The Chiropractic Journal of Australia (CJA) is a peer-reviewed journal of record dedicated to the advancement of chiropractic science, principles and practice. CJA seeks to fulfil this purpose by critical review and publication of research and scholarly works relating to the scientific bases and clinical applications of chiropractic, and supportive presentations of an educational and/or professional nature. CJA is proudly supported by Guild Insurance. CONTACT Any enquiries Phone: +61 2 8844 0400 Email: journal@chiropractors.org.au
Australian Chiropractors Association Ltd
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CHIROPRACTORS CAN MOVE BEYOND THE DEFICIT DISCOURSE TOWARD A STRENGTHS-BASED APPROACH WHEN WORKING WITH AUSTRALIA’S FIRST PEOPLES.
In the lands now known as Australia the health of its First People has historically been framed using the lens of deficit. While the discourse of deficit may permit the chiropractor to problem-solve issues and concerns related to neuro-musculoskeletal health, chronic disease, and related socioeconomic factors, it can become pervasive and defeatist. A strength-based approach allows the chiropractor to work with and alongside First Peoples in a collaborative manner. It involves shared decision-making, creating proactive collaborative management and as a result, manifests a truer representation of empowered and person-centred care. The history of Chiropractic is replete with professional exclusion from public health systems, barriers to service provision and political suppression. We advance the position that the profession has a moral and social obligation to take measures that will enable a greater proportion of Australia’s First Peoples to access its services. This paper presents lessons derived from personal perspectives toward chiropractic healthcare with the First Australians and moves into a broader commentary, discussing issues of social justice, equity, and liberty in healthcare.
Copyright (c) 2024 William (Bill) Hayward, Troy Walker, Lyndon Gene Amorin-Woods
IMMEDIATE IMPACT OF SPINAL MANIPULATION ON STANDING CENTER OF PRESSURE OF CHIROPRACTIC COLLEGE STUDENTS WITH COMBINED NECK AND LOW BACK PAIN.
Objective: Determine if spinal manipulation positively impacted standing center of pressure of college students with combined neck and low back pain. Methods: At baseline 97 participants with combined neck (2.8 + 1.3 Numeric Rating Scale/NRS, mean + SD) and low back (3.1 + 1.5 NRS) pain had their standing eyes-closed balance assessed for 30 seconds on a force plate. Participants then stepped off the force plate and received spinal manipulation to their cervical and lumbar spine areas of greatest pain. Afterwards, participants had their balance reassessed for 30 seconds. Anterior-to-posterior and medial-to-lateral center of pressure (COP) mean amplitude and range were the dependent variables compared pre to post utilizing a paired samples t-test. Results: There was no statistically significant immediate change in center of pressure parameters assessed in response to spinal manipulation for individuals with combined neck (2.8 + 1.3 NRS, 15.3 + 4.9 months) and low back (3.1 + 1.5 NRS, 20.4 + 8.8 months) pain. However, sub-analysis of 32 individuals with moderate combined neck (4.1 + 1.2 NRS, 32.1 + 6.6 months) and low back (4.6 + 1.3 NRS, 31.8 + 12.5 months) pain demonstrated small positive improvements in medial-to-lateral COP mean amplitude and range. Conclusion: Spinal manipulation did not impact immediate COP amplitude or range of chiropractic college students with low levels of combined neck and low back pain.
ASSESSING CENTRAL NERVOUS SYSTEM AND PERIPHERAL NERVOUS SYSTEM FUNCTIONING IN RESTING AND NON-RESTING CONDITIONS IN A HEALTHY ADULT POPULATION
Emerging research suggests that chiropractic adjustments and spinal manipulative therapy (SMT) modulate the activity of the central and peripheral nervous systems (CNS and PNS); however, robust methodologies to investigate both systems in tandem are currently lacking in this space. This feasibility study sought to test a newly developed battery which incorporates robust, evidence informed methods for neurophysiological data collection across resting and non-resting conditions. We enrolled a convenience sample of 11 adults in and around Atlanta, Georgia. Signals captured during resting and non-resting states included electroencephalography (EEG), respiration, electrocardiography (ECG), impedance cardiography (ICG), electrodermal activity (EDA), and continuous blood pressure (cBP). Primary outcomes included efficiency, compliance, tolerability, acceptability, and data quality with progression criteria based on the traffic light (i.e., red, amber, green) approach. Of the 11 subjects, 10 completed the full battery with 1 subject withdrawing due to an unanticipated adverse event. Overall, the results suggested that our battery is feasible with minor changes. Chiropractic intervention trials are currently underway exploring the feasibility of a modified version of this battery in clinical populations.
Copyright (c) 2024 Tyson Perez, Emily Drake, Stephanie Sullivan
REHABILITATION AFTER LATERAL ANKLE STABILISATION SURGERY AS GUIDED BY A SPORTS CHIROPRACTOR – A CASE REPORT
Objective: The purpose of this case study was to report the chiropractic management of a patient following a Bröstrom-Gould surgical intervention. Clinical Features: A 41-year-old woman presented with lateral ankle instability and pain following a number of inversion sprains over a 3 year period. Following specialist reviewal, a reconstructive surgical procedure, a Bröstrom-Gould procedure, was recommended. Intervention and Outcome: A three phase approach was applied to rehabilitation aiming at ankle range of motion, rebuilding strength through the calf and lower limb musculature and return to sport with plyometric and strength endurance featuring. The athlete returned to unencumbered athletic participation with significant changes in Foot and Ankle Outcome Score (FOAS) questionnaires. Follow up evaluation revealed no pain or functional complaints. Conclusion: Graded rehabilitation focusing on range of motion, strength and plyometric qualities can return athletes to full function athletic participation, and can be adequately applied by sports chiropractors.
Copyright (c) 2024 Richard Kan, Jenny Truong
MASSAGE THERAPY AND VERTEBRAL ARTERY DISSECTION
Case reports are often published on cervical artery dissection (CAD) with one subgroup of these being vertebral artery dissection (VAD). VAD following neck massage has been reported in literature but not summarized. Head and neck massage is sometimes delivered by inadequate or un-trained people (eg barbers/ salon people). These un-trained lay people appear to also deliver spinal manipulative therapy (SMT). Chiropractic care often includes SMT, massage, soft tissue therapy, and other forms of therapy. However, other professions, including physiotherapy (physical therapy), osteopathy, and medical practitioners, also deliver SMT. In addition, many other “therapists” deliver SMT, with and without massage therapy. Sometimes these “therapists” do not necessarily have any formal training or qualifications. Qualified professionals such as physiotherapists (physical therapists), osteopaths, and massage therapists also deliver massage therapy. Some case reports incorrectly use the term “Chiropractic” or “Chiropractic technique” when describing a manual therapy such as massage. Clearly, massage therapy and SMT are not exclusively delivered by one profession (namely chiropractic). This paper is a review of recent case reports on VAD following massage, and will also discuss why the term “Chiropractic” was incorrectly used. In addition, this paper discusses some evidence assessing chiropractic as a trigger for CAD. Many case reports regarding CAD continue to be lacking in detail and make significant methodological errors.
FUNCTIONAL NEUROLOGICAL DISORDER AND CHIROPRACTIC: TWO CASE REPORTS
Functional Neurological Disorder (FND) is a complex condition characterised by neurological symptoms that cannot be explained by a structural or organic disease. Traditional interventions often emphasise psychological and physiotherapeutic approaches. This case series explores the efficacy of an integrative treatment combining Chiropractic care, Vestibular Rehabilitation (VR), and Sensory Motor activities in two patients diagnosed with FND. Two patients (one female, age 15 and one male, age 48) with confirmed FND were treated. Each presented with distinct neurological complaints including motor weaknesses, sensory disturbances, and movement disorders. An individualised treatment regimen was designed for each patient combining Chiropractic Adjustments, tailored VR exercises, and specific sensory motor activities. The intervention spanned 3-36 weeks, and outcomes were evaluated based on symptom reduction and functional improvement. Both patients achieved complete resolution. The movement disorders, such as psychogenic non-epileptic seizures, tremors and dystonia, were reported as achieving complete remission. The results of these two cases suggest that an integrative approach, melding Chiropractic care with Vestibular Rehabilitation and Sensory Motor activities, may offer a promising avenue for the management of FND. Larger controlled studies are warranted to validate these findings and to further explore the underlying mechanisms behind this synergistic therapeutic approach. The clinical presentation and treatment course of each patient is presented, including the specific VR and Chiropractic techniques used, and report on their outcomes with discussion of the potential mechanisms by which VR and Chiropractic treatment may be effective for individuals with FND.
POST-SURGICAL REHABILITATION OF A SEMI ELITE SOCCER PLAYER UTILISING A BIOMECHANICAL AND NEUROCOGNITIVE APPROACH BY A SPORTS CHIROPRACTOR
Background This case study underscores a sports chiropractor's comprehensive rehabilitation approach, integrating neurological rehabilitation into the post-surgical recovery of an ACL (anterior cruciate ligament) repair. Through the incorporation of neurocognitive training, specifically directed at enhancing visual processing and anticipatory reactions, the primary objective is to mitigate motor errors and minimise the susceptibility to secondary injuries. Conventional protocols for managing ACL injuries may neglect the on-field neurocognitive demands imposed on athletes. Inadequate cognitive training may render athletes less equipped to manage biomechanical stresses and navigate the dynamic environment of a match, potentially resulting in compensatory movements and an elevated risk of reinjury. Case Presentation The patient, a 35-year-old female semi-elite soccer player, sustained a left knee injury during a game. Despite a normal orthopedic examination, subsequent MRI revealed extensive damage, including a complete ACL rupture, leading to successful ACL reconstructive surgery. The objective of this case study is to illustrate how the integration of biomechanical and neurocognitive rehabilitation can diminish the likelihood of reinjury and facilitate a successful return to high-level athletic performance. Conclusion The rehabilitation program prioritised incremental biomechanical loading and neurocognitive training, employing an external focus of control to mitigate compensatory movements. Throughout the intervention, the patient's capabilities were consistently evaluated using the BalanceTrackS system, enabling adjustments to the rehabilitation plan. Standardised questionnaires were also administered at various intervals (one week, one month, three months, and six months) to assess progress and determine readiness for a secure return to play.
HOW CHIROPRACTIC RECOGNITION WAS ACCOMPLISHED WITHIN THE AUSTRALIAN HIGHER EDUCATION SYSTEM
This paper tells the good news and success story of the first chiropractic course in the world to achieve both full government funding and government accreditation. It also tells the story of Dr. James Barry Ritchie, former Principal of Preston Institute of Technology, who explicates the context in which Chiropractic was allowed to flourish in the interest of serving patients, mainly in Australia.
Copyright (c) 2024 Andries Mentz Kleynhans
SLED RESISTED SPRINT TRAINING - A REVIEW OF THE LITERATURE
Background: Sled-resisted sprint training (RST) has emerged as a common intervention strategy for enhancing sprint performance, yet the optimal implementation strategies and expected outcomes remain debated in the literature. Objective: To systematically review and evaluate the effectiveness of sled-based training interventions on sprint performance across different populations and loading protocols. Methods: Twenty-one studies involving athletic and active populations were analyzed for training effects on sprint performance, focusing on acceleration and maximal velocity phases. Studies examining various sled loads and comparing RST with unresisted sprint training (UST) were included. Results: Heavier sled loads (20-30% of body mass) demonstrated greater effectiveness in improving early acceleration ability, while lighter loads (5-12.5% body mass) were more beneficial for maximal velocity development. Combined RST and UST programs produced superior results compared to UST alone (-2.43 ± 0.67% vs -1.15 ± 0.72% improvement over 30m). RST showed stronger evidence supporting acceleration development rather than maximal velocity training. Phase-specific improvements were observed, with distinct outcomes in acceleration versus maximal velocity phases. Conclusions: RST is an effective targeted intervention, particularly beneficial for athletes in sports requiring explosive acceleration over short distances (10-20m). Training protocols should be tailored to specific objectives, with load selection based on whether acceleration or maximal velocity enhancement is the primary goal. While both RST and UST demonstrate performance benefits, practitioners should align training modality and load with specific performance goals and athletic requirements.