CAMPUS NEWS
FOR
IMMEDIATE RELEASE
03/14/01
Shaping the Future of Chiropractic Research:
Sherman College Faculty and Students Subject
Subluxation Concept to Contemporary Scientific
Study
MARCH 14, 2001 - Throughout much of
chiropractic’s history, the idea of applying
formalized, scientific research techniques to
the study and validation of chiropractic
principles was seen as almost at odds with the
vitalistic philosophy upon which the field was
developed. Many in the young profession did not
want to see chiropractic shoe-horned into a
medical model of study. Long-time practitioners
learned from mentors and knew from direct
experience how to find and correct vertebral
subluxations and witnessed for themselves the
changes in their own and in their patients’
lives when interference to the nervous system
was removed. But as chiropractic has grown in
public use and acceptance, it has also come
under greater scrutiny and demand to build
evidence for the philosophies and tenets on
which it is based.
There is a perception within the profession, I
think, that vertebral subluxation-centered
chiropractic is not evidence- or science-based
and that it does not lend itself to critical
study,” asserts Edward Owens, M.S, D.C., Sherman
College director of research. “We are so
accustomed to thinking in terms of the
traditional medical model that relies on
studying the body as a machine made up of
separate parts and of treating specific
conditions with new procedures and drugs and
watching for changes in those conditions. It is
difficult for many people to even conceive of
conducting true chiropractic research that
focuses on quality of life, preventive care and
maintenance care,” Owens says.
A major goal of the research program at Sherman
College is to demonstrate that it is possible to
study the elements of vertebral subluxation in a
scientific setting and to use contemporary,
objective research techniques to test and gain a
better understanding of many of the precepts
espoused by straight chiropractic philosophy.
“We are making great progress in modernizing our
approach to chiropractic research and developing
unique methods of studying and validating
subluxation theory. We are trying to bring out
the straight chiropractic view, as opposed to
using a therapeutic approach,” Owens says.
New Paradigm
One of the greatest challenges to enhancing
vertebral subluxation-centered research is the
same one often encountered in straight
chiropractic - it requires breaking new ground
and developing whole new approaches to
scientific research. “Straight chiropractic does
not fit with the prevailing biomedical approach
to research,” says Owens. “In traditional
biomedical research you look at and measure
symptoms and conditions. You then apply a
particular therapy and gauge whether the
condition got better or worse. Those methods
don’t fit when you are trying to measure quality
of life, performance and health maintenance,” he
says.
Even if you look at other chiropractic research,
it almost always revolves around conditions -
how chiropractic impacts low back pain or
sciatica or even asthma. As straight
chiropractors we don’t treat diseases and
conditions, so of course we don’t want to study
that approach either. We want to know how
removing nerve interference enhances life
expression,” Owens asserts.
The most important and exciting aspect of our
research agenda at Sherman College is that we
are truly breaking new ground,” says Brian J.
McAulay, D.C., Ph.D., interim president. “We are
developing entirely new approaches to
health-oriented research and establishing
scholarship priorities that reflect the
vitalistic principles of straight chiropractic
philosophy.”
Because the Sherman College research program is
built around a different paradigm of health and
performance than traditional medical models, the
researchers have to develop ways to study a
whole different set of questions than
traditional biomedical research poses and
answers. They must also search for new sources
of funding. “The existing public and private
funding agencies for health research all tie in
with the condition-related model,” Owens
explains.
The Sherman College research program includes
exploration of the subluxation concept,
measuring the impact of regular chiropractic
care on human performance and quality of life,
searching for better methods of locating and
assessing vertebral subluxations, and evaluating
the efficacy of existing analysis and adjusting
techniques and the circumstances under which
particular techniques might work best.
Research Projects Enhance Student Learning
In addition to furthering faculty understanding
of straight chiropractic and contributing to the
advancement of the profession, the college’s
research program enhances students’ learning
experiences by involving them in hands-on
discovery and scholarship. “Several students
hold formal work-study positions in the Research
Department,” explains Owens, “but any student
can become involved in a research project. All
it takes is enthusiasm and interest.”
All students complete at least one research
course that introduces them to concepts and
tools for conducting research and helps them get
started on a life-long, self-directed search for
information. “Students won’t always have their
faculty mentors around to answer questions,”
Owens says. “It’s important that future
graduates gain the skills for finding answers to
questions on their own.” Numerous elective
courses are also available to give students
advanced training in research and allow them to
develop and carry out their own project with
faculty support. Thirteenth-quarter student Mike
Johnson is currently completing a research
externship through which he will conduct a
project of his own design in his field doctor’s
office.
Current Research Projects
Sherman College faculty and students are
currently pursuing four major research
initiatives. Each reflects elements of the
college’s curriculum, as well as faculty
interests and strengths. When faculty develop a
concept for a research project, Owens serves as
a mentor and helps them refine the question they
hope to explore and develop a valid study that
will help answer it. He also helps faculty and
students organize and design the study and
secure the tools and equipment to carry it out.
Once data is collected, Owens provides
statistical advice and tools and assists with
data analysis. Finally, he serves as editor of
all studies written for publication.
Prone Leg Check
Conducted by Alan Hartley, Ph.D., D.C.,* dean of
clinical sciences, and Sherman College graduates
Leigh Charley and Tony Southwell
Hartley, Charley and Southwell have been working
to identify factors that can influence or
interfere with the accurate interpretation of
the prone leg check. Through the study, the
college is exploring how much outside variables
contribute to changes in results. Practitioners
use the prone leg check, or leg length
inequality, to look for asymmetry in the
neuromuscular tone of the body, which might
indicate the presence of vertebral subluxation.
In the leg check, the chiropractor has the
patient move his head or flex his legs in
various ways and looks for changes in the
balance of the legs. Although chiropractic
literature includes several studies that assess
intra and interexaminer reliability of the prone
leg check, little has been done to describe and
standardize the test in postural leg checks.
The reliability of the leg check is greatly
lowered by spontaneous changes that might be
occurring at the same time as the check,”
explains Hartley. “So many other factors can
confuse the information you get from a leg
check. The practitioner might not perform it
exactly the same way each time. The legs seem to
change by themselves sometimes.” He calls such
changes “noise” because they act like static
that interferes with an accurate and reliable
reading. The goal of this study is to identify
the producers of such “noise” and evaluate how
much they contribute to changes in results.
Hartley, Charley and Southwell explored such
issues as the level of consistency of clinicians
in their application of force, the consequences
of asymmetrical application of force, and
correlations between the side of the short leg
and the dominant handedness of the doctor.
To date, Hartley, Charley and Southwell have
completed the first phases of their study and
drawn several conclusions. They found that some
doctors seem to have a bias toward finding a
short leg more often on one side than the other,
which reduces their ability to agree with other
doctors’ findings. They also failed to find
evidence for a relationship between the side of
the short leg and a tendency for foot inversion
on the same side, a concept that is often taught
in technique protocols.
In the next phases of the study the researchers
will search for ways to standardize the leg
checking procedure, looking at how doctors judge
leg length and how much force they apply during
a standard leg check.
Pattern Analysis
Conducted by John Hart, D.C., associate
professor of clinical sciences, and Edward
Owens, M.S., D.C., director of research
Paraspinal temperature readings and analysis of
the patterns created by comparing several
readings over time are frequently used to
determine the presence of subluxation. Pioneered
by B.J. Palmer, the theory behind the approach
holds that, because the nervous system is
reacting and adapting to its internal and
external environment all the time, the normally
functioning system is dynamic. When an
individual is not subluxated, therefore,
paraspinal temperature readings would vary
throughout the day and from day to day. So
little or no pattern would exist in ongoing
temperature readings.
Palmer surmised that the nervous system of an
individual who exhibited a clear pattern over
several different sessions was “stuck” in one
mode of operation or reaction and was not
functioning as a dynamic system. Therefore, the
presence of such a pattern would suggest that
the individual is subluxated. Generally, if a
practitioner observes a pattern on three
successive visits, he or she will adjust and
then watch for changes in future readings. If
the pattern changes or becomes random, it is an
indication that the nerve system is again
functioning in a dynamic way.
As part of this study of the effectiveness of
pattern analysis in predicting subluxation, the
researchers wanted to be able to provide an
objective measure of how similar patterns were
from reading to reading. Owens wrote a unique
software program to calculate the congruence (or
agreement) among various patterns and to provide
an objective measure of the similarity of
patterns taken at different times. “The software
takes the guesswork out of the process and
provides a reliable number that represents a
degree of similarity among various readings,”
Owens explains. “This provides us with more
accurate and helpful information because the
software measures the variance in objective
terms without human interference. It also
provides us with a degree of variance. That’s
much more useful than a simple yes or no type of
answer.” It’s still too early in the study,
however, to say how the numerical readings
should be interpreted, Owens asserts. “We need
to better understand the range of results and to
develop thresholds and cut-offs for readings to
be able to say what types of results suggest
when adjustment is indicated.”
Next steps include comparing the scales to the
readings of experts who are accustomed to
interpreting thermograms. “We want to see if the
results from the software will agree with
doctors’ interpretations of patterns,” Owens
said. As the researchers test the results and
determine if they are reliable, they will next
need to determine if they are valid. “Once we
are certain the software is reliable, we will
compare our results to other subluxation
detection methods to see if the pattern readings
are an accurate indicator of subluxation,” he
says.
Twelfth-quarter student Torsten Stein works with
Owens and Hart as a research assistant and has
received co-authorship on several articles. “I
helped Dr. Owens test his pattern analysis
program by applying it on test files generated
from mathematical formulas and calculating the
slope of developed curve tangents,” Stein says.
“The program passed all its tests and is
definitely capable of analyzing patients’
patterns. This program helps take pattern
analysis as we know it to the next level.”
Hart teaches instrumentation classes at Sherman
College and is introducing this new technology
into his courses. The research team is currently
fine-tuning the comparison and plans to follow a
group of patients to assess their temperature
patterns over a period of time.
Muscle Palpation
Conducted by Joseph Donofrio, D.C., assistant
professor of clinical sciences
Muscle palpation was expanded and refined at
Sherman College as a subluxation detection
technique, and Donofrio currently teaches muscle
and motion palpation at the college. The concept
behind it holds that a vertebral subluxation
creates an asymmetry in local muscle tone. The
muscle fibers around a vertebral subluxation
will have a greater degree of tension in them
because they are working to correct the
subluxation.
Donofrio’s research focuses on attempting to
define how reliable muscle palpation is in
identifying subluxated vertebrae. “Muscle
palpation is a highly subjective art that
requires a high degree of sensitivity to changes
in muscle tension on the part of the
chiropractor,” Donofrio says. “We are studying
the approach to determine how much the findings
of various practitioners agree.”
In a preliminary study conducted in the Sherman
College Chiropractic Health Center during Lyceum
1999, researchers found very little agreement in
the findings of several practitioners. Four
doctors were set up with patients in four
isolated locations apart from their colleagues.
Blindfolded, the chiropractors did not know
which patients they were palpating, and they had
no access to the findings of their colleagues.
The findings from one practitioner to another
varied considerably. Further study is needed to
clarify what factors contributed to these
results.
Our next step is to try to determine where the
breakdown in the effectiveness of the technique
occurred,” Owens says. “We need to evaluate if
the set up of the experiment itself made the
task artificially difficult or if the problem
was in performing the assessment itself. We need
to pull apart the results to see if, for
example, the difficulty lies in locating the
structure or in testing to see how much tension
is present.”
Sherman College researchers have recently
designed a follow-up study and secured funding
from the Federation of Straight Chiropractors
and Organizations (FSCO) to compare
practitioners’ abilities to locate structural
landmarks in the cervical area with the findings
of a three-dimensional digitizer. “This study
will enable us to determine if doctors can
reliably locate specific bony structures and the
attachment points for muscles. We will have
doctors locate key structures and then have the
computer track the point of the digitizer to the
same point and plot it. With this technique
we’ll be able to determine if the practitioners
are pointing to the same structure,” Owens
explains. “This will help us understand if part
of the reason for varied findings among
practitioners of muscle palpation is that they
actually aren’t palpating the same locations.”
The FSCO funding will provide valuable support
to the researchers in terms of equipment and
faculty release time.
Owens next plans to measure whether the
chiropractors have a high enough degree of
sensitivity in their fingers to discern hard
versus soft structures. He plans to develop a
“palpometer” to measure relative hardness and
softness in spinal structures. “If we do
eventually determine that the problem lies in
applying the technique correctly, we would need
to evaluate how the technique is taught and
develop ways to improve it,” he says.
Maintenance/Wellness: Applications of
Subluxation-Centered Care
Conducted by Brian J. McAulay, D.C., Ph.D.,
interim president, Edward Owens, M.S., D.C.,
director of research, and Robert Irwin, D.C.,
instructor in clinical sciences
A key question facing straight chiropractic is
how to determine the impact subluxation
correction has on health, performance and the
expression of potential. McAulay, Owens and
Irwin are developing a network of practicing
chiropractors to help carry out a major study of
people under regular care. Using highly regarded
and tested surveys, they want to measure the
impact of regular maintenance care on general
health and quality of life.
One of our goals is to conduct a true
longitudinal study through which we will survey
the same people over a time span of several
years,” McAulay explains. “This study has the
potential to be groundbreaking. This is the type
of project where we are functioning in a whole
different paradigm than traditional biomedical
research. If we can show a positive relationship
between vertebral subluxation-centered care and
better function and performance, it would have a
profound impact on the progress and growth of
our profession,” McAulay says. The study will
measure the impact of vertebral subluxation
correction on issues such as life satisfaction
and physical performance.
For the study to be successful, however, the
researchers must rely on the participation of a
cadre of chiropractors in the field who will
distribute the surveys to their patients and
share the data with them. “We don’t ask much
more from the doctors than that they
consistently give the surveys to their patients
and ask them to complete them. But we have to
have access to large numbers of patients to
ensure the results are meaningful and reliable,”
McAulay explains. “We also need to work with
chiropractors who promote a maintenance approach
to chiropractic and have significant numbers of
patients who have been under care for several
years.”
Robert Irwin, D.C., instructor in clinical
sciences, recently joined the research staff on
a part-time basis to spearhead the development
of a network of practitioners for this study.
Doctors who are interested in participating in
this important study should contact Irwin at
Sherman College at rirwin@sherman.edu or at
800-849-8771, extension 1238. Owens, McAulay and
Irwin are developing a training program to help
doctors and their staff members utilize the
surveys in their offices. Training will be
conducted on campus during Sherman College
Lyceum 2001.
As Sherman College looks to the future of the
profession, we believe that exploring the impact
of vertebral subluxation correction on human
health and performance could have a significant
influence on the use and acceptance of ongoing,
meta-therapeutic chiropractic care,” explains
McAulay. “As the only institution in the world
that trains straight chiropractors, we have a
crucial role to play in advancing the body of
knowledge of our profession. It is important for
Sherman College to be at the forefront of
chiropractic scholarship, holding our own
philosophies, theories and techniques up to the
rigorous examination of objective study,” he
says.
Owens plans to continue to expand the college’s
research program by encouraging more involvement
from a broad range of individuals at different
levels of participation. He explains that
practicing chiropractors can help promote
research in the field by providing confidential
access to patients who might be willing to
participate in studies and by submitting case
studies for research and teaching uses. “We also
need practitioners to become more involved by
supporting research through financial
contributions and even simply by reading and
reacting to published research in the field,”
Owens asserts. On campus, the Sherman College
Research Department will continue to support and
encourage student and faculty participation in
original research projects.
I am very proud of the level of productivity in
our research department, the broad-based
involvement of our faculty and students in
conducting original research and our leadership
in developing entirely new approaches to
chiropractic research,” McAulay says. “Sherman
College is the institution that must advance the
straight chiropractic profession, and conducting
meaningful research is one strong way to
accomplish that goal.”
*Hartley recently relocated to the Charlotte,
NC, area and plans to open a private practice
there.
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