March 2006 
 SOT Quarterly Research Update - Supplemental Edition
News from ACC/RAC 2006
SOT Events
SOT Related Research Information
Research Conferences
Research Search Engines
Dural Connection Internet Edition
SOT and Chiropractic Research Lists
International SOT Events
SOT and SOT Cranial Events



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Dear Colleague:

The theme of this year’s ACC/RAC Conferences (Association of Chiropractic Colleges / Research Agenda Conference) was multidisciplinary collaboration and integrative treatment. Some of the goals involved sharing how chiropractors are working in integrative arenas such as in hospital settings, military health centers, and developing new and innovative possible models such as Cleveland Chiropractic College – Los Angeles’ current building relationship with University of Southern California’s student medical health center. Ultimately the question is, “What is in the best interest of the patient?” While in typical chiropractic clinical practice we are not dealing with life threatening conditions, this is not the case when treating patients in a hospital setting or for that case for the treatment of various types of visceral mimicry syndromes. A model will be shared, following this introduction, that addresses a possible scenario for medical chiropractic collaborative efforts. One goal of Sacro Occipital Technique Organization (SOTO) – USA is to foster multidisciplinary intercommunication as exemplified by our yearly clinical symposium.

While there were many wonderful platform and poster presentations at this RAC/ACC conference I will share a few I think might particularly be of interest to practitioners using (sacro occipital technique) SOT related techniques. Three papers were accepted that had a relationship to the SOT world. All the abstracts from this recent conference are listed in the Journal of Chiropractic Education, Spring 2006 issue, I am included two case histories and a qualitative systematic analysis on the relationship between cervical disc related MRI findings with asymptomatic subjects.

Please contact me directly at drcblum@aol.com if you are aware of others who might be interested in receiving this quarterly newsletter. If you didn't receive the first Research Update please let me know.

 Angina visceral mimicry syndrome: A proposed collaborative integrative treatment model
 Blum CL, Globe G, Journal of Chiropractic Education, Spr 2006;20(1): 51-2.

In this paper it discussed tangentially a case history of a patient presenting with a history of multiple heart catheterizations for evaluation and treatment of persistent angina. The patient was seen for chiropractic (SOT) treatment for chronic cervical spine pain. When his pain was resolved following 2 office visits it was believed that he had what has been recently described in the literature as cervicothoracic angina, a type of visceral mimicry syndrome. Mimicry syndromes are neuromuscular syndromes which resemble the visceral pain patterns associated with visceral dysfunction. Some studies suggest that 15% or greater of the visceral related pain syndromes are not related to visceral disturbances. A question might be, "How can a medical doctor minimize extensive tests and medication, yet protect a patient suspected with an angina mimicry syndrome?" This study offers an algorithm which protects the patient, has the cardiologist in constant overview of the case, and in the absence of positive cardiological instrument findings avails the patient to a trial period of chiropractic care to rule out cervicothoracic angina.

Angina visceral mimicry syndrome: A proposed collaborative integrative treatment model 


 Patient preference for wellness care: Is it on the menu?
 Blum CL, Globe G, Mirtz TA, Greene L, Journal of Chiropractic Education, Spr 2006;20(1): 53-4.

In this study SOT chiropractors were contacted through the internet to be part of a survey evaluating patient’s preferences for seeking care at their office. Over 1,300 single patient responses were gathered from the United States, Europe and Australia. Of significance is that recent studies of patient preferences have found that 6-10% of patients seek a chiropractor for wellness care. While the survey of SOT doctors was evaluating patients seeking care for the first time as well as ongoing patients, the findings of the study indicated that over 42% of the SOT patients sought care not related solely for pain relief. The point of the paper focused on the question, “If all the doctor is offering is pain relief treatment why would the patient ever suspect that wellness care is an option?” It was postulated that SOT doctors have both a “pain relief” and “wellness” paradigm which fits a wellness model for patient care and that other chiropractic techniques might benefit from this model. It is noteworthy that SOT doctors tend to focus on how quickly a patient will respond to SOT care and generally are not focusing on long-term frequent-visit type management programs.

Patient preference for wellness care: Is it on the menu? 


 The Effect of Sacro Occipital Technique Category II Blocking on Spinal Ranges of Motion: A Case Series
 Hochman JI, Journal of Chiropractic Education, Spr 2006;20(1): 69.

Dr. Hochman presented a paper at this conference relating to lumbar range of motion and category two supine block placement. This treatment is commonly used to treat sacroiliac joint hypermobility associated with a pelvic torsion syndrome. While SOT doctors might find increasing range of motion with a pelvic adjustment to be a “matter of fact,” there are not many studies that address this phenomena, and with regard to SOT prior to this study, there were none. The goal of the study was to evaluate range of motion in the cervical and lumbar regions following category two supine pelvic block placement. While this pilot study used only 5 subjects the results were significant for the increase in lumbar range of motion in all motions except extension and did not show any appreciable change in cervical ranges of motion. This may indicate that greater pelvic stability subsequent to supine block placement might diminish lumbar muscular excitation or facilitation.

SOT Category II Blocking on Spinal ROM 


 Interesting Case Histories from ACC/RAC
 

There are quite a few interesting case histories presented at the RAC/ACC conferences but due to space limitations I have singled out two that I think might be of interest. These two case histories presented at this conference are believed to be of particular interest to SOT doctors since they might commonly treat low back pelvis conditions as well as severe headaches or cranial neurological dysfunction. Case #1 is about Renal Cell Carcinoma and case #2 relates to severe headaches due to Intracranial Aneurysm.

 


 A case study of back and renal cell carcinoma
 Rectenwald R, Mathew MBK, Journal of Chiropractic Education, Spr 2006;20(1): 41.

Of significance is that renal cell carcinoma is generally an incidental finding occurring during extensive imaging studies or autopsy. By the time the condition is recognized often it can be fairly advanced with osteolytic or metastatic proliferation. In this study a patient presented with back pain along with related expected radiological and orthopedic neurological findings. The chiropractor found that following a few atlas orthogonal treatments the patient's low back pain decreased and radiographic analysis showed better vertebral biomechanical positioning, however one of the patient’s presenting symptoms, knee weakness, was worsening.

Some common findings prevalent with patients presenting with a renal cell carcinoma include a history of cigarette smoking, exposure to diesel fuel fumes, hypertension, and obesity. Recreational exercise was shown to reduce the risk, whereas a Western-style diet increased the risk. Red flags (reasons for extreme clinical concern) can often be found with patients who following treatment have improvement with some presenting complaints and worsening of another, which does not make sense clinically. These incongruous finding should alert the doctor that further studies are warranted along with a possible need to refer for co-treatment and evaluation.

Renal cell carcinoma: etiology, incidence and epidemiology 


 Headache due to intracranial aneurysm: A case stud
 Larkin-Their S, Livdans-Forret A, Journal of Chiropractic Education, Spr 2006;20(1): 77.

The point of this case history is to point our some “red flags” regarding any patient that might present with a headache to a chiropractor’s office and then to discuss this case history’s specific “red flags.” Generally a doctor should always be concerned when a patient presents with a headache and has a history of hypertension, cigarette smoking, oral contraceptive use, alcohol consumption, pregnancy, and use of cocaine. With this specific patient she presented with a few other specific red flags. She said this was the “worst headache she has ever had,” noted that her headache affected her whole head and centralized at the base of her occiput, and had some unilateral eye deviation.

With any patient presenting with these red flags a clinical evaluation should be performed, no adjustment should be rendered and immediate transfer for emergency care needs to be arranged. Please see the following link for a very helpful PowerPoint program on cervical manipulation and cerebrovascular events, how to predict them, and what you as a doctor can and should do. This PowerPoint program was produced by Dr. Gerald Clum, President of Life West Chiropractic College.

Cervical Spine Adjusting and the Vertebral Artery: Contemporary perspectives on patient safety and protection, clinical reality and patient management 


 Applied Kinesiology in Chiropractic
 Zhang J, Hambrick T, Conable K, Journal of Chiropractic Education, Spr 2006;20(1): 112-3.

The purpose of this study was to investigate important factors that affect the practice of applied kinesiology (AK) in chiropractic care. Various research questions were explored in a survey of 147 AK practitioners. One aspect of the survey inquired about their attitude towards muscle testing and future research.

While in orthopedic neurological circles muscle testing is considered a valid approach to test the function of traumatized or dysfunctional muscles or joints as well as neurological deficits, AK attempts to use the muscle test as a window into body function. Therefore clarity is needed of how a muscle test is performed by each clinician.

Some survey questions investigated how AK practitioners used doctor-initiated, patient-initiated, and simultaneous muscle testing in patient care. These types of intricacies about muscle testing are not readily found in the orthopedic neurological literature and require AK doctors to do more study into whether it matters who initiates a muscle test and relate their findings to clinical outcomes.

Applied Kinesiology in Chiropractic 


 International Research Conferences - Abstract Deadline Schedule
 See left side for direct conference links

European Chiropractic Union Annual Convention - May 25-27, 2006 - Stockholm, Sweden: Abstract Deadline February 15, 2006 (past due date)

The Conference on Chiropractic Research - September 15-16, 2006 - Chicago, IL: Abstract Deadline March 31, 2006

WFC/ACC Conference on Identity - October 26-28, 2006 - Cancun, Mexico: Abstract Deadline June 30, 2006

International Research and Philosophy Symposium - November 3-5, 2006 - Spartanburg, SC: Abstract Deadline April 28, 2006

ACC/RAC Association of Chiropractic Colleges / Research Agenda Conferences - March 15-17, 2007 - To be Announced: Abstract/Paper Deadline August 21, 2006 (author signatures) - August 25, 2006 (paper submission)

WFC/FCER International Conference on Chiropractic Research (formerly ICSM) - May 17-19, 2007 - Vilamoura, Portugal: Abstract Deadline December 31, 2006

6th Interdisciplinary World Congress on Low Back & Pelvic Pain - November 7-10, 2007 - Barcelona, Spain: Abstract Deadline To be Announced

 


Next year we hope to have more studies shared at the ACC/ RAC conferences that help illustrate what is commonly taking place in SOT doctor’s offices. Regretfully until it is published and/or shared at a research conference it isn’t research and our scientific community doesn’t really care about any anecdotal clinical story. Please know that if I can ever help you with a SOT research project I am only an email away.

Thank you for your dedication and interest


Charles Blum
Sacro Occipital Technique Organization - USA

phone: 310-392-9795
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