Posts Tagged ‘Posture’

THE MOST UP TO DATE POSTURE RESEARCH

Thursday, January 31st, 2013

 

It’s been a while since I have done a review of research relevant to good and bad posture. And in that time some things have changed – the most noticeable is that if you look closely in the following papers you should notice that digital photography and the objective measurements possible as a result are a key feature. Now I don’t hate to tell you that “I told you so” – but I have been pushing the use of digital postural analysis since about 1996!

The other clear point from the following abbreviated abstracts is just how powerful postural analysis is as an outcome tool, and a predictor of morbidity. If you are not incorporating objective postural analysis and including corrective strategies that work in your practice – then WHY NOT?

Check out the world’s best postural analysis software at this link: www.torquerelease.com.au/Posture-Pro-Software.htm

 

1) Sensitivity of clinical assessments of sagittal head posture.

J Eval Clin Pract. 2010 Feb;16(1):141-4. Gadotti IC, Biasotto-Gonzalez DA.

Historically, clinicians visually evaluate posture using anatomical landmarks. Advances in technology made digital photographs now feasible to use in clinical practice. Photogrammetry may increase the reliability of the assessment of postural changes. However, differences between visually estimated and photogrammetric recorded changes in posture need to be tested. The objective of this study was to evaluate the sensitivity of visual assessments of changes in head posture in the sagittal plane in relation to photogrammetric recorded data… Visual assessments of sagittal head posture were sensitive to detect differences between no FHP and FHP groups, but were not sensitive to detect differences between no FHP and slight FHP groups. Head posture photogrammetry is recommended to quantitatively detect less evident differences in head posture.

 

2) Differences in Standing and Sitting Postures of Youth with Idiopathic Scoliosis from Quantitative Analysis of Digital Photographs.

Phys Occup Ther Pediatr. 2013 Jan 8. Fortin C, Ehrmann Feldman D, Cheriet F, Labelle H.

The objective of this study was to explore whether differences in standing and sitting postures of youth with idiopathic scoliosis could be detected from quantitative analysis of digital photographs. Standing and sitting postures of 50 participants aged 10-20-years-old with idiopathic scoliosis (Cobb angle: 15° to 60°) were assessed from digital photographs using a posture evaluation software program… Significant differences between standing and sitting positions (p < 0.05) were found for head protraction, shoulder elevation, scapula asymmetry, trunk list, scoliosis angle, waist angles, and frontal and sagittal plane pelvic tilt. Quantitative analysis of digital photographs is a clinically feasible method to measure standing and sitting postures among youth with scoliosis and to assist in decisions on therapeutic interventions.

 

3) Trunk deformity is associated with a reduction in outdoor activities of daily living and life satisfaction in community-dwelling older people.

Osteoporos Int. 2005 Mar;16(3):273-9. Takahashi T, Ishida K, Hirose D, Nagano Y, Okumiya K, Nishinaga M, Matsubayashi K, Doi Y, Tani T, Yamamoto H.

We have evaluated the association between trunk deformities of the sagittal plane and functional impairment of daily living in community-dwelling elderly subjects. The analysis involved a detailed assessment of indoor and outdoor activities of daily living, satisfaction with life, and mental status. The participants in this study were 236 community-dwelling older adults, aged 65 years and older, living in Kahoku district of Kochi in Japan. The participants were classified based on their posture, which was assessed using photographs of the subjects, and interviewed to assess their basic activities of daily living (BADL), instrumental ADL (IADL), and cognitive well-being in the cross-sectional study… The lumbar kyphosis group received significantly lower BADL and IADL scores than the normal group. The trunk deformity group which were defined as kyphosis, flat back, and lumbar lordosis groups exhibited decreases in activities that included going out, shopping, depositing and withdrawing money, and visiting friends in the hospital. These activities require going outdoors; thus, this study showed that the trunk deformity group had limitations in outdoor activities… The abnormal trunk deformity groups tended to score lower than the normal group with regard to subjective healthiness and life satisfaction measures, including subjective health condition, everyday feeling, satisfaction with human relationships, satisfaction with economic condition, and satisfaction with present life.

 

4) Video analysis of sagittal spinal posture in healthy and young adults

Journal of Manipulative and Physiological Therapeutics. Volume 32, Number 3, 2009;32:210-215. Yi-Liang Kuo, Elizabeth A. Tully, PhD, and Mary P. Galea, PhD

Changes in posture are of concern because of their association with pain or impaired physical function… Compared to young adults, healthy older adults demonstrated a forward head posture, with increased lower cervical spine flexion and increased upper cervical extension in both positions. Older adults also sat with significantly increased thoracic kyphosis and decreased lumbar spine flexion… The angular relationship between adjacent spinal regions in the sagittal plane can be objectively quantified using image-based analysis. The concept that the anteroposterior tilt of the pelvis in standing dictates the lumbar and thoracic curves was supported by the correlations between these adjacent regions in both age groups. The model of skin marker placement used in this study can have a broader application as a clinical tool for image-based postural assessment.

 

5) Reliability of a quantitative clinical posture assessment tool among persons with idiopathic scoliosis.

Physiotherapy. 2012 Mar;98(1):64-75. Fortin C, Feldman DE, Cheriet F, Gravel D, Gauthier F, Labelle H.

Seventy participants aged between 10 and 20 years with different types of idiopathic scoliosis (Cobb angle 15 to 60°) were recruited from the scoliosis clinic… Based on the XY co-ordinates of natural reference points (e.g., eyes) as well as markers placed on several anatomical landmarks, 32 angular and linear posture indices taken from digital photographs in the standing position were calculated from a specially developed software program… Posture can be assessed in a global fashion from photographs in persons with idiopathic scoliosis. Despite the good reliability of marker placement, other studies are needed to minimise measurement errors in order to provide a suitable tool for monitoring change in posture over time.

 

6) Postural compensations and subjective complaints due to backpack loads and wear time in schoolchildren.

Pediatr Phys Ther. 2013 Spring;25(1):15-24. Kistner F, Fiebert I, Roach K, Moore J.

This study investigated the effects of carrying weighted backpacks of up to 20% of body weight on the posture and pain complaints of elementary-school children. Craniovertebral, forward trunk lean and pelvic tilt angles were measured from sagittal photographs of 62 children (8-11 years old) before and after walking while carrying backpacks containing 10%, 15%, or 20% of body weight. Pain severity after a 6-minute walk with the loaded backpack was recorded. Subjective complaints of pain were assessed using a visual analog scale after walking. Repeated-measures ANOVA revealed statistically significant differences in postural angles and increased complaints of pain after walking with increased backpack loads. These results indicate that typical backpack loads create worsening postural changes due to backpack loads and time spent carrying those loads, putting children at increased risk for injury and pain, the latter of which is a strong predictor for back pain in adulthood.

 

7) Effect of backpack load carriage on cervical posture in primary schoolchildren.

Work. 2012;41(1):99-108. Kistner F, Fiebert I, Roach K.

This study examined the effects of various backpack loads on elementary schoolchildren’s posture and postural compensations as demonstrated by a change in forward head position. Sagittal digital photographs were taken of each subject standing without a backpack, and then with the loaded backpack before and after walking 6 minutes (6MWT) at free walking speed. This was repeated over three consecutive weeks using backpacks containing randomly assigned weights of 10%, 15%, or 20% body weight of each respective subject. The craniovertebral angle (CVA) was measured using digitizing software, recorded and analyzed. Subjects demonstrated immediate and statistically significant changes in CVA, indicating increased forward head positions upon donning the backpacks containing 15% and 20% body weight. Following the 6MWT, the CVA demonstrated further statistically significant changes for all backpack loads indicating increased forward head postures. For the 15 & 20%BW conditions, more than 50% of the subjects reported discomfort after walking, with the neck as the primary location of reported pain.

 

8) Effect of backpack weight on postural angles in preadolescent children.

Indian Pediatr. 2010 Jul;47(7):575-80. Ramprasad M, Alias J, Raghuveer AK.

Carrying heavy backpacks could cause a wide spectrum of pain related musculoskeletal disorders and postural dysfunctions. To determine the changes in various postural angles with different backpack weights in preadolescent children… digitizing software was used for analyzing photographs to determine craniovertebral (CV), head on neck (HON), head and neck on trunk (HNOT), trunk and lower limb angles. Postural angles were compared with no backpack and with backpacks weighing 5% to 25% of the subject’s bodyweight. The CV angle changed significantly after 15% of backpack load (P <0.05). The HON and HNOT angles changed significantly after 10% of backpack load (P <0.05). The trunk and lower limb angle also changed significantly after 5% of backpack load (P <0.05). Carrying a backpack weighing 15% of body weight change all the postural angles in preadolescent children.

 

9) Spinal Posture in the Sagittal Plane Is Associated With Future Dependence in Activities of Daily Living: A Community-Based Cohort Study of Older Adults in Japan.

J Gerontol A Biol Sci Med Sci. 2013 Jan 28. Kamitani K, Michikawa T, Iwasawa S, Eto N, Tanaka T, Takebayashi T, Nishiwaki Y.

Accumulated evidence shows how important spinal posture is for aged populations in maintaining independence in everyday life. However, the cross-sectional designs of most previous studies prevent elucidation of the relationship between spinal posture and future dependence in activities of daily living (ADL). We tried to clarify the association by measuring spinal posture noninvasively in a community-based prospective cohort study of older adults, paying particular attention to thoracic curvature, lumbar curvature, sacral hip angle, and inclination to determine which parameter is most strongly associated with dependence in ADL… This study indicates that spinal inclination is associated with future dependence in ADL among older adults.

 

10) Association of spinal inclination with physical performance measures among community-dwelling Japanese women aged 40 years and older.

Geriatr Gerontol Int. 2012 Dec 26. Abe Y, Aoyagi K, Tsurumoto T, Chen CY, Kanagae M, Mizukami S, Ye Z, Kusano Y.

Spinal inclination assesses spinal posture as a whole. However, the association between spinal inclination and physical performance has not yet been fully elucidated. Therefore, this study aimed to explore the association of spinal inclination with physical performance measures. The participants were 107 Japanese women aged 40-84 years. Spinal posture was assessed as inclination to a perpendicular line by using a computer-assisted device. Increased inclination value means forward inclination of the spine. Physical performance was measured by using the following methods: 6-m walking time, chair stand time, functional reach, Timed Up & Go Test, and grip strength. Information on participants’ comorbidities, osteoporosis, knee joint pain, back pain, falls in the previous year, regular exercise and usage of non-steroidal anti-inflammatory drugs (NSAIDs), was also collected. Pearson’s correlation analysis showed significant associations between spinal inclination and all of the physical performance measures. Pearson’s partial correlation analysis adjusted for age showed significant associations of increased inclination with poor physical functioning in 6-m walking time, chair stand time, functional reach, and Timed Up & Go Test, but not in grip strength. Linear regression analysis adjusted for age, grip strength, number of comorbidities, osteoporosis, knee joint pain, back pain, falls in previous year, regular activity and taking NSAIDs showed that spinal inclination was associated with poor function in 6-m walking time, chair stand time, functional reach and Timed Up & Go Test. Forward spinal inclination was associated with impairment in various physical performance measures. Proper prevention and treatment of underlying disorders should be prompted.

 

11) Importance of posture assessment in ankylosing spondylitis. Preliminary study.

Rev Med Chir Soc Med Nat Iasi. 2012 Jul-Sep;116(3):780-4. Roşu MO, Ancuţa C, Iordache C, Chirieac R.

The aim of this study is to perform a screening of patients diagnosed with ankylosing spondylitis (AS) in order to evaluate the static spinal disorders and correlate the results with the main clinical and functional parameters that characterize this disease… The assessment of lumbosacral pain in the morning and daytime lumbosacral pain showed a higher scores in patients suffering from kyphoscoliosis than in those with scoliosis, or kyphosis. Ott and modified Schöber index, and chest expansion, had higher mean values in patients with scoliosis compared with the other postural disorders. Statistically higher mean BASFI values were recorded in patients with kyphoscoliosis, while the mean BASMI values were lower in scoliosis patients. As to the quality of life of AS patients, HAQ-DI index recorded significantly lower mean values for kyphoscoliosis compared with other postural disorders. Our study suggests that posture assessment and implicitly the correction of possible misalignments should be part of the kinetic physical therapy program. Rigorous observing of postural recommendations can prevent the respiratory system complications.

 

12) Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults.

Man Ther. 2013 Feb;18(1):65-71. Quek J, Pua YH, Clark RA, Bryant AL.

It is unclear how age-related postural changes such as thoracic spine kyphosis influence cervical range-of-motion (ROM) in patients with cervical spine dysfunction. The purpose of this study was to explore the mediating effects of forward head posture (FHP) on the relationship between thoracic kyphosis and cervical mobility in older adults with cervical spine dysfunction. Fifty-one older adults… with cervical spine dysfunction – that is, cervical pain with or without referred pain, numbness or paraesthesia – participated. Pain-related disability was measured using the neck disability index (NDI). Thoracic kyphosis was measured using a flexicurve. FHP was assessed via the craniovertebral angle (CVA) measured from a digitized, lateral-view photograph of each subject. Cervical ROM - namely, upper and general cervical rotation and cervical flexion – was measured by the Cervical Range-of-Motion (CROM) device. Greater thoracic kyphosis was significantly associated with lesser CVA whereas greater CVA was significantly associated with greater cervical flexion and general rotation ROM, but not with upper cervical rotation ROM… Our results show that FHP mediated the relationship between thoracic kyphosis and cervical ROM, specifically general cervical rotation and flexion. These results not only support the justifiable attention given to addressing FHP to improve cervical impairments, but they also suggest that addressing thoracic kyphosis impairments may constitute an “upstream” approach.

 

13) Increased forward head posture and restricted cervical range of motion in patients with carpal tunnel syndrome.

J Orthop Sports Phys Ther. 2009 Sep;39(9):658-64. De-la-Llave-Rincón AI, Fernández-de-las-Peñas C, Palacios-Ceña D, Cleland JA.

To compare the amount of forward head posture (FHP) and cervical range of motion between patients with moderate carpal tunnel syndrome (CTS) and healthy controls. We also sought to assess the relationships among FHP, cervical range of motion, and clinical variables related to the intensity and temporal profile of pain due to CTS… FHP and cervical range of motion were assessed in 25 women with CTS and 25 matched healthy women. Side-view pictures were taken in both relaxed-sitting and standing positions to measure the craniovertebral angle. A CROM device was used to assess cervical range of motion. Posture and mobility measurements were performed by an experienced therapist blinded to the subjects’ condition… Patients with mild/moderate CTS exhibited a greater FHP and less cervical range of motion, as compared to healthy controls. Additionally, a greater FHP was associated with a reduction in cervical range of motion…

 

14) The role of forward head correction in management of adolescent idiopathic scoliotic patients: a randomized controlled trial.

Clin Rehabil. 2012 Dec;26(12):1123-32. Diab AA.

To investigate the effectiveness of forward head correction on three-dimensional posture parameters and functional level in adolescent idiopathic scoliotic patients… All the patients (n = 76) received traditional treatment in the form of stretching and strengthening exercises. In addition, patients in the study group (n = 38) received a forward head posture corrective exercise programme… Craniovertebral angle, Functional Rating Index and posture parameters, including: lumbar lordosis, thoracic kyphosis, trunk inclination, trunk imbalance, lateral deviation, surface rotation and pelvis torsion were measured before treatment, after 10 weeks, and at three-month follow-up… A forward head corrective exercise programme combined with conventional rehabilitation improved three-dimensional scoliotic posture and functional status in patients with adolescent idiopathic scoliosis.

 

15) The efficacy of forward head correction on nerve root function and pain in cervical spondylotic radiculopathy: a randomized trial.

Clin Rehabil. 2012 Apr;26(4):351-61. Diab AA, Moustafa IM.

To investigate the effect of forward head posture correction on pain and nerve root function in cases of cervical spondylotic radiculopathy… Ninety-six patients with unilateral lower cervical spondylotic radiculopathy (C5-C6 and C6-C7) and craniovertebral angle measured less than or equal to 50° were randomly assigned to an exercise or a control group… The control group (n = 48) received ultrasound and infrared radiation, whereas the exercise group (n = 48) received a posture corrective exercise programme in addition to ultrasound and infrared radiation… Forward head posture correction using a posture corrective exercise programme in addition to ultrasound and infrared radiation decreased pain and craniovertebral angle and increased the peak-to-peak amplitude of dermatomal somatosensory evoked potentials for C6 and C7 in cases of lower cervical spondylotic radiculopathy.

 

16) The effect of the forward head posture on postural balance in long time computer based worker.

Ann Rehabil Med. 2012 Feb;36(1):98-104. Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI.

To estimate the effects of a relatively protruded head and neck posture on postural balance, in computer based worker… Thirty participants, who work with computers for over 6 hrs per day (Group I), and thirty participants, who rarely work with computers (Group II), were enrolled. The head and neck posture was measured by estimating angles A and B. A being the angle between the tragus of the ear, the lateral canthus of the eye, and horizontal line and B the angle between the C7 spinous process, the tragus of the ear, and the horizontal line. The severity of head protrusion with neck extension was assessed by the subtraction of angle A from angle B. We also measured the center of gravity (COG) and postural balance by using computerized dynamic posturography to determine the effect of computer-based work on postural balance… The results of this study suggest that forward head postures during computer-based work may contribute to some disturbance in the balance of healthy adults. These results could be applied to education programs regarding correct postures when working at a computer for extended periods of time.

 

17) Musculoskeletal dysfunction and pain in adults with asthma.

J Asthma. 2011 Feb;48(1):105-10. Lunardi AC, Marques da Silva CC, Rodrigues Mendes FA, Marques AP, Stelmach R, Fernandes Carvalho CR.

The mechanical alterations related to the overload of respiratory muscles observed in adults with persistent asthma might lead to the development of chronic alterations in posture, musculoskeletal dysfunction and pain; however, these changes remain poorly understood… This study aimed to assess postural alignment, muscle shortening and chronic pain in adults with persistent asthma… In comparison with non-asthmatic subjects, patients with mild or severe persistent asthma held their head and shoulders more forward and had lower chest wall expansion, decreased shoulder internal rotation, and decreased thoracic spine flexibility. Chronic lower thoracic, cervical, and shoulder pain was significantly increased in patients with mild or severe asthma compared with non-asthmatic subjects…

 

18) Head and shoulder alignment among patients with unilateral vestibular hypofunction.

Rev Bras Fisioter. 2010 Jul-Aug;14(4):330-6. Coelho Júnior AN, Gazzola JM, Gabilan YP, Mazzetti KR, Perracini MR, Ganança FF.

To investigate head and shoulder alignment among patients with unilateral vestibular hypofunction (UVH), using computerized biophotogrammetry (CB) and to correlate these measurements with gender, age, duration of clinical evolution, self-perception of intensity of dizziness and occurrences of falls… The patients with UVH had greater forward and lateral head deviation angles than did the normal individuals, with a statistically significant difference… Forward head was associated with the duration of clinical symptoms of the vestibular disease, age, intensity of dizziness and occurrence of falls.

 

19) Influence of forward head posture on scapular upward rotators during isometric shoulder flexion.

J Bodyw Mov Ther. 2010 Oct;14(4):367-74. Weon JH, Oh JS, Cynn HS, Kim YW, Kwon OY, Yi CH.

We assessed the effects of forward head posture in the sitting position on the activity of the scapular upward rotators during loaded isometric shoulder flexion in the sagittal plane. Healthy volunteers (n = 21; 11 men, 10 women) with no history of pathology participated in the study. Subjects were instructed to perform isometric shoulder flexion with the right upper extremity in both the forward head posture (FHP) and neutral head posture (NHP) while sitting. Surface electromyography (EMG) was recorded from the upper trapezius, lower trapezius, and serratus anterior muscles… Significantly increased EMG activity in the upper trapezius and lower trapezius and significantly decreased EMG activity in the serratus anterior were found during loaded isometric shoulder flexion with FHP. Thus, FHP may contribute to work-related neck and shoulder pain during loaded shoulder flexion while sitting. These results suggest that maintaining NHP is advantageous in reducing sustained upper and lower trapezius activity and enhancing serratus anterior activity as compared with FHP during loaded shoulder flexion.

 

20) Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks.

J Electromyogr Kinesiol. 2010 Aug;20(4):701-9. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N.

Forward head and rounded shoulder posture (FHRSP) is theorized to contribute to alterations in scapular kinematics and muscle activity leading to the development of shoulder pain. However, reported differences in scapular kinematics and muscle activity in those with forward head and rounded shoulder posture are confounded by the presence of shoulder pain. Therefore, the purpose of this study was to compare scapular kinematics and muscle activity in individuals free from shoulder pain, with and without FHRSP. Eighty volunteers were classified as having FHRSP or ideal posture. Scapular kinematics were collected concurrently with muscle activity from the upper and lower trapezius as well as the serratus anterior muscles during a loaded flexion and overhead reaching task using an electromagnetic tracking system and surface electromyography. Separate mixed model analyses of variance were used to compare three-dimensional scapular kinematics and muscle activity during the ascending phases of both tasks. Individuals with FHRSP displayed significantly greater scapular internal rotation with less serratus anterior activity, during both tasks as well as greater scapular upward rotation, anterior tilting during the flexion task when compared with the ideal posture group. These results provide support for the clinical hypothesis that FHRSP impacts shoulder mechanics independent of shoulder pain.

 

21) The influence of cranio-cervical posture on maximal mouth opening and pressure pain threshold in patients with myofascial temporomandibular pain disorders.

Clin J Pain. 2011 Jan;27(1):48-55. La Touche R, París-Alemany A, von Piekartz H, Mannheimer JS, Fernández-Carnero J, Rocabado M.

The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular pain disorders… The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.

 

22) Body posture evaluations in subjects with internal temporomandibular joint derangement.

Cranio. 2009 Oct;27(4):231-42. Munhoz WC, Marques AP.

The aim of this study was to verify possible relationships between global body posture and temporomandibular joint internal derangement (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Body posture was assessed using the analysis of muscle chains on several photographs… There was a trend noticed in the group with the most severe dysfunction, to present a forward head and shoulders posture…

 

23) Global body posture evaluation in patients with temporomandibular joint disorder.

Clinics (Sao Paulo). 2009;64(1):35-9. Saito ET, Akashi PM, Sacco Ide C.

To identify the relationship between anterior disc displacement and global posture (plantar arches, lower limbs, shoulder and pelvic girdle, vertebral spine, head and mandibles). Common signs and symptoms of anterior disc displacement were also identified… Global posture deviations cause body adaptation and realignment, which may interfere with the organization and function of the temporomandibular joint… Our results suggest a close relationship between body posture and temporomandibular disorder, though it is not possible to determine whether postural deviations are the cause or the result of the disorder. Hence, postural evaluation could be an important component in the overall approach to providing accurate prevention and treatment in the management of patients with temporomandibular disorder.

 

24) Respiratory dysfunction in chronic neck pain patients. A pilot study.

Cephalalgia. 2009 Jul;29(7):701-10. Kapreli E, Vourazanis E, Billis E, Oldham JA, Strimpakos N.

The aim of this pilot study was to add weight to a hypothesis according to which patients presenting with chronic neck pain could have a predisposition towards respiratory dysfunction. Twelve patients with chronic neck pain and 12 matched controls participated in this study. Spirometric values, maximal static pressures, forward head posture and functional tests were examined in all subjects. According to the results, chronic neck patients presented with a statistically significant decreased maximal voluntary ventilation and respiratory muscle strength. Furthermore, the current study demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck patients. The connection of neck pain and respiratory function could be an important consideration in relation to patient assessment, rehabilitation and consumption of pharmacological agents.

 

25) Influence of forward head posture on condylar position.

J Oral Rehabil. 2008 Nov;35(11):795-800. Ohmure H, Miyawaki S, Nagata J, Ikeda K, Yamasaki K, Al-Kalaly A.

There are several reports suggesting that forward head posture is associated with temporomandibular disorders and restraint of mandibular growth, possibly due to mandibular displacement posteriorly. However, there have been few reports in which the condylar position was examined in forward head posture. The purpose of this study was to test the hypothesis that the condyle moves posteriorly in the forward head posture. The condylar position and electromyography from the masseter, temporal and digastric muscles were recorded on 15 healthy male adults at mandibular rest position in the natural head posture and deliberate forward head posture. The condylar position in the deliberate forward head posture was significantly more posterior than that in the natural head posture. The activity of the masseter and digastric muscles in the deliberate forward head posture was slightly increased. These results suggest that the condyle moves posteriorly in subjects with forward head posture.

 

Check out the world’s best postural analysis software at this link: www.torquerelease.com.au/Posture-Pro-Software.htm

 

Yours for better health and better chiropractic

Nick Hodgson

EVEN MORE RESEARCH SHOWING THE DRAMATIC CLINICAL EFFECTS OF AURICULOTHERAPY

Monday, September 12th, 2011

There are a lot of modalities available to complementary health care professionals nowadays, and many claim significant benefits and often share testimonials of miraculous results. Whenever I check out a new technique the first question I ask is “how does it work?” The answer needs to follow some kind of logical and plausible physiological principles before I even ask the second question; “is there any research?” I have to be honest that I struggle with web-sites and marketing materials that are full of claims and stories, but lacking in rationale and evidence. Auriculotherapy is one method that has continued to impress and excite me, and for this reason it is one of the primary modalities that I offer in my own practice. This is the third in a regular update of recent research.

First let’s summarise the most recent findings:

1) Satisfaction in a wellness clinic: This study involved feedback from health professionals being given access to wellness services including Auriculotherapy once a week in the workplace. Most participants agreed or strongly agreed they felt more relaxed after sessions (97.9%), less stress (94.5%), more energy (84.3%), and less pain (78.8%). Ninety-seven percent (97%) would recommend it to a co-worker. Among surveys completed after five or more visits, more than half (59%-85%) strongly agreed experiencing increased compassion with patients, better sleep, improved mood, and more ease in relations with co-workers. Perceived benefits were sustained and enhanced by number of visits.

2) Effects on autonomic function in healthy individuals: The results of this study using non-invasive assessment methods showed a significant decrease in heart rate, a significant increase in heart rate variability total, and marked (but statistically insignificant) decrease in pulse wave velocity. This translates to signs of decreased stress physiology internally.

3) Chronic low back pain: This pilot study found that Auriculotherapy was safe and demonstrated additional clinical benefits when combined with exercise for people with chronic low back pain. This supports my own observation that the best treatment for low back pain is a combination of passive and active treatment.

4) Effect on inflammatory reactions: This study using animals showed that Auriculotherapy can increase serum Tumour Necrosis Factor and Interleukin-6, and down-regulate pulmonary NF-kappa B p 65 expression suggesting a cholinergic anti-inflammatory mechanism. This suggests a neurological pathway for antiinflammatory effects of Auriculotherapy which makes sense since Auriculotherapy is a neurological intervention!

5) Treatment of migraine attacks: This study compared using a reflex point well documented to relieve migraine (group A) versus a point unlikely to have a therapeutic effect (group B). During treatment, there was a highly significant trend in the reduction of symptoms in group A, whereas no significance was observed in group B. Symptoms were significantly lower in group A than in group B at 10, 30, 60 and 120 min after treatment. This study suggests that the therapeutic specificity of auricular points exists and is linked to the somatotopic representation of our body on the ear.

6) Analgesia and sedative effects during abdominal gynecological operation and effects on postoperative recovery of body function: This showed sedative, analgesic and function-regulating effects from Auriculotherapy. Anxiety was less, lower-doses of anaesthesia were required, breathing response was improved after the operation, and higher levels of serum beta-endorphin were found when Auriculotherapy was added. Anything that potentially improves surgical outcomes sounds like a really good thing to me!

7) Improving postural stability: Balance performance was measured on a force platform before and after Auriculotherapy. Main balance parameters pointed to an average short-term improvement of about 15% 1 hour after treatment and 5-10% after an interval of 3 days. However, a few participants showed a better than 30% improvement with the same parameters. The explanation tentatively put forward to account for the results was that Auriculotherapy reduces nociceptive interference and thus improves postural control.

8) Treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy: In this study Auriculotherapy treatment showed pain alleviation in headache, trigeminal neuralgia, and retro-auricular pain levels. The researchers noted that treatment number should be no less than 10 sessions.

9) Preoperative anxiety treatment: Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. The study concluded that Auriculotherapy was significantly effective in decreasing anxiety in preoperative patients.

Sounds like some good reasons to check out Auriculotherapy training to me… Go to http://www.torquerelease.com.au/Auriculotherapy-Discount.htm to find out more…

Now for the abstracts:

1) Employee use and perceived benefit of a complementary and alternative medicine wellness clinic at a major military hospital: evaluation of a pilot program.

J Altern Complement Med. 2011 Sep;17(9):809-15. 2011 Aug 11. Duncan AD, Liechty JM, Miller C, Chinoy G, Ricciardi R.

Abstract Objectives: The objectives of this study were to examine the feasibility of a weekly on-site complementary and alternative medicine (CAM) wellness clinic for staff at a military hospital, and to describe employees’ perceptions of program effectiveness. Setting: The study setting was the Restore & Renew Wellness Clinic at a United States Department of Defense hospital. Subjects: The subjects were hospital nurses, physicians, clinicians, support staff, and administrators. Interventions: The walk-in wellness clinic was open 8:00am – 2:00pm 1 day a week. Participants selected one or more modalities each visit: ear acupuncture, clinical acupressure, and Zero Balancing. Outcome measures: A self-report survey was done after each clinic visit to evaluate clinic features and perceived impact on stress-related symptoms, compassion for patients, sleep, and workplace or personal relationships. Results: Surveys completed after first-time and repeat visits (n=2,756 surveys) indicated that most participants agreed or strongly agreed they felt more relaxed after sessions (97.9%), less stress (94.5%), more energy (84.3%), and less pain (78.8%). Ninety-seven percent (97%) would recommend it to a co-worker. Among surveys completed after five or more visits, more than half (59%-85%) strongly agreed experiencing increased compassion with patients, better sleep, improved mood, and more ease in relations with co-workers. Perceived benefits were sustained and enhanced by number of visits. The most frequently reported health habit changes were related to exercise, stress reduction, diet/nutrition, and weight loss. Conclusions: This evaluation suggests that a hospital-based wellness clinic based on CAM principles and modalities is feasible, well-utilized, and perceived by most participants to have positive health benefits related to stress reduction at work, improved mood and sleep, and lifestyle.

2) Brain-modulated effects of auricular acupressure on the regulation of autonomic function in healthy volunteers.

Evid Based Complement Alternat Med. 2011 Aug 29. Gao XY, Wang L, Gaischek I, Michenthaler Y, Zhu B, Litscher G.

Auricular acupuncture has been described in ancient China as well as Egypt, Greece, and Rome. At the end of the 1950s, ear acupuncture was further developed by the French physician Dr. Paul Nogier. The goal of this study was to develop a new system for ear acupressure (vibration stimulation) and to perform pilot investigations on the possible acute effects of vibration and manual ear acupressure on heart rate (HR), heart rate variability (HRV), pulse wave velocity (PWV), and the augmentation index (AIx) using new noninvasive recording methods. Investigations were performed in 14 healthy volunteers (mean age ± SD: 26.3 ± 4.3 years; 9 females, 5 males) before, during, and after acupressure vibration and manual acupressure stimulation at the “heart” auricular acupuncture point. The results showed a significant decrease in HR (P ≤ 0.001) and a significant increase in HRV total (P = 0.008) after manual ear acupressure. The PWV decreased markedly (yet insignificantly) whereas the AIx increased immediately after both methods of stimulation. The increase in the low-frequency band of HRV was mainly based on the intensification of the related mechanism of blood pressure regulation (10-s-rhythm). Further studies in Beijing using animal models and investigations in Graz using human subjects are already in progress.

3) Exercise and Auricular Acupuncture for Chronic Low-back Pain: A Feasibility Randomized-controlled Trial.

Clin J Pain. 2011 Jul 12. Hunter RF, McDonough SM, Bradbury I, Liddle SD, Walsh DM, Dhamija S, Glasgow P, Gormley G, McCann SM, Park J, Hurley DA, Delitto A, Baxter GD.

OBJECTIVES: To evaluate the feasibility of a randomized-controlled trial (RCT) investigating the effects of adding auricular acupuncture (AA) to exercise for participants with chronic low-back pain (CLBP).

METHODS: Participants with CLBP were recruited from primary care and a university population and were randomly allocated (n=51) to 1 of 2 groups: (1) “Exercise Alone (E)”-12-week program consisting of 6 weeks of supervised exercise followed by 6 weeks unsupervised exercise (n=27); or (2) “Exercise and AA (EAA)”-12-week exercise program and AA (n=24). Outcome measures were recorded at baseline, week 8, week 13, and 6 months. The primary outcome measure was the Oswestry Disability Questionnaire.

RESULTS: Participants in the EAA group demonstrated a greater mean improvement of 10.7% points (95% confidence interval, -15.3,-5.7) (effect size=1.20) in the Oswestry Disability Questionnaire at 6 months compared with 6.7% points (95% confidence interval, -11.4,-1.9) in the E group (effect size=0.58). There was also a trend towards a greater mean improvement in quality of life, LBP intensity and bothersomeness, and fear-avoidance beliefs in the EAA group. The dropout rate for this trial was lower than anticipated (15% at 6 mo), adherence with exercise was similar (72% E; 65% EAA). Adverse effects for AA ranged from 1% to 14% of participants.

DISCUSSION: Findings of this study showed that a main RCT is feasible and that 56 participants per group would need to be recruited, using multiple recruitment approaches. AA was safe and demonstrated additional benefits when combined with exercise for people with CLBP, which requires confirmation in a fully powered RCT.

4) Effect of electroacupuncture of auricular concha on inflammatory reaction in endotoxaemia rats.

Zhen Ci Yan Jiu. 2011 Jun;36(3):187-92. Zhao YX, He W, Gao XY, Rong PJ, Zhu B.

OBJECTIVE: To evaluate the effect of electroacupuncture (EA) of the auricular concha (EA-AC) on serum cytokines contents and pulmonary transcription factor nuclear factor-kappaB (NF-kappaB) expression in lipopolysaccharide (LPS) induced endotoxaemia rats so as to study its mechanism underlying cholinergic anti-inflammatory efficacy.

METHODS: Male SD rats were randomized into normal control, model (LPS), simple EA-AC, EA-AC + LPS, vagal nerve stimulation (VNS) + LPS, and EA-Zusanli (ST 36) + LPS groups (n = 12/group). Endotoxaemia model was duplicated by intravenous (tail vein) injection of LPS (0.5 mL/kg). Two intradermal needles were inserted into the central sites of the cavity of concha and cymba of auricular concha respectively on each side and stimulated electrically by using an electrical stimulator (i.e, EA-AC). VNS was applied to the left cervical vagal nerve, and EA (1 mA, 10 Hz, pulse-width 1 ms) was also applied to bilateral “Zusanli” (ST 36). Serum cytokines (TNF-alpha IL-6) contents 2 h after modeling were determined by using enzyme linked immunosorbent assay (ELISA), and pulmonary NF-kappaB p 65 expression 2 h after modeling was detected by using western blotting.

RESULTS: Compared with the normal control group, serum TNF-alpha and IL-6 contents, and pulmonary NF-kappaB p65 expression level in the model group were increased significantly (P < 0.01). In comparison with the model group, serum TNF-alpha contents in the simple EA-AC, EA-AC + LPS, VNS+ LPS and ST 36 + LPS groups, and serum IL-6 contents and pulmonary NF-kappaB p 65 expression levels in the simple EA-AC, EA-AC + LPS and VNS + LPS groups were down-regulated considerably (P < 0.05, P < 0.01). Compared with the VNS + LPS group, serum TNF-alpha -28) and IL-6 contents, and pulmonary NF-kappaB p 65 expression level in the ST 36 + LPS group were increased significantly (P < 0.05, P < 0.01). In comparison with the EA-AC + LPS group, pulmonary NF-kappaB p 65 expression level in the ST 36 + creased remarkably (P < 0.05).

CONCLUSION: Both EA of auricular concha and vagus nerve stimulation can increase serum TNF-alpha and IL-6 contents, and down-regulate pulmonary NF-kappaB p 65 expression level in endotoxaemia similar cholinergic anti-inflammatory mechanism between them.

5) Ear acupuncture in the treatment of migraine attacks: a randomized trial on the efficacy of appropriate versus inappropriate acupoints.

Neurol Sci. 2011 May;32 Suppl 1:S173-5. Allais G, Romoli M, Rolando S, Airola G, Castagnoli Gabellari I, Allais R, Benedetto C.

Ear acupuncture can be a useful mean for controlling migraine pain. It has been shown that a technique called the Needle Contact Test (NCT) can identify the most efficacious ear acupoints for reducing current migraine pain through just a few seconds of needle contact. The majority of the points were located on the antero-internal part of the antitragus (area M) on the same side of pain. The aim of this study was to verify the therapeutic value of area M and to compare it with an area of the ear (representation of the sciatic nerve, area S) which probably does not have a therapeutic effect on migraine attacks. We studied 94 females suffering from migraine without aura, diagnosed according to the ICHD-II criteria, during the attack. They were randomly subdivided into two groups: in group A, tender points located in area M, positive to NCT were inserted; in group B, the unsuitable area (S) was treated. Changes in pain intensity were measured using a VAS scale at various times of the study. During treatment, there was a highly significant trend in the reduction of the VAS value in group A (Anova for repeated measures: p < 0.001), whereas no significance was observed in group B. VAS values were significantly lower in group A than in group B at 10, 30, 60 and 120 min after needle insertion. This study suggests that the therapeutic specificity of auricular points exists and is linked to the somatotopic representation of our body on the ear.

6) Effects of magnetic auricular point-sticking on adjuvant anesthesia and postoperative recovery of body function.

Zhongguo Zhen Jiu. 2011 Apr;31(4):349-52. Li WS, Cui SS, Li WY, Zhao WX, Wanlai SQ.

OBJECTIVE: To prove analgesia and sedative effect of adjuvant anesthesia with magnetic auricular point-sticking on abdominal gynecological operation and its effect on postoperative recovery of body function.

METHODS: Ninety-two patients with abdominal gynecological operation were randomly divided into 3 groups. The auricular point-sticking group (APS group, n=31) was pasted and pressed by plasters with magnetic beads at bilateral Shenmen, Pizhixia (subcortex), Zigong (uterus) and Penqiang (pelvic cavity), etc. the night before operation. The placebo group (n=31) was pasted by plasters without magnetic beads. The blank group (n=30) was given no intervention. The mental and gastrointestinal functional changes before and 3 days after the operation were observed.

RESULTS: As compared with those in the control group and the blank group, the postoperative score of Self rating Anxiety Scale (SAS) was less (25.5 +/- 0.81 vs. 28.9 +/- 3.19, 28.3 +/- 2.36, both P < 0.01), with lower-dose of Innovar [(2.5 + 1.1) mL vs. (3.4 + 1.8) mL, (3.2 + 1.6) mL, both P < 0.05], earlier exsufflation after the operation [(34.2 + 12.1) h vs. (46.3 + 10.9) h, (43.2 + 14.8) h, both P < 0.01] and higher level serum of beta-endorphin before and after the operation in the APS group (all P < 0.05).

CONCLUSION: The magnetic auricular point-sticking has sedative, analgesic and function-regulating effects on the abdominal gynecological operation.

7) Laser acupuncture and auriculotherapy in postural instability – a preliminary report.

J Acupunct Meridian Stud. 2011 Mar;4(1):69-74. Bergamaschi M, Ferrari G, Gallamini M, Scoppa F.

The risk of falling is rather high among elderly people. Indexes obtained through the Romberg stabilometric test on a force platform have been suggested to be correlated with the risk of falling. This work aimed to test the effectiveness of auriculopuncture and ultralow-power laserpuncture versus placebo (sham stimulation) in improving postural control in an elderly population. Balance performance was measured on a force platform before and after both forms of stimulation. Main balance parameters pointed to an average short-term improvement of about 15% 1 hour after treatment and 5-10% after an interval of 3 days. However, a few participants showed a better than 30% improvement with the same parameters. Although the sample size does not allow reliable statistical analysis, the modifications are remarkable and some differences are observed between the two kinds of stimulation. Further testing with larger sized groups and including one further group using both stimulations is suggested. Although postural instability has to be defined as multi-factorial, it is often associated with balance dysfunctions that cannot be related to vestibular or central impairments but rather to proprioceptive deficits. A significant role may be ascribed to (even subliminal) nociceptive interferences with proprioceptive inputs and to a reduced capacity for updating cortical motor control models in the case of progressively declining locomotor capabilities. The explanation tentatively put forward to account for the results observed in the present preliminary study is that laser acupuncture and auriculopuncture stimulations reduce nociceptive interference and thus improve postural control.

8) A clinical pilot study comparing traditional acupuncture to combined acupuncture for treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy.

J Acupunct Meridian Stud. 2011 Mar;4(1):29-43. Ahn CB, Lee SJ, Lee JC, Fossion JP, Sant’Ana A.

Traditional acupuncture (TA) and ear acupuncture (EA) are used for treatment of headache, trigeminal neuralgia, and retro-auricular pain. The purpose of this study is to develop effective treatment using combined acupuncture (CA) which consists of TA and EA and to set clinical protocols for future trials. Participants were divided into TA (n = 15) control and CA (n = 34) experimental groups. Obligatory points among Korean Five Element Acupuncture and optional individual points along with symptom points were used in the TA group. The CA group was exposed to ear points of Fossion and TA. Acupuncture treatment consisted of six mandatory sessions per patient over 3 weeks and extended to 12 sessions. Pain was assessed using the visual analogue scale. We compared TA to CA and researched their relevant publications. No significant difference was observed between the two groups (p = 0.968) which showed pain-alleviating tendency. Pain alleviation was significantly different after the fifth and sixth sessions (p = 0.021, p = 0.025), with headache being the most significantly relieved (F = 4.399, p = 0.018) among the diseases. When assessing pain intensity, both the Headache Impact Test and the Migraine Disability Assessment Scale should be adopted for headache and the fractal electroencephalography method be used in pain diseases. In the future, studies should consist of TA, EA, and CA groups; each group having 20 patients. Treatment number should to be no less than 10 sessions. Korean Five Element Acupuncture should be a compulsory inclusion along with individual points being optional inclusion in TA. EA could be selected from Nogier, Fossion and so forth. In conclusion, acupuncture treatment, whether TA or CA, showed pain alleviation in headache, trigeminal neuralgia, and retro-auricular pain, but no significant difference was seen between groups. Prospective, well-controlled, and relevant protocols using multimodal strategies to define the role of TA, EA, and CA are needed.

9) Comparing the treatment effectiveness of body acupuncture and auricular acupuncture in preoperative anxiety treatment.

J Res Med Sci. 2011 Jan;16(1):39-42. Wu S, Liang J, Zhu X, Liu X, Miao D.

BACKGROUND: Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. Many studies have reported the effect of body acupuncture in reducing anxiety syndromes. The aim of this study is to compare the treatment effect of body acupuncture and auricular acupuncture in preoperative patients with preoperative anxiety.

METHODS: Thirty five elective ambulatory surgery patients were selected in the randomized and blinded trial. Subjects were randomly categorized in two intervention groups, the body acupuncture group who received acupuncture in the special points of body, and the auricular acupuncture group who received ear acupuncture. Zung Self-Rating Anxiety Scale (SAS) was used before and after the study.

RESULTS: For the auricular acupuncture group, the mean score of SAS was 57.57 ± 8.22 before the intervention and 46.32 ± 6.37 afterward. For the body acupuncture group, the SAS score was 55.39 ± 5.41 and 44.82 ± 6.76 before and after the intervention, respectively. For both groups, the difference between pre- and post-treatment scores reached the significant level (p = 0.00).

CONCLUSIONS: Both auricular and body acupuncture treatment methods were effective in decreasing anxiety in preoperative patients.

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HOLOGRAPHIC BRAIN MODEL AND CHIROPRACTIC

Monday, May 31st, 2010

I’ve seen a Tasmanian Tiger! Well if I’m completely honest it was a hologram of a Tassie Tiger – but boy did it look pretty damn real: I kept trying to reach out to touch it – probably not something you would have done had you met one in the wild? Now I could make the claim that if there had been more Chiropractors and less poachers in Tasmania – the Tassie Tiger may still be alive today: But that’s not what this article is about – we’ll get back to chiropractic later…

Holograms are quantum physics photographs – a different paradigm in recording and then projecting an image of a three dimensional object. Have you ever bought one while strolling around a Sunday morning community market? You look at it from any angle and you still see the 3D image. And here is another fact about holograms – if you were to break it in half you would still see the whole image on each of the broken fragments: This is because each fragment of the whole records enough information about the whole to be able to reproduce an image of it. Another way of considering this is that the whole is in the part – and the part can reproduce the whole.

Let’s take a closer look: A traditional photograph is stored dots with spatial relationship to each other – it is a linear analogue recording of the object being photographed. When you photograph the object the information is converted to dots which copy the colour and shade of each part of the object. The higher the resolution, the more the dots in a concentrated area, and hence the more detail the image will record. Now think of how your computer printer works – it sprays coloured dots onto a piece of paper based on this image recording to give you a reproduction of the object in 2-D. Now take pair of scissors and cut the paper in half – you’ll now be left with a top half and a bottom half of the image. Keep cutting into halves and you’ll end up with a jigsaw puzzle – small parts of  a photo that make no sense until they are all pieced back together again.

A holographic recording is very different – instead of recording dots, it records relationships. The reason you see an amazingly accurate copy of the object when looking at a holographic image is because the relationships of all the components of the object are three dimensional so the image looks 3-D. And if you break the holographic image into half – what’s left will still record those relationships, so that you will see what looks like the whole object. Each time you break the image into a smaller part you lose clarity because the amount of information that is stored about the relationships of the object diminishes, but you’ll still see the whole object in the image.

Now what has this got to do with Chiropractic? The “whole in every part” concept suggested by the holographic model should not be a difficult concept for the average Chiropractor. But next we need to look at what holographic modelling has to do with the brain – then we can make the jump to what we do in our offices all day every day.

As neuroscientists were studying how the brain functions they were repeatedly confronted by major problems: Where does a memory live was one of those big questions. In undergraduate studies we are taught about anatomical regions of the brain and we try to memorise the primary function of each one of these components. Problem is that it is actually not that simple even though it is a great way of writing really difficult exam papers.

As brain imaging advanced and researchers started to be able to observe which parts of the brain switch on when particular mental and physical functions are being performed it had to be concluded that memories are stored based on the relationships between different brain cells and centres that are activated when perceiving the experience – that is, memories are dispersed throughout the brain. Prior to this it was thought that the brain stored information in an analogue form – they just couldn’t find the part of the brain where the dots were stored.

In a series of landmark experiments in the 1920s, brain scientist Karl Lashley found that no matter what portion of a rat’s brain he removed he was unable to eradicate its memory of how to perform complex tasks it had learned prior to surgery. The only problem was that no one was able to come up with a mechanism that might explain this curious “whole in every part” nature of memory.

Then in the 1960s Karl Pribram encountered the concept of holography and realized he had found the explanation brain scientists had been looking for. Pribram believes memories are encoded not in neurons, or small groupings of neurons, but in patterns of nerve impulses that criss-cross the entire brain in the same way that patterns of laser light interference criss-cross the entire area of a piece of film containing a holographic image. In other words, Pribram believes the brain is itself a hologram.

And based on this breakthrough, it was recognised that the anatomical centres that had been suspected to be storage facilities, were actually processors that help to convert the perceptions of images into stored relational information and then back into being 3-D images that can be retrieved.

Pribram’s theory also explained how the brain can memorize something in the order of 10 billion bits of information during the average human lifetime (or roughly the same amount of information contained in five sets of the Encyclopaedia Britannica): Similarly, holograms possess an astounding capacity for information storage – simply by changing the angle at which the two lasers strike a piece of photographic film, it’s possible to record many different images on the same surface. It has been demonstrated that 1cm3 of film can hold as many as 10 billion bits of information.

This shift in understanding has even been taken to new heights with attempts to explain creative, intuitive, spiritual and even paranormal insight based on the idea that we as an individual are not as isolated as we might think and may be part of a bigger holographic picture – the universe: I’ll leave that for you to ponder with friends and a glass of good red in your hand, sitting on the side of a hill watching an awesome sunrise, or while meditating or worshipping however you do.

So let’s get closer to a Chiropractor in his or her practice, trying to help his or her practice members to enjoy a better quality of life. There in is the keyword – QUALITY. The quality of a holographic image is dependent on the quality of the information recorded – you have to have some pretty high-tech lasers and electronics to make a holographic image.

(A hologram is a three- dimensional photograph made with the aid of a laser. To make a hologram, the object to be photographed is first bathed in the light of a laser beam. Then a second laser beam is bounced off the reflected light of the first and the resulting interference pattern (the area where the two laser beams co-mingle) is captured on film. When the film is developed, it looks like a meaningless swirl of light and dark lines. But as soon as the developed film is illuminated by another laser beam, a three-dimensional image of the original object appears.)

In the human context the quality of your perceptions and hence all your choices that follow is dependent on your senses and the quality of the neurological connections that record and then access the stored relationships to result in pro-life choices much like a hologram.

According to Pribram, if you divide neural activity, you can divide it into propagative nerve impulses on the one hand, and then these slow potentials – hyperpolarizations, steep polarizations – that don’t go anywhere. And they form this holographic-like pattern, and it’s those that he feels are what we experience as images. DD Palmer described these polarizations as the “Mental Impulse” and this pattern as “TONE”.

The term which is most apt to connect the concept of holographic brain modelling and the chiropractic concept of subluxation is dysafferentation. Increasing numbers of research papers and intellectual commentaries are discussing how a subluxation interferes with the body’s proprioceptive awareness: And if you mess with the input, you mess with the output – “junk in – junk out”.

Another way of looking at this is that a Subluxation is like a missing piece of the hologram – the whole body picture remains, BUT, the quality of the image will be diminished – reduced quality of life!

Let’s consider this in the light of what we look at every day – posture. When you look at someone’s posture you are seeing so much more than head, shoulder and pelvis levels, forward head posture, forward pelvic tilt, and abnormal spinal curves – you are seeing a holographic projection of that person’s image of themselves. Let me say that in another way – when you observe posture you are reading that person’s language of how they see themselves – their body language – and what you see is a holographic projection from their nervous system.

I like to stretch Chiropractors perception of what they see and do and one concept that I often discuss is that posture is not body part alignment – it is the representation of a person’s ability to perceive and position their body parts in space. This depends on excellent kinaesthetic awareness and accurate somatic coordination – these are neurological phenomena, not mechanical functions.

The way I describe this to my practice members is I show them a digital photos of themselves standing, along with objective measurements of their body alignment and ask them what they see. People are not silly, and they nearly always notice their head and neck alignment and the belly that results from their pelvic distortion. I then ask them why they think they are carrying their head around like that! While some will come up with lame excuses like, “I wasn’t ready to have my picture taken, take it again and I’m sure I’ll look better” (they never do – I’ve done it), or “I wasn’t feeling too good that day, I’m feeling better today so I’m sure it will be fine now” (it never is), most on the other hand shrug their shoulders and ask me to explain: I then ask them that if they could feel that their head and pelvis were that far out of alignment do they think that they could attempt to self-correct and they all agree that they could. And that is the answer – the reason their head and pelvis and whatever else is so far away from gravitational efficiency is because they don’t know! Their holographic image of themselves is so distorted the image that they present to the world around them is distorted.

Similarly when your practice member is lying prone on your adjusting bench and you attempt to centre their torso and legs on the bench, how often do they say to you; “now I feel crooked”. But you know and can see that they are now centred – their original position was the crooked one. Again the relationship between their perception of their body alignment and the expression of their body alignment is disconnected – dysafferentation due to Subluxation has led them to express a distorted self-image – a dysfunctional holographic image.

When teaching Torque Release Technique we discuss the fourteen indicators of Subluxation, one of these being postural assessment. We break postural assessment into three types: standing, sitting and prone – each being a separate and distinct neurological projection from within. And we translate this language to assist the Chiropractor to interpret what Subluxation patterns may be underlying. A better understanding of posture acts as a great objective outcome tool, helps to make the Chiropractor’s clinical decision more intuitive and precise, and impresses practice members enormously when they see how differently they look with improved posture.

AND, if you understand and communicate the deeper neurological dimensions of posture and all the other indicators that you observe, you can shift your practice members away from pain and suffering, towards a more vitalistic and wellness focussed outlook and behaviours.

But from an even bigger picture – if you improve the holographic photo that someone is taking of themselves every second of their life, you can enormously alter and improve the holographic image that they present to the world and based on the holographic model this will impact the self image and behaviour of every cell in the human body – and perhaps even the universe around them – now that sounds like a truly BIG IDEA!

To find out more about Torque Release Technique Training and to take advantage of great online savings go to this link: www.torquerelease.com.au/Torque-Release-Discount.htm

© 2010, Dr Nick Hodgson, 2005 Victorian Chiropractor of the Year

GROW YOUR PRACTICE IN 3 EASY STEPS

Thursday, November 13th, 2008

1) More word of mouth referrals

How many times have you been talked around by a slick sales-type offering you the greatest marketing opportunity yet? From Newspaper ads, to calendars and target audience magazines, to bigger and bigger Yellow Pages displays, to online directories with millions of visitors, to radio stations and even TV presenting themselves as the only way to convert prospects to buyers!

Have you worked this out yet? Some of your ads work and some don’t; but when you average the cost of all your campaigns against the return on your investment – you might be better spending your hard earned cash on something more reliable and sustainable.

What about spending some of that money on a practice resource that will consistently and persistently increase the number of word of mouth referrals you receive, AND, is a one-off investment?

Don’t we all know that word of mouth referrals are what have built this great profession? Nothing will grow your practice faster and stronger than a steady stream of new patients who have been recommended by an established patient – it seems to become contagious.

2) Impress your new patients so much that they commit to your recommendations

Do you hear this after you have examined and explained your recommendations to a prospective patient? “Why hasn’t anyone else checked me out this thoroughly before? You are the first person who has been able to explain why I am feeling the way I am! What do I need to do to fix this?”

If on the other hand you hear statements like this after conducting your report of findings: “So is it just muscles?” (they haven’t understood a word you said); “how long do you think it will take for my pain to go away” (you haven’t shifted their consciousness beyond how they are feeling to how they are functioning); “My doctor said it was lumbago” (you aren’t the expert in their mind and they won’t listen to you); “so overall I’m not so bad” (nothing you have done or said has shifted their denial mechanisms).

To make this quantum shift in practice growth in this day and age requires technology that demonstrates clearly, visually and impressively that the person has definite functional problems which need your help to correct (whatever it is that YOU do to help, regardless of how long you think this will take, and no matter how much you charge to do it).

3) Maximise your patient retention

Fred Barge used to ask the pointed question: “Are you the doctor, doctor?” Here’s the plain truth – if you are relying on how your patients are feeling to determine if they continue to see you – you are at the mercy of the retention angels: Some people will feel better, and will still stop coming to see you. Some won’t feel better and will stop coming to see you. Some won’t hang around long enough to even find out if they are feeling better or not. In other words you could be practicing in a leaky boat, and totally dependent on the flow of new patients in, to compensate for the outflow.

There are only three reasons why someone continues to see you, regardless of whether we are talking about for the next few weeks, or for the next several years:

a) They are consciously aware of the benefit/s that they have been receiving from seeing you: Do you have the tools to assist them to be completely aware of the benefits of your care?

b) They perceive that they will receive benefits in the future from continuing to see you: Do you have a tool that can demonstrate room for improvement, and justify them to continue to see you till their next re-exam and beyond?

c) They like you and your staff and will do whatever you say to continue the relationship: This may be enough to plateau a practice but it will never grow a practice.

Posture Pro Digital Postural Analysis Software is a tried, trusted, reliable and proven tool to stimulate referrals, improve conversion and increase retention for the following reasons:

1) Generate an impressive full colour posture report which people not only look at themselves, but they show it to others, and refer others to have an assessment

2) It is very quick and efficient to conduct an exam: Can even be performed by a trained tech CA. In exam mode you should be able to complete the assessment and print it in 5 minutes. Even quicker if using screening mode.

3) Is very visual requiring little translation: People usually can see the problems without any need for explanation – “is that really me – what do I have to do to change that?”

4) Is an objective functional assessment: Posture is an accepted functional outcome by many professions and has a substantial research base which justifies the need for corrective measures – It’s convincing!

5) Can be monitored and compared through time as regularly as you like – you don’t have to wait three months to re-exam if you don’t want to. Posture can be improved quickly and progressively through time, making it both a great short term and long term measure

6) Demonstrates both visually and objectively progress under care acting as a reward for positive response, and as a motivator for continued improvement under your care

7) Is an awesome quality assurance tool – I often get asked, does posture improve under your care? There are two answers to this: “YES”, and, “if it doesn’t then it’s about time you had the tool to direct you to improve your methodologies to improve your outcomes”.

8) When you compare the initial cost to the returns from referrals, compliance and retention this software pays for itself in a couple of months, and then generates consistent increased returns for miniscule ongoing costs (paper and ink for your printer)

9) Can be completely portable making it great for presentations, screenings, expos and external events.

10) Is simple and easy to introduce and implement into any style of practice: Easy to install, email tech support, free upgrades, thorough instruction manual, plus a pile of bonus materials to help get you started or to maximise your results in diverse ways.

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MAYBE THOSE PHYSICAL FINDINGS… AREN’T…

Friday, July 18th, 2008

THE MIND BODY CONNECTION

Within our chiropractic training and culture is a diverse range of physical indicators that we observe, measure and monitor to help us to diagnose our patients’ physical state: The history is used to narrow down our list of disorders or even diseases which may be causing the problem; Posture tells us how misaligned someone’s body and spine is; Radiographs show us how much decay and degeneration has developed; Range of motion tests measure how stiff they have become; SEMG assesses how tight muscles are; our palpation skills feel where there is contraction, restriction, fixation and misalignment.

And then we apply a physical therapy to try and intervene on the physical disorder that we have isolated.

It has almost become a cliché that there is a mind/body connection. But have we tended to minimise this relationship? Or have we even missed the point of this revelation? Are we persisting with the convenient separation and compartmentalisation of these two dimensions? We say, “oh yes the mind can affect the body, and the body can affect the mind” – but in saying this do we miss the paradigm of the mind/body relationship?

In other words the mind IS the body, and the body IS the mind.

When you are feeling certain emotions like anger, resentment, guilt, frustration – your physical body is different to how it is when you are feeling emotions like love, acceptance, peace, joy, reward. And if your physical body is different, then your thoughts, feelings and emotions are different. One doesn’t lead to the other – one is the other.

Let’s take another look at our list of “physical indicators” from another point of view, to see if we can see what they might really mean in terms of the mind/body:

The History is really someone’s story about the suffering they currently feel. And we are very good at asking questions about how the suffering feels: Where it hurts, how much it hurts, how big an area does the hurt cover, when does it feel a bit better and when does it feel a bit worse? But do we miss the most important question? What does the hurt mean – to them? Here’s another way of asking this question to help those who can’t make a connection – “if this hurt didn’t go away what would it mean you couldn’t do?”, or “if this hurt didn’t go away what aspect of your life do you think would be most affected?” Do you know that if something in your therapeutic relationship and encounter doesn’t allay or release this connection between their pain and suffering, that their mind/body will resist healing?

Postural Assessment: Why does anyone have bad posture? Because they don’t know they have it! Why would anyone carry their head too far forwards when that skull and its contents are as heavy as a bowling ball? Because they don’t recognise that it is where it is – they have poor somatic awareness. Here’s a thought – they will also have a proportionately poor psychic awareness. In other words they will actually have poor somatopsychic awareness. Check it out next time you examine someone with really bad posture: Ask them how they are feeling emotionally, ask them how aware they are of each of their internal bodily functions: More often than not the same disconnect will exist.

What about those protective buttresses that are being layered down inside their body – the ones you see growing around their skeleton on their Radiographs? Ask yourself this question: How strong, thick and solid are the protective mechanisms that this person has built around their emotions and memories? What will it take to chip away this person’s emotional fortress? The resistance, slowness of their recovery and the common poor prognosis could be reflective of their hardened interaction with the world in a more general sense.

And that stiffness that has built up in their Spinal Range of Movement, that you prescribe stretching exercises to reverse. Here is my observation: Range of motion is directly proportionate to range of emotion. My saying goes like this – “concrete body – concrete mind”. Observe how flexible these people are to suggested changes in their state of mind or lifestyle, and you may see a mirror image of their body’s flexibility.

What about that tension that you see on their SEMG? You may interpret it as physical tension: And you might ask; “maybe you are working too hard”, “maybe you did too much gardening on the weekend”, “maybe you aren’t sitting up straight”? How about this one – muscle tension is proportionate to neurological tone, which is dependent on emotional state. Maybe their body hasn’t been working overtime – maybe their mind has.

And all those things you “feel” while you are Palpating: Stiffness, resistance, swelling, and misalignment. Have you ever taken a moment to ask yourself while you have a direct connection with this person’s field of intelligence: “What am I feeling as I palpate this person?” You may be great at palpating, but, if you get good at feeling, then you will get even better at FEELING. You may even glean more insight into that person’s state of wellbeing in thirty seconds of palpation than sixty minutes of talk…

How does any of this help you to become a better healer, or a more profitable businessman? When you GET IT, that you are a body/mind and that your practice members are body/minds – Then you will experience greater quality and wholeness in your life, and your customers will receive greater quality and wholeness from you as a healer – and people pay for quality

(ps. If you think that this is suggesting that you have to become more of a psychologist or counsellor to be a better chiropractor – then you have missed the point – this has nothing to do with analysing and identifying the past hurts and experiences and helping someone to cognitively overcome the related dysfunctional thoughts and feelings. What this is about is that there is a whole new dimension awaiting you when you become more conscious of the mind/body synergy – what you are doing right now therapeutically will offer a much deeper meaning for both you and your practice members. In other words I am not talking about a change in procedure – but a change in consciousness.)

Find Out More About Training To Help You Make This Transition at http://www.torquerelease.com.au/TRT-Training.htm