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Spinal Manipulations the Similarities and Disparities Between Osteopaths, Chiropractors and Physical Therapists Around the World

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Spinal Manipulations the Similarities and Disparities Between Osteopaths, Chiropractors and Physical Therapists Around the World 12/3/2008 Spinal Manipulations The Similarities and Disparities Between Osteopaths, Chiropractors and Physical Therapists Around the World My origins? Belgium - Europe 1 12/3/2008 Lived in Brussels - Belgium “The Great Market” Belgium… the land of 2 12/3/2008 University Education: Catholic University Of Louvain-la-Neuve Physical Education Physical Therapy Job Worked as a physical therapist in Belgium, then in South America in a hospital in Paramaribo (Suriname) 3 12/3/2008 Opportunities Opportunities following South America y Belgium: School of Osteopathy y USA: Graduate School Job + Graduate School USA – Texas Tech University 4 12/3/2008 History of spinal manipulation therapy Roots of spinal manipulation found in folk traditions of "bone setting" Documented use as far back as y Ancient Egyptians y Asian Cultures y Hippocrates Often associated with audible "popping" sound. Still practiced in the UK and is protected Bonesetter. Wikipedia Encyclopedia. http://en.wikipedia.org/wiki/Bone-setting; Accessed 07/25/08 Chiropractic: its history from Greek chiro- χειρο- "hand-"+ praktikós πρακτικός "concerned with action" Daniel D Palmer, founder of chiropractic (1897) 1895: in Davenport, Iowa, Daniel Palmer, a canadian immigrant who worked as a grocer manipulated the cervical vertebra of Henry Lillard and reported relief of the patient' s deafness. Livingston MCP: Spinal manipulation in medical practice: A century of ignorance. Med J Aust 2:552–555, 1963. Brownson RJ, Zollinger WK, Madeira T, Fell D: Sudden sensorineural hearing loss following manipulation of the cervical spine. Laryngoscope 96:166–170, 1986. 5 12/3/2008 Chiropractic: definition Chiropractic treatment emphasizes manual therapy including spinal manipulation and other joint and soft tissue manipulation, and includes exercises and health and lifestyle counseling. Traditionally, it assumes that a vertebral subluxation or spinal jjyoint dysfunction can interfere with the body 's function and its innate ability to heal itself. Livingston MCP: Spinal manipulation in medical practice: A century of ignorance. Med J Aust 2:552–555, 1963. Brownson RJ, Zollinger WK, Madeira T, Fell D: Sudden sensorineural hearing loss following manipulation of the cervical spine. Laryngoscope 96:166–170, 1986. Chiropractic schools in the World USA: 18 Sweden: 1 UK: 3 Mexico: 1 Canada: 2 New Zealand: 1 Australia: 2 Denmark: 1 Japan: 2 France: 1 Brazil: 2 South Africa: 2 6 12/3/2008 Chiropractors in Europe Over 70 years of presence y FbtFrance: rebouteux y Germany: knochen-einrichter y Spain: algebrista y Denmark: kloge folk y Britain: bonesetters Chiropractic Education y Highly variable y In the US: doctorate degree – 4-year program y Other countries: Bachelor and Masters of Sciences World Health Organization (2005). "WHO guidelines on basic training and safety in chiropractic" (PDF). Retrieved on 2008-03-03. 7 12/3/2008 Chiropractors in Europe Switzerland y PtfiPart of insurance law Greece y Unrecognized, uncovered, but not illegal Osteopathy: its history Andrew Taylor Still, founder of Osteopathy (1892) in Kirksville, Missouri In Medical school in Kansas City, lost 4 children due to spinal meningitis and pneumonia. Disgusted with traditional medicine. Did not finish medical school. medical practice relying on a system of manipulation and spinal reflexes that he devised to treat all types of conditions named his new school of medicine "osteopathy," reasoning that "the bone, osteon, was the starting point from which [he] was to ascertain the cause of pathological conditions.” Livingston MCP: Spinal manipulation in medical practice: A century of ignorance. Med J Aust 2:552–555, 1963. 8 12/3/2008 Osteopathic schools in the World USA: 28 Cd2Canada: 2 UK: 8 More in European and Asian countries (China has approached the AOA to train family physicians) Osteopathic Education y Variable y In the US & Canada: doctorate degree – 4-year program y Practice as MD’s y Other countries: Bachelor and Masters of Sciences y Can be osteopathy on his own, or physical therapists and MD’s http://en.wikipedia.org/wiki/Osteopathy 9 12/3/2008 What about Physical Therapy Phyypysiotherapy Fysiotherapy Kinésitherapie Masso-kinésithérapie same meanings Physical Therapy: its history 400 B.C. Hippocrates and Hector usedtthttid water therapy, traction, movemen t as therapeutic approaches. 1894: as a profession in Great Britain with 4 nurses 1940s mainly exercise, massage, and ttitraction. 1950s Manipulative procedures to the spine and extremity joints began to be practiced 10 12/3/2008 Physical Therapy schools in the World USA: 200 Educa tion y USA: doctorate level (3-3 or 4-2) y Other countries highly variable: ○ Some European countries: university degree and others not Contentious history of spinal manipulation 1895: Daniel Palmer, manipulated the cervical vertebra of Henry Lillard and reported relief of the patient's deafness. 1986: Brownson et al. described the development of sudden deafness in two patients who underwent manipulation of the cervical spine by osteopathic physicians. Livingston MCP: Spinal manipulation in medical practice: A century of ignorance. Med J Aust 2:552–555, 1963. Brownson RJ, Zollinger WK, Madeira T, Fell D: Sudden sensorineural hearing loss following manipulation of the cervical spine. Laryngoscope 96:166–170, 1986. 11 12/3/2008 Manipulation – Physical Therapy Guide to Physical Therapist Practice y Mo biliza tion /man ipu la tion: AlthA manual therapy technique comprising a continuum of skilled passive movements to the joints and/or related soft tissue that are applied at varying speeds and amplitudes, including a small-amplitude/ high- velocity therapeutic movement. y Thrust manipulation as “high velocity, low amplitude therapeutic movements within or at end range of motion.” Manipulation Education Manual For Physical Therapist Professional Degree Programs - Manipulation Education Committee: APTA Manipulation Task Force, 2004 Manipulation – Chiropractic y Spinal Manipulation: Passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. Winkler K, Hegetschweiler-Goertz C, Jackson PS et al. (2003). Spinal manipulation policy statement. American Chiropractic Association. http://www.acatoday.org/pdf/spinal_manipulation_policy.pdf Accessed on 2008-07-08 12 12/3/2008 Manipulation – Osteopathic y Manipulation: the therapeutic application of manual pressure or force. In osteopathy, the manipulation itself is only part of a philosophy of care; it is regarded as an adjunct to other medical care. An emphasis on the importance of the musculoskeletal system in health and disease is a strong feature of the education of an osteopathic physician. Osteopathic Medicine in the United States - http://en.wikipedia.org/wiki/Osteopathic_medicine_in_the_United_States ; Accessed on 2008-07-08 Andersson GB, Lucente T, Davis AM, Kappler RE, Lipton JA, Leurgans S. A comparison of osteopathic spinal manipulation with standard care for patients with low back pain. N Engl J Med. 1999;341(19):1426-31 Manipulation - Osteopathic Thoracic 13 12/3/2008 Manipulation – Chiropractic Thoracic Manipulation – Physical Therapy Thoracic 14 12/3/2008 Manipulation – Osteopathy Lumbar Manipulation – Chiropractic Lumbar 15 12/3/2008 Manipulation – Physical Therapy - Maitland Lumbar So what is the difference? Homola S.Chiropractic: history and overview of theories and methods. Clin Orthop Relat Res. 2006 Mar;444:236-42. Cyriax J. Textbook of Orthopaedic Medicine: Treatment by Manipulation, Massage, and Injection. Vol 2, 11th Ed, London, Bailliere Tindall; 1984. 16 12/3/2008 So what is the difference? Goals of treatment – Osteopathy y Osteopppyathic physicians are trained to p lace emphasis on the achievement of normal body mechanics as central to maintaining good health. y Manipulative treatment is taught as an adjunctive measure to other biomedical interventions for a number of disorders and diseases. Osteopathic Medicine in the United States. http://en.wikipedia.org/wiki/Osteopathic_medicine_in_the_United_States; Accessed 07/20/2008 Osteopathy. http://en.wikipedia.org/wiki/Osteopathy#cite_note-31 ; Accessed 11/29/2008 Johnson SM, Kurtz ME. Diminished use of osteopathic manipulative treatment and its i h i f h hi f i A d M d 2001 6 821 828 So what is the difference? Goals of treatment – Physical Therapy y Phyypjpsical therapists use joint manipulation/ mobilization to relieve and prevent physical disability. y Physical therapists base their manipulative treatment on loss of mobility and pain. y Physical therapists will discontinue use of manipulation when mobility is restored and symptoms are resolved Homola S.Chiropractic: history and overview of theories and methods. Clin Orthop Relat Res. 2006 Mar;444:236-42. 17 12/3/2008 So what is the difference? Goals of treatment – Chiropractic y use adjustment/manipulation over the spine to restore and maitiintain hea lth. y may focus on correcting and preventing vertebral “subluxations”. y A chiropractor who follows the subluxation theory may continue manipulating the spine of an asymptomatic patient for preventive maintenance purposes. y Some chiropractic patients have preventive maintenance spinal adjustments to correct what they believe is a constant cause of disease in their spine. James Cyriax, MD referred
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