Chiropractic treatment techniques: Difference between revisions
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===Diversified technique=== |
===Diversified technique=== |
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{{main|Diversified technique}} |
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Like many chiropractic and osteopathic manipulative techniques, Diversified technique is characterized by a high-velocity, low-amplitude thrust.<ref name=Cooperstein_Gleberzon/> It is considered the most generic chiropractic manipulative technique and is differentiated from other techniques in that its objective is to restore proper movement and alignment of spine and joint dysfunction.<ref name=Cooperstein_Gleberzon>''[http://books.google.com/books?id=x7hrs-7YJx0C&pg=PA143&lpg=PA143&dq=diversified+chiropractic+technique&source=web&ots=uJPTVCWlYI&sig=qKW8O71v0HGyrKW-N7z5Rgd3zJg Technique Systems in Chiropractic]'' - Cooperstein & Gleberzon</ref> |
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===Atlas Orthogonal technique=== |
===Atlas Orthogonal technique=== |
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===Extremity manipulating/adjusting=== |
===Extremity manipulating/adjusting=== |
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===Activator methods=== |
===Activator methods=== |
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{{Refimprove section|date=December 2007}} |
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{{main|Activator technique}} |
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[[File:Activator_V_adjusting_instrument.jpg|thumb|right|Activator V Chiropractic Adjusting Instrument]] |
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The Activator Method Chiropractic Technique (AMCT) is a chiropractic treatment method and device created by Arlan Fuhr as an alternative to manual [[spinal manipulation|manipulation of the spine]] or extremity [[joint manipulation|joints]]. The device is categorized as a mechanical force manual assisted (MFMA) instrument which is generally regarded as a softer chiropractic treatment technique. |
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The activator is a small handheld spring-loaded instrument which delivers a small impulse to the spine. It was found to give off no more than 0.3 J of kinetic energy in a 3-millisecond pulse. The aim is to produce enough force to move the vertebrae but not enough to cause injury.<ref name=Fuhr2005>{{cite journal |last=Fuhr |first=Arlan W. |authorlink= |author2= J. Michael Menke |date=February 2005 |title=Status of Activator Methods Chiropractic Technique, Theory, and Practice |journal=[[Journal of Manipulative and Physiological Therapeutics]] |volume=28 |issue=2 |pages=e1–e20 |id= |url=http://linkinghub.elsevier.com/retrieve/pii/S0161475405000023 |accessdate=2008-08-18 |quote= |doi=10.1016/j.jmpt.2005.01.001 |pmid=15800504 }}</ref> |
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The AMCT involves having the patient lie in a prone position and comparing the functional leg lengths. Often one leg will seem to be shorter than the other. The chiropractor then carries out a series of muscle tests such as having the patient move their arms in a certain position in order to activate the muscles attached to specific vertebrae. If the leg lengths are not the same, that is taken as a sign that the problem is located at that vertebra. The chiropractor treats problems found in this way moving progressively along the spine in the direction from the feet towards the head.<ref name=Fuhr2005/> |
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Although prone "functional leg length" is a widely used chiropractic tool, it is not a recognized [[Anthropometry|anthropometric]] technique, since legs are often of unequal length, and measurements in the prone position are not entirely valid estimates of standing X-ray differences.<ref name=Rhodes_prone>D W Rhodes, E R Mansfield, P A Bishop, J F Smith. [http://lib.bioinfo.pl/pmid:7595107 The validity of the prone leg check as an estimate of standing leg length inequality measured by X-ray.] ''J Manipulative Physiol Ther.'' ;18 (6):343-6</ref> Measurements in the standing position are far more reliable.<ref name=Hanada_standing>E Hanada, R L Kirby, M Mitchell, J M Swuste. [http://lib.bioinfo.pl/pmid:11441382 Measuring leg-length discrepancy by the "iliac crest palpation and book correction" method: reliability and validity.] ''Arch Phys Med Rehabil.'' 2001 Jul ;82 (7):938-42</ref> Another [[confounding|confounding factor]] is that simply moving the two legs held together and leaning them imperceptibly to one side or the other produces different results.<ref name=PBS_activator>[http://www.pbs.org/saf/1210/features/spine.htm Keeping Your Spine In Line], [http://www.pbs.org/saf/1210/segments/1210-3.htm Adjusting the Joints], and [http://www.pbs.org/saf/1210/video/watchonline.htm Video], [[Alan Alda]], [[Public Broadcasting Service|PBS]], [[Scientific American Frontiers]]. Video discusses Activator and leg length</ref> Fuhr claims that properly trained doctors show good interexaminer reliability.<ref name=Fuhr2005/> |
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In 2003, the [[National Board of Chiropractic Examiners]] found that 69.9% of chiropractors used the technique, and 23.9% of patients received it.<ref name=NBCE_techniques10>{{cite book |title= Job Analysis of Chiropractic |chapter= Professional functions and treatment procedures |year=2005 |pages=121–38 |author= Christensen MG, Kollasch MW |location= Greeley, CO |publisher= [[National Board of Chiropractic Examiners]] |chapterurl=http://nbce.org/pdfs/job-analysis/chapter_10.pdf |chapter-format=PDF |accessdate=2008-08-25 |isbn=1-884457-05-3}}</ref> The majority of U.S. chiropractic schools and some schools in other countries teach the AMCT method, and an estimated 45,000 chiropractors worldwide use AMCT or some part of the technique.<ref name=Fuhr2005/> |
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There have been a number of studies of AMCT, including case reports, clinical studies and randomized controlled trials, but there are still unanswered questions. A few studies suggest that the activator may be as effective as manual adjustment in treatment of back pain.<ref name=Fuhr2005/> |
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=== Graston technique === |
=== Graston technique === |
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Several examples of Graston treatment have been used in contact sports where scars and contusions are common.<ref>{{cite web | last = Lauzon | first = L | url = http://www.lutamma.com/Videos-de-MMA/Joe-Lauzon-aplica-tecnica-Graston-em-cicatriz-2037/ | title = Joe Lauzon chooses the Graston Technique for combat injury treatment | date = 2013-03-15 | accessdate = 2013-03-15 | publisher = lutamma.com }}</ref> However, the Graston Technique has not been rigorously scientifically tested and its evidence basis and assumptions are considered questionable at best. There are no high quality clinical trials that validate the efficacy of the Graston Techniques.<ref>{{cite web | last = Hall | first = H | url = http://www.sciencebasedmedicine.org/?p=3170 | title = The Graston Technique – Inducing Microtrauma with Instruments | date = 2009-12-29 | accessdate = 2010-01-09 | publisher = sciencebasedmedicine.org }}</ref> |
Several examples of Graston treatment have been used in contact sports where scars and contusions are common.<ref>{{cite web | last = Lauzon | first = L | url = http://www.lutamma.com/Videos-de-MMA/Joe-Lauzon-aplica-tecnica-Graston-em-cicatriz-2037/ | title = Joe Lauzon chooses the Graston Technique for combat injury treatment | date = 2013-03-15 | accessdate = 2013-03-15 | publisher = lutamma.com }}</ref> However, the Graston Technique has not been rigorously scientifically tested and its evidence basis and assumptions are considered questionable at best. There are no high quality clinical trials that validate the efficacy of the Graston Techniques.<ref>{{cite web | last = Hall | first = H | url = http://www.sciencebasedmedicine.org/?p=3170 | title = The Graston Technique – Inducing Microtrauma with Instruments | date = 2009-12-29 | accessdate = 2010-01-09 | publisher = sciencebasedmedicine.org }}</ref> |
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===Koren Specific |
===Koren Specific technique=== |
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Koren Specific Technique (KST) is a technique developed by [[Tedd Koren]].<ref name=DynChiro2009>{{cite news|last1=Editorial Board|title=Koren Specific Technique Not Chiropractic? WFC Alleges "Serious Professional Misconduct"|url=http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53614|accessdate=29 March 2016|work=Dynamic Chiropractic|date=29 January 2009}}</ref> While the technique is associated with chiropractic techniques, Koren has variously described it as an "analysis protocol" or "healthcare protocol".<ref name=DynChiro2009/> KST may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and adjustments.<ref name=Aetna/> KST can use different postures.<ref name=AlbertLeaTribune2009>{{Cite web| title=Lake Mills Family Chiropractic practices new method|work=AlbertLeaTribune|date=October 15, 2009|url=http://www.albertleatribune.com/2009/10/lake-mills-family-chiropractic-practices-new-method/}}</ref> The insurers NHS Leeds West CCG,<ref>{{Cite web| title = Complementary and Alternative Therapies Evidence Based Decision Making Framework| author = NHS Leeds West CCG Assurance Committee| work = leedswestccg.nhs.uk| date = 2014-01-02| accessdate = 2015-06-30| url = http://www.leedswestccg.nhs.uk/content/uploads/2014/07/Complementary-and-alternative-therapies.pdf}}</ref> North Dakota Department of Human Services,<ref>{{cite web|title=Provider Manual for Chiropractic Services|url=https://www.nd.gov/dhs/services/medicalserv/medicaid/docs/chiropractic-manual.pdf|website=North Dakota Department of Human Services|publisher=State of North Dakota}}</ref> Aetna,<ref name=Aetna>{{cite web|title=Chiropractic Services - Policy |url=http://www.aetna.com/cpb/medical/data/100_199/0107.html|website=Aetna|access-date=29 March 2016}}</ref> and Oklahoma State University<ref>{{cite web |title=Chiropractic Policy |url=https://osuhealthplan.com/sites/all/themes/osuhealthplan/pdf/policies/Chiropractic%20Policy.pdf|publisher=Oklahoma State University Health Plan|accessdate=14 April 2016|date=1 April 2016}}</ref> cover other chiropractic techniques but exclude KST from coverage because they consider it to be "experimental and investigational."<ref name=Aetna/> Aetna's policy states there is a lack of efficacy regarding this method.<ref name=Aetna/> |
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{{main|Koren Specific Technique}} |
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===Cox Flexion/Distraction=== |
===Cox Flexion/Distraction=== |
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===Thompson technique=== |
===Thompson technique=== |
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=== Gonstead technique === |
=== Gonstead technique === |
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The Gonstead technique is chiropractic method that had been developed by [[Clarence Gonstead]] since 1923.<ref name=McNamee1997>{{cite book|author=Kevin P. McNamee|title=The Chiropractic College Directory, 1997-98|url=http://books.google.com/books?id=gKUJvpoU7b0C|date=1 January 1997|publisher=K M Enterprises|isbn=978-0-945947-04-2}}</ref> The technique focuses on hands-on adjustment and is claimed to expand "''standard diversified technique''" by implementing additional instrumentation including [[X-ray]]s, Gonstead Radiographic Parallel, a measuring device, and the development of Nervo-Scope,<ref>{{cite book|author1=Anderson M. D. Robert Anderson M. D.|author2=Robert Anderson|title=The Back Door to Medicine: An Embedded Anthropologist Tells All|url=http://books.google.com/books?id=tgABfwgaHx4C&pg=PT59|date=October 2009|publisher=iUniverse|isbn=978-1-4401-7289-2|pages=59–}}</ref> an ineffective and pseudoscientific device said to detect nerve imbalance based on skin temperature.<ref>{{Cite web|url=http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/nervoscope.html|title=The Nervo-Scope|website=www.quackwatch.org|access-date=2016-05-02}}</ref> The technique gained popularity in the 1960s.<ref>{{Cite web| title = Technique Summary: Gonstead Technique| work = ChiroACCESS| date = 2010-02-08| accessdate = 2015-07-01| url = http://www.chiroaccess.com/Articles/Technique-Summary-Gonstead-Technique.aspx?id=0000128}}</ref> About 28.9% of patients have been treated with the Gonstead technique.<ref name=Cooperstein2003>{{cite journal|last1=Cooperstein|first1=Robert|title=Gonstead Chiropractic Technique (GCT)|journal=Journal of Chiropractic Medicine|volume=2|issue=1|year=2003|pages=16–24|issn=15563707|doi=10.1016/S0899-3467(07)60069-X|pmid=19674591}}</ref> |
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{{main|Gonstead technique}} |
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== References == |
== References == |
Revision as of 00:06, 10 May 2016
This article may present fringe theories, without giving appropriate weight to the mainstream view and explaining the responses to the fringe theories. (May 2016) |
Chiropractors primarily use manipulation ("adjustment") of the spine as a treatment. Such treatments trace back to ancient China, Greece and Egypt.[1] It gained popularity in the late 19th century, with the development of osteopathic and chiropractic medicine in North America.[2]
Spinal manipulation (SMT) became more popular in the 1980s.[3] It includes manipulation and massage to "adjust" the spine and related tissues,[4] and is a primary basis of chiropractic.[5] Systematic reviews have not found evidence that chiropractic manipulation is effective for any medical condition, with the possible exception of treatment for back pain.[6] The safety of manipulation, particularly on the cervical spine has been debated.[7] Adverse results, including death, are rare, with very low mortality rates.[8][9] Chiropractors may use exercise and other treatments and advice.[5]
Interventions
Skilled, specific hands-on techniques, including manipulation and mobilization, are used to diagnose and treat soft tissues and joint structures, to reduce pain and to increase range of motion and general health.[10]
The approach is generally conservative, and treatment may include:
- manual procedures, including spinal or joint manipulation or mobilization, soft‐tissue and reflex techniques;
- exercise, and other active care;
- psychosocial aspects of patient management;
- patient education on spinal health, posture, nutrition and lifestyle modifications;
- emergency treatment and acute pain management;
- other supportive measures, including the use of back supports and orthotics;
- recognition of the limitations of chiropractic care, and of the need for referral to other health professionals.
Chiropractors may also use exercise and other conservative treatments and advice.[5]
Manual and manipulative therapy
The Chinese used such therapy more than 3000 years ago. Hippocrates also used such techniques[1] as did the ancient Egyptians and other cultures.
In the late 19th century in North America, therapies including osteopathy and chiropractic became popular.[2] Spinal manipulation gained mainstream recognition during the 1980s.[3]
In this system, hands are used to manipulate, massage or otherwise influence the spine and related tissues.[4] It is the most common and primary intervention used in chiropractic care.[5]
Effectiveness
Neuromusculoskeletal disorders
Treatment is usually for neck or low back pain and related disorders.[11]
For acute low back pain, low quality evidence has suggested no difference between real and sham spine manipulation,[12] and moderate quality evidence has suggested no difference between spine manipulation and other commonly used treatments, such as medication and physical therapy.[12][13][14]
National guidelines vary; some recommend the therapy for those who do not improve with other treatment.[15] It may be effective for lumbar disc herniation with radiculopathy,[16][17] as effective as mobilization for neck pain,[18] some forms of headache,[19][20][21] and some extremity joint conditions.[22][23] A 2011 Cochrane review found strong evidence that suggests there is no clinically meaningful difference between spinal manipulation therapy and other treatments for reducing pain and improving function for chronic low back pain.[24] A 2008 review found that with the possible exception of back pain, chiropractic manipulation has not been shown to be effective for any medical condition.[6][25]
Non-musculoskeletal disorders
The use of spinal manipulation for non-musculoskeletal is controversial. It has not been shown to be effective for asthma, headache, hypertension, or dysmenorrhea.[14] There is no scientific data that supports the use of SMT for idiopathic adolescent scoliosis.[26][27]
Cost-effectiveness
Spinal manipulation is generally regarded as cost-effective treatment of musculoskeletal conditions when used alone or in combination with other treatment approaches.[28] Evidence supports the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain whereas the results for acute low back pain were inconsistent.[29]
Safety
All treatments need a thorough medical history, diagnosis and plan of management. Chiropractors, must rule out contraindications to any treatments, including adverse events.
Relative contraindications, such as osteoporosis are conditions where increased risk is acceptable in some situations and where mobilization and soft-tissue techniques may be treatments of choice. Most contraindications apply to the manipulation of the affected region.[30]
While safety has been debated,[7] and serious injuries and deaths can occur and may be under-reported,[8] these are generally rare and spinal manipulation is relatively safe[12] when employed skillfully and appropriately.[9]
Adverse events are believed to be under-reported [31] and appear to be more common following high velocity/ low amplitude manipulation than mobilization.[32] Mild, frequent and temporary adverse events occur in SMT which include temporary increase in pain, tenderness and stiffness.[7] These effects generally are reduced within 24–48 hours [33] Serious injuries and fatal consequences, especially to SM in the upper cervical region, can occur.[34] but are regarded as rare when spinal manipulation is employed skillfully and appropriately.[30]
The relationship to stroke has been debated. Stroke is statistically associated with both general practitioner and chiropractic services in persons under 45 years of age, and these associations may be related to preexisting conditions.[35][36][37] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy and vertebrobasilar artery stroke.[38] A 2012 review found that there is not enough evidence to support a strong association or no association between cervical manipulation and stroke.[39] A 2008 review found chiropractic are more commonly associated with serious related adverse effects than other professionals following manipulation and concluded that the risk of death from manipulations to the neck outweighs the benefits.[8]
Techniques
This section needs expansion. You can help by adding to it. (May 2016) |
According to the American Chiropractic Association the most frequently used techniques by chiropractors are Diversified technique 95.9%, Extremity manipulating/adjusting 95.5%, Activator Methods 62.8%, Gonstead technique 58.5%, Cox Flexion/Distraction 58.0%, Thompson 55.9%, Sacro Occipital Technique [SOT] 41.3%, Applied Kinesiology 43.2%, NIMMO/Receptor Tonus 40.0%, Cranial 37.3%, Manipulative/Adjustive Instruments 34.5%, Palmer upper cervical [HIO] 28.8%, Logan Basic 28.7%, Meric 19.9%, and Pierce-Stillwagon 17.1%.[40] There are about 200 chiropractic technique, but there is a mostly overlap between them, and many techniques involve slight changes of other techniques.[41]
Diversified technique
Like many chiropractic and osteopathic manipulative techniques, Diversified technique is characterized by a high-velocity, low-amplitude thrust.[42] It is considered the most generic chiropractic manipulative technique and is differentiated from other techniques in that its objective is to restore proper movement and alignment of spine and joint dysfunction.[42]
Atlas Orthogonal technique
Atlas Orthogonal Technique is an upper cervical chiropractic treatment technique created by Roy Sweat, DC.[43] It is a technique which uses a percussion instrument in attempts to adjust what is perceived to be a subluxation of the atlas vertebra, the top vertebra in the cervical spine. It is based on the teachings of B. J. Palmer, who advocated the Hole-In-One version of spinal adjustment. It is primarily used by straight chiropractors. Referring to the origins of upper cervical techniques, Dan Murphy, DC, DABCO, wrote: "Over the past 100 years, the practice of chiropractic has branched into dozens of specialty techniques. However, historically, for a third of this time, from the 1930s into the 1960s, the predominant practice of chiropractic involved primarily the upper cervical spine."[44]
Extremity manipulating/adjusting
Activator methods
This section needs additional citations for verification. (December 2007) |
The Activator Method Chiropractic Technique (AMCT) is a chiropractic treatment method and device created by Arlan Fuhr as an alternative to manual manipulation of the spine or extremity joints. The device is categorized as a mechanical force manual assisted (MFMA) instrument which is generally regarded as a softer chiropractic treatment technique.
The activator is a small handheld spring-loaded instrument which delivers a small impulse to the spine. It was found to give off no more than 0.3 J of kinetic energy in a 3-millisecond pulse. The aim is to produce enough force to move the vertebrae but not enough to cause injury.[45]
The AMCT involves having the patient lie in a prone position and comparing the functional leg lengths. Often one leg will seem to be shorter than the other. The chiropractor then carries out a series of muscle tests such as having the patient move their arms in a certain position in order to activate the muscles attached to specific vertebrae. If the leg lengths are not the same, that is taken as a sign that the problem is located at that vertebra. The chiropractor treats problems found in this way moving progressively along the spine in the direction from the feet towards the head.[45]
Although prone "functional leg length" is a widely used chiropractic tool, it is not a recognized anthropometric technique, since legs are often of unequal length, and measurements in the prone position are not entirely valid estimates of standing X-ray differences.[46] Measurements in the standing position are far more reliable.[47] Another confounding factor is that simply moving the two legs held together and leaning them imperceptibly to one side or the other produces different results.[48] Fuhr claims that properly trained doctors show good interexaminer reliability.[45]
In 2003, the National Board of Chiropractic Examiners found that 69.9% of chiropractors used the technique, and 23.9% of patients received it.[49] The majority of U.S. chiropractic schools and some schools in other countries teach the AMCT method, and an estimated 45,000 chiropractors worldwide use AMCT or some part of the technique.[45]
There have been a number of studies of AMCT, including case reports, clinical studies and randomized controlled trials, but there are still unanswered questions. A few studies suggest that the activator may be as effective as manual adjustment in treatment of back pain.[45]
Graston technique
Graston Technique (GT) is a trademarked therapeutic method for diagnosing and treating disorders of the skeletal muscles and related connective tissue. The method employs a collection of six stainless steel tools of particular shape and size, which are used by practitioners to rub [50] patients' muscles in order to detect and resolve adhesions in the muscles and tendons.[51] Practitioners must be licensed by the parent corporation (Graston Technique, LLC.) in order to use the Graston Technique trademark or the patented instruments.[52]
Several examples of Graston treatment have been used in contact sports where scars and contusions are common.[53] However, the Graston Technique has not been rigorously scientifically tested and its evidence basis and assumptions are considered questionable at best. There are no high quality clinical trials that validate the efficacy of the Graston Techniques.[54]
Koren Specific technique
Koren Specific Technique (KST) is a technique developed by Tedd Koren.[55] While the technique is associated with chiropractic techniques, Koren has variously described it as an "analysis protocol" or "healthcare protocol".[55] KST may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and adjustments.[56] KST can use different postures.[57] The insurers NHS Leeds West CCG,[58] North Dakota Department of Human Services,[59] Aetna,[56] and Oklahoma State University[60] cover other chiropractic techniques but exclude KST from coverage because they consider it to be "experimental and investigational."[56] Aetna's policy states there is a lack of efficacy regarding this method.[56]
Cox Flexion/Distraction
Thompson technique
Gonstead technique
The Gonstead technique is chiropractic method that had been developed by Clarence Gonstead since 1923.[61] The technique focuses on hands-on adjustment and is claimed to expand "standard diversified technique" by implementing additional instrumentation including X-rays, Gonstead Radiographic Parallel, a measuring device, and the development of Nervo-Scope,[62] an ineffective and pseudoscientific device said to detect nerve imbalance based on skin temperature.[63] The technique gained popularity in the 1960s.[64] About 28.9% of patients have been treated with the Gonstead technique.[65]
References
- ^ a b Swedlo DC (2002). "The historical development of chiropractic" (PDF). In Whitelaw WA (ed.) (ed.). Proc 11th Annual History of Medicine Days. Faculty of Medicine, The University of Calgary. pp. 55–58. Retrieved 2008-05-14.
{{cite conference}}
:|editor=
has generic name (help); Unknown parameter|booktitle=
ignored (|book-title=
suggested) (help) - ^ a b Keating JC Jr (2003). "Several pathways in the evolution of chiropractic manipulation". J Manipulative Physiol Ther. 26 (5): 300–21. doi:10.1016/S0161-4754(02)54125-7. PMID 12819626.
- ^ a b Francis RS (2005). "Manipulation under anesthesia: historical considerations". International MUA Academy of Physicians. Retrieved 2008-07-06.
- ^ a b Winkler K, Hegetschweiler-Goertz C, Jackson PS, et al. (2003). "Spinal manipulation policy statement" (PDF). American Chiropractic Association. Retrieved 2008-05-24.
- ^ a b c d Christensen MG, Kollasch MW (2005). "Professional functions and treatment procedures" (PDF). Job Analysis of Chiropractic. Greeley, CO: National Board of Chiropractic Examiners. pp. 121–38. ISBN 1-884457-05-3.
{{cite book}}
:|access-date=
requires|url=
(help);|chapter-format=
requires|chapter-url=
(help); External link in
(help); Unknown parameter|chapterurl=
|chapterurl=
ignored (|chapter-url=
suggested) (help) - ^ a b Ernst E (2008). "Chiropractic: a critical evaluation". J Pain Symptom Manage. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. PMID 18280103.
- ^ a b c Ernst, E (Jul 2007). "Adverse effects of spinal manipulation: a systematic review". Journal of the Royal Society of Medicine. 100 (7): 330–8. doi:10.1258/jrsm.100.7.330. ISSN 0141-0768. PMC 1905885. PMID 17606755.
{{cite journal}}
: Unknown parameter|laydate=
ignored (help); Unknown parameter|laysource=
ignored (help); Unknown parameter|layurl=
ignored (help) - ^ a b c E Ernst (2010). "Deaths after chiropractic: a review of published cases". Int J Clinical Practice. 64 (8): 1162–1165. doi:10.1111/j.1742-1241.2010.02352.x. PMID 20642715.
- ^ a b World Health Organization (2005). "WHO guidelines on basic training and safety in chiropractic" (PDF). ISBN 92-4-159371-7. Retrieved 2008-02-29.
{{cite journal}}
: Cite journal requires|journal=
(help) - ^ Gatterman MI, Hansen DT. (1994). "Development of chiropractic nomenclature through consensus". J Manipulative Physiological Therapeutics. 17 (5): 302–309.
- ^ Hawk C, Long CR, Boulanger KT (2001). "relevance of nonmusculoskeletal complaints in chiropractic practice: report from a practice-based research program". J Manipulative Physiol Ther. 24 (3): 157–169. doi:10.1067/mmt.2001.113776. PMID 11313611.
- ^ a b c Rubinstein SM; Terwee CB; Assendelft WJ; de Boer MR; van Tulder MW (Sep 2012). "Spinal manipulative therapy for acute low-back pain". Cochrane Database Syst Rev. 12 (9): CD008880. doi:10.1002/14651858.CD008880.pub2. PMID 22972127.
- ^ Dagenais S, Gay RE, Tricco AC, Freeman MD, Mayer JM (2010). "NASS Contemporary Concepts in Spine Care: Spinal manipulation therapy for acute low back pain". Spine J. 10 (10): 918–940. doi:10.1016/j.spinee.2010.07.389. PMID 20869008.
- ^ a b Bronfort G, Haas M, Evans R, Leininger B, Triano J (2010). "Effectiveness of manual therapies: the UK evidence report". Chiropractic & Osteopathy. 18 (3): 3. doi:10.1186/1746-1340-18-3. PMC 2841070. PMID 20184717.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ Koes, BW; van Tulder, M; Lin, CW; Macedo, LG; McAuley, J; Maher, C (December 2010). "An updated overview of clinical guidelines for the management of non-specific low back pain in primary care". European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 19 (12): 2075–94. doi:10.1007/s00586-010-1502-y. PMID 20602122.
- ^ Leininger B, Bronfort G, Evans R, Reiter T (2011). "Spinal manipulation or mobilization for radiculopathy: a systematic review". Phys Med Rehabil Clin N Am. 22 (1): 105–25. doi:10.1016/j.pmr.2010.11.002. PMID 21292148.
- ^ Hahne AJ, Ford JJ, McMeeken JM (2010). "Conservative management of lumbar disc herniation with associated radiculopathy: a systematic review". Spine. 35 (11): E488–504. doi:10.1097/BRS.0b013e3181cc3f56. PMID 20421859.
- ^ Gross A, Miller J, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Brønfort G, Hoving JL (2010). "Manipulation or mobilisation for neck pain: a Cochrane Review". Manual Therapy. 15 (4): 315–333. doi:10.1016/j.math.2010.04.002. PMID 20510644.
- ^ Chaibi A, Tuchin PJ, Russell MB (2011). "Manual therapies for migraine: a systematic review". J Headache Pain. 12 (2): 127–33. doi:10.1007/s10194-011-0296-6. PMC 3072494. PMID 21298314.
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- ^ Posadzki, P; Ernst, E (June 2011). "Spinal manipulations for the treatment of migraine: a systematic review of randomized clinical trials". Cephalalgia : an international journal of headache. 31 (8): 964–70. doi:10.1177/0333102411405226. PMID 21511952.
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