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Never-ending Auriculotherapy Research

Tuesday, April 25th, 2017

Auriculotherapy to reduce anxiety and pain in nursing professionals: A randomized clinical trial.

Rev Lat Am Enfermagem. 2017 Apr 6;25 - Kurebayashi, Turrini, Souza, Marques, Rodrigues, Charlesworth.

https://www.ncbi.nlm.nih.gov/pubmed/28403335

Objectives: To evaluate the effectiveness of the auricular protocol (APPA) in reducing pain and anxiety and improving the quality of life of the nursing staff of a hospital.

Method: Randomized clinical trial with an initial sample of 180 professionals divided into 4 groups Control (G1), Seed (G2), Needle (G3) and Tape (G4). The evaluation instruments were the State-Trait Anxiety Inventory, Pain Visual Analog Scale and Quality of Life instrument, applied at the start and after five and 10 sessions (five weeks).

Results: There was a statistical difference (p < 0.05) for anxiety according to the repeated measures ANOVA, with better results for the G3 in the final assessment. There was a reduction of pain of 36% in G3 and 24% in G2 and a 13% increase in the mental aspect of quality of life for the G3, although without statistical significance.

Conclusion: The APPA protocol reduced the anxiety levels of nursing staff after 10 sessions…

Auricular Acupuncture Analgesia in Thoracic Trauma: A Case Report.

J Acupunct Meridian Stud. 2017 Jan;10(1):49-52. Papadopoulos, Tzimas, Liarmakopoulou, Petrou.

https://www.ncbi.nlm.nih.gov/pubmed/28254102

We report a case of thoracic trauma (rib fractures with pneumothorax and pulmonary contusions) with severe chest pain leading to ineffective ventilation and oxygenation. The patient presented to our emergency department. The patient had chronic obstructive pulmonary disease and was completely unable to take deep breaths and clear secretions from his bronchial tree. After obtaining informed consent, we applied auricular acupuncture to ameliorate pain and hopefully improve his functional ability to cough and breathe deeply. Within a few minutes, his pain scores diminished considerably, and his ventilation and oxygenation indices improved to safe limits. Auricular acupuncture analgesia lasted for several hours. Parallel to pain reduction, hemodynamic disturbances and anxiety significantly resolved. A second treatment nearly a day later resulted in almost complete resolution of pain that lasted at least 5 days and permitted adequate ventilation, restored oxygenation, and some degree of mobilization (although restricted due to a compression fracture of a lumbar vertebra). Nonopioid and opioid analgesics were sparsely used in low doses during the entire hospitalization period. Hemodynamic alterations and anxiety also decreased, and the patient was soon ready to be discharged.

Effects of Auricular Acupressure Therapy on Stress and Sleep Disturbance of Middle-Aged Women in South Korea.

Holist Nurs Pract. 2017 Mar/Apr;31(2):102-109. Cha NH, Park YK, Sok SR.

https://www.ncbi.nlm.nih.gov/pubmed/28181975

This study sought to examine the effect of auricular acupressure therapy on the stress and sleep status of middle-aged women in South Korea. A quasi-experimental pre-test/post-test control group design was employed. The study sample consisted of 67 middle-aged women (experimental: 35 samples; control: 32 samples) in Seoul, South Korea. Auricular acupressure therapy including the auricular acupressure needle on the skin paper tape was applied on an ear for 2 weeks, 2 times per week. The acupoints were Gyogam, Sinmun, Bushin, Naebunbi, and Pijilha. For the placebo control group, only the skin paper tape without the auricular acupressure needle was applied on the same acupoints. Measures were a stress scale, cortisol level in blood, and a sleep status scale. The findings showed that there were significant differences on stress, cortisol level in blood, and sleep status. Health care providers should consider providing auricular acupressure therapy as an alternative method for reducing physical and psychological stress, cortisol level in blood, and sleep disturbance…

Effects of auriculotherapy on labour pain: A randomized clinical trial.

Rev Esc Enferm USP. 2016 Sep-Oct;50(5):726-732. Mafetoni RR, Shimo AK.

https://www.ncbi.nlm.nih.gov/pubmed/27982389

OBJECTIVE: Assessing the effects of auriculotherapy in pain control and its outcomes on the duration of labour.

METHOD: This is a randomized, controlled, double-blind trial with preliminary data. Thirty pregnant women with gestational age ≥ 37 weeks, cervical dilatation ≥ 4 cm and two or more contractions in 10 minutes were selected and randomly divided into three groups: auriculotherapy, placebo and control. Auriculotherapy was applied using crystal beads on four strategic points.

RESULTS: No statistical significance was found between the groups with regard to pain; however, the women from the auriculotherapy group had lower intensity and less perception of pain at 30, 60 and 120 minutes of treatment. The average duration of labour was shorter in the auriculotherapy group (248.7 versus placebo 414.8 versus control 296.3 minutes); caesarean section rates were higher in the placebo group (50%) and the same in the other groups (10%).

CONCLUSION: Mothers who received auriculotherapy presented a tendency for greater pain control and shorter labour duration; however, caesarean section rates in this group were similar to the control group. This trial precedes a larger study in progress.

Combined Acupuncture and Auriculotherapy in Burning Mouth Syndrome Treatment: A Preliminary Single-Arm Clinical Trial.

J Altern Complement Med. 2017 Feb;23(2):126-134. Franco FR, Castro LA, Borsatto MC, Silveira EA, Ribeiro-Rotta RF.

https://www.ncbi.nlm.nih.gov/pubmed/27585312

BACKGROUND: Burning mouth syndrome (BMS) is a chronic pain disorder that is difficult to diagnose and refractory to treatment; it is more prevalent in pre- and postmenopausal women. Acupuncture and auriculotherapy have been suggested as options for the treatment of pain because they promote analgesia and allow for the reduction of symptoms with lower doses of drugs; this leads to greater patient compliance with treatment and has a positive effect on quality of life. Clinical trials investigating the effectiveness of acupuncture in the treatment of BMS are scarce in the literature.

OBJECTIVE: To investigate the effect of combined acupuncture and auriculotherapy on pain management and quality of life in patients with BMS.

METHODS: Sixty patients with BMS were subjected to a thorough differential diagnosis. Of these, 12 met the inclusion criteria and agreed to participate. Eight patients completed treatment with acupuncture and auriculotherapy using a previously established protocol. The outcome variables were analyzed before and after treatment: pain/burning (visual analog scale; VAS), salivary flow (unstimulated sialometry), and quality of life (Short-Form Oral Health Impact Profile [OHIP-14]). Two-year follow-up was carried out by assessing VAS and OHIP-14.

RESULTS: The intensity of pain/burning decreased significantly after the first treatment sessions, as shown by low values on the VAS (0-2) and a subjective indicator of quality of life. There was no relationship between salivary flow and the intensity of pain/burning. At 2-year follow-up, no statistically significant difference was observed for VAS, but improvement on OHIP-14 was seen.

CONCLUSIONS: Combined acupuncture/auriculotherapy was effective in reducing the intensity of burning and improving quality of life. There was no relationship between salivary flow and the intensity of burning mouth. Patients’ status improved after acupuncture and auriculotherapy at 2-year follow-up.

Auricular Acupuncture Versus Progressive Muscle Relaxation in Patients with Anxiety Disorders or Major Depressive Disorder: A Prospective Parallel Group Clinical Trial.

J Acupunct Meridian Stud. 2016 Aug;9(4):191-9. de Lorent L, Agorastos A, Yassouridis A, Kellner M, Muhtz C.

https://www.ncbi.nlm.nih.gov/pubmed/27555224

Although acupuncture treatment is increasingly in demand among psychiatric patients, to date no studies have investigated the effectiveness of auricular acupuncture (AA) in treating anxiety disorders or major depressive disorder. Thus, this study aimed to compare the effectiveness of AA versus progressive muscle relaxation (PMR), a standardized and accepted relaxation method. We examined 162 patients with a primary diagnosis of anxiety disorder or major depressive disorder, and each patient chose between treatment with AA, executed according to the National Acupuncture Detoxification Association protocol, and treatment with PMR. Each group had treatments twice a week for 4 weeks. Before and after treatment, each participant rated four items on a visual analog scale: anxiety, tension, anger/aggression, and mood. Statistical analyses were performed with the original visual analog scale scores and the Change-Intensity Index, an appropriate indicator of the difference between two values of a variable. Our results show that treatment with AA significantly decreased tension, anxiety, and anger/aggression throughout the 4 weeks, but did not elevate mood. Between AA and PMR, no statistically significant differences were found at any time. Thus, we suggest that both AA and PMR may be useful, equally-effective additional interventions in the treatment of the above-mentioned disorders.

A case series of auricular acupuncture in a veteran’s population using a revised auricular mapping-diagnostic paradigm (RAMP-uP).

Complement Ther Med. 2016 Aug;27:130-6. Huang W, Halpin SN, Perkins MM.

https://www.ncbi.nlm.nih.gov/pubmed/27515887

OBJECTIVES: To evaluate clinical effects of auricular acupuncture treatments for pain based on a revised auricular mapping and diagnostic paradigm (RAMP-uP).

MAIN OUTCOME MEASURES: Pain and efficacy rating scores based on visual analogue scales during each clinical visit. Duration of acupuncture treatment effects based on clinic notes documentation.

RESULTS: Patients’ average pain score decreased by almost 60% (p<0.0001). The treatment effects lasted 1-3 months (47%). The overall efficacy reported by most patients was helpful (83.6%).

CONCLUSION: The observed clinical effects of auricular acupuncture based on RAMP-uP are promising. Further research is needed to assess its feasibility to generalize and generate clinical effects in randomized controlled clinical trials.

The effect of auricular acupressure on nausea and vomiting caused by chemotherapy among breast cancer patients.

Complement Ther Clin Pract. 2016 Aug;24:189-94. Eghbali M, Yekaninejad MS, Varaei S, Jalalinia SF, Samimi MA, Sa’atchi K.

https://www.ncbi.nlm.nih.gov/pubmed/27502820

OBJECTIVE: The aim of this study was to determine the effect of auricular acupressure in relieving nausea and vomiting among the women who received chemotherapy.

METHODS: 48 women suffering from Breast Cancer and receiving chemotherapy were recruited for the study. The patients were randomly assigned into two groups of experiment and control. In the initial phase of chemotherapy, the experimental group received standard medications to control nausea and vomiting and auricular acupressure for five days. Meanwhile, the control group received only the standard medications.

RESULTS: The use of auricular acupressure led to the decrease in the number and intensity of nausea and vomiting in both the acute and delayed phases in experimental group which were significantly lower than the control group (P = 0/001).

CONCLUSIONS: It is suggested that nurses use this pressure technique as a complementary treatment, non - pharmacological, inexpensive, non-invasive approach for the relief of chemotherapy-induced nausea and vomiting.

Active Somatic and Psychic Ear Acupuncture Points in Newborn Infants with Neonatal Abstinence Syndrome.

J Altern Complement Med. 2016 Oct;22(10):788-793. Kurath-Koller S, Pansy J, Mileder LP, Schmölzer GM, Urlesberger B, Raith W.

https://www.ncbi.nlm.nih.gov/pubmed/27486672

BACKGROUND: Neonatal abstinence syndrome (NAS) occurs within the first days after birth in newborns of mothers with a history of drug abuse. It may also occur in newborns whose mothers are undergoing substitution therapy.

OBJECTIVE: To determine the presence of active ear acupuncture points in newborn infants with NAS.

METHODS: Among newborn infants with NAS admitted to the Division of Neonatology at the University Hospital Graz between March 2009 and November 2014, an acupuncture-point detector (PS3 Silberbauer, Vienna, Austria) was used to identify active ear acupuncture points. An integrated optical and acoustical signal detects the ear points, which were then assigned to the ear map. A total of 31 newborn infants were assessed; 1 infant was excluded, however, because the mother had already weaned herself off opiates before admission.

RESULTS: The excluded infant did not develop signs of NAS, had a low Finnegan score (3 points), and did not present any detectable active psychic ear acupuncture points. In all included newborn infants with NAS, active ear acupuncture points were identified: The psychovegetative rim was the most common active somatic area in each infant, followed by a few somatic and psychic ear acupuncture points. In all infants with symptoms of NAS, active psychic ear points were identified, of which the most frequently found points were the Frustration point and the R point.

CONCLUSION: The activity of psychic ear acupuncture points may be specific for neonates with NAS.

Effects of Auricular Acupressure on Obesity in Women with Abdominal Obesity.

J Korean Acad Nurs. 2016 Apr;46(2):249-59. Cha HS, Park H.

https://www.ncbi.nlm.nih.gov/pubmed/27182021

PURPOSE: The purpose of this study was to examine the effects of auricular acupressure on reducing obesity in adult women with abdominal obesity.

METHODS: The study design was a non-equivalent control group pretest-posttest design. Participants were 58 women, aged 20 years or older, assigned to the experimental group (n=30) or control group (n=28). Auricular acupressure using vaccaria seeds was administered to the experimental group. The sessions continued for 8 weeks. Outcome measures included body weight, abdominal circumference, and body mass index, body fat mass, body fat percentage, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and serum glucose.

RESULTS: Women in the experimental group showed significant decreases in body, abdominal circumference, and body mass index after 8 weeks compared with those in the control group.

CONCLUSION: Results show that auricular acupressure using vaccaria seeds was effective in decreasing body weight, abdominal circumference, body mass index, and triglyceride levels in adult women with abdominal obesity.

Efficacy of modified auriculotherapy for post-operative pain control in patients subjected to laparoscopic cholecystectomy.

Cir Cir. 2016 Apr 27. Toca-Villegas J, Esmer-Sánchez D, García-Narváez J, Sánchez-Aguilar M, Hernández-Sierra JF.

https://www.ncbi.nlm.nih.gov/pubmed/27131979

BACKGROUND: The high frequency of post-operative pain in the patients after laparoscopic cholecystectomy has led to the need to use multiple analgesic therapies. These include auriculotherapy, although not very good results have been obtained with the traditional techniques.

OBJECTIVE: To evaluate the effectiveness of modified auriculotherapy for post-operative pain control in laparoscopic cholecystectomy patients.

MATERIAL AND METHODS: Double-blind controlled clinical trial. Experimental group: Different points ear puncture with xylocaine without needles vs. placebo group. Post-operative visual analogue scale (VAS) at 6, 12, 18, 24, 36, and 48h and rescue doses of analgesics, were measured in both groups.

RESULTS: At 6h post-operative, 87% of the auriculotherapy group had a VAS of <4 vs. 48% of placebo group, and 96 vs. 74%) at 18hours. At 24, 36 and 48h after surgery there were no differences, and as all of the patients in both groups had a VAS<4, they were discharged to the hospital.

CONCLUSIONS: Modified auriculotherapy was better to the conventional analgesics for post-operative pain control in patients subjected to laparoscopic cholecystectomy.

Efficiency of auricular acupuncture in climacteric symptoms after cancer treatments.

Climacteric. 2016 Jun;19(3):274-8. Viel E, Vanoli A, Melis A, Rocher F, Schipman B, Truong D.

https://www.ncbi.nlm.nih.gov/pubmed/27102586

OBJECTIVES: This paper aims to highlight the efficiency of auriculotherapy in the treatment of hot flushes, especially in cancer-related menopausal transition.

METHODS: We used systematically collected data from patients in 2014 in a medical oncology practice. The treatment was made according to the guidelines of The Inter-University Diploma and the cartography of the World Health Organization; data on satisfaction were collected orally.

RESULTS: In 2014, 49 patients, among whom 41 had cancer, were treated for hot flushes. Although it is not recommended to treat several symptoms during the same session, we dealt with 1.7 symptoms per session on average. Sixty-nine percent of the patients were satisfied. We lacked data for nine patients, who did not come to the minimal recommended number of treatments (three). Only one patient among those who did not observe any improvement received three treatments.

CONCLUSIONS: Auricular acupuncture is a safe and cheap method to treat hot flushes. It has been effective in numerous and various cases, among which were patients who presented cancer-related menopausal symptoms. It may be applied for a large variety of other symptoms.

Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial.

J Am Board Fam Med. 2015 Nov-Dec;28(6):697-705. Moss DA, Crawford P.

https://www.ncbi.nlm.nih.gov/pubmed/26546644

BACKGROUND: Sore throat is a common cause of pain in outpatient encounters. Battlefield auricular acupuncture (the placing of needles in specific points in the ear) is a modality used to treat acute pain associated with a variety of ailments. The aim of our study was to determine whether auricular acupuncture reduces pain, medication usage, and missed work hours when added to standard therapy in adult patients with acute sore throat.

METHODS: We conducted an unblinded, pragmatic, randomized controlled trial among adult, non-pregnant patients presenting to an Air Force family medicine clinic with pain from acute sore throat. A total of 54 patients were followed for 48 hours after treatment.

RESULTS: Patients receiving auricular acupuncture reported lower pain scores than those who did not at 15 minutes (6.0 vs 2.6), 6 hours (4.8 vs 2.5), and 24 hours (4.1 vs 1.3). They also reported taking fewer cumulative doses of pain medication at 6 hours (1.07 vs 0.39), 24 hours (2. vs 1.37), and 48 hours (4.07 vs 2.19). There was no difference in time missed from work between the auricular acupuncture and standard therapy groups.

CONCLUSIONS: Compared with usual treatment, battlefield auricular acupuncture was associated with reduced sore throat pain for 24 hours and decreased use of pain medication for up to 48 hours. There was no apparent effect on hours missed from work.

Exploring Self-Reported Benefits of Auricular Acupuncture Among Veterans With Posttraumatic Stress Disorder.

J Holist Nurs. 2016 Sep;34(3):291-9. King CH, Moore LC, Spence CD.

https://www.ncbi.nlm.nih.gov/pubmed/26530240

PURPOSE: Auricular acupuncture treatments are becoming increasingly available within military treatment facilities, resulting in an expansion of non-pharmacologic treatment options available to veterans with posttraumatic stress disorder (PTSD). This study aimed to explore the self-reported benefits of auricular acupuncture treatments for veterans living with PTSD.

DESIGN: A qualitative research methodology, thematic content analysis, was used to analyze data.

METHOD: Seventeen active duty veterans with PTSD provided written comments to describe their experiences and perceptions after receiving a standardized auricular acupuncture regimen for a 3-week period as part of a pilot feasibility study.

FINDINGS: A variety of symptoms experienced by veterans with PTSD were improved after receiving auricular acupuncture treatments. Additionally, veterans with PTSD were extremely receptive to auricular acupuncture treatments. Four themes emerged from the data: (1) improved sleep quality, (2) increased relaxation, (3) decreased pain, and (4) veterans liked/loved the auricular acupuncture treatments.

CONCLUSIONS: Veterans with PTSD reported numerous benefits following auricular acupuncture treatments. These treatments may facilitate healing and recovery for veterans with combat-related PTSD, although further investigations are warranted into the mechanisms of action for auricular acupuncture in this population.

Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students.

Evid Based Complement Alternat Med. 2015; Iunes DH, Chaves Éde C, Moura Cde C, Côrrea B, Carvalho LC, Silva AM, de Carvalho EC.

https://www.ncbi.nlm.nih.gov/pubmed/26495012

The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n = 31) and an AA sham group (n = 13). The mustard seeds were applied to the shen men, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p < 0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p = 0.04) and in the right side of the submandibular region (p = 0.02). Complaints of bilateral pain were reduced in the temporal tendon (p ≤ 0.01) and in the left side of the ATM (p < 0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p = 0.03).

Conclusion: Auriculotherapy was effective in the treatment of students with anxiety and TMDs.

Auricular vagal nerve stimulation ameliorates burn-induced gastric dysmotility via sympathetic-COX-2 pathways in rats.

Neurogastroenterol Motil. 2016 Jan;28(1):36-42. Li H, Yin J, Zhang Z, Winston JH, Shi XZ, Chen JD.

https://www.ncbi.nlm.nih.gov/pubmed/26486522

BACKGROUND: Severe burn injury has been demonstrated to delay gastric emptying. The aim of this study was to investigate effects and cellular mechanisms of auricular electroacupuncture (AEA) at the acupoints innervated by the auricular branch of vagus nerve on burn-induced gastric dysmotility in rats.

METHODS: Propranolol (β-adrenoceptor antagonist) was injected intraperitoneally after the rats underwent burn injury. All experiments were performed 6 h following burn/sham burn injury. AEA was performed at bilateral auricular acupoints for 45 min. Electrocardiogram was recorded for 30 min. Plasma hormones were measured; cyclooxygenase (COX)-2 expressions in gastric tissue were measured using western blotting and real-time RT-PCR.

KEY RESULTS: (i) Burn injury delayed gastric emptying (p = 0.006) and AEA increased gastric emptying by 49% (p = 0.045). (ii) Burn injury evoked a significant elevation in plasma noradrenaline, which was suppressed by AEA. (iii) Burn injury significantly increased protein and mRNA expressions of COX-2 in gastric fundus and antrum. AEA suppressed burn-induced increase in protein expressions, but not mRNA expressions of COX-2.

CONCLUSIONS & INFERENCES: Burn injury delays gastric emptying by up-regulating COX-2 attributed to sympathetic overactivity. AEA improves burn-induced delay in gastric emptying, possibly mediated via the sympathetic-COX-2 pathway.

Auricular acupuncture for pre-exam anxiety in medical students: a prospective observational pilot investigation.

Acupunct Med. 2016 Apr;34(2):90-4. Klausenitz C, Hesse T, Hacker H, Hahnenkamp K, Usichenko T.

https://www.ncbi.nlm.nih.gov/pubmed/26438557

OBJECTIVE: Auricular acupuncture (AA) is effective for the treatment of preoperative anxiety. We aimed to study the feasibility and effects of AA on exam anxiety in a prospective observational pilot study.

METHODS: Healthy medical students received bilateral AA using indwelling fixed needles at points MA-IC1, MA-TF1, MA-SC, MA-AH7, and MA-T on the day before an anatomy exam. The needles were removed after the exam. Anxiety levels were measured using the State-Trait-Anxiety Inventory (STAI) and a 100 mm visual analogue scale (VAS-100) before and after the AA intervention and once again immediately before the exam. The duration of sleep on the night before the exam was recorded and compared to that over the preceding 1 week and 6 months (all through students’ recollection). In addition, blood pressure, heart rate and the acceptability of AA to the students were recorded.

RESULTS: Ten students (all female) were included in the final analysis. All tolerated the needles well and stated they would wish to receive AA again for exam anxiety in the future. Exam anxiety measured using both STAI and VAS-100 decreased by almost 20% after AA.

CONCLUSIONS: AA was well accepted, the outcome measurement was feasible, and the results have facilitated the calculation of the sample size for a subsequent randomised controlled trial.

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The research showing the many benefits of Auriculotherapy just keeps coming…

Thursday, February 18th, 2016

It’s been such a long time since I have done one of these research updates: Partly because I regularly update the facebook page at https://www.facebook.com/AuriculotherapyAus/ , also some slackness in keeping this blog updated. Definitely not because there hasn’t been any research – there is heaps. So much I won’t even editorialise it too much…

Clinical study of cervical spondylotic radiculopathy treated with massage therapy combined with Magnetic sticking therapy at the auricular points and the cost comparison…

Compared with the simple massage therapy, the massage therapy combined with magnetic sticking therapy at auricular points achieves the better effect and lower cost in health economics.

I can vouch for this finding personally as we combine Auriculotherapy with Chiropractic work and my personal opinion is that the mix gives me faster and better results and allows us to tap more into organic and emotional issues…

http://www.ncbi.nlm.nih.gov/pubmed/26571889?dopt=Abstract

Clinical observation of breast hyperplasia treated with auricular point sticking therapy and Xiaopijian…

The combined therapy of auricular point sticking and Xiaopijian achieves the superior efficacy on breast hyperplasia as compared with the simple application of Xiaopijian…

Auriculotherapy is a great stand-alone treatment modality but I believe is an even better complement to other holistic approaches…

http://www.ncbi.nlm.nih.gov/pubmed/26571890?dopt=Abstract

Auricular Acupressure Can Modulate Pain Threshold.

Our results showed a significant higher pain threshold in the maximal test at 24 hours after Auriculotherapy (AT) compared to sham treatment. This result indicates for the first time that AT can increase pain tolerability…

http://www.ncbi.nlm.nih.gov/pubmed/26236378?dopt=Abstract

Effect of auricular pressing treatment on myopia in children.

There was significant improvement in binocular naked vision in the experimental group after the intervention compared with the control group…

http://www.ncbi.nlm.nih.gov/pubmed/26237831?dopt=Abstract

Acupuncture for pain control after Caesarean section: a prospective observational pilot study.

Pain intensity on movement on the first postoperative day was 4.3±2.4 and decreased to 2.2±1.2 on the day of discharge. Patient satisfaction was 1.9±0.8 and compliance (rated by their nurses) was 1.5±0. Acupuncture for additional analgesia after CS was well accepted.

http://www.ncbi.nlm.nih.gov/pubmed/26307554?dopt=Abstract

Effects of auricular electrical stimulation on vagal activity in healthy men: evidence from a three-armed randomized trial.

Electroacupuncture but not manual acupuncture was found to have a positive effect on respiratory sinus arrhythmia adjusted for tidal volume indicating vagal activity. The results underline the potential role of auricular electrical stimulation to induce an increase in vagal activity, and it therefore might be used as preventive or adjuvant therapeutic intervention promoting health…

This can get a bit controversial as it is almost taboo to suggest that an electro approach has advantages over traditional needling – but this is why I choose to utilise a more modern approach – especially since diagnosing points is much easier and accurate with the right electronic equipment: I am convinced the relative efficacy of Auriculotherapy lies in precise point identification…

http://www.ncbi.nlm.nih.gov/pubmed/19895369

Auricular acupuncture and vagal regulation.

It has been shown that auricular acupuncture plays a role in vagal activity of autonomic functions of cardiovascular, respiratory, and gastrointestinal systems. Mechanism studies suggested that afferent projections from especially the auricular branch of the vagus nerve to the nucleus of the solitary tract form the anatomical basis for the vagal regulation of auricular acupuncture…

http://www.ncbi.nlm.nih.gov/pubmed/23304215

Transcutaneous auricular vagus nerve stimulation protects endotoxemic rat from lipopolysaccharide-induced inflammation.

Transcutaneous auricular vagus nerve stimulation (ta-VNS) could evoke parasympathetic activities via activating the brainstem autonomic nuclei, similar to the effects that are produced after vagus nerve stimulation (VNS). VNS modulates immune function through activating the cholinergic anti-inflammatory pathway.

This is powerful results when you consider the invasiveness of VNS…

http://www.ncbi.nlm.nih.gov/pubmed/23346208

Effects of serum derived from rats undergone auricular acupuncture intervention on expression of TNF-alpha mRNA, cell adhesion factor-1 and vascular intercellular adhesion molecule-1 proteins of incubated cerebral microvascular endotheliocytes with diabetic injury.

Auricular Electro Acupuncture intervention can lighten diabetic cellular injury, suppress TNF alpha mRNA expression and reduce ICAM-1 and sVCAM-1 concentrations of cerebral microvascular endotheliocytes…

http://www.ncbi.nlm.nih.gov/pubmed/23383451

Effects of electroacupuncture at auricular concha region on the depressive status of unpredictable chronic mild stress rat models.

The present study suggested that Electro Acupuncture in the Auricular Concha Region can elicit similar cardio-inhibitory effects as Vagus Nerve Stimulation, and significantly antagonized Unpredictable Chronic Mild Stress induced depressive status… The antidepressant effect is possibly mediated via the normalization of the hypothalamic-pituitary-adrenal axis hyperactivity…

http://www.ncbi.nlm.nih.gov/pubmed/23431349

Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity.

Ear Transcutaneous Vagus Nerve Stimulation (tVNS) can increase HRV and reduce sympathetic nerve outflow, which is desirable in conditions characterized by enhanced sympathetic nerve activity, such as heart failure. tVNS can therefore influence human physiology and provide a simple and inexpensive alternative to invasive VNS…

http://www.ncbi.nlm.nih.gov/pubmed/25164906

Transcutaneous auricular vagus nerve stimulation triggers melatonin secretion and is antidepressive in Zucker diabetic fatty rats.

Our results show that ZDF rats are ideal candidates of innate depression and that taVNS is antidepressive through triggering melatonin secretion and increasing its production…

http://www.ncbi.nlm.nih.gov/pubmed/25347185

Electrical stimulation of the vagus nerve dermatome in the external ear is protective in rat cerebral ischemia.

Electric stimulation of the vagus nerve dermatome in the external ear activates brainstem afferent vagal nuclei and reduces infarct volume in rats. This finding has potential to facilitate the development of treatments that leverage the brain’s endogenous neuroprotective pathways at the setting of acute ischemic stroke…

I can speak for this effect first hand – I sat next to my unconscious mother as she slowly passed from the impacts of a stroke and performed Auriculotherapy at regular intervals – each time noticeable physiological improvements occurred from visible breathing patterns, to sense of ease to blood pressure…

http://www.ncbi.nlm.nih.gov/pubmed/25312600

Non-invasive Access to the Vagus Nerve Central Projections via Electrical Stimulation of the External Ear: fMRI Evidence in Humans.

Cymba conchae stimulation, compared to earlobe (control) stimulation, produced significant activation of the “classical” central vagal projections…

Any Auriculotherapist will say “why of course” – the concha is the thoracic and abdominal zone or vagal zone while the lobe is the head and brain zone or cervical plexus…

http://www.ncbi.nlm.nih.gov/pubmed/25573069

Transcutaneous Vagus Nerve Stimulation Modulates Default Mode Network in Major Depressive Disorder.

tVNS can significantly modulate the DMN FC of MDD patients; our results provide insights to elucidate the brain mechanism of tVNS treatment for MDD patients - the 24-item Hamilton Depression Rating Scale score reduced significantly…

http://www.ncbi.nlm.nih.gov/pubmed/25963932

Chinese auriculotherapy to improve quality of life of nursing team.

Individualized auriculotherapy had greater effect compared to the protocol auriculotherapy for reducing stress and improving life quality…

This demonstrates the importance of individualised point selection – you need the correct technology to guarantee this…

http://www.ncbi.nlm.nih.gov/pubmed/25946503

Auricular acupressure for pain relief in adolescents with dysmenorrhea: a placebo-controlled study.

Auricular acupressure relieves menstrual pain and distress in high-school adolescents…

http://www.ncbi.nlm.nih.gov/pubmed/23130943

The long-term effects of auricular therapy using magnetic pearls on elderly with insomnia.

The results of this study indicate that auricular therapy could have a long-term effect on improving the quality as well as the quantity of sleep among the elderly…

Many of my patients comment on how well they sleep after a session – we have even joked about running a sleep clinic where people come in for treatment as close to bed time as possible…

http://www.ncbi.nlm.nih.gov/pubmed/12801493?dopt=Abstract

A randomized controlled trial of auricular acupressure in heart rate variability and quality of life for hypertension.

Acupressure can be applied at the acupoints of shenmen, sympathetic, kidney, liver, heart, and subcortex to improve physical pain and mental health for hypertensive patients…

http://www.ncbi.nlm.nih.gov/pubmed/25847557?dopt=Abstract

Study on the best solution of immediate analgesia of acupuncture for migraine.

Comparing with the headache before treatment, at the time points of 10 and 20 minutes after treatment, the best solution for headache relief was needling therapy, auricular electroacupuncture therapy and bloodletting at Taiyang, Zimai or Taiyang and Ashi points…

http://www.ncbi.nlm.nih.gov/pubmed/21058472?dopt=Abstract

Efficacy of acupuncture combined with auricular point sticking on the content of serum prostaglandin F2α, and plasma arginine vasopressin in patients with menstrual headache.

Body acupuncture combined with auricular point sticking achieves positive efficacy for menstrual headache and its mechanism could be related to regulating the abnormal levels of serum PGF2α and plasma AVP….

http://www.ncbi.nlm.nih.gov/pubmed/25854019?dopt=Abstract

The effects of auricular electroacupuncture on obesity in female patients - a prospective randomized placebo-controlled pilot study.

In conclusion electrical auricular acupuncture could be a safe, additive, non-pharmacological treatment in obese patients.

http://www.ncbi.nlm.nih.gov/pubmed/24559812

Acupuncture in treating sudden sensorineural hearing loss: a report of 2 cases.

Fullness in ear disappeared during the first treatment in both cases, and the first patient also felt great improvement in hearing during the first treatment. After 10 treatments, the first patient had recovered. In the other patient, hearing had greatly improved after 19 treatments… Acupuncture may be worth trying in patients with SSHL who do not respond to routine medical treatment.

http://www.ncbi.nlm.nih.gov/pubmed/25231566

Clinical efficacy on vertebrobasilar insufficiency treated with auricular acupuncture.

The auricular acupuncture therapy achieves the definite efficacy on VBI and the efficacy is better than flunarizine hydrochloride capsules.

http://www.ncbi.nlm.nih.gov/pubmed/25876341

Improvement in Signs and Symptoms of ADHD, Migraines and Functional Outcomes While Receiving Subluxation Based Torque Release Chiropractic and Cranial Nerve Auriculotherapy…

http://www.torquerelease.com.au/AVSR-Hodgson-Fox.pdf

Correlation of electrical conductance in meridian and autonomic nervous activity after auricular acupressure in middle-aged women.

Auriculotherapy tends to inactivate the sympathetic nervous activity demonstrated by both Heart Rate Variability and meridian electrical conductance changes and so it may modulate the autonomic nervous system to exert its physiological effect…

http://www.ncbi.nlm.nih.gov/pubmed/24865945

Effect of auriculotherapy on menstrual irregularities in single girls with polycystic ovarian syndrome and aged 18-35 years in Isfahan in 2012.

Auriculotherapy is more effective on reduction of menstruation disorders, compared to medicational therapy.

Wow that should be well known?

http://www.ncbi.nlm.nih.gov/pubmed/25878694

Ear acupuncture for co-occurring substance abuse and borderline personality disorder: an aid to encourage treatment retention and tobacco cessation.

The use of acudetox was positively correlated with both successful completion of the programme for those with BPD as well as successful tobacco cessation, which ultimately improves the ability to maintain sobriety.

http://www.ncbi.nlm.nih.gov/pubmed/24824499

Ear acupuncture and fMRI: a pilot study for assessing the specificity of auricular points.

Our results provide preliminary evidence on the specificity of two auricular acupoints; further research is warranted by means of fMRI both in healthy volunteers and in patients carrying neurological/psychiatric syndromes.

http://www.ncbi.nlm.nih.gov/pubmed/24867864

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COMMUNICATION

Monday, April 8th, 2013

How much do you think that your success in practice depends on communication? Communication is the exchange and flow of information and ideas between one person and another. I say that your success in practice is directly proportionate to your ability to communicate.

Let’s look at this from some differing points of view though:

A new practice member consults you – they are in pain! Their sleep has been disturbed, they can’t do what they want to, their emotional system is somehow thrown into disarray, and their inner voices are starting to say things like: “What if you are like this forever?” “Something might be broken.” “Maybe it’s cancer.” “What if this is going to kill me?” Irrational thoughts to a highly qualified primary health care professional like you – but it’s not your pain is it?

You do your case history, conduct whatever tests you do and then explain a number of options to them:

  1. You explain that you don’t treat pain – you adjust subluxations so that their body can heal itself – to many people you have just communicated that you can’t help them – they don’t know what a Subluxation is, they just want their pain to stop. If they discontinue we internally scoff because they didn’t get the big idea.
  2. You show them their functional assessments and do an amazing report of findings convincing them that if they don’t do what you say then they are going to stay in the disgusting shape that they are in. But have you communicated that this may help their pain – if not there may be a break in the flow of information – a disconnect – dare I say a Subluxation of sorts?
  3. Or, you come from another viewpoint and simply tell them that you can help with their pain, and you should have them out of pain in 4-8 visits. You may have allayed someone’s fears more than scenarios 1 & 2, but have you fixed their mind on a discontinuation date? Have you been negligent in not sharing the possible greater benefits of ongoing chiropractic care? Has your communication been too miserly in its exchange?

The purpose of communication in the chiropractic setting should be to align the expectations, goals and aspirations of both parties – chiropractor and practice member – an Adjustment North of the Atlas may be required to produce any necessary realignment between these two poles.

Let’s face the cold hard fact that the biggest dropout rate happens within the first few adjustments – and we each have any number of rationalizations as to why this happens – the real reason is that communication didn’t succeed – they either didn’t understand that you could offer them what they were looking for – so they went somewhere else, or you didn’t understand what they wanted and therefore had no way of communicating whether you could help them achieve this.

I would love to be able to impose my will upon my practice members – weekly adjustments for every member of the human race to maximize human potential: But I have to accept that the majority of people that walk through my office door have aspirations somewhere between my goal and the other extreme unrealistic expectation that one quick back crack will save the day.

Note the definition of communication above – exchange and flow. If the information offered is not accepted, or if some former belief blocks the flow then communication has broken down. Have you ever done a report of findings where you thought you’d explained their poor condition succinctly, and then they say “so I’m not that bad then?”

Now let’s look from another point of view. One of the definitions of an Adjustment used in Torque Release Technique is “Communication Through Touch”. Stop and think about that for a few minutes – A Subluxation is impairment within the nervous system (I hope that’s not too much of a stretch) – a break in communication – afferent, and/or efferent: A separation from wholeness. If communication within a human is impaired then it is not hard to imagine that the ability to accept communication from without the human would be impaired also.

A huge part of your communication on each and every visit is non-verbal - your hands speak louder than your words!

Chiropractors do not correct Subluxations: They adjust subluxations. Only if communication within the body improves can that body then correct the Subluxation. If you have offended someone with your words, you can apologise but it only leads to reconciliation if it is heard and accepted. This is where intent comes into play – an apology without intent of love and humility will rarely hit the mark. An adjustment without intent of love and healing will rarely hit the bulls-eye. An adjustment is not an apology though – we didn’t create their subluxations – an adjustment is a wake-up call, a revelation, a resolution?

So our verbal communication needs to connect the aspirations of the treater with the treated. I’m willing to confess my own insufficiency in this.

I love adjusting, I love measuring, observing and demonstrating the functional and quality of life shifts that occur with regular adjustments, I’m happy when I’m in that zone of “finding and fixing” Subluxations. My fantasy practice environment is me moving from table to table, turning the power on, with great music feeding the atmosphere, happy satisfied people coming and going (quietly), who then walk back into the world and tell everyone else about how awesome chiropractic is. If I could find an assistant that could talk FOR me; explain all the wonderful benefits of chiropractic, and negotiate the schedule and the fee, and allay the winges and moans, and hold the hands and reassure and encourage the doubters to hang in there for the course, and promote and soapbox for me, then I’d pay him/her really well. BUT, the cold hard fact is that that person that can do all of these things doesn’t exist for the simple cosmic reason that they are not supposed to.

So instead I continue to fail often when it comes to mastering verbal communication – I guess that means I am learning a lot? After all he who fails the most, learns the most…

I’ve often wondered if it is possible to sum up chiropractic in one word (other than the word chiropractic that is): I don’t think Subluxation is the word – no-one should be defined by the problem – they should be defined by the solution. Maybe one word could be “relationship”. A healthy body comes from correct relationship between chemicals, cells, tissues, organs, systems – within the organism. A subluxation is a separation from wholeness, a misalignment in relationship between chemicals, cells, tissues, organs, and systems – within the organism. Our adjustment is our attempt to restore the communication within the disconnected physiology.

A healthy community comes from correct relationships between individuals, families, groups, cultures, societies. The best chiropractic practices are “communities”. Interesting isn’t it that we started talking about communication, and here we are talking about community – strikingly similar words with shared origins I would expect… Our verbal and non-verbal communications within our practice are what it takes to develop the relationship within this community.

So take a look at your practice community, and ask of yourself what are you doing to facilitate the flow of verbal and non-verbal communication? You may have the best scripts for telling your truth, but do you have a communication strategy that discovers their truth so that you can achieve alignment?

And then, do you have adjusting skills that maximise your non-verbal communication at the meso-limbic depth?

Try this practical experiment: See if you can define three clear goals or aspirations for each clinical relationship. Here is a really boring garden variety chiropractic example:

  1. Their goal – eg to reduce or remove their low back pain.
  2. A shared goal – eg to improve their lumbopelvic posture – they get to have a belly that doesn’t stick out so far, you get to achieve better spinal biomechanics.
  3. Your goal – eg to increase their lumbar range of motion.

Come up with a time frame for when you should review and celebrate progress. Take the time to have a moment of communication with this person about these goals and then enjoy the shift in the quality and longevity of your relationship.

Attending a Torque Release Technique Seminar will help you to maximise your verbal and non-verbal communication skills - find out more at http://www.torquerelease.com.au/Torque-Release-Discount.htm

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Who needs a Paradigm Shift?

Thursday, March 21st, 2013

Paradigm shift is an often heard phrase in chiropractic motivational circles – and as a profession we have been waiting for the community to have the necessary paradigm shift to comprehend and gravitate towards our vitalistic healing services. But what if it is us that need the paradigm shift?

We beat up on the medical profession and quote the growing body of evidence of harm produced by pharmacy and surgery. We beat up on the common man as though he is too simple to understand that a spinal adjustment can release his inborn healing potential. But even if these two scenarios are true – can we change them? Can you make someone else have a paradigm shift? Will a research paper convert the medical profession to refer each and every inpatient to our rooms instead? Will a better spinal health care class transform the average Jo into a compliant, new patient referring machine? If we could just get our educational brochure to say what we really want it to say, then the world will finally notice us? Maybe a glossy TV advertising campaign will convert the masses…

If chiropractic is the answer that many of us think it is – and I’m not talking about curing cancer, turning HIV+ to HIV-, blind seeing, lame walking and deaf hearing: I’m talking about the ability of chiropractic adjustments to improve quality of life – regardless of the ailment. Haven’t we been around long enough for others to notice this is happening? Maybe not enough have seen what we see because:

1) It isn’t happening – maybe the clinical benefits from adjustments aren’t as big as we would hope?? Maybe only a small percentage of adjustments release innate intelligence – If so, is this a failing of chiropractic or of chiropractors? I am a huge fan of objective functional assessments and progress exams, but in my long involvement with professional development I have noticed that few in our profession truly share this obsession. Most want a tool that converts sceptics to long term practice members – few want to have their therapeutic effectiveness or lack thereof exposed and measured. I have to be honest that I have needed to make some significant shifts in the way I do things to find ways to more consistently and significantly improve function – and I am still looking for better ways.

2) It is happening but we don’t have the evidence to show anyone else. I am bamboozled by members of our profession that desire to limit our scope of practice to musculoskeletal pain on the basis that there isn’t any evidence to support any wider claims. I wonder how you can adjust large numbers of people and not see internal physiological improvements of some sort – surely at least one asthmatic, bed-wetter, parkinsonian, multiple sclerotic, migrainous, immune deficient would have returned to their office and thanked them for the help? Maybe not? But I think that this alludes to a wider challenge – how do we SEE the changes that our adjustments deliver? Can an Xray do it, CAT scan, MRI, blood test? My fantasy is that we will develop the skill and acumen to decipher which body function tests best measure the most important changes that occur in someone who receives regular chiropractic care. I’m a bit disappointed with our scientific and academic community that this hasn’t already been achieved: I don’t think the oswestry questionnaire is the answer…

3) It is happening, and we have the evidence, but we can’t get the message out. There’s a neuroscience to marketing – and I don’t think we use it – in fact to a degree we are forbidden to use it. I’ve never been fully able to find the words or images that convey the message that I want my surrounding community to perceive and comprehend. I’m still looking for the perfect imagery that encompasses a subluxation – and it is definitely not the one with two vertebrae pinching against each other and shrivelling the spinal nerve. And I scratch my head as to how McDonalds, Coca-Cola and other life threatening products succeed where I fail. But I do know that if you tell the wrong story then you will be misunderstood – I don’t think that anyone will expect improved quality and quantity of life from visiting a profession that promotes themselves as the spinal care experts.

Paradigm shifts birth from A-Ha moments: Someone looks at why and how they do things and all of a sudden sees a problem, but more than that, they envision a different way of thinking, being and doing: The thought that a circle could be turned into transport, electricity into light, sound transmitted along wires or through the air etc etc. So what is the paradigm shift awaiting chiropractic?

We have this concept that spinal dysfunction leads to nerve dysfunction. And regardless of our technique, practice management style, straight or narrow, type o or type m etc – the language of chiropractic tends to centre back to this one concept. And we claim that this is a vitalistic concept – it’s not – it is a mechanistic concept!

IF we are vitalistic then we need to practice with model, theory and technique that are also vitalistic. Let me illustrate what I believe was a paradigm shift in my own chiropractic world. We say that a Subluxation is a mechanical lesion which can interfere with the transmission of something in the nervous system (Let’s not argue today about whether that something is intelligence, mental impulse, action potentials, neuropeptides, type c fibres, proprioceptors – Whatever). What if the mechanical lesion is not the cause – what if it is merely a symptom of what’s really going on? It’s not a huge paradigm shift in terms of language but what if a Subluxation is a neurological lesion first and foremost? What we see and intervene against is a manifestation of this disturbed neurological state. Hence our intervention does not necessarily have to be mechanical as is required by the former model – but it does need to be “neurological”.

How else can we describe the variation in adjustment vectors, forces and contact points all having similar therapeutic outcomes: Without regressing to the placebo copout that is. Many have tried to win the argument of which technique is best on biomechanical grounds, but maybe that misses the active ingredient? How often have we seen in the nutritional product world where they try to extract the active ingredient only to find that they have lost something magic in the process?

Stop for a moment and allow your mind to stretch around the idea that the Subluxation is a neurological pattern – an altered state of frequency that may manifest with tightening muscles, reducing range of motion, and amended flow of neuropetides – but the underlying state is at least electrical and perhaps more accurately energetic. When you read this, do you have this internal mental tension attempting to bring it back to the fact there must be a mechanical explanation – if you do then you are not ready for the paradigm shift quite yet.

I’ve been teaching vitalistic, neurological, tonal chiropractic for roughly eight years now and I have observed the furrowing of the chiropractic brow when I present the idea that we can forget the mechanical component of the Subluxation altogether and still be a Chiropractor: DD Palmer predicted that we would find better ways of doing things. But I often have Chiropractors approach me during the refreshment breaks asking “you’re not really serious are you”?

Let me put it another way – we have a public image problem, and a professional image problem. The public has trouble comprehending how a “bone out of place” can produce anything but a sore back bone. And the other health care professions doubt that spinal dysfunction can cause anything but mechanical back pain. And we have to go through this long-winded process of trying to explain spinal anatomy to connect the dots between a vertebra and the immune system, or an organ or even the brain.

What if you just skip the vertebra part of the explanation? If you talk in terms of nervous system only you will observe some different A-Ha experiences occurring in your practice members. As soon as you mention a bone or a muscle their minds will get stuck there and they won’t hear anything else you say. If you hear this statement– “so it’s just a muscle” or “so something is out” – then the chance of new communication has ended.

Here is a challenge for the next two weeks in practice: Do not mention a single bone or muscle. Make all of your conversations about nerves. It’s not easy for most chiropractors and the temptation to take the easy path will be strong. Don’t talk about pinched nerves – that’s a mechanistic concept. Use words like tone, tune, tension, frequency, vibration, electricity, energy, balance, harmony, spinal cord, spinal nerves.

Use illustrations like guitars and pianos being tuned, electricity flowing through the body, fuse-boxes with blown fuses, switchboards with switches in the off position, radios or televisions tuned to the wrong frequency/channel or with volume switches turned up or down too far. Talk about the nervous system and how it controls and regulates every cell in everybody – but avoid the need to then talk about spinal bones – instead talk about the flow of information around the body and how there can be blockages – and how your specialty is to locate and reduce those blockages.

Here’s what you may discover – your practice members stop asking you about whether this will help their sore neck or back, instead they will ask about the internal functions that need help. You see – they innately know that the nervous system controls and regulates every cell in every body. And they innately know that the spinal bones don’t control and regulate every cell in every body. Heresy you say? Paradigm shift I say…

Now give yourself permission to attend a Torque Release Technique Seminar to complete the shift to a vitalistic and neurological adjusting system – one that DD himself aspired to. Check the details of the next TRT Seminar at this link: www.torquerelease.com.au/Torque-Release-Discount.htm

Yours for better health and better chiropractic
Dr Nick Hodgson, 2005 Victorian Chiropractor of the Year

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Every Case a Case Study

Thursday, March 14th, 2013

Some time ago I set myself a goal to write up case studies based on the positive results that have I seen in my practice. Like every Chiropractor I get excited when I hear of life changing turnarounds in a wide range of health complaints. And not always because that person first consulted me with “Condition X” – they may come to me with the garden variety neck and back ailments. But then weeks later the person shares their story of healing and improved quality of life since starting to see me.

Well you might say I have opened a can of worms because the reality of “writing up” has been daunting: A clear history, examination findings and having some sort of outcome measure in place so that after those weeks of adjustments you can say for real that signs and symptoms have diminished – the objective before and after as opposed to the testimonial. And then there is the challenge of writing up an introduction and discussion of the condition in question – requires literature research and time.

So retrospectively I began to dig out files of my fondest case memories and quickly discovered that I did not have much more to go on than a testimonial. Child was a bed wetter – now they aren’t, teenager had reduced asthma medications and number and severity of attacks but no actual numbers to go along with those subjective observations, person who attended for low back pain and was then able to become pregnant after being adjusted (why didn’t they tell me they were infertile when they presented?), a parent stating that their child’s ADHD had significantly improved but now I have the challenge of finding out of their academic and social performance has improved – where to start?

I had been haunted by the words of an “old-timer” chiropractor at a Dynamic Growth Congress years before. He asserted that you “never ask your patients how they are – you tell them!” How do you do that? Now I know that we get to know our practice member’s bodies and that we can to a degree sense where they are at – but that intuition wasn’t quite enough for me – I wanted tools to measure where someone was in their functional journey. I’ve never been a dedicated user of Xrays and biomechanical lines and would always prefer non-invasive technologies so I began searching. The first purchase I made somewhere in the mid-nineties was software to analyse posture (www.torquerelease.com.au/Posture-Pro-Software.htm) and to come up with some objective calculations – cool tool and patients love the before and after pictures – a win-win. Back then this type of software cost thousands. This was in the days when computers were like old-age pensioners – took half the morning to warm up, and then didn’t do much after lunch. And we had to buy excessively expensive cameras that had a removable floppy disc – remember what those were? I envy today’s chiropractors who can pick up the latest version of this software for less than a grand, and download and install it on their high-speed notebook, and already have the camera that connects wirelessly.

Next I took out a five-year lease to get my hands on an Insight Subluxation Station (www.subluxation.net.au) and discovered that surface EMG, thermography and inclinometry were awesome tools for me to see if I was making the physiological changes that I hoped my adjustments produced. Boy was this confronting as I was forced along a pathway of finding better ways to deliver better adjustments and advice. I think we Chiropractors have had it too easy for too long because the only quality assurance that we have had to answer to is customer satisfaction. I remember one of my associate Chiropractors who was notorious for bypassing initial and progress exams, who when confronted stated that he didn’t see the point in using the measurements when they didn’t change! I guess my conclusion had been different as my revelation was that maybe I had to find the best ways for making positive changes – After all if a spine isn’t better aligned, more flexible and surrounded by less muscle tension after a series of adjustments, then what has been the actual benefit of those adjustments?

My next revelation was that I needed better outcome measures in my practice for a range of health concerns: If someone consults me and they suffer with migraines then I need to be able to demonstrate that the improvements in the sEMG, posture, thermography and range of motion are matched by measurable improvements in the regularity and severity of the signs and symptoms of migraine – sounds simple – just visit outcomemeasures.? to download the free tools I hoped? Not! My fantasy was a file of severity questionnaires that could be accessed depending on the name of the presenting dis-ease. So I contacted the academics and was told that such standardized and validated tools did exist. Next step was to find them… Still looking! Here’s the problem – they all have different completion and rating systems, most aren’t free or at least accessible, and regardless of whether they are scientifically validated few have been designed by chiropractors, for chiropractic – what is the point of a headache questionnaire that lacks a question about neck pain or dysfunction, or a low back questionnaire that fails to note any associated gastrointestinal or genitourinary signs? Since this time I have been gradually authoring my own range of health questionnaires – as I encountered a different health syndrome in practice, I would spend hours researching and then listing the “top twenty” associated signs and symptoms which would then be pasted into my template – each having exactly the same rating and format (www.torquerelease.com.au/Health-Questionnaires.htm) . Now these aren’t validated research tools but I love them for the power that they offer in terms of being able to take a subjective snapshot in time.

Nowadays I am in a newer practice and while designing my new systems I spent numerous hours (internet) searching for the best outcome tools out there: They had to be affordable, simple to use, and easy for the practice member to comprehend. After much shopping I combined Posture Pro, with digital photographic range of motion analysis software, Heart Rate Variability (www.torquerelease.com.au/emWave.htm) , along with the Torque Release Technique Indicators of Subluxation Scoring System that I had developed, and my Health Outcomes Questionnaires. Now I present my practice members with what I call their Spinal Functional Age (SFA) and Self-Perceived Health Age (SPHA).

The next barrier was in getting humans to follow the plan. I realised that my chances of producing legitimate case studies retrospectively were small. I needed to have a prospective plan: When Master Bedwetter, or Miss Asthma, or Mr Parkinsons or Mrs Multiple Sclerosis arrives at my rooms then I need the procedures in place so that I have sufficient pre-examination findings. Next challenge is to achieve sufficient compliance with care that will result in the types of positive changes we aspire to. And step three is to conduct a progress examination that supplies the “evidence” that I crave which is going to look good in ink.

What I am trying to say here is that my initial urge to write up a simple case study that is of some value to the evidence-base has actually sent me on a path of research and development that I like to think is making me a better Chiropractor.

Have you ever watched an episode of Geoffrey Robertson’s Hypothetical? This famous legal shark draws together a diverse cross section of “experts” and then forces them through a hypothetical case scenario that pushes the ethical, moral and human boundaries. Entertaining and usually enlightening viewing. To a point I believe it is valuable to apply this principle in our practice development pathway.

So, how does MY hypothetical influence YOUR life in practice? Ask yourself these questions:

1) Is your initial intake process thorough and objective enough that you could present clear evidence of what it is you are setting out to change for that person?

2) Do you have objective measurement tools to demonstrate how much this person’s functional status needs to change and whether you will have been able to initiate a change in their health concern?

3) Do you conduct a progress or review exam to measure whether you are achieving your shared goals?

4) Have you had the guts to put your technique to the objective litmus test across your entire practice population and not just your favourite miracle cases?

5) Do you have enough evidence to contribute a Case Study for the advancement of the Chiropractic Evidence Base?

When I present the stats from my own practice I show the average functional changes that occur and share the journey I have had to follow to ensure that I consistently generate significant objective improvements. At one seminar a Chiropractor pulled me aside during a refreshment break, and with a concerned look on his face stated that the changes I had documented were not very BIG. “Oh really” I said “how big are the changes that you are seeing?” “Well I don’t know” he said “but I know that they would be better than yours”. I almost envy his delusions of grandeur, but the reality is if you don’t know for sure, then you don’t know! My own research based on the functional tools that I currently prefer, suggest that one adjustment reduces someone’s functional age by one year. I personally think that is very significant – name any other healing method that can make someone one year younger in one visit?

To find out more about the next Torque Release Technique Seminar visit: www.torquerelease.com.au/Torque-Release-Discount.htm

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