Dear Colleague:
The SOT Quarterly Research Update is a service
offered by
SOTO-USA to keep doctors who are familiar with
sacro
occipital technique (SOT) aware of the latest
research
related events, papers, and concepts affecting our
practices.
Please contact me directly at drcblum@aol.com if you
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CLINICAL
SYMPOSIUM, October 25-28th, 2007, in Nashville,
Tennessee.
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This current update will focus on research presented at
the recent Portugal International Conference, the New
York Chiropractic College Symposium, and an update
on a new
chiropractic journal in PubMed and available search
engines.
This past May 17-19th, 2007 at the International
Conference on Chiropractic Research in Vilamoura,
Portugal SOT and TMJ related information was
shared internationally to chiropractic researchers.
Developing an awareness of SOT and TMJ care in
the chiropractic research community is important to
help move SOT forward as well as to assist the
formulation of future research
that can help to improve patient care. The
conference was exciting as can be witnessed by the
following abstracts of presentations from Brazil,
Australia and the United States.
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Chiropractic Treatment of Temporomandibular Joint Pain: A Case Series
Priscila Nilson, DC and her colleagues (Chiropractic,
Allopathic and Dental Physicians) from the
Universidade Anhembi Morumbi in Brazil have been
performing research investigating chiropractic care of
the TMJ. Their principal focus is interdisciplinary
treatment with the dental profession, treating patients
presenting with
conditions associated with TMJ dysfunction, and
evaluating their pain and occlusion. They are
furthering
their study with a new control group in order to gain
better statistical significance. The following study is
an
abstract of their presentation from the recent Portugal
Conference
Appiano PRN, Suzuki MA, Kouri M,Depintor JDP,
Fagundes DJ, Bracher ESB. Chiropractic Treatment
of Temporomandibular Joint Pain: A Case Series.
International Conference on Chiropractic Research.
Vilamoura, Portugal - May 17-19, 2007: CM54.
Introduction: Integrated treatment procedures
by dentists and chiropractors may improve outcomes for
this condition. In this study, a protocol for the treatment
of patients with TMJ pain was tested in a series of
patients treated at a university-based center for orofacial
pain.
Methods: Patients with primary TMJ pain for
more than six months were selected for the study at
São Paulo University School of Dentistry Department
of Occlusion and TMJ, Brazil, undergoing an initial
triage by a Doctor of Dental Surgery. Standardized
treatment protocol consisted of four weekly sessions
with the following procedures: cervical and TMJ joint
mobilization; cervical joint manipulation; intra and
extra-oral myofascial release and ischemic
compression of muscles of mastication and cervical
muscles; postural orientation and a home exercise
program.
Results: Eleven patients (10 women and one
man), with an average age of 36.8 years participated
of the study. Pain intensity, measured by the Modified
Chronic Pain Graded Scale (CPGS) revealed a shift
from high-intensity to low-intensity pain between the
beginning and end of treatment (decrease of high-
intensity pain from 63.6% to 18.2%, of patients,
p=0.025). A significant change of mouth opening
range was also observed between the beginning and
end of treatment, from an average value of 37.55 mm
(SD= 11.41) to 42.36 mm (SD=8.04) (p=0.03).
Conclusions: This study showed an
improvement of symptoms and objective measures after
a four-session standardized Chiropractic treatment for
patients with chronic TMJ pain. Comparative studies
with longer follow-up periods are necessary to confirm
the present findings.
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Chiropractic Intraoral Craniomandibular Technique for Migraine
Allan Kalamir, DC from Australia presented three
TMJ related papers at the Portugal conference. Dr.
Kalamir graduated from Macquarie University in
1995 with a Masters degree in Chiropractic and
returned there to pursue his interest in the
chiropractic management of temporomandibular
disorders by working toward a PhD. He is the
consultant lecturer in TMJ orthopedics at Macquarie
University, as well as a senior tutor in diversified
technique. Dr. Kalamir is a member of the prestigious
chiropractic research group MIMG (Macquarie Injury
Management Group). His TMJ research inevitably led
him to SOT, which he now routinely uses in practice
and he would like to see more research conducted
into postural distortion patterns, psychosomatic
reflexes and sacroiliac dysfunction. The following
are three papers he presented at the Portugal
conference:
Kalamir A, Chiropractic Intraoral Craniomandibular
Technique for Migraine. International
Conference on Chiropractic Research. Vilamoura,
Portugal - May 17-19, 2007: CM18.
Two female patients suffering from (at least
fortnightly) chronic classic migraine (migraine without
aura classification 1.1), who were unresponsive to
chiropractic (SMT), physiotherapy, acupuncture and
allopathic medication were assessed and found to
have ADDWR (anterior disc displacement with
reduction) of their TMJs.
A 5 week protocol involving chiropractic soft tissue
myofascial techniques (e.g. Ischemic pressure, PIR).
Aside from improved TMJ biomechanics (ROM), both
patients noted dramatic improvement in their migraine
symptoms over the course of 6 weeks.
It is proposed that chiropractors are well positioned to
address autonomic disturbances that are implicated in
migraine, and that TMJ techniques that are widely
taught should be utilized more often in practice.
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A Randomised Controlled Pilot Study of Chiropractic Craniomandibular Treatment for Chronic TMD.
Kalamir A, A Randomised Controlled Pilot Study of
Chiropractic Craniomandibular Treatment for Chronic
TMD. International Conference on Chiropractic
Research. Vilamoura, Portugal - May 17-19, 2007:
CM14.
30 blinded chronic TMD sufferers were randomized
into 3 groups (control, Rx, and Rx plus self care/
education). Rx intervention involved osseous
adjustments to the TMJs, along with intraoral
craniomandibular soft tissue releases (involving
ischemic pressure, and PIR). No spinal treatment
was performed. Practitioner was blinded to outcomes
and assessor was blinded to group assignment.
Results showed statistically and clinically significant
differences in resting pain, clenching pain, inter-
incisal opening, maximum opening pain between
both Rx groups and control over 6 weeks and
6months. No statistical difference between the 2 RX
groups at this stage. It is proposed that chiropractic
treatment of the masticatory apparatus may be of
benefit in cases of chronic TMD.
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Pronation Associated with Temporomandibular Joint Sounds
Kalamir A, Pronation Associated with
Temporomandibular Joint Sounds., International
Conference on Chiropractic Research. Vilamoura,
Portugal - May 17-19, 2007: SI10.
Two male patients with spinal symptoms (and TMJ
sounds with ADDWR) were assessed and found to
have moderate pronation of their feet. Occasional
chiropractic SMT alleviated their spinal symptoms but
not the TMJ sounds and ROM. Both patients were
fitted with EVA prefabricated arch supports (orthotics)
to address their pronation.
Within 48 hours, both patients noted marked
improvement in their TMJ sounds, TMJ range of
movement normalization, and improvement in spinal
symptoms. Both patients additionally commented that
when they failed to wear the orthotics for more than a
few days, the joint sounds gradually returned, only to
disappear again with days upon reinsertion of
orthotics. It is proposed that orthotics, when indicated,
may be of benefit in managing chronic cases of TMJ
dysfunction.
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Developmental Delay Syndromes and Chiropractic: A Case Report
Blum CL, Cuthbert S, Williams S, Developmental
Delay Syndromes and Chiropractic: A Case Report.
International Conference on Chiropractic
Research. Vilamoura, Portugal - May 17-19, 2007:
CM53.
Chiropractic treatment for developmental delay
syndromes (DDS), while controversial to some, has
growing support in the research literature. Yet at this
time there is no conclusive information on the
causation of DDS. This ultimately leads to some lack
of clarity about treatment options, particularly for
children sensitive to medication or who do not
choose medication as an option.
Patients are actively seeking alternative care, and
particularly care that offers low risk and measurable
benefits should be brought to their attention. Since for
many patients and their families the option of no
treatment for DDS is not an "option," we need to explore
which patients might best respond to conservative
therapies such as chiropractic.
The current evidence supports the premise that some
DDS may be secondary to trauma and related to the
sensory-motor impairment syndrome known as
dyspraxia. While the studies are inconclusive, there
is an emerging evidence base that does show
chiropractic care may be successfully employed in
the treatment of patients with DDS such as dyslexia,
dyspraxia, learning disabilities, and ADHD.
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New York College of Chiropractic - 2nd Annual Symposium
New York College of Chiropractic - 2nd Annual
Symposium "The Art of Chiropractic: A Symposium on
Chiropractic Technique" April 21-22, 2007, New York
City, NY.
New York College of Chiropractic in conjunction with
both the New York Chiropractic Council and New
York State Chiropractic Association presented the
2nd Annual Symposium "The Art of Chiropractic: A
Symposium on Chiropractic Technique" April 21 -
22, 2007 in New York City. A subplot of the whole
conference was the great hope for chiropractic
exhibited by the spirit of unity found between the two
New York State Associations.
The conference was a great success with a packed
room full of chiropractors receiving up to date
research as well as being introduced to some
chiropractic techniques with a focus on evidenced
based practice. The keynote speakers were Anthony
Rosner, PhD, Kimberly S. Brown, DC and Gerald
Clum, DC with the invited symposium presenters
being Frank Nicchi, DC and Scott Surasky, DC
(Flexion/Distraction), Charles Blum, DC (Sacro
Occipital Technique), Mark Charrette, DC (Diversified
and Extremity Adjusting), Peter Lope, DC
(Chiropractic Biophysics), Greg Bruno, DC (Graston
Technique), and Gary Deutchman, DC (Scoliosis
Treatment).
The sacro occipital technique (SOT) presentation
focused primarily on how chiropractic might develop
greater interdisciplinary relationships with allied
health professions such as allopathy and dentistry.
Visceral mimicry syndrome is a condition where the
somatic nervous system or myofascialskeletal
imbalance creates a pain syndrome that closely
resembles visceral referred pain patterns. In some
studies it was reported that this may occur 10-15% of
the time and indicates a need for developing a close
working relationship between allopathy and
chiropractic.
Two case histories were presented one that treated a
patient with a history of angina by SOT protocols who
had sacroiliac joint hypermobility (category two) and
cervical spine imbalance and another a patient post
gallbladder surgery with persisting pain that
responded to SOT visceral reflex treatment called
CMRT (chiropractic manipulative reflex technique).
Algorithms were discussed that provided similar type
cases cautiously having allopath oversight while
incorporating a trial of chiropractic care in non-acute
cases. Of great interest was research that illustrated
how sometimes visceral dysfunction can produce
somatic symptoms and conversely how somatic
dysfunction can produce visceral mimicry syndromes.
Also discussed was how chiropractic treatment might
reduce visceral referred pain patterns yet not affect
the visceral dysfunction.
Interdisciplinary relationships with dentistry for the
co-treatment of temporomandibular joint dysfunction
(TMD) were also presented in the SOT section. For
too long dentists and chiropractors have been
treating TMD (temporomandibular disorders)
independently, and successful integration of dentistry
and chiropractic care involves understanding that: (1)
The body functions as a closed kinematic chain and
effecting one part will have a cascade of effects
throughout the musculoskeletal system from head to
toe. (2) There are postural imbalances that travel
superiorward towards the TMJ called ascending
patterns and postural imbalances that travel
inferiorward from the TMJ called descending
patterns.
The New York Chiropractic College (NYCC)
conference organized by Thomas Ventimiglia, DC
focused on research, evidenced based practice,
chiropractic technique, and developing
interdisciplinary relationships. NYCC has multiple
interdisciplinary centers to help train students in both
evidenced based practice and how to work with
allied healthcare practitioners. So the camaraderie
and sharing amongst the presenters and doctors in
attendance provided anticipation for the next
symposium in the upcoming year which will help to
further lead the chiropractic profession into the 21st
Century.
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Sacro Occipital Technique Organization - USA is a
non-profit,
professional organization formed to promote the
awareness,
understanding and utilization of the Sacro Occipital
Technique
method of chiropractic as founded and developed by
Dr.
Major Bertrand DeJarnette.
The SOTO-USA family all looks forward to seeing you
in
Nashville for October 25-29th,
2007 Clinical
Symposium. It will be a great opportunity learn the
essence of SOT or advance your SOT training with
integrative classes in SOT, CMRT, and Cranial.
For those interested in working with the dental
profession
treating TMD then this symposium will be leading the
way.
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