July 2008

After 113 years of waiting

by Dr. Richard Barwell

Getting favorable results from chiropractic care is much easier than explaining "why" or "how" those results are achieved. This has led to an attitude within the profession of, "Even if we can't prove why we get results, we know it works and that's good enough". 

Well, this is no longer acceptable. Those who oppose our existence as a profession are now using this as evidence that we are unscientific and have no validity. We need acceptable, credible, objective proof.

The profession continues to seek acceptable instrumentation that will demonstrate the connection between the chiropractic adjustment and neurological change. Our first attempt at instrumentation was radiology. The old concepts of vertebral mal-position correction being the field of chiropractic lead to X-rays to prove that the adjustment moved the bone. The questions however are: Do static radiographs provide proof and/or correction of cause and is the vertebral mal-position the cause or is it an effect? According to BJ Palmer, the Vertebral Subluxation is a result of neurological influence and not the cause.(1)

Over the years there have been several developments in instrumentation for use in the chiropractic field: weight scales, posture measuring, galvanic skin response measurements and para-spinal thermal devises. Much of the instrumentation over the years provided information which appeared to have value for chiropractic, but was either unacceptable from a scientific perspective or gave non-reproducible results.

With the development of the computer, much has changed. We can now gather data over a wide range of neurological activity which has lead to an understanding of normal or ideal function levels. The surface electromyography (sEMG) and para-spinal thermal scans made their contribution about 12 to 15 years ago.

While these seemed to support the chiropractic position of spinal care and joint mechanics, the question has to be, "Does this deal with "cause?" Further to that, what is really important to understand is that X-rays, sEMG and thermal scans offer a static view or a moment in time of a dynamic being.

To base any care on a single static view is questionable at best. That said, these instruments have served their purpose, which was to demonstrate the value of objective measurements in replacing the anecdotal foundations of chiropractic. Better some proof, even if challengeable, than just another story.

Today, we have the next generation of instrumentation: instrumentation that can finally address "the cause" (abnormal neural activity) which leads to abnormal muscle activity which in turn creates abnormal joint mechanics. 

This new instrumentation provides information about neurological function at both the cortex (brain function) and at the Limbic System level (sympathetic/para-sympathetic responses), and is designed to test these over time and situations of stress and recovery. It is a dynamic test for a dynamic system which deals directly with cause and can demonstrate the ability and power of chiropractic to alter neural function. (2,3) The instrument was developed by chiropractors, to provide research-quality findings and has been used in chiropractic offices for the last four years.

This instrument is about to go through its third upgrade even though it is already light years ahead of anything on the market today.  The non-reproducibility of static sEMG (4) and/or thermal scans has created many challenges, including that third party payers won't cover the costs, which leaves many of the old sEMG/thermal units either gathering dust or used as a marketing tool at mall displays.

The new Quixote Instrument offers computer driven programs including, Neurological Stress Response Evaluation, Dynamic sEMG and Neurological Retraining. Staff can be trained to set it up and the computer does the rest. It provides acceptable neurological data at research quality levels.

References

1. In a speech given in 1930 entitled  "The Hour Has Arrived."

2. "A four-case study: The effect of the chiropractic adjustment on the brain wave pattern as measured by QEEG. Richard Barwell, DC; Annette Long, Ph.D.; Alvah Byers, Pd.D; Craig Schisler, B.A., M.A., DC. Winner of the Best Paper, Sherman Chiropractic College International Research and Paper Symposium 2005

3. "Cervical spine manipulation alters sensorimotor integration: A somatosensory evoked potential study." Heidi Haavik-Taylor, Bernadette Murphy.  Human Neurophysiology and Rehabilitation Laboratory, Department of Sport and Exercise Science, Tamaki Campus, University of Auckland, Private Bag 92019,261 Morrin Road, Glen Innes, Auckland, New Zealand accepted September, 11, 2006.

4. Reliability and Validity of Surface Electromyography (SEMG) to Study the Functional Status of Lumbar Para spinal Muscles during Execution of the Unsupported Sitting Posture

Ken Kamei, Dinesh Kant Kumar And Barbara Polus Chiropractic Journal of Australia, Volume 37, Number 3, March 2007

(For additional information contact DeDe Van Riper, Director of Quixote Instrumentation a division of Quixote Software. Ms. Van Riper has extensive knowledge and experience in the chiropractic field, having worked with Insight Technology, CLA [Chiropractic Leadership Alliance], Now You Know, and other major chiropractic companies. For questions about chiropractic instrumentation, call her at 866-760-1048.)