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Chiropractic “Name Techniques”: a Review of the Literature

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Chiropractic “Name Techniques”: a Review of the Literature 0008-3194/2001/86–99/$2.00/©JCCA 2001 Name techniques Chiropractic “Name Techniques”: a review of the literature Brian J. Gleberzon, DC* In a previous article, the author discussed current trends Dans un article précédent, l’auteur discutait des in utilization rates of chiropractic “Name Techniques” tendances actuelles dans les taux d’utilisation des in Canada, and provided recommendations for their « techniques de nom » chiropratiques au Canada et inclusion into the curriculum at the Canadian Memorial fournissait des recommandations pour leur inclusion Chiropractic College. In this article, a review of the au programme du Canadian Memorial Chiropractic literature on “Name Techniques” was conducted, with College. Cet article fournissait un examen qualitatif interpretation and synthesis by the author. One hundred de la littérature sur les « techniques de nom », avec and eleven articles were found. These were: technique interprétation et synthèse par l’auteur. 111 articles ont discussions (N = 39), case studies (N = 25), case series été étudiés. Il s’agit de : discussions des techniques (N = 5), experimental studies (N = 25) and clinical trials (N = 39), exposés de cas (N = 25), série de cas (N = 5), (N = 17). The literature suggested that prone leg length études expérimentales (N = 25) et études cliniques testing and some x-ray mensurations may have (N = 17). La littérature suggérait que les tests de acceptable inter and intra-rater reliability. In addition, longueur de jambe en pronation et certaines there are several case studies that reported significant mensurations radiographiques pouvaient avoir une clinical benefits by patients receiving Activator, fiabilité inter et intra-évaluateur. En outre, plusieurs Alexander, and Upper Cervical treatments. Patients also exposés de cas rapportaient des avantages cliniques reported improvements in quality of life while under significatifs pour des patients recevant les traitements either Upper Cervical or Network Spinal Analysis care. Activator, Alexander et Upper Cervical. Les patients ont This information may help develop professional practice également signalé une amélioration de leur qualité de vie guidelines, and it may have implications for chiropractic durant des soins Upper Cervical ou Network Spinal. Ces research and education. informations pourront contribuer à définir des consignes (JCCA 2001; 45(2):86–99) de pratique professionnelles et peuvent avoir des retombées dans la recherche et l’éducation chiropratique. (JACC 2001; 45(2):86–99) KEY WORDS: chiropractic, technique. MOTS CLÉS : chiropratique, techniques. * Assistant Professor, Canadian Memorial Chiropractic College, 1900 Bayview Avenue, Toronto, Ontario M4G 3E6. Bedford Park Chiropractic Clinic, 3189A Yonge Street, Toronto, Ontario M4N 2K9. Office 416-482-4476: Fax 416-482-9233: email: [email protected] © JCCA 2001. 86 J Can Chiropr Assoc 2001; 45(2) BJ Gleberzon Introduction Results In a previous article, the author discussed current trends in One hundred and eleven articles were found within the utilization rates of chiropractic “Name Techniques” in search parameters, and an annotated bibliography was Canada, and provided recommendations for their inclu- compiled. Each article was then grouped together by tech- sion at the Canadian Memorial Chiropractic College.1 The nique (Table 1). When the articles were grouped by term “Name Techniques” refers to the group of chiroprac- “type”, this search revealed the following; technique de- tic technique systems that can trace their origins back to scriptions (N = 39), case studies (N = 25), case series individual developers, such as Clarence Gonstead, Clay (N = 5), experimental studies (N = 25) and clinical trials Thompson, Hugh Logan or BJ Palmer. The purpose of this (N = 17). It should be noted that it is possible that other article is to describe the results of a literature search of studies described as using “spinal manipulative therapy” several different “Name Techniques”. This process is an were in fact performed using a “Name technique” such as important first step in building an evidentiary foundation Gonstead or Thompson Terminal Point, which would not upon which clinical decisions should be made, and it fur- be identified by this search strategy. However, no effort ther guides research efforts by exposing those areas that has been made by the author to identify if this had oc- are insufficiently investigated. Moreover, this information curred, and only articles found within the search strategy may better enable academic administrators to make more parameters are included in this report. rational decisions with respect to the inclusions of those For the purposes of this article, “experimental studies” “Name Techniques” previously identified by the author refers to studies that sought to investigate a diagnostic or into the colleges’ curricula. therapeutic feature of a Name Technique such as leg length evaluation or x-ray mensuration. Such studies typi- Method cally investigate the intra and inter-reliability of a particu- A review of the literature was conducted, with interpreta- lar procedure. However, this does not include those studies tion and synthesis by the author. The search strategy in- that assessed the effectiveness of a technique on a patient volved accessing Mantis, Medline and CINAHL databases in a clinical setting, which are instead referred to as “clini- from 1993–2000 (English language) using the following cal trials” in this article. key words: Activator, Activator Methods, Active Release Therapy, Review of the literature by technique Alexander, Applied Kinesiology, Atlas Orthogonality Technique, Barge, Basic, Blair, BioEnergetic Synchroni- Activator Methods Chiropractic Technique Twenty one studies were found on Activator Methods zation Technique, BEST, Carver, Chiropractic Biophys- 2–4 ics, Cox Flexion-Distraction, Crane Lift, Directional Chiropractic Technique. Three articles were descrip- Non-Force Technique, DNFT, Duffy, Flexion-Distraction tions of the technique (history, philosophy, diagnostic or Technique, Gonstead, Grostic, HIO, Leander Technique, therapeutic protocols etc.). Six articles were case studies, detailing the successful Activator treatment of patients Life Upper Cervical, Logan Basic, Kale, Mears, Meric, 5 6 Mitza Neuroemotional Technique, NET, Network Spinal with coccygodynia, lumbar disc herniation, cervical disc protrusions,7 adhesive capsulitis,8 frozen shoulder associ- Analysis, National Upper Cervical Chiropractic Associa- 9 10 tion technique, NUCCA, Occipital Lift, Orthospinology, ated with metastatic carcinoma, and torn meniscus. Ac- Palmer HIO, Pettibon, Pierce-Stillwagon, Sacro-Occipital tivator technique was also reported to have successfully managed 10 patients with primary chronic uncomplicated Technique, Spinal Stressology, SOT, Sweat Adjusting 11 Technique, Thompson Terminal Point, Total Body Modi- sacro-iliac joint syndrome, as well as 3 patients with calcaneal subluxations with plantar fascitis and heel fication, TBM, Toftness, Torque Release Technique, 12 Touch for Health, Truscott System, Upper Cervical, Van spurs. Rumpt Technique. The search revealed eight experimental studies involv- ing Activator technique. In two of these studies, investiga- The majority of chiropractic literature is indexed by tors reported good inter-rater reliability of activator prone these databases. leg check procedures.13,14 Five other experimental studies J Can Chiropr Assoc 2001; 45(2) 87 Name techniques sought to measure or describe the characteristics of the Two randomized clinical studies were reported using force pattern that results from the administration of an Activator technique.21,22 One study compared the immedi- activator adjustment.15–19 These studies indicated that ate effect of Activator versus Meric adjustments on pa- there was a measurable adjustive force generated by an tients with acute low back pain.21 The other study sought to activator which had characteristics that were different compare differences in pain and lateral flexion among pa- from those measured by a high-velocity, low amplitude tients with neck pain by either Activator or spinal manipu- (Diversified-style) thrust. Another study concluded that lative therapy (7 patients in each group).22 No statistically the activator set to zero (no thrust) was a useful research significant differences were found in either study. tool to simulate a sham adjustment.20 Table 1 Summary of Annotated Bibliography of Name Technique within search parameters DESCRIPTION CASE CASE EXP’T CLINICAL TECHNIQUE OF TECHNIQUE STUDY SERIES STUDY TRIAL N Activator 3 6 2 8 2 21 ART 1 1 Alexander 5 2 1 1 9 AK 5 2 1 8 BEST 1 1 2 CBP 5 1 3 9 Flex/ Dist 1 1 Gonstead 1 2 3 Logan 1 1 2 NSA 2 1 1 1 5 Palmer HIO 6 10 2 5 6 29 SOT 6 4 1 11 Thompson 1 1 Toftness 1 1 2 4 Mixed 2 3 5 Total 39 25 5 25 17 111 Code: Exp’t study (experimental study), ART active release therapy, AK applied kinesiology, BEST BioEnergetic Synchroni- zation Technique, CBP Chiropractic BioPhysics, NSA Network Spinal Analysis, SOT sacro-occipital technique 88 J Can Chiropr Assoc 2001; 45(2) BJ Gleberzon Active Release Technique response to oral provocation test). The researchers com- Only one study was found within the search parameters, pared these findings to any hypersensitivity serum reac- and it was a description of ART by its developer.23 tions (IgE and IgG). These serum tests reportedly confirmed the presence of 19 of 21 food allergies sus- Alexander Technique pected by AK screening procedures.39 Alexander
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