An audiometric study of the effects of paraspinal stimulation on hearing acuity in human subjects understanding the Harvey Lillard phenomenon

BACKGROUND: The founder of chiropractic, Daniel David Palmer, constructed a model of causation of disease based on his seminal experience with a patient, Harvey Lillard, who lost his hearing at the instant of injuring his upper back, but had his hearing restored suddenly 17 years later after receiving spinal manipulation. Palmer’s model of disease causation, that of displaced vertebrae impinging on spinal nerves and thereby disrupting the innervation of dependent organs, was in fact incongruent with what was known at the time about human neuroanatomy and neurophysiology. The current study proposes and tests an alternative hypothesis: that increased afferent input from paraspinal muscles attenuates the central transmission of auditory information. METHODS: Between September 13 and November 13, 2013, forty healthy young adults were recruited and randomly divided into two cohorts: one receiving successive trials of sham TENS, and the second receiving sham and then authentic TENS. During the administration of sham and authentic TENS to the upper thoracic spine, hearing acuity was measured to determine perception thresholds at the frequencies normally tested clinically. RESULTS: In the first cohort, there were no differences in perception thresholds in the first and second trials of sham TENS, speaking to the reliability of the testing process. In the second cohort, there were no significant differences in perception thresholds during sham and authentic TENS. CONCLUSIONS: Within the constraints of the current study design, including demographic characteristics and TENS parameters, there was no evidence that innocuous afferent input to upper thoracic paraspinal muscles modulated thresholds of audibility

The effect of spinal manipulative therapy on spinal range of motion: a systematic literature review

Abstract Background Spinal manipulative therapy (SMT) has been shown to have an effect on spine-related pain, both clinically and in experimentally induced pain. However, it is unclear if it has an immediate noticeable biomechanical effect on spinal motion that can be measured in terms of an increased range of motion (ROM). Objective To assess the quality of the literature and to determine whether or not SMT is associated with an immediate increase in ROM. Design A systematic critical literature review. Method Systematic searches were performed in Pubmed, the Cochrane Library and EMBASE using terms relating to manipulation, movement and the spine. Selection of articles was made according to specific criteria by two independent reviewers. Two checklists were created based on the needs of the present review. Articles were independently reviewed by two reviewers. Articles were given quality scores and the data synthesized for each region treated in the literature. Findings were summarized in tables and reported in a narrative fashion. Results Fifteen articles were retained reporting on experiments on the neck, lumbar spine, hip and jaw. The mean quality score was 71/100 (ranges 33/100 - 92/100). A positive effect of SMT was reported in both studies where mouth opening was assessed after cervical manipulation. In five of the nine studies on cervical ROM a positive effect was reported, whereas the remaining four studies did not show improvement. None of the three studies of the lumbar spine showed an effect of SMT on lumbar ROMs and one study of sacroiliac manipulation reported no effect on the ROM of the hip joint. In relation to the quality score, the seven highest ranked studies, showed significant positive effects of SMT on ROM. Continuing down the list, the other studies reported no significant differences in the outcomes between groups. Conclusion SMT seems sometimes to have a small effect on ROM, at least in the cervical spine. Further research should concentrate on areas of the spine that have the potential of actually improving to such a degree that a change can be easily uncovered

Cerebrospinal fluid pressure in the anesthetized rat

Objective: The primary aims of this study were to determine the major frequencies and powers of oscillations in cerebrospinal fluid (CSF) pressure in the anesthetized rat, and determine whether the CSF pressure oscillations correlated with the major oscillation frequencies in the cardiovascular and respiratory systems as proposed by some chiropractic theories. Methods: The cardiac and ventilatory cycles, and CSF pressure were simultaneously recorded during spontaneous and positive-pressure mechanical ventilation in the anesthetized rat. Power spectra were generated from the raw data to identify the major oscillation frequencies in cardiorespiratory and CSF data sets. Entrainment of CSF pressure with ventilation was tested by mechanically pacing the ventilation over a range of frequencies. Results: The most powerful oscillation in CSF pressure was coincident with ventilatory chest movement during both spontaneous and mechanically paced ventilation. In 22 of 26 trials, there was also a very weak oscillation in CSF pressure that was entrained to heart rate. In addition, in 21 of 26 trials, it was possible to identify a low-frequency oscillation (<0.25 Hz) in CSF pressure that was coincident with a low-frequency oscillation in the power spectrum of the cardiac cycle. Conclusions: This study suggests oscillations in CSF pressure in the anesthetized rat are entrained to and driven by ventilation. The arterial pulse pressure makes little contribution to oscillations in CSF pressure in the immobile, anesthetized rat. This study provides normative, quantitative data on which to develop studies concerning the effects of vertebral movements and spinal posture on CSF dynamics

Cerebrospinal fluid pressure response to upper cervical vertebral motion and displacement in the anesthetized rat

Objective: This study examined whether aligned or off-axis(subluxated) static and dynamic vertebral displacement within normal physiological ranges modulated cerebrospinal fluid pressure (CSF) as is considered to occur by some chiropractic theories. Methods: Cerebrospinal fluid pressure pressure was measured via a subarachnoid catheter implanted at the lumbar level in 12 anesthetized adult male Wistar rats. A computer-driven manipulator was used to impose 3 motion patterns on the C2 vertebra: (i) dynamic oscillatory displacement (24° peak-to-peak 1.0 and 2.0 Hz), (ii) static rotary (ramp 20° at 10° per second and hold for 4 minutes) displacement about both the normal and an offset axis of rotation, and (iii) a spinal manipulative thrust displacement (200° per second; 12° peak-to-peak). Results: The CSF pressure at rest for all rats ranged from 4.5 to 9.1 mm Hg, with a mean (± SD) of 6.3 ± 1.4 mm Hg. Of the imposed movements, only an offset ramp and hold displacement resulted in a significant (P < .05) difference between the CSF pressure before (6.1 ± 0.7 mm Hg) and during the imposed movement (6.6 ± 0.7 mm Hg). None of the interventions were associated with significant changes in the powers of the principal peaks of the CSF pressure power spectrum. Conclusions: The results of this study suggest that static or dynamic displacement of an upper cervical vertebra within the limits of tissue integrity do not induce physiologically important changes in absolute CSF pressure or pressure dynamics in anesthetized rats

Principles And Practice of Chiropractic

xxii, 1223 pages ; 28.5 cm

The boot camp program for lumbar spinal stenosis: a protocol for a randomized controlled trial

Abstract Background Lumbar spinal stenosis (LSS) causing neurogenic claudication is a leading cause of pain, disability and loss of independence in older adults. The prevalence of lumbar spinal stenosis is growing rapidly due to an aging population. The dominant limitation in LSS is walking ability. Postural, physical and psychosocial factors can impact symptoms and functional ability. LSS is the most common reason for spine surgery in older adults yet the vast majority of people with LSS receive non-surgical treatment. What constitutes effective non-surgical treatment is unknown. The purpose of this study is to evaluate the effectiveness of a multi-modal and self-management training program, known as the Boot Camp Program for LSS aimed at improving walking ability and other relevant patient-centred outcomes. Methods We will use a pragmatic two-arm randomized controlled single blinded (assessor) study design. Eligible and consenting participants will be randomized to receive from licensed chiropractors either a 6-week (twice weekly) self-management training program (manual therapy, education, home exercises) with an instructional workbook and video and a pedometer or a single instructional session with an instructional workbook and video and pedometer. The main outcome measure will be the self-paced walking test measured at 6 months. We will also assess outcomes at 8 weeks and 3 and 12 months. Discussion Symptoms and functional limitations in LSS are variable and influenced by changes in spinal alignment. Physical and psychological factors result in chronic disability for patients with LSS. The Boot Camp Program is a 6-week self-management training program aimed at the multi-faceted aspects of LSS and trains individuals to use self-management strategies. The goal is to provide life-long self-management strategies that maximize walking and overall functional abilities and quality of life. Trial registration ClinicalTrials.gov ID: NCT02592642