Dr.

Cremata Chioropractic Review

Aspects of Chiropractic
Science

Art

Philosophy

Helps with growth and evidence informed patient care;

research helps us decide what procedures to use/add and
what to throw out
Vertebral subluxation/mechanical dysfunction;
Chiropractors primary outcome of adjusting is to
decrease the misalignment, dysfunction, and neurologic
disturbances. Adjustments dont improve health, but
reduction of neuromechanical dysfunctions can.
Therefore, only adjustments done properly and at the
involved levels and side are likely to provide a
measurable objective benefit.
Provides focus within the chiropractic profession; assists
with preventive care; example cancer, diabetes, and
CVD risk decreases with improving lifestyle factors such
as smoking cessation, limitation of alcohol consumption,
exercise, diet, weight management, dietary changes,
potentially improved nerve function, etc. (chiropractors
have practiced preventive health and the chiropractic
lifestyle for a long time, but allopathic practitioners are
just recently prioritizing this concept)
Aspects of Diagnosis

Redness (rubor)
Swelling (tumor)
Heat (calor)
Pain (dolor)
Altered function

Red reflex, inspection

Inspection, palpation
Thermography (infra-red best), feeling with back of hand,
Hippocratic method of inspecting where mud dried faster
Algometry, History (OPQRST) (history if often the most
valuable clue)
a. Mechanical (global range of motion, motion
palpation for specific motor unit or motor region
dysfunctions, functional x-ray)
b. Neurologic (red reflex, match stick test, sensory,
NCT, autonomic testing, girth and strength for
motor testing)

Vertebral Subluxation Complex (neuromechanical dysfunctions) without

philosophical or pseudoreligious implications
Kinesiopathology

a. Fixation (motion palpation, visual inspection, range

of motion studies, lateral bending x-ray)
b. Positional Dyskinesia (change in position of joint
such as posture or segmental alignment); structure

Myopathology

Histopathology
Neuropathology

Pathophysiology

affects function and function affects structure

a. Local (taut and tender fibers, inspection, surface
EMG, algometry)
b. Distal (manual muscle testing, identification of
Trigger Points (Denervation Supersensitivity
Gunn-, muscle atrophy)
Rigidity with specific and global ROM testing, confirmed
with imaging
a. Autonomic (NCV, e.g. 5Hz Medi-Dx 7000 or
Neurometer , sweat tests, red reflex response,
match stick test, thermography)
b. Sensory (pinwheel, 2 point discrimination, brush,
NCV, vibration, DTRs)
c. Motor (DTRs, NCV, strength, girth, inspection)
History, Labs, common signs and symptoms of certain
diseases
Additional Information:

Range of motion studies such as lateral bending x-rays look for:

1. Side of fixation
2. Level of fixation
3. Individual level fixation (i.e. lateral bending sign) due to disc material shift
(McKenzie, Weitz, Wentz, Gonstead)
Normal differences in girth when compared bilaterally:
1. Upper Extremity: 1cm
2. Lower Extremity: 2cm
Use only the most valid test (in terms of positive and negative predictive values,
sensitivity, specificity, etc.), since additional tests can decrease as well as increase
validity and clinical usefulness of tests

Outcome Measures
Frequently intervaled re-examinations, dependent on diagnosis and treatment plan
prognosis, confirm improvement in VSC correction or improvement. Sometimes
management over cure becomes the principle goal (Kirkaldy-Willis), controlling
ADLs, pain levels, abilities for gainful employment, decreased medication needs,
etc.
Per Kirkaldy-Willis, progression of spinal injury progresses from dysfunction, to
instability, to stabilization. Therefore, chronicity helps determine value of test
choices in different stages.