Friday, October 24, 2008
Conservation of energy and efficient use of that energy
The human brain is an expensive tissue whose evolution, development and function have been shaped by available metabolic energy within and without neurons. The human nervous system is innately tuned towards survival of the organism. This survival tendency manifests itself as the development and continuance of efficient use of energy for all its processes.
This survival tendency, or drive, is for the conservation of energy and efficient use of that energy towards expression of optimal potential in life. These processes and pathways are directed on the input (sensory) side of the system. Chiropractic should address conservation of energy and the efficient use of that energy towards expression of optimal potential in life. Chiropractic should not ignore the 6 million year history of the evolution and development of the human brain. Working in synergy with this reality leads to incredible clinical results.
The purpose of human life goes far beyond survival; it is the expression of our abundant potential. This potential is reached by the efficient relationship between self (innate) and our internal and external environment. It is my hope that functional analysis technique and the functional approach to a patient’s health pathology may lead to a more rational, common sense advance that weighs the evidence of biology and science over superstition and blind faith (current allopathy).
Sensory Exercise and Clinical Decision Making
Sensory Exercise and Clinical Decision Making
The purpose of any rehabilitation exercise, sensory therapy or regime should be to make the nervous system more efficient. When taking a functional approach the processing within the CNS becomes the primary consideration.
How mechanistic, reductionistic and allopathic thought has infected vitalistic chiropractic theory is a subject for another book and not this seminar manual, but we can look at a few clinical decision making scenarios to flesh out a few keys.
Lets us look at a right sided upper extremity contracture from a left sided CVA. The right elbow becomes flexed and the wrist flexes due to the stroke. In traditional North American physical therapy and chiropractic, the therapists will stretch out the contracture, of course, to return the joint to normal. Many hours will be spent jumping on a chronically contracted biceps. But this increases somato-sensory representation of the biceps. Is this what we want to do with an already over-contracted (over represented in the somato-sensory cortex) biceps? No thought as to the true process of the disorder.
Muscles can only contract. The biceps in our scenario above is not dysfunctional; it is contracting efficiently and vigorously, doing what it is suppose to do. The problem is lack of inhibition from the triceps. The afferentation processing from the antagonist, triceps, is damaged from the CVA. By stimulating the triceps, increasing somato-sensory representation of the triceps, magically the elbow contracture improves immediately. The biceps (elbow flexion) should be hands off unless you are stimulating the triceps while at the same time trying to reduce the biceps contracture.
Again, looking at all components of the symphony above (upper extremity movement), one would have to assess that the biceps is working and the triceps is not. The CVA has damaged the amount of “triceps” afferentation that gets to the cortex. By increasing the amount of input from the antagonist (if the program for normal upper extremity movement still exists in the CNS) the biceps contracture improves. When the program is non-existent, then the challenge is to place the program into the CNS. A subject for another manual.
Let’s look at an acute situation. The running back in a football game starts running and pulls up screaming in pain, grabbing his left hamstring. The trainer runs onto the field, grabs the hobbled elite athlete and begins to stretch out the tight ‘pulled’ hamstring.
Question: Does this increase or decrease somato-sensory representation of the spasmed hamstring? By stimulating the quadriceps (tapping, contracting), the hamstring tone is decreased. This is observed immediately.
By looking at each component/module of dynamic equilibrium, the coordination within each module of dynamic equilibrium, a global plan for rehabilitation can be attained.
One needs to look just not at antagonist and agonist relationships, but the timing of when a module or muscle group should be activated and de-activated and the proprioceptive and vestibular component. Functional processing of all the incoming information, always being weighted by efficiency, should drive all our rehabilitative (exercise therapy and sensory integrative exercises) efforts.
Traditional allopathic medicine
Traditional allopathic medicine has defined health as merely the absence of disease. This foundational definition has limited allopathy to limit its goals as the eradication of pathogens or the attainment of certain lab values. Present evidence has accumulated to show that the health state involves more than the lack of detectable pathogens in the body or attainment of certain lab value ranges. In the face of this information, the basic position of traditional allopathic medicine concerning the achievement of health has not changed. Medical schools and managed care organizations, with their emphasis on a diagnosis and rationed care, promulgate this traditional orientation by teaching that diagnosis and treatment of the named “disease” is the major pathway to health.
Synergistic Neurophysiological Efficiency
Synergistic Neurophysiological Efficiency: Over time, all neural processing moves to the most energy efficient state. Neuroplasticity is driven by long term efficiency of the information processing NOT the long term survival needs of the individual.
Neuronal communication and computation are efficient when considered in the dual (synergistic) context of energy and information rather the either context alone.
Neurophysiological Partitioning: since the CNS controls and regulates all physiological process of the human body, these optimizations must occur at the microscopic cellular level in the nervous system first.
All these changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy (available ATP) is finite. It is reasonable to assume that the limiting factor for this energy efficiency optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS.
Thalamic Integration and Filtering
Thalamic Integration and Filtering: The thalamus does not passively relay information from the sensory system to the cortex. Rather, via feedback from the cortex and the brain stem, the thalamus controls the type and amount of information that reaches the cortex. Recent scientific findings prove the thalamus plays a role in how the cortex functions. Cortico-cortical communication depends heavily on how messages are integrated, filtered and modified through the thalamus.
The complex cell and circuit properties of the thalamus leave little doubt that the relay of sensory information to the cortex is an active, adjustable and modifiable process. Thus, the full impact of the thalamus recent research has shown is much more than simply controlling flow of information from the periphery and from other parts of the brain to the cortex: it is the most active partner in all cortical computations.
Integration in the thalamus is the sum of different driver inputs (highly prioritized afferents) to produce an output that differs qualitatively from that of any of the inputs. Filtering in the thalamus is the summing of different driver inputs (highly prioritized afferents) to produce an output that differs quantitatively from that of any of the inputs. So if the thalamus is intact, symptoms and dysfunction are the sum (integration and filtering) of different inputs into the thalamus. Symptoms, dysfunction and dis-ease are dependent on thalamic firing. Thus if the chiropractor can change input into the intact thalamus to move the CNS to produce a healthier functional status, the output will be health. The “nerve interference” is on the afferent side.
Pediatric Chiropractic Paradigm
Chiropractic is concerned with the enhancement, promotion, preservation and restoration of health and focuses particular attention on the subluxation. A chiropractic vertebral subluxation complex (VSC) is a complex of functional and/ or structural and/or pathological articular changes that compromise neural integrity and may influence the homeostasis of multiple organ systems and the body as a whole. The chiropractic vertebral subluxation complex can only be evaluated by chiropractors utilizing profession specific procedures based on the best available rational, scientific, empirical evidence. Over 100 years of chiropractic care for children has shown in the scientific literature to be the safest interventional health care modality available to the public.
The role of the chiropractor, though trained and educated in the function of disease labeling and therapy, is to identify and correct vertebral subluxation complexes that have a profound negative impact on the physiological development of the child. Health promotion through well child maintenance care as well as VSC corrective care is an invaluable contribution the chiropractor can make to the health and well being of the child. Since human function and innate homeostasis is neurologically integrated, Doctors of Chiropractic evaluate and facilitate biomechanical and neuro-biological function though the appropriate application of the chiropractic adjustment and diagnostic procedures. When the pediatric patient’s homeostasis is overwhelmed and produces an identifiable disease, the pediatric patient moved from wellness into the interventionist medical paradigm, the chiropractic focus on the location and adjustment of the VSC remains unchanged. This dedicated therapeutic focus does not exempt the chiropractor from the responsibilities of practicing the art and science of whole body diagnosis.
Even in the most severe disease states, chiropractic has a critical role to play in the management of the pediatric patient who clearly belongs within the allopathic interventionist model. Disease is a struggle to maintain homeostatic balance of the body despite tissue damage and chiropractic adjustments move the child closer to wellness and away from pathologic dysfunction of tissues and organ systems. By contrast, allopathy has little role to play in the management of the patient who fits within the chiropractic wellness paradigm because of the lack of an identifiable pathology. Even preventive measures such as prophylaxis for asthma are dependent for their implementation upon the manifestation of the disease in the first place. Chiropractic care has been proven effective in positively effecting children with various “named” disease manifestations and empirically has blamed for the increased general health status of chiropractically treated children versus the general allopathic population.
Therefore, direct access and widespread utilization of chiropractic care is an integral part of the pediatric patient’s healthy development. Chiropractic should be included first in the health care planning of every child.
The Safety of Chiropractic for Children
Pediatrics. 2007 Jan;119(1):e275-83.
Adverse events associated with pediatric spinal manipulation: a systematic review.
BACKGROUND: Spinal manipulation is a noninvasive manual procedure applied to specific body tissues with therapeutic intent. Although spinal manipulation is commonly used in children, there is limited understanding of the pediatric risk estimates. OBJECTIVE: Our goal was to systematically identify and synthesize available data on adverse events associated with pediatric spinal manipulation. METHODS: A comprehensive search was performed of 8 major electronic databases (eg, Medline, AMED, MANTIS) from inception to June 2004 irrespective of language. Reports were included if they (1) were a primary investigation of spinal manipulation (eg, observation studies, controlled trials, surveys), (2) included a study population of children who were aged 18 years or younger, and (3) reported data on adverse events. Data were summarized to demonstrate the nature and severity of adverse events that may result rather than their incidence. RESULTS: Thirteen studies (2 randomized trials, 11 observational reports) were identified for inclusion. We identified 14 cases of direct adverse events involving neurologic or musculoskeletal events. Nine cases involved serious adverse events (eg, subarachnoidal hemorrhage, paraplegia), 2 involved moderately adverse events that required medical attention (eg, severe headache), and 3 involved minor adverse events (eg, midback soreness). Another 20 cases of indirect adverse events involved delayed diagnosis (eg, diabetes, neuroblastoma) and/or inappropriate provision of spinal manipulation for serious medical conditions (ie, meningitis, rhabdomyosarcoma). CONCLUSIONS: Serious adverse events may be associated with pediatric spinal manipulation; neither causation nor incidence rates can be inferred from observational data. Conduct of a prospective population-based active surveillance study is required to properly assess the possibility of rare, yet serious, adverse events as a result of spinal manipulation on pediatric patients.
9 Serious chiropractic injuries in the history of medicine versus thousands of deaths EVERY YEAR from allopathy?