE:   Topics in Clinical Chiropractic 2000; 7 (3): 1–10
Thomas F. Bergmann, DC, Bradley A. Finer, DC, DACAN

Professor, Clinical Science Division
Northwestern Health Sciences University
College of Chiropractic
Bloomington, Minnesota



Purpose:   An approach to systematically perform clinical work-up for chiropractic subluxation is proposed. Literature on assessment approaches is reviewed and a discussion is presented.

Method:   A qualitative review of clinical and scientific literature related to assessment methodologies for subluxation was performed.

Summary:   Variation in assessment techniques exists for identification of spinal and other articular joint dysfunction. Useful scientific data also are limited to only a few approaches, and there is a need for a more systematic assessment approach profession wide.

Key words:   Articular range of motion, chiropractic, Medicare, palpation, physical examination, subluxation


From the FULL TEXT Article

Background

Doctors of chiropractic are portals of entry to the health care system for many patients seeking health care services. As such, they must maintain broad and thorough assessment/diagnostic skills. Before employing any therapy, a clinician must first determine if there is a need for treatment. Therefore, the clinical information that any primary contact provider would want, including a case history, physical examination, clinical laboratory findings, radiographic findings, and any other tests necessary to check for suspected health problems, is needed. Having gathered and interpreted this information, it must be processed in order to arrive at a sound clinical conclusion.

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LOCATING SUBLUXATIONS Section

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Chiropractic Lexicon: Useful or Not?

By |January 7, 2023|Subluxation|

Chiropractic Lexicon: Useful or Not?

The Chiro.Org Blog


SOURCE:   Asia Pacific Chiropractic Journal 2023; 3.3
David Cahill, BAppSc(Chiro)

President,
Australian Chiropractors Association



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


From the FULL TEXT Article:

      We all address something

For well over a century, chiropractors have successfully been addressing ‘something’, primarily within the spine and its adjacent structures. They observed a phenomenon and devised ways to impact upon it. This resulted in health outcomes significant enough to grow a profession, and an associated body of literature evidence.

      Words were chosen

It was chosen early on to use the term subluxation, which is understandable as it often feels to palpation that some sort of misplacement is involved. Right from the very start, it was more than a ‘bone out of place’. Neurological involvement was part of the concept from the beginning, endeavouring to explain the body-wide effects that were observed.

      Concepts were developed

Over the years, conceptual frameworks for the ‘something’ were developed. This conceptual development was significantly clinician-driven and therefore, one would imagine, informed and motivated by patient outcomes; to this day our great strength. With time, these frameworks gained considerable complexity, and diversity. Again, this is understandable, as human beings are both complex and diverse. For example, the SOT group had a focus on dural attachments, CSF flow, and their relationship to the functioning of the sacrum and cranium; the various upper cervical techniques zeroed-in on adjusting C0, C1 and C2; Logan had more of a base-up approach, as did Gonstead, etc.

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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

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 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

The Chiro.Org Blog


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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