Publications 2015 2018-01-18T21:38:02+00:00

Publications 2015

Changes in H-reflex and V-Waves Following Spinal Manipulation

Niazi, I. K., Türker, K. S., Flavel, S., Kinget, M., Duehr, J., & Haavik, H (2015)

Experimental Brain Research, 233(4), 1165-1173

This study investigates whether spinal manipulation leads to neural plastic changes involving cortical drive and the H-reflex pathway. Soleus evoked V-wave, H-reflex, and M-wave recruitment curves and maximum voluntary contraction (MVC) in surface electromyography (SEMG) signals of the plantar flexors were recorded from ten subjects before and after manipulation or control intervention. Dependent measures were compared with 2-way ANOVA and Tukey’s HSD as post hoc test, p was set at 0.05. Spinal manipulation resulted in increased MVC (measured with SEMG) by 59.5 ± 103.4 % (p = 0.03) and force by 16.05 ± 6.16 4 % (p = 0.0002), increased V/M max ratio by 44.97 ± 36.02 % (p = 0.006), and reduced H-reflex threshold (p = 0.018). Following the control intervention, there was a decrease in MVC (measured with SEMG) by 13.31 ± 7.27 % (p = 0.001) and force by 11.35 ± 9.99 % (p = 0.030), decreased V/M max ratio (23.45 ± 17.65 %; p = 0.03) and a decrease in the median frequency of the power spectrum (p = 0.04) of the SEMG during MVC. The H-reflex pathway is involved in the neural plastic changes that occur following spinal manipulation. The improvements in MVC following spinal manipulation are likely attributed to increased descending drive and/or modulation in afferents. Spinal manipulation appears to prevent fatigue developed during maximal contractions. Spinal manipulation appears to alter the net excitability of the low-threshold motor units, increase cortical drive, and prevent fatigue.

Improvements in Mood, Posture and Balance in an Older Patient Receiving Chiropractic Care: A Case Study

Bredin, M., Putt, K. (2015)

Annals of Vertebral Subluxation Research May 21, 2015 (125-129)

Objectives: To report on and discuss the changes in a 72 year old male who presented for chiropractic care suffering from multiple health complaints.

Case History: A 72 year old male presented to a private chiropractic practice in Auckland, New Zealand suffering from severe postural alterations, mild depression, low back pain, balance disturbances, perpetual tiredness and mild depression.

Interventions and Outcomes: Over a nine week period, a specific and conservative chiropractic care plan was provided to the patient. The care plan involved Network Spinal Analysis (NSA) adjustments and the frequency of care was altered throughout this period based on both subjective and objective measures. A complete health history and physical examination was completed prior to care. A full posture analysis (Posture Pro 8 posture analysis system), and surface electromyography (sEMG) scans were performed at baseline and were then monitored regularly over the nine week period. Subjective measures were also monitored during each adjustment visit. Significant improvements were noted in postural and sEMG findings as well as in subjective measures of health over the 9 week period.

Conclusions: While under chiropractic care, improvements in both self-reported subjective and objective measures were noted in a patient with severe postural alterations, low back pain, balance disturbances, perpetual tiredness and a mildly depressive state of mind. These improvements include overall physical, mental, and emotional well-being of the patient.

Long Term Chiropractic Care and Parkinson’s Disease in a 73 Year Old Male: A Case Report

Bredin, M., Morahn, A. (2015)

Annals of Vertebral Subluxation Research June1, 2015 (130-134)

Objective: To present the case of a 73 year old patient with Parkinson’s disease with concomitant vertebral subluxations.

Clinical Features: The patient presented to a chiropractor at age 63 seeking relief for chronic lower back pain. He had been experiencing a resting tremor in his right arm since 2000 and was diagnosed with Parkinson’s disease in 2003 at which time he was prescribed Disipal (50 mg, once daily). His main complaints at the time of presentation were loss of balance, trouble initiating gait, and foot drop in the left leg.

Interventions and Outcomes: Chiropractic adjustments were delivered using Diversified technique at a frequency of three times per week for four weeks, then decreased to once a week for the next ten years. After 10 years of chiropractic care and medical therapy the patient is now experiencing fewer symptoms than when he was first diagnosed with Parkinson’s disease and is still able to have an active lifestyle caring for himself and playing sports several times per week.

Conclusion: It is possible that this patient benefited by adding chiropractic care to his existing drug treatment for Parkinsonian symptoms. Further research is needed to investigate the potential role chiropractors may play in providing care to people with Parkinson’s disease.

Resolution of Breastfeeding and Gastrointestinal Complaints in Infant Twins with Plagiocephaly & Scaphocephaly Following Birth Trauma: A Case Series Report

Collins, K., Alcantara, J., Holt, K (2015)

J. Pediatric, Maternal & Family Health, 2015(1) 34-41

Objective: This article describes and discusses the chiropractic care of seven month old prematurely delivered fraternal twin boys with plagiocephaly and scaphocephaly.

Clinical Features: Seven month old fraternal twin boys with chronic reflux, breastfeeding difficulties, irritability, excessive crying, plagiocephaly, and scaphocephaly were presented by their mother for chiropractic care.

Intervention and Outcome: The children received spinal and cranial adjustments based on Sacro Occipital and Neuro Emotional Technique protocols. After 8 weeks of chiropractic care the mother reported a decrease in severity of the twins reflux, breastfeeding difficulties and irritability. At 16 weeks of chiropractic care the twins reflux had ceased and their cranial symmetry had markedly improved.

Conclusion: Complaints associated with birth trauma including deformational plagiocephaly, breastfeeding difficulties and general irritability improved in seven month old twin boys while they were receiving chiropractic care. We support further research to examine the role chiropractors may play in caring for infants with plagiocephaly and other complaints associated with birth trauma.

Somatosensory Evoked Potentials Show Plastic Changes Following a Novel Motor Training Task With the Thumb

Andrew, D., Haavik, H., Dancey, E., Yielder, P., & Murphy, B. (2015)

Clinical Neurophysiology, 126(3), 575-580

Objective: Accumulating evidence indicates that plastic changes can be maladaptive in nature, resulting in movement and neurological disorders.
The aim of this study was to further the understanding of these neurophysiological changes in sensorimotor integration (SMI) using somatosensory evoked potentials (SEPs) and concurrent performance changes following a repetitive typing task.

Methods: SEPs were recorded following median nerve stimulation at the wrist and performed pre and post intervention. 24 participants were randomly assigned to either an intervention group which performed a 20 min repetitive typing task or a control group which participated in a 20 min period of mental recitation.

Results: The P22–N24 amplitude increased by 59.6%, compared to only 0.96% increase following the control. The P22–N30 SEP peak amplitude increased on average 13.4% following the motor training, compared to only 0.92% following the control. Significant improvement in reaction time when comparing performance of the motor task for the intervention group was observed.

Conclusions: The N24 increase supports the involvement of cerebellar connections and the N30 increase provides further support for changes in SMI following motor learning.

Significance: Combining motor training tasks with electrophysiological techniques gives insight into the mechanisms of disordered SMI and whether the changes are adaptive or maladaptive.

Comparison of Features for Movement Prediction from Single-Trial Movement-Related Cortical Potentials in Healthy Subjects and Stroke Patients

Kamavuako, E. N., Jochumsen, M., Niazi, I. K., & Dremstrup, K. (2015)

Computational Intelligence and Neuroscience, 2015

Detection of movement intention from the movement-related cortical potential (MRCP) derived from the electroencephalogram (EEG) signals has shown to be important in combination with assistive devices for effective neurofeedback in rehabilitation. In this study, we compare time and frequency domain features to detect movement intention from EEG signals prior to movement execution. Data were recoded from 24 able-bodied subjects, 12 performing real movements, and 12 performing imaginary movements. Furthermore, six stroke patients with lower limb paresis were included. Temporal and spectral features were investigated in combination with linear discriminant analysis and compared with template matching. The results showed that spectral features were best suited for differentiating between movement intention and noise across different tasks. The ensemble average across tasks when using spectral features was (error = 3.4 ± 0.8%, sensitivity = 97.2 ± 0.9%, and specificity = 97 ± 1%) significantly better (?? < 0.01) than temporal features (error = 15 ± 1.4%, sensitivity: 85 ± 1.3%, and specificity: 84 ± 2%). The proposed approach also (error = 3.4 ± 0.8%) outperformed template matching (error = 26.9 ± 2.3%) significantly (?? > 0.001). Results imply that frequency information is important for detecting movement intention, which is promising for the application of this approach to provide patient-driven real-time neurofeedback.

EMD-Based Temporal and Spectral Features for the Classification of EEG Signals Using Supervised Learning

Riaz, F., Hassan, A., Rehman, S., Niazi, I. K., & Dremstrup, K. (2015)

IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2015

This paper presents a novel method for feature extraction from electroencephalogram (EEG) signals using empirical mode decomposition (EMD). Its use is motivated by the fact that the EMD gives an effective time-frequency analysis of non-stationary signals. The intrinsic mode functions (IMF) obtained as a result of EMD give the decomposition of a signal according to its frequency components. We present the usage of up to third order temporal moments, and spectral features including spectral centroid, coefficient of variation and the spectral skew of the IMFs for feature extraction from EEG signals. These features are physiologically relevant given that the normal EEG signals have different temporal and spectral centroids, dispersions and symmetries when compared with the pathological EEG signals. The calculated features are fed into the standard support vector machine (SVM) for classification purposes. The performance of the proposed method is studied on a publicly available dataset which is designed to handle various classification problems including the identification of epilepsy patients and detection of seizures. Experiments show that good classification results are obtained using the proposed methodology for the classification of EEG signals. Our proposed method also compares favorably to other state-of-the-art feature extraction methods.

Comparison of Spatial Filters and Features for the Detection and Classification of Movement-Related Cortical Potentials in Healthy Individuals and Stroke Patients

Jochumsen, M., Niazi, I. K., Mrachacz-Kersting, N., Jiang, N., Farina, D., & Dremstrup, K. (2015)

Journal of neural engineering, 12(5), 056003

Objective: The possibility of detecting movement-related cortical potentials (MRCPs) at the single trial level has been explored for closing the motor control loop with brain–computer interfaces (BCIs) for neurorehabilitation. A distinct feature of MRCPs is that the movement kinetic information is encoded in the brain potential prior to the onset of the movement, which makes it possible to timely drive external devices to provide sensory feedback according to the efferent activity from the brain.

The aim of this study was to compare methods for the detection (different spatial filters) and classification (features extracted from various domains) of MRCPs from continuous electroencephalography recordings from executed and imagined movements from healthy subjects (n = 24) and attempted movements from stroke patients (n = 6) to optimize the performance of MRCP-based BCIs for neurorehabilitation.

Approach: The MRCPs from four cue-based tasks were detected with a template matching approach and a set of spatial filters, and classified with a linear support vector machine using the combination of temporal, spectral, time-scale, or entropy-based features. Main results. The best spatial filter (large Laplacian spatial filter (LLSF)) resulted in a true positive rate of 82 ± 9%, 78 ± 12% and 72 ± 9% (with detections occurring ~200 ms before the onset of the movement) for executed, imagined and attempted movements (stroke patients). The best feature combination (temporal and spectral) led to pairwise classification of 73 ± 9%, 64 ± 10% and 80 ± 12%. When the detection was combined with classification, 60 ± 10%, 49 ± 10% and 58 ± 10% of the movements were both correctly detected and classified for executed, imagined and attempted movements. A similar performance for detection and classification was obtained with optimized spatial filtering.

Significance: A simple setup with an LLSF is useful for detecting cued movements while the combination of features from the time and frequency domain can optimize the decoding of kinetic information from MRCPs; this may be used in neuromodulatory BCIs.

Spectral features for the detection of movement intention from EEG signals

Ernest Nlandu Kamavuako, Mads Jochumsen, Imran Khan Niazi and Kim Dremstrup (2015)

Computational Intelligence and Neuroscience – Vol. 2015, 858015, 2015.

Improvements in posture, mood, and balance in an older patient receiving chiropractic care: A case report

Bredin, M, Putt, K. L.. (2015)

Ann Vert Sublux Res – May 21, 2014: 125-9

Objectives: To report on and discuss the changes in a 72 year old male who presented for chiropractic care suffering from multiple health complaints.

Case History: A 72 year old male presented to a private chiropractic practice in Auckland, New Zealand suffering from severe postural alterations, mild depression, low back pain, balance disturbances, perpetual tiredness and mild depression.

Interventions and Outcomes: Over a nine week period, a specific and conservative chiropractic care plan was provided to the patient. The care plan involved Network Spinal Analysis (NSA) adjustments and the frequency of care was altered throughout this period based on both subjective and objective measures. A complete health history and physical examination was completed prior to care. A full posture analysis (Posture Pro 8 posture analysis system), and surface electromyography (sEMG) scans were performed at baseline and were then monitored regularly over the nine week period. Subjective measures were also monitored during each adjustment visit. Significant improvements were noted in postural and sEMG findings as well as in subjective measures of health over the 9 week period.

Conclusions: While under chiropractic care, improvements in both self-reported subjective and objective measures were noted in a patient with severe postural alterations, low back pain, balance disturbances, perpetual tiredness and a mildly depressive state of mind. These improvements include overall physical, mental, and emotional well-being of the patient.

Key Words: chiropractic, Network Spinal Analysis (NSA), adjustment, well-being, posture, surface EMG scans, vertebral subluxation

Resolution of chronic dysphagia in a 73 year old female receiving chiropractic care: A case report

Rhodes C, Bentley M, Link G, Fong P. (2015)

Ann Vert Sublux Res, 2015 March:23-25

Objective: To describe the care of a 73 year old female with a 20 year history of dysphagia which resolved while she was receiving chiropractic care.

Clinical Features: A 73 year old female was pain free at the time of presentation but she reported a 20 year history of chronic difficulty in swallowing with a feeling of choking on food. Multiple levels of vertebral subluxations were observed, otherwise her physical examination was unremarkable.

Interventions and Outcomes: The patient was initially scheduled for three chiropractic visits per week for a period of four weeks. The patient noted that after her first adjustment visit her chronic dysphagia resolved. A full progress evaluation was performed after 12 visits to determine further clinical changes. Her dysphagia remained in remission and she was now able to eat a normal diet without a feeling of choking on her food.

Conclusion: This is the first case study to report complete resolution of chronic dysphagia in an older patient that is temporally associated with the provision of chiropractic care.

Key Words: Dysphagia, swallowing disorder, chiropractic, vertebral subluxation, adjustment, spinal manipulation

Resolution in dermatomal numbness in a 61 year old female patient receiving chiropractic care: A case report

Lorigan, A. L., Smith, S. Bennett, H.

Annals of Vertebral Subluxation Research – September 9, 2015: 154-6

Objective: To describe a case in which cervical radiculopathy in a geriatric patient improved while they were receiving chiropractic care.

Clinical Features: This case report outlines the presentation and conservative management of a 61 year old New Zealand Samoan female with chronic progressive symptomatic radiculopathy. The working diagnosis was vertebral subluxation with C5 and C6 radiculopathy with moderate to severe degeneration. The patient history revealed chronic progressive cervical radiculopathy for two months prior to commencing chiropractic care. The patient had numbness and a burning sensation in the right arm and stiffness in the lower cervical spine.

Interventions and Outcomes: The patient received chiropractic care using the Diversified protocol to adjust vertebral subluxations. After 11 visits the patient reported a significant improvement in numbness and tingling in her arm and improvement in quality of life as demonstrated by the RAND 36 health survey.

Conclusions: In this case cervical radiculopathy in a geriatric patient improved while she received chiropractic care. This case study adds to the existing body of evidence that suggests that chiropractic care may help patients with cervical radiculopathy.

Key words: Vertebral subluxation, paresthesia, chiropractic, cervical radiculopathy, conservative therapy, geriatric

Improvement in Mobility, Emotional Wellbeing & Quality of Life in an Older Adult Following Subluxation Based Chiropractic Care: A Case Report

Patel, D, Russell, D. (2015)

Annals of Vertebral Subluxation Research – September 17, 2015: 157-62

Objective: To describe the changes in mobility, emotional status, and quality of life in an 82 year old female with bilateral osteoarthritis of the knees who was receiving chiropractic care.

Clinical Features: An 82 year old female presented to a chiropractor with lack of mobility and function due to chronic osteoarthritis of the knees bilaterally, and degenerative disc disease and postural alterations through the lumbar spine. Associated emotional stress was also of concern as a contributor to impaired quality of life.

Intervention & Outcome: Chiropractic care using Activator Methods Chiropractic Technique was provided for the correction of vertebral and extremity subluxations. The patient demonstrated physical improvements in mobility and RAND36 assessment revealed an improvement in her Physical Component Summary score of 11.65. Emotional wellbeing improvements were also found by using both RAND36 and PHQ-4 assessments.

Conclusion: Chiropractic care was associated with improvements in the patient’s presenting complaints and quality of life. More research is needed to investigate the role chiropractors may play in helping older adults with conditions associated with aging.

Key words: Aging, chiropractic, stress, psychological, emotions, knee, mental health, osteoarthritis, Activator Methods, vertebral subluxation

Resolution of Cervicalgia, Paraesthesia and Chronic Adhesive Capsulitis in a 67-Year-Old Male: A Case Study

David (June-ki) Ham, B.S.C., Tae Bum Lim, Graham Dobson, D.C. (2015)

Annuals of Vertebral Subluxation Research –October 8, 2015, 163-166

Objective: To describe the chiropractic care of a geriatric patient with complaints of cervicalgia, arm paraesthesia and adhesive capsulitis using Activator Methods Chiropractic Technique (AMCT).

Clinical features: A 67-year-old male presented to the New Zealand College of Chiropractic, Chiropractic Centre with severe cervicalgia, right arm paraesthesia of two years duration, and adhesive capsulitis of his left shoulder of 20 years duration. His cervicalgia was constant and rated 8/10 at its worst on the Numeric Pain Scale, and his left shoulder abduction was restricted to 90°.

Intervention and outcome: The patient’s vertebral subluxations were addressed using Activator Methods Chiropractic Technique. After 4 visits spread over 4 weeks he regained the full range of motion in his left shoulder and the cervicalgia subsided to 1/10 with no right arm paraesthesia.

Conclusion: The findings of this case suggest that chiropractic care using Activator Methods protocol for reduction of vertebral subluxations had a positive effect on cervicalgia and adhesive capsulitis in an elderly patient with a complex clinical history.

Key words: Chiropractic, vertebral subluxation, geriatrics, neck pain, adhesive capsulitis, paraesthesia

Developmental advancements following chiropractic care in a four-year-old child with dyspraxia and associated developmental delays: A case report

Troy, J., Dennis, T., and Cade, A. (2015)

Journal of Clinical Chiropractic Pediatrics 15(1), 1207-1210

Objective: To present the chiropractic management of a 4-year-old child diagnosed with dyspraxia and concomitant vertebral subluxations.

Clinical Features: A four-year-old boy with a history of developmental motor delays was presented by his mother for chiropractic evaluation. The child was previously diagnosed with dyspraxia at one year of age, based on a delay in developmental milestones being met; specifically of speech and fine motor control. The patient was 1.25-years-old before starting to walk and 3-years-old before being able to produce any basic sounds such as “Ma” or “Da”. At the commencement of chiropractic care the child was undergoing concomitant speech therapy; six weeks of intensive repetitive therapy was the average amount of time required for the patient to learn and retain one new sound or word.

Intervention: Modified Diversifed (Touch-and-hold) and Sacro-Occipital Techniques were utilized to reduce subluxation indicators through the cranium, upper cervical and lumbopelvic spine. Fifteen adjustments were administered over a 4-month period.

Outcome: The child experienced a number of developmental advancements over the duration of chiropractic care, specifically in speech, fine motor control and coordination. After 8 visits the patient learned 20 new words in one week, after 12 visits all primitive reflexes were tested to be within normal limits and after 15 visits their vocabulary consisted of hundreds of words and continued to expand.

Conclusion: This patient experienced significant developmental advancements while receiving chiropractic care. Additional research is necessary to assess the role chiropractors may play in caring for children with developmental delays.

Key words: Dyspraxia, developmental delays, chiropractic, pediatric, vertebral subluxation.

Detecting and classifying movement-related cortical potentials associated with hand movements in healthy subjects and stroke patients from single-electrode, single-trial EEG

Jochumsen, M., Niazi, I. K., Taylor, D., Farina, D., & Dremstrup, K. (2015)

Journal of neural engineering, 12(5), 056013.

Objective: To detect movement intention from executed and imaginary palmar grasps in healthy subjects and attempted executions in stroke patients using one EEG channel. Moreover, movement force and speed were also decoded. Approach. Fifteen healthy subjects performed motor execution and imagination of four types of palmar grasps. In addition, five stroke patients attempted to perform the same movements. The movements were detected from the continuous EEG using a single electrode/channel overlying the cortical representation of the hand. Four features were extracted from the EEG signal and classified with a support vector machine (SVM) to decode the level of force and speed associated with the movement. The system performance was evaluated based on both detection and classification. Main results. ~75% of all movements (executed, imaginary and attempted) were detected 100 ms before the onset of the movement. ~60% of the movements were correctly classified according to the intended level of force and speed. When detection and classification were combined, ~45% of the movements were correctly detected and classified in both the healthy and stroke subjects, although the performance was slightly better in healthy subjects.

Significance: The results indicate that it is possible to use a single EEG channel for detecting movement intentions that may be combined with assistive technologies. The simple setup may lead to a smoother transition from laboratory tests to the clinic.

Resolution of Frozen Shoulder Following Upper Cervical Chiropractic Care to Reduce Vertebral Subluxation

Min Shin D.C., Joel Alcantara, D.C. (2015)

Annals of Vertebral Subluxation Research

Objective: To describe the chiropractic care of a patient with shoulder pain and restricted range of motion.

Clinical Features: A 51-year-old male presented for chiropractic care with right shoulder pain and motion restriction that began 2 days prior with no known cause such as trauma or overuse.

Intervention and Outcome: Chiropractic adjustments characterized as high velocity, low amplitude thrusts applied exclusively to the C1-C2 joint complex in the Cervical Chair resulted in immediate relief of shoulder pain and increased range of motion.

Conclusion: This case report provides support on the use of chiropractic adjustments directed to the upper cervical spine in patients with shoulder pain and dysfunction. We support further research in the care of similar patients.

Key words: Frozen shoulder, chiropractic, adjustments, vertebral subluxation

Resolution of Hypertension in a 72-Year-Old Male Following Subluxation Based Chiropractic Care: A Case Report & Selective Review of the Literature

Vanessa Van Dyke, David Russell, Joel Alcantara (2015)

Annals of Vertebral Subluxation Research

Objective: To report on the outcomes of a male patient who presented for chiropractic care with hypertension.

Clinical Features: 72-year-old male presented with a history of hypertension, arthritis, ringing/buzzing in the ears and numbness/burning in his shoulder. He was on blood pressure medication for one year prior to beginning chiropractic care.

Intervention and Outcome: A specific technique protocol was adopted over a period of three months for the detection and correction of vertebral subluxation. Blood pressure was measured and decreased over the course of care. The four domains of health (physical state, emotional/mental state, stress and life enjoyment) were assessed using self-rated health/wellness (SRHW) surveys prior to care and a questionnaire regarding changes experienced since care was completed after three months. Static EMG and Thermal scanning were performed using the Insight surface EMG and thermal scanning technology with improvements noted. A decrease in blood pressure following the commencement of chiropractic care was reported.

Conclusion: Decreased blood pressure and increased ease of physical activity were documented following chiropractic care in a patient with a history of medically treated hypertension.

Keywords: Chiropractic, subluxation, adjustment, manipulation, hypertension, surface electromyography, thermal scanning, Torque Release Technique (TRT)

Resolution of Adhesive Capsulitis Following Subluxation Based Chiropractic Care: A Case Series & Selective Review of the Literature

Min Shin, D.C., Joel Alcantara, D.C. (2015)

Annals of Vertebral Subluxation Research

Objective: To describe the chiropractic care of two patients with shoulder pain and restriction in motion.

Clinical Features: A 45-yr-old female and a 47-year-old male presented for chiropractic care with complaints of shoulder pain and dysfunction. The female patient injured her right shoulder following a fall. She did not receive medical care as her pain was tolerable. However, 2 months later, she could not move her right shoulder due to pain and experienced right-sided neck pain. Over-the-counter medication was ineffective. The male patient suffered from restricted shoulder motion following a motor vehicle collision 2 months prior. Physical therapy was ineffective and therefore sought chiropractic care.

Intervention and Outcome: Chiropractic adjustments characterized as high velocity, low amplitude thrusts applied exclusively to the C0-C1 joint complex was rendered to both patients. Ultrasound was applied to the male patient only following spinal adjustments to the upper cervical spine. Baseline and comparative measures of shoulder ROM and pain rating showed significant improvements in both patients.

Conclusion: This case series provides support on the use of chiropractic adjustments directed to the upper cervical spine in patients with shoulder pain and dysfunction. We support further research in the care of similar patients.

Key words: Adhesive capsulitis, frozen shoulder, chiropractic adjustments, vertebral subluxation

Improvement in Mobility, Emotional Wellbeing & Quality of Life in an Older Adult Following Subluxation Based Chiropractic Care: A Case Report

Dipal Patel, David Russell (2015)

Annals of Vertebral Subluxation Research

Objective: To describe the changes in mobility, emotional status, and quality of life in an 82 year old female with bilateral osteoarthritis of the knees who was receiving chiropractic care.

Clinical Features: An 82 year old female presented to a chiropractor with lack of mobility and function due to chronic osteoarthritis of the knees bilaterally, and degenerative disc disease and postural alterations through the lumbar spine. Associated emotional stress was also of concern as a contributor to impaired quality of life.

Intervention & Outcome: Chiropractic care using Activator Methods Chiropractic Technique was provided for the correction of vertebral and extremity subluxations. The patient demonstrated physical improvements in mobility and RAND36 assessment revealed an improvement in her Physical Component Summary score of 11.65. Emotional wellbeing improvements were also found by using both RAND36 and PHQ-4 assessments.

Conclusion: Chiropractic care was associated with improvements in the patient’s presenting complaints and quality of life. More research is needed to investigate the role chiropractors may play in helping older adults with conditions associated with aging.

Key words: Aging, chiropractic, stress, psychological, emotions, knee, mental health, osteoarthritis, Activator Methods, vertebral subluxation

Resolution of Cervical Radiculopathy in a 61 Year Old Female Receiving Subluxation Based Chiropractic Care: A Case Report

Adele L. Lorigan, Shelley Smith, Helen Bennett (2015)

Annals of Vertebral Subluxation Research

Objective: To describe a case in which cervical radiculopathy in a geriatric patient improved while they were receiving chiropractic care.

Clinical Features: This case report outlines the presentation and conservative management of a 61 year old New Zealand Samoan female with chronic progressive symptomatic radiculopathy. The working diagnosis was vertebral subluxation with C5 and C6 radiculopathy with moderate to severe degeneration. The patient history revealed chronic progressive cervical radiculopathy for two months prior to commencing chiropractic care. The patient had numbness and a burning sensation in the right arm and stiffness in the lower cervical spine.

Interventions and Outcomes: The patient received chiropractic care using the Diversified protocol to adjust vertebral subluxations. After 11 visits the patient reported a significant improvement in numbness and tingling in her arm and improvement in quality of life as demonstrated by the RAND 36 health survey.

Conclusions: In this case cervical radiculopathy in a geriatric patient improved while she received chiropractic care. This case study adds to the existing body of evidence that suggests that chiropractic care may help patients with cervical radiculopathy.

Key words: Vertebral subluxation, paresthesia, chiropractic, cervical radiculopathy, conservative therapy, geriatric

Resolution of Cervicalgia, Paraesthesia and Chronic Adhesive Capsulitis in a 67-Year-Old Male: A Case Study

David (June-ki) Ham, B.S.C., Tae Bum Lim, Graham Dobson, D.C. (2015)

Annals of Vertebral Subluxation Research

Objective: To describe the chiropractic care of a geriatric patient with complaints of cervicalgia, arm paraesthesia and adhesive capsulitis using Activator Methods Chiropractic Technique (AMCT).

Clinical Features: A 67-year-old male presented to the New Zealand College of Chiropractic, Chiropractic Centre with severe cervicalgia, right arm paraesthesia of two years duration, and adhesive capsulitis of his left shoulder of 20 years duration. His cervicalgia was constant and rated 8/10 at its worst on the Numeric Pain Scale, and his left shoulder abduction was restricted to 90°.

Intervention and Outcome: The patient’s vertebral subluxations were addressed using Activator Methods Chiropractic Technique. After 4 visits spread over 4 weeks he regained the full range of motion in his left shoulder and the cervicalgia subsided to 1/10 with no right arm paraesthesia.

Conclusion: The findings of this case suggest that chiropractic care using Activator Methods protocol for reduction of vertebral subluxations had a positive effect on cervicalgia and adhesive capsulitis in an elderly patient with a complex clinical history.

Key words: Chiropractic, vertebral subluxation, geriatrics, neck pain, adhesive capsulitis, paraesthesia

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