A Resume of Research Questions
By Reed Phillips, DC, PhD
While in the midst of our centennial year, how appropriate to blend an historical perspective with the research focus of this column. Research has been a maligned term in the semantics of chiropractic, partially due to the lack of understanding and appreciation of the fundamentals of scientific investigation.
Yet, bright stars from our past reflect with insight and perceptions beyond their time. Though only partially heeded conceptually, they have advanced chiropractic, all the while overcoming the resistance of a dogmatic tenacity to cling to beliefs founded upon a priori assumptions rather than empirical observations.
One such visionary and educational master was Joseph Janse, DC, former president of the National College of Chiropractic. Over a 38-year history as college president, Dr. Janse was integral in the development and focus of research imperatives for chiropractic. Although he wrote about these imperatives in many places, I have drawn from a 1982 publication1 as a primary source for his collection of thoughts. We can gain from the vision of this great educator as we direct our research agendas into the next century.
- Is there need and value to the attempt to competently develop a program of computer data banking as to the common type of cases handled in the college clinics with an overview of such factors as age, sex, ethnic grouping, occupation, economic status, complaint, diagnosis, x-ray findings, lab findings, type of treatment, frequency, response, and post-therapy findings?
- Would there be investigatory and instructional value to a well prepared computer graphics film portraying the normal motor conduct at the atlanto-occipital, atlanto-axial, cervicobrachial, thoracolumbar, lumbosacral and sacraliliac spinal levels?
- In the discipline of applied clinical spinal biomechanics is there any further teaching value to additional competently edited cinema radiographic films? Would the reinstallation of the cinema radiographic unit serve any useful further investigatory purpose?
- In the discipline of applied biomechanics would it be of value to thoroughly investigate the Illi and Janse principles, namely:
a. Spinal and pelvic segments deviate into distortion more readily than out of the distortion pattern?
b. In lateral bending and in scoliotic deviation there normally is attending segmental compensatory rotation, otherwise there is an undue disc compression dural, root sleeve traction, and extension of the vertebral column?
- Would it be of any further investigatory value to expand upon the work done originally by Illi and Janse and attempted in repeat by Phillips and Eddington in investigating the seeming phenomenon that segmental fixation places undue traction upon the radices, dural root sleeves and cauda equina?
- Is the project now in process in the anatomy department of debriding spines, suspending the spinal nerves, permitting dehydration by simple air exposure drying in the attempt to demonstrate the possibility of existence of IVF microtraumatic adhesions of any relevant value? The Suderland nerve root entrapment concept?
- Does the original work done by Awad (now continuing at the U. of Maryland Medical School) on inducing (without too much interventive surgical trauma) segmental derangement in the spines of laboratory animals have any pertinence?
- Should this project be continued by Lin (who maintains that he has perfected a more competent method) and introduce phase two by simply determining the gross vascular and myological reactions upon the visceral beds?
- Might the Awad and Lin vertebral derangement technic in the spines of laboratory animals lead to the possibility of monitoring the vascular, myological, neurological, endocrine and chemical changes that might be affected, and do we have the personnel on campus who might be interested and possess the ability to make the attempt?
- Have we been sufficiently thorough in investigating (by means of the synchronized four scale instrumentation) of the Illi and Janse concept that more weight is carried on the side of the "anatomical short leg"?
- Is it at all probable that by means of image intensification radiologically (on regular clinic patients) we can determine the effect of a vertebral adjustment at a select spinal level upon visceral conduct?
- Would such instrumentations as electromyography and physiography lend themselves to the investigation of the effect of:
a. discogenic spondylosis and pathological subluxation upon the neurological element?
b. a chiropractic connection at this segmental level upon the somatic and visceral neurological elements?
- Is there any clinical value and investigatory interest to the investigation of the effect upon head and neck posture by optometric prism of changes?
- Two types of major scoliotic deformities are defined (1) congenital -- characterized by asymmetrical segmental developments; (2) idiopathic -- characterized by a collapsing of the spine into scoliotic deformity without apparent cause. Is there any value in seeking to determine whether chiropractic care and controlled supervised kinesiological assignment have meaningful corrective value?
- Does anyone on campus have the interest and the ability to create a method whereby it might be possible to determine the effect of subluxation (in a total broad concept) and a specific spinal dynamic mobilization upon the chemical atmospheres of the nervous system?
- Is there any interest in the helping to determine whether chiropractic care has any value in the care of the autistic child?
- Would it be of any significance in fully investigating the effects of controlled fasting and dieting in the management of rheumatoid arthritic conditions (the investigation of the principles of nature cure)?
- Would anyone dare to assume the responsibility of determining whether the Illi and Janse concept of sacroiliac mechanism function is correct or wrong?
- Is there any validity to the claim that spinal manipulations are helpful to those with chronic respiratory ailments whether asthomatoid, emphyasemetous, bronchiectasis, etc.?
- Is there any merit to a careful investigation of the effect of sole and heel lifts or heel drops and foot levelers upon spinal balance, as determined by synchronized scale evaluation?
Though our research questions may reflect the application of new technology or research methodological skills, the same fundamental questions regarding altered mechanics and its disturbance on the nervous system remain central to chiropractic's search for answers and identity. As a profession, we need to support and encourage investigation and study that pull at our very heart strings. Questioning fundamental beliefs does not assure an absence of faith and confidence in evidence of response to the application of those principles. The goal is not to abdicate our roots but rather to define them and to more clearly understand the significance of their existence. The efficacy of the value of chiropractic, the efficiency of the chiropractic adjustment, and cost-effectiveness of chiropractic care should be of paramount importance to man ever since he decided to stand up and go for a walk.
1. Janse J. A resume of research questions. National College of Chiropractic News Bulletin, Jan. 1982.
Reed Phillips, DC, PhD
President, Los Angeles College of Chiropractic
for previous articles by Reed Phillips, DC, PhD.