Home PublicationsChiropractic Journal of AustraliaBack Issues: 2000-2009Volume 39 Vol 39 Issue 2

CJA Vol.39 Issue 2

Editorial: The Crossroads Was Really a Fork - p.45
Phillip Ebrall

Mary Ann Chance Memorial Paper - p. 46
Phillip Ebrall

Chiropractic in the Twenty-First Century - p. 47
Meridel I. Gatterman

In Memoriam: James G. Maxwell, DC, FICC, FACC - p. 52
Peter S. Cowie, Rolfe E Peters

Kjellberg Lumbar Technique - p. 54
Daniel D. Crocker, Luke R. Larsen, Leah M. Dundas, Peter W. Bull

Occipitalisation: A One in a Hundred Risk? - p. 60
Peter W. Bull

An Accounting of Pathology Visible on Lumbar Spine Radiographs of Patients Attending Private Chiropractic Clinics in the United Kingdom - p. 63
Kenneth J Young, Aamer Aziz

Upper Cervical Chiropractic Treatment for a Patient Demonstrating a Non-traumatic Bipartite Atlas: A Literature Review and Case Report - p. 70
Jeffrey S. Hannah

New National Registration and Accreditation Scheme for Health Professionals: Report on First Consultation Paper - p. 75
Stanley P. Bolton

Bringing Chiropractic to Aboriginal Communities: The Durri Model - p. 80
Dein Vindigni, Barbara Polus, Gay Edgecombe, Joan van Rotterdam, Nicole Turner, Leanner Spencer, Geoff irvine, Max Walsh

ABSTRACTS

Kjellberg Lumbar Technique

Daniel D. Crocker, Luke R. Larsen, Leah M. Dundas, Peter W. Bull

Objective: To review and document the Kjellberg lumbar technique, developed in Australia for the manipulation of the lumbar spine. Methods: In the absence of extensive literature regarding this technique, the information presented in this paper is derived principally from discussion with, and observation of, a small group of the remaining second generation Kjellberg practitioners. Data was also drawn from published peer-reviewed literature 1970-2007 located from searches of PubMED, CINHAL, MEDLINE and ICL electronic databases and other relevant texts. Discussion: The Kjellberg lumbar technique is unique compared to the majority of manipulative techniques previously researched and commonly practiced. The details of the adjustments are discussed and the biomechanical mechanisms which may underlie their purported effectiveness are proposed and examined. Conclusion: Steps must be taken towards the preservation of this unique Australian technique before it is lost to history. This initial review and documentation of the technique should stimulate further research into the Kjellberg system of manipulation which will work to preserve this technique and further the chiropractic knowledge base.

INDEX TERMS:(MeSH): MANIPULATION; CHIROPRACTIC; LUMBAR SPINE; AUSTRALIA (Other): KJELLBERG; QUEENSLAND

Chiropr J Aust  2009;39:54-9

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Occipitalisation: A One in One Hundred Risk?

Peter W. Bull

Objective: To present a case of a patient presenting to the University Outpatient’s Clinic for chiropractic spinal manipulation with occipitalisation and to discuss the relevance of this condition to the chiropractor. Design: A case report & literature review. Setting: A chiropractic intern outpatient clinic. Patient: A 62-yr old male patient presented with a two week history of left posterior thigh pain. The history revealed that the patient had also had laminectomy at C3, C4, C5 and C6 performed 4 years earlier. The patient declined to reveal the exact reason for this procedure, arguing that he had come to the clinic for low-back related problems only. Intervention: Plain film imaging was performed on the cervical and lumbar regions. Discussion: The clinical significance of this finding to the chiropractor is discussed along with a literature review and radiological classification of the condition. Conclusion: Chiropractors need to be aware that this potentially serious condition exists in one in every hundred patients and presents an absolute contraindication to spinal adjustment in this region.

INDEX TERMS: MeSH: CHIROPRACTIC; MANIPULATION, SPINAL,(Other):OCCIPITALISATION.

Chiropr J Aust 2009; 39:60-2

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An Accounting of Pathology Visible on Lumbar Spine Radiographs of Patients Attending Private Chiropractic Clinics in the United Kingdom

Kenneth J Young and Aamer Aziz

Objective: To enumerate the types of pathology seen on lumbar spine plain radiographs of patients reporting to private chiropractic clinics in the United Kingdom. Design: Retrospective analysis of radiology reports from a chiropractic radiology consultancy. Setting: Private chiropractic radiology practice. Patients/Participants: All lumbar spine radiograph reports from a chiropractic radiology consulting practice over the course of one year were reviewed and the diagnoses were noted. 276 reports were reviewed and 262 were included in the study. Reports were included if they had definitive diagnoses, contained all relevant clinical information such as patient age, and reported on the lumbar spine only (e.g. full spine and thoracolumbar reports were excluded). Intervention: None. Main Outcome Measures: The types of pathology and number of times each was encountered were entered on to a spreadsheet and totaled by type and category. Results: Postural alterations and degenerative arthropathies were the most common pathologies encountered. The most serious pathologies encountered included two patients with tumours, three with acute compression fractures, 31 with osteoporosis and 80 with atherosclerosis. Seven patients with potentially significant findings were lost to follow up. Conclusions: This study was limited by convenience sampling and small sample size, however some indication of the types of pathologies that chiropractors find on their images was obtained. Improved communication between manual therapy practitioners and the medical community would benefit all parties involved, including patients.

INDEX TERMS: SPINE; LUMBAR VERTEBRAE; RADIOGRAPHY;
PATHOLOGY; CHIROPRACTIC; RETROSPECTIVE STUDIES.

Chiropr J Aust 2009; 39:63-9

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Upper Cervical Chiropractic Treatment for a Patient Demonstrating a Non-traumatic Bipartite Atlas: A Literature Review and Case Report.

Jeffrey S. Hannah

Objective: The purpose of this case report is to describe a process to diagnose and to adjust a congenital anomaly known as anteroposterior spondyloschisis (aka bipartite atlas). Clinical Features: A 30-year-old female presented with a history of chronic cervicalgia, uncoordinated reflexes, and whole-body soreness. Radiographic examination demonstrated radiolucent clefts through the anterior and posterior arches of the atlas. Intervention and Outcome: Given no history of trauma to suggest Jefferson fracture, the patient was diagnosed with a bipartite atlas. After demonstrating atlantodental and atlantoaxial stability, the patient consented to upper cervical (Atlas Orthogonal) chiropractic treatment. Conclusion: The patient in this case study responded favorably to upper cervical treatment. Considerations and treatment protocols are outlined in order to assist health care providers, who may encounter this anomaly in other patients.

INDEX TERMS: (MeSH):ATLAS; CHIROPRACTIC; MANIPULATION,
CHIROPRACTIC; SPINAL DYSRAPHISM; ABNORMALITIES;
SPINAL FRACTURES. (Other): CONGENITAL DEFECTS; CHIROPRACTIC ADJUSTMENT.

Chiropr J Aust 2009; 39:70-4

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New National Registration and Accreditation Scheme for Health Professionals: Report on First Consultation Paper

Stanley P. Bolton

2010 will mark a seismic shift in legislative regulation and accreditation of all health professions and professionals in Australia. This is a major and significant generational shift from past decades of State regulatory and accreditation legislation to a future national registration and accreditation scheme. Nor is it confined to healthcare fields. Other fields of human endeavour face similar national regulation and common codes of conduct nationally to be brought about by implementation of Federal Government policy.

How is the chiropractic profession affected in this pending 2010 seismic shift and what will it mean to the practising chiropractor?

This paper attempts to find some answers to these questions.

INDEX TERMS: (MeSH): ACCREDITATION; CERTIFICATION; LICENSURE; LEGISLATION.

Chiropr J Aust 2009; 39:75-9

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Bringing Chiropractic to Aboriginal Communities: The Durri Model

Dein Vindigni, Barbara Polus, Gay Edgecombe, Joan Van Rotterdam, Nicole Turner, Leanne Spencer, Geoff Irvine and Max Walsh

Aboriginal Medical Services (AMSs) are the main portal of health care for Aboriginal communities, particularly in rural and remote areas where access to community centres and public hospitals is limited. Aboriginal Health Workers (AHWs) are also the first point of contact for people in their community. They have the community`s vital trust, respect and local knowledge required in promoting the health of their people through health screening and a range of specialized clinical skills including cardiovascular, diabetes and mental health.

Recent studies have unearthed a disproportionately high prevalence of painful and disabling musculoskeletal conditions in Indigenous people compared with non-Indigenous Australians. These conditions are thought to be overshadowed by more notable causes of mortality including cardiovascular disease, diabetes and death from road trauma. 

Though previously under-reported, musculoskeletal conditions commonly treated by chiropractors are thought to impact substantially on the quality of life experienced by Indigenous Australians. These conditions are further complicated by the burden imposed by a range of socio-economic hardship, geographical and cultural barriers.
If a person living in economic hardship and/or in a rural or remote community is injured or suffers from a chronic, disabling condition, she or he is often unable to readily access the appropriate tactile therapies such as chiropractic, massage therapy, osteopathy or physiotherapy required in order to manage their condition(s). There are also important philosophical similarities between healthcare as traditionally practiced in Aboriginal communities and tactile therapies such as chiropractic care.

This article describes the development of a community-based chiropractic program, delivered in Aboriginal Community Controlled Health Services which was informed by a community advisory group in all phases of its evolution including its development, implementation and the delivery of health services and interventions. It demonstrates the importance of listening and learning from each other`s experience in helping to achieve sustainable and culturally sensitive health outcomes for Indigenous communities. It describes an evolving model with potential to be adapted in other Indigenous communities. Evaluating the program`s development and shortcomings through participatory action research is designed to ensure that it is sensitive and responsive to the Indigenous community that it serves.

INDEX TERMS: (MeSH): CHIROPRACTIC; AUSTRALIA.(Other):ABORIGINAL COMMUNITIES.

Chiropr J Aust 2009; 39:80-3

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