aaCM 13 in design

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editor’s note
Change is almost always a little bit daunting. No
matter how broken or good the past, the idea of
change often plays to our insecurities. What if future
directions are not as good? What if future directions
change our identity? What if future directions are
not exactly how we would want? All of our concerns
about change often reflect our own values, what we
hold dear and what we expect. But as an experience,
change can also be hugely rewarding and positive.
With any change of editorship comes a different flavour and also revisions
in both process and expectation. However, as the new editor of this key
publication in UK Chiropractic, the title of ‘Chiropractic Matters’ speaks
loudest of all about its direction and what is to be expected of me in
preserving its heart. I am proud to say that this magazine is not just a
itor’s no
publication for the Chiropractic matters of a few, but a firm beacon to the
testament that Chiropractic really does matter to us all as practitioners and
also the wider public that we serve.

te
te
The new format of this magazine is a reenergised
mash of what I see was good with the
Chiropractic Matters magazine of old, the best
of Cheiron (it’s wonderful predecessor) and also
a mix of numerous healthcare, Chiropractic and
lifestyle magazines that I have had the pleasure
of trawling through, connecting with and being
inspired by over the last few months. The
magazine will have a more contemporaneous
eye on what is going on in the profession as a
whole and will provide clinically relevant tidbits,
recaps and information as well as articles from
a wide range of Chiropractors and healthcare
professionals worldwide, whilst retaining
both the spirit and heart that we have come
to expect as being a force within our wider
Chiropractic family. The slightly more seasoned
reader will note a slight renaissance in some of
the article formats to the early days of Cheiron
as the focus of the magazine returns to its
content, value and footprint.
My goal is to provide something you would
be proud to leave on your home coffee table
or clinic waiting room table, something that
will be more relevant and inspiring to your
practice, whether you are based in the UK
or more internationally and something that
will leave more of a definite legacy for us as
Chiropractors. No matter your reading per
champ, this publication will serve as a home
for everyone in Chiropractic. If you don’t
feel that we are catering for you,
please contact me and I will be
more than happy to assist
you in writing an
article for the
following issue. Whether the articles on the
more clinical, philosophical or professional
aspects interest you most, the publication
under my leadership will undoubtedly contain
something that should be of interest to all
Chiropractors, Chiropractic students and,
hopefully, the odd patient too.
We know that in order to improve quality
we had to up our game in terms of what we
can deliver and so that we, as an association,
can free up funds for issues that matter or
affect you the most. I am hugely proud to
announce therefore that we have changed the
way we print and distribute the publication
so that we have saved well over 50% of the
cost of producing each issue. We are also
reinvigorating the way we handle our advertising
and authorship to make it more dynamic and
rewarding for people to get involved with us.
We are also now proud to encourage you
(whoever and wherever you are) to become
more social and interactive with us too. To get
in touch with me, submit an article or advert for
consideration, make a comment to the editor
or just pose a question/bulletin for the next
issue, please email me at james@mctimoneychiropractic.org.
It would be lovely to hear from
you.
So whilst change may be a little scary and a
little daunting, and there may be a few hurdles
in managing changes a long the way, change
can also be a good thing. It’s time to stop
spending energy on being worried and embrace
the change with stealth and positivity. It’s
time to reshape, free and focus ourselves in a
way so that we can more effectively burn the
boundaries that hold us back and light beacons
of everything we do right. It’s time to be better
connected to each other and the wider
profession and public that we serve.
Why? Because Chiropractic
undoubtedly matters. And
so do you.
James Harrison
LL.B (Hons),
MChiro, MMCA

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Bern
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Liz Interview.

An overlooked fact about the term
SUBLUXATION
Phillip Ebrall PhD
Phillip Ebrall (Right) is Vice-President (International) of the Tokyo College of Chiropractic and
Adjunct Professor of the Faculty of Health at the International Medical University Kul Lumpur.
He recently retired as a Professor of Chiropractic at CQUniversity (Australia) and was formerly an
Associate Professor of Chiropractic Education at RMIT University (Also in Australia).
Most academics repeat incorrect facts about what we
know today as the vertebral subluxation complex, the
most common of which being the attribution of the
concept to DD Palmer. To do so is a foolish and
misleading comment.
The fact is the concept is rooted in medicine and dates
from the 1820s to British physician Edward Harrison.
The first known attribution of minor derangements of
vertebrae and ligaments in the spine being associated
with clinical signs and symptoms is given in his 1827 text
Pathological and practical observations on spinal disease.
London: Thomas and George Underwood: 1827 (1)
He argued that if the spine was moved
Commentary out of its original position, whatever
the cause, distortion pressed on the
spinal cord. He also reported a man who
fell from a horse and lay motionless until his neck was
treated, saying I visualise that he had a subluxation or
concussion of his brain or spine. There was then discussion
at a dinner party as to what was the cause of it. For
my part, I believe that the vertebrae was displaced compressing
the cord and phrenic nerve. (2) As a piece of
trivia to add fun to facts, Dr Harrison, a graduate of Edinburgh
and a medical reformer was a doctor to Sir Joseph
Banks (1743-1820) the famous naturalist who served as
President of the Royal Society for over 41 years.
I am not taking anything away from DD Palmer who’s
role was to codify subluxation, place it in a broader clinical
context, and develop manual approaches to identify
and treat ‘it.’ In fact I have published elsewhere of my
admiration for Palmer. (3-4) He was a learned man who
gave the world a new paradigm of health and wellness
care, laying a solid foundation for the work being
undertaken today to better understand the role of
subluxation in chiropractic practice.
The inability to participate in this intellectuallydemanding
work is the simple reason why a handful of
garrulous chiropractors are making inane calls, including
issuing joint communiques (5) to relegate subluxation to
‘simply an historical concept.’
It is even worse to suggest chiropractic should now
divide into two camps. The foolishness of this lies in the
simple reality that without subluxation there is no
framework to guide clinical decision-making. (I will
explore this in future articles.) Those who want to
disassociate themselves would be better-off becoming an
osteopath or forming a new discipline of manual
medicine. We have seen the challenges associated with
that approach in Germany.
A simple fact remains; every chiropractor identifies by
some means an area of the spine to which they then
direct a therapeutic input in some manner. This is
incontrovertible and a person registered as a
chiropractor either does this or acts under false
pretences. Rome has published nearly 300 synonyms for
subluxation. (6) He has also published on the use of the
links to the automatic (7) and somatovisceral systems. (8)
It seems incongruous that a minority of chiropractors
are arguing for ‘subluxation’ to be discarded while
medicine is embracing and publishing regarding the term
and its clinical presentation. (9-10) It is even worse for
them to claim they are ‘evidence-based’ while ignoring
the evidence.
References
1. URL: https://www.ncbi.nlm.nih.gov/pubmed/19227603).
2. ibid. p.173, 31–63.
3. Ebrall PS. A review of the neurological concepts of 1895. Chiropr J Aust 1995; 25:56-60.
4. Ebrall PS. A review of the practise of medicine in 1895. Chiropr J Aust 1995; 25:93-100.
5. European Schools Sign Anti-Subluxation Position Statement. The Chronicle of Chiropractic. 17 May
2015. UR: http://chiropractic.prosepoint.net/113734
6. Rome PL.Usages of Chiropractic terminology in the literature: 296 ways to say ‘subluxation.’ J Chiropr
Tech. 1996;8(2): 49-60
7. Rome PL. Neurovertebral influence upon the autonomic nervous system: some of the somato- autonomic
evidence to date. Chiropr J Aust: Mar 2009(39:1): 2-17.
8. Rome PL. Neurovertebral influence upon visceral and ANS function: Some of the evidence to date –
Part II: Somatovisceral. Chiropr J Aust: Mar 2010(40:1): 9-33.
9. Haselmeyer K, Haselmeyer S. Asymptomatic Vertebral Subluxations in Chiropractic Patients Presenting
for Care in Germany. J Vert Subluxation Res. 2016;Jan 28: 6-9.
10. Biedermann H. Manual Therapy in children. Edinburgh: Churchill Livingstone; 2004.

Neurology
Shimizu Reflex
Orthopaedic
Thomas’ Test
A muscle stretch reflex, innervated by the high cervical
spinal cord.
The reflex is performed by caudally tapping the tip of the
spine of the scapula with a reflex hammer.
Elevation of the scapula or abduction of the humerus is
noted as a positive test
Presence of a hyperactive reflex is considered diagnostic
for craniovertebral or high cervical lesions. The major
muscles participating in the reflex are considered to be the
upper portion of the trapezius, the levator scapulae, and
the deltoid.
This is a test for fixed flexion deformities of the hip. It can also
be used to assess muscle length of the rectus femoris, iliacus,
tensor fascia lata and the iliotibial band.
With the patient supine, the patient flexes the unaffected hip
and knee towards the chest. grasping the knee with both hands.
In a positive test ‘the affected hip will be drawn into a degree of
flexion bringing the thigh away from the couch’ (1) If the hip
goes into abduction more than flexion (known as the ‘J sign’ it
can specifically indicate shortening of the ITB (2) Fixed flexion
deformities may be due to soft tissue (such as muscle) shortening,
postural imbalances, fixed lumbar lordosis, significant
posterior pelvic tilt, or may be secondary to pathologies such as
osteoarthritis or fracture (1)
Source:
Shimizu T, Shimada H, Shirakura K (1993)
Scapulohumeral reflex (Shimizu). Its clinical
significance and testing maneuver. Spine,
18(15): 2182-90
GCC Code
THE
REFRESHER
PAGE
Nothing on this page
should be new ...
... but sometimes
it is worth refreshing...
References:
1) Hattam P, Smeatham A (2010) Special Tests in
Musculoskeletal Examination; An evidence-based
guide for clinicians, Churchill Livingstone Elsevier,
Pages 166-169
2) Magee DJ (2008), Orthopaedic Physical
Assessment, 5 edn., Saunders, Philadelphia.
Hodgkin's
Lymphoma
Source:
http://www.gcc-uk.org/UserFiles/Docs/
G20.006%20CofP_stage%203%20hyperlinks%202708.pdf
(Effective from June 30 2016)
Source:
Souza (2009) Differential Diagnosis and Management
for the Chiropractor, 4 edn,Jones & Bartlett
Publishers, USA, Page 976
C4: Develop, apply and document a plan of care in full
agreement with the patient. You must check the
effectiveness of the care and keep the plan of care under
review. A more formal reassessment of the effectiveness of
the plan of care must be undertaken at intervals
that suit the patient and their needs. All subsequent
modifications to the plan of care must be discussed and
agreed with the patient and properly documented.
F1: Explore care options, likely outcomes, risks and benefits
with patients, encouraging them to ask questions. You
must answer fully and honestly, bearing in mind patients
are unlikely to possess clinical knowledge.
Professional
Malignancy of the lymphatic system. 60% occur in children
10-16 years old.
Signs and symptoms include fatigue, fever, chronic cough,
night sweats, weight loss, painless cervical or
supraclavicular lymphadenopathy, pruritis and pain worse
with alcohol ingestion.' 50% have mediastinal mass on xray.
CT scans, lymphangiography, bone marrow aspirate and
biopsies determine spread of the disease. Presence of
malignant Reed-Sternberg cells is diagnostic.
Condition

WCCS UPDATE
The 38th WCCS Annual General Meeting
22nd-28th April 2016 Paris, France
Jodi Harris
Guided by our head delegate, Danielle Webster, the
McTimoney WCCS chapter arrived in Paris the day
before congress began. Together, along with students
from schools in Australia and New Zealand we took a
guided history tour, stopping at each floor to absorb the
beauty of the illuminations that Paris had to shine as the
sun went down. At 10pm, standing at the very top, the full
moon glowing, a light began to transcend through all of
us..... The spirit of congress had begun.
DAY 1:
Day one began slowly with a pleasurably long breakfast,
followed by a (not so pleasurable) team McT gym session!
The afternoon was spent registering, meeting lots of
new faces (three of the four McT delegates this year had
never been to congress before!), getting
accustomed to the rules of congress and
WCCS Update the Opening ceremony. We were graced
with the presence of Mr Philippe
Fleuriau, a former IFEC graduate and
now the president of the French Association of
Chiropractic, who gave a warm hearted welcoming
speech inviting us to experience all that French
Chiropractic has to offer. We ate, drank, danced and
talked the night away, initiating and rekindling friendships
on a global scale.
"Get excited people because
we are going to be bringing the
beauty, love and family of WCCS
to your very doorstep!"
DAY 2:
Day two and another McT gym session. We were going
strong until Sara from Life-West took us through her
favourite abdominal workouts, leaving me feeling sick. (I
hadn’t even eaten by that point!) Out of the 120
delegates attending from colleges and universities around
the world 70% were new delegates and so we spent the
best part of the day agonising over the very first
proposal. To start with I was concerned, along with many
of the other delegates in the room as we were not used
to the systems. Trust me when I say that it did get better
and much more efficient throughout the week. After a
refreshing lunch we heard from another IFEC graduate,
Mr Mathieu Spencer, who is focused on the health of
Jodi Harris is a first year FTE student at the McTimoney College of Chiropractic.
Pictured above are the McTimoney College Chapter 2016 Delegation in front of the Eiffel Tower;
Tacy Wright, Danielle Webster, Jodi Haris, Chris Barron.
performing artists and empowering them to naturally
maximise their performance. To fully understand the
stress and strain of his patients workloads, he subjected
himself to a 2 month world tour that put him on the
road covering in excess of 1000km a day! That evening
was the Alumni party, hosted at the St.Germain Theatre.
I think it is fair to say we were the last chapter standing,
standing united having had such fun meeting and dancing
with lots of fellow students.
DAY 3:
With proposals being dealt with efficiently, day three
gave rise to a wealth of speakers from across Europe.
Dr Carlos Gevers, President of the Spanish Chiropractic
Association and former Life West graduate enlightened
us to the political situation currently governing Spain and
his main objective for pursuing legislation within Spain.
Dr Gitte Tonner spoke passionately about her
involvement with WCCS over the years and how she
emphasises a holistic approach when it comes to
empowering her patients to make healthier life choices.
We were overwhelmed by the presence of Dr Vivian Kil
who emanated strength and power through a tireless
work ethic. Along side her patients she has served as a
board member of the Netherlands Chiropractic
Association to then become its president, was elected
vice president of the European Chiropractors union and
council member of the World Federation of Chiropractic.
To centre us before lunch we were also engaged by Dr
Ryan Rider who taught us to show up and be present in
the now! In the afternoon we were blessed to have the
opportunity to ask questions to our Alumni to find out
how WCCS has helped them throughout their studies
and their now professional lives. They were also available
to talk with throughout the rest of the day which was

fantastic as it gave us new delegates a first hand insight
into the benefits and power of WCCS! Feeling on fire we
had a free evening at the hotel where the McT Chapter
separated and mingled with other schools, getting to
know the other students better, how their schools operate
and how their programmes are taught.
DAY 4:
Official photo day!! Everyone was dressed in their best
for the congress photo shoot. Amongst this excitement
we got down to and discussed further, new proposals.
We then met the beautiful Jean-Paul Pianta, another
IFEC graduate. He spoke passionately about the role of
chiropractic within our society and moved us all with
his display of affection and love for his patients. His spirit
was captivating and he made everyone smile. This evening
was my favourite night by far! We were treated to pure
French culture on the River Seine and embraced the
oenology evening that the IFEC team had so graciously
put together for us. Situated on a river boat just down
from Notra-Dame, we experienced wines from regions
all over France, were taught a brief history and the
traditions behind wine making.
DAY 5:
Treasure Hunt Day!!! Tuesday had been planned as a day
off from congress for everyone. We were taken by bus
into Paris City centre, split into groups so that everyone
could network and have the opportunity to talk with
other students that they may have not had a chance to
meet yet. Our team was the Brilliant Bananas and
consisted of students from England, New Zealand,
Australia, France, Spain, South Africa and Spain. Together
we followed our guide all over the city answering clues
to lead us to the next destination whilst taking in the
magic and romance that Paris exudes. In the sun, rain, hail
and then sun again we had so much fun. We met with all
the other teams for a picnic lunch in the park besides
the Eiffel Tower with home made macrons from the IFEC
students!! In the evening we toured the IFEC facilities at
their chiropractic school, consumed a superb BBQ. Later
we stood around the burning coals enjoying each others
company talking all things chiropractic.
"The WCCS is an organisation that I
fully encourage you to do your upmost
to be apart of as its support and
energy is unrivalled to anything I have
ever experienced before"
DAY 6:
NINJA TRAINING!! I was up early to watch the sunrise
over Paris from the 10th floor of our hotel. Back down
in the lobby at 06.30 with around 60 other students all
intrigued by what Lance and Brett from Adjusting Ninjas
were going to show us. We did laps, mountain climbing
chiropractic technique.
and meditation over the course of an hour and a half
with the intention of enlightening us as to what their
training camp can offer. Adjusting Ninjas is a program
designed to test you physically and mentally to aid you
in becoming an elite athlete in your delivery of the
Wednesday evening was a casual, relaxed philosophy
night with speakers Patrick Sermet, Chloe Blanchard and
Giles Duteil. We sat enchanted by the truths that they
spoke, inviting us all to think of something bigger than
ourselves and to surrender to love.
DAY 7:
ELECTION DAY!! This was our final day of congress
and what an exciting one it was. The final proposal was
voted on, our new board of directors was selected and
the regional locations chosen. This saw our very own
Mc Timoney College of Chiropractic being nominated
and unanimously voted in to convene the 2018 WCCS
European Regional!! Get excited people because we are
going to be bringing the beauty, love and family of WCCS
to your very doorstep!
Congress finished late as we had much to cover and get
organised before the gala dinner.From what I heard this
party was in full swing till the early hours of the morning.
For me, not being one for goodbyes, (I get far too
emotional and I certainly hadn’t prepared myself with
the waterproof mascara that I would've so desperately
needed) I vacated discreetly as every single one of the
120 individuals that I had the honour of meeting during
our week in Paris, regardless of language or accent, spoke
to my heart.
The WCCS is an organisation that I fully encourage you
all to do your upmost to be apart of as its support and
energy is unrivalled to anything I have ever experienced
before. From my heart, thank you Mc Timoney for allowing
me this experience, to be seen and valued as an equal
in the evolution of our profession.
For more information about the McTimoney WCCS Chapter
please visit www.mccwccs.weebly.com
The MCA is proud to support students attending international events such as WCCS.

Graduation article

Chiropractors, Chiropractic and
The media
- By Roger Crisp
Have you ever wondered what it would be like to be
on a Radio or TV programme, or at the local newspaper
talking about what you do? How would you
explain clearly what a chiropractor does?
What if you took the initiative to be a media expert
in how Chiropractic could assist with certain issues?
You would be respected and in control from the start,
and perhaps even find that more business also comes
your way as result of being better known. Learning
how to deal effectively with the media (TV, Radio,
Press, Social Media) isn't just about sorting out a crisis
and ducking for cover.
Finding out what it would be like to face an
interviewer through basic media training gives you
valuable transferable skills and can be useful in
preparation for meetings, health talks, presentations
or even communicating with your patients. It's all
about finding out how best to get your message
across.
On TV or radio you have about 15 seconds to keep
the attention, so you must start with your conclusion
and then elaborate according to how much time is
given to you. Being prepared is more than half the
battle.
The 6 steps below give an outline as to what is
involved in understanding and dealing effectively with
the media, and where to begin.
1. Contact the MCA -
for support, guidance and advice
2. Before the Media Interview -
e.g. agree your media contract; your key message
3. What do the Media want? -
e.g. a coherent story; use open/closed questions
4. During the Media Interview -
e.g. start with your conclusion; take control
5. Radio & TV interviews -
e.g. know your audience first; Never talk "off the
record”!
.6. What do you want to gain from the
Media? -
e.g. offer them your expertise
There are also two steps
you can take straight away
that can help pave the way to having a positive
relationship with the media and to both
understanding and feeling more confident about
speaking to the media.
1. Local Media. Explore whether the local
newspaper, your local Radio or TV is interested in
having you on hand for interviews about what's going
on in healthcare in general. Perhaps your local
newspaper would be interested in a column about
Chiropractic, healthcare issues, your own developments
and achievements?
2. Social Media. Social media can be a great way to
get your information and expertise
out to a much wider and diverse
audience, to keep up with younger
Guest Article
patients, and to attract newcomers
to your clinic. You can post interesting
pieces, invitations and newsletters to reach people
beyond your own network. Linkedin, Twitter,
Facebook and Instagram are the most well known.
Did you also know that Youtube is now the second
busiest search engine, so if you have some video
footage you can put it and attract further attention?
Taking the initiative with Media, and having inside
experience with how they will operate will pay
dividends should they come calling during difficult
times.
The MCA should be your first point of call
for assistance should you have to deal with
the media, but it doesn't hurt to think
things through and prepare in advance
also- just in case.
Roger Crisp is a non-executive director of communications in media relations and crisis
management, having previously worked as a broadcaster for BBC World Service,
trained leaders in UK and international organisations across various industry sectors.
He is author of the online training “How to deal effectively with the Media” at
www.5stepmediaexpert.com. For more information, visit www.rogercrisp.com

PAEDS ARTICLE

NEWS FROM
The Royal College of Chiropractors
By Rob Finch
Chief Executive
Rob Finch, pictured right, is the Chief Executive Officer of the Royal College of Chiropractic
T: +44 (0)118 946 9727
E: admin@rcc-uk.org
W: www.rcc-uk.org
F: https://www.facebook.com/royalcollegeofchiropractors
Annual PRT Review
Each year, the RCC’s PRT Committee undertakes a
review of the PRT programme in order to help ensure
it meets the needs of participants and stakeholders. The
review involves collection and analysis of a range of data,
including feedback information from candidates and
trainers (mentors), and an Annual Review Meeting
to which all professional associations
are
RCC News
invited. The feedback information
collected from candidates and trainers
is particularly important in helping us
to determine whether the PRT programme is achieving
its aims, especially in terms of meeting the needs of
participants. It provides insight and enables us to identify
and explore ways that we can continually improve our
scheme.
As a direct outcome of the review, a number of
modifications are planned, including encouraging candidates
to observe as many other chiropractors as they
can in practice during their programme. We will also be
widely distributing a response to the questionnaire feedback
received from candidates and trainers.
Chronic Pain Quality Standard
Following the recent public consultation, the RCC’s
sixth chiropractic quality standard, entitled ‘Chronic
Pain’ will be published in July and will be openly available
on the RCC website at http://rcc-uk.org/quality-standards/.
Note that all published RCC chiropractic quality
standards are now listed in NICE Evidence at
http://www.evidence.nhs.uk/
PPQM and CMQM Call for Applications
Calls for applications for the RCC’s two
quality marks for the period 2017-2019 are now live.
Launched in 2006, the Patient Partnership Quality
Mark (PPQM) recognises excellence in meeting
patient expectations, as defined and assessed by The
Royal College of Chiropractors' Lay Partnership
Group. To be successful, practices must demonstrate
that patient expectations are met in a range
of areas including accessibility, booking systems and
out-of-hours cover, cleanliness, safety and privacy,
communication, patient education, record keeping
and forward planning. More than 150 chiropractic
practices currently hold this prestigious award.
The Clinical Management Quality Mark (CMQM)
was launched in 2008 to complement the PPQM. To
be successful, applicants must be able to
demonstrate an appropriately managed and systematic
approach in respect of clinical audit, risk
management, incident reporting, outcome
measurement, patient satisfaction and operational
policies.
Both awards demonstrate excellence in terms of
maintaining and improving the quality of clinical
services to patients, other healthcare professionals,
external organisations and commissioners. Full
application details are available at http://rcc-uk.org/
rcc-quality-marks/. The deadlines for receipt of applications
are Friday 30th September 2016 (PPQM)
and Friday 4th November 2016 (CMQM). Practices
can choose to apply for either or both awards.

Updates
College
MCA
RCC
AECC
WIOC
ECU
Frans Article
Trust Article
Dates for diary
Graduation
Ed Lectures
30th September 2016 – 2nd October 2016
Event: ICCSP Lower Extremity Module
Speaker: Multiple Speakers
Convenors: RCC Sport and Exercise Faculty & FICS
Venue: Jurys Inn Oxford, Godstow Road, Oxford, OX2 8AL
Contact: lucianna.harrison@rcc-uk.org | 01189469726
Register at: rcc-uk.org/rcc-events
10th September 2016
Event: Kinesiology and Pregnancy Taping
Speaker: Richard Moore
Convenors: Jenny Hudson MRCC
Venue: Holiday Inn Express Birmingham NEC, Bickenhill Parkway, Birmin
Contact: lucianna.harrison@rcc-uk.org | 01189469726
Register at: rcc-uk.org/rcc-events

RESEARCH
From the McTimoney College of Chiropractic
All of these abstracts have been previously represented
at both national and international research conferences.
Neurophysiological response to spinal adjustment:
An investigation using changes in electrodermal activity.
John-Paul Taylor MChiro, Adrian Hunnisett PhD MPhil, Christina Cunliffe DC PhD
Introduction
Chiropractic theories postulate a relationship between the spine and the
nervous system. An important manifestation being pathophysiology of the
subluxation and the effects of spinal adjustment on the body’s organ systems. If
such theories are correct, there should be an aetiological connection between
spinal dysfunction and visceral dysfunction as well as a therapeutic
connection [1].
Changes in Autonomic Nervous System (ANS) activity can result from a
variety of factors including physical movement, sleeping, disease and ageing [2].
In terms of spinal adjustments the value of examining the ANS is to determine
a neurophysiologic basis for the therapeutic benefits chiropractic patients
report following chiropractic healthcare.
This study is a basic science investigation into the neurophysiologic
response of a specified chiropractic spinal adjustment, building on scientifically
acknowledged spinal adjustment/manipulation research and utilising EDA as an
accepted objective measure of neurophysiologic effect.
Method
Following ethical approval from the university IRB, a prospective, double-blind,
placebo-controlled, randomized trial was designed to determine the percentage
difference in skin conductance measures, obtained before and after a
specific chiropractic spinal adjustment relative to sham and control conditions.
A total of 45 eligilble healthy, asymptomatic, volunteers from the
student, ex-student and staff populations of a chiropractic college were recruited
to make up the total sample population. All
volunteers gave informed consent prior to participating in the research study.
Participants were randomly allocated to one of three groups:
1) Treatment: pre-intervention protocol, intervention protocol, and post-intervention
protocol. Treatment involved specific high velocity low amplitude
(HVLA) adjustment to the relative anterior transverse process of C1, on the
Subject’s asymptomatic side.
2) Placebo: pre-intervention protocol, mimic the intervention protocol, and
post-intervention protocol. In this case manual contact applied in the same
manner as the treatment group to perform adjustment set-up (pisiform preload
to transverse process), but with no adjustment of the vertebra.
3) Control: Pre-intervention protocol and post-intervention protocol while
investigator neither undertakes or mimics the intervention on subjects.
Introduction
In the United Kingdom chiropractors are required to be evidence-based
practitioners[1]. Evidence based practice (EBP) is the integration of best available
evidence with clinical expertise and patient values in order to select the
most appropriate management and deliver the best outcome for that patient.
This necessitates that healthcare practitioners are able to access relevant
research, understand how to appraise the quality of evidence that it provides
and integrate this with their clinical expertise and apply it in practice[2]. One
of the major barriers to the advancement of EBP in chiropractic is the lack of
relevant clinical research and the funds to undertake high quality research[3].
No studies have been carried out in the UK to evaluate the willingness of
chiropractors to provide funds for research, nor of their attitudes toward the
necessity to generate research, perceived priority areas of research or opinions
regarding administration of any funds. That is the aim of this study.
Pre-intervention protocol consisted of an initial 2 minute ‘stabilisation’ period
followed by a 3 minute ‘baseline-data’ period, giving a total of 5 minutes SC
data. Intervention protocol represented the ‘intervention’ period when one of
the three conditions was undertaken. The post-intervention protocol included
a 3 minute ‘final-data’ period immediately after the intervention and a further 2
minute ‘rest‘ period, another total of 5 minutes SC data.
Data was analysed using InStat v3 (www.GraphPad.com) following data preparation
with Microsoft Excel.
Results
The chiropractic adjustment to C1 produced a sympathoexcitatory response
compared with control group (p

of chiropractic adjustment should be a priority along with improving patient
outcomes, 79% and 78% respectively (Fig.1).
Conclusion
This appears to be the first study of this type. It clearly demonstrates that UK
chiropractors are willing to donate funds for further research, via subscription
from their Associations.
An infrastructure will need to be developed to manage potential funds.
Additionally further research will be required to assess chiropractors priorities
and beliefs regarding further research.
References
[1] GCC (2010) Code of Practice and Standards of Proficiency. General Chiropractic Council, UK.
[2] Sackett DL. (1997) Evidence-based medicine. How to practice and teach EBM, 2nd ed. Churchill
Livingstone, New York.
[3] Stuber K, Bussieres A, Gotlib A (2009) Chiropractic research capacity in Canada in 2008 – Phase 3. J
Can Chiropr Assoc 2009; 53(4).
Fig 1: Participant responses
regarding research priorities.
Presenting complaints to Chiropractors:
Has there been any change in the last 10 years?
Daniel Piper MChiro, Adrian Hunnisett PhD MPhil, Christina Cunliffe DC PhD
Introduction
Each year 150,000 new patients consult a chiropractor[1]. A study carried out
in 2002 recognised that the typical new patient presenting to a
chiropractic practitioner was female, between the age of 41-60 years old and
mostly presented with low back pain (LBP)[2]. This profile is supported by
other research in the field [3,4].
The aim of the study is to collect new data that may show any change of
trends of primary presenting complaint as well as any other presenting
complaints that have increased in affliction frequency. It helps to answer the
question ”Is there any change in the ‘typical’ patient?”. This may provide a
beneficial indicator of target demographics for marketing and teaching
purposes.
Method
Following ethical approval, a retrospective survey of patient notes was undertaken.
Records were reviewed from all new patients (n=556) attending a student
clinic of a Chiropractic College. The data collection instrument was similar to
that of the original 2002 study [2] but with some added data fields, including
referral source and occupation. There was also a change to the segmentation
of the body to provide data for overlapping symptoms.
This strategy allowed direct comparison of results but the changes made to
the chart also worked to address the original authors’ recognised limitation of
the data quality and quantity.
Results
In 2012 there were a total number of 556 new patients with 43% male and
57% female. The primary presenting complaint are indicated in Figure 1. It
is clear that the most common complaint was LBP (57%) followed by lower
extremity pain (11%). This compared with 47% and 10% respectively in 2002.
Analysis of other presenting complaints showed similar patterns of presentation
over both sample years.
There were no statistically significant differences shown between the 2 year
groups.
Conclusion
This study clearly shows that low back pain is still the most common primary
presenting complaint. Comparing the results directly with the 2002 study body
segmentation, there would appear to be an increase of 12% of new patients
presenting with low back pain.
The study data indicates a perception that chiropractic is still viewed
predominantly for low back pain alone. It is in the interest of the profession
to change this stereotype by educating the population at large of the benefits
to total body health that chiropractic can provide.
References
[1] Hawk C, Long C R, Boulanger K T (2001). Prevalence of non-musculoskeletal complaints in chiropractic
practice: report from a practice based research programme. JMPT March-April 2001, Vol 24, No 3.
[2] Smith S (2003). What are the primary complaints of new patients visiting a McTimoney chiropractor
in 1997 compared with 2002? BSc dissertation, McTimoney College of Chiropractic, Abingdon, UK.
[3] Hartvigsen J, Bolding-Jensen O, Hviid H, Grunnet-Nilsson N (2003). Danish Chiropractic, patients
then and now: a comparison between 1962 and 1999. JMPT Feb 2003, Vol 26, No 2, Pages 66-69.
[4] Hartvigsen J, Sorensen L P, Graesborg K, Grunnet-Nilsson N (2002). Chiropractic patients in Denmark:
a short description of basic characteristics. JMPT 2002 Vol 25, No 3, Pages 162-67.

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