The Chiropractors' Association of Australia

Chiropractic: healthy spine, healthier life

CJA Vol.26 Issue 4

Editorial: The Patient, the Payer, and the Policy Maker
Mary Ann Chance and Rolf E. Peters

Tools for Refining Patient-Centred Care: A Consideration of LOC and SOC in the Chiropractic Consultation
Jennifer R. Jamison

TMJ Pain and Chiropractic Adjustment—A Pilot Study
Anthony O’Reilly and Henry Pollard

A Mathematical Basis for Defining Vertebral Subluxations and Their Correction
John A. Dulhunty

The Best of Books (and a Lemon) for 1996: A Chiropractor’s Reading List
Phillip Ebrall

Scope of Practice, Research, Education and the Future
Herbert J. Vear

A Backward Glance...The Western Australian Story
Stanley P. Bolton

In Memoriam

ABSTRACTS

Tools for Refining Patient-Centred Care: A Consideration of LOC and SOC in the Chiropractic Consultation

JENNIFER R. JAMISON

ABSTRACT: Introduction: Chiropractors offer a patient-centred form of clinical care. Locus of control (LOC) and sense of coherence (SOC) are constructs which provide insight into the global orientation of an individual. These indices could be used to provide the practitioner with additional insight into the particular psychological management needs of individual patients. This study described the LOC and SOC of a number of chiropractic patients and sought to identify whether routinely gathered clinical information deserved further investigation as a possible screening index for formal measurement of SOC and/or LOC. Method: Forty-nine chiropractors were asked to participate in a pilot study and invite six of their patients to complete a closed-question questionnaire which evaluated the patient’s SOC, LOC and perception of their condition. Practitioners were asked to supply information about the diagnosis, progress and management of each patient.
Results: Twenty-five chiropractors and 149 patients participated. One hundred twenty patients were included in the final sample. No routinely collected clinical data was identified in this study which could serve as a screening tool to identify the desirability of undertaking formal SOC and/or LOC assessment. The clinical profiles of 120 patients with respect to these indices are reported.
Discussion: Consideration is given to how knowledge of SOC and LOC may refine chiropractic practice with respect to providing patient-orientated clinical care. Conclusions: Assessment of LOC and SOC deserves consideration as a potential data collection tool in the development of a sophisticated, patient-centred, chiropractic model of health care.

INDEX TERMS: MeSH: INTERNAL-EXTERNAL CONTROL; CHIROPRACTIC. OTHER: SENSE OF COHERENCE; LOCUS OF CONTROL; PATIENT CENTRED MODEL.

Chiropr J Aust 1996; 26:118-24.

TMJ Pain and Chiropractic Adjustment-A Pilot Study

ANTHONY O’REILLY and HENRY POLLARD

Objective: This project investigates the relationship between spinal adjustment and temporomandibular joint (TMJ) pain. Design: Controlled pilot trial.
Setting: Private chiropractic practice. Patients: Twelve (12) patients assessed by dentists in private practice as having TMJ syndrome, randomly assigned to a chiropractic treatment or a placebo treatment (remote trigger point therapy) group.
Intervention: Patients in the chiropractic group received weekly chiropractic adjustments for six weeks to correct cervical spine vertebral dysfunctions, and controls received weekly trigger point therapy to cervico-thoracic muscles for six weeks.
Main Outcome Measure: McGill Pain Questionnaire administered before and after the trial. Results: Both groups demonstrated similar changes. Due to greater than anticipated reduction in pain in the trigger point therapy (control) group, the results were statistically the same using a Mann-Whitney non-parametric test (p = 0.9025), however a subjective, graphical comparison of results suggests that spinal adjustment may have some superiority over the trigger point method.
Conclusions: Further investigation is warranted, but future studies should involve a larger sample, sham treatment other than cervico-thoracic trigger point therapy, and a pain assessment tool specifically designed for TMJ symptoms.

INDEX TERMS: MeSH: CHIROPRACTIC; TEMPOROMANDIBULAR JOINT SYNDROME; CERVICAL VERTEBRAE; MYOFASCIAL PAIN SYNDROMES; PAIN MEASUREMENT. OTHER: MANIPULATION, CHIROPRACTIC.

Chiropr J Aust 1996; 26:125-9.

A Mathematical Basis for Defining Vertebral Subluxations and Their Correction

JOHN A. DULHUNTY

Objective: To define the mechanical component of the "vertebral subluxation" in terms that can be expressed as an all-encompassing mathematical formula.
Method: A review of the literature relating to the vertebral subluxation suggests that it is not a well defined entity and that confusion exists over the nature of the spinal lesion it is supposed to describe. A mathematical and mechanical basis for defining the vertebral subluxation is presented, encompassing both static and dynamic components. This model attempts to embrace the historical and semantic factors underlying the concept as well as incorporating contemporary concepts such as the vertebral subluxation complex.
Results: A formula was developed based on mechanical principles that relates the four basic mechanical components of the subluxation, namely displacement (D), load (L), resistance (R) and time (t). It provides a mathematically based definition of a subluxation. The subluxation is defined as "a loss of positional integrity of the spine." The formula representing the subluxation is D = L/R(t).
Conclusion: The mathematical formula used to describe the vertebral subluxation is flexible enough to unify many apparently divergent subluxation concepts, yet specific enough to allow quantitative as well as qualitative analysis of spinal integrity

INDEX TERMS: MeSH: CHIROPRACTIC; BIOMECHANICS. OTHER: SUBLUXATION; VERTEBRAL SUBLUXATION COMPLEX.

Chiropr J Aust 1996; 26:130-8.

The Best of Books (and a Lemon) for 1996: A Chiropractor's Reading List

PHILLIP EBRALL

Reviews are presented of a number of recently published books, selectively sampled by the author as having relevance to the clinical practice of chiropractic. The review comments are prefaced by evidence-based commentary on aspects of the current general state of chiropractic publishing. The conclusion is made that 1996 has been a good publishing year for work of relevance and interest to the chiropractic profession

INDEX TERMS: MeSH: CHIROPRACTIC; AUSTRALIA.

Chiropr J Aust 1996; 26:139-46

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