October 2014 Volume 10 Number 2

Newsletter of the European Chiropractors’ Union

In BACKspace:

3 President’s message

4 ECU news

8 Convention

15 Research

16 General news

23 Feature • PhD for Joyce Miller

25 Making the most of it • Gitte Tønner Jonathan Mulholland of Foot Levelers presents a seminar on pelvic stabilisation 27 Chiropractic Swiss trailblazers Diversity a hit chiropractic • Coralie Pellissier programme 29 EAC with delegates at gains government 31 Review 2014 Convention accreditation • Born to Walk ver 400 delegates on neurology, sports and debate, Swiss chiropractors have Odescended on Dublin with big names from the world been celebrating the news in May for the ECU’s annual of chiropractic coming together that their Zürich programme Convention, where a fresh to share thoughts, ideas and has been formally accredited. new format introduced by new perspectives on the profession. In a statement issued on 16 Academic Convention Organiser The Convention began July, Professor Kim Humphreys, Gitte Tønner included a rich mix on the Wednesday evening Head of the Chiropractic of plenary sessions, debate and with a welcome reception, Medicine Programme at the practical workshops. where the Executive, General University of Zürich, announced Held in the iconic Convention Council, researchers, students, that with immediate effect, and Centre Dublin (CCD) the annual delegates and guests mingled for a period of seven years, the ECU event welcomed delegates with sponsors and traders in the Master in Chiropractic Medicine from as far afield as Canada and exhibition area. With background (M.Chiro.Med) degree has been the United States. music provided by a local harpist, officially accredited by the Swiss This year’s Convention focused ECU President Øystein Ogre University Conference (SUK) on including all facets of the welcomed all to what was to and the Swiss Accreditation profession, resulting in over 95% be one of the most successful Council (CSA). Trailblazing – see page 27 of delegates reporting that they Conventions in recent years. would be returning for future Continued on page 17 Previous issues of BACKspace ECU events. The emphasis was Continued on page 8 are available from the ECU office. See page 3 for contact details.

BACKspace www.ecunion.eu October 2014 1 BACKspace Mag_Layout 1 8/15/14 9:08 AM Page 1

THE ACTIVATOR METHOD The World’s #1 Chiropractic Technique with the Most Innovative Adjusting Instruments in the Industry

Activator is the only Chiropractic technique to be supported by Clinical Trials and offer hands-on training to gain experience while perfecting your Activator Method skills Take the opportunity to learn from the best Dr. Arlan W. Fuhr, DC, Co- Inventor and developer of the Activator technique and associated adjusting instrument Don’t miss the chance to see Dr. Arlan Fuhr and attend one of the following Activator Seminars: England • Norway • Brazil • Spain

All dates and specifics are pending, visit www.activator.com or call, 1-800-598-0224 for more information.

Be at the forefront of the Instrument Adjusting Industry and Register today! visit www.activator.com or call, 1-800-598-0224 for more information.

ACTIVATOR V

ACTIVATOR IV

ACTIVATOR II

ACTIVATOR I

Activator and Activator Methods are registered trademarks of Activator Methods International, Ltd. in the United States and other countries. Activator Methods International UK, Ltd. Newsletter of the European Chiropractors’ Union

President’s message Why we need to integrate with mainstream health care

or most of the 119- been considered to be alternative exercises, trigger point therapy Zürich and Southern Denmark Fyear period of chiropractic’s gain acceptance and recognition, and soft tissue techniques. The have inter-professional training as existence, chiropractors have they are no longer considered only objective difference between a natural part of their education been looked upon as practitioners alternative. This inevitably means the professions was the level of already, with chiropractic students of alternative medicine. When that conventional medicine is education. To our satisfaction, being educated alongside their I graduated, chiropractic was likely to accept the methods and the study found that it was medical colleagues. However, this virtually unknown and colleagues implement them. chiropractors who were the best- should become the norm and I feel in other health professions referred Today, there are a number of trained health professionals to take that we need to see all chiropractic to it as unscientific and dangerous professions that include spinal care of spinal problems. educational programmes follow this to the public. manipulation in their training. pathway. How can we expect our Now chiropractic is a household We are no longer alone in offering What is our answer to students to co-operate and interact word. Those health professionals, manipulative spine care. this situation? with other health professionals when who had said years ago that When I started in practice, The Achilles heel of chiropractic we never taught them how to? chiropractic was dangerous or most chiropractors performed remains the lack of integration In many countries in Europe, unscientific, now find themselves spinal adjustments as their only into the health care system. and also the United States, the competing with us and copying method of treating patients. It was Traditionally, chiropractors have physiotherapy education is moving everything we do. easy for the public: chiropractors entered single practices and worked towards a five-year programme adjusted, physiotherapists did on their own throughout their instead of the three-year bachelor Natural development rehab. Today, we see chiropractors professional careers and chiropractic programme. During the course of I think we need to accept that when utilising a broad range of other institutions have often had their training, physiotherapists (and also methods that have traditionally techniques: soft tissue work, focus on students mastering osteopaths who are physiotherapists advanced rehabilitation exercises, this part of their professional with some extra training) cognitive behavioural therapy and lives. However, today we see a are trained in hospitals and acupuncture. Investigations have movement towards improved inter- multidisciplinary institutions. They moved forward too. From x-raying professional relations, especially are trained to communicate and BACKspace is published twice a most patients, chiropractors now in countries with advanced work together with different health year by the European Chiropractors’ Union (ECU) and distributed free use other imaging methods and we legislation and regulation such as care professionals and use their to all ECU members. Opinions in have seen great growth in the use of Denmark, Norway, Liechtenstein language. Who do you think health BACKspace are not necessarily those MRI and ultrasound. and Switzerland. Nowadays, care professionals, like medical of the editor or the ECU, who reserve the right to edit all contributions. What we are seeing is a natural the trend is that chiropractors doctors, are more likely to refer The ECU accepts no responsibility for development in a modern society, establish practices with other patients to? People you have worked advertising content. where knowledge and skills health professions or join already- with and speak the same language European Chiropractors’ Union, belong to everyone, not one single established multi-disciplinary as you, or some chiropractor you The Glasshouse, 5A Hampton Road, Hampton Hill, Middlesex TW12 1JN group. The different health care centres. Sole practice is no longer don´t really know? Tel: +44 (0) 20 8977 2206 professions look at the evidence for the only option. I think we need to see a shift Email: [email protected] what most benefits patients and In my opinion, we must learn in our chiropractic programmes Website: www.ecunion.eu adopt methods that work. and be comfortable in working towards inter-professional Edited and produced by with other health professionals training. If we manage to make Manya McMahon at Pinpoint Communication Ltd What does this mean in the health care system and our this shift, then I see a great future www.pinpoint-uk.co.uk for the public? chiropractic institutions must work for our profession; improving [email protected] Tel: +44 (0) 1395 269573 It is becoming increasingly difficult to develop their inter-professional our interaction with other health Design by Impress Publications Ltd for the public to see the big training. We must move away from professions and integration of Print by Advent Colour Ltd, differences between the professions. the situation where I still see fear chiropractic into mainstream health 19 East Portway Industrial Estate, A study recently undertaken by and discomfort in students’ eyes care. The ECU is committed to see Andover, Hampshire SP10 3LU the Norwegian Health Directorate when they pick up the phone in this happen. To advertise in BACKspace, showed that physiotherapists, order to communicate with the local please contact Claire Wilmot at ECU Head Office: [email protected] manual therapists, osteopaths, medical doctor or physiotherapist. Øystein Ogre DC, FEAC naprapaths and chiropractors all I know there are exceptions ECU President © ECU. All rights reserved. Reproduction of any part of BACKspace is not allowed performed methods like spinal within our chiropractic Blog address: ecupresidentblog.com without the written permission of ECU. adjustments, stretching, rehab programmes. The universities of Email: [email protected]

BACKspace www.ecunion.eu October 2014 3 ECU news ECU General Council Meeting – Dublin 2014 The meeting heard from the DC Title Working Group, set up following the last GC meeting to examine the issues surrounding the awarding of DC certificates to graduates. The Chair of the Working Group, Vivian Kil gave a presentation and a discussion followed. It was agreed that the group would reconvene and report back to the GC at its he 82nd ECU Annual President of the Chiropractic The meeting was chaired by next meeting. TGeneral Council meeting Association of Australia, and ECU President Øystein Ogre Reports were given by Sidney took place this year on 28 May Lone Koulsgaard, President of the and was conducted in a spirit Rubinstein, Chair of the Research in Dublin. It was attended by 19 Danish Chiropractic Association. of co-operation and harmony. Council, Philippe Druart, Chair GC representatives of the 22 ECU For the first time, student As well as having completed a of the EU Affairs Committee Members, all members of the leaders were invited to attend and detailed questionnaire prior to and Martin Wangler, Dean Executive Council and Secretariat, the ECU was pleased to welcome the meeting, GC representatives of the EAC. In an historic Chairs of the three ECU sub- Mario Olarte of the Barcelona described the current status of decision, the GC agreed that committees (EAC, Research College of Chiropractic and Chris chiropractic in their countries, from 1 January 2015, every ECU Council and EU affairs) and 16 Wood of the McTimoney College outlining both achievements and member chiropractor would observers, including Laurie Tassell, of Chiropractic. challenges. automatically become a member of the European Academy of Chiropractic (see page 29). AECC receives ECU The meeting was honoured by the presence of Laurie Tassell, who grant towards described recent attacks on the profession from sceptic groups MRI facility and the media. He stressed the need for a clear identity and for he ECU General Council am extremely the profession to stop making Thas approved a grant of grateful to unfounded claims. €30,000 in support of the new the ECU for The GC considered two open and upright MRI facility at approving financial requests and granted the Anglo-European College of this grant. €30,000 to AECC in respect Chiropractic (AECC). Not only of its new upright open MRI Installation of the MRI unit, will it help scanner (see left) and €5,000 to the first of its kind in aE uropean to support what is an the Hungarian Chiropractors’ chiropractic institution, is nearly exciting and important website (www.justgiving.com/ Association for translation of complete and is on schedule advancement for the institution, AECCMRI) for donations towards important documents from to open in mid-September. its students and patients, but the MRI scanner project. I English into Hungarian. Once the unit is commissioned, ultimately it will be of benefit to would like to thank all of those Finally, the GC voted third applications training for the the profession in Europe. individuals and organisations terms of office to ECU President dedicated MR radiologist and “Our recent MRI awareness who have already donated and Øystein Ogre and ECU Treasurer the radiography team will take CPD event sold out and we are encourage others to follow suit.” Vasileios Gkolfinopoulos, who place and imaging protocols and now in the process of building For more information about will both continue to serve on the sequences will be finalised. the Bournemouth Open and the AECC’s open and upright Executive Council until 2016. Principal of the AECC, Upright MRI (BOUMRI) website. MRI, visit www.bournemouth The next meeting of the GC Professor Haymo Thiel, said, “I We also have a JustGiving openuprightmri.co.uk. will take place in Stockholm, Sweden on 14-15 November.

4 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union Dr. Robert Melillo ECU news Disconnected Kids Childhood and developmental disorders within chiropractic practice

april, 18th, 19th bologna, italy

Register at chiropratica.it/aic-seminars AIC SPRING SEMINARS 2015

Dr. Robert Melillo is an internationally known lecturer, author, educator, researcher and clinician in the areas of neurology, rehabilitation, neuropsychology and neurobehavioral disorders in children. He's also an expert in nutrition with more than 20 years of clinical experience.

ASSOCIAZIONE ITALIANA CHIROPRATICI chiropratica.it - [email protected] - +390105533036

© s.sobold - fotolia.com aic continuing education seminar 12 credits awarded BACKspace www.ecunion.eu October 2014 5 ECU news Philippe Druart receives 2014 Honour Award ast ECU President Philippe Belgian-born Philippe Druart “Over the course of 18 years, PDruart has been recognised qualified from AECC in 1972. At I had a fairly good idea of what for his contribution to the that time, AECC was housed in was going on within the ECU!” chiropractic profession in Europe Cavendish Road, Bournemouth he says. “As President, I had the with the 2014 ECU Honour and was a far smaller institution opportunity to work with some Award. than it is now. Proud of his alma very strong national presidents At the annual ECU Gala mater, he served not only as who were at the GC table and we said Dr Ogre. “For the ECU Dinner, held this year in Dublin the Belgian representative (for quickly moved towards a much this knowledge is valuable as it’s at the conclusion of its successful 18 years!) but also as Chair of more European approach. It was important that we have a coherent Convention, Dr Druart was the AECC Board of Governors. also great to see the development strategy to ensure that chiropractic honoured for his work, which has During this time he saw the profile of the ECU Conventions, is best represented.” spanned over 40 years. of chiropractic education grow in especially the 2007 joint ECU/ In receiving the ECU Honour Presenting the award, ECU Europe and worked closely with WFC event in Vilamoura where Award, Dr Druart also paid President Øystein Ogre paid past AECC principal Dr Kenneth we celebrated the ECU’s 75th tribute to long-serving Executive tribute to Dr Druart: “Philippe’s Vall. anniversary.” Secretary, Anne Kemp, with whom contribution has been immense As well as working in his In 2005, Dr Druart moved to he worked closely for many years: over many years and the successful clinics within Spain with his wife, Kate, where “Anne had a massive workload, profession owes him a huge debt the Belgian towns of Liège they settled in Andalucía. “It is a but she dealt with everything of gratitude. Over the time he has and Waremme, Dr Druart beautiful area with lovely people really well. It was a blow when she been involved in the politics of the became involved with the and plenty of sunshine,” he says. decided to retire and we were all profession in Europe, we have seen ECU in 1986, serving as the “It was not easy to give up my very sad to see her go.” many positive achievements, not Belgian Chiropractors’ Union practices, but I felt it was the right Dr Druart is grateful for having least of which was the publication representative on the General time for me and the quality of life been given the opportunity to of the first ever European Standard Council until he was elected ECU here in Spain is good.” return to ECU activities, but is for a health profession.” President in 2004. After his presidency, Dr Druart realistic about the challenges that returned to clinical practice, this lie ahead: “The current climate time in Spain, where, he says, in the EU is not easy. We’ve chiropractic-ecu.org – a things are somewhat different than not long had elections. It takes in Belgium. at least six months for the new new website for the ECU “In some ways, it has felt a little administration to get itself in like going back to when I first place, then another six to start he ECU has continued its of a new site is long overdue. graduated in 1972. There is a need becoming effective! Trebranding exercise with It seemed crazy to us that to build chiropractic’s reputation “Our biggest opportunities the developing and launch of a there were separate websites and we have no legislation in lie with the Recognition of new website. covering what were all Spain. Sadly, we also have to pay Professional Qualifications With the development of its functions of the ECU and VAT. There is a need to educate Directives and with EU Patient new logo last year, the ECU has with the decision to formally and inform our communities mobility issues. We need been working on a fresh new look reincorporate the EAC within there, which will take some time.” chiropractic to be legislated in for its site, which will incorporate the ECU, it seemed sensible In 2013, Dr Druart was every EU Member State and this both the European Academy and to cover all areas of the ECU’s appointed as the Chair of a is what we all must work hard to the Research Council. work under one site.” new committee charged with achieve for the future success of Designed to be simple and The new site, www. overseeing EU Affairs. After his our profession.” intuitive, it is hoped that the chiropractic-ecu.org carries success in steering through the Dr Druart is clear on what new site will serve as a resource news and features, as well as CEN Standard for the chiropractic needs to be done for the future of for chiropractors, chiropractic forthcoming CPD events and profession, Øystein Ogre the ECU: “I want to appeal to the patients and other interested information about member considered him just the person for young people in our profession to parties wanting to find out national associations. It will the job. invest themselves for the future more about chiropractic. also link to a brand new Twitter “Philippe brings with him of chiropractic in Europe. We Secretary-General Richard feed, @ECUchiropractic and its such a wealth of experience and have so much to offer as a natural, Brown said: “The development Facebook page. has a very detailed knowledge manual, scientific profession – of the EU and its various arms,” often copied, but never equalled!”

6 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

ECU news ECU GC agrees to fund EU Affairs Joint Working project

he ECU General Council in terms of the European health with other stakeholders, including an analysis of current practice as it Thas agreed to grant €12,000 workforce (which it is estimated will the Health Ministries of 24 relates to best practice. to allow the EU Affairs Committee reach one million by 2020) and the EU States, professional groups • WP6 focuses on horizon to participate in a new Joint Action challenges of a mobile workforce (including AIC chiropractors), scanning, including the Planning and Forecasting project. between Member States. teaching institutions, the WHO estimation of future needs in The project, known as JA-HWF, While mobility is a core value of and NGOs. In this way, key terms of skills and competencies. was initiated to address current the EU, it creates problems when decision-makers in EU Health have • WP7 is concerned with the challenges within health systems. An the valued workforces of some been introduced to chiropractic. sustainability of the Joint Action ageing population, ageing workforce, countries migrate to their wealthier The Joint Action project lasts project as it relates to activities increased demands for health care neighbours. The JA-HWF will for three years. For the ECU to and collaboration. and rising costs all contribute to focus on meeting challenges in fund this project, an estimated From a chiropractic perspective, a need to transform the current terms of the availability of health €12,000 is required for 2014, with the current focus is on WP5 and framework. This has been recognised workers and their skill mixes. an anticipated lesser amount for the opportunity to demonstrate within the European Commission The AIC has taken the lead in 2015 and 2016. chiropractic’s role in best practice and the JA-HWF provides a platform this project and John Williams, There are four main areas of models. for collaboration and exchange Baiju Khanchandani and Donatello work in the project, known as The key aim of ECU involvement within EU Member States to prepare Testerini have already been involved, Work Packages: is to try to convince the large for a future health workforce. including attendance at a meeting • WP4 focuses on data collection, existing stakeholders (medical The JA-HWF project is funded in Bratislava in January 2014. particularly as it relates to doctors, dentists, pharmacists, etc.) by the Health Programme of They are familiar with the mobility and migration. of the need to include chiropractic the European Union. It relates objective of the project and have • WP5 looks at supply and demand as part of the solution in relation to specifically to the identified shortage been able to network effectively planning methodologies based on health system transformation.

Continuing Professional Development

Motion Palpation Institute - MPI Spine - Corey Campbell 18-19 October Primary Spine Practitioner - Course A - Donald Murphy 8-9 November Neuro Orthopaedic Institute in association with AECC presents - Explain Pain - 15-16 November Tim Beames Series in Clinical Musculoskeletal Paediatrics - Seminar 1 Pregnancy and Foetal 15-16 November Development - Joyce Miller & Maria Browning Gonstead Seminar of Chiropractic - John Cox & William Droessler 15-16 November Cervicogenic Dizziness and Vestibular Rehabilitation - Richard O’Hara 6-7 December Series in Clinical Musculoskeletal Paediatrics - Seminar 2 Paediatric Feeding, 31 January - 1 February Nutrition and Growth - Joyce Miller & Maria Browning Dynamic Neuromuscular Stabilisation - DNS - Exercise Course 31 January - 1 February Management of Lumbar Disc Derangements - William Morgan 7-8 February (Chiropractic representative for the United States Navy’s Musculoskeletal Continuum of Care Advisory Board) Primary Spine Practitioner – Course B - The Cervical Spine - Donald Murphy 14-15 February Prague School to Athletic Development Series - Faulty Movement Patterns & 6-8 March Rehab of the Athlete - Craig Liebenson

For details of all postgraduate opportunities please visit: www.aecc.ac.uk/cpd

BACKspace www.ecunion.eu October 2014 7 Convention Diversity a hit with delegates at 2014 Convention Continued from page 1 their minds to new ideas. At the end of a busy first day, The first day of the event over 200 delegates and guests began with an energetic display made their way to the Jameson of Irish dancing following by an Irish Whiskey Museum for an official welcome from the hosts, evening of traditional food, drink the Chiropractic Association of and entertainment hosted by the Ireland. Øystein Ogre gave an CAI. The mix of Jameson’s and inspiring opening address before lively Irish singing and dancing Gitte Tønner chaired a lively ensured that people were on opening session on the value of their feet very quickly! diversity in the profession. Day two saw more excellent High-profile sports chiropractor presentations, with Dr Mary Alan Sokoloff delivered Baker of the European Brain an energetic and inspiring L-R David Newell, Øystein Ogre, Erik Poulsen, Gitte Tønner Council, Professor David presentation on the value of Cassidy and Professor Ted teamwork, and shared his quality presentations. This sponsors Activator Methods and Carrick presenting in the area practical knowledge during some provided some difficulty for the Foot Levelers providing excellent of neurology and brain injury. highly popular workshops. judges, chaired by ECU Research instructors to share techniques With increasing interest in the Chair, Sidney Rubinstein, in as well as captivating sessions on field of functional neurology, Research, workshops, deciding which researcher would functional neurology and sports the presentations stimulated quantum physics … receive the annual Jean Robert chiropractic. delegates and proved popular and whisky Award for Research, but in the A big attraction at this year’s with all. As usual, the Convention end it was Denmark’s Erik Poulson Convention was Professor attracted submissions of who was named the winner for his Bruce Lipton. His work in the Maintenance care, original research, with both new work on osteoarthritis of the hip field of quantum physics drew masterclass and and experienced researchers (see page 15). a large audience as he shared moving forward presenting their latest work. The One of the features of this his thought-provoking work, as Among the liveliest debates was quality of this year’s abstract year’s new format was the range delegates were invited to discard one on the value of maintenance submissions was extremely high, of practical workshops. Delegates traditionally-held views and open care. Conflicting views ensured with individual and institutional were given a wide choice of researchers producing high themes with ECU joint platinum

Tim Raven with Lise Lothe Prab Chandhok with Professor Jenni Bolton

8 BACKspace www.ecunion.eu October 2014 Customize and order your table at vodamed.com We proudly build each table to order!

Choose your own table style, options and colour BEST PATENTED DROPS ON THE MARKET The Patented modular Accele- rator™ III manual drop design provides faster acceleration Build your practice with BEST-IN-CLASS with increased tension and future upgradeability. Ergonomically designed tables

VODAMED is Europe’s leading supplier of chiropractic tables and supplies. Over REINVENTING THE 10 years VODAMED has brought together some of the industries finest brands. ADJUSTING TABLE We are the proud importer of ErgoStyle Tables, Eurotech & Tradeflex Table series, ErgoStyle™ changes how all Techniques Tables, FMST Tools, Thumper Massagers and more. adjusting table are viewed. It’s modular design allows for quick • Variable Height / Elevation • Benches modifications and upgrades • Manual or Auto-cocking Drops • Roller Massage Tables in the field. Upgrades can be • Manual or Automatic Flexion • Portable Chiropractic Tables added later as your techniques • Stationary Tables • Traction & Decompression Tables and practice grow. • HYLO

For a complete chiropractic table listing and a dealer in your area:

Call us on +31 (0)85 4010900 or visit vodamed.com Scan to learn more Convention

the chiropractic profession, for spine care. embrace Darwinism and move The Convention ended with forward. Offering differing the presentation of research philosophical perspectives the awards and a closing speech two traded ideas on the merits from Øystein Ogre, who paid of modernising the profession, tribute to the efforts of the CAI yet on the whole a respectful organising team and to Gitte consensus was achieved. Tønner. Thankfully, the debate did not On Saturday evening, boil down to a dance-off at the delegates were treated to the Saturday night gala dinner! best of Irish hospitality at a well-attended Gala Dinner with Popular new format great food, fine wine, lively This year’s Convention saw a rich entertainment and dancing until thread of workshops that ensured the early hours. that there was something for All agreed that Dublin 2014 everyone. The new format was a great success and with proved extremely popular, with the joint WFC Congress/ECU options to learn new techniques Convention next year in Athens, relating to peripheral joint care, now is the time to start making attend ultrasound workshops, plans for what promises to and find out more about the be another stimulating and latest evidence-based methods enjoyable event.

Sue Wakefield, who is retiring asE xecutive Director of the BCA, on being presented with a gift in recognition of her service to the ECU. “Participants were treated to a diverse range of ideas on treatment prescription and volume” audience participation and with including David Byfield, Tammy Eurovision-style voting, there de Koekkok and Dominique were plenty of opinions voiced Hort. Participants were treated from all parties! The debate was to a diverse range of ideas enhanced by the presence of on treatment prescription Charles Normand, a professor of and volume. The debate was health policy and management conducted in a lively spirit and economics. Stressing the and the exchanges were both value of supportive care in long- entertaining and stimulating. term conditions, he provided Focusing on the theme of a stimulating ‘outsider’s view’ diversity, Saturday afternoon on the issue of maintenance in saw a ‘fireside chat’ styled chiropractic. debate between Gerry This year’s EAC masterclass Clum and Richard Brown. was entitled The Great Dosage Chaired by David Chapman- Debate and featured a host Smith, Drs Clum and Brown Mark Zieglar of Foot Levelers with of chiropractic personalities, debated the need to evolve AECC Director of Clinic Neil Osborne

10 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Convention

ECCE President Olivier Lanlo with Brenda van der Vossen ECU President Øystein Ogre with CAA President Laurie Tassell “There was so much on offer” Second-year chiropractic student Mario Olarte talks of his experience at Dublin 2014 his year’s ECU to be there. Being a volunteer was Grant. The Activator seminar from and sponsors showed off their TConvention was not my first, really not too challenging at all; I Arlan Fuhr was also great and I instruments, programmes, but for me it was by far the best. helped out at the registration desk, found the final debate between protocols and techniques, some of As a student, I was really pleased completed some light tasks and Gerard Clum and Richard Brown which I had never seen before. to see that the programme had was available at the busy times of about the adaptability of our Away from the academic material not just for qualified the Convention, but really I was profession in the near future really programme, the Convention chiropractors but also plenty for us largely free to attend whatever I fascinating. provided an excellent opportunity students, too! wanted to. But for me, the highlight was the to socialise with students from The organisation of this year’s What I appreciated this year is exciting and inspiring talk of Bruce colleges all over Europe, to speak event ensured that there was that even as a second-year student, Lipton. This was just so interesting with prestigious chiropractors and a huge range of activities and I felt really comfortable being and it left me speechless! meet inspiring speakers. different workshops, seminars there and was able to really benefit At some points, there were It was great to catch up with and debates to choose from from being exposed to so many so many inviting seminars and friends and meet fellow students throughout the Convention. They different areas of the profession. workshops going on at the same whom I had met at previous appealed to a wide spectrum; from I particularly enjoyed the time, it was really hard to choose ECU conventions. To be at such second-year students like me, to presentations on functional which one to attend! Fortunately, a large international gathering of recent graduates, to those with neurology, and especially those a number of them were repeated chiropractors, listen to their stories many years of experience. There from Ted Carrick and Heidi so that it was possible to get to and learn from their experiences was also a diverse range of subjects most of what was on offer. – not to mention experience their covered and I was exposed to The ECU General Assembly generosity towards us students at new ideas that both inspired and was really worth attending. the bar – was unforgettable! excited me about my future career. Øystein Ogre told us about the From all of the above it is I found the debates about current status of the chiropractic unnecessary for me to say that current issues to be interesting profession in Europe and many after Dublin 2014, I’m definitely and the hands-on workshops of the issues related to it. It was looking forward to the joint WFC were stimulating. I also enjoyed also interesting to hear about the Congress/ECU Convention in learning about the latest research experiences of Laurie Tassell in Athens next year! going on in our profession. Australia. I attended this year’s During the breaks, I really Mario Olarte Convention as a student volunteer enjoyed exploring the exhibition Year 2 student, Barcelona and jumped at the opportunity area, where all kinds of vendors College of Chiropractic

BACKspace www.ecunion.eu October 2014 11 Convention “The Convention provided an excellent opportunity to socialise, to speak with prestigious chiropractors and meet inspiring speakers”

Claire Wilmot with AECC Head of Marketing Lisa Martinez Academic Organiser Gitte Tønner with Alan Sokoloff Alpha and Omega: Athens 2015 ext year’s joint WFC from the ancient roots of spinal speakers will describe what they in a host of exciting and NCongress/ECU Convention manipulation right through to see as the ‘Rules of Engagement’ innovative areas. With Dr Dan promises a dazzling array of world futuristic technology that would and the realities of practice. Murphy describing the science class speakers and something for have shocked our forefathers. Leading figures from the fields of subluxation, to adjusting and everyone. The opening plenary session will of paediatrics, adolescent care, McKenzie workshops, to Lindsey Held in the ancient Greek city feature some of the biggest names pregnancy and seniors will be the Rowe’s ever-popular radiology of Athens from 13 to 16 May in spinal research from around main attraction on the final day sessions, the opportunities 2015, The Alpha and Omega of the world. Jan Hartvigsen, Greg of the Congress. Arguably the are endless. There is even the Spinal Healthcare will be the Kawchuk, Scott Haldeman and foremost chiropractic paediatrician chance to get a taste of animal WFC’s 13th Biennial Congress Christine Goertz will look at the in the world, Dr Joyce Miller, chiropractic with a special equine and will incorporate the ECU’s impact of spinal manipulation on will speak alongside Drs Lisa adjusting session! Annual Convention. Presentations body systems and its utilisation Hestbaek, Rosemary Oman, Paul Registration is now open for will include those from policy for mechanical, neurological and Dougherty and Lisa Killinger in this unique chance to experience makers, practitioners and those at medical conditions. Fascinating the discussion of the management the world’s leading chiropractic the cutting edge of research. developments in neuroscience of special populations. event. Visit www.wfc.org now WFC President Dr Greg also feature in the first morning’s As is customary at both to reserve your place and start Stewart, explained: “The line-up session with names such as Ted WFC and ECU events, the planning to visit Greece in 2015. of speakers we have assembled for Carrick and Heidi Haavik applying profession’s leading researchers President of the Hellenic our 2015 Congress is amongst their knowledge and research to will be presenting their original Chiropractors’ Association, Dr the best ever. I challenge any evidence-based spinal health care. work, competing for the awards Vasileios Gkolfinopoulos, adds: chiropractor to look at the Day two will see an inspiring that recognise outstanding “We look forward to welcoming academic programme and not find line-up of speakers exploring contributions to the development chiropractors from around the a whole host of subjects that will the current opportunities in of spinal health care by world to our beautiful and historic fascinate and inspire.” spinal health care. Chaired by chiropractors and institutions. country. We have ancient history, As its title suggests, the focus one of the profession’s leading This year there will be a record beautiful beaches, a vibrant culture for the joint WFC/ECU event researchers, Denmark’s Professor number of technique workshops and of course the very best that will be on spinal health care, Jan Hartvigsen, a succession of and special interest presentations the sun gods can offer!”

12 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Convention

The Alpha and Omega of Spinal Healthcare HILTON ATHENS HOTEL

www.wfc.org/congress2015

BACKspace www.ecunion.eu October 2014 13 Research Research Corner: What is the role of systematic reviews?

n the last issue of BackSpace bewildered and questioning whether What are meta-analyses? based medicine (EBM) renaissance II wrote about study design and the therapy was effective or not and Use of meta-analysis is a statistical came the need for a repository for discussed briefly which designs are whether it should be implemented technique for pooling data. The systematic reviews and a global optimal to answer your clinical in practice. basic idea is that if, for example, organisation that could achieve question. In this issue I would like there were three RCTs with 40 this. The answer came with the to discuss the role of systematic The present subjects in each trial, pooling allows Cochrane Collaboration which reviews and meta-analyses. Following this period came us to combine the trial data from was established in 1993. Today it enlightenment and attempts these three studies (assuming that includes more than 28,000 people What are systematic were made to bring order from they all measure the same effect from more than 100 countries reviews? chaos. Emphasis was placed and are roughly equal in terms of who have collectively produced Systematic reviews are an attempt on ‘systematic’. Explicit search design, population, intervention, more than 4,500 reviews. to summarise the available evidence strategies and selection criteria and outcome). If they aren’t, this Cochrane reviews are highly and support clinicians in bringing became the norm, so it was clear introduces ‘heterogeneity’, which regarded due to their detailed their practice more in-line with to the reader which databases makes the interpretation of the analysis and rigour and are often evidence-based principles. Their were searched and which studies results questionable and potentially seen as the gold standard of necessity becomes painfully were included or excluded. compromises the validity of the systematic reviews; as the author obvious when one considers that Furthermore, attempts to evaluate results. of two such reviews I can attest there are more than 20,000 medical methodological quality were In short, with a far larger to the exacting standards that are and allied journals, collectively introduced. number of subjects, pooling gives required in their preparation. publishing more than one million This process of ensuring us greater statistical power. It also articles per year. good methodological quality of gives us better insight into the Conclusion studies is not just an exercise for effect of a therapy and makes it Evidence-based practice is the The past epidemiologists who are looking possible to detect small effects, and use of the best available scientific Prior to the 1990s, reviews were for work in their ‘free time’, but effects in sub-groups. One of the research, the experience of nothing more than narrative (or serves to raise the likelihood of main criticisms of meta-analyses clinicians and the preferences of descriptive) reviews. In practice, their being more representative occurs when combining uniquely patients. Chiropractors, like all an author was invited to write his health professionals, should be commentary about a given therapy “Chiropractors should be encouraged to utilise evidence- but these types of reviews often based practice in the best interests reflected nothing more than the encouraged to utilise evidence- of their patients. Over the opinion of the author. With no strict based practice in the best years, systematic reviews have selection criteria of the articles being undergone development, and listed, readers were left to question interests of their patients” now represent an important link why certain articles had been of the true picture. Typically, different studies, resulting in the EBM hierarchy. It is no included or excluded. Often, articles poorly-conducted studies over- essentially in a comparison of longer acceptable to cite individual were included to demonstrate that estimate the effect of a given ‘apples with oranges’. Obviously, studies that support a particular a particular therapy was effective therapy, thus making it appear in order to prevent this, clinical style of practice while ignoring which supported the preferences more effective than in reality. For insight is necessary, but it can those that are less supportive or of the author, while those which example, in RCTs the process of also be ‘tested’ by conducting critical. While scientific research had a ‘negative’ or equivocal result randomisation is critical and it is sub-group or sensitivity analyses still does not have all of the were excluded. Furthermore, in the important to consider whether in order to determine if and how answers, we should all look to see early days, no attempt was made patients were properly assigned much the apples and oranges really what works best and then apply to ‘pool’ (or combine) data from to the therapy or control group. are dissimilar. this to our patients. the individual studies (which I During this period, techniques for explain later) with the result that ‘pooling’ (or combining) data from The Cochrane Sidney Rubinstein DC, PhD reviews were long, dry narrative individual RCTs were introduced, Collaboration Chair, ECU Research reports leaving the reader even more and are known as meta-analysis. Around the time of the evidence- Council

14 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Research Jean Robert Research Award

First Prize: Erik Poulsen Patient education with or without manual therapy compared to a control group in patients with Osteoarthritis of the Hip. A proof-of-principle three-arm parallel group randomized clinical trial Erik Poulsen1, Jan Hartvigsen2, Henrik Wulff Christensen1, Ewa Roos2, Werner Vach4, Søren Overgaard5

1 Nordic Institute of Chiropractic and Clinical Biomechanics; Odense; Denmark 2 University of Southern Denmark, Department of Sports Science and Clinical Biomechanics; Odense; Denmark 4 University of Freiburg, Institute of Medical Biometry and Medical Informatics; Freiburg; Germany 5 odense University Hospital, Department of Orthopedic Surgery and Traumatology; Odense; Denmark

Introduction: on an 11-box numerical rating intervention demonstrated Patient education (PE) is scale and primary end-point was clinically and statistically significant recommended as a core at 6 weeks immediate following differences in comparison to a intervention for patients interventions. Secondary outcome home-based stretching program with hip osteoarthritis (OA) measures included the Hip for patients with hip OA. The but effectiveness in terms of disability and Osteoarthritis patient education program alone improvement in pain and Outcome Score (HOOS), was no better than the home-based function is small and conclusions patients’ perceived global effect of stretching program. form systematic reviews are interventions (PGE) and numbers contradictory. Manual therapy having had hip replacement Erik Poulsen (MT) is recommended as an surgery at 12 month follow-up. Dr Poulsen is a 1989 graduate of Palmer College of Chiropractic, adjunct intervention but evidence Davenport and has since worked as a chiropractor in the US, England, is limited to a few randomized Results: Scotland and Denmark. In 2006 he completed his MSc in Advanced clinical trials (RCT). Therefore, Follow-up data was available Professional Development from the Anglo European Chiropractic the objectives of this study were for 111/118 patients. Baseline- College and Portsmouth University and has for the last 10 years had a to investigate the feasibility of adjusted reduction in pain special clinical and research interest in hip disorders. He received his including a PE program and intensity was 1.9 points (95% PhD in 2012 from the University of Southern Denmark. Erik currently MT in a randomized clinical CI 0.9 – 2.9) greater for the works part-time at the Nordic Institute of Chiropractic and Clinical trial in a Danish health care combined PE/MT group when Biomechanics and part-time in private practice. setting for patients with hip OA compared with the home-based Dr Poulsen is an individual member of the ECU. and specifically examine the stretching group. No difference effectiveness of a PE program was found between the PE and alone or in combination with MT home-based stretching group when compared to a minimal (-1.0 – 1.0). The HOOS scale control intervention. demonstrated similar results as the primary outcome. At 6 weeks, Methods: 76.5% of patients in the PE+MT A total of 118 patients with group had classified themselves unilateral hip OA were as improved compared to 22.2% randomized into one of three in the PE group and 12.5% groups: PE, PE plus MT, and a in the MCI group, p<0.001. home-based stretching program. At 12 months, 12 patients in PE involved 5 (2 individual the PE group had received hip and 3 group) educational replacement surgery, 4 in the PE/ sessions taught by a specially MT group and 7 in the home- trained physiotherapist and based stretching group. MT involved 12 sessions delivered by a chiropractor Conclusions: including a combination of The chosen trial set-up and trigger point release therapy, selected outcome measures were Jonathan Branney, who won muscular stretching and joint feasible in a Danish health care the ‘New Investigator’ award manipulation. Primary outcome setting and a combined patient at the Convention in Dublin was patient-rated pain intensity education and manual therapy

BACKspace www.ecunion.eu October 2014 15 Research Research Council update here are currently 11 cervical spine inter-vertebral that researchers are encouraged chiropractor, manual therapist) Tprojects being supported motion patterns and patient- to seek co-funding from their and types of manipulative by the ECU Research Fund. This reported outcomes, and has respective national organisations techniques (e.g. HVLA includes one that has recently been presented at many and other stakeholders. In manipulation, mobilisation) been completed and several international spine symposia. It fact, the Research Council which are likely to influence that are nearing completion. has also recently been published looks favourably upon those the overall treatment effect. Just under half of these include in Chiropractic & Manual applicants who are able to Use of IPD data will allow for chiropractors working on post- Therapies. demonstrate other sources of exploration of individual patient doctoral studies, while the Seven new funding proposals funding. and treatment characteristics remainder include chiropractors were considered by the This year funding went to which are masked by the use working towards PhDs and one Research Council earlier this support an exciting new PhD of aggregate data in standard working on a Masters project. year. For a number of reasons, project lead by Dr Annemarie meta-analyses. This means The Research Council is only one of these was funded. de Zoete, a chiropractor from that IPD meta-analyses have proud to have supported As a Research Council, we would the Netherlands. The project the potential to produce more young researchers such as like to support more high- will use individual patient clinically relevant results than Johnny Branney at AECC, quality projects, but restrictions data (IPD) from RCTs of spinal standard meta-analyses. The who recently won the ‘New on funding require us to make manipulative therapy (SMT) results are expected in 2017. Investigator’ award at the 2014 tough decisions. Despite for chronic low-back pain. The ECU Convention in Dublin (see this, the Research Council goals, among other things, are Sidney Rubinstein DC, PhD page 15). His study investigated looks forward to many future to identify characteristics of SMT Chair, ECU Research the effects of manipulation on applications, but we would stress such as type of practitioner (e.g. Council

General news IFEC announces new collaboration he Institut Franco- an innovative collaboration, at the same time introducing as an artificial TEuropéen de Chiropraxie comprising a behavioural contemporary ideas. split between (IFEC) has announced exciting approach, incorporating “We firmly believe that it is so-called developments in its collaborative, biomechanics, experimental important that our profession scientific educational and research work. psychology and neuroscience, and understands its history and chiropractors With strong existing links to a social science approach, which maintains its roots, but does so and the world-renowned Université includes political sociology and in a lucid manner,” he said. “By philosophical Paris Sud as well as the chiropractic relationships between body, mind, using the academic skills and chiropractors. programmes at Univiersité du health and cultural factors. research expertise of the faculty “Here at Québec at Trois Rivières, Perth’s Head of IFEC, Dr Olivier at the university, I am confident IFEC, we are Murdoch University and the Lanlo, is positive about the that the student experience will be modernising University of Zürich, IFEC is new collaboration. “The long enhanced and that the identity of our approach constantly strengthening its term plan here is to expose our the profession will be maintained to educating tomorrow’s academic and research capacities at students to a wide range of factors by graduating chiropractors chiropractors. We want to its campuses in Paris and Toulouse. associated with sport and human who are both scientifically and understand our students - their In a ground-breaking performance. In particular, we want philosophically grounded.” personalities, beliefs, goals and partnership agreement, IFEC to show them how knowledge of In other developments, IFEC what they need to get from our has joined up with the Program the various philosophies of health has announced a new research programme. We recognise that for Interdisciplinary Research can be combined with research and initiative working with a team ensuring a solid understanding of in Sports Science and Human the current evidence base.” of sociologists to build on the the social sciences is as important Movement (PRISSMH) at the Dr Lanlo recognises that PhD thesis of Dr P L Gaucher- as anything else. By marrying pure University of Toulouse III (Paul there are historical conflicts Pesherbe, a French chiropractor science with the history, traditions Sabatier). between philosophy and science who studied the sociological and philosophy of chiropractic we PRISSMH is attached to the in chiropractic. He is keen history of chiropractic. are confident that we will succeed in Life Sciences department at the to maintain the fundamental Dr Lanlo stresses the importance better integrating chiropractic into university and has developed identity of the profession, whilst of putting an end to what he sees the health system.”

16 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

General news AECC develops links Swiss chiropractic programme gains government accreditation

with WHO in Geneva Continued from page 1 Speaking after the announcement Professor Humphreys said: “This is an historic day for chiropractic. As the first Chair for Chiropractic in a university in Switzerland I am deeply honoured to be part of this amazing achievement. There are many Swiss chiropractors who have worked long and hard for this day and I am grateful for their sacrifice and perseverance that made it possible. “I am also grateful for the tremendous support and encouragement we have received from our home, the Orthopaedic University Hospital of Balgrist. They have been amazing in helping us to establish ourselves as valued members of the team.” The first cohort of students began the six-year M.Chiro.Med programme at the University of Zürich in September 2008. The programme is fully integrated within the University of Zürich Medical Faculty and students study chiropractic along with four full t is often said that some of which could include students and years of medicine. Ithe best education takes place graduates from AECC. After graduation, students must pass a federal examination and outside the classroom. Four Not only was this a great then enter a two-year postgraduate programme. The postgraduate senior AECC student interns, learning experience for the programme was accredited by the Swiss government in 2011 under accompanied by Dr Neil Osborne students, but the WHO has also the same procedures and conditions as all other medical faculties (AECC Director of Clinic), asked AECC to consider collecting (i.e. residency programmes). eagerly accepted a recent invitation data for it; a unique opportunity Graduates are eligible for the Doctor of Chiropractic Medicine to visit the World Health to collaborate with the (D.Chiro.Med) degree upon completion of an additional research Organisation (WHO) in Geneva, organisation. The AECC, which thesis submitted at least one year after completion of the M.Chiro. Switzerland. The AECC has now developed the Bournemouth Med programme. been asked to collect data for the Questionnaire, has a strong After an extensive accreditation process and site visit in 2013, organisation. track record in the collection of the SUK and CSA announced their approval of the chiropractic This memorable day began with self-reported data, from patients programme on 3 July 2014. a tour of the WHO Campus, recording pain and anxiety levels, Professor Humphreys concluded: “The future of chiropractic followed by presentations from a and has strongly engaged with in Switzerland is bright as we are where we should be; working number of WHO staff members, Care Response, a leading method together, shoulder-to-shoulder, as a respected member of the including a discussion with of collecting and summarising health care team for the benefit of patients.” the lead author of the first-ever presentations and outcomes of Commenting on the announcement, ECU Secretary General Richard International Disability Report. patient treatment. Brown said: “This is a proud time for chiropractic in Europe and another The group then shared time Professor Haymo Thiel, AECC landmark achievement for the profession in Switzerland. The ECU with WHO interns, who outlined Principal, said of the link: “With salutes the work of Professor Humphreys and his colleagues. They set the exciting and important approximately 50,000 patient high standards for chiropractic education and deserve the thanks and contributions that students and visits per year, AECC hopes to appreciation of all within the profession for what has been achieved.” new graduates could make to become a leading collaborating the work of the WHO. This is institution for the WHO in the something that has been extended field of musculoskeletal pain National handball triumph to the chiropractic profession in and disability. This is an exciting recent years, due largely to the development and demonstrates for AECC Ladies team outstanding contribution of Dr the potential for collaboration at he AECC Ladies Handball team has been crowned champion at Molly Meri Robinson Nicol, a the highest level.” Tthe UK Student Handball Championship. former intern herself, but now a The final play-offs, held earlier this year in Dagenham, London, Senior Technical Officer within the saw disaster strike for the AECC at the outset, losing one of WHO Classifications Department. their players to a knee injury. With no substitutes, the team was Dr Robinson Nicol explained forced to play on with just six players, winning every match before how there were opportunities for defeating Nottingham in the final. undergraduates and new graduate As a result of winning the UK Championship, the AECC ladies went chiropractors at the WHO as on to represent the UK in the European play-offs in the Netherlands. part of a Fellowship programme,

BACKspace www.ecunion.eu October 2014 17 General news Barcelona College celebrates first graduates

he Barcelona College president of the Asociación Tof Chiropractic (BCC) and Española de Quiropractica, Dr Universitat Pompeu Fabra (UPF) Carlos Gevers and the president graduated their first cohort of of the European Chiropractors’ chiropractors on 5 July 2014 Union, Dr Øystein Ogre. after the class of 20 students Graduates of the programme satisfactorily completed the receive a Titulo Superior en five-year full-time (310 ECTS) Quiropráctica from the BCC programme of study. and a Master en Quiropráctica Dr Budgie Hussain, Director of the Centre for Ultrasound Studies, The graduation ceremony from the UPF. with one of the new SonoSite machines took place on the campus of Of the 20 graduating the UPF and was attended by students, three passed with more than 350 family members, distinction and two with merit. AECC diagnostic friends and officials. The Valedictorian was Cristina The commencement speech Elena Egea. Separate awards ultrasound unit was delivered by Dr Gerard for philosophy, art and science Clum, who is the immediate were received by Gerard Rovira, past president of Life College Christin Jaesch and Richelle gets major boost of Chiropractic West and a Gardner respectively. former president of the World The BCC currently holds ECC has signed a major introduction of six new consulting Federation of Chiropractic. candidate status with Anew agreement with FujiFilm and teaching rooms. The The graduating class was also the European Council on SonoSite to equip its diagnostic agreement signed with FujiFilm addressed by the principal of Chiropractic Education (ECCE) ultrasound teaching unit with SonoSite equips the centre the BCC, Dr Adrian Wenban, and is now in the process of eight new high specification with state-of-the-art ultrasound the chair of the BCC Board of applying for full accredited ultrasound machines worth over machines for these teaching Governors, Dr Jake Smith, the status. €800,000. facilities. Since the introduction of the The loan agreement, in place Centre for Ultrasound Studies for three years, reflects the (CUS) and the appointment of reputation of AECC as being at its Director, Dr Budgie Hussain, the leading edge of diagnostic the programmes have gone from ultrasound education and training strength to strength. There are nationally, and is an endorsement currently 75 students at CUS, of the high regard in which global studying diagnostic ultrasound manufacturer FujiFilm holds in musculoskeletal, obstetrics AECC as a centre of excellence. and gynaecology and abdominal AECC Principal Professor applications as well as in specialist Haymo Thiel commented: “The areas such as nuchal translucency AECC is delighted to enter into screening and ultrasound-guided this agreement with SonoSite, injections. from which students can train on Students come from a variety the latest high-tech equipment to of backgrounds, including enhance their learning experience medicine, nursing and midwifery, and ensure they leave with up-to- radiography and physiotherapy as date skills and competencies. We well as chiropractic. hope this agreement will continue To reflect the success of this well into the future with mutual initiative, in 2013 the AECC benefits for both SonoSite and the expanded the centre with the College.”

18 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

General news International Obituary: Medical Robert Jean Gevers University visits AECC (1948-2014) and WIOC r Robert Gevers, a medicine without a licence) President, Carlos Gevers-Montoro. Dfounder member of the constantly hanging over them. Carlos paid tribute to his father: he Anglo European Spanish Chiropractic Association, Dr Gevers was active in the ECU “Since my father founded the TCollege of Chiropractic passed away in May this year and participated in the establishing AEQ, the Spanish chiropractic (AECC) and Welsh Institute following a short illness. Dr of the World Federation of family has grown to more than of Chiropractic (WIOC) were Gevers was instrumental in Chiropractic. Well-known within 230 members and every year visited by the President of the developing the chiropractic the profession, his charismatic and chiropractors are graduating from International University of profession in Spain and was the persuasive character ensured that our two extraordinary colleges, Malaysia (IMU) and several first President of the Asociación the AEQ maintained a strong push Barcelona Chiropractic College members of its executive, Española de Quiropráctica (AEQ). for legislative recognition, although and the Madrid Chiropractic including the Head of the Born in 1948 in Antwerp, this did not come to fruition College. None of this would have Chiropractic Programme at IMU, Belgium, Dr Gevers’ first degree during his lifetime. been possible without my father. Dr Peter Diakow, in June. was in economics, graduating ECU Past President and fellow He was more Spanish than any of IMU is Malaysia’s first and most from the University of Leuven in Belgian chiropractor, Philippe his Spanish-born children!” established private medical and 1970 before deciding to pursue Druart, recalls: “Whilst trying Dr Gary Auerbach of Tucson, health sciences university with a career in chiropractic. Having to look at ways that chiropractic Arizona, served as the WFC’s first over 22 years of dedicated focus married into a family in which the could achieve legislation in Spain, president in 1988. He comments: in health care education. It is also parents had been direct disciples Robert would look at all of the “Robert was a close friend and the first university in Malaysia of BJ Palmer himself, Dr Gevers angles and would sometimes call partner in the 1980s as we worked that offers a chiropractic degree boarded a ship, sailed to the me up to 10 times a day! If he together on the international programme alongside other health United States and embarked on didn’t get the answers he was after, organisation of the profession, subjects, including medicine and the chiropractic programme at he would call again and again, with formation of the World dentistry. Palmer Chiropractic College. Four examining every possible area. Federation of Chiropractic and AECC has had a Memorandum years later, in 1974, with his first “Concerning his beloved the development of chiropractic of Understanding with IMU for child and a chiropractic degree, he profession, Robert never gave up in Spain. He had so much to do a number of years, under which flew back to Spain. and remains a shining example for with the successful growth of students from its chiropractic Dr Gevers opened multiple all young chiropractors starting the profession in Spain and will programme can apply to AECC clinics in Madrid and, with their own practice: first, to defend continue to do so through his son at a certain point in their studies unrivalled passion for his new your profession at all levels and Carlos.” to finish their education in the profession, soon developed an second, to be dedicated to your Dr Gevers had one final UK. Similarly, agreements have excellent reputation, leading patients as much and for as long as adventure in 2013, when he opened been made with WIOC and to first a three-month, then a you can.” a practice in Leon, Mexico and constructive discussions were held six-month waiting list for new As a past AEQ president, Dr delivered his last adjustments. It was when the IMU representatives patients. Within a very short space Gevers continued to work tirelessly there that he passed away peacefully visited WIOC as part of their UK of time, Dr Gevers was Spain’s for the association, meeting in his sleep on 18 May, 2014. trip. most celebrated chiropractor. with Ministries of Health and Robert Gevers is quoted as saying: David Byfield of WIOC with It became clear that a Education in pursuit of legal “Chiropractic is the most gratifying representatives of Malaysia’s professional association was recognition for chiropractic in profession there is if practised with International Medical University necessary to organise and promote Spain. His efforts were rewarded generosity and a giving attitude.” chiropractic in Spain. With Dr by the establishment of the Madrid As the legacy of his work lives on, Gevers as one of its five pioneering College of Chiropractic (formerly those words will resonate with founder members, the AEQ was RCU) and the Barcelona College chiropractors across the world. established in November 1986 of Chiropractic. He finally stepped The ECU offers its sincere and became a full member of the down as AEQ President in 1994. condolences to Carlos, his family ECU in December of that year. With his wife, a native of Spain, and others who were close to Dr This was a challenging time for Dr Gevers had four children, three Gevers. With his passing, the chiropractors in Spain, with the of whom became chiropractors, chiropractic profession has lost an threat of prosecution (for practising including the current AEQ inspirational leader.

BACKspace www.ecunion.eu October 2014 19 General news DEXA Scanner Non-ECU affiliated institutions installed at WIOC to contribute to ECCE costs ollowing and Dublin, Ireland as well as new state-of-the-art commonly is used in women over Frepresentations from the McTimoney College of A DEXA scanner has been 50 and men over 60. It is non- the ECU, the European Council Chiropractic in the UK. installed at the Welsh Institute of invasive and works by utilising low- on Chiropractic Education ECU President Øystein Ogre Chiropractic. dose x-rays at two different energies (ECCE) has approached the welcomed the move: “The ECU Operational training on the to distinguish between bone and soft educational institutions of grants over €35,000 per year for scanner took place in June and tissue. The examination is usually non-ECU member countries to help in maintaining international planning is now well-advanced performed at the commonest sites of request that a contribution be standards, yet it seems that for the business and research fracture: spine, hip and wrist. made towards its running costs. beneficiaries such as those from components of the initiative. Currently, the ECCE accredits non-ECU countries pay nothing. Dr David Byfield, Head of What do T and Z three institutions which are not I am very keen that this move WIOC, commented: “There is a scores mean in DEXA associated with ECU Member may lead to a fairer way of great deal of interest from the Local scanning? National Associations. These sharing the costs of supporting Health Board in this technology DEXA measures bone mineral are in Durban, South Africa quality standards in Europe.” as waiting lists in the area are density and is considered the currently exceeding nine months. gold standard in osteoporosis “There are a number of people scanning. Results are given in New research department to thank for this development, the form of ‘T’ and ‘Z’ scores. particularly Dr Simon Williams, The T score is also known at Madrid College of principal lecturer at the Faculty as the ‘young normal’ Chiropractic of Life Sciences and Education, measurement and indicates who was instrumental in the grant how bone mineral density he Madrid College of Chiropractic (formerly RCU) has application that secured funding compares to that of a healthy Testablished a new research department at its campus at the Maria for the equipment.” 30-year-old female. Peak Cristina University at El Escorial. WIOC will be collaborating bone density is reached at 30 Under the directorship of Dr Arantxa Ortega de Mues, the first projects with Dr Williams and others in the and should ideally remain at have commenced in collaboration with the Jimanez Diaz Hospital Faculty to maximise the academic this level. Foundation and the University San Pablo CEU. Collection of data has been and research potential of the service. The T score is the most undertaken and Dr Ortega and her team are now proceeding to the next DEXA (Dual Energy X-Ray important value. It is phase of the project. Absorptiometry), often referred to measured in units of standard Other major institutions in Madrid have shown interest in collaborating as bone density scanning, measures deviation (SD) from this ideal, with MCC as part of a larger research group. However, without funds bone mineral density and is used to either above normal (+) or except those from the institutional budget and the Spanish Chiropractic diagnose osteoporosis. It is the most below (-). Optimal bone mass Association, the launch of further projects is currently on hold. widely-used and thoroughly studied T-scores range from -1 to form of bone density analysis. It +1. Osteopenia is diagnosed can be used at any age, but most when the T-score is between ECCE accreditation visits -1.75 and -2.5. A T-score wo institutions which As well as first accreditations, below -2.5 is considered Tcurrently have European re-accreditation visits have diagnostic of osteoporosis. Council on Chiropractic been scheduled by the ECCE’s The Z-score is also known Education (ECCE) Candidate Committee on Accreditation for as the ‘age-matched’ status will be undergoing the Institut Franco-Européen measurement and compares full accreditation visits this de Chiropraxie (November bone mineral density with autumn. 2014) and the Welsh Institute of what would be expected Both the Barcelona College Chiropractic (February 2015). in someone of the same of Chiropractic (BCC) and In compliance with European age and size. Again, the full-time programme at Association for Quality measurements are in SD the McTimoney College of Assurance in Higher Education units. Z scores do not reflect Chiropractic (MCC) have (ENQA) regulations, the the strength of the bone, just graduated their first cohort accreditation process and all how it relates to a reference of students and under the visit reports are now available Head of WIOC David Byfield value for age-, race- and regulations of ECCE, are now for review on the ECCE website with Dr Simon Williams with the gender-matched individuals. eligible to apply for full status. (www.cce-europe.com). new DEXA scanner

20 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

General news Richard Brown to be next WFC Secretary General he World Federation produced five highly-talented Tof Chiropractic (WFC) has final candidates at interview, announced that Richard Brown his selection was unanimous by will be its next Secretary- both the Search Committee and General from 1 July, 2015. He the WFC Council.” Ceri Jones and Bianca Zietsman celebrate winning the prize for will succeed David Chapman- Current WFC Secretary- non clinical research at BritSpine Smith, who retires from this General David Chapman-Smith position, but will remain in a added his endorsement: “In transitional role for one year Richard I see a person with CTDRU wins until June 2016. exactly the qualities the WFC Richard has been in private now needs and that I hoped award at BritSpine practice since graduating from my successor would have. He AECC in 1990 and until selling is a man of many talents, has The Clinical Technology and Diagnostic Research his practice earlier this year was a true spirit of service, strong Unit (CTDRU) incorporates the former Chiropractic the owner and clinic director of communication skills and a Research Unit at the University of South Wales. a large multidisciplinary practice profound understanding of the Here, its head, Professor Peter McCarthy, in Stroud, Gloucestershire. He international profession and the outlines its recent activities and achievements. has a keen interest in sports direction both it and the WFC chiropractic and served as a should take for future success.” eri Jones and Bianca discussions and gave a podium chiropractor in the medical Richard, 46, is married CZietsman presented our presentation and hosted a group team at the Polyclinic in the with two adult daughters. ACROM work at the BritSpine of poster presentations based on athlete’s village at the London He is a keen football fan and Conference at Warwick University. his research into forces transmitted 2012 Olympic Games. He has combines his enthusiasm with This work was a composite of during a manipulative thrust. extensive experience as an providing chiropractic services Ceri’s and other undergraduates’ CTDRU has recently managed expert witness in regulatory to two professional teams work, co-ordinated and quality- to obtain two small grants. In practice hearings and clinical in the Football League. He assured by Bianca. The awards March we heard we had been negligence litigation, drawing enjoys writing and is a keen were being presented while we successful in attracting £49,500 on his combined qualifications motorcyclist. In preparation for were discussing possible research (equivalent of £132,000 when in law and chiropractic. his move to Canada he has just collaborations and with many including the matched funding In recent years Richard has sold his practice and he plans to excellent pieces of research being from industrial partners) to become well-known to the provide volunteer chiropractic presented, we hadn’t considered continue the work into Raynaud’s profession internationally as services to an under-served the possibility of winning! Only phenomenon. This secures Bianca an invited lecturer in many community through World Spine later did we realise that CTDRU Zietsman‘s research assistantship countries and world regions. Care during the first half of 2015. had won the special presentation position until December 2014. “We are award for non-clinical research! In addition, Lee McCarthy and most excited to On the sporting front, we are Bianca have been doing some have someone about to host a long-term sports exploratory work regarding of Dr Brown’s injury collaborator of ours, Dr possible future collaboration outstanding abilities, Sally Lark, who is currently with iThink Sport, a company character and based in Massey University, New interested in the psychology of proven leadership Zealand. Although it will be a sport performance. This work was experience to carry short visit, we will be looking at funded by the Strategic Insight the WFC forward preparing data for publication Programme (£2,500). during the next and designing the protocol for an Follow our Twitter feed decade,” said additional research collaboration. @CTDRU, like us on Facebook WFC President Dr The ECU’s 2014 Convention at www.facebook.com/ctdru. Greg Stewart of in Dublin was attended by usw and visit us at http://ctdru. Canada. “Although David Byfield and Mike Barber. research.southwales.ac.uk/ the search process David Byfield moderated some

BACKspace www.ecunion.eu October 2014 21 General news Belgium announces Royal Decree for chiropractic

elgian Sadly, the progress of the Bchiropractors second Royal Decree was halted The pursuit of are celebrating after a surprise by electoral in-fighting and a legislation in publication of a Royal Decree blocking of the dossier by one of Belgium: a timeline that included a range of health the political parties. As the result, 1923 The first chiropractor professions, including chiropractic. the Minister of Health was unable arrives in Belgium Humanitarian The Royal Decree, which to complete the work, leaving 1932 Formation of the ECU work continues incorporates homeopathy, matters outstanding until such with Belgium as a acupuncture and osteopathy as time as a new Minister prioritises founder member at Madrid well as chiropractic, covers a range and passes the second Decree. 1946 Belgian Chiropractors’ College of general conditions: The history of legislative pursuit Union named in statutes 1. Professional indemnity dates back many years, but was 1994 Petition containing of he Madrid College of insurance firmly established in 1999 with 213,000 signatures TChiropractic (formerly 2. A system of registration for the Colla Law, named after a calling for legal RCU) is continuing its individual practitioners Belgian Minister of Health, recognition of humanitarian work with the 3. Regulations regarding publicity Marcel Colla. The Colla Law chiropractic poor and underprivileged 4. A list of non-authorised acts for recognised formally four main 1999 Colla Law is passed both in Spain and beyond. non-medical practitioners who complementary health professions, 1999 Chiropractic treatment Working with Caritas are not medical doctors but despite this, nothing partly reimbursed, yet Madrid, an agency of the The Royal Decree further progressed until 2011 when the not implemented in the Catholic Church, students makes provision for the then Health Minister executed social security system from the Madrid college are establishment for a Chamber the three next critical steps in 2001 Publication of Royal engaged in working with of Chiropractic. This Chamber, the process: the recognition Decree concerning the poor. MCC maintains a comprising five members of the of the Belgian Syndicate of conditions on recognising satellite clinic within a home in Belgian Chiropractors’ Union Chiropractic; the establishment of professional association Madrid where students on the and five medical practitioners a Chamber of Chiropractic; and of non-conventional MChiro programme, under (representing medical faculties of the establishment of a Paritary medical professions. the supervision of extended Belgian Universities), will act as Commission. The Chamber 2007 recognition of the BCU faculty, provide care to staff a sovereign body to register the provided specific advice on details by the State Council and service users at the individual practitioners. of the chiropractic profession, 2011 recognition of the BCU sheltered housing facility. However, there remain specific while the Paritary Commission’s by the Ministry of Health Staff and members of the conditions that will necessitate role was evaluate this advice. The 2011 establishment of 2014 graduating class also a further Royal Decree, which outcomes of these discussions led the Chamber of travelled to Nepal to work cover undergraduate and to the historic announcement in Chiropractic and the with the local NGO Into the postgraduate education, graduate May 2014. Paritary Commission World to provide care at its education programmes, a system Speaking on the development, 2014 Announcement of the mobile clinic (see page 27). of continuing professional BCU Vice President and ECU GC Royal Decree Head of the MCC development, a list of authorised Representative Bart Vandendries, chiropractic programme, Dr acts and a code of ethics. All of said: “The passing of this Decree first step is a historic development Ricardo Fujikawa, said: “This these conditions will need to be is excellent news. We still have for the chiropractic profession in experience is aimed towards satisfied in order to register as a some way to go but this important Belgium.” developing in the graduating chiropractor in Belgium. students a sense of duty and Over the last two-and-a-half changing the reality of health years the BCU has worked care in specific settings and tirelessly with the authorities under challenging conditions.” to ensure every detail of every All care was provided condition would be satisfied. under the supervision of MCC This has led to a detailed series of faculty, extended faculty and so-called ‘advices’, the products local professionals serving of intense negotiations and WIOC’s largest with the NGO. consensus, which were passed to ever clinic intake cohort pictured earlier this year the Minister of Health.

22 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Feature Paediatric chiropractic celebrates PhD for Dr Joyce Miller Dr Joyce Miller has long been recognised as one of the chiropractic profession’s leading paediatric specialists. She has recently been awarded a PhD by Bournemouth University for her research into the connection between musculoskeletal health and excessive crying in infants. BackSpace reports on this inspiring American who has devoted her life to the chiropractic care of infants and children.

he name Joyce Miller has become synonymous with paediatric Tchiropractic care; she is in great demand as a teacher and lecturer. Hundreds, if not thousands, of chiropractors throughout the world have been touched by her passion for treating infants and children and for the past 17 years AECC graduates have benefited from her wisdom and expertise. Now, Joyce has another qualification to add to her already-impressive CV; she has successfully defended her thesis and has been made a Doctor of Philosophy for her research into excessive crying in babies and its relationship with musculoskeletal health. As she explains, she had to overcome her fears before embarking on her PhD: “The most difficult part of the PhD was feeling convinced that I could do it. Haymo Thiel (Principal of AECC) encouraged me hugely and gave me the confidence that I should go for it. Haymo is a great leader as he not only pushes you to do more, but he also actively assists throughout the process. He taught me how to avoid procrastination and just get on with things. “This determination was absolutely essential for me to attempt the “I remember that week really well. It was the best week of weather PhD as the work was more or less continuous and needed to be done that has ever occurred in Bournemouth! I couldn’t work out why it was alongside my day job at AECC. However, I just loved it! I had been that everyone did not want to live here as the climate seemed just like thinking deeply about the subject of excessive crying in babies and California! musculoskeletal health for well over a decade and being able to express “I suppose looking back on it, I was having a late mid-life crisis. I my ideas and roll them out with evidence was for me a source of joy felt overworked and fatigued and really needed a change. It was while I rather than a chore.” was in Bournemouth that I spoke to Professor Kim Humphreys and he “I’m so pleased that I took up the challenge of a PhD. I had a brilliant suggested that as I was a diplomate from National and Logan College supervisor in Professor Edwin van Teijlinen. He is the Professor of Maternal I apply to manage the orthopaedic programme at AECC. I was hired, and Perinatal Health Research at Bournemouth University and being able started in September 1997 and the rest, as they say, is history.” to discuss my simple ideas with such a great mind was a major treat.” Joyce graduated from Northwestern Health Sciences University, Minnesota, in 1984. Upon graduating she practised for 12 years in Green Bay, Winsconsin, home of the famous Green Bay Packers NFL American Football Team. It was while treating ‘the Packers’ that Joyce developed an interest in treating younger patients. With a range of musculoskeletal conditions presenting at her practice, largely as a result of American Football, she developed a thriving teen-based practice. As these teens grew up and had children of their own, Joyce’s practice expanded into treating babies. She says: “Even then, I found crying babies a fascinating enigma but couldn’t explain why it was that they often stopped crying with chiropractic treatment. When an RCT was started at Northwestern, I was really keen to get involved and, inspired by the likes of Gert Bronfort, I went back to see what I could do.” Joyce came to Bournemouth in 1996 to present her US research findings at a BCA conference that was being held at the Bournemouth International Centre. She recalls it fondly:

BACKspace www.ecunion.eu October 2014 23 Feature

estimate may be very conservative. Injuries can occur before birth (due to intra-uterine constraint) or at birth, which in modern obstetric practice is increasingly likely to be assisted rather than natural. Joyce is certain that early management of musculoskeletal disorders in children is vital to prevent problems occurring later in life: “Never has it been more necessary for chiropractors to recognise the contribution they can make to public health by caring for babies and children,” she says. “There are special issues involved in paediatric care; from newborn babies right through to adolescence and the musculoskeletal challenges seen in teenagers. Research has repeatedly demonstrated that early treatment is important as it can prevent long- term disabilities.” With colleagues at AECC, Joyce established a dedicated feeding clinic in collaboration with Bournemouth University. She has seen remarkable results: “When babies are helped so that they can breastfeed successfully, it improves the lifelong health for both the baby and the mother. We feel that this is our small contribution to the public health goals of breastfeeding for all infants.” Joyce has encouraging words for chiropractors considering pursuing an academic higher degree: “I would recommend all chiropractors to consider it,” she says. “My experience in pursuing a PhD programme is that it helped me to understand my work in a way that no other method can. The mind is only satisfied when it is open to receiving and developing new ideas. As well as this being my personal experience, my MSc students say the same thing; they are quite often disappointed when the programme comes to an end!” ECU Secretary General Richard Brown said of Joyce’s PhD award: “This is an achievement of which the whole profession in Europe should be extremely proud. Building the research capacity in the field of paediatric chiropractic is important, not just in expanding the evidence base, but in inspiring other chiropractors with a similar interest to formally pursue their studies. “Joyce’s work is an excellent endorsement of what can be achieved within this special population and I hope it will stimulate others to build on her work.” Joyce has strong words for critics of paediatric chiropractic care: It was after having started as a tutor at AECC that Joyce identified the “Anyone opposed to treating babies and children with chiropractic opportunity for a dedicated paediatric practice within the college clinic. simply has no idea about the problems that musculoskeletal imbalances Building the practice did not take place overnight and Joyce describes cause in this population and their impact on families. how it gradually evolved: “Recognising that dramatic changes have occurred is not a matter of “The infant practice was built slowly but surely. We experienced a number guesswork. The differences in the health and behaviour of children is of successes in conditions such as excessive crying, sleeplessness and problems often immediate and the families we work with are simply amazed at the with feeding and so it was that parents of babies and GPs started sending changes occurring before their eyes. more and more babies to us at AECC. “Take infant colic, for example. Our RCT showed that while “We never did any marketing at all for the service we were providing. reassurance was a factor, it was actually the manual treatment that was Word just spread and we found ourselves seeing more and more.” effective in decreasing excessive crying.” Joyce is convinced that the benefits of treating a paediatric population A self-confessed workaholic, Joyce spends most of her time engrossed extends beyond just caring for infants and children: in furthering her knowledge and developing new areas of interest. “Treating babies is a privilege as it changes families for the better and “I have a great deal to accomplish before I die,” she says. “I must do this in turn helps whole communities. We so often see that once the baby some more research studies myself, but importantly, I am committed to gets better, the grandparents come in, then the father, then the siblings; nurturing enough chiropractors with Masters’ degrees such that we reach even the mother finds the time to get help with her musculoskeletal a critical mass and the research capacity evolves to a sufficient level.” maladies.” “My life’s goal is to help develop the safety and effectiveness of The World Health Organisation estimates that over one third of chiropractic care for the paediatric patient,” says Joyce. “We need to focus children have musculoskeletal complaints and acknowledges that this on research and make every effort to achieve these goals.”

24 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Making the most of it Gitte Tønner Gitte Tønner is the ECU’s Convention Academic Organiser. She is also a member of the Board of the Netherlands Chiropractic Association and runs a busy private practice in Amsterdam. Richard Brown spoke to her to find out how this tireless Danish chiropractor manages to fit everything into her life.

hen you first meet he set out to do and just quietly WGitte Tønner it is difficult got on with things. He was my not to be struck by her energy and hero and we just had an amazing presence. She is powerfully built connection.” and it is clear that she is someone Gitte has always had a strong who takes care of herself; when she sense of adventure and when she casually mentions in conversation left high school at 18 she spent that she has just cycled hundreds two years travelling around the of kilometres across the world, visiting Nepal, India, Netherlands, through Belgium and Canada and Australia. During into Switzerland to visit friends for this time, she remembers having a few days, you immediately sense some interesting jobs and to earn that this is a lady who routinely enough money for the next leg of undertakes tasks that would defeat her journey she found herself as mere mortals. a rickshaw driver, a festival face- Gitte first came to the attention painter and a cleaner in some of of the ECU in 2012, when, as a Australia’s less salubrious hostels. member of the host committee “Suffice to say, I don’t mind for the Amsterdam ECU getting my hands dirty,” she Convention, her organisational laughs. ”I’m not sure I’d want to skills made her a stand-out return to those jobs but they were candidate for the Academic certainly an eye-opener for me!” Organiser’s job. With big shoes On her return to Denmark, to fill following the retirement Gitte worked in a hospital before of Vassilis Maltezopoulos, Gitte embarking on an English degree quickly set about putting her own at the University of Copenhagen. mark on the Convention, moving She found that she loved reading the format away from a strictly books and analysing novels but scientific meeting to a diverse mix during her course she broke her of speakers from all quarters of the foot, an event that was to change chiropractic world. the course of her life – and career. “I know it was a risky While she was recovering, Gitte strategy,” says Gitte. “People were read a Danish book called What comfortable with the format and “No-one in my family had ever You Can Be. At that time, she regularly attended, but I felt that had no idea what she wanted to we were missing out on a large visited a chiropractor or even do, but on working through the segment of the profession who knew much about them” book concluded that she wanted didn’t feel that the Convention to work with her hands, work met their needs. I wanted a had enjoyed the programme. At much of her childhood outdoors, fairly normal hours and have the broader appeal that would bring the end of the event, Gitte was riding horses and exploring the broadest and deepest knowledge chiropractors of all persuasions tired, but happy. area around Copenhagen. Her late within whatever field she chose to together.” “I think we achieved what we father was a profound influence work in. She also wanted to work It was a strategy that worked. set out to do,” she commented. during her childhood and into her with people, one-on-one. With The Dublin 2014 Convention “The feedback was positive and early adult life. She says: this shortlist of requirements, was hailed as a great success, with those I spoke to found the new- “He was a man of few words. Gitte discovered chiropractic. over 95% of delegates saying that look Convention was refreshing.” However, what it meant was that “No-one in my family had ever they would like to come back next Gitte Tønner was born in 1974, when he spoke, people listened visited a chiropractor or even year and both undergraduates the daughter of working-class and respected what he had to say. knew much about them, so there and chiropractors of many years’ Danish parents. She grew up More than that though, he was a was no resistance,” she says. “To standing saying how much they loving the countryside and spent do-er; he made sure he did what be honest, while I knew what I

BACKspace www.ecunion.eu October 2014 25 Making the most of it wanted to do, my knowledge of with the university to broaden its command of Dutch rather than Ninja, also keep me grounded and chiropractic was pretty minimal.” programme. my adjusting skills! It was a steep quickly tell me when I’m getting Still on crutches, Gitte hobbled In 2003, Gitte travelled to learning curve on all counts. That too stressed and intense!” to an open day at the University Quebec as part of a WCCS curve has now flattened off a bit, It is no surprise that Gitte lists of Southern Denmark (USD) at delegation to explain more about but my enjoyment curve continues her father among her heroes, Odense. Listening to an inspiring the Danish programme and in to climb.” but within the profession she speech from Niels Nilsson, then 2004 she represented USD at Now with her own practice in specifically mentions Danish director of the programme, Gitte Sherman College. Here, she was Amsterdam, Gitte works as a sole chiropractor Carsten Nøeddskou instantly knew that chiropractic introduced to the concept of practitioner and continues to love and German Chiropractic was the profession for her. She straights and mixers and witnessed chiropractic. Association President Timo enrolled on the course. first-hand chiropractic evangelism. “I treat people in my practice, Kaschel. As it happened, 1998 was the “Those guys had so much not conditions,” she says. “I “I really admire Timo,” she says. first year of a new curriculum at passion and energy. It was like suppose you could describe my “He has three children, a really Odense, with both students and arriving on a different planet,” practice as wellness-based, but busy family life, and faces constant lecturers having quickly to get resistance on a legal and political acquainted with a new model of level. However, he takes it all in integrated teaching. Gitte found “I like to provide whole-body his stride, with humour and good herself part of small, intimate grace. I know that there are a lot groups of students rather than health and facilitate healing of people in the profession who the large mass. For her, having sacrifice time to devote to the in-depth debates among small in my patients. I have a profession, but Timo stands out groups of passionate individuals certificate in neurochemistry for me.” held more appeal than, as she says, So what of the biggest drinking beer and partying. and nutrition and I like to tell challenges facing the profession? Gitte became involved in the “We need to listen to each Student Union early on and was patients how they can help other more and respect other part of the welcoming committee themselves” people’s perspectives. We also for the visit of the ECCE need passionate, skilled people accrediting team. She became a who are leaders, regardless of student faculty adviser and was says Gitte. “For me, it was a really that term has been abused out of gender. I don’t agree with trusted with representing the influential trip and taught me that all proportion in the chiropractic women being put in positions university during official events. we really had to learn to listen to profession. I like to provide whole- just because of their gender, but It was after having organised a each other.” body health and facilitate healing at the same time women need visit to AECC in 2001 that Gitte Inspired by these events, Gitte in my patients. I have a certificate to get out there, use their skills first learned about the World organised the WCCS meeting in in neurochemistry and nutrition and talents and demonstrate Congress of Chiropractic Students Denmark in 2005. Having already and I like to tell patients how they what they can offer.” (WCCS). As a result, in 2002 graduated and set up in practice in can help themselves. My current It is obvious to anyone who she went to Palmer College and the Netherlands, she organised the love is Vitamin D; I’ve attended meets her that, like her father, remembers attending a meeting event remotely. She invited ECU two international conventions on Gitte is ‘a do-er’. Her energy is which changed her perspective on President Øystein Ogre, Barry it already this year and it’s just infectious and she is now focusing the profession: Lewis and Ingrid White and, with awesome!” her attentions on next year’s joint “At Odense, on the chiropractic all philosophical views expressed, Gitte’s time away from practice ECU/WFC Congress in Athens. It course I was really a student of the event was seen as a celebration is similarly energetic. She is clear that she is enjoying her role clinical biomechanics. We had of diversity within the profession. continues to indulge her passion as ECU Convention Academic not been exposed to philosophy Upon graduating, Gitte’s sense for the outdoors by racing around Organiser. She says: and going to Palmer was a real of wanderlust had not abated and the countryside in her open top “My aim is to bring people revelation. In fact the USD’s she had interviews in both Norway sports car and keeps herself fit together. It sounds idealistic but chapter did not get accepted into and the UK before deciding to with running and weights at the we have to do this for the sake WCCS at first because we did not move to the Netherlands to start gym. Somewhat surprisingly, of chiropractic. I sometimes see have enough philosophy.” her career. Not being able to speak she also admits to enjoying quiet myself as just a pawn in a big Gitte’s trip to the USA Dutch did not deter her. times. chess game, but most of the time continued with a visit to Western “Once I got the job, I had “I love reading and at the it’s really fun and inspiring to be States Chiropractic College, five weeks of Dutch lessons. moment I’m working my way in a position of influence and where she met and interviewed I’ve always been able to pick through a book on the history of inspiration. I want people to get Stefan Pallister. On her return to up languages quickly, so I was Amsterdam. It makes a refreshing out of their suits, open dialogue Denmark, she took what she had finding, thankfully, that patients change from functional neurology and work together to positively learned and set about working were concentrating on my textbooks. My cats, Victor and impact on the profession.”

26 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Chiropractic trailblazers Coralie Pellissier Coralie Pellissier is a remarkable young woman. In just six years since she qualified as a chiropractor, she has become a recognised expert in sports chiropractic and has set up an international humanitarian mission which provides chiropractic treatment to the people of Nepal. Richard Brown spoke to this chiropractic trailblazer to find out more about her and her work as President of the Into The World Corporation.

oralie was born 32 years fell in love with Asia. As an advocate for chiropractic, Cago in Scarborough, Canada, Deciding to embark on a career Coralie also became involved the daughter of a chiropractor. as a chiropractor, Coralie attended in promoting the profession at She received her first chiropractic the Anglo-European College of a national level and has been a adjustment at the age of five Chiropractic in Bournemouth, prolific author for the Italian months and has not stopped being from which she graduated with chiropractic patients’ association adjusted since. a Master of Chiropractic degree magazine, Pro-Chiropractica. “To grow up in a chiropractic (MChiro) in 2008. She speaks Her sporting achievements family is something pretty special fondly of her education: led to a specialist interest in and unique,” she says. “I can “AECC is a wonderful college. sports chiropractic and she count on the fingers of one hand The clinical preparation and the served as the vice-president of the times I can remember taking knowledge you gain in those the Italian Committee of Sports painkillers and I am rarely sick. five intensive years of study is Chiropractic from 2010 to 2013. Becoming a chiropractor was spectacular. The college campus She continued her studies and in therefore a natural choice for me.” and its resources are in my view 2009 was awarded the prestigious When she was nine, she moved A keen swimmer, she gained amongst the best in the world.” FICS-recognised International with her parents to Italy. This early qualifications as a lifeguard and A year after graduating, Coralie Chiropractic Sports Science move may explain her excellent was an enthusiastic scuba-diver. opened a clinic with her father Diploma (ICSSD). Putting her linguistic ability and as a fluent “I suppose I was a bit of an in the Italian city of Genoa. Her skills into practice straight away, speaker of four languages (French, adrenaline junkie,” laughs Coralie. private practice flourished, and she Coralie volunteered at a number Italian, English and Spanish) her “If there was an element of danger quickly became well-recognised of international events, working as communication skills throughout involved, I was up for it. I think for her skills and ability in treating a chiropractor for the Italian teams the world have contributed to her I terrified my parents! I still love both adults and children. at the World Student Games in success. bungee jumping, sky diving, “Children have something Turkey, the World Tae Kwon Do At an early age she showed climbing and white water rafting, special; their spontaneity, their Championships and for the Italian considerable talent for sport, so I suppose it’s in my blood.” expressions … or simply their Disabled Ski Team at the 2011 representing Italy in international With a strong interest in seeing sincerity. Taking care of new Championships in Sestriere. snowboarding championships and the world, when she was 29 generations means taking care of Coralie’s first experience as a attaining a black belt in karate. Coralie spent a year travelling and our future!” she says. volunteer was in Costa Rica during

BACKspace www.ecunion.eu October 2014 27 Chiropractic trailblazers her fifth year at AECC: “I think to let the students come and also this was where my dream began,” become a businesswoman. Did says Coralie. “In Costa Rica we I ever regret it? No way! I love had to go back to the real basics of travelling. I love teaching. I love chiropractic. There were no fancy helping the poorest in need and machines, no cool tables; just our I am extremely proud of what we knowledge, our hands and our have set up here in Nepal.” feelings! It was there that I learned Into The World is an so much about myself and where international organisation that I had the opportunity to put into aims to promote, develop and practice what AECC had taught support health internships and me. The experience was priceless.” voluntary work tied to English This ignited a passion for language teaching in Asia. It bringing chiropractic to those provides an unforgettable cultural in under-served communities exchange for students and brings a around the world and in 2011 positive influence on the Nepalese she travelled to Nepal as part of a social and economic environment. chiropractic mission. The mission has provided She was so moved by her students from AECC, IFEC, massage. With two- or three-week Life in Nepal is intense but experience that in 2013 she decided BCC, MCC (Madrid) and internship packages available, despite this, Coralie finds time to to set up Into The World. During recently IMU (Malaysia) with students spend time volunteering relax. She says: its first official mission, three the opportunity of immediately in Kathmandu and Shaktikhor, “I love Asia. I’m lucky to have chiropractors spent two weeks in putting into practice what but also spend three days visiting a supportive family, a wonderful Nepal, treating over 300 patients. they have learned during their the memorable Chitwan National husband and a fantastic partner “It was an incredible academic careers through the Park. and colleague in my sister. Nepal experience,” says Coralie. “Nepal practical experience of working in Coralie is passionate about what has it all: jungle adventures, is a country of amazing natural an under-served area. As Coralie she does and about the potential elephant walks, canoe trips, all of beauty and its people are among explains, volunteering in Nepal is for Into The World to achieve which really help to recharge the the warmest I have ever met. I quite unique: lasting, meaningful change. As batteries. And don’t forget, we live soon realised that this was a very “Of course, those receiving she frequently quotes: “A dream next door to the highest mountain special place for me and one where chiropractic care benefit greatly dreamed alone will never become in the world – the views are simply I could make a difference to the from it, but for the young people reality.” She has established a team magnificent.” lives of those who would otherwise taking part, Into The World with a pyramid structure where Speaking of this year’s mission, not have access to chiropractic. provides a life-changing experience every individual has a part to play. Coralie says: “I would personally “Every day is a challenge. I and an opportunity to learn about “We believe that the internship like to congratulate and thank started from scratch and had to themselves, their roles as health provides a once-in-a-lifetime each and every person who has find accommodation, transport, professionals and also as human chance for students to enrich taken part and I am grateful for food, a water supply, a translator beings.” themselves before heading the support of those who continue and, of course, chiropractic Medical internships are into private practice. The skills to spread the word about the benches. I had to make contact currently offered to students of acquired from volunteering in positive things we have and will with the colleges, convince them chiropractic, physiotherapy and Nepal develop interpersonal continue to achieve together”. communication, and nurture And what of the future? Coralie independence, open-mindedness has set her sights on expanding and adaptability. Working her vision, with potential alongside experienced doctors in opportunities being explored sometimes stressful situations also in Borneo, Africa and India. prepares students for the realities However, she is keeping her feet of practice.” firmly on the ground: Into The World’s 2014 missions “Our vision is a long term involved 40 chiropractors treating project and we really want to some 10,000 patients. Students change the health system here in from a range of chiropractic Nepal where we operate. With institutions were exposed to patience and continuous effort we Asian culture, cooked with can do so much.” families, played with children and For more information about integrated themselves into the lives Into The Worldvisit http:// of the Nepalese community. volunteersintotheworld.com.

28 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

EAC European Academy of Chiropractic membership for all ECU chiropractors Martin Wangler, Dean of the EAC, reports on an exciting year so far.

he EAC Governing Council has been working hard to try and raise its sharing of knowledge and best practice Tprofile and create real value in being a Member or Fellow of the Academy. • It will promote CPD through the national associations It is committed to ensuring access to postgraduate education and the promotion in order to meet EAC and CEN standards including of lifelong learning so that it may be enjoyed by all ECU chiropractors. support for Masterclasses, and Researchers’ Day, Under the lead of the ECU Executive Council, the ECU General through its Special Interest Groups (SIGs); Council decided at its meeting in Dublin in May to open up EAC • It will facilitate development of research capacity by membership to all members of ECU member national associations. supporting PhDs and Post Doctorate studies This means that with effect from 1 January 2015, all ECU member • It will facilitate the understanding of research that bridges the gap chiropractors will benefit from the work of the Academy. between researchers, clinicians and politicians This is great news for the profession and great news for the EAC! So, from next year onwards, all members of the ECU will also be The benefits of this decision are clear. The fundamental aims of the current members of the EAC, which means that the Academy will represent EAC and the ECU will be better served and the advantages to ECU member approximately 3500 member chiropractors and over 100 Fellows, chiropractors will be expanded. The identity of the ECU as a body committed supported by a Secretariat and Governing Council. to academic excellence and professional development will be strengthened by In order to work on key educational activities for our profession in a reintegration of the academic and political arms of the ECU. Europe, we need your personal input and feedback. We would like to Our goals and objectives are clear and well-established: hear whether our goals and strategies as well as our activities are matching • The EAC will continue to respond to the needs of the profession in your individual and national association needs. the areas of Graduate Education Programmes (GEP), Continuing 2014-2015 will be my last year as Dean of the EAC. I would like Professional Development (CPD) and Research to take this opportunity to direct our special thanks to all active EAC • It will facilitate the development of GEP programmes in those countries members for their strong commitment, support and great work for where there is currently no such provision, developing broad criteria to our Academy since its inception in 2007. Your professional support, facilitate programme development and in particular financial contribution, year by year, has been greatly • It will continue to support established GEP programmes and facilitate appreciated by the Governing Council of the Academy. Support EAC journal iomed Central’s co-owned, online, open-access journal profession is through research. As with all other professions in BChiropractic and Manual Therapies (C&MT) should be supported modern health care, we need to systematically scrutinise our theories, by all ECU chiropractors, says Secretary-General Richard Brown. methods and results.” “It is important for the journal and for the development of the C&MT aims to provide chiropractors, manual therapists and profession that Chiropractic and Manual Therapies attains an impact related health professionals with clinically-relevant, evidence-based factor,” said Richard. “For this to happen, we need chiropractors and information. It serves as a critical resource in its field of interest and others to cite its research in their own academic papers. With high- by being open-access, it is more readily available to practitioners, quality papers being accessible in full, free of charge, via its website researchers and clinicians worldwide. www.chiromt.com, C&MT is an excellent resource for high-quality, All articles published in C&MT are included in PubMed, the most peer-reviewed materials.” widely used biomedical bibliographic database service, which is run The Impact Factor (IF) of an academic journal is a measure by the US National Library of Medicine. It is also included in no fewer reflecting the average number of citations of recent articles published than 12 other medical bibliographic databases. in the journal. It is used as a measure of importance of a journal within The journal has a robust peer-review process and at present an academic field. Journals with a higher IF are considered more publishes approximately half of the submissions it receives. It welcomes important than those with a lower IF. manuscripts from researchers and clinicians and publishes not only C&MT is the official journal of the European Academy of original research, but commentaries, reviews, debate articles, case Chiropractic (EAC), the Royal College of Chiropractors (RCC) and reports, methodology articles, study protocols and systematic reviews. the Chiropractic and Osteopathic College of Australasia (COCA). Professor McCarthy says: “I believe it is important for chiropractic Its Editor-in-Chief is Associate Professor Bruce Walker of Murdoch to have a functioning journal of high quality and impact as it is a very University, Australia, while both associate editors Dr Iben Axen and important way to assure other professions of the scientific endeavours Professor Peter McCarthy are based in Europe. Dr Axen says: of this manual therapy profession. I agree with many others that the “I am convinced that the way forward for the chiropractic profession must adapt as understanding and knowledge base increases.”

BACKspace www.ecunion.eu October 2014 29 EAC

Researchers’ Day focuses on ‘tectonic shifts’ in health care provision

he world is facing tectonic shifts in the nature of health issues This year’s Researchers’ Day saw over 35 researchers from Europe Tfacing the western world, a leading health economist has claimed. and North America meet at the Convention Centre Dublin (CCD) to Professor Charles Normand, Chair of the European observatory on debate how research could counter the potential threats and further health systems and policies, was speaking in Dublin at the 2014 EAC the opportunities presented to the chiropractic profession in Europe. Researcher’s Day. Also speaking at the event were Jakob Lothe, President of the In a powerful speech, Professor Normand, who is based at Dublin’s Norwegian Chiropractors’ Association, and Netherlands Chiropractic Trinity College, emphasised the dramatic rise in chronic conditions, Association member Igor Dijkers, who set out the role that research was which has led to shifting demographics and a marked impact on playing in professional development within their respective countries. public health. He also pointed to the changing relationships between WFC Secretary-General David Chapman Smith provided an insight patients and health providers, and a move away from treatment on the international perspective, particularly his experiences with towards a preventative model of health care. He suggested that the World Health Organisation. He confirmed his view that research success should be measured not simply by mortality rates, but by a constitutes the door to mainstream health care, suggesting that those reduction in the rate of decline or even a plateauing in the impact of WFC countries that had invested in research had prospered, while chronic conditions. those that had not, had done less well. In the afternoon, delegates divided into four groups to generate a SWOT (strengths, weaknesses, opportunities, threats) analysis for the profession in Europe. Groups went on to look at potential solutions that research could offer. There were several key messages that came out of the day’s discussions, not least of which was the claim that health care should be organised as a network, not a hierarchy. It was agreed that there was a need for patient-centred, rather than system-centred, care. Jakob Lothe gave an outline of Norway’s journey towards legitimacy, characterised by a united front, long-term planning and integration into the health system. On the other hand, Igor Djikers highlighted the disparity between groups and cited the lack of a clear identity beyond the chiropractic profession in the Netherlands. In summarising the day, Professor Normand stressed the need to shift health priorities from cure to management and from a disease- focus to a focus on the individual. This view was welcomed by the chiropractic delegates, but it was agreed that it would only ever be achieved if chiropractors worked to justify their role and prove their worth in the health care system. The role of inter-professional networks was stressed, with integrated health projects gaining special attention. The organisers of Researchers’ Day, Lise Hestbaek and David Newell, were delighted with the day. Lise said: “Bringing together and listening to such a range of inspiring speakers was such a treat. EAC Dean Martin Wangler with AECC Principal As usual, the EAC has put on a great day. We’re looking forward to Haymo Thiel at the Dublin Convention meeting up again next year in Athens.”

30 BACKspace www.ecunion.eu October 2014 Newsletter of the European Chiropractors’ Union

Review Born To Walk: Myofascial Efficiency and the Body in Movement James Earls Lotus Publishing ISBN: 978-1-58394-769-2

orn to Walk commences by looking lengthening are set out along Bat the ‘Walking System’, recognising the with the impact of loading connection of the components of the neuro- created by the push-off action myo-fascial-skeletal-vestibular system. Earls of gait. stresses the point that gait is a structurally Moving on to the lateral line, integrated movement - a whole-body the role of the pelvic stabilisers movement - not simply something that is the and the scalene muscles of the preserve of the lower body. He goes on to look neck are introduced. Here, at the impact of the surface upon which we the impact of leg length walk and the evolution of a highly economical inequality is discussed, with system, where joints, muscles and fascia work the consequent impact of in sync to produce effective locomotion. lengthening or shortening on the sacral base, lines nevertheless have the potential to impact There is a strong focus on Thomas Myers’ facet joints, arches of the foot and the effect on on the efficiency of gait and overlap with Anatomy Trains and the transference of the fibularis muscle. The cascade effect on the anterior and posterior lines, particularly as they forces through lines of fascia. The impact of spinal structures, thoracic cage and intercostal relate to the magnitude of arm swing. stretching and shortening of tissues as part of muscles and the potential for chronicity is The book concludes with a look at footwear an integrated system is discussed. Interestingly, outlined. and the hazards of high-heeled shoes and lack he refers to each step as being a controlled Perhaps one of the most interesting chapters of appropriate biomechanical support. It points fall, where counter movements prevent describes the Spiral Line, chiefly due to the out that a three-inch heel increases the stress on overbalancing. number of tissues that are involved in creating the metatarsal heads by some 76 per cent and In the second chapter, Earls discusses the propulsion and counter nutation in the pelvis advocates that, for a normal foot, the ideal shoe mechanical chain and the four functions of and associated structures. In particular, the would be flat. walking: propulsion, stance stability, shock ‘switch’ of the greater trochanter, stimulating At 213 pages, this is not an exhaustive absorption and energy conservation. He the tensor fascia lata and the opposite shoulder text on the anatomy of gait, but will be an explains that healthy walking is about striking girdle. This creates a crossover effect which extremely useful book for chiropractors a balance between movement and stability. necessarily stabilises the skull and allows the looking to enhance their knowledge and Starting with the impact of the foot on the head to remain static. consideration of the functional elements of ground and its relationship with the ankle, The Inner Core is addressed by reference to walking. Chiropractors will readily relate to the Earls takes the reader through the mechanical the Deep Front Line, connecting the jaw to the application of principles of forces, vectors and chain, looking at the forces and actions of soles of the feet via the neck, chest, abdomen biomechanics. With posture and gait playing fascia, joints and muscles, before focusing and pelvis. Here the diaphragm and the pelvic an important role in spinal biomechanics, on the components of the rest of the lower floor are important components, along with the consideration of walking patterns and limb. Not ignoring the influence of the rest the visceral fascia and protective coverings of functional of the body, he describes events in the torso delicate organs. lines will assist and shoulder girdles, as well as the impact of As well as the impact of these tissues in expanding dysfunction in just one of the components on on movement, the constant effects of the the clinical the rest of the system. proprioceptors are considered, particularly in skill set for all The bulk of the text (Chapters 3 to 7) is the deep posterior compartment of the calf. chiropractors. given over to analysing the impacts of the The last of the functional Lines considered in Functional Lines and how vectors are created the text relates chiefly to the upper extremities Richard Brown to give maximum efficiency of the system. and the dissipation of energy related to bipedal DC, LL.M, Sagittal plane mechanics and the role of fascial gait. While less involved in walking, the arm FRCC

BACKspace www.ecunion.eu October 2014 31 Call, Cast, or Scan Foot Levelers Gives You the Power of Choice

Call for a reorder, use a casting kit or scan with our 3D BodyView® to fit your patients for Stabilizing Orthotics today

Supporting Every Body ARCH ADVANTAGE™ FLX ARCH FootLevelers.com | ADVANTAGE™ 1.877.658.9552

FLA-090114 - BACKspace - cast.indd 1 8/21/14 2:46 PM