A multi-phase study funded by a 2008 National Institutes of Health grant to Palmer College of Chiropractic is in full swing, with researchers from Palmer's Center for Chiropractic Research teaming with investigators from Loyola University Stritch School of Medicine and the Edward Hines Jr. Veterans Affairs Hospital to study the effects of Cox distraction manipulation on neck pain. The three-part project, "Cervical Distraction Sham Development: Translating From Basic to Clinical Studies," includes pilot studies (already completed), the formal research study, underway since March 2010, and the development of sham and active treatment parameters for clinical studies.
The Hines VA Hospital and Loyola's Stritch School of Medicine are the settings for the formal study, a collaborative effort between researchers at those facilities, researchers from Palmer College, clinicians who perform this technique in their practices, and Dr. James Cox, who originated the Cox distraction procedure.
"As the manipulation procedure is performed, we are measuring the variability between four different clinicians trained in this procedure by measuring the loads and the controlled displacements of the table using a basic science approach as well as a clinical approach," said M. Ram Gudavalli, PhD, from the Palmer Center, who joins lead investigator Christine Goertz, DC, PhD, Palmer's vice chancellor for research and health policy, on the collaborative study. "According to practicing doctors of chiropractic, this chiropractic procedure has provided relief for musculoskeletal conditions such as neck pain. However, there is a need for studies that provide information on the biomechanical characterization of such therapies, the biomechanics of normal and pathological joint and muscle systems, and the development of new technologies that study such biomechanics in real time. In other words, what physiological effect does the procedure have that is responsible for its clinical successes?"
The NIH awarded Palmer the $2.8 million grant back in 2008 to establish a multidisciplinary Developmental Center for Clinical and Translational Science in Chiropractic and carry out three research projects: "Upper Cervical Manipulation for Patients With Stage I Hypertension," "Conservative Treatment of Patients With Temporomandibular Disorders: A Pilot Study," and the Cox distraction project, which is funded through May 2012.
According to Palmer, "The results of this study will aid in the planning and development of controlled procedures in the clinical setting, and test the validity of delivering the controlled procedures by conducting clinical studies and obtaining patients' perception on the controlled intervention. This knowledge has the potential to guide the future conduct of clinical research in this area and impact training of students and doctors in the chiropractic profession.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
