Dr. Fred Clary's Functional Analysis Chiropractic Technique

Aluminum and Vaccine Ingredients: What Do We Know? What Don’t We Know?

2011-03-29T17:06:00.000-07:00

Thimerosal, which contains the organic compound ethyl mercury, is a known neurotoxin and used to be a major ingredient in childhood vaccines. There are over 15,000 articles in the medical literature describing the adverse health effects on the human body with exposure to varying amounts and forms of mercury.

In 1999 the American Academy of Pediatrics (AAP) urged government agencies to work rapidly toward reducing children's exposure to mercury from all sources. Because any potential risk was of concern, the AAP and the USPHS (United States Public Health Service) agreed that the use of thimerosal-containing vaccines should be reduced or eliminated.[1] The AAP recommended that it would be a good idea to remove thimerosal from vaccines, even though according to them, there was no evidence linking childhood health issues to thimerosal exposure from vaccines. In 2008, children are still being injected with thimerosal-containing vaccines, and old stocks of thimerosal-containing vaccines manufactured by 1999 continued to be administered to children up to 2003.

However, a growing number of physicians, scientists and parents maintain that thimerosal has played, and continues to play a large role in contributing to the emergence of multiple chronic illnesses in children and adults, including the neurological spectrum disorders. Aluminum, which is present in the environment and in many childhood vaccines, may be affecting the health of our children in ways that we have yet to understand.

Aluminum is a heavy metal with known neurotoxic effects on human and animal nervous systems. It can be found in the following childhood vaccines – DTaP, Pediarix (DTaP-Hepatitis B-Polio combination), Pentacel (DTaP-HIB-Polio combination), Hepatitis A, Hepatitis B, Haemophilus influenzae B (HIB), Human Papilloma Virus (HPV), and Pneumococcal vaccines.[2]

In 1996, the American Academy of Pediatrics issued a position paper on Aluminum Toxicity in Infants and Children which stated in the first paragraph, “Aluminum is now being implicated as interfering with a variety of cellular and metabolic processes in the nervous system and in other tissues.[3]

A review of the medical literature on aluminum reveals a surprising lack of scientific evidence that injected aluminum is safe. There is limited understanding of what happens to children when aluminum is injected into their bodies, including whether or not it accumulates in tissues and organs or is properly eliminated from the body. It is also unknown if genetic factors affect long term adverse health outcomes for those injected with aluminum containing vaccines.

One in 6 children under the age of 18 in this country has developmental/learning disabilities, although the numbers may be higher since this 1994 report was published.[4] Ten percent of all children have asthma.[5] Growing numbers of children are living with different types of allergies. That means they have impairment, or even irreversible damage to their nervous and immune systems. Isn’t it possible that injected aluminum plays a role in affecting the health of our children’s nervous and immune systems, as the science we do have seems to suggest?

What is even more concerning is the lack of accepted scientific data explaining whether injected aluminum interacts with other vaccine ingredients to cause harm to our children. Boyd Haley, PhD, Professor Emeritus of Chemistry at the University of Kentucky completed lab experiments showing the damaging effects on nerve cells when he exposed them to aluminum, especially in the presence of other vaccine ingredients like mercury, formaldehyde, and the antibiotic neomycin.[6] [7] His data, however, have been ignored by the scientific, medical and governmental institutions making vaccine policies.[8] The scientific community needs to be doing these experiments in the lab before shooting kids with these ingredients and declaring unequivocal vaccine safety for all children.

Aluminum is added to vaccines as an adjuvant so vaccines will produce a stronger antibody response and be more protective. It is this role as an adjuvant that may reveal to us the most significant relationship between aluminum in vaccines and the damage it imparts on the long term health of our children’s nervous and immune systems.

A Little Science Review
Children are born with a cellular mediated immune system (TH1 cells – T-helper 1), a humoral immune system (TH2 cells – T-helper 2), and a regulator immune system (TH3 cells – T-helper 3) as major pieces of their overall immune systems. These three arms are immature when babies are born, and begin to mature as children are exposed to their environments through their nervous systems, skin, airways and intestines. Antibiotics, poor nutrition, stress, exposure to heavy metals and other environmental toxins, and the use of vaccines, may interfere with the proper maturing process of these three arms of children’s immune systems. In theory, if the TH system is allowed to mature, and is not interfered with, children will develop a mature, balanced TH1, TH2 and TH3 immune system by age three.

TH1 and TH2 develop to protect children from the outside world, producing inflammation and anti-inflammation responses to foreign particles from the natural environment. TH3 immune cells develop to keep the TH1/TH2 arms of the immune system in check so the body only produces the amount of inflammation and anti-inflammation that is needed to protect itself from exposures in the natural environment.

When TH2 cells are activated properly, either directly via the natural environment, or through a direct signal from the TH1 system, the B cell arm of the immune system is then stimulated, leading to the production of the desired protective antibodies.[9] [10]

It’s important for the reader to know that the hallmark of a healthy, mature immune system in children is demonstrated by an equal and balanced TH1, TH2 and TH3 immune response to the natural environment. TH1, TH2 & TH3 do not work independently, and require a very important synergistic relationship to function properly in our bodies. As soon as one or more of these three arms begins to over or under work in relation to the other, chronic illness begins to express itself.

More on Aluminum
Aluminum is placed in the vaccines to selectively target the up-regulation of the humoral arm (TH2 cells) of children’s immune systems, to drive the production of antibodies. The medical community leads us to believe that this production of antibodies is what imparts for children a protective nature against vaccine-preventable illnesses. Yet, this outcome may come at a cost.

There are multiple articles in the medical literature demonstrating how chronic illnesses like allergies,[11] [12] asthma, [13] [14] [15] eczema,[16] lupus, [17] inflammatory bowel disease, [18] ADD/ADHD[19] and autism[20] all exhibit a skewed production and over-activity of the TH2 arm of the immune system.

Similarly, chronic illnesses like juvenile diabetes mellitus[21] [22] and rheumatoid arthritis,[23] multiple sclerosis,[24] uveits,[25] inflammatory bowel disease,[26] and autism[27] [28] all exhibit skewed production and over-activity of the TH1 arm of the immune system.

While aluminum in the vaccines is specifically targeting the over-activation of TH2 to encourage the body to produce antibodies, any direct or indirect effect of aluminum on the health or maturation of the TH1 or TH3 system is unknown. Yet, in many of these TH2 dominant chronic illnesses, TH1 and TH3 have also been shown to exhibit an impaired immune response to the environment.[29]

Any direct or indirect effect on the health or maturation of the TH1, TH2 and TH3 arms of children’s immune systems from any of the injected vaccine ingredients, either due to their individual action, or due to their combined interaction, is unknown as well.

The important synergistic, balanced activity of TH1, TH2 and TH3, in response to the environment is dysfunctional and impaired in all chronic illnesses. Children are not necessarily born with this dysfunction or impairment, although they may inherit the susceptibility from their parents. How then, do children develop the expression of these TH1, TH2, TH3 impairments, into what we describe as chronic illness?

What is clear is aluminum pushes the TH2 immune system to over perform, and multiple chronic illnesses in children show immune systems where the TH2 immune response over performs, while TH1 and TH3 responses are also impaired. Is there a connection? By having this type of effect on the TH2 system, is aluminum in any way contributing to the development of these chronic illnesses in children; especially in those children from families with a genetic history of the above mentioned chronic illnesses?

Does aluminum also affect the TH1 immune response, unbeknownst to scientists, clinicians and parents? Does aluminum play a role in impairing the overall synergistic, balanced activity of TH1, TH2 and TH3, which is a requirement for a healthy immune system response to the natural environment? There is no scientific evidence to clarify our understanding one way or the other, but the evidence may be right in front of us to conclude otherwise.

Aluminum forces the undeveloped and immature immune system of infants and children to produce greater amounts of humoral immune cells (TH2) and antibodies, before their immune systems have a chance to adapt to the world in which they’ve barely had a chance to live in.

Under these circumstances, the activity of aluminum appears to play a vital role in disrupting the maturation of the immune system in infants and children through its effects on TH2 and therefore, on TH1 and TH3.

What effect this has on their overall health in the short or long term is unknown, but this model appears to help us understand how we may be contributing to the development of chronic illness in infants and children with the use of aluminum in vaccines. We also have little understanding of what might happen to the overall health of their immune systems if parents wait until later in life to expose them to vaccines containing aluminum, or if they’re exposed in smaller doses one at a time.

How much of a role does injected aluminum play, either acting alone, or in conjunction with other vaccine ingredients and environmental toxins, in the selection and subsequent development of chronic illnesses, in a susceptible population of children, through the disruption of TH1, TH2, TH3? There is no science to answer this question because no one has investigated this issue.

We have no scientific studies in infants, children or adults to help us understand the nature of the progression of TH1, TH2 and TH3 immune responses to any of the injected materials in vaccines.

You cannot do research on questions that enough people don’t believe is worth asking, or are afraid of what the answers might show if the proper studies were done.

It is unfortunate that we continue to drag out this dialog by singling out each individual vaccine ingredient as a detriment to the health of our children. First thimerosal needed to be removed, despite contentions from the medical community that there were any real medical reasons to do so, and now aluminum. According to Environmental Defense[30] (formerly known as the Environmental Defense fund), all the vaccine ingredients are poisonous, carcinogenic or potentially harmful to the skin, gastrointestinal, pulmonary, immune and neurological systems in our bodies.

What about formaldehyde? Are we going to wait until another brave physician or scientist writes about the damaging effects of injected vaccine-containing formaldehyde on our children’s brains before we are called to demand that formaldehyde be removed? Or about the problems associated with having Polysorbate-80 in the vaccines?

Polysorbate-80 is used in pharmacology to assist in the delivery of certain drugs or chemotherapeutic agents across the blood-brain-barrier. What viral, bacterial, yeast, heavy metal or other vaccine containing ingredient need to pass into the brains of our children? Do they belong in the brain? Is that part of the needed immune response to protect our children from disease? Do vaccine materials pass across the blood-brain barrier with the help of Polysorbate-80? If so, are there complications from being in the brains of our children? Is this another connection to help us get an understanding of why 1 in 150[31] children have autism, or 1 in 6 children has developmental/learning disabilities?

If we’re going to do justice to the topic of vaccine ingredients, we need to look at the potential harm of all the vaccine ingredients at once, and examine their individual effects on our children’s immune and nervous systems. Then, we can examine the interactive effects of the vaccine ingredients on human tissue, and evaluate the potential for harm, as Dr. Haley has already successfully done.

How many more children need to be potentially harmed before we invoke the precautionary principle and the Hippocratic Oath – First, Do No Harm? If there’s no adequate science, and we have positive evidence of toxicity from aluminum, injected alone or in conjunction with other ingredients, and we have a potential model to understand why certain chronic conditions may be developing in a susceptible population of children, then injecting aluminum containing vaccines into anyone should stop right now until we have the proper scientific proof we need to say otherwise. We need the same scientific proof of safety for all vaccine ingredients and their interactions, and we need parents, scientists and practitioners to stand up and demand nothing less before we make matters worse.

Lawrence B. Palevsky,
MD, FAAP Pediatrician

1 PEDIATRICS Vol. 104 No. 3, September 1999, pp. 570-574 [Return]
2 MOTHERING No. 146, January-February 2008, pp. 46-53 [Return]
3 PEDIATRICS Vol. 97, 1996, pp. 413-416 [Return]
4 PEDIATRICS, Vol. 93 No. 3, 1994, pp 399-403 [Return]
5 AMA, Vol. 297, No. 24, June 27, 2007,pp. 2755-2759 [Return]
6 General Vaccine Issues: Mercury, Thimerosal and Neurodevelopmental Outcomes: Affidavit of Boyd E. Haley, PhD, Professor and Chair, University of Kentucky [Return]
7 http://www.whale.to/m/haley.html [Return]
8 http://www.safeminds.org/pressroom/press_releases/2005-07-01-Haley-IOM-Response.pdf [Return]
9 IMMUNOLOGY RESEARCH, Vol. 20, 1999, pp.147-161 [Return]
10 ALTERNATIVE MEDICINE REVIEW, Vol. 8, No. 3, August 2003, pp. 223-246 [Return]
11 CLINICAL OPINION IN CLINICAL ALLERGY and IMMUNOLOGY, Vol. 3, No. 3, 2003, pp.199-203 [Return]
12 JOURNAL of ALLERGY and CLINICAL IMMUNOLOGY, Vol. 113, No. 3, 2004, pp. 395-400 [Return]
13 JOURNAL of ALLERGY and CLINICAL IMMUNOLOGY, Vol. 111, 2003, pp. 450-463 [Return]
14 ANNUAL REVIEW OF MEDICINE, Vol. 53, 2002, pp. 477-498 [Return]
15 RESPIRATORY RESEARCH, Vol. 2, No. 2, 2001, pp. 80-84 [Return]
16 CLINICAL and EXPERIMENTAL ALLERGY, Vol. 32, No. 5, 2002, pp. 796-802 [Return]
17 SCANDANAVIAN JOURNAL of RHEUMATOLOGY, Vol. 27, No. 3, 1998, pp. 219-224 [Return]
18 WORLD JOURNAL of SURGERY, Vol. 22, No. 4, 1998, pp. 382-389 [Return]
19 ANNALS of ASTHMA, ALLERGY and IMMUNOLOGY, Vol. 6, No. 6 Suppl 3, 2003, pp. 71-76 [Return]
20 INTERNATIONAL REVIEW OF NEUROBIOLOGY, Vol. 71, 2005, pp. 317-341 [Return]
21 JOURNAL of AUTOIMMUNITY, Vol. 11, No. 6, 1998, pp. 635-642 [Return]
22 JOURNAL of IMMUNOLOGY, Vol. 162, No. 5, 1999, pp.2511-2520 [Return]
23 BAILLERE’S BEST PRACTICE & RESEARCH. CLINICAL RHEUMATOLOGY, Vol. 15, No. 5, 2001, pp. 677-691 [Return]
24 BRAZILIAN JOURNAL of MEDICAL and BIOLOGICAL RESEARCH, Vol. 31, No. 1, 1998, pp. 55-60 [Return]
25 IMMUNOLOGIC RESEARCH, Vol. 23, No. 1, 2001, pp. 59-74 [Return]
26 INFLAMMATORY BOWEL DISEASE, Vol. 12, Suppl 1, 2006, pp. S3-9 [Return]
27 JOURNAL of NEUROIMMUNOLOGY, Vol. 172, No. 1-2, 2006, pp. 198-205 [Return]
28 JOURNAL of PEDIATRICS, Vol. 146, No. 5, 2005, pp. 605-610 [Return]
29 CRITICAL REVIEWS in IMMUNOLOGY, Vol. 25, No. 2, 2005, pp. 75-102 [Return]
30 http://www.environmentaldefense.org [Return]
31 http://www.cdc.gov/ncbddd/autism/documents/AutismCommunityReport.pdf [Return]

Autism itself is not the enemy

2011-03-23T12:10:00.001-07:00

Autism itself is not the enemy… the barriers to development that are included with autism are the enemy. The retardation that springs from a lack of development is the enemy. The sensory problems that are often themselves the barriers are the enemy. These things are not part of who the child is… they are barriers to who the child is meant to be, according to the developmental blueprint. Work with the child’s strengths to overcome the weaknesses, and work within the autism, not against it, to overcome the developmental barriers. You do not have to wipe all of us out (“cure autism”) to solve the problems that the low-functioning autistics face. As I see it, autistics are another kind of person, almost like another species, that has an unfortunately high rate of sensory dysfunction and resultant mental retardation in its children. You do not have to get rid of the whole group (again, by that, I mean curing autism) to get rid of the retardation that is all too common among my kind. That would be like trying to get rid of sickle-cell anemia by “curing” blackness (eliminating blacks). We have too much to offer society for that to be allowed to happen… if we are helped to develop as much as possible. I think that is a great and wonderful goal, and I hope you will agree.”

From an Autistic Patient

This is chiropractic’s greatest challenge and opportunity for increasing human potential.

2011-03-22T20:48:00.000-07:00

The central theory of biology is evolution through natural selection. Frankly, if we assume a stationary environment, natural selection improves the ability of an average organism to reproduce fertile offspring. But the internal and external environment is certainly not stationary. Since internal and external resources are limited and finite, organisms evolve as compromises. Most of these compromises can be expressed in terms of energy efficiency. Consequently we arrive at the notion of natural selection as an energy efficiency optimization process. These plastic changes have to happen at the microscopic cellular level (DNA expression) and globally in neural connections and signaling.

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 and other resources needed by the neuron to process and communicate information. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP (and other energy resources such as lactate) to the areas of greatest physiological need in the CNS. Or the CNS will ‘turn off’ or mute metabolically expensive processing programs. This is neurophysiological partitioning.

Immediate energy-efficient processing of information can explain seemingly isolated physiological processes. The energy used for signaling (communication & processing) constrains the flow of information within cells and between cells and regions in the CNS.

In the context of energy, neural processing is rather expensive. The adult human brain accounts for 20 percent or more of the body’s total energy use (metabolic costs). In young children, whose brains are nearly as large as an adult, the energy use by this organ can account for nearly 50 percent of the ATP use. Recent studies have shown that 85 percent of the energy used by the brain goes toward restoring the ion fluxes across neuronal membranes that are the biophysical basis of computation and communication in the neocortex. Thus signaling, processing, filtering, controlling, filtering, summing, integrating and management of incoming information account for up to 85 percent of the energy used by the brain.

Thus information processing, although perhaps five or six orders of magnitude more energy efficient than man-made computation, is a considerable expense for the organism.

Energy usage is decisively coupled to neuronal performance in the immediate, during the organism’s lifetime and over the natural selection process over millions of years. The evidence is strong that neuronal processing has evolved to be metabolically efficient.

Because of such energy costs, natural selection has optimized energy use as well as information processing in constructing the way neurons compute and communicate. Our survival and dominance as a species is dependent on the energy efficiency of CNS processing. The large metabolic costs of neural processing and CNS signaling suggest that efficiency is fundamental for survival. Neurons are unable to generate enough energy to meet the requirements of maximal physiological activity. Energy limitation is a factor in shaping the normal operation of the brains circuitry. A process requiring less energy is preferred to a process requiring more energy. The process is forced to become efficient or is eliminated.

Energy metabolism is central to life because cells cannot exist without an adequate supply of ATP. The CNS is particularly sensitive to any disturbances in energy generation and even short term interruption can lead to long lasting damage. Understanding the relations between energy metabolism and function during brain development has not only enormous theoretical but also practical implications for the human race.

This is chiropractic’s greatest challenge and opportunity for increasing human potential. Increasing the efficiency of CNS processing is the chiropractor’s true goal.

Neurophysiological partitioning

2011-03-22T20:46:00.000-07:00

I have heard it said many times—only by chiropractors—that an adjustment could never do harm or damage. But this does not follow the theory that if the chiropractic adjustment can be a powerful force for health improvement, then it can also have deleterious effects if improperly applied. The pain may abate at L5 but do we know for sure that we have not caused non-physiological neurophysiological partitioning of energy elsewhere? Neurophysiological partitioning is the shunting of available ATP and energy resources from one functional area of the CNS to the currently most important component of the brain. Did we get rid of the LBP but cause the patient heart arrhythmias months later? Did we leave the patients basic physiological processes (breathing, heart rate, blood pressure) in an improved state after each adjustment?

the human body intrinsically has more knowledge than the chiropractor

2011-03-22T20:43:00.000-07:00

Interestingly, those chiropractors that perform manipulation under anesthesia (MUA) know firsthand that these listings (those slight rotations on X-Ray) disappear when the motor cortex is inhibited. Perhaps, those wedges and high spots are physiological adaptations rather than lesions. Perhaps, pain going down the right lower extremity with a rotated L5 on the right does not equate to an adjustment of L5 on the right. The human body that has been adapting to the internal and external environment constantly for 6.2 million years just may need that rotated L5 to maintain its survival tendency.

Even in the pain-free population I have never seen a model-perfect spine. Even after 10,000 patients. I don’t think my next 10,000 will be statistically different. This model, with perfectly aligned spinous processes, only exists in chiropractic textbook drawings and one or two film studies that are included in textbooks.

My conviction to help more patients forced me to read the neurological theory, evolutional biology and neuroscience texts more carefully. I also looked into the study of education and learning theory in Western nations and realized that we had long ago abandoned the teaching of critical thinking and logic in secondary schools, not to mention teaching logic in our colleges and health care programs.

If the human body is truly a self-regulating, self-adapting machine that is constantly adapting to the internal and external environment at all times and has been for the last 6.2 million years, then perhaps the human body intrinsically has more knowledge than the chiropractor about the whys and reasons for the chronically misaligned L5.

Cranial motion

2011-03-22T20:40:00.001-07:00

Cranial motion was introduced to the osteopathic profession by William G. Sutherland, DO, in the 1920’s. Sutherland was inspired by the 18th century philosopher and scientist Emmanuel Swedenborg, who described a rhythmic expansion and contraction of the brain.1 Using, first, self-experimentation and, later, working on others, Sutherland discovered and described, in great detail, the rhythmic movement of the individual cranial bones and the skull, as a whole. He is considered the father of cranial osteopathy.

Why are we taught cranial bones don’t move?

2011-03-22T20:37:00.000-07:00

Why are we taught cranial bones don’t move?

Dr. Upledger was lecturing and demonstrating CST to a medical audience in Israel when he noticed that his statement on cranial bone movement didn’t get the dramatic (skeptical)
response he’d received from American medical audiences. He mentioned this to his host, who brought him to the hospital library and showed him an Italian anatomy book. His host translated: “Italian anatomists, in the early 1900’s, taught that cranial suture ossification was pathological in the mature human adult. These teachings, therefore, contradict the British anatomists, who taught the doctrine of sutural ossification and cranial immobility as a normal condition.

“You Americans learned your anatomy from English and German texts which state the skull bones don’t move. The Italian anatomists did not hold to that doctrine,” stated his host.

nature’s most unique and beautiful biological organism

2011-03-22T03:40:00.000-07:00

After many years of chiropractic practice, I stopped looking at symptoms, diagnoses, subluxation patterns, and unpredictability of treatment and began to gaze in disbelief at what I had been missing in thousands of patients: The human body, controlled by the nervous system, is nature’s most unique and beautiful biological organism. It is designed and driven for a purpose.

Brains are evolution’s answer to the fundamental necessity to collect, transmit process and store information. The nervous system has developed to identify signals, detect patterns, manage inputs and outputs, produce patterns in space and time and store information. Nervous systems develop and expand a set of molecular mechanisms for intra- and intercellular communication that enable living systems to organize components and achieve homeostasis. Because nervous systems are specialized for speed, efficiency and wide-scale integration, the molecular, cellular and system wide constraints that determine signaling and computation in complex systems is obvious. Nervous system information theory stipulates that in the nervous system, noise (ineffectual signals), response range (physiological capacity) and speed of response are the most researched constraints to processing information in the nervous system processing.

A more obvious constraint, metabolic & local resource cost has just been ‘discovered’. Humans are slow to discover the obvious, especially the purpose of life.

CNS processing

2011-03-14T18:07:00.001-07:00

This is chiropractic’s greatest challenge and opportunity for increasing human potential. Increasing the efficiency of CNS processing is the chiropractor’s true goal.

How did the chiropractic profession get to where it is today, as believed by the public and many allopathic chiropractors, as a pain-care modality?

neuronal performance

2011-03-14T18:06:00.001-07:00

energy efficiency of neural communication

2011-03-14T14:23:00.001-07:00

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.

chronic intermittent hypoxia

2011-03-08T18:42:00.000-08:00

In conclusion, CIH leads to hypercholesterolemia and lipid peroxidation in the absence of obesity, and the degree of metabolic dysregulation is dependent on the severity of the hypoxic stimulus.

Abnormal breathing Patterns

2011-03-08T16:46:00.000-08:00

Abnormal breathing patterns have been shown to
cause breathlessness, chest tightness, chest pain,
lightheadedness, paraesthesiae, and anxiety.

The CNS Efficiency Model of the Chiropractic Subluxation Theory

2011-03-02T03:40:00.001-08:00

Chiropractic traditionally uses static structure to diagnose dynamic functional loss. Segmental and Postural Chiropractic techniques presuppose that structural correction (by our imposed standards) will lead to functional improvement. The overriding belief is poor structure leads to poor function. Yet everyday we see cases that defy this underlying belief. Clinical cases were dysfunction and pain are not in doubt but the structure is grossly normal. Also everyday we see cases were structure, as verified by MR and other objective tests, is grossly abnormal yet the functional performance of the individual is above what would be considered normal for normal structure.

Does structure determine function or does function determine structure, or does each determine the other, and if the latter, how can it be? The answers to these questions seem to be matters of definition, personal paradigm and recognition of the driving purpose of the natural order.

In the inorganic world, structure may be regarded merely as a mechanical collocation of parts in a whole. But in the biological world, structure is a mechanical collocation of parts adapted to an end.

One cannot argue that “structure leads to function” is a popular belief yet when evolutionary forces are considered one is drawn to concepts such as Wolff’s Law: Function precedes structure. A look at biology gives the clinician a unique understanding. That understanding is that efficient function and behavior in the external environment leads to adaptable structure through natural selection. Saving and economic use of resources drives the individual and the species. Efficient function with available finite resources determines the survival of an individual. With enough time and offspring, structure adapts to save resources and energy. What can be said definitively is that structure and function are interdependent with the biologic drive of survival being efficient utilization of available resources.

Another Model of the VSC

The brain seems to be run by a program that says, “Do it in the most efficient way.” In all of its functions, the brain seeks optimum metabolic (energy) efficiency, or the path of least resistance. If one particular function is not accessible, the brain will automatically go on to the next most efficient process for doing that particular task. If the second task is not available, it will go on to the third or the fourth most efficient way. Because each alternative process is less efficient, it becomes more stressful and energy expensive.

The brain will keep searching for an appropriate processing method, until eventually the activity may become so metabolically inefficient that the brain will either strengthen the program to make it more efficient through neuroplasticity or not run the program at all. The individual will decrease the energy partitioning to that process, making this activity minimized or force the program to be more efficient. Disease and dysfunction depend on whether the strengthened program is physiological or pathological. If the program is not run, there could still be symptoms if the minimized program is physiological. It all depends on where the process is located in the physiological hierarchy.

A chiropractic subluxation is interference in the CNS summation, filtering and integration of sensory input leading to an inefficient output. The main challenge is the processing component.

The reason an adjustment is effective in the treatment of disease and dysfunction is due to the extensive network of connections possessed by the neuronal clusters in the composite thalamus and cortical maps representing and interacting with the chiropractic listing (the adjustable areas of the spine) in the periphery. This afferent information from the chiropractic adjustment gives the CNS just the right recipe to formulate and process more functional efficient local and global outputs

We now understand the biophysical, energy constraints and energy efficiency impulses that have governed the evolution of thalamo-cortical networks. To operate efficiently within these constraints, natural selection has optimized the structure and function of CNS networks with design principles similar to those used in electronic networks. The brain also exploits the adaptability of biological systems to reconfigure (neuroplasticity) in response to changing needs caused by the internal and external environment.

Shifts in neuronmodulation such as caused by chiropractic adjustments, exercise, yoga, positive mediation and diet or any other systematic constant afferent input help assure a favorable balance in the CNS of performance (processing, integration, summary and filtering) and metabolic efficiency.

In the subluxated patient, the brain is not processing or organizing the flow of sensory impulses in a manner that gives the individual good, precise information about himself or his world. Thus any efferent output will be inefficient and lead to eventual dysfunction and limitation.

The chiropractic subluxation is stress to the system that causes inefficient processing that leads to long-term pathology.

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 400 million year history of the evolution and development of the vertebrae brain. Working in synergy with this reality leads to incredible clinical results

Dr. Fred Clary

1752 Lexington Ave

Roseville, MN 55113

drfredclary@yahoo.com

Vitamins for the Mind by Jim Rohn

2011-03-02T03:37:00.001-08:00

Goals/Goal-Setting

The major reason for setting a goal is for what it makes of you to accomplish it. What it makes of you will always be the far-greater value than what you get.

When Andrew Carnegie died, they discovered a sheet of paper upon which he had written one of the major goals of his life: to spend the first half of his life accumulating money and to spend the last half of his life giving it all away. And he did!

Some people are disturbed by those tough days because all they have is the days. They haven't designed or described or defined the future.

Goals. There's no telling what you can do when you get inspired by them. There's no telling what you can do when you believe in them. And there's no telling what will happen when you act upon them.

We all need lots of powerful long-range goals to help us past the short-term obstacles.

The ultimate reason for setting goals is to entice you to become the person it takes to achieve them.

Don't set your goals too low. If you don't need much, you won't become much.

If you go to work on your goals, your goals will go to work on you. If you go to work on your plan, your plan will go to work on you. Whatever good things we build end up building us.

We all have two choices: We can make a living or we can design a life.

Thinking Like a Farmer by Jim Rohn

2011-03-01T04:55:00.001-08:00

One of the difficulties we face in our industrialized age is the fact we’ve lost our sense of seasons. Unlike the farmer whose priorities change with the seasons, we have become impervious to the natural rhythm of life. As a result, we have our priorities out of balance. Let me illustrate what I mean:

For a farmer, springtime is his most active time. It’s then when he must work around the clock, up before the sun and still toiling at the stroke of midnight. He must keep his equipment running at full capacity because he has but a small window of time for the planting of his crop. Eventually winter comes when there is less for him to do to keep him busy.

There is a lesson here. Learn to use the seasons of life. Decide when to pour it on and when to ease back, when to take advantage and when to let things ride. It’s easy to keep going from nine to five year in and year out and lose a natural sense of priorities and cycles. Don’t let one year blend into another in a seemingly endless parade of tasks and responsibilities. Keep your eye on your own seasons, lest you lose sight of value and substance.

CHANGE IT!

2011-03-01T03:35:00.000-08:00

One of the most powerful things you can do to live a happier and more successful life is to stop complaining. Starting today, make the decision to stop whining, stop complaining, and stop playing the victim. All of these actions will keep you from living a better, more positive life. They will also keep you from achieving your most important goals.

It is especially damaging to complain about things you can change but choose to do nothing about. Complaining about the cold weather is one thing; complaining about your job, your house, or your spouse is an entirely different thing. When you are at work, do you complain about your spouse? When you are at home, do you complain about your boss? How useless is that cycle? How about you make the hard decisions and go to your boss and explain what you don't like about how he runs your department. How about you sit down with your spouse and tell them what is missing in your relationship.

Doing either of these things is way more productive and will result in some action! If your boss continues to drive you nuts, you can decide to look for a new job knowing your concerns will not be addressed. If your spouse clearly understands your concerns, maybe then you can begin to fix the relationship. If not, you can begin to look for a more loving partner.

Make it your priority today to stop complaining about the things you can change. If you don't like your home, your job, your car, your career, or your financial position... CHANGE IT! Everything is 100 percent your responsibility. You have either created everything in your life or allowed everything to happen to you.

The CNS Efficiency Model of the Chiropractic Subluxation Theory

2011-02-26T17:40:00.000-08:00

Another Model of the VSC

A chiropractic subluxation is interference in the CNS summation, filtering and integration of sensory input leading to an inefficient output. The main challenge is the processing component.

The chiropractic subluxation is stress to the system that causes inefficient processing that can lead to long-term pathology.

Any inefficient neurological program

2011-02-24T05:05:00.001-08:00

Any inefficient neurological program would lead to inefficient physiological processes, thus producing decreased survival capacity for the individual, offspring and/or species. The metabolic cost of neural information processing has been neglected by theorists attempting to understand the basic mechanisms of brain function. The large metabolic cost of neural processing implies that metabolic and local physiologic efficiencies will be critical for a mammal’s survival and adaptation over 240 million years of natural selection and physiological refinement and 6.2 million years of improvements for a human.

Consequently, the patient that comes in with a chronic (not acute) L5 right rotation should be considered a magnificent adapted machine geared towards energy efficiency. By removing our allopathic goggles and looking from a vitalistic viewpoint at the human body, the chronic L5 right rotation can be seen as the best short-term energy-efficient adaptation that 6.2 million years of evolution, modification, enhancement and survival through immediate energy efficiency could marshal. With these conclusions, I stopped seeing chronic short legs and a chronic L5RR as subluxations in all cases but perhaps adaptations of an efficient body doing the best it could to conserve energy in the here and now. Although a few weeks, months or years down the road the body could be damaged by these adaptations, energy efficiency of CNS processing in the immediate is the primary purpose of life.

Ground Reaction Force

2011-02-24T04:57:00.000-08:00

Ground Reaction Force: The reaction to the force you exert on the ground and is the most important external force acting on human motion

Potentially the most damaging force affecting human motion

Such as, if you jumped off the bottom step of a staircase and locked your knees

Example:

If you drop a basketball on cement, it absorbs the force and bounces

If you drop a glass bottle, it shatters

Thoughts!

2011-02-20T18:37:00.000-08:00

Ajit Varki : I would agree with that. That would imply, then,
that we are caught in a feedback loop where we’re very
dependent, that is, our systems are designed to expect
certain environments to come back to us.

Steven Pinker: Yes.

Ajit Varki : But those environments are not consisting of
molecules or pH or anything like that. They’re consisting
of the input from the prior generations.

The Ant Philosophy by Jim Rohn

2011-02-20T18:30:00.001-08:00

Over the years, I've been teaching kids about a simple but powerful concept: the Ant Philosophy. I think everybody should study ants. They have an amazing four-part philosophy.

Here is the first part: Ants never quit. That's a good philosophy. If they're headed somewhere and you try to stop them, they'll look for another way. They'll climb over. They'll climb under. They'll climb around. They keep looking for another way. What a neat philosophy-to never quit looking for a way to get where you're supposed to go.

Second, ants think winter all summer. That's an important perspective. You can't be so naive as to think summer will last forever. So ants gather their winter food in the middle of summer.

An ancient story says, "Don't build your house on the sand in the summer." Why do we need that advice? Because it is important to think ahead. In the summer, you've got to think storm. You've got to think rocks as you enjoy the sand and sun.

The third part of the Ant Philosophy is that ants think summer all winter. That is so important. During the winter, ants remind themselves, "This won't last long; we'll soon be out of here." And the first warm day, the ants are out. If it turns cold again, they'll dive back down, but then they come out the first warm day. They can't wait to get out.

And here's the last part of the ant philosophy. How much will an ant gather during the summer to prepare for the winter? All he possibly can. What an incredible philosophy, the "all-you-possibly-can" philosophy.

Wow, what a great philosophy to have-the ant philosophy. Never give up, look ahead, stay positive and do all you can.

Five Major Pieces to the Life Puzzle

2011-02-20T18:27:00.000-08:00

Jim Rohn's book Five Major Pieces to the Life Puzzle, published in 1991, was built around what he considered the five components of success:

Philosophy - how you think
Attitude - how you feel
Action - what you do
Results - measure often to see if you are making progress
Lifestyle - the kind of life you can make for yourself out of the first four pieces

Tesla!

2011-02-17T10:32:00.001-08:00

Nikola Tesla

The Forgotten Father of Today

One of the greatest minds of the 19th and 20th centuries, responsible for today's modern world, Nikola Tesla is still virtually unknown to today's textbooks, teachers, and general public. Thinking back to your high school years and looking through an encyclopedia, who do you remember as the inventor of radio? The name that probably comes to mind is Marconi. And if I asked the same about X-rays, you'd probably say Roentgen. And a vacuum tube amp, probably de Forest. While you're at it, who invented the florescent bulb, neon lights, speedometer, auto ignition system, and the basics behind radar, the electron microscope, and the microwave oven? Chances are you see little, if any, mentions of Tesla. Very few people today have ever even heard of him. The all-around nice guy Thomas Edison made sure of that. Nikola Tesla was born in Smijlan, Croatia (now Yugoslavia) in 1858. Young Nikola had a great memory and spoke six languages. He spent four years at the Polytechnic Institute at Gratz studying math, physics, and mechanics. The amazing thing about him was that he had a great understanding of electricity (remember that this was at a time when electricity was still at infancy, the electric light bulb hadn't even been invented yet). Tesla moved to the United States in 1884. When he arrived, he worked as an assistant to Thomas Edison, then in his late 30's. Edison had just invented the electric light bulb, but he needed a system to distribute electricity to houses. He designed a DC (direct current) system, but it had many bugs in it. Edison promised Tesla lots of money in bonuses if he could get the bugs out. Tesla took the challenge and ended up saving Edison over $100,000, which was millions of dollars by today's standards. Edison later refused to keep his promise. Tesla quit not long after that, and Edison spent the rest of his life trying to discredit Tesla (which is the main reason why he is so unknown today). In 1888, Tesla devised a better system of transmission, the AC (alternating current) system used in houses around the world today. By using Tesla's newly developed transformers, AC could be stepped up and transmitted over long distances through thin wires. Edison's DC couldn't be stepped up, required a large power plant every square mile and thick cables for transmission. Electricity is useless if it can't do anything, so in 1890, Tesla invented a motor to run on AC, the same type of motor used in every household appliance today. Scientists of the late 1880's were convinced that no motor could work with AC. After all, AC electricity reverses itself 60 times a second, so all previous motors would just rock back and forth 60 times a second. Tesla solved this problem and proved them all wrong. Word of AC eventually got to George Westinghouse. In 1893, Tesla signed a contract with Westinghouse to get $2.50 per Kilowatt of AC sold. Nikola finally had the money to conduct all of the experiments that he had dreamt of.

Tesla developed and used florescent bulbs in his lab some 40 years before industry "invented" them. At the World's Fair, Tesla took glass tubes and bent them into famous scientists' names- the first neon signs. Tesla also designed the world's first hydroelectric plant at Niagara Falls in 1895. Tesla also patented the first speedometer for cars in 1916. In fact, Tesla invented all of the things that are listed at the beginning of the paper. But Edison soon had too much money invested into his DC system, and he tried his best to discredit Tesla by showing that AC was more dangerous than DC. Edison paid local children 25 cents for each stray dog they could bring him. Then he would hold press conferences and electrocute the dogs at public gatherings to frighten people. He claimed that DC could not kill, but in fact, it could. Below is a drawing from 1889 of a horse being electrocuted in Edison's Menlo Park Laboratory.
Edison felt that it was necessary to experiment by killing animals before he could guarantee his electric chair would kill efficiently. Yes, it was actually Edison who invented the electric chair to frighten people away from Tesla's AC system, as shown in the below drawing from 1890.
But Tesla counteracted by staging his own marketing campaign. At the 1893 World Exposition in Chicago, attended by 21 million, Tesla demonstrated the safety of AC by passing high frequency AC through his body to power light bulbs. He was then able to shoot large lightning bolts into the crowd without harm. When royalties owed to him by Westinghouse exceeded $1 million, Westinghouse ran into financial trouble. Tesla realized that if he kept his contract, Westinghouse would go out of business, so Tesla took his contract and ripped it up! Instead of becoming the first billionaire, he got $216,600 outright for his patents. In 1898, Tesla demonstrated the first remote controlled model boat at Madison Square Garden. After all of these technological breakthroughs, Tesla still had not achieved his lifelong dream. All Tesla's life, he had dreamt of free wireless energy and other signals to the world. In 1900, Tesla was backed with $150,000 from J. P. Morgan. Tesla began construction of "Wireless Broadcasting System" tower on Long Island, New York. Tesla intended to use it to link the world's telephone and telegraph and to transmit pictures, stock reports, and weather information.
When Morgan found out that it meant FREE energy, he cut Tesla's funding. There is still a lot of controversy to what happened to Tesla's original tower. One story says that the government tore it down during World War I for fear that the German U-boat spies would use the tower as landmark to navigate by. Another story says that Tesla ran into financial trouble and sold the tower for scrap to pay off creditors. The world thought that Tesla was crazy. Transmission of voice and pictures was unheard of in that time. What they didn't know is that he had already demonstrated the principals behind radio nearly ten years before Marconi's supposed invention. In 1943, the year that Tesla died, the Supreme Court ruled that Marconi's patents invalid due to Tesla's previous descriptions, but yet most textbooks and encyclopedias credit Marconi. The Press started to exaggerate Tesla's claims. Tesla reported that he received radio signals from Mars and Venus. Today we know that these were really signals from distant pulsing stars. In his Manhattan lab, Tesla made Earth into and electric tuning fork. He made a steam driven oscillator vibrate at the frequency of the ground beneath him. The result was a small earthquake in the surrounding city blocks. It was here that he contended that in theory, he could do the same to even split the earth in two. He accurately determined the resonant frequency of Earth almost 60 years before science could confirm it. In his Colorado Springs, Colorado lab, in 1899, Tesla made what he thought was his biggest discovery ever-- terrestrial stationary waves. He sent waves of energy through Earth that bounced back to the source. When they came back, he added more electricity to it. He lighted 200 lamps without wires from a distance of 25 miles and created the biggest man-made lightning bolt ever, 130ft. long! That's a world record still unbroken. Strange electrical things happened near that lab. People would walk near the lab, and sparks would jump up from the ground to their feet One boy took a screwdriver, held it near a fire hydrant, and drew a four inch electrical spark from the hydrant. Sometimes the grass around his lab would glow with an eerie blue corona, St. Elmo's Fire. What they didn't know was this was small stuff. The man in the lab was merely tuning up his apparatus. Unfortunately, he blew out some of the power plant's equipment and was never able to repeat his experiment. At the beginning of World War I, the government desperately searched for a way to detect German submarines. The government put Thomas Edison in charge of the search for a good method. Tesla proposed the use of energy waves - what we know today as radar - to detect these ships. Edison rejected Tesla's idea as ludicrous and the world had to wait another 25 years until it was invented. What was his reward for a lifetime of creativity? The prized (to everyone but Tesla) Edison Medal! A real slap in the face after all the verbal abuse Tesla took from Edison. Lacking capital, he was forced to place his untested theories into countless notebooks. The man who invented the modern world died nearly penniless at age 86 on January 7, 1943. More than two thousand people attended his funeral. In his lifetime, Tesla received over 800 different patents. He probably would have exceeded Edison's record number if he wasn't always broke - he could afford very few patent applications during the last thirty years of his life. Unlike Edison, Tesla was an original thinker whose ideas typically had no precedent in science. Unfortunately, the world does not financially reward people of Tesla's originality. We only award those that take these concepts and turn them into a new, useful product. Scientists today continue to scour through his notes. Many of his far-flung theories are just now being proven by our top scientists. For example, the Tesla bladeless disk turbine engine that he designed, when coupled with modern materials, is proving to be among the most efficient motors ever designed. His 1901 patented experiments with cryogenic liquids and electricity provide the foundation for modern superconductors. He talked about experiments that suggested particles with fractional charges of an electron - something that scientists in 1977 finally discovered - quarks! Tesla was one of the world's most original and greatest inventors and thinkers, but because he was so original and out of his time, his genius was mistaken for insanity and science fiction. Maybe next time, the world will recognize a true genius when it comes around.

If the CNS is damaged

2011-02-14T18:02:00.001-08:00

If the CNS is damaged, there will of necessity be a compensation by other parts of the system, which can be either positive or negative, and can be shaped by experience.

New View of Thalamic Functioning

2011-02-14T17:43:00.001-08:00

A consideration of the complexity of thalamic cell and circuit properties puts a lie to the old notion that thalamus represents a simple, machine-like relay of information to cortex. We can now be certain of two major concepts to replace this. The first is that the thalamus represents a last bottleneck of information flow, providing a convenient substrate to influence that flow. This is achieved by the many modulatory pathways that innervate relay cells to influence relay function in numerous ways. One detailed above is the burst/tonic transition in the firing mode of relay cells, but this is just the tip of the iceberg. We need much more information about the many ways thalamic circuitry controls information flow to cortex.

The second point is that the role of thalamus is not limited to getting information to cortex in the first place, which is the role of first order relays, but also continues to function in the higher order cortico-thalamo-cortical pathways, thereby providing an essential, ongoing function for cortical processing. This dramatically alters long-standing views of cortical processing, and we need to know much more about the different roles of cortico-thalamo-cortical versus direct corticocortical pathways in cortical functioning.

Exploring the Thalamus and Its Role in Cortical Function

2011-02-14T17:40:00.001-08:00

Exploring the Thalamus and Its Role in Cortical Function, Second Edition
S. Murray Sherman and R. W. Guillery

The thalamus plays a critical role in perceptual processing, but many questions remain about what thalamic activities contribute to sensory and motor functions. In this book, two pioneers in research on the thalamus examine the close two-way relationships between thalamus and cerebral cortex and look at the distinctive functions of the links between the thalamus and the rest of the brain. Countering the dominant "corticocentric" approach to understanding the cerebral cortex—which does not recognize that all neocortical areas receive important inputs from the thalamus and send outputs to lower motor centers—S. Murray Sherman and R. W. Guillery argue for a reappraisal of the way we think about the cortex and its interactions with the rest of the brain.

The book defines some of the functional categories critical to understanding thalamic functions, including the distinctions between drivers (pathways that carry messages to the cortex) and modulators (which can change the pattern of transmission) and between first-order and higher-order thalamic relays—the former receiving ascending drivers and the latter receiving cortical drivers. This second edition further develops these distinctions with expanded emphasis throughout the book on the role of the thalamus in cortical function. An important new chapter suggests a structural basis for linking perception and action, supplying supporting evidence for a link often overlooked in current views of perceptual processing.

About the Authors

S. Murray Sherman is Professor and Chair of the Department of Neurology, Neurobiology, Pharmacology, and Physiology at the University of Chicago.

R. W. Guillery is Emeritus Professor in the Department of Anatomy at the University of W

Stroke warning signs

2011-02-14T17:36:00.000-08:00

: Call 911

Warning signs of stroke may last a short time and disappear. They are often present when you wake up. These are signs of a serious medical condition.

If you have any of these symptoms, call 911 right away:

weakness - sudden or temporary weakness, numbness or paralysis in an arm, hand, leg or facial muscles, usually only on one side of the body
vision - sudden blurred double vision or dimness in one or both of the eyes
confusion - sudden confusion, trouble speaking or understanding language, or thinking
loss of balance - sudden clumsiness, loss of balance or dizziness
headache - sudden severe headache: the worst headache of your life

The secret to a successful life

2011-02-08T19:41:00.000-08:00

The secret to a successful life....Win some, lose some, learn always!... & apply that learning to the next step in your growth & contribution.

Thots

2011-01-31T06:48:00.001-08:00

The nervous system, with its sensory organs being at first genetically determined, constitutes the first set of biological filters that distinguishes external reality from our internal representation of that same reality. Furthermore, our genetically endowed biological limitations allow us to understand only a small portion of the true nature of human functionality. This is in part because our emotional development is so evenly correlated to our physical development. This correlation exists not only in a physiological capacity, but also in a psychological one. For example, from the moment an individual identifies with his body, and becomes aware of his surrounding environment, the rising level of emotional cognizance creates an existential need to survive, along with a powerful fear of death. This is the level in which man's emotional and thought processes, as well as his personal will, first begin to develop. For instance, the period in which an infant begins to develop the capacity to differentiate between himself and his surroundings is most often the same period in which the child’s motor skills begin to develop. The child starts to walk and to talk and at the same time, and becomes more emotionally separated from others due to an increased sense of awareness and independence.

All of the answers will be found in simple and repeating events

2011-01-31T06:43:00.000-08:00

Thought of the week:

The evolution of a nervous system: All of the answers will be found in simple and repeating events that can make the complexity possible.

Why? How?

Thank You

2011-01-31T06:22:00.000-08:00

Thank You to all the doctors at the Inaugural FACT Certification Series Weekend.

http://www.fettermanevents.com/FACTCertification.html

I appreciate your tolerance and patience as we work out the rough edges from the seminars. It was a great learning lesson for me, although I received plenty of accolades and warm comments, and a growing experience. It is my profound wish that if the students just apply one or two concepts, their practice members will benefit!

My apologies (LOL) to those doctors that are starting to attract dystonia, CP, strokes, brain injuries ans seizures! Welcome to the matrix!

Functional Analysis Chiropractic Technique Certification Quiz 1.0

2011-01-28T06:48:00.000-08:00

Functional Analysis Chiropractic Technique Certification Quiz 1.0

1) What is the definition of Tone?

2) What is the definition of Reductionism?

3) What is the definition of Thalamic Integration and Filtering?

4) What is the definition of Neurophysiological Partitioning?

5) What is the definition of Neuroplasticity ?

6) What is the definition of Dysponesis?

7) What is the definition of Adaptation?

8) Explain the assessment of Breathing Mechanics at Initiation.

9) Explain the assessment of Gait by a tonal method.

10) Explain the 3 Classifications of Chiropractic Technique.

11) Explain Efficient Use of Energy by the CNS.

12) Explain Neurological rehabilitation vs Physical Therapy in the Bobath Model. (What makes this model different)

13) All epidemiology studies directly point to Breathing Efficiency as a Long Term predictor of Mortality in the General Population. Why?

14) Explain why a segmental or postural adjustment may have a long term deleterious effect.

The Bobath Concept

2011-01-25T08:25:00.001-08:00

Any discussion of the Bobath Concept requires a common understanding of what the Bobath Concept is. In an interview almost twenty years ago, Bobath explained it this way: "......... A whole new way of thinking, observing, interpreting what the patient is doing, then adjusting what we do in the way of techniques- to see and feel what is necessary, possible for them to achieve. We do not teach movements, we make them possible........." (Bobath, 1981). It was also made clear that Bobath was not a method or technique, not limiting, but fluid; was not rigid but changing, and still changing. The Concept can be summarised as follows: It is primarily a way of observing, analysing and interpreting task performance. This also includes the assessment of the client's potential, which was considered to be that task or those activities which could be performed by the person with a little help, and therefore possible for that person to achieve independently where possible. Of course the Concept also involves the use of various techniques, and Bobath always advocated that the therapist should- "do what works the best" (Bobath, 1978). In the present day, this should mean, that therapy is based on sound evidence when it is available, while recognising that currently much of what therapists do has not been evaluated. This does not mean that these therapy strategies should be discarded, but does mean that they require investigation and possibly an alternative explanation of their effect. There is evidence to support some of what therapists do, but there are still many unanswered questions. For the Bobath therapist, there is also the dilemma of what it means to be a Bobath therapist. A study by Davidson and Waters (2000) showed that 88% of neurological physiotherapists in the UK use the Bobath approach. But, it depends on when you trained, where and who with. I very much doubt that those 88% of the therapists surveyed would explain or clinically apply the Bobath Concept with any degree of similarity.

When therapists attending the paediatric course at the Bobath Centre are asked what Bobath, the reply usually concerns the use of techniques of inhibition of abnormal tone and movement patterns, facilitation of more normal movement, and possibly stimulation in cases of hypotonia or muscle inactivity. These techniques should not be considered to be Bobath, and yet for most therapists Bobath these techniques are Bobath. Given the diverse understanding of the Bobath Concept, it seems important to ask this question: Is Bobath a relevant therapy approach in the year 2000? It might be, but only if it is based on current scientific evidence, is actively finding ways to produce such evidence, and additionally an agreement to leave old ideas, such as the inhibition of spasticity, in the past. We need to have the courage to challenge our current practise and clinical reasoning. With this in mind, several of the assumptions underlying the Bobath Concept need to be re-evaluated. The following questions are intended in part to address some of the current issues facing therapists.

1. Is tone relevant? Bobath proposed that the main reason for reduced functional ability resulted from abnormalities of tone e.g. spasticity was thought to be due to abnormally increased tonic reflex activity and therefore could be inhibited. It is necessary to define what normal tone is in order to understand any deviation from that norm.

Tone is the resistance offered by muscles to continuous stretch (Brooks, 1986)

......... at complete rest a muscle has not lost its tone although there is no neuromuscular activity in it (Basmajan & De Luca, 1985)

Normal tone can be defined as a slight constant tension of healthy muscles (Kandel, Schwarz & Jessell, 1991)

A state of readiness (Bernstien, 1967)

These definitions suggest that tone comprises both neural (eg. Proprioceptive reflexes, and arousal level of the CNS) and non-neural (eg. visco-elastic properties of muscle) components. Commensurate with this idea, any abnormal tone will also demonstrate neural and non-neural changes. For many years, spasticity has been clearly defined by Lance (1980) as a velocity-dependent increase in stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of the upper motor neurone syndrome. The UMN which consists of positive symptoms (exaggeration phenomena such as hyperreflexia, extensor plantar response) and negative symptoms (functional deficits such as weakness, loss of dexterity) was described by Hughlings-Jackson (1954), and subsequently explained by Burke (1988) and Carr and Shepherd (1998). When viewed in this context, spasticity is often only a small component of the movement disorder, and in some cases can even be of functional value to the client, e.g. standing. We should conclude from the preceding discussion that spasticity and hypertonia are not the same. Spasticity is a part of hypertonia and of course they co-exist, but velocity dependent hyperreflexia does not usually in itself explain the clients movement disorder, and therefore simply reducing spasticity is not the solution for providing effective, evidence-based intervention. Therapists can reduce hypertonia, but can they by handling inhibit spasticity? The term inhibition was introduced by Bobath as a physiological explanation for the effect of handling on spasticity, based on the assumption that spasticity resulted from exaggerated / released, abnormal tonic reflexes and subsequently abnormal tonic reflex activity (Mayston 2001a). Although on passive movement spasticity is shown to be present by evidence of hyperreflexia, on voluntary movement there is usually an inability to generate sufficient electrical activity in the muscle (Ibrahim et al 1993). Inhibition physiologically is defined as a decrease in transmitter release, a way of moulding excitation and shaping the firing of action potentials, and is present at all levels of the CNS. But suggesting inhibition is a physiological explanation for what therapists achieve by handling is not scientifically correct. Therapists are effecting changes in both inhibitory and excitatory synapses simultaneously, but their "inhibition" also affects visco-elastic properties of muscle and by improving muscle length can gain a better biomechanical advantage for more efficient muscle action for the performance of functional tasks. Handling via stretch will of course affect and reduce muscle spindle firing and resultant abnormal reflex activity, but for any lasting effect of spasticity to be obtained the therapist must enable the client to perform more effective, efficient functional activity.

2. Muscle weakness is secondary to the problems of abnormal tone. For all their working life, the Bobaths considered that muscle weakness was a secondary problem to that of abnormal tone in the management of the neurologically impaired person. They assumed that when hypertonia was reduced the client would have near normal activity with which to function. This may be potentially true, but any person will know that disuse and lack of opportunity to activate muscles results in atrophy and weakness. More significantly, the person with an UMN lesion will most likely lose some of their voluntary drive onto the motoneurone pools in the spinal cord resulting in a lack of activation of muscles for action, despite exhibiting hyperreflexia at rest. Even those with significant velocity dependent hyperreflexia encounter difficulty in generating sufficient voluntary activity, rather than being limited by an exaggeration of abnormal muscle activity on attempts at self-generated activity.

Recent evidence suggests that weakness is a problem for the neurologically impaired adult and child (Bourbonnais & van der Noven 1989; Giuliani 1992). While therapists can work to increase strength by the use of activity, repetition and weight bearing, it has been shown that when used appropriately, strengthening can improve function and does not increase spasticity (Miller and Light 1997; Damiano and Abel 1998). This evidence suggests that therapists must direct more attention to the role of muscle strength and ways of improving it, for the rehabilitation / habilitation of the neurologically impaired person, of course with the proviso that the individual has sufficient muscle activity to participate in a strengthening regime.

3. Bobath proposed that working for normal movement patterns would lead to function. This idea has been misinterpreted by some to the extent that it is thought that the person with neurological impairment can become normal if only they receive the "right" therapy and do not make themselves spastic by overactivity or activity too early. Firstly, the CNS is highly task oriented in its organisation (Flament et al 1993; Ehrsson et al 2000), therefore movement patterns will not automatically lead to function- the function must be practised in the correct context. Secondly, there is no evidence to suggest that stopping a client from moving will stop the development of spasticity. My experience of working with Mrs Bobath was that the therapists role was to help the person function in the best way possible, helping them to counteract any unwanted increase in tone, not to stop them moving. While certain activities are not encouraged in some cases, the idea of stopping a client from moving, especially if they are motivated to do so, cannot be supported on financial, moral or scientific grounds.

Although learning movement patterns might be a part of the re-learning process, clients need the opportunity to practise functional, meaningful tasks if therapy is to be effective.

4. Related to this is the question of compensation. If the CNS is damaged, there will of necessity be a compensation by other parts of the system, which can be either positive or negative, and can be shaped by experience. Compensation means to take the place of that which is lost, but is understood in a variety of ways. For example, the person with hemiplegia will have to compensate with the sound side for the loss of function on the affected side if recovery is less than optimal. The person with spastic diplegia will overuse their upper body and limbs to compensate for the lack of useful activity of their lower limbs. The critical questions to ask are the following: how much of that compensation is necessary and how much can be avoided by training the affected body parts to function more effectively. It has long been part of the Bobath approach to restrain use of the less affected body parts manually during a therapy session to try and activate the affected body parts, e.g. Hold back the sound arm to force the use of the affected arm, providing there is activity for the person to work with. For the person with diplegia, it might mean, activating the legs without overuse of the upper body and arms e.g. to sit to stand without pushing on the arms. Support for this idea is found in the recent work of Taub (Taub, et al 1993; Taub & Wolf, 1997), described as Constraint Induced Therapy, or forced use. One of the basic ideas underlying the Bobath Concept is that each person with a neurological lesion has the potential for improved functional performance- this is one way that it might be achieved for clients who meet the criteria for inclusion in such a regime. I very much doubt that therapy can make a person normal- if so, their CNS had the potential for recovery and they would have been normal anyway (whatever normal is!). The CNS if damaged has to compensate, it is the therapists' job to guide the persons recovery so that they can achieve their maximal functional potential within the constraints of the damaged CNS. How soon and how much is unclear, but Tardieu (1988) states that a muscle must be stretched for 6 hours a day in order for length to be maintained; the clients receiving forced use therapy were trained for at least three hours a day. The work of Nudo (1996) and colleagues indicates that specifically training activity can enhance behavioural recovery and reduce the loss of secondary areas around the infarct. Forced use of the lower limbs by treadmill training has also been shown to be effective in improving function for both adults and children (Hesse et al 1994; Schindl et al, 2000). The caveat is of course, that the person can only enter this kind of regime if they have sufficient activity to utilise. Forced use in clients who have little or no activity may drive negative changes in the CNS and result in further loss of neural tissue around the original lesion site.

These are only a few of the considerations for the Bobath therapist in the light of changes in our understanding of the control of movement and changes in the clinical presentation of clients. It is essential to continuously read the available literature and to review our mode and frequency of therapy intervention. Carr and Shepherd (1998) have contributed much by their aggressive encouragement that we read the literature and act upon it. Their motor learning approach to optimise functional performance is of value in clients with a reasonable level of ability. But what about the less able client, and is the emphasis on training and biomechanics sufficient? It should be noted that their ideas for motor re-learning are predominantly based on data from healthy individuals. It is not known if those same principles can be directly applied to the neurologically impaired person.

I would like to propose some factors that we might take into account when planning an intervention programme.

Muscles need to be at the best length for activation. It is known that muscles generate the most efficient active force at a mid-length. For this reason alone it would seem important to gain alignment (see Fig. 1., Mayston 2001a). This may involve muscle stretching to achieve length, perhaps we could call it tone reduction, the judicious use of equipment and /or orthoses. Sustained muscle stretch may also prepare for more efficient muscle activity by reducing the effect of hypersensitive muscle spindles.

The muscle needs sufficient activity to generate force for action. In the case of reduced drive onto the motoneurone pool, there might need to be stimulation of muscle activity through the use of weight bearing, resistance, sensory stimulation in appropriate postures and patterns to enable the person to have a sufficient basis for the training of functional tasks. Splinting and orthoses may also be indicated to gain alignment, or a good weight-bearing base for improved proximal and truncal activity (Mayston 2001b).

This activity needs to be translated into functional, meaningful goals for that person. Bobath advocated specific preparation for specific function, which is another way of stating this principle of translating activity into function.

There needs to be opportunity for practise for learning/ re-learning to occur, either by the individual or with the help of carers.

Goals need to be realistic according to the client's potential and appropriate to the environment encountered during daily life.

These principles integrate with the main ideas of motor learning theory, which requires the active participation of the client. This is not new. Bobath in the 1960s stated that "unless you stimulate or activate your patient in the way in which new activities are possible, you have done nothing at all. So the handling techniques as such are only the very first step in treatment, though they are very important" (Bobath, 1965).

Secondly, motor learning emphasises the need for practise, also advocated by Bobath though perhaps less rigorously, by stressing the importance of home activities for the client. Thirdly, learning requires that there be meaningful goals, relevant to the client. This aspect of motor learning is now important, and at the Bobath Centre goals are set in collaboration with the client and their family (at least for each child) and their achievement is monitored using a variety of outcome measures.

In summary, the Bobath Concept states that each client has the potential for improved function and that we should work with our clients doing "what works the best". This requires an ongoing knowledge of current scientific motor control and rehabilitation literature, and courage to put old ideas in the past.

References:

Basmajan JV and De Luca, Carlo J 1985 Muscles Alive.

Their Functions Revealed by Electromyography Williams and Wilkins.

Chapter 10 and 11

Bernstein, N 1967 The Co-ordination and Regulation of Movements.

Oxford : Pergamon

Bobath B 1965 Notes on Reflex Inhibiting Postures.

Archival material, Bobath Centre, London.

Bobath B 1978 Course notes, Bobath paediatric 8-week course.

Bobath B & Bobath K 1981 Interview for NDTA. Baltimore.

Bourbonnais D & Van den Noven S 1989 Weakness in patients with hemiparesis.

American Journal of Occupational Therapy: 43: 676-685.

Brooks, Vernon (1986): Neural Basis of Motor Control.

Oxford University Press. Chapter 1,8

Burke D 1988 Spasticity as an adaptation to pyramidal tract injury.

Advances in neurology. Vol 47. Raven Press NY.

Carr J, Shepherd R 1998 Neurological Rehabilitation - optimizing motor performance.

Butterworth Heinemann, Oxford.

Damiano DL and Abel MF. 1998 Functional outcomes of strength training in spastic cerebral palsy.

Archives of Physical Medicine and Rehabilitation; 79: 119-25.

Davidson I, Waters K 2000 Physiotherapists working with stroke patients:

A national survey. Physiotherapy 86: 69-80.

Ehrsson HH, Fagergren A, Jonsson T, Westling G Johansson RS, Forssberg H. 2000 Cortical activity in precision versus power grip tasks: an fMRI study. Journal of Neurophysiology; 83: 528-536.

Flament D, Goldsmith P, Buckley CJ, Lemon RN. 1993 Task dependence of responses in first dorsal interosseous muscles to magnetic brain stimulation in man. Journal of Physiology (London); 464: 361-378.

Giuliani CA. 1992 Dorsal rhizotomy as a treatment for improving function in children with cerebral palsy. In: Movement Disorders in Children, ed. Forssberg H, Hirschfeld H. 247-254.

Hesse S, Bertelt CH, Schaffrin A, Malezik M, Mauritz KH. 1994 Restoration of gait in non-ambulatory patients by treadmill training with partial body-weight support. Archives of Physical Medicine and Rehabilitation; 75: 1087-1093.

Ibrahim IK, Berger W, Trippel M, Dietz V. 1993 Stretch-induced electromyographic activity and torque in spastic elbow muscles. Brain; 116:971-989.

Lance JW. 1980 Symposium synopsis. In: Spasticity: disordered motor control. Ed. Feldman RG, Young RR, Koella WO. Chicago: Year Book of Medical Publishers; 485-495.

Mayston MJ. (2001a) Setting the scene. In: Edwards S, ed, Neurological Physiotherapy - a Problem Solving Approach. 2nd edition, Churchill Livingstone. (in press).

Mayston MJ. (2001b) People with cerebral palsy: effects of and perspectives for therapy. Neural Plasticity (in press).

Miller GJT and Light KE 1997 Strength training in spastic hemiparesis: should it be avoided? Neurorehabilitation, 9, 17-28.

Nudo RJ, Wise BM, SiFuentes F, Milliken GW 1996 Neural substrates for the effects of rehabilitative training on motor recovery after ischaemic infarct. Science 272:1791- 1794

Schindl MR, Forster C, Kern H, Hesse S. 2000 Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy. Archives of Physical Medicine and Rehabilitation; 81: 301-306.

Tardieu C, Lespargot A, Tabary C, Bret MD. For how long must the soleus be stretched each day to prevent contracture? Developmental Medicine Child Neurology 1988; 30: 31-10.

Taub E, Miller NE, Novack TA 1993 A technique for improving chronic motor deficit after stroke. Archives of Physical Medicine and Rehabilitation, 74, 347-354

Taub E and Wolf SL 1997 Constraint induced techniques to facilitate upper extremity use in stroke patients. Topics in Stroke Rehabilitation 3: 38-61

Happiness

2011-01-25T08:22:00.001-08:00

"Happiness always looks small while you hold it in your hands, but let it go, and you learn at once how big and precious it is.” Maxim Gorky

Powerful Communication

2011-01-23T13:54:00.000-08:00

1) The Keys to Powerful Communication

a) The best communication occurs when both people are sincere – one sincerely wishing to learn or listen, and the other sincerely wishing to share

b) A diet of words can feed the mind and inspire us to faith, vision and articulation. That’s how miracles can happen

c) Success is like an ocean – it’s not in short supply, the problem is, some people go to the ocean with a teaspoon

d) Vocabulary is a way to express understanding, awareness, comprehension, perception, or vision

e) The right combinations of words can produce almost God-like results. If you are in the dark they can illuminate your path clearly. If you are blind, they can help you to see

True courage

2011-01-23T12:57:00.000-08:00

is not the brutal force of vulgar heroes, but the firm resolve of virtue and reason. ~Alfred North Whitehead

Courage

2011-01-23T12:56:00.001-08:00

It is curious that physical courage should be so common in the world and moral courage so rare. ~Mark Twain

Integrity

2011-01-23T12:53:00.000-08:00

Integrity

Being honest and truthful, as well as having a sense of humor, being understanding, kind and gentle.

To Be A Champ

2011-01-23T12:50:00.000-08:00

A SUCCESSFUL LIFE IS OFTEN EXPENSIVE. IT WILL COST YOU SOMETHING TO BECOME A CHAMPION, TIME, ENERGY, AND FOCUS BUT THE MONETARY COST IS VARIABLE

Efficiency is the driving force

2011-01-11T05:03:00.000-08:00

Efficiency is the driving force, not convenience for the organism. The subluxation can only be rightly called a subluxation if it negatively affects the body’s most important systems and leads to inefficiency in the system. The chiropractor must be removing afferent information from the system that leads to inefficient processing.

neuronal performance

2011-01-11T05:01:00.001-08:00

Neuroplasticity

2011-01-10T18:12:00.000-08:00

Neuroplasticity does not consist of a single type of morphological change, but rather includes several different processes that occur throughout an individual’s lifetime. Many types of brain cells are involved in neuroplasticity, including neurons, glia, and vascular cells.

As connections that are not needed are functionally or morphologically removed/pruned, other connections are strengthened by neo-arborization of new synapses and other means to allow for a more powerful response (more neurons firing) and more coordinated response.

Chapman's reflexes

2011-01-03T09:41:00.000-08:00

Chapman’s Points

Somatovisceral reflexes have received little attention yet are significant for physiologic regulation. Among the more important reflexes for regulation of physiology are Chapman's reflexes. In the late 1930s, Frank Chapman, D.O., first published his findings identifying specific neurolymphatic reflex points that correspond to particular organs and glands. There is a discussion of the diagnostic and therapeutic application of Chapman's reflexes in the text An Endocrine Interpretation of Chapman's Reflexes. Most of these points are located on the front of the body between the ribs next to the sternum and on the back along the spine between the spinous processes and the tips of the transverse processes. Palpation of Chapman's points can be used for assessment of lymphatic function with correlation to specific organs. Stimulation of Chapman's points can influence the motion of the lymph and can also influence visceral functions through nervous system reflexes. Stimulation of Chapman's points is performed by firm pressure in a gentle circular motion on the point. Owen thought that Chapman's reflexes exerted a particularly profound influence on the glandular system.⁴³ Kuchera and Kuchera interpret palpatory changes in Chapman's points as indicating functional involvement of the sympathetic nervous system.

Patriquin gives practical guidelines for diagnosis and treatment using Chapman's reflexes. For example, for irritable bowel syndrome, Chapman's reflexes for the colon are found along the anterior aspect of the iliotibial bands, a 2inch strip on the lateral side of each thigh. The anatomic location of the reflex ganglioform masses found can be correlated with specific portions of the colon. These can be treated with soft tissue kneading, a mechanical percussion hammer, or other types of vibration to produce a somatovisceral influence on the sympathetic innervation to the colon.

Some of the Chapman's points bear an obvious segmental relationship to the target organ. For example, the anterior point for bronchitis is the intercostal space between the second and third rib close to the sternum. The posterior point is located at the second dorsal (thoracic) vertebra, midway between the spinous process and the tip of the transverse process.⁴³ On the other hand, some of the Chapman's points bear little obvious relation to the target organ. For example, the anterior points for the eye problems of retinitis and conjunctivitis are located on the front of the humerus.

It is not clear how Chapman's reflexes actually work physiologically. Some have a segmental relationship, but some are aberrant (e.g., the eye-humerus reflex cited above). Patriquin is uncomfortable relating Chapman's reflexes to autonomic responses, because in his view, the autonomics, by the time they reach the surface, tend to be quite diffuse (the thermodiagnosis
movement, which relies on surface temperature findings to make specific diagnoses, would tend to counter this). Chapman's reflexes, on the other hand, are very localized, small, distinct areas. Patriquin also notes that Chapman himself saw the reflexes as neurolymphatic, but this could not be confirmed by biopsy. Patriquin admits, "I think we're trying to influence the visceral disturbance by treating some part of a reflex arc, even though we haven't the foggiest notion what reflex arc it is."

Despite the unclear anatomic justification for Chapman's reflexes, there is a solid experimental physiologic basis for regulation of visceral function by manual surface stimulation and inhibition. Sato explored somatic-autonomic reflexes in animals. Sato and his colleagues, working with anesthetized animals, traced reflexes from various types of mechanical, thermal, and chemical
stimulation of the skin to visceral effector organs including the heart, stomach, sweat glands, bladder, and adrenal medulla. For example, heart rate can be increased in anesthetized cats by stimulation of any one of a variety of skin areas. This reflex is produced mainly by an augmentation of cardiac sympathetic efferent nerve activity. Similarly, in the anesthetized rat, Sato demonstrated inhibition of gastric contractions by stimulating the abdominal skin. Conversely, noxious stimulation of a hind paw sometimes augments gastric motility, mediated by reflex facilitation of gastric vagal efferent nerve activity.

Breathing Efficiency

2011-01-03T09:39:00.000-08:00

Contrary to what has been previously thought, HDL Cholesterol, Body Mass, or Blood Pressure is NOT the best predictor of long-term longevity in the general population---Pulmonary function occupies that role. Although the former is extremely important, few clinics assess breathing mechanics & efficiency to determine dysfunctional breathing even though all epidemiology studies directly point to Breathing Efficiency as a Long Term predictor of Mortality in the General Population.

Our modern medical paradigm bases pulmonary function on factors that relate to the anatomy and physiology of the lungs. At times, the mechanical relationships of the chest cavity and of the diaphragm are considered important, but for the most part, they are rarely considered in the ordinary management of most pulmonary diseases such as emphysema, asthma, and restrictive lung disorders.

The bulk of our management of these kinds of disorders is aimed at pharmacological intervention. Drugs fail to appreciate the potential role of CNS coordinated muscle firing synergy, posture, rib flexibility or diaphragmatic excursion as independent factors that can improve lung function. It would be unheard of in the development of opera singing, powerful public speaking, or world class athletics to ignore the importance of respiratory faults, accessory breathing muscles, and breathing coordination.

Autism

2011-01-03T07:18:00.000-08:00

Autism is a life-long developmental disability, which, in the United Kingdom, affects approximately 90 people in every 10,000. Put into clinical perspective, this means that the average general practitioner (GP) will have 18 people with autism on
their list.

Individuals with autism are affected in different ways, but all seem to suffer from a triad of impairments: difficulty in interacting with others, impairments in social communication and difficulty thinking imaginatively. An absence of play is often one of the first obvious signs of autism.

The cause of autism is unknown; there are no universally accepted explanations. Current research favors a genetic component, although other factors are also implicated, including environmental triggers and imbalances in neurochemistry.

There is no medication that can ‘cure’ autism. When medication is used, it is to treat a particular
symptom of the syndrome. Specialist education often dramatically improves the quality of life for sufferers and their families.

Many chiropractors and other manipulativetherapists report good symptomatic improvements
following treatment.

Cholesterol is an extremely important substance for life

2011-01-03T07:15:00.000-08:00

Cholesterol is an extremely important substance for life. To maintain the integrity of cell wall, each cell of the body requires cholesterol
Cholesterol is the starting material in the body to make hormones, bile acids and Vitamin D.
It also assists the body to fight against various infections. This one of the most important function of cholesterol. It has been researched that arteriosclerosis and heart diseases are caused by the organisms that are infectious. The higher cholesterol level assists and safeguards the body from these provocative microorganisms.
It also acts as a proactive substance to prevent the body from cancer and stroke
The body uses the cholesterol to repair the injuries.
Cholesterol is used by the brain to build up the connection between its cells. The fact is the brain has some special cells which are responsible for making the cholesterol for the brain.
People "suffering" from high cholesterol levels live longer. Various studies have been conducted to support these findings
Cholesterol is such an important substance for the body that if the diet is unable to provide adequate quantity then the body can work itself to make up the required level. Because of this self-regulation the low fat diet usually fails to lower down the cholesterol level. The lesser the fat you consume the greater the cholesterol the body will make.

The Benefits of High Cholesterol

2011-01-03T07:14:00.001-08:00

The Benefits of High Cholesterol

By Uffe Ravnskov, MD, PhD

People with high cholesterol live the longest. This statement seems so incredible that it takes a long time to clear one's brainwashed mind to fully understand its importance. Yet the fact that people with high cholesterol live the longest emerges clearly from many scientific papers. Consider the finding of Dr. Harlan Krumholz of the Department of Cardiovascular Medicine at Yale University, who reported in 1994 that old people with low cholesterol died twice as often from a heart attack as did old people with a high cholesterol. Supporters of the cholesterol campaign consistently ignore his observation, or consider it as a rare exception, produced by chance among a huge number of studies finding the opposite.

But it is not an exception; there are now a large number of findings that contradict the lipid hypothesis. To be more specific, most studies of old people have shown that high cholesterol is not a risk factor for coronary heart disease. This was the result of my search in the Medline database for studies addressing that question. Eleven studies of old people came up with that result, and a further seven studies found that high cholesterol did not predict all-cause mortality either.

Now consider that more than 90 % of all cardiovascular disease is seen in people above age 60 also and that almost all studies have found that high cholesterol is not a risk factor for women.2 This means that high cholesterol is only a risk factor for less than 5 % of those who die from a heart attack.

But there is more comfort for those who have high cholesterol; six of the studies found that total mortality was inversely associated with either total or LDL-cholesterol, or both. This means that it is actually much better to have high than to have low cholesterol if you want to live to be very old.

High Cholesterol Protects Against Infection

Many studies have found that low cholesterol is in certain respects worse than high cholesterol. For instance, in 19 large studies of more than 68,000 deaths, reviewed by Professor David R. Jacobs and his co-workers from the Division of Epidemiology at the University of Minnesota, low cholesterol predicted an increased risk of dying from gastrointestinal and respiratory diseases.

Most gastrointestinal and respiratory diseases have an infectious origin. Therefore, a relevant question is whether it is the infection that lowers cholesterol or the low cholesterol that predisposes to infection? To answer this question Professor Jacobs and his group, together with Dr. Carlos Iribarren, followed more than 100,000 healthy individuals in the San Francisco area for fifteen years. At the end of the study those who had low cholesterol at the start of the study had more often been admitted to the hospital because of an infectious disease. This finding cannot be explained away with the argument that the infection had caused cholesterol to go down, because how could low cholesterol, recorded when these people were without any evidence of infection, be caused by a disease they had not yet encountered? Isn't it more likely that low cholesterol in some way made them more vulnerable to infection, or that high cholesterol protected those who did not become infected? Much evidence exists to support that interpretation.

Low Cholesterol and HIV/AIDS

Young, unmarried men with a previous sexually transmitted disease or liver disease run a much greater risk of becoming infected with HIV virus than other people. The Minnesota researchers, now led by Dr. Ami Claxton, followed such individuals for 7-8 years. After having excluded those who became HIV-positive during the first four years, they ended up with a group of 2446 men. At the end of the study, 140 of these people tested positive for HIV; those who had low cholesterol at the beginning of the study were twice as likely to test positive for HIV compared with those with the highest cholesterol.

Similar results come from a study of the MRFIT screenees, including more than 300,000 young and middle-aged men, which found that 16 years after the first cholesterol analysis the number of men whose cholesterol was lower than 160 and who had died from AIDS was four times higher than the number of men who had died from AIDS with a cholesterol above 240.

Cholesterol and Chronic Heart Failure

Heart disease may lead to a weakening of the heart muscle. A weak heart means that less blood and therefore less oxygen is delivered to the arteries. To compensate for the decreased power, the heart beat goes up, but in severe heart failure this is not sufficient. Patients with severe heart failure become short of breath because too little oxygen is delivered to the tissues, the pressure in their veins increases because the heart cannot deliver the blood away from the heart with sufficient power, and they become edematous, meaning that fluid accumulates in the legs and in serious cases also in the lungs and other parts of the body. This condition is called congestive or chronic heart failure.

There are many indications that bacteria or other microorganisms play an important role in chronic heart failure. For instance, patients with severe chronic heart failure have high levels of endotoxin and various types of cytokines in their blood. Endotoxin, also named lipopolysaccharide, is the most toxic substance produced by Gram-negative bacteria such as Escherichia coli, Klebsiella, Salmonella, Serratia and Pseudomonas. Cytokines are hormones secreted by white blood cells in their battle with microorganisms; high levels of cytokines in the blood indicate that inflammatory processes are going on somewhere in the body.

The role of infections in chronic heart failure has been studied by Dr. Mathias Rauchhaus and his team at the Medical Department, Martin-Luther-University in Halle, Germany (Universitätsklinik und Poliklinik für Innere Medizin III, Martin-Luther-Universität, Halle). They found that the strongest predictor of death for patients with chronic heart failure was the concentration of cytokines in the blood, in particular in patients with heart failure due to coronary heart disease.8 To explain their finding they suggested that bacteria from the gut may more easily penetrate into the tissues when the pressure in the abdominal veins is increased because of heart failure. In accordance with this theory, they found more endotoxin in the blood of patients with congestive heart failure and edema than in patients with non-congestive heart failure without edema, and endotoxin concentrations decreased significantly when the heart’s function was improved by medical treatment.

A simple way to test the functional state of the immune system is to inject antigens from microorganisms that most people have been exposed to, under the skin. If the immune system is normal, an induration (hard spot) will appear about 48 hours later at the place of the injection. If the induration is very small, with a diameter of less than a few millimeters, this indicates the presence of "anergy," a reduction in or failure of response to recognize antigens. In accordance, anergy has been found associated with an increased risk of infection and mortality in healthy elderly individuals, in surgical patients and in heart transplant patients.

Dr. Donna Vredevoe and her group from the School of Nursery and the School of Medicine, University of California at Los Angeles tested more than 200 patients with severe heart failure with five different antigens and followed them for twelve months. The cause of heart failure was coronary heart disease in half of them and other types of heart disease (such as congenital or infectious valvular heart disease, various cardiomyopathies and endocarditis) in the rest. Almost half of all the patients were anergic, and those who were anergic and had coronary heart disease had a much higher mortality than the rest.

Now to the salient point: to their surprise the researchers found that mortality was higher, not only in the patients with anergy, but also in the patients with the lowest lipid values, including total cholesterol, LDL-cholesterol and HDL-cholesterol as well as triglycerides.

The latter finding was confirmed by Dr. Rauchhaus, this time in co-operation with researchers at several German and British university hospitals. They found that the risk of dying for patients with chronic heart failure was strongly and inversely associated with total cholesterol, LDL-cholesterol and also triglycerides; those with high lipid values lived much longer than those with low values.

Other researchers have made similar observations. The largest study has been performed by Professor Gregg C. Fonorow and his team at the UCLA Department of Medicine and Cardiomyopathy Center in Los Angeles. The study, led by Dr. Tamara Horwich, included more than a thousand patients with severe heart failure. After five years 62 percent of the patients with cholesterol below 129 mg/l had died, but only half as many of the patients with cholesterol above 223 mg/l.

When proponents of the cholesterol hypothesis are confronted with findings showing a bad outcome associated with low cholesterol--and there are many such observations--they usually argue that severely ill patients are often malnourished, and malnourishment is therefore said to cause low cholesterol. However, the mortality of the patients in this study was independent of their degree of nourishment; low cholesterol predicted early mortality whether the patients were malnourished or not.

Smith-Lemli-Opitz Syndrome

As discussed in The Cholesterol Myths (see sidebar), much evidence supports the theory that people born with very high cholesterol, so-called familial hypercholesterolemia, are protected against infection. But if inborn high cholesterol protects against infections, inborn low cholesterol should have the opposite effect. Indeed, this seems to be true.

Children with the Smith-Lemli-Opitz syndrome have very low cholesterol because the enzyme that is necessary for the last step in the body’s synthesis of cholesterol does not function properly. Most children with this syndrome are either stillborn or they die early because of serious malformations of the central nervous system. Those who survive are imbecile, they have extremely low cholesterol and suffer from frequent and severe infections. However, if their diet is supplemented with pure cholesterol or extra eggs, their cholesterol goes up and their bouts of infection become less serious and less frequent.

Laboratory Evidence

Laboratory studies are crucial for learning more about the mechanisms by which the lipids exert their protective function. One of the first to study this phenomenon was Dr Sucharit Bhakdi from the Institute of Medical Microbiology, University of Giessen (Institut für Medizinsche Mikrobiologie, Justus-Liebig-Universität Gießen), Germany along with his team of researchers from various institutions in Germany and Denmark.

Staphylococcus aureus α-toxin is the most toxic substance produced by strains of the disease-promoting bacteria called staphylococci. It is able to destroy a wide variety of human cells, including red blood cells. For instance, if minute amounts of the toxin are added to a test tube with red blood cells dissolved in 0.9 percent saline, the blood is hemolyzed, that is the membranes of the red blood cells burst and hemoglobin from the interior of the red blood cells leaks out into the solvent. Dr. Bhakdi and his team mixed purified α-toxin with human serum (the fluid in which the blood cells reside) and saw that 90 percent of its hemolyzing effect disappeared. By various complicated methods they identified the protective substance as LDL, the carrier of the so-called bad cholesterol. In accordance, no hemolysis occurred when they mixed α-toxin with purified human LDL, whereas HDL or other plasma constituents were ineffective in this respect.

Dr. Willy Flegel and his co-workers at the Department of Transfusion Medicine, University of Ulm, and the Institute of Immunology and Genetics at the German Cancer Research Center in Heidelberg, Germany (DRK-Blutspendezentrale und Abteilung für Transfusionsmedizin, Universität Ulm, und Deutsches Krebsforschungszentrum, Heidelberg) studied endotoxin in another way. As mentioned, one of the effects of endotoxin is that white blood cells are stimulated to produce cytokines. The German researchers found that the cytokine-stimulating effect of endotoxin on the white blood cells disappeared almost completely if the endotoxin was mixed with human serum for 24 hours before they added the white blood cells to the test tubes. In a subsequent study they found that purified LDL from patients with familial hypercholesterolemia had the same inhibitory effect as the serum.

LDL may not only bind and inactivate dangerous bacterial toxins; it seems to have a direct beneficial influence on the immune system also, possibly explaining the observed relationship between low cholesterol and various chronic diseases. This was the starting point for a study by Professor Matthew Muldoon and his team at the University of Pittsburgh, Pennsylvania. They studied healthy young and middle-aged men and found that the total number of white blood cells and the number of various types of white blood cells were significantly lower in the men with LDL-cholesterol below 160 mg/dl (mean 88.3 mg/l),than in men with LDL-cholesterol above 160 mg/l (mean 185.5 mg/l). The researchers cautiously concluded that there were immune system differences between men with low and high cholesterol, but that it was too early to state whether these differences had any importance for human health. Now, seven years later with many of the results discussed here, we are allowed to state that the immune-supporting properties of LDL-cholesterol do indeed play an important role in human health.

Animal Experiments

The immune systems in various mammals including human beings have many similarities. Therefore, it is interesting to see what experiments with rats and mice can tell us. Professor Kenneth Feingold at the Department of Medicine, University of California, San Francisco, and his group have published several interesting results from such research. In one of them they lowered LDL-cholesterol in rats by giving them either a drug that prevents the liver from secreting lipoproteins, or a drug that increases their disappearance. In both models, injection of endotoxin was followed by a much higher mortality in the low-cholesterol rats compared with normal rats. The high mortality was not due to the drugs because, if the drug-treated animals were injected with lipoproteins just before the injection of endotoxin, their mortality was reduced to normal.

Dr. Mihai Netea and his team from the Departments of Internal and Nuclear Medicine at the University Hospital in Nijmegen, The Netherlands, injected purified endotoxin into normal mice, and into mice with familial hypercholesterolemia that had LDL-cholesterol four times higher than normal. Whereas all normal mice died, they had to inject eight times as much endotoxin to kill the mice with familial hypercholesterolemia. In another experiment they injected live bacteria and found that twice as many mice with familial hypercholesterolemia survived compared with normal mice.

Other Protecting Lipids

As seen from the above, many of the roles played by LDL-cholesterol are shared by HDL. This should not be too surprising considering that high HDL-cholesterol is associated with cardiovascular health and longevity. But there is more.

Triglycerides, molecules consisting of three fatty acids linked to glycerol, are insoluble in water and are therefore carried through the blood inside lipoproteins, just as cholesterol. All lipoproteins carry triglycerides, but most of them are carried by a lipoprotein named VLDL (very low-density lipoprotein) and by chylomicrons, a mixture of emulsified triglycerides appearing in large amounts after a fat-rich meal, particularly in the blood that flows from the gut to the liver.

For many years it has been known that sepsis, a life-threatening condition caused by bacterial growth in the blood, is associated with a high level of triglycerides. The serious symptoms of sepsis are due to endotoxin, most often produced by gut bacteria. In a number of studies, Professor Hobart W. Harris at the Surgical Research Laboratory at San Francisco General Hospital and his team found that solutions rich in triglycerides but with practically no cholesterol were able to protect experimental animals from the toxic effects of endotoxin and they concluded that the high level of triglycerides seen in sepsis is a normal immune response to infection. Usually the bacteria responsible for sepsis come from the gut. It is therefore fortunate that the blood draining the gut is especially rich in triglycerides.

Exceptions

So far, animal experiments have confirmed the hypothesis that high cholesterol protects against infection, at least against infections caused by bacteria. In a similar experiment using injections of Candida albicans, a common fungus, Dr. Netea and his team found that mice with familial hypercholesterolemia died more easily than normal mice. Serious infections caused by Candida albicans are rare in normal human beings; however, they are mainly seen in patients treated with immunosuppressive drugs, but the finding shows that we need more knowledge in this area. However, the many findings mentioned above indicate that the protective effects of the blood lipids against infections in human beings seem to be greater than any possible adverse effects.

Cholesterol as a Risk Factor

Most studies of young and middle-aged men have found high cholesterol to be a risk factor for coronary heart disease, seemingly a contradiction to the idea that high cholesterol is protective. Why is high cholesterol a risk factor in young and middle-aged men? A likely explanation is that men of that age are often in the midst of their professional career. High cholesterol may therefore reflect mental stress, a well-known cause of high cholesterol and also a risk factor for heart disease. Again, high cholesterol is not necessarily the direct cause but may only be a marker. High cholesterol in young and middle-aged men could, for instance, reflect the body’s need for more cholesterol because cholesterol is the building material of many stress hormones. Any possible protective effect of high cholesterol may therefore be counteracted by the negative influence of a stressful life on the vascular system.

Response to Injury

In 1976 one of the most promising theories about the cause of atherosclerosis was the Response-to-Injury Hypothesis, presented by Russell Ross, a professor of pathology, and John Glomset, a professor of biochemistry and medicine at the Medical School, University of Washington in Seattle.23,24 They suggested that atherosclerosis is the consequence of an inflammatory process, where the first step is a localized injury to the thin layer of cells lining the inside of the arteries, the intima. The injury causes inflammation and the raised plaques that form are simply healing lesions.

Their idea is not new. In 1911, two American pathologists from the Pathological Laboratories, University of Pittsburgh, Pennsylvania, Oskar Klotz and M.F. Manning, published a summary of their studies of the human arteries and concluded that "there is every indication that the production of tissue in the intima is the result of a direct irritation of that tissue by the presence of infection or toxins or the stimulation by the products of a primary degeneration in that layer." Other researchers have presented similar theories.

Researchers have proposed many potential causes of vascular injury, including mechanical stress, exposure to tobacco fumes, high LDL-cholesterol, oxidized cholesterol, homocysteine, the metabolic consequences of diabetes, iron overload, copper deficiency, deficiencies of vitamins A and D, consumption of trans fatty acids, microorganisms and many more. With one exception, there is evidence to support roles for all of these factors, but the degree to which each of them participates remains uncertain. The exception is of course LDL-cholesterol. Much research allows us to exclude high LDL-cholesterol from the list. Whether we look directly with the naked eye at the inside of the arteries at autopsy, or we do it indirectly in living people using x-rays, ultrasound or electron beams, no association worth mentioning has ever been found between the amount of lipid in the blood and the degree of atherosclerosis in the arteries. Also, whether cholesterol goes up or down, by itself or due to medical intervention, the changes of cholesterol have never been followed by parallel changes in the atherosclerotic plaques; there is no dose-response. Proponents of the cholesterol campaign often claim that the trials indeed have found dose-response, but here they refer to calculations between the mean changes of the different trials with the outcome of the whole treatment group. However, true dose-response demands that the individual changes of the putative causal factor are followed by parallel, individual changes of the disease outcome, and this has never occurred in the trials where researchers have calculated true dose-response.

A detailed discussion of the many factors accused of harming the arterial endothelium is beyond the scope of this article. However, the protective role of the blood lipids against infections obviously demands a closer look at the alleged role of one of the alleged causes, the microorganisms.

Is Atherosclerosis an Infectious Disease?

For many years scientists have suspected that viruses and bacteria, in particular cytomegalovirus and Chlamydia pneumonia (also named TWAR bacteria) participate in the development of atherosclerosis. Research within this area has exploded during the last decade and by January 2004, at least 200 reviews of the issue have been published in medical journals. Due to the widespread preoccupation with cholesterol and other lipids, there has been little general interest in the subject, however, and few doctors know much about it. Here I shall mention some of the most interesting findings.

Electron microscopy, immunofluorescence microscopy and other advanced techniques have allowed us to detect microorganisms and their DNA in the atherosclerotic lesions in a large proportion of patients. Bacterial toxins and cytokines, hormones secreted by the white blood cells during infections, are seen more often in the blood from patients with recent heart disease and stroke, in particular during and after an acute cardiovascular event, and some of them are strong predictors of cardiovascular disease. The same is valid for bacterial and viral antibodies, and a protein secreted by the liver during infections, named C-reactive protein (CRP), is a much stronger risk factor for coronary heart disease than cholesterol.

Clinical evidence also supports this theory. During the weeks preceding an acute cardiovascular attack many patients have had a bacterial or viral infection. For instance, Dr. Armin J. Grau from the Department of Neurology at the University of Heidelberg and his team asked 166 patients with acute stroke, 166 patients hospitalized for other neurological diseases and 166 healthy individuals matched individually for age and sex about recent infectious disease. Within the first week before the stroke, 37 of the stroke patients, but only 14 of the control individuals had had an infectious disease. In half of the patients the infection was of bacterial origin, in the other half of viral origin.

Similar observations have been made by many others, for patients with acute myocardial infarction (heart attack). For instance, Dr. Kimmo J. Mattila at the Department of Medicine, Helsinki University Hospital, Finland, found that 11 of 40 male patients with an acute heart attack before age 50 had an influenza-like infection with fever within 36 hours prior to admittance to hospital, but only 4 out of 41 patients with chronic coronary disease (such as recurrent angina or pervious myocardial infarction) and 4 out of 40 control individuals without chronic disease randomly selected from the general population.

Attempts have been made to prevent cardiovascular disease by treatment with antibiotics. In five trials treatment of patients with coronary heart disease using azithromyzin or roxithromyzin, antibiotics that are effective against Chlamydia pneumonia,yielded successful results; a total of 104 cardiovascular events occurred among the 412 non-treated patients, but only 61 events among the 410 patients in the treatment groups. In one further trial a significant decreased progression of atherosclerosis in the carotid arteries occurred with antibiotic treatment. However, in four other trials, one of which included more than 7000 patients, antibiotic treatment had no significant effect.

The reason for these inconsistent results may be that the treatment was too short (in one of the trials treatment lasted only five days). Also, Chlamydia pneumonia, the TWAR bacteria, can only propagate inside human cells and when located in white blood cells they are resistant to antibiotics. Treatment may also have been ineffective because the antibiotics used have no effect on viruses. In this connection it is interesting to mention a controlled trial performed by Dr. Enrique Gurfinkel and his team from Fundación Favaloro in Buenos Aires, Argentina. They vaccinated half of 301 patients with coronary heart disease against influenza, a viral disease. After six months 8 percent of the control patients had died, but only 2 percent of the vaccinated patients. It is worth mentioning that this effect was much better than that achieved by any statin trial, and in a much shorter time.

Does High Cholesterol Protect Against Cardiovascular Disease?

Apparently, microorganisms play a role in cardiovascular disease. They may be one of the factors that start the process by injuring the arterial endothelium. A secondary role may be inferred from the association between acute cardiovascular disease and infection. The infectious agent may preferably become located in parts of the arterial walls that have been previously damaged by other agents, initiating local coagulation and the creation of a thrombus (clot) and in this way cause obstruction of the blood flow. But if so, high cholesterol may protect against cardiovascular disease instead of being the cause!

In any case, the diet-heart idea, with its demonizing of high cholesterol, is obviously in conflict with the idea that high cholesterol protects against infections. Both ideas cannot be true. Let me summarize the many facts that conflict with the idea that high cholesterol is bad.

If high cholesterol were the most important cause of atherosclerosis, people with high cholesterol should be more atherosclerotic than people with low cholesterol. But as you know by now this is very far from the truth.
If high cholesterol were the most important cause of atherosclerosis, lowering of cholesterol should influence the atherosclerotic process in proportion to the degree of its lowering. But as you know by now, this does not happen.
If high cholesterol were the most important cause of cardiovascular disease, it should be a risk factor in all populations, in both sexes, at all ages, in all disease categories, and for both heart disease and stroke. But as you know by now, this is not the case

I have only two arguments for the idea that high cholesterol is good for the blood vessels, but in contrast to the arguments claiming the opposite they are very strong.

The first one stems from the statin trials. If high cholesterol were the most important cause of cardiovascular disease, the greatest effect of statin treatment should have been seen in patients with the highest cholesterol, and in patients whose cholesterol was lowered the most. Lack of dose-response cannot be attributed to the knowledge that the statins have other effects on plaque stabilization, as this would not have masked the effect of cholesterol-lowering considering the pronounced lowering that was achieved. On the contrary, if a drug that effectively lowers the concentration of a molecule assumed to be harmful to the cardiovascular system and at the same time exerts several beneficial effects on the same system, a pronounced dose-response should be seen.

On the other hand, if high cholesterol has a protective function, as suggested, its lowering would counterbalance the beneficial effects of the statins and thus work against a dose-response, which would be more in accord with the results from the various trials.

I have already mentioned my second argument, but it can’t be said too often: High cholesterol is associated with longevity in old people. It is difficult to explain away the fact that during the period of life in which most cardiovascular disease occurs and from which most people die (and most of us die from cardiovascular disease), high cholesterol occurs most often in people with the lowest mortality. How is it possible that high cholesterol is harmful to the artery walls and causes fatal coronary heart disease, the commonest cause of death, if those whose cholesterol is the highest, live longer than those whose cholesterol is low?

To the public and the scientific community I say, "Wake up!"

the only corrective technique

2011-01-03T06:36:00.001-08:00

Proprioception generated within joints, ligaments and muscles contributes to awareness of the relative orientation of functional units of the spine (and other articulations) at rest and in motion. This is fundamental to posture, station, balance, dynamic equilibrium and all movements. Treatment aimed at physiological proprioceptive reeducation and increasing CNS efficiency is the only corrective technique.