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Journal of Clinical Chiropractic Pediatrics (JCCP)
The JCCP is a peer-reviewed journal published bi-annually by the ICA Council on Chiropractic Pediatrics.

Open Access: www.jccponline.com

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- Journal Abstracts

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  • ADHD
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    ADHD [ BACK TO TOP ]  

    Upper Cervical Chiropractic Care For A Nine-Year-Old Male With Tourette Syndrome, Attention Deficit Hyperactivity Disorder, Depression, Asthma, Insomnia, and Headaches: A Case Report
    By Erin Elster, DC

    [JSVR, July 12, 2003, pp. 1-11]

    Objective: To review the effectiveness of chiropractic care using an upper cervical technique in the case of a nine-year old male who presented with Tourette Syndrome (TS), Attention Deficit Hyperactivity Disorder (ADHD), depression, asthma, insomnia, and headaches.

    Clinical Features: This nine-year-old boy suffered from asthma and upper respiratory infections since infancy; headaches since age 6; TS, ADHD, depression and insomnia since age 7; and neck pain since age 8. His mother reported the use of forceps during his delivery. His medications included Albuterol, Depakote, Wellbutrin, and Adderall. Intervention: During the patient’s initial examination, evidence of a subluxation stemming from the upper cervical spine was found through thermographic and radiographic diagnostics. Chiropractic care using an upper cervical technique was administered to correct and stabilize the patient’s upper neck injury. Diagnostics and care were performed in accordance with the guidelines of the International Upper Cervical Chiropractic Association.

    Outcome: Evaluation of the patient’s condition occurred through doctor’s observation, patient’s and parents’ subjective description of symptoms, and thermographic scans. After six weeks of care, all six conditions were no longer present and all medications were discontinued with the exception of a half-dose of Wellbutrin. At the conclusion of his case at five months, all symptoms remained absent.

    Conclusion: The onset of symptoms soon after the boy’s delivery; the immediate reduction in symptoms correlating with the initiation of care; and the complete absence of symptoms within six weeks of care; suggest a link between the patient’s traumatic birth, the upper cervical subluxation, and his neurological conditions. Further investigation into upper cervical trauma as a contributing factor to Tourette Syndrome, ADHD, depression, insomnia, headaches, and asthma should be pursued.

    Key Terms: upper cervical spine, chiropractic, Tourette Syndrome, depression, asthma, Attention Deficit Hyperactivity Disorder, headaches, trauma, thermography

    Attention Deficit Hyperactivity Disorder and the Triad of Health
    By Tracy A. Barnes, D.C., D.I.C.C.P.

    Objective: To provide a literature review of the multiple etiologies for attention deficit problems in children and to examine alternative non-pharmacological treatment options for children with attention deficit hyperactivity disorder.

    Method: Attention deficit hyperactivity disorder (ADHD) has been estimated to affect approximately 3.5 million American children. The primary medical intervention involves the prescription of the psychostimulant drug methylphenidate. It has been estimated that the number of children being treated with psychostimulant medication for ADHD doubles every two years. A literature review was undertaken examining recent references from the Medline database, together with other references from alternative sources, such as Chirolars database, conference proceedings and the Internet. Possible etiologies for ADHD are discussed and classified into physical, chemical and mental categories. Alternative treatment options, identified from the literature search, are discussed.

    Conclusion: ADHD refers to a combination of symptoms encompassing inattention, impulsiveness, and hyperactivity. The behavior exhibited by the child with ADHD is usually seen as being disruptive and unacceptable by parents and teachers, and the child may be socially handicapped as a result. Traditionally, the treatment of ADHD had relied on behavior techniques and psychostimulant medication. In planning an appropriate treatment program for the child with ADHD, it is important to consider learning disability and hyperactivity separately. Since ADHD is strongly associated with learning disabilities, its treatment should be based on educational intervention, not drug therapy. The doctor of chiropractic can play a significant role in the care of children with ADHD by assessing all aspects of a childs problem and working to restore balance to the physical, chemical, and mental aspects of the child's life. although the doctor of chiropractic may not be an expert in all areas of care for the ADHA child, it is important to recognize this interplay of structural, chemical and mental influences to provide appropriate chiropractic evaluation and care and to consult with an interdisciplinary health care management team, when necessary. (JCCP, Volume 1, No. 2, April 1996)

    Allergy [ BACK TO TOP ]  

    Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States
    By Eric L. Hurwitz, DC, PhD and Hal Morgenstern, PhD

    Background: Findings from animal and human studies confirm that diphtheria and tetanus toxoids and pertussis (DTP) and tetanus vaccinations induce allergic responses; associations between childhood vaccinations and subsequent allergies have been reported recently.

    Objective: The association of DTP or tetanus vaccination with allergies and allergy-related respiratory symptoms among children and adolescents in the United States was assessed.

    Methods: Data were used from the Third National Health and Nutrition Examination Survey on infants aged 2 months through adolescents aged 16 years. DTP or tetanus vaccination, lifetime allergy history, and allergy symptoms in the past 12 months were based on parental or guardian recall. Logistic regression modeling was performed to estimate the effects of DTP or tetanus vaccination on each allergy.

    Results: The odds of having a history of asthma was twice as great among vaccinated subjects than among unvaccinated subjects (adjusted odds ratio, 2.00; 95% confidence interval, 0.59 to 6.74). The odds of having had any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects (adjusted odds ratio, 1.63; 95% confidence interval, 1.05 to 2.54). The associations between vaccination and subsequent allergies and symptoms were greatest among children aged 5 through 10 years.

    Conclusions: DTP or tetanus vaccination appears to increase the risk of allergies and related respiratory symptoms in children and adolescents. Although it is unlikely that these results are entirely because of any sources of bias, the small number of unvaccinated subjects and the study design limit our ability to make firm causal inferences about the true magnitude of effect. (J Manipulative Physiol Ther 2000;23:81–90)

    Publishing and Reprint Information

    • Eric L. Hurwitz, PhD and Hal Morgenstern, PhD - UCLA School of Public Health, Department of Epidemiology, Los Angeles, Calif.
    • Eric L. Hurwitz, DC - Los Angeles College of Chiropractic, Whittier, Calif.
    • Submit reprint requests to: Eric L. Hurwitz, DC, PhD, UCLA School of Public Health, Department of Epidemiology, Box 951772, Los Angeles, CA 90095-1772; ehurwitz@ucla.edu .
    • © 2000 JMPT
    • 0161-4754/2000/$12.00 + 0 76/1/105090
    • doi:10.1067/mmt.2000.105090

    Asthma [ BACK TO TOP ]  

    Management of Pediatric Asthma & Enuresis with Probable Traumatic Etiology
    By Trent R. Bachman, D.C. and Charles A. Lantz, D.C., Ph.D.

    The chiropractic management of asthma and enuresis of traumatic etiology in a two-year, ten-month-old male child. In May 1987 at the age of 22 months the child was medically examined and subsequently diagnosed with asthma. In an attempt to control the asthmatic symptoms two medications were prescribed, Metaproterenal Syrup and Theodore Sprinkle. On May 20, 1988 the child was seen for chiropractic examination and evaluation, and from that date to August 3, 1991 the child received 28 chiropractic adjustive/manipulative treatments. Dramatic improvement of asthma and enuresis followed chiropractic management. The application of Gonstead adjustive/manipulative therapy and the rationale for the correction of vertebral subluxation complex in the case of childhood asthma and enuresis are discussed. (1991 Proceedings)

    Key Terms: Gonstead, adjustive/manipulative, chiropractic, therapeutic goals, asthma, enuresis

    Chronic pediatric asthma and chiropractic spinal manipulation: A prospective clinical series and randomized clinical pilot study
    By Gert Bronfort, DC, PhD; Roni L. Evans, DC; Paul Kubic, MD, PhD; and Patty Filkin

    Objectives: The first objective was to determine if chiropractic spinal manipulative therapy (SMT) in addition to optimal medical management resulted in clinically important changes in asthma-related outcomes in children. The second objective was to assess the feasibility of conducting a full-scale, randomized clinical trial in terms of recruitment, evaluation, treatment, and ability to deliver a sham SMT procedure.

    Study Design: Prospective clinical case series combined with an observer-blinded, pilot randomized clinical trial with a 1-year follow-up period.

    Setting: Primary contact, college outpatient clinic, and a pediatric hospital.

    Patients: A total of 36 patients aged 6 to 17 years with mild and moderate persistent asthma were admitted to the study.

    Outcome Measures: Pulmonary function tests; patient- and parent- or guardian-rated asthma-specific quality of life, asthma severity, and improvement; am and pm peak expiratory flow rates; and diary-based day and nighttime symptoms.

    Interventions: Twenty chiropractic treatment sessions were scheduled during the 3-month intervention phase. Patients were randomly assigned to receive either active SMT or sham SMT in addition to their standardized ongoing medical management.

    Results: It is possible to blind the participants to the nature of the SMT intervention, and a full-scale trial with the described design is feasible to conduct. At the end of the 12-week intervention phase, objective lung function tests and patient-rated day and nighttime symptoms based on diary recordings showed little or no change. Of the patient-rated measures, a reduction of approximately 20% in 2 bronchodilator use was seen (P = .10). The quality of life scores improved by 10% to 28% (P < .01), with the activity scale showing the most change. Asthma severity ratings showed a reduction of 39% (P < .001), and there was an overall improvement rating corresponding to 50% to 75%. The pulmonologist-rated improvement was small. Similarly, the improvements in parent- or guardian-rated outcomes were mostly small and not statistically significant. The changes in patient-rated severity and the improvement rating remained unchanged at 12-month posttreatment follow-up as assessed by a brief postal questionnaire.

    Conclusion: After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. There were no important changes in lung function or hyperresponsiveness at any time. The observed improvements are unlikely as a result of the specific effects of chiropractic SMT alone, but other aspects of the clinical encounter that should not be dismissed readily. Further research is needed to assess which components of the chiropractic encounter are responsible for important improvements in patient-oriented outcomes so that they may be incorporated into the care of all patients with asthma. (J Manipulative Physiol Ther 2001;24:369-77)

    Publishing and Reprint Information

    • Gert Bronfort, DC, PhD and Roni L. Evans, DC, Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, Minn.
    • Paul Kubic, MD, PhD and Patty Filkin, Children's Health Care, St Paul, Minn.
    • This study was funded by the Foundation for Chiropractic Education and Research.
    • Gert Bronfort, DC, PhD, holds the Greenawalt Research Chair, funded through an unrestricted grant from Foot Levelers, Inc.
    • Submit reprint requests to: Gert Bronfort, DC, PhD, Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, 2501 West 84th Street, Bloomington, MN 55431. Paper submitted June 5, 2000.
    • In revised form September 5, 2000
    • J Manipulative Physiol Ther 2001;24:369-77
    • 0161-4754/2001/$35.00 +0 76/1/116417
    • © 2001 JMPT
    • doi:10.1067/mmt.2001.116417

    A Wholistic Approach to the Treatment of Bronchial Asthma in a Chiropractic Practice
    By Dean H. Lines

    Three case studies involving two children and a mature adult with medically established diagnoses of bronchial asthma are presented. Management in each case involved chiropractic adjustments combined with a 'clinical ecology' approach which has been found useful in identifying food and environmental allergens that may act as triggering factors for asthma attacks. This paper suggests that such a broad-based management approach may lead to higher rates of response to chiropractic treatment of asthma, as well as providing greater long-term relief for its victims. Chiropractic J Aust 1993 Mar;23(1):4-8

    Key Terms: MeSH: asthma; chiropractic; Other: clinical ecology

    An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
    By Robert L. Graham, D.C. and Richard A. Pistolese, B.S.

    [JSVR, Vol 1, No. 4. p 1-8]

    Abstract: A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma 'attacks' in the 30 day period prior to the study, the number of 'attacks' decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic 'attacks.' The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

    Key Terms: asthma, adjustment, children, chiropractic, impairment rating, pediatric, vertebral subluxation

    Autism [ BACK TO TOP ]  

    Chiropractic Care and Behavior in Autistic Children
    By Andrew Aguilar, B.S., D.C., M.B.A., John D. Grostic, D.C., and Bruce Pfleger, ph.D., M.S.

    Autism is a severe behavioral and neurological disorder including gross deficits in language development. If speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, or pronominal reversal frequently will exist. A child with autism may display bizarre responses to various aspects of the environment including resistance to change, peculiar interest in or attachments to animate or inanimate objects.

    A systematic series of chiropractic adjustments were administered to 26 autistic children to see if behavioral or neurological remediations would occur concomitant to the nine month care plan. The children were recruited through three local autism societies from the greater Atlanta area.

    Behavioral data for the study were collected by both the classroom teachers and the children’s parent(s). Objective data were collected through Brain Stem Evoked Potential (BSEPs) recordings, pre and post x-ray films, a dual probe infrared heat recording graph instrument, and a supine leg check analysis. Student clinicians performed physicals on each child reevaluating at three month intervals. Subjective data were collected through both a Modified Autism Checklist and a Childhood Autism Rating Scale (CARS). (JCCP, Volume 5, Number 1, Spring/Summer 2000)

    Key Terms: autism, pervasive developmental disorder, developmental delayed, subluxation, upper cervical technique, Grostic technique, orthospinology

    Back Pain [ BACK TO TOP ]  

    Evaluation of chiropractic management of pediatric patients with low back pain: A prospective cohort study
    By Jill A. Hayden, DC, Silvano A. Mior, DC, and Marja J. Verhoef, PhD

    Background: Recent epidemiologic studies have estimated that the lifetime prevalence of low back pain (LBP) in children is approximately 50%, with almost 15% of children experiencing frequent or continual pain. A literature search revealed no published studies addressing conservative treatment of childhood LBP.

    Objective: To describe chiropractic management of LBP in patients between the ages of 4 and 18 years, as well as outcomes and factors associated with the outcomes.

    Methods: Prospective cohort study of consecutive pediatric patients with LBP seeing randomly selected chiropractors within the cities of Calgary, Alberta, and Toronto, Ontario, Canada. Follow-up data collection included the type and extent of treatment rendered and its outcome, which was measured with a 5-point subjective rating scale and a self-report pediatric visual analogue scale.

    Results: Fifteen chiropractors provided data on 54 consecutive pediatric patients with LBP. The average age of the patients was 13.1 years, 57% were male, 61% were acute, with 47% attributing onset to a traumatic event (most commonly sports-related); 24% reported an episode duration of greater than 3 months. Almost 90% of cases presented with uncomplicated mechanical LBP, most frequently diagnosed as lumbar facet dysfunction or subluxation. Patients were managed with manipulation, with a minority (7.7%) receiving some form of active management. “Important” improvement was seen in 62% and 87% on the visual analogue and subjective scales, respectively, within a 6-week course of management (Kaplan-Meier survival analysis). Patients with chronic LBP were less likely to respond within the median number of treatments (relative risk = 2.1).

    Conclusions: Patients responded favorably to chiropractic management, and there were no reported complications. Future investigations should establish the natural history and compare chiropractic management with other forms of treatment to gain knowledge about the effectiveness of chiropractic in managing pediatric LBP. (J Manipulative Physiol Ther 2003;26:1-8)

    Publishing and Reprint Information

    • Jill A. Hayden, DC, Institute for Work and Health, Toronto, Ontario, Canada, and Department of Health Policy, Management, and Evaluation, Clinical Epidemiology, University of Toronto, Toronto, Ontario, Canada.
    • Silvano A. Mior, DC, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.
    • Marja J. Verhoef, PhD, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
    • Sources of support (research grants): Canadian Foundation for Spinal Research, and Faculty of Medicine, University of Calgary.
    • Sources of support (personal funding): Canadian Institutes of Health Research (Postdoctoral Fellowship Award to Dr Jill Hayden).
    • Submit requests for reprints to: Dr Jill Hayden, Institute for Work and Health, 481 University Avenue, 8th Floor, Toronto M5G 2E9, Ontario, Canada.
    • Paper submitted July 16, 2001; in revised form October 16, 2001.
    • Copyright © 2003 by JMPT
    • 0161-4754/2003/$35.00 + 0 76/1/11
    • doi:10.1067/mmt.2003.11

    Back pain reporting in children and adolescents: The impact of parents' educational level
    By Charlotte Leboeuf-Yde, DC, MPH, PhD, Niels Wedderkopp, MD, PhD, Lars Bo Andersen, DMSc, Karsten Froberg, MSc, and Henrik Steen Hansen, DMSc

    Background: Social class, including educational level, is a strong predictor for health-related perceptions and behavior and for health outcomes in general. It is not known whether parental education has an effect on back pain in their offspring.

    Objectives: To establish whether parents' educational level is associated with back pain reporting and consequences of back pain in their children.

    Design: A cross-sectional survey.

    Data Collection: Information on parental education was obtained through questionnaires to parents and back pain information through standardized interviews with the children.

    Participants: Children aged 8 to 10 years (n = 481) and adolescents aged 14 to 16 years (n = 325) obtained through a proportional 2-stage cluster sample.

    Setting: Local schools in Odense, Denmark.

    Main Outcome Measures: The strength of association and dose-response connection were studied between parental educational level (high/medium/low) and the outcome variables (back pain in the preceding month, and consequences of back pain) in their children.

    Results: There was a significant modest negative association between the level of parental education and back pain in children but not in adolescents. There was no significant association between parental educational level and back pain consequences.

    Conclusions: Further research in this area requires a more ingenious approach such as use of more socially heterogeneous study populations than those usually found in Denmark. (J Manipulative Physiol Ther 2002;25:216-220)

    Publishing and Reprint Information

    • Charlotte Leboeuf-Yde, DC, MPH, PhD, Medical Research Unit in Ringkjøbing County, Ringkøbing, Denmark
    • Niels Wedderkopp, MD, PhD and Karsten Froberg, MSc, Institute of Sportsscience and Clinical Biomechanics, Odense University, Odense, Denmark
    • Lars Bo Andersen, DMSc, Institute for Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
    • Henrik Steen Hansen, DMSc, Department of Cardiology, The Odense University Hospital, Odense, Denmark
    • Submit requests for reprints to: Charlotte Leboeuf-Yde, Research Director, The Medical Research Unit in Ringkøbing County, Postbox 142, DK-6950 Ringkøbing, Denmark.
    • Paper submitted November 29, 2000; in revised form March 14, 2001.
    • Copyright © 2002 by JMPT
    • 0161-4754/2002/$35.00 + 0 76/1/123172
    • doi:10.1067/mmt.2002.123172

    Breast-Feeding [ BACK TO TOP ]  

    Chiropractic Evaluation and Treatment of Musculoskeletal Dysfunction in Infants Demonstrating Difficulty Breastfeeding
    By Sharon Vallone, DC, FICCP

    Objective: Breastfeeding during the first year of an infant’s life is currently supported and promoted by lactation consultants, midwives, naturopaths, chiropractors and allopathic physicians. In 1997, the American Academy of Pediatrics and in 1998, the World Health Organization published their position papers that advocated breastfeeding as the optimal form of nutrition for infants. This study was to investigate problems interfering with a successful breastfeeding experience and to see if proper lactation management, with the chiropractor acting as a member of a multidisciplinary support team, can help to assure a healthy bonding experience between mother and infant.

    Methods: 25 infants demonstrating difficulties breastfeeding were evaluated for biomechanical dysfunction potentially resulting in an inability to suckle successfully. The biomechanics of 10 breastfeeding infants without complaint were also evaluated for comparison.

    Results: An overview of the infants with breastfeeding difficulty revealed imbalanced musculoskeletal action as compared to the infants without difficulty breastfeeding.

    Utilization of soft tissue therapies and chiropractic adjustments of the cranium and spine resulted in improved nursing in over 80% of the patients.

    Conclusions: The results of this study suggest that biomechanical dysfunction based on articular or muscular integrity may influence the ability of an infant to suckle successfully and that intervention via soft tissue work, cranial therapy and spinal adjustments may have a direct result in improving the infant’s ability to suckle efficiently.

    (JCCP, Volume 5, No. 1, 2004)

    Key Terms: hiropractic, subluxation, vertebral subluxation complex, spinal manipulative therapy, chiropractic adjustment, craniosacral therapy, myofascial release, massage therapy, breastfeeding, lactation, latch, suckle, breastfeeding dysfunction

    Resolution of suckling intolerance in a 6-month-old chiropractic patient
    By David P. Holtrop, DC, DICC

    Objective: To discuss the management and resolution of suckling intolerance in a 6-month-old infant.

    Clinical Features: A 6-month-old boy with a 4½-month history of aversion to suckling was evaluated in a chiropractic office. Static and motion palpation and observation detected an abnormal inward dishing at the occipitoparietal junction, as well as upper cervical (C1-C2) asymmetry and fixation. These indicated the presence of cranial and upper cervical subluxations.

    Intervention and Outcome: The patient was treated 5 times through use of cranial adjusting; 4 of these visits included atlas (C1) adjustment. The suckling intolerance resolved immediately after the first office visit and did not return.

    Conclusion: It is possible that in the infant, a relationship between mechanical abnormalities of the cervicocranial junction and suckling dysfunction exists; further research in this area could be beneficial. Possible physiological etiologies of painful suckling are presented. (J Manipulative Physiol Ther 2000;23:615-8)

    Publishing and Reprint Information

    • Private practice of chiropractic, Sheboygan, Wis.
    • Submit reprint requests to: David P. Holtrop, DC, 4171 S. 15th Street, Sheboygan, WI 53081; drdave@nconnect.net
    • Paper submitted October 14, 1999; in revised form December 22, 1999.
    • J Manipulative Physiol Ther 2000;23:615-8
    • © 2000 JMPT
    • 0161-4754/2000/$12.00 + 0 76/1/110943
    • doi:10.1067/mmt.2000.110943

    Chiropractic Care for Infants with Dysfunctional Nursing: A Case Series
    By Elise Hewitt, D.C., D.I.C.C.P.

    Objective: To present the cases of two infants with dysfunctional nursing who were able to breastfeed normally after receiving chiropractic care. Physiological mechanisms are presented explaining how chiropractic care may restore normal suckling.

    Clinical Features: The first case involves an 8-week-old girl unable to maintain suction while breastfeeding since birth. She was diagnosed by a chiropractor with cranial subluxations. The second infant, a 4-week-old boy, had been unable to suckle effectively since birth. He was diagnosed with spinal and cranial subluxations.

    Intervention and Outcome: Each infant received diversified spinal adjusting and/or craniosacral therapy based on the clinical findings. The first was able to nurse normally after receiving 2 chiropractic adjustments over 14 days. The second infant suckled immediately following his first adjustment and received a total of 4 adjustments in 21 days.

    Conclusions: This paper reports two cases in which chiropractic care was followed by immediate resolution of dysfunctional nursing. Further research is needed to determine the role of the chiropractic adjustment in normalizing neonatal suckling. (JCCP, Volume 4, Number 1, May 1999)

    Key Terms: chiropractic, pediatrics, dysfunctional breastfeeding, adjustment, manipulation

    Chiropractic Management of an Infant Experiencing Breastfeeding Difficulties and Colic: A Case Study
    By Wesley E. Sheader, D.C., D.I.C.C.P.

    Objective: To discuss chiropractic care of an infant with symptoms of colic and breastfeeding difficulties. This paper also discusses colic subsequent to the administration of the second Hepatitis vaccination.

    Design: Individual case

    Setting: A private chiropractic office

    Outcome Measure: Improvement was determined by the observations of the mother and clinical findings of the chiropractors.

    Result: Immediate improvement of infant’s symptoms following the first adjustment with complete resolution within five days. A recurrence, with exacerbated presentation, (as reported by the mother) was noted within three hours of the infant receiving his second Hepatitis B Vaccine. Immediate remission was not observed nor was the infant able to remain subluxation free during the stress-reaction phase described by Scheibner. However, complete remission of symptoms and the ability of the infant to remain subluxation free occurred once the infant was past that acute reaction phase.

    Conclusion: It is impossible to generalize the results of a single case to the population of patients with colic. However, this case study raises important issues regarding the role of chiropractic care in infants with colic, and the possible complicating factors of vaccinations. (JCCP, Volume 4, Number 1, May 1999)

    Key Terms: Infant, colic, breastfeeding, chiropractic, vaccination, hepatitis, adjustment, manipulation, stress-reaction

    Whey Milk: The Next Best Thing to Breast Milk
    By Navine Haworth, D.C., D.I.C.C.P.

    Breastfeeding should always be encouraged as it provides infants with the optimum nutrition. Whey milk may be considered as a substitute for breast milk for infants where breastfeeding is not possible as it is the more compatible for the infant in composition and nutritional requirements than dairy or soy formula, and less allergenic. In this paper, the author attempts to outline the benefits of whey as an alternative for those infants where breastfeeding is not an option, especially for infants who are intolerant to formula. Its nutritional benefits, hypoallergenic status and immunogenic benefits are also considered.

    Data Source: Data was extracted from two computer-based sources, Medline and Immunotec.

    Conclusion: If breast milk, nature’s intended nutrient for the infant, is not available, whey milk poses as the next best alternative. Unlike other infant formulas, it appears to be as immunogenic and antigenic as breast milk. (JCCP, Volume 4, Number 1, May 1999)

    Cerebral Palsy [ BACK TO TOP ]  

    Chiropractic Management of Cerebral Palsy: A Case Report
    By Tracy A. Barnes, D.C.

    A nine-year-old girl with medically diagnosed mild cerebral palsy wore lower extremity twister cable braces for four years. After eight months of chiropractic care, she was discharged by her orthopedic physician. Her braces were removed and she was returned to her normal activities. This patient is an example of how patients with cerebral palsy may benefit from chiropractic management. It has implications for future research into the area of chiropractic and special needs children. (1994 Proceedings)

    Child Abuse [ BACK TO TOP ]  

    Mandated Reporters of Child Abuse and Neglect: An Overview of Information and Issues for Chiropractors
    By Jeanne Murrone, Ph.D.

    In many states, chiropractors have been designated as mandated reporters of suspected incidents of child abuse or neglect. This article presents an overview of the information needed to guide a professional in making a decision to report to a child protective agency. This presentation must be generalized as laws governing mandated reporters are state-specific. While several topics and issues are addressed here, time and space necessitate brevity. It is critical for chiropractors to contact their state’s agency to obtain information about the precise mandate under which they are governed and practice. To help professionals obtain this information, the address of each state’s child protective agency has been listed at the end of this paper. (1993 Proceedings)

    Chirodontics [ BACK TO TOP ]  

    Chirodontics: The Importance of Structural Correlation and Management in Childhood Dental Orthodontic and TMJ Procedures
    By Clayton D. Skaggs, D.C.

    Included in this article are three case histories of children at different levels of maturation and treatment. They give you an introduction to the encompassing approach utilized in chirodontic diagnosis and treatment. The clinical necessity of this discipline is outlined, reviewing neurological and embryological connections. The Temporal Mandibular region is shown to be as critical, if not more so, in childhood health as in adult health. Anatomical connections clearly link dysfunction of this region (TMJ) to common childhood conditions. Brief coverage will also be given to specific criteria and protocols that have been found to be key elements in optimizing the chiropractic/dental relationship’s success. (1991 Proceedings)

    Colic [ BACK TO TOP ]  

    Chiropractic Adjustments and Infantile Colic: A Case Study
    By Christine Hyman, D.C.

    A case report involving symptoms of infantile colic in a 5-week-old male infant. This case study addresses the various factors of infantile colic including the concept of vertebral subluxation, which should not be overlooked as a possible factor. The results of this study showed remarkable improvement of the infant after each chiropractic adjustment, as related by both parents. (1994 Proceedings)

    Key Terms: infantile colic, vertebral subluxation, chiropractic adjustment, abdominal distress

    Chiropractic Management of an Infant Patient Experiencing Colic and Difficulty Breastfeeding: A Case Report
    By Janet M. Cuhel, D.C., D.I.C.C.P. and Mike Powell, D.C.

    Objective: The purpose of this case study is to discuss the essential spinal and nutritional considerations in the management of infant who is experiencing colic and difficulty breastfeeding. This report also emphasizes the importance of communication between all health care providers attending to a patient.

    Clinical Features: A twelve-day-old male was presented for chiropractic examination and treatment by his mother. The mother related difficulty in feeding on the right breast. She also stated that he seemed “fussy” and had been producing excess bowel gas. Twenty-four hours after delivery, a Depo-Provera injection was administered to the mother. Initial chiropractic examination of this infant included palpation and motion studies which revealed decreased movement at the right atlanto-occipital joint, and as prominent transverse process on the right side of the atlas.

    Intervention and Outcome: Following history and examination, a chiropractic adjustment was performed to the atlas. Over the course of this patient’s care, additional chiropractic adjustments were performed. This course of treatment was met with limited success. The patient history was reviewed for a second time. This prompted the mother to add that an injection of Depo-Provera had been administered 24 hours after the delivery. The parent was advised that this injection may have been a contributor to the infant’s problem. Acting on this advice the mother did not receive the next injection as scheduled. Nutritional supplementation was utilized, and adjustments were continued. The infant’s pattern of breastfeeding and bowel function normalized.

    Conclusion: This case involves the chiropractic management of an infant experiencing colic and difficulty breastfeeding. This case demonstrates the possible effectiveness of chiropractic intervention with this patient. It also demonstrates the importance of a thorough history and communication with other health care providers. The use of the injectable contraceptive, Depo-Provera, may have contributed to the difficulties this infant was experiencing. More research in this products’ use in breastfeeding mothers; as well as more effective communication between the manufacturer and prescribing doctor are needed. (JCCP, Volume 2, Number 2, October 1997)

    Key Terms: adjustment, breastfeeding, chiropractic, coli, Depo-Provera, infant, nutrition

    Chiropractic Care of Infantile Colic: A Case Study
    By Lisa Z. Killinger, D.C. and Ayla Azad, D.C.

    Objective: This study outlines the chiropractic care of an eleven-month-old male with severe, complicated, late onset infantile colic. The infant had been unable to consume solid foods for a period of four months, and suffered from severe constipation. In addition, this subject demonstrated extreme muscular weakness and lack of coordination. The baby was unable to crawl, stand, or walk, and was greatly unresponsive to his surroundings.

    Subject: An eleven-month-old baby boy

    Setting: A chiropractic college teaching and research clinic; Circa 1949

    Methods: Upper Cervical Specific chiropractic adjustments for a subluxation of the first cervical vertebra.

    Results: Immediate improvements in muscle strength, coordination, responsiveness, and ability to consume solid foods without vomiting. (JCCP, Volume 3, Number 1, August 1998)

    Colic with Projectile Vomiting: A Case Study
    By Meghan Van Loon, D.C.

    Objective: The purpose of this case study is to discuss the chiropractic care of a patient who presented to the author’s office with a medical diagnosis of colic, with additional projectile vomiting. The proposed etiology, the medical approach to colic, and the chiropractic care for this infant is detailed. Also examined is the connection between birth trauma and non-spinal symptoms.

    Design: A case study.

    Setting: Private practice.

    Patient: A three-month-old Caucasian male presenting with medically diagnosed colic. Symptoms had been increasing in severity over the previous two months despite medical intervention.

    Results: The resolution of all presenting symptoms within a 2-week treatment period is detailed. Care consisted of chiropractic spinal adjustments and craniosacral therapy.

    Conclusion: This case study details the chiropractic management of a three-month-old male with a medical diagnosis of colic who also exhibited projectile vomiting. Complete resolution of all symptoms was achieved. Proposed cranial and spinal etiologies are discussed, as well as the connection between birth trauma and non-spinal symptoms. (JCCP, Volume 3, Number 1, August 1998)

    Key Terms: chiropractic, vertebral subluxation complex, vertebral-cranial subluxation complex, spinal adjustment, craniosacral therapy, colic, projectile vomiting

    Constipation [ BACK TO TOP ]  

    Chiropractic Treatment of a 7-Month-Old with Chronic Constipation: A Case Report
    By Elise G. Hewitt, D.C.

    The effect of chiropractic care on visceral conditions currently generates wide interest. Practitioners in this clinic have observed bowel function changes in patients following chiropractic treatment. This report has the added interest that it involves a 7-month-old suffering from chronic constipation since birth. The infant had a history of hard, pellet-like stools following hours of painful straining, ranging in frequency from once per day to once every three days. After receiving treatment consisting of full spine and cranial adjusting, the patient’s bowel function normalized to 1-2 soft, effortless stools per day. Results were confirmed at the eight-week follow-up visit. This response, although observed on a single subject, suggests that chiropractic care may affect pediatric visceral conditions through treatment of the spine and cranium and expresses the need for further observation. We are beginning to record such results for similar or related conditions. A major investigation into such conditions would be welcomed. (1992 Proceedings)

    Developmental Disorders [ BACK TO TOP ]  

    Longitudinal Clinical Case Study: Multi-Disciplinary Care of Child with Multiple Functional and Developmental Disorders
    By Lorraine M. Golden, D.C. and Coralee Van Egmond, D.C.

    The clinical course of a pediatric patient over eight years of chiropractic care with concurrent multi-disciplinary supportive intervention is reviewed. A 22-month-old non-ambulatory male with presenting diagnoses of spinal meningitis, cerebral palsy, seizures requiring medication, and physical and mental retardation undergoes comprehensive serial evaluation and treatment of multiple disorders at a multi-professional facility. Longitudinal description and analysis of findings and treatment from infancy through nine-years-old provides clinical insight on coordinating treatment of multiple health problems rendered by other health care fields while undergoing primary chiropractic care. The clinical course involves consolidation of data over longitudinal and cross-professional parameters at significant points in the patient’s progress. Compilation of clinical results through such monitored variables as repeated objective measures provides a rich data base for future investigation. In addition, this interactive data furnishes a unique opportunity for relevant assessment of chiropractically coordinated care for the multiply disordered pediatric patient. (1992 Proceedings)

    Chiropractic Care of a Child with Significant Short Stature, Hypotonia, Developmental Delay, and Seizures
    By Carol Parnell, D.C., D.I.C.C.P.

    Objective: The purpose of this case study is to discuss the chiropractic care of a child diagnosed with congenital encephalopathy, associated hypotonia, seizures and developmental delay of unknown etiology. The medical history and management of chiropractic care for this child is detailed. Also examined is the connection between traumatic birth syndrome as a possible etiology.

    Design: A case study

    Setting: Private practice

    Patient: A 3-year-old Caucasian female presented with the height and weight of a 12-month-old, who could not walk or talk. Also noted were facial dysmorphism and unresolved cradle cap over the frontal/parietal suture.

    Results: Improved cranial facial symmetries. Marked resolution of cradle cap. Improvements in physical and cognitive development.

    Conclusions: This case study details the medical evaluation and chiropractic management of a 3-year-old female with short stature and developmental delay of unknown etiology. Improvement in patient’s development while under chiropractic care is noted. Proposed cranial and spinal etiologies are discussed, as well as a hypothesized connection between traumatic birth syndrome and clinical manifestations. (JCCP, Volume 5, Number 1, Spring/Summer 2000)

    Key Terms: traumatic birth syndrome, chiropractic, vertebra-cranial subluxation complex, spinal adjustment, craniosacral therapy, birth trauma, periventricular leukomalacia

    Developmental - Behavioral Pediatrics: The Chiropractor’s Role
    By Joan M. Fallon, D.C., F.I.C.C.P.

    Behavioral-developmental pediatrics can be defined as the study of normals and variations in the sequential acquisition of fine and gross motor competencies, cognitive skills and adaptive functioning in social and non-social settings of the child.

    Increasingly, children with developmental or behavioral variations or delay are finding their way to the chiropractor. It is the author’s belief that the chiropractic study and approach to pediatric care allows the chiropractor to understand and address these issues for the child in a less invasive and in many cases more effective way than most other disciplines. (JCCP, Volume 2, Number 1, January 1997)

    Key Terms: behavior, developed motor skills, chiropractic, pediatrics

    Epilepsy [ BACK TO TOP ]  

    Epilepsy and seizure disorders: A review of literature relative to chiropractic care of children
    By Richard A. Pistolese, DC

    Objective: To review the currently available literature regarding chiropractic care relative to patients with epilepsy, particular emphasis being placed on those who have epilepsy as children.

    Data Sources: The Index to Chiropractic Literature was searched for the years 1980 through 1998 through use of the keywords epilepsy and seizure. The MANTIS database was searched for the years 1970 through 2000 through use of the Medical Subject Heading (MeSH) keywords chiropractic, epilepsy, seizure, and child/children. In addition, a MEDLINE search of the literature was performed for the years 1966 through 2000 through use of the same subject headings.

    Results: The present study reviews 17 reports of pediatric epileptic patients receiving chiropractic care. Fourteen of the 17 patients were receiving anticonvulsive medications, which had proven unsuccessful in the management of the condition. Upper cervical care to correct vertebral subluxation was administered to 15 patients, and all reported positive outcomes as a result of chiropractic care.

    Conclusions: Chiropractic care may represent a nonpharmaceutical health care approach for pediatric epileptic patients. Current anecdotal evidence suggests that correction of upper cervical vertebral subluxation complex might be most beneficial. It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients. (J Manipulative Physiol Ther 2001;24:199-205)

    Publishing and Reprint Information

    • Richard A. Pistolese, DC, International Chiropractic Pediatric Association, Research Department, Stone Mountain, Ga.
    • This study was supported by the International Chiropractic Pediatric Association.
    • Submit reprint requests to: Richard A. Pistolese, DC, Research Department, International Chiropractic Pediatric Association, 5295 Highway 78, Suite #D362, Stone Mountain, GA 30087-3414
    • J Manipulative Physiol Ther 2001;24:199-205
    • Paper submitted March 30, 1999; in revised form April 15, 1999.
    • © 2001 JMPT
    • 0161-4754/2001/$35.00 + 0 76/1/113771
    • doi:10.1067/mmt.2001.113771

    Erb’s Palsy [ BACK TO TOP ]  

    Chiropractic Adjustments and Erb’s Palsy: A Case Study
    By Christine A. Hyman, D.C., D.I.C.C.P.

    Objective: The purpose of this case study is to discuss the chiropractic care of a patient presenting to the author’s chiropractic office, with obstetrical brachial plexus injury at the level of C5-C6 nerve roots (Erb’s palsy). This article relates the proposed mechanism of injury, along with the current medical treatment available and the chiropractic care provided to the patient.

    Design: A case study.

    Setting: Private practice.

    Patient: A two-month-old, black female presented with obstetrical brachial plexus injury (Erb’s palsy). This infant had been under the care of several medical pediatrician’s without resolution.

    Outcome Measures: Resolution of this condition was determined by observation and physical examination of the infant.

    Results: The progression and resolution of the infant’s condition is presented for each of the chiropractic office visits. The chiropractic office visits consisted of evaluation of the infant and chiropractic spinal adjustments. Complete resolution was noted, without any complications or residual impairments.

    Conclusion: The author has presented a case study of a two-month-old, black female with obstetrical brachial plexus injury who underwent a program of chiropractic care, which was inclusive of chiropractic spinal adjustments. The infant had complete resolution of her condition with no complications or residual impairments. (JCCP, Volume 2, Number 2, October 1997)

    Key Terms: chiropractic, spinal adjustments, vertebral subluxation, brachial plexus paralysis, obstetrical brachial plexus injuries, phrenic nerve injuries, peripheral nerve trauma, Erb’s palsy

    Failure To Thrive [ BACK TO TOP ]  

    Evaluation of a Pediatric Patient with a Medical Diagnosis of Failure to Thrive
    By Marsha Heikkinen, D.C.

    Objective: To present the importance of taking a complete case history, maternal/prenatal, birth and postnatal.

    Clinical Features: A four-week-old infant girl who is suffering with failure-to-thrive symptoms.

    Intervention and Outcome: Prescription of a TENS unit to wean the mother off of pain medications. Specific chiropractic adjustments to both mother and infant.

    Conclusion: In this case chiropractic adjustments were secondary to the root of the failure to thrive symptoms. However, maternal case history was vital to the survival of the female infant. (1994 Proceedings)

    Fever [ BACK TO TOP ]  

    Chiropractic Management of the Acute Febrile Paediatric Patient
    By Neil J. Davies

    Chiropractic management of the acute febrile paediatric patient is discussed with emphasis on differential diagnostic factors which are readily obtained and which, properly interpreted, indicate a clear need for referral to other health care providers more expert in emergency care. A case report is given to illustrate this need and a diagnostic flow plan for use when confronted by such a case is presented. J Aust Chiropr Assoc 1987 Dec;17(4):126-30

    Key Terms: Febrile Disorders; Chiropractic Management; Paediatrics

    Glaucoma [ BACK TO TOP ]  

    Chiropractic Care of a Pediatric Glaucoma Patient: A Case Study
    By Cynthia M. Conway, D.C., D.I.C.C.P.

    This case study involves a 17-month-old female presenting with glaucoma and recurrent, chronic sinus infections. This study addresses the reduction of infections as well as the restoration of normal intraocular pressure to the patient using chiropractic adjustments and nutritional therapy. (JCCP, Volume 2, Number 2, October 1997)

    Key Terms: glaucoma, sinus infections, intraocular pressure, chiropractic adjustments, nutritional therapy, hydropthalmos, goniotomy

    Headache [ BACK TO TOP ]  

    Chiropractic Care of a 13-year-old with Headache and Neck Pain: A Case Report
    By Elise G. Hewitt, D.C.

    Headaches are the most frequent cause of visits to primary care practitioners. Standard medical care for headaches is prescription of pain relieving medication. Is chiropractic care an effective treatment for headaches in children? This report describes a 13-year-old female who had suffered from severe headache and neck pain for five days. Following a series of four chiropractic treatments over a twp-week period, her headache and neck pain resolved. A thorough search of the scholarly literature revealed no data involving chiropractic treatment of headaches in children. This patient’s response suggests chiropractic care may be effective in this area and requests further investigation. (1993 Proceedings)

    Key Terms: chiropractic, headache, child, manipulation

    The Role of Chiropractic Care in the Resolution of Migraine Headaches and Infertility
    By Ronit Vilan, DC, DICCP

    Objective: The purpose of this case study is to discuss the chiropractic care of a patient who presented with a chief complaint of migraine headaches. The association between the patient’s migraines and her medical history of infertility is discussed.

    Design: A case study.

    Setting: Private practice.

    Patient: A 28-year-old Caucasian female.

    Results: The resolution of the patient’s migraines as well as her infertility occurred after three months of chiropractic care.

    Conclusion: This case study details a 28-year-old female who received chiropractic care for migraines. The patient had complete resolution of the migraines and consequently infertility. Spinal etiology appears to be associated with headaches and infertility.

    (JCCP, Volume 5, No. 1, 2004)

    Key Terms: migraines, infertility, chiropractic, vertebral subluxation complex, pituitary, spinal adjustments

    Chronic Pediatric Migraine-Type Headaches Treated by Long-Term Inderol Prior to Chiropractic Care A Case Report
    By Vickie L. Haney, D.C.

    An 11-year-old pediatric female was referred to our practice by her aunt because of an eight year history of severe migraine-type headaches, and a four year history of 20 mg. intake of Inderol daily. This was prescribed for the headaches, which were still incapacitating the child approximately two times per week, despite medication. During examination it was eventually revealed that the child had been a hit and run victim at 18 months, with her first “known” headache occurring at about the age of three. Cervical and thoraco-lumbo-pelvic x-rays revealed cervical hypolordosis, C1/C2 hyperextension subluxation and pelvic unleveling. Correction was accomplished using diversified style adjustments following an applied kinesiological work-up. The patient’s initial complaint of severe headaches seems to have been resolved, follow-up x-rays show that there has been a decrease in thoracic and lumbar curvatures, she has slowly been weaned from Inderol, and is off all pain medications as well. (1993 Proceedings)

    Key Terms: headaches, migraine, pediatric, inderol

    Chiropractic Treatment of Childhood Migraine Headache: A Case Study
    By Julia A. Cochran, D.C.

    Researchers have indicated that single-subject case studies may be ov value for the doctor in clinical practice, as well as for setting up a scientific data base. The purpose of this case study is to describe the history and response of a condition (childhood migraine headache), which may or may not be commonly treated in a chiropractic practice, but which is thought by some to be responsive to chiropractic adjustment. (1994 Proceedings)

    Key Terms: migraine headache, chiropractic adjustment, acute confusional migraine, prodrome, trigger

    Chiropractic Care of Children with Headaches: Five Case Reports
    By Elizabeth S. Anderson-Peacock, D.C., D.I.C.C.P.

    In this case series, five children presented with varying types of headaches to a family-based chiropractic practice. In each case, spinal subluxations were present. Following reduction of those subluxations through chiropractic adjustments to the child’s chief complaint remissed. Adjunctive therapy (education on diet, posture and exercise) was not given until the headaches remissed. Thus it was felt that the headache reduction may have been due to the restoration of nervous system function through the chiropractic adjustment. Chiropractic management of headaches should be further researched in children. (JCCP, Volume 1, Number 1, January 1996)

    Key Terms: headache, pediatric, adjustment

    Head Injury [ BACK TO TOP ]  

    Post-traumatic Evaluation and Treatment of The Pediatric Patient with Head Injury: A Case Report
    By H. Jason Araghi, D.C.

    A 2-year-old boy suffering from vomiting and loss of energy following impact trauma to the head was found by neurologic examination and computerized axial tomography to have suffered a concussion, with no evidence of brain or spinal cord pathology. Chiropractic examination revealed upper cervical vertebral subluxation complex, along with a straightening of the cervical curve verified radiographically. Cervical curve was restored, and the patient’s symptoms resolved after a series of specific adjustments to the C0-C1 articulations. Examination and correction of the upper cervical vertebral subluxation complex is discussed. (1992 Proceedings)

    EEG and CEEG Studies Before and After Upper Cervical or SOT Category II Adjustment in Children after Head Trauma, in Epilepsy and in “Hyperactivity”
    By Lasca A. Hospers, Ph.D., D.C.

    Localization and categorization of central nervous system dysfunction with the EEG or CEEG before and after chiropractic adjustment in case histories of five children will be presented. Conventional EEG studies demonstrate responses of two children with petit mal (absent seizures) with potential for generalizing into grand mal. Upper cervical adjustment reduced invasion of primary epileptic foci into surrounding regions of the brain and concurrently reduced the frequency of seizures over a four month period. In two cases of “hyperactivity” and attention deficit disorder, upper cervical adjustment reduced non coherence between right and left hemispheres in one child and in another, CEEG demonstrated restoration of normal incidence of the alpha frequency spectrum. Increased attention span and improvement of social behavior were reported in both cases. A child rendered hemiplegic in an automobile accident displayed predominantly delta spectrum and a deficiency of beta spectrum over the sensory motor cortex of the injured side of the brain. After adjustment, the CEEG demonstrated a decreased percentage of delta spectrum and increased beta spectrum. He was able to utilize his arm and leg contralaterally to the injured side of the brain without assistance after upper cervical adjustment. (1992 Proceedings)

    Infertility [ BACK TO TOP ]  

    The Restoration of Female Fertility in Response to Chiropractic Treatment
    By Brent McNabb, D.C.

    Case study of a 36-year-old white female with primary presenting complaint of almost constant lower neck and upper back pain, most pronounced on the right side. Patient also stated that for the past year and a half she had been experiencing episodes of deep lower lumbar pain which seemed to be associated with her menstrual cycle. She had just completed a year of tests and examinations for infertility. No positive findings or abnormalities were found and she was told her chance of becoming pregnant was almost nonexistent without some form of medical intervention. Chiropractic assessment included subluxation and biomechanical dysfunction primarily of the right sacroiliac, L4, T11, C2 and C1 articulations concommitant with muscular contractures related to the above motor units with suspected facet syndrome of the lumbosacral articulation. Treatment consisted of specific spinal adjustments, primarily to the above segments, soft tissue mobilization, spinal stretching exercises, and postural habits modification. The review of symptoms subsequent to care, were the following: no lower cervical nor upper thoracic pain; the chronic headache pattern had stopped with only mild headaches noted on rare occasions; no tinnitis; no deep pelvic pain; and only occasional lumbar ache noted with fatigue but not with menses. Within a year of completing treatment, the patient became pregnant by natural means and later delivered her infant son without complications. (1994 Proceedings)

    Sacro Occipital Technique Management of a Thirty Four Year Old Woman with Infertility
    By Martin G. Rosen, DC, CC, CSP

    [JSVR, December 17, 2003, pp 1-4]

    Abstract - Objective: This article presents a discussion of the response to corrective chiropractic care, specifically Sacro Occipitial Technique, in a woman with a history of infertility.

    Clinical Features: On January 10, 2000, a thirty-four year old woman presented for chiropractic care. Her concerns listed a variety of conditions, including a history of infertility. With her first child, she had attempted to get pregnant naturally but was unable to. Medical treatment included fertility drugs that were unsuccessful, but she was able to conceive through in vitro fertilization. Her son was born on July 3, 1998. Approximately one year after his birth she attempted to naturally conceive a second child, but was unsuccessful. Her clinical history revealed a number of gymnastic injuries over a twelve-year period and several “minor” car accidents. She suffered from chronic back pain and spasms for years, occasional neck pain, and a chronic condition of unknown etiology that caused her hands and feet to be painful and difficult to use in the morning.

    Chiropractic Care and Outcome: Sacro Occipital Technique evaluation determined a primary Category II sacro-iliac joint instability complex, and the patient committed to a six-week intensive care program. Adjustments included Category II blocking procedures for a left short leg, corrections of psoas muscle imbalance, and cervical cavitation. Upon re-evaluation after six weeks, objective findings noted marked improvement and a stabilization of her Category II subluxation complex since January 21, 2000. Subjective findings included the resolution of low back and neck pain, as well as the pain and stiffness in her hands and feet. Also, for the first time in the patient’s life conception occurred naturally, approximately 4-5 weeks into the care program. Reconstructive care was continued on a reduced frequency basis through October 2000, at which time her daughter was born.

    Conclusion: This patient made no other alterations in her lifestyle or clinical situation besides the addition of chiropractic care to afford the positive outcome of increased fertility. Correlation of clinical findings support the reduction of the patient’s subluxation complex and changed neurophysiological parameters. As infertility is a growing concern, and existing medical alternatives offer limited success and while involving a myriad of concerns for the patient, it is prudent to consider other less invasive and costly approaches for dealing with interference to fertility.

    Key Terms: Sacro Occipital Technique, infertility, low back pain, neck pain, chiropractic, vertebral subluxation complex

    Healthy Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care: A Case Report
    By Jessica Shelley , D.C.

    [JSVR, December 8, 2003, pp 1-7]

    Objective: This case study describes the chiropractic care and progress of a female patient with a history of infertility; examining the relationship between D.N.F.T. specific care and the patient’s clinical improvement and ultimate success in becoming pregnant.

    Clinical Features: A 32-year-old female with a history of infertility sought chiropractic care in November of 2001. She had attempted to become pregnant since August 1999, with no success. She had received conventional medical treatment, including detailed fertility testing, artificial insemination, and treatment with the fertility drug Clomid. On October 17, 2001, the patient underwent in vitro fertilization, which failed. She sought chiropractic care three weeks later and an intitial evaluation was performed on November 3, 2001. The case history revealed additional complaints, including endometriosis, low back pain, and frequent headaches. Surface EMG showed significant muscle asymmetry, with a marked elevation of muscle tension on the left side in the area of L3. Chiropractic Assessment, Intervention and Outcomes: D.N.F.T. chiropractic analysis and correction were performed over the next six weeks and during this time, the patient’s secondary complaints of low back pain and headaches improved dramatically. A re-examination was performed on December 28, 2001. Surface EMG showed a substantial improvement in muscle symmetry, as well as a reduction in the muscle tension previously noted at L3. The patient’s fertility specialists noted that her estrogen levels, endometrial thickness, and cervical mucus levels were all at more favorable levels than at the time of the first in vitro attempt. A second attempt at in vitro fertilization was made on February 17, 2002, and the patient had a positive pregnancy test on March 2, 2002. She remained under chiropractic care and was in her 34th week of pregnancy at the time of this writing.

    Conclusion: The human body is designed to be healthy and to reproduce. Impairment of this ability indicates dysfunction on a fundamental level. Subluxations of the spine and the associated nervous system dysfunction can hinder proper function of body systems. This study serves to document the application of chiropractic care and the subsequent response, including restoration of proper reproductive function, in a 32 year old woman previously diagnosed as infertile.

    Key Terms: chiropractic, infertility, D.N.F.T., subluxation, pregnancy, EMG

    Successful Pregnancy Following Diagnosis of Infertility And Miscarriage: A Chiropractic Case Report
    By Leslie Bedell, D.C.

    [JSVR, December 2, 2003, pp 1-7]

    Objective: This case describes the chiropractic care of a woman with a history of infertility and miscarriage.

    Clinical Features: A 27 year old female presented for chiropractic care to improve her overall health, in the hope that she may ultimately be able to have a child. In the previous year she had suffered 2 miscarriages, and had been anovulatory for 9 months. She was under medical treatment for infertility and ulcerative colitis, and followed a restrictive diet. Prior to attempting to become pregnant, she had been on the birth control pill for 7 years.

    Chiropractic Care and Outcome: Examination protocols of Torque Release Technique™ (TRT) were utilized to detect vertebral subluxations. Adjustments were applied with the Integrator instrument; the initial visit schedule was twice weekly for 30 days, and then one visit per week for an additional 30 days. Other therapies used included: craniosacral therapy, relaxation exercises, stretching and audio tapes. After 60 days of care, a normal ovulatory cycle occurred, and she became pregnant after her second normal cycle.

    Conclusion: This case report of a woman with a history of infertility and miscarriage contributes to the growing body of literature on the response to chiropractic care among infertile women. The article discusses the impact of stress on a woman’s nervous system, and the possible associated changes in reproductive health. Further research is called for to evaluate the safety, cost, and effectiveness of chiropractic care in women’s health.

    Key Terms: chiropractic, Torque Release Technique (TRT), vertebral subluxation, infertility, miscarriage

    Response to Gonstead Chiropractic Care in a 27 year old Athletic Female with a 5 year history of Infertility
    By Daniel D. Lyons, DC, LCP

    [JSVR, November 9, 2003, pp 1-3]

    Objective: This article describes the chiropractic care of a 27 year old athletic female with a 5 year history of infertility.

    Clinical Features: Following a marathon, the subject experienced an unresolved injury and sought out chiropractic care. The initial chiropractic evaluation revealed a history of numerous alterations in physiological function, including low back pain, constipation, neck pain, headaches, loss of balance, tension, as well as 5 years of infertility which medical treatments had been unsuccessful for.

    Chiropractic Care and Outcome: Evidence of vertebral subluxation, including dysautonomia and dysponesis, were detected at multiple levels, and chiropractic care was applied using the Gonstead System. The details of 1 month of care are described.

    Conclusion: One month after the application of chiropractic care, marked reduction in dysautonomia and dysponesis is demonstrated, and while previously infertile for 5 years this woman conceived and sustained a successful pregnancy. Further research is suggested examining the application of chiropractic care and associated restoration of function, including reproductive function.

    Key Terms: Chiropractic, Vertebral Subluxation, Infertility, Gonstead, Athletic Female

    Female Infertility and Chiropractic Wellness Care: A Case Study on the Autonomic Nervous System Response while Under Subluxation Based Chiropractic Care and Subsequent Fertility
    By Tammy M. Kaminski, D.C.

    [JSVR, November 2, 2003, pp. 1-10]

    Abstract - Objective: This case study describes a woman, previously diagnosed with a lazy (reproductive) system, who became pregnant after commencing subluxation-based chiropractic care.

    Clinical Features: A 31 year old woman presented to have her nervous system evaluated after her husband’s encouragement. They were under medical treatment for infertility as they had been attempting to become pregnant for over 12 months, and the woman had been taking Clomiphine Citrate (clomid) for 3 months. Her previous child, three years old, had been conceived naturally.

    Chiropractic Care and Outcome: The initial chiropractic examination revealed increased aberrant autonomic and motor nervous system function detected on the thermography scans and sEMG scans, respectively. For the first three months (21 visits) of care the practice member received Diversified chiropractic adjustments followed by four months (12 visits) of Torque Release adjustments. At each visit prior to structural diversified adjustments, motion and static palpation, visual observation, Deerfield leg check and cervical syndrome test were performed to detected vertebral subluxations. The Torque Release Technique (TRT) utilizes the Intergrator™, a torque and recoil release adjusting instrument and three phases comprised the evaluation. After one month of care the practice member chose to stop taking the clomid. By the third month of care she reported having normal menses for two months and drug-free ovulation by month four. Nine months after chiropractic wellness care, the practice member conceived and proceeded to experience a successful full term pregnancy.

    Conclusion: After receiving wellness chiropractic care for the detection and correction of vertebral subluxations, the practice member showed marked improvement in autonomic and motor system function as demonstrated on her sEMG and thermography scans. In additon, after having great difficulty conceiving, she became pregnant nine months after commencing chiropractic care. Further studies are needed to document the relationship between infertility, autonomic nervous system function, and the response to wellness chiropractic care, including subsequent fertility.

    Key Terms: infertility, chiropractic, wellness, subluxation, practice member, Torque Release Technique, Diversified Chiropractic Technique, EMG, thermography

    Reduction of Vertebral Subluxation using Torque Release Technique with Changes in Fertility: Two Case Reports
    By Elizabeth Anderson-Peacock, DC, DICCP

    [JSVR, July 19, 2003, pp 1-6]

    Abstract - Objective: This article offers a description of two women who presented with varying complaints to a family-based chiropractic practice. In each case one of the complaints was infertility.

    Clinical Features: In both case histories, the women had been deemed medically infertile and artificial insemination was being considered. Upon presentation, complete chiropractic evaluations were performed which detected spinal subluxations.

    Chiropractic Care and Outcome: Torque Release Technique Protocols were utilized for both evaluation and application of care. Adjustments were performed with an instrument, the Integrator, to improve spinal-neural integrity. During the course of chiropractic care both women were able to conceive.

    Conclusion: Although chiropractic care is not a treatment for infertility, it is postulated that improvement of spinal neural integrity through specific chiropractic adjustments may have contributed to improved homeostasis and physiological adaptation thus allowing the body to express a greater level of health as an outcome. Various effects via the reduction of the vertebral subluxation complex are postulated.

    Key Terms: Chiropractic, Infertility, Torque Release technique, Vertebral Subluxation

    Insult, Interference and Infertility: An Overview of Chiropractic Research
    By Madeline Behrendt, D.C.

    [JSVR, May 2, 2003, p 1]

    Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

    Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

    Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

    Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

    Key Terms: chiropractic, vertebral subluxation, pregnancy, infertility, research funding,Applied Kinesiology, Diversified, Directional Non-Force Technique, Gonstead, Network Spinal Analysis, Torque Release Technique, Sacro-occipital Technique, Stucky-Thompson Terminal Point Technique

    Limp [ BACK TO TOP ]  

    Radiologic Imaging of the Child With an Acute Limp
    By Sharon Lee Mellott, D.C.

    While most children with an acute onset of limping have minor soft tissue injuries which usually resolve in a few days without requiring diagnostic workup or treatment, acute or newly discovered limping does occur, for which a traumatic cause is not clearly obvious. This paper presents an overview of causes of acute limp, differential diagnosis, and appropriate radiological imaging procedures in the pediatric patient. (1993 Proceedings)

    Myasthenia Gravis [ BACK TO TOP ]  

    Juvenile Myasthenia Gravis: A Case Study in Chiropractic Management
    By H. Jason Araghi, D.C.

    A two-year-old female presented to a chiropractic clinic for symptoms related to Myasthenia Gravis. The patient had previously been diagnosed with this condition through clinical examinations and laboratory tests performed by a neurologist and pediatric opthalmologist (e.g. positive Tensilon Test). The patient’s symptoms included lethargy, weakness of the lower extremities, ptosis of the right eye, bilateral toe-in of both feet, and moderate left head tilt. The patient’s history included an automobile accident. Eight days following this trauma the patient developed otitis media and ptosis of the right eye. The patient presented for chiropractic evaluation approximately six months following the automobile accident. Clinical and roentgenological examinations were performed on the full spine. Plain films disclosed disruption of the normal contour of the sacrum at the S1-S2 level, hypolordosis of the cervical spine and a left tilt of the cervical spine in the coronal plane. The patient was diagnosed as having S2 intersegmental sacral subluxation and subluxation complexes of the occipito-atlantal and atlanto-axial motion segments. Specific chiropractic adjustments were performed in the seated position. The patient’s lethargy and ptosis improved following treatment. Post-radiological evaluation of the cervical spine demonstrates improvement of the cervical lordosis. The clinical features and diagnosis of this disorder are discussed. (1993 Proceedings)

    Neurofibromatosis [ BACK TO TOP ]  

    Chiropractic Management of Neurofibromatosis (Von Recklinhausen’s Disease): A Case Study
    By Leslie L. Bedell, D.C.

    This is the case of a 13-year-old female patient with Neurofibromatosis. Chiropractic care was administered to reduce secondary symptomatology and improve posture. This paper emphasizes the need for Doctors of Chiropractic to be well-informed and trained to diagnose and treat this disease since there is a large probability that patients with Neurofibromatosis will come into our offices. It also addresses the role chiropractic care can play in the multifaceted symptomatic picture this disease presents as well as the limitations of working with such an un-researched condition. (1993 Proceedings)

    Neurological [ BACK TO TOP ]  

    Risk Assessment of Neurological and/or Vertebrobasilar Complications in the Pediatric Chiropractic Patient
    By Richard A. Pistolese, B.Sc.

    [JSVR, Vol 2, No. 2, p 1-9]

    Abstract: Reports suggest that chiropractic accounts for a large percentage of visits to alternative health practitioners. Moreover, pediatric patients represent a significant proportion of these visits. In light of this trend, it is important to evaluate the risk potential to the pediatric patient presenting for chiropractic care. This paper has reviewed literature concerning the occurrence of neurological and/or vertebrobasilar (N/VB) complications in patients receiving either specific chiropractic adjustments and/or non-specific manipulations of the spine. This topic was chosen due to the potentially severe consequences of N/VB complications, regardless of etiology. The current study was conducted in a quasi-meta analysis format to derive data for the period encompassing 1977 through the first quarter of 1998, using an eclectic compilation of data from three survey sources. Based on this information, the number of pediatric visits, extrapolated to also include the periods between 1966 and 1977, was estimated to be 502,184,156. Reports of the occurrence of N/VB complications in chiropractic pediatric patients were also investigated over the same time period by searching the scientific/clinical literature. The estimate of risk due to the pediatric chiropractic patient in this category of complication was estimated to be 4.0 x 10 -7 % of all visits. Stated otherwise, there would be a chance of approximately 1 in 250 million pediatric visits that a N/VB complication would result. While some pre-existing conditions may predispose a pediatric patient to a higher incidence of such complications, the estimates derived in the present study are considered applicable to the general pediatric population. The estimates derived in the present study are intended to be an initial risk assessment. Since very few reports exist relative to the incidence of N/VB complications in children, additional studies will be necessary to confirm this risk estimate.

    Key Terms: adjustment, child, children, chiropractic, complication, injury, manipulation, neural complication, risks, neurological incident, vertebrobasilar incident

    Nocturnal Enuresis [ BACK TO TOP ]  

    Chiropractic Management of Primary Nocturnal Enuretic Children
    By William R. Reed, D.C.; Scott Beavers, D.C.; Saroja K. Reddy, PhD.; Greg Kern, D.C.

    A controlled clinical trial of 46 primary enuretic children was conducted over a period of 14 weeks to assist in evaluating the influence of chiropractic care. Subjects were between five and 13 years of age. There were 31 in the treatment group which received a spinal evaluation and/or adjustment at a minimum of every ten days. The remaining 15 subjects were control which came in with the same frequency but received a “sham” adjustment over an equal period of time. Chiropractic care was rendered for ten weeks, preceded and followed by a 14-day non-treatment baseline. The mean post-treatment frequency of wet nights for the treatment group was statistically significantly less than its pre-treatment frequency; while there was practically no difference between mean pre- and post-frequency for the control group. However, mean pre- to post-treatment group change in frequency of wet nights of the treatment group did not differ significantly from that of the control. Subjects receiving chiropractic care averaged a 17.9% reduction in wet night frequency compared with an actual .1% increase in frequency of wet nights for the control over the same period of time. Further investigation will be required to determine the complete effectiveness or ineffectiveness, impact, or influence of chiropractic with nocturnal enuresis. (1993 Proceedings)

    Key Terms: chiropractic, enuresis, nocturnal, children

    Evaluation and Chiropractic Treatment of the Pediatric Patient with Nocturnal Enuresis: A Case Report
    By Diana J. Hudgins, D.C.

    There are many diverse opinions as to the correct etiology of what seems to be a very commonly reported problem: nocturnal enuresis. This report gives the history of a pediatric patient with nocturnal enuresis and the results with chiropractic management of care. (1994 Proceedings)

    Nutrition [ BACK TO TOP ]  

    Pediatric Nutrition
    By Ronald G. Lanfranchi, D.C., Ph.D.

    Just as malnutrition/dysnutrition in the womb is devastating in fetal development, the lack of essential nutrients in early life handicaps an infant’s normal physiological and emotional maturation. Studies have shown that the earlier the dysnutrition occurs and the longer it lasts, the more severe and more permanent the impairment. The major reason for these consequences is that the human brain is relatively immature at birth; its major growth spurt starts midway through gestation and lasts until two years of age. This critical period is particularly susceptible to alteration and damage from the lack of essential nutrients. There are also socio-economic factors which effect intellectual development and often cannot be separated from the nutritional aspect. However, researchers have found that dysnutrition plays a key role, independent of social status. Children suffering from dysnutrition are more illness-prone and tend to be less socially interactive than their properly nourished peers. The susceptibility to illness and its effects are exhibited at various levels of the biochemical imbalance. Physical and mental fatigue, the inability to concentrate, and low personal motivation all result in poor academic performance. Frequent illness, the most obvious physical manifestation, is a tell-tale sign of nutritional dysfunction. Recurrent illness often results in numerous absences from class, resulting in the child falling behind in schoolwork at a critical learning period. This paper presents the interrelationship of essential nutrients and their effects on a child’s health. (1992 Proceedings)

    Oral Apraxia [ BACK TO TOP ]  

    Oral Apraxia: A Case Study in Chiropractic Management
    By H. Jason Araghi, D.C.

    A 5-year-old female presented to a chiropractic clinic for symptoms related to oral apraxia (inability to speak). The patient was previously diagnosed with this condition through clinical examinations and laboratory tests performed by a neurologist, child psychologist, and speech therapist. The patient’s symptoms consisted of inability to speak, an abundance of energy, and deep, heavy snoring while sleeping. The patient’s history included a traumatic birth process and a fall on the head at approximately age 2. The mother stated that as the child was growing up, she could understand spoken language and could respond with sign language, but the ability to speak never developed. The child would make periodic screaming sounds. Clinical and roentgenological examinations were performed on the full spine. Loss of the cervical lordosis was noted along with postural deviations. The patient was diagnosed as having subluxation complex of the occipito-atlantal and atlanto-axial motion segments. The patient had received and continues to receive specific upper cervical adjustments in the seated position. After the first adjustment, the mother stated that the child was in a deep sleep for an unusually long period of time and no snoring was noted. Later that night, after awaking, the child reached out to the mom and said the word “apple,” meaning that she wanted apple juice. The patient’s speech continued to improve everyday over the next twelve months. She is now able to say two or three consecutive words, count numbers, and is developing her vocabulary base. Post cervical flexion radiographs indicate improved function and an increase in the cervical lordosis. The clinical features, diagnosis, treatment protocol and results are discussed. Video footage before chiropractic and after care, intermittent care, with follow-up and comments from the parents and speech therapist are also presented. (1994 Proceedings)

    Otitis Media [ BACK TO TOP ]  

    Acute Otitis Media in Children What is the Cause and How is it Treated?
    By Peter N. Fysh, D.C.

    Acute otitis media is a common disorder affecting children in the early years of life and is the most common cause of fever in this age group. According to published statistics, up to one third of the childhood population will have six or more episodes of this disorder before entering school and some otitis prone children may have between six and twelve episodes in one year. This paper examines the current medical model for diagnosis and management of acute and recurrent otitis media and reviews the literature relative to the effectiveness of this model. For several decades, antibiotics have been recommended and used as the first line of approach to the treatment of upper respiratory infection. This paper examines an apparent controversy which exists within the medical profession regarding the use of antibiotics as a form of treatment for acute otitis media. The contention that upper respiratory infection, including otitis media, may be due in part to reduced drainage of the deep cervical lymphatics is also discussed and some research evidence is presented to support this hypothesis. (1991 Proceedings)

    Otitis Media in Children
    By Michael A. Schmidt, B.S., C.C.N., D.C.

    Otitis media is the most common pediatric disorder in the United States. For many children, earaches begin in infancy. By the age of three, over two-thirds of all children have had one or more episodes of acute otitis media, including 33 percent who have had three or more episodes. Despite dramatic increases in the use of antibiotic and surgical treatment, the incidence of otitis media has risen sharply. (1991 Proceedings)

    A feasibility study of chiropractic spinal manipulation versus sham spinal manipulation for chronic otitis media with effusion in children
    By Charles E. Sawyer, DC, Roni L. Evans, DC, Patrick D. Boline, DC, Richard Branson, DC, and Anne Spicer, DC

    Background: Pediatric otitis media with effusion is a common and costly condition. Although chiropractors have anecdotally claimed success in treating otitis media, there is little research to support their claims.

    Objective: A pilot study was undertaken for the purpose of assessing the feasibility of conducting a full-scale randomized clinical trial investigating the efficacy of chiropractic spinal manipulative therapy (SMT) for children with chronic otitis media with effusion.

    Methods: This study was a prospective, parallel-group, observer-blinded, randomized feasibility study. Twenty-two patients, ages 6 months to 6 years, received either active chiropractic SMT or placebo chiropractic SMT. Otoscopy and tympanometry were used to create a middle ear status profile, and daily diaries were collected.

    Results: Five newspaper advertisements over 6 months generated 105 responses. Twenty patients subsequently qualified and were randomized into the study. Collection of tympanometric and otoscopic data proved to be challenging. Compliance with the treatment and evaluation protocols and daily diaries was excellent. There were no reports of serious side effects as a result of either the active or placebo chiropractic treatments.

    Conclusion: Recruitment for a randomized controlled trial is feasible and could be enhanced by medical collaboration. Patients and parents are able and willing to participate in a study comparing active SMT and placebo SMT. Parents were extremely compliant with the daily diaries, suggesting that similar quality-of-life and functional status measures can be successfully used in a larger trial. We found the objective outcomes assessment involving tympanometry and otoscopy extremely challenging and should be performed by experienced examiners in future studies. (J Manipulative Physiol Ther 1999; 22:292–8)

    Publishing and Reprint Information

    • Charles E. Sawyer, DC, Vice President for Academic Affairs, Northwestern College of Chiropractic, Bloomington, Minnesota.
    • Roni L. Evans, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
    • Patrick D. Boline, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
    • Richard Branson, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
    • Anne Spicer, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
    • Submit reprint requests to: Charles E. Sawyer, DC, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, 2501 W 84th St, Bloomington, MN 55431.
    • Paper submitted September 15, 1998.
    • Supported by the Foundation for Chiropractic Education and Research by means of a restricted grant from the National Chiropractic Mutual Insurance Company.
    • © 1999 JMPT
    • 0161-4754/99/$8.00 + 0 76/1/98567
    • doi:10.1067/mmt.1999.98567

    The Role of the Chiropractic Adjustment in the Care and Treatment of 332 Children with Otitis Media
    By Joan M. Fallon, D.C., F.I.C.C.P.

    Objective: To conduct a pilot study of chiropractic adjustive care on children otitis media using tympanography as an objectifying measure, and to propose possible mechanisms whereby subluxation is implicated in the pathophysiology of otitis media.

    Design: Case Series

    Setting: Subjects presented in a private clinical practice in New Rochelle, New York. The subjects were referred by various sources including pediatricians, other MSs, chiropractors and parents.

    Participants: 332 children who presented consecutively with previously diagnosed otitis media, aged 27 days to 5 years

    Main outcome measures: A survey of the parent/guardian was used to determine historical data with respect to previous otitis media bouts, age of onset of initial otitis media, feeding history, history of antimicrobial therapy, referral patterns, and birth history. Otoscopic and tympanographic data was collected as well as data concerning the number of adjustments administered to produce resolution of the otitis media. Data with respect to recurrence rates over six months was also collected.

    Results: The average number of adjustments administered by types of otitis media were as follows: acute otitis media (n=127) 4.0+/- 1.03, chronic/serous otitis media (n=104) 5.0 +/- 1.53, for the mixed type of bilateral otitis media (n=10) 5.3 +/- 1.35 and where no otitis was initially detected on otoscopic and tympanographic exam (but with history of multiple bouts) (n=74) 5.88 +/- 1.87. The number of days it took to normalize the otoscopic examination was for acute 6.67 +/- 1.9 chronic/serous 8.57 +/- 1.96 and mixed 8.3 +/- 1.00. The number of days it took to normalize the tympanographic examination: acute 8.35 +/- 2.88, chronic/serous 10.18 +/- 3.39, and mixed 10.9 +/- 2.02. The overall recurrence rate over a six month period from initial presentation in the office was for acute 11.02%, chronic/serous 16.34%, for mixed 30% and for none present 17.56%.

    Conclusion: To our knowledge this is the first time that tympanography has been used as an objectifying tool with respect to the efficacy of the chiropractic adjustment in the treatment of children with otitis media. As tympanography has been used extensively in the medical assessment of children with otitis media, it also serves as a bridge from which the chiropractic field and the medical field can begin to communicate with respect to otitis media. The results indicate that there is a strong correlation between the chiropractic adjustment and the resolution of otitis media for the children in this study. This pilot study can now serve as a starting point from which the chiropractic profession can begin to examine its role in the treatment of children with otitis media. Large scale clinical trials need to be undertaken in the field using tympanography as an objectifying measure. In addition, the role of the occipital adjustment needs to be examined. This study begins the process of examining the role of the vertebral cranial subluxation complex in the pathogenesis of otitis media, and the efficacy of the chiropractic adjustment in its resolution. (JCCP, Volume 2, No. 2, October 1997)

    Treatment Protocols for the Chiropractic Care of Common Pediatric Conditions: Otitis Media and Asthma
    By Sharon Vallone, D.C., F.I.C.C.P. and Joan Fallon, D.C., F.I.C.C.P.

    Objective: With increasing numbers of children being brought to alternative health care practitioners, the majority of whom are chiropractors, it is imperative that the chiropractic profession work toward establishing consensus treatment guidelines for the management of common childhood conditions. The purpose of this paper is to present the results of a survey of chiropractors enrolled in the first three year postgraduate course in chiropractic pediatrics. The survey sought to establish if consensus existed with respect to the modalities these doctors used to treat two of the most common childhood disorders seen by chiropractors: otitis media and asthma.

    Method: Thirty-three doctors of chiropractic enrolled in the first year of at three year postgraduate course in chiropractic pediatrics were surveyed to determine which management protocol they most commonly employed in the care of children with either otitis media or asthma. Consensus was established at a level where seventy-five percent of the respondents used a particular approach. Additional data was gathered with respect to the chiropractic college attended, size of pediatric practice, and number of years in practice.

    Results: Thirty-three doctors of chiropractic participated in the survey. For otitis media, twenty-four specific treatment modalities were identified. Twelve modalities reached consensus in that they were utilized by at least seventy-five percent of the respondents. Of the twelve, sixty-seven percent of the modalities represented manual adjusting procedures, seventeen percent dietary changes, eight percent soft tissue manipulation, and eight percent supplementation. For asthma, twenty one modalities were cited. Eight modalities reached consensus. Of the eight that reached consensus, fifty percent represented evaluative procedures, twenty-five percent manual adjusting procedures, thirteen percent dietary changes and thirteen percent soft tissue manipulation. The average number of pediatric visits per week were 14.7 with 6.8 for otitis media and 4.1 for asthma. The average number of years in practice was 8.2 with a median of 7.5. The doctors graduated from 10 different chiropractic colleges.

    Conclusion: Several interesting patterns emerged from the results of this survey. The first was that of the primary therapeutic modalities employed by the chiropractor, spinal adjusting was the most commonly used for both asthma and otitis media. The second was the identification of certain areas of the spine to which adjustments were most frequently applied for each of these two conditions. The third was the significant number of non-spinal adjustment modalities used and the high frequency of usage by the survey group. It should be reiterated that the survey was taken as doctors entered the post-graduate program and is therefore not reflective of the training provided by the program. These results may therefore be more representative of therapeutic modalities generally in sue by the profession at large. However, the sample size is small and inadequate to form any generalizations. This study in no way addressed the efficacy of the treatment modalities reported. Further research needs to be undertaken to evaluate each of the modalities as single entities before any specific claims can be made. Once the research has been completed in those areas, further attempts at consensus, and establishment of standard treatment approaches for these conditions can be undertaken. (JCCP, Volume 2, Number 1, January 1997)

    Key Terms: otitis media, asthma, chiropractic, treatment protocol

    Paraspinal EMG Potentials [ BACK TO TOP ]  

    Paraspinal EMG Potentials in Pediatric Patients: Preliminary Observations
    By Christopher Kent, D.C. and Patrick Gentempo, Jr., D.C.

    Paraspinal surface EMG examinations are used by some chiropractors to characterize and quantify muscular changes associated with the vertebral subluxation complex. Normative data for paraspinal sites have been collected and published by several investigators. All of these studies involved adult subjects. Clinical observation has demonstrated that the paraspinal surface EMG potentials of children are substantially higher than those of adults. In this study, paraspinal EMG scans were performed on a small population of asymptomatic children under chiropractic care. The clinical implications of these findings are discussed. (1991 Proceedings)

    Plagiocephaly [ BACK TO TOP ]  

    Chiropractic Care of an Infant with Plagiocephaly
    By Donna Quezada, DC, DICCP

    Objective: The purpose of this case study is to discuss the chiropractic care of a child diagnosed with cranial plagiocephaly due to intrauterine constraint and developmental delay of unknown etiology. This article will also discuss the subsequent rapid progression of developmental skills as craniosacral therapies were administered.

    Design: A case study.

    Setting: Private Practice

    Patient: A Caucasian male, 8 months of age, presented with a large posterior bilateral prominence of the occipital bone. His developmental milestones were predominantly equivalent to those of a three-month-old and cranial facial asymmetries were detectible. He fussed or screamed if his head was touched or if placed to sleep in the supine position due to pressure on the back of his head. His sleep and feeding habits were also abnormal.

    Results: With chiropractic care, this infant’s developmental milestones progressed to match his age, and his cranial facial symmetries improved even though the shape of his occipital bone changed minimally. He was able to eat normally and sleep through the night in the supine or side-laying positions. He also allowed his head to be touched and caressed without fussing.

    Conclusions: This is a case where attempts to remold the occipital bone were made using Upledger and Sacro-occipital Techniques. Although changes in the shape of the occipital bone were minimal, the child benefited by experiencing a rapid progression of developmental skills bringing him from grossly delayed to current. His facial features, sleeping and feeding patterns normalized, and he would allow his head to be touched.

    (JCCP, Volume 5, No. 1, 2004)

    Key Terms: posterior plagiocephaly, chiropractic, adjustment, craniosacral therapy, birth trauma, vertebral-cranial subluxation complex, cranial facial asymmetry

    Posture [ BACK TO TOP ]  

    Detection of Pediatric Postural Anomalies Which Can Impose Pathological and Life-Long Effects
    By Fred J. Kippenbrock, D.C.

    This is an introduction to a thirty-year investigation and finding that the human body’s posture-related musculature almost universally presents in patterns of hyper/hypotonicity and that correction of these patterns provides a means for greatly improved chiropractic intervention and management of health-effecting spinal scoliosis and other postural problems. This article also provides indicators for the detection of hypertonic muscle groups that contribute to postural distortions. The rationale is that detection and relief of hypertonicity provides stabilization of the correction of vertebral subluxations (through chiropractic adjustments) not otherwise achievable. (1993 Proceedings)

    Shoulder Asymmetry and Handedness in Adolescents
    By Charlotte Leboeuf, Richard A. Ames, Stephen W. Griffith and Krishna Keswani

    The posture of 144 school children, aged 14-16 was examined. Shoulder height and side of dominant hand were recorded. Eighty-two percent were found to have an elevated shoulder contralateral to the side of the dominant hand. There was a significant association between high shoulder and dominant hand for dextral but not for sinistral children. Only 0.7% of the sample had equal shoulder height. J Aust Chiropr Assoc 1988 Dec;18(4):122-4

    Key Terms: Posture; Scoliosis

    Pregnancy [ BACK TO TOP ]  

    Chiropractic Prenatal Care: A Case Series Illustrating The Need for Special Equipment, Examination Procedures, Techniques and Supportive Therapies for the Pregnant Patient
    By Pene Kunau, D.C.

    Objective: This paper presents special equipment, examination procedures, low-force and soft tissue techniques and supportive therapies useful in providing chiropractic prenatal care. Fourteen case studies are presented to illustrate the benefits of using such specialized procedures.

    Design: A case series

    Setting: Private practice

    Patients: Fourteen pregnant women with a variety of complaints and findings

    Conclusion: Chiropractic prenatal care should include more than the “standard” orthopedic-neurologic exam and spinal adjustment. This population has special needs in terms of testing and treatment modalities. Chiropractors are considered primary contact providers in most states and may be well positioned to offer alternative prenatal care. However, we must become educated in differentiating between the appropriateness of alternative methods versus medical treatment in each case. (JCCP, Volume 4, Number 1, May 1999)

    Key Terms: chiropractic, pre-natal care, pregnancy, in-utero constraint, equipment, examination, techniques

    Pyloric Stenosis [ BACK TO TOP ]  

    Assessing the Efficacy of Chiropractic Care in Pediatric Cases of Pyloric Stenosis
    By James P. Fallon, D.C.

    Objective: To present a case study of pyloric stenosis in infancy that responded to conservative chiropractic care.

    Clinical Features: A three-week old infant experiencing projectile vomiting. A clinical diagnosis of pyloric stenosis was made.

    Intervention and Outcome: The patient received specific chiropractic adjustments to the upper cervical spinal segments. Projectile vomiting ceased after the third treatment.

    Conclusion: Clinical evidence suggests that chiropractic adjustments can be an effective conservative treatment of pyloric stenosis. Additional studies are required to validate the efficacy of chiropractic care in cases of infantile hypertrophic pyloric stenosis. (1994 Proceedings)

    Key Terms: pyloric stenosis, cervical vertebrae, chiropractic, projectile vomiting, extramucosal pyloromyotomy

    Rett Syndrome [ BACK TO TOP ]  

    The Effect of Chiropractic Care on Rett Syndrome: A Case Report
    By Laurie Gossett, D.C.

    Objective: This case study describes a 13-year-old child previously diagnosed with Rett Syndrome who received chiropractic care following an auto accident. The chiropractic management of this child and her improvements are discussed along with her childhood history and the diagnostic criteria of Rett Syndrome.

    Design: An individual case study

    Setting: A private chiropractic office

    Outcome Measures: Improvement was determined by observations of the patient’s mother. Due to the patient’s inability to speak, wincing and recoil on palpation were also used.

    Results: Following chiropractic care, this child’s general mood improved, her bowel movements became regular and her menstrual periods became less painful. A decrease in her scoliosis was also noted on comparative x-ray films.

    Conclusion: The implementation of chiropractic care was immediately followed by improvements in symptoms of Rett-Syndrome. Future investigation is required to investigate the effectiveness of chiropractic care in Rett Syndrome. (JCCP, Volume 4, Number 1, May 1999)

    Key Terms: Rett Syndrome, auto accident, chiropractic, massage therapy

    Sagittal Suture Synostosis [ BACK TO TOP ]  

    Evaluation and Cranial Treatment of the Pediatric Patient with Sagittal Suture Synostosis: A Case Report
    By Benners Vail, IV, D.C.

    A three-month-old boy, found by medical and radiological examinations to be suffering from sagittal suture synostosis, presented for chiropractic consultation. The patient had no abnormal neurologic findings, however, was recommended for surgical intervention for cosmetic purposes and to prevent the development of neurologic complications. Chiropractic examination revealed multiple cranial lesions that were felt to precipitate the patient’s condition. During treatment a medical follow-up confirmed the correction of the condition. Examination and treatment are discussed. (1993 Proceedings)

    Scoliosis [ BACK TO TOP ]  

    Scoliosis as a Visible Variation of the Vertebral Subluxation Complex and its Reduction Under Chiropractic Care
    By Joseph S. Siragusa, D.C., F.A.C.O.

    Two cases of scoliosis are presented. In both, a young girl was x-rayed and found to have a mild (less than 10 degree) scoliosis. Several years later, the patients returned and were found to have curves that had significantly progressed. After chiropractic care those curves reduced by 50% to 13%. Chiropractic care consisted of specific adjustments aimed, not necessarily at straightening the spine–but at the components of the vetebral subluxation complex. Hypotheses are presented to explain the impact of adjustments on the scolioitic curves and a model is presented which views scoliosis as just one variation of the vertebral subluxation complex. (1992 Proceedings)

    The potential role of brain asymmetry in the development of adolescent idiopathic scoliosis: A hypothesis
    By Wieslaw Niesluchowski, MD, Anna Dabrowska, MD, Krzysztof Kedzior, PhD, and Tomasz Zagrajek, PhD

    Background: The size asymmetry of cerebral hemispheres may predispose to head tilt and asymmetric blocking of the zygapophysial joints, potentially leading to the development of compensatory curvatures in the lower segments of the spine.

    Objective: To analyze the effects of spinal manipulation, maintained by an exercise program, on the progression of idiopathic adolescent scoliosis in 2 children aged 6 and 10.

    Clinical Feature: The scoliosis found was 16 and 60 degrees.

    Intervention and Outcome: For diagnosis and monitoring of therapy, we recorded qualitative parameters of shoulder asymmetry, axillary line asymmetry, and scapular angle position. Manual treatment consisted of the examinations of all sliding motion in zygapophysial joints and both sacroiliac joints and removing the limitations of the sliding motions according to the method of Karel Lewit. The treatment procedure consisted of 3 or 4 manipulations within 17 months and an exercise program. The manipulation effects were maintained by the exercise program. The exercises were done in 2 or 3 sessions weekly for a year. In both patients we observed that scoliosis decompensation was successfully stopped and the effects of the correction persisted for 10 years.

    Conclusion: Brain and head asymmetry may be only a transient state, predisposing to asymmetric blocking at the atlanto-occipital level. Removal of blocking may prevent curve progression in children who had adolescent idiopathic scoliosis. The manipulative therapy may also have a promising effect on retarding curve progression when used in skeletally immature patient. (J Manipulative Physiol Ther 1999;22:540–4)

    Publishing and Reprint Information

    • Wieslaw Niesluchowski, MD, Vigor's Clinic, 02-325 Warsaw, Bialobrzeska, Poland.
    • Anna Dabrowska, MD, Department of Pathology, Warsaw Medical Academy, 02-004 Warsaw, Chalubinskiego 5, Poland and Drug Institute (BRSFiMM) 30/34 Chelmska Str PL-00-725 Warszawa.
    • Krzysztof Kedzior, PhD and Tomasz Zagrajek, PhD, Institute of Aircraft Engineering and Applied Mechanics, Warsaw University of Technology, 00-665 Warsaw, Nowowiejska 24, Poland.
    • Submit reprint requests to: Wieslaw Niesluchowski, Vigor's Clinic, 02-325 Warsaw, Bialobrzeska 57, Poland.
    • Paper submitted September 9, 1998. Revised form October 5, 1998.
    • Supported by Vigor's Clinic.
    • © 1999 JMPT
    • 0161-4754/99/$8.00 + 0 76/1/101181
    • doi:10.1067/mmt.1999.101181

    Effect of chiropractic intervention on small scoliotic curves in younger subjects: A time-series cohort design
    By Charles A. Lantz, DC, PhD and Jasper Chen, DC

    Background: Chiropractors have long claimed to affect scoliotic curves, and case studies abound reporting on successful outcomes. No clinical trials exist, however, that evaluate chiropractic's effectiveness in the management of scoliotic curves.

    Objective: To assess the effectiveness of chiropractic intervention in the management of adolescent idiopathic scoliosis in curves less than 20°.

    Design: Cohort time-series trial with all subjects electing chiropractic care. Entry-level Cobb angle was compared with postmanagement curve.

    Methods: Forty-two subjects completed the program of chiropractic intervention. Age range at entry was 6 to 12 years, and patients were included if their entry-level x-ray films revealed curves of 6° to 20°. Participants had adjustments performed for 1 year before follow-up. Full-spine osseous adjustments were the major form of intervention, but heel lifts and postural and lifestyle counseling were used as well.

    Results: There was no discernable effect on the severity of the curves as a function of age, initial curve severity, frequency of care, or attending physician.

    Conclusion: Full-spine chiropractic adjustments with heel lifts and postural and lifestyle counseling are not effective in reducing the severity of scoliotic curves. (J Manipulative Physiol Ther 2001;24:385-93)

    Publishing and Reprint Information

    • Charles A. Lantz, DC, PhD, Life University, Marietta, Ga, and Life Chiropractic College West, San Lorenzo, Calif.
    • Jasper Chen, DC, Assistant Professor, School of Medicine, Oregon Health Sciences University, Portland.
    • This project was supported by funds from the Foundation for Chiropractic Education and Research.
    • Submit reprint requests to: Charles A. Lantz, DC, PhD, Life Chiropractic College West, 2005 Via Barrett, San Lorenzo, CA 94580. E-mail: slantz@lifewest.edu.
    • Paper submitted March 2, 2000. In revised form May 29, 2000.
    • 0161-4754/2001/$35.00 + 0 76/1/116419
    • © 2001 JMPT
    • doi:10.1067/mmt.2001.116419

    Seizure [ BACK TO TOP ]  

    Chiropractic Adjustments and the Reduction of Petit Mal Seizures in a Five-Year-Old Male: A Case Study
    By Christine A. Hyman, D.C., F.I.C.C.P.

    This case study involves a five-year-old Caucasian male, presenting with petit mal (absence) seizures and bilateral toe in foot flare with leg pain. This study addresses the reduction in petit mal seizures, decrease in toe in foot flare and the cessation of bilateral leg pain while under chiropractic care. (JCCP, Volume 1, Number 1, January 1996)

    Key Terms: Epilepsy, petit mal seizures, vertebral subluxation, chiropractic adjustments, philosophy, leg pain, toe in foot flare

    Sleep [ BACK TO TOP ]  

    Case Report: The Effect of a Chiropractic Spinal Adjustment on Toddler Sleep Pattern and Behaviour
    By Peter L. Rome

    The interaction of the cervical spine with the nervous system, and the effectiveness of spinal adjustment in the management of the poor sleeping pattern of a 12-month-old male toddler are discussed. The history of an often irritable, unsettled and at times, very distressed infant, is also presented with a brief, but relevant, literature review. Chiropr J Aust 1996 Mar;26(1):11-4

    Key Terms: (MeSH) Behavior; Cervical Vertibrae; Chiropractic; Insomnia; Nervous System; Pediatrics. (Other): Manipulative Therapy; Sleep Pattern; Spinal Adjustment

    Spinal Tumors [ BACK TO TOP ]  

    Plain Film Recognition of Benign Pediatric Spinal Tumors
    By James P. Noia, D.C.

    Discussion is limited to the plain film recognition of spinal tumors that may be found in the pediatric patient. The reason for this is that is how you will most likely encounter them in your offices. Most often once discovered there will be followed up by other imaging modalities and/or biopsy. But those are not performed in our office settings. Also realize that while this discussion is limited to the radiological detection of tumors it is only one tool that doctors use in coming to any diagnosis. A diagnosis based solely on radiographic considerations is one done only for academic purposes. (1992 Proceedings)

    TMJ [ BACK TO TOP ]  

    Birth Induced TMJ Dysfunction: The Most Common Cause of Breastfeeding Difficulties
    By Victoria Arcadi, D.C.

    In a clinical setting, 1,000 newborns were observed and treated (ages one hour to 21 days), for failure and/or difficulty with breast feedings. In 800 or 80%, birth induced Temporomandibular Joint Dysfunction was found to be the cause. In all cases the babies were treated with chiropractic cranial and spinal adjustments, with excellent results in 99% of the cases. This paper discusses the basic clinical findings and related newborn discomforts and associated symptomatology involving other symptoms. (1993 Proceedings)

    Toe Walking [ BACK TO TOP ]  

    Receptor Based Manipulative Lesions in Children Who Toe Walk
    By Henry Press, D.C.

    The purpose of this study was to determine the neurological etiology of excessive toe walking in four children presenting with the diagnosis of childhood schizophrenia, with histories of hyperactive distractible behavior and resulting learning disabilities. A neurological examination including diagnostic manipulation, caloric testing and post rotatory nystagmnus tests, galvanic skin responses, bounce test, were administered to compare the group of four excessive toe walkers, to a group of four normal non-toe walkers. This author hypothesizes that excessive toe walking is a receptor based manipulative lesion that can be differentially diagnosed and rehabilitated with a reasonable degree of medical certainty. (1993 Proceedings)

    Torticollis [ BACK TO TOP ]  

    Presentation of a Neonate with Congenital Muscular Torticollis and Response to Chiropractic Intervention
    By Elizabeth Anderson-Peacock, D.C.

    To present a case of congenital muscular torticollis at a chiropractor’s office. Diagnostic criteria and the potential relationship between chiropractic manual adjustive care and a resolution of symptoms is presented. (1994 Proceedings)

    Key Terms: torticollis, congenital, pediatrics, chiropractic

    Pediatric Traumatic Torticollis: A Case Report
    By Tiffany McCoy Moore, D.C. and Thomas J. Pfiffner, D.C.

    Objective: The purpose of this article is to present a case of a child who sustained a trauma and presented to a chiropractic campus clinic. The child displayed the “cock robin” position that is typical for atlantoaxial rotary fixation, which allows this entity to be placed in the differential diagnosis. The chiropractic management of this child is discussed along with the medical treatment options available. This article also discusses the different types or presentations of rotary fixation and different causes of torticollis in children.

    Design: A case study.

    Setting: A chiropractic college campus clinic.

    Outcome Measures: Resolution of the condition was determined by resolution of the torticollis and return to normal daily activities as reported by the child’s guardian.

    Results: In this case, the child responded favorably to a single chiropractic adjustment along with soft tissue therapy. No complications were noted. The child was released after a short period of follow-up.

    Conclusion: This case report describes a four-year-old male presented to our clinic after moderate trauma (falling off a bed landing head first) with left lateral head tilt and mild right head rotation. The discussion incorporates torticollis that can be the presenting sign of atlantoaxial rotary fixation. The similarities and differences in the literature between torticollis and atlanto-axial rotary fixation are addressed as well. Any child presenting with a recent upper respiratory infection, sore throat, otitis media, or minor trauma with torticollis is a candidate for consideration f atlantoaxial rotary fixation. The occurrence of altantoaxial rotary fixation is not an everyday event, nor is the etiology and mechanism certain. The treatment protocol for this patient is discussed and correlation of possible etiologies form the literature is given. (JCCP, Volume 2, Number 2, October 1997)

    Key Terms: torticollis, atlantoaxial joint, atlantoaxial fixation, atlantoaxial rotation, chiropractic, cervical vertebrae

    Chiropractic Care of the Newborn with Congenital Torticollis
    By Joan M. Fallon, D.C., F.I.C.C.P. and Peter N. Fysh, D.C., F.I.C.C.P.

    Objective: To discuss the various causes of congenital torticollis in the newborn infant and to present an approach to the chiropractic management of torticollis based on the author’s experiences.

    Method: Congenital torticollis has been estimated to affect approximately two percent of newborn infants. The frank breech birthing position has been reportedly associated with the highest incidence of torticollis, with up to 34 percent of infants born in this position being affected. It has been suggested that a fetal posture with both the knees and the cervical spine extended is responsible for much of the high incidence of congenital torticollis resulting in stretching of the sternocleidomastoid muscle during the delivery process. The most common type of congenital torticollis is that associated with subluxation of the upper cervical spine. Chiropractic management of congenital torticollis is primarily directed at reducing cervical spine subluxations which have been identified as commonly present with this condition. Chiropractic evaluation and management techniques appropriate for this condition are described.

    Conclusion: Chiropractic management of congenital torticollis, using a combination of spinal adjustments, cranial re-alignment and soft tissue therapies can produce rapid resolution in many cases of congenital toriticollis and plagiocephaly in the newborn infant. Spinal adjustments have been demonstrated to be efficacious to the resolution of the congential torticollis. Before commencing a course of conservative spinal care however, accurate indentification of the cause of the torticollis must be made to rule out complicating conditions which may result in high morbidity or mortality. The typical course of spinal adjustments for torticollis is usually of short duration requiring just a few treatments. Early correction of congenital torticollis should be the goal since prolonged contraction of the SCM can be the cause of cranial and facial anomalies as well as scoliosis.

    The medical approach to a protracted torticollis is surgical intervention. While surgical intervention is typically a solution of last resort, it is frequently the only solution considered by the medical community. Chiropractic care is considered essential to the health and maintenance of the child’s spine and nervous system. It is therefore important that the doctor of chiropractic become part of the multi-disciplinary team and that medical doctor s become aware of chiropractic management as a solution to the most common causes of congenital torticollis. (JCCP, Volume 2, Number 1, January 1997)

    Key Terms: congenital torticollis, chiropractic, spinal adjustments

    Acute Cervical Torticollis and Palmer Upper Cervical Specific Technique: A Report of Three Cases
    By Philip S. Bolton and Stanley P. Bolton

    We present reports of three patients with acute torticollis who were assessed and treated using a traditional chiropractic protocol involving the Palmer (“Hole in One”) Upper Cervical Specific analysis and the toggle recoil adjusting technique. The clinical approach taken in respect of our cases was that of the traditional chiropractic clinical paradigm, that is the identification and reduction of putative vertebral subluxations rather than directing intervention (treatment) at the presenting symptoms. Our case reports support a previous single case report in which it was suggested that the identification of putative vertebral subluxations in the neck and the use of the toggle recoil technique may play a role in limiting the duration of the acute torticollis and severity of the pain associated with this condition. This hypothesis, however, remains to be suitably tested. While there was an apparent successful outcome in our cases, this should not be over-interpreted to mean that the paradigm used in these cases was necessarily responsible for the outcome. We have been unable to find a prospective study that has determined the true “burden of illness” associated with acute torticollis that adequately defines its incidence, natural history and associated complication(s). Consequently, it is possible that the cases of acute torticollis reported here, and those reported elsewhere, may have resolved even without intervention. Anecdotal clinical evidence, however, suggests that this was not the case. Chiropr J Aust 1996 Sep;26(3):89-93

    Key Terms: MeSH: Chiropractic; Neck; Manipulation, Orthopedic; Torticollis. Other: Adjustment; Toggle Recoil; Palmer Upper Cervical; Spinography

    Upper Cervical Subluxation [ BACK TO TOP ]  

    Upper Cervical Chiropractic Care of an Infant with Irregular Bowel Function: A Case Study
    By Julie Mayer Hunt, D.C., D.I.C.C.P.

    Objective: To present a case study of a three-month-old female breast-fed infant with irregular bowel habits since birth. This article will discuss observations of this case while under chiropractic care, and the subsequent return of healthy bowel function.

    Clinical Features: A three-month-old female breast-fed infant presents with bowel dysfunction since birth. The parent reports the patient does not move her bowels without assistance of suppositories. The frequency of bowel movements ranges from one week to ten days.

    Intervention and Outcome: Treatment is initiated and over the next five weeks the patient is adjusted utilizing the Laney instrument. The patient’s bowel function is restored and no longer requires assistance in evacuation of her bowels.

    Conclusion: This is a case where upper cervical adjustments were given to an infant with bowel dysfunction. Care and treatment for this patient was approached with the hypothesis that reduction of the upper cervical subluxation complex may result in improved function of the gastrointestinal tract. (JCCP, Volume 5, Number 1, Spring/Summer 2000)

    Key Terms: constipation, Hirschsprung’s disease, chiropractic, upper cervical

    Upper Cervical Chiropractic Care and the Resolution of Cystic Hygroma in A Twelve-Year-Old Female: A Case Study
    By Julie Mayer Hunt, D.C., D.I.C.C.P.

    Objective: To discuss the case of a 12-year-old female presenting with a mass in the right submandibular region consulting for chiropractic evaluation.

    Clinical features: A 12-year-old female, accompanied by her mother presented for chiropractic consultation regarding a diagnosis of cystic hygroma. Her mother stated that a mass had developed in her daughter’s right submandibular muscle at approximately 5 years of age. Since the age of nine she had four surgical procedures in an effort to resolve the mass and the severe sinus drainage she experienced. All surgical procedures had failed to relieve her severe sinus drainage or contain the development of the mass. The mass was approximately the size of a golf ball on her first visit to the chiropractor. The subject has also suffered from daily morning neck pain and headaches for the past year.

    Intervention and Outcome: Following seven months of conservative chiropractic care, the patient’s mass completely remissed and has not recurred during 2 years of wellness care. The patient’s neck pain and headaches are also completely resolved. She also can breathe with ease allowing her to participate in active sports (tennis and cross country) whereas she had been limited o minimal athletic activity in the past due to her condition.

    Conclusion: A case report of a 12-year-old female with cystic hygroma is presented. Integral to her condition is the physical exam finding of significant left C2 lamina pedical point tenderness and associated paravertebral muscle spasms resulting in loss of vertebral motoricity of the cervical vertebral units. The care and treatment was approached with the hypothesis that reduction of the subluxation complex of the upper cervical region may result in improved sinus function and or lymphatic drainage. The successful resolution of the patient’s cystic hygroma while under chiropractic care indicates the need for further study of the role of chiropractic care in the case of non-musculoskeletal conditions. (JCCP, Volume 5, Number 1, Spring/Summer 2000)

    Key Terms: hygroma, lymphangioma, chiropractic, orthospinology

    Upper Cervical Chiropractic Care of a Pediatric Patient with Asthma: A Case Study
    By Julie Mayer Hunt, D.C., D.I.C.C.P.

    Objective: To discuss observations of the effects of chiropractic care on asthma symptomology in a four-year-old female patient over a period of three years.

    Clinical features: A four-year-old female was diagnosed with asthma at 2 ½ years of age. Treatment consisted of utilization of a humidifier and Ventalin inhaler. By the time the patient was 3 ½ years old, the Ventalin inhaler was not controlling her symptoms. The patient was taken to a hospital emergency room and after one dose of nebulizer her symptoms were relieved. Approximately one year later the nebulizer was no longer effective and the patient was nearly hospitalized. The patient sought chiropractic care in March 1996 just prior to her fifth birthday.

    Intervention and Outcome: Following a two-month reduction based treatment frequency plan, the patient’s asthma symptoms steadily improved and overall growth rate distinctly progressed. The patient’s mother reports only one mild episode since treatment was initiated.

    Conclusion: This case report illustrates chiropractic management of asthma symptoms. Chiropractic care was approached with the hypothesis that reduction of the upper cervical subluxation complex may result in improved function of the respiratory system. (JCCP, Volume 5, Number 1, Spring/Summer 2000)

    Key Terms: asthma, respiratory disorders, chiropractic, orthospinology

    Vaccination [ BACK TO TOP ]  

    Mandatory Childhood Vaccinations
    By Ronald G. Lanfranchi, D.C., Ph.D.

    Although there have been numerous reports regarding the adverse effects of vaccinations, the government still requires that our children receive them. At best, vaccination against childhood diseases confers only temporary immunity. This leaves our children more vulnerable to these “childhood” diseases as adults, when the effects are more devastating. Current reporting methods by governmental agencies appear to be full of bias and inaccuracies. Medical researchers cannot even agree on how long an interval is a reasonable amount of time for vaccine-induced reactions. Some believe 24 hours, others say up to 10 days. This is only one variable which results in inaccurate statistical reporting. There are conflicting views on the benefits of childhood vaccination. The government should not mandate that we inject these potentially harmful substances into our children. In a free society, reasonable disagreement on matters of conscience and health which are heretofore unproven is the right of each individual. (1992 Proceedings)

    Hepatitis Vaccine Induced Seizures Relieved by Manipulation
    By Carla Hoelting Harris, D.C.

    Seizures began in a fifteen-year-old female two days following administration of a hepatitis vaccine. Grand Mal seizures were experienced for seven weeks following vaccination. Patient began care four weeks following vaccination and had experienced four seizures prior to manipulation. Patient experienced one seizure nine days after beginning treatment and has not experienced an episode since that date. Patient had received four chiropractic adjustments as of that date. Due to the ongoing debate on immunizations and vaccinations it is necessary to introduce connections between possible reactions to these vaccinations. (1994 Proceedings)

    Verbal Aphasia [ BACK TO TOP ]  

    Acquired Verbal Aphasia in a 7-Year-Old Female: Case Report
    By Jack D. Manuele, D.C., D.I.C.C.P. and Peter N Fysh, D.C., F.I.C.C.P.

    Objective: To discuss the case of a 7-year-old female patient with a vocabulary of three words, presenting for chiropractic evaluation.

    Clinical Features: By history, this child apparently had developed normally for about the first 18 months of her life. Language development had followed the normal patterns and by this age she was using small strings of words and communicating appropriately for her age. At about 18 months of age, however, her parents noticed that her verbal communication ceased. The childs sudden failure to communicate using the spoken word caused her parents to seek professional help. She was examined by a pediatrician who referred her to an audiologist for hearing assessment, to a psychologist and to a speech-language pathologist. Despite careful evaluation and assessment by these multi-disciplinary specialists, no definitive cause could be identified.

    Intervention and Outcome: At the age of seven years, she underwent chiropractic evaluation. Following a seven week course of spinal and cranial adjustments, she was able to communicate successfully using a vocabulary of more than 60 words. Several years after chiropractic care was initiated, she continues to sustain and make these improvements in her speech.

    Conclusion: A case report is presented of a seven-year-old female patient with acquired verbal aphasia. Despite appropriate referral to specialists in pediatrics, audiology and speech and language pathology, the patients verbal difficulties failed to respond to conventional therapies. Chiropractic evaluation disclosed disclosed biomechanical abnormalities in the spinal and pelvic region and cranium, which had previously gone unrecognized. The patient's speech difficulties improved following the commencement of chiropractic care. Follow-up evaluations over a period of 18 months demonstrated that speech improvements had been maintained. It is impossible to generalize the results of a single case to the population of patients with aphasia. However, this case study raises important issues regarding the role of chiropractic care in the multidisciplinary management of patients with acquired aphasia. (JCCP, Volume 1, No. 2, April 1998)

    Vision [ BACK TO TOP ]  

    The Prospective Treatment of Visual Perception Deficit by Chiropractic Spinal Manipulation: A Report on Two Juvenile Patients
    By Danny Stephens and Frank Gorman

    Objective: To demonstrate that chiropractic spinal manipulation (SMT) may be effective in the treatment of concentric narrowing of the visual fields.

    Clinical Features: Two juvenile patients with constricted visual fields were examined by visual acuity testing and computerised static perimetry before and after chiropractic spinal manipulation therapy.

    Intervention and Outcomes: Chiropractic spinal manipulation therapy was associated with improvement to normal in the visual acuity and the visual fields in both patients. Seven treatments were required for one patient and three for the other.

    Conclusion: Chiropractic spinal manipulation therapy was effective in the treatment of visual perception deficit in these two patients. Chiropr J Aust 1996 Sep;26(3):82-8

    Key Terms: MeSH: Chiropractic; Manipulation, Orthopedic; Perimetry, Computerised Static; Visual Fields; Visual Perception. Other: Manipulation, Chiropractic; Tunnel Vision

    The Effects of Chiropractic Spinal Adjustments in a Case of Bilateral Anterior and Posterior Uveitis
    By Jack E. Manuele, DC, DICCP and Peter N. Fysh, DC, FICCP

    Objective: A case report is presented to illustrate the effects of chiropractic spinal adjustments in a case of anterior and posterior uveitis in a male child, six years of age. Previous medical options for management of this child’s condition had been ineffective. A hypothetical pathophysiological mechanism for the improvement of uveitis observed in this child is discussed.

    Design: Case report

    Outcome Measures: Resolution of the condition was determined by funduscopic examination as well as Snellen chart eye examination. Evaluation by a medical ophthalmologist at each occurrence was used to confirm the results.

    Results: Progressive improvement occurred with chiropractic care. The patient was treated through eight exacerbations of his uveitis, each of which was associated with trauma to the head or neck. Complete resolution of each exacerbation was achieved while the patient was under chiropractic care. No complications were noted.

    Conclusion: The authors present a case study of a six-year-old male with anterior and posterior uveitis. Following identification of the diagnosis of anterior and posterior uveitis, the child was evaluated and monitored by a medical ophthalmologist throughout a four month course of topical and systemic steroid therapy without significant improvement. The patient then underwent a course of chiropractic spinal care. Two weeks after commencement of the chiropractic program, significant improvement was recorded in both visual acuity and fundus detail. The patient’s condition was closely monitored by both the chiropractor and the ophthalmologist for a period of two years, during which time several exacerbations of the condition occurred following sporting injuries involving blows to the head and neck. After each of these incidents, the exacerbations subsided following a course of chiropractic spinal adjustments. During a further five year follow-up period, the child had no further exacerbations of uveitis. This case is presented to provide a possible new approach to the management of uveitis in children. The potential for chiropractic spinal care to help maintain a child’s sight in the face of advancing permanent visual loss is considered significant. Additional studies are required to confirm the applicability of these findings to a larger population of children with this condition.

    (JCCP, Volume 5, No. 1, 2004)

    Key Terms: child, chiropractic, uveitis, iridocyclitis, spinal adjustment, vertebral subluxation, vision, sight, ophthalmology

    Chiropractic Adjustments and Esophoria: A Retrospective Study and Theoretical Discussion
    By Benjamin Schutte, Heather M. Teese and Jennifer R. Jamison

    Anecdotal experience suggests that esophoria (and other eye disturbances) can be influenced by spinal subluxations. This paper reports on a retrospective study of 12 children with esophoria. The findings suggest that certain types of esophores may respond to cervical spine adjustments. The neurophysiology of cervical proprioception and gaze control are discussed. J Aust Chiropr Assoc 1989 Dec;19(4):126-8

    Key Terms: Chiropractic; Esophoria; Cervical Proprioception; Cervical Ocular Reflex. Vertebral Subluxation; Manipulation

    Webster In-Utero Constraint Technique [ BACK TO TOP ]  

    Application of the Webster In-Utero Constraint Technique: A Case Series
    By Pene L. Kunau, M.S., D.C.

    Objective: The purpose of this paper is to present a brief review of the medical versus chiropractic management of breech presentation. This paper includes a description of the Webster In-Utero Constraint Technique and the author’s application of the technique with six pregnancies.

    Design: A case series.

    Setting: Private practice.

    Patients: Amish women of varying ages and parity who had developed third trimester breech malpositions.

    Outcome Measures: Correction of the malposition was determined by palpation using Leopold’s maneu4ver and verified by medical doctors.

    Results: All cases were successfully treated using the Webster In-Utero Constraint technique. One woman had a failed external cephalic version attempt by a medical doctor. Five of the deliveries were uncomplicated; one birth is still pending as of this writing.

    Conclusion: The author has presented a series of women with successfully corrected breech malpositions using a chiropractic technique developed by Larry Webster, D.C. (JCCP, Volume 3, Number 1, August 1998)

    Key Terms: chiropractic, Webster technique, breech presentation, In-Utero Constraint, prenatal care, pregnancy, sacral adjustments

    Whiplash [ BACK TO TOP ]  

    The Detection and Management of Pediatric Whiplash Injuries
    By David J. BenEliyahu, D.C.

    Management of whiplash injuries is commonplace in clinical practice. Oftentimes children are also involved in an accident that their parent was injured in, and the doctor must decide whether or not to examine and treat if necessary. This paper presents case studies on the detection and management of pediatric whiplash injuries. (1993 Proceedings)

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