•  Home
•  News and Events Home
•  Archived News Releases
•  Campus News
•  Media Coverage
 

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.


Archived News Releases

Back to Campus News

 


Site Map | Calendar | Ask Sherman | News and Events | Accreditation and Licensure | Contact Us
 Copyright © Sherman College of Straight Chiropractic. All rights reserved.
P.O. Box 1452 , Spartanburg, SC  29304   800-849-8771