NOW IN JMPT INTEREXAMINER RELIABILITY OF SUPINE LEG CHECKS FOR DISCRIMINATING LEG-LENGTH INEQUALITY
H. Charles Woodfield, RPh, DC, B. Burt Gerstman, DVM, MPH, PhD, Renate Henry Olaisen, DC, MPH, and Dale F. Johnson, PHD recently published the findings of this pilot study in the May Issue, Volume 34, of the Journal of Manipulative and Physiological Therapeutics (JMPT)
Download Article (PDF, 1.49MB)
Image Depicts Low Force Impact of NUCCA Procedure
The chart below demonstrates a plot of adjustment force vs time [in vivo] on a patient with a right laterality. Instrumentation enabled a sophisticated direct measurement of the external force applied on the subject’s transverse process. This is one of many applied triceps pulls providing a series of applied forces used in the correction of the studied misalignment. Note that the vectored-force is in the mobilization range and not in the manipulation range. The "thrust" is spread over a half second, a relatively long time interval, implying that it is not of high velocity. The thrust is less than 2 pounds over the general load phase. These results support the validation as to the safety of the NUCCA adjustment protocol.
The in vivo adjusting force measured using Tekscan pressure measurement system during a National Upper Cervical Chiropractic Association (NUCCA) chiropractic adjustment. (K. Denton)
UCRF/NUCCA Research Funding
NUCCA/UCRF research now stands where we have wanted it to be for a very long time. We received record funding for the majority our 2010/2011 projects which include the Supine Leg Check Study, X-ray Reliability, and the Calgary-based Phase Contrast Study.
As a result of our successful fundraising efforts to meet the terms of the Tao Matching Funds pledge of $100,000, NUCCA/UCRF was awarded much more than expected with funding for half of the three previously mentioned studies. Also, specifically for the Phase Contrast study, we received an additional $40,000 gift from Canada's Hecht Foundation, $25,000 from Trans Canada Pipeline, and another $15,000 from Mr. Hal Kvisle, a Canadian NUCCA patient. This means that the Phase Contrast study is now fully funded!
We extend a heartfelt thanks to all of you for participating in our fundraising efforts. A special thanks to Dr. Scholten for his work and profound success with the Tao Foundation, and to Dr. Hasick, who has gone beyond the call and raised more in Small Steps funds than any of our clinics, and also approached the new Canadian foundation donors. We are very appreciative of these commitments, and to those who joined or renewed memberships to the Gregory Circle to help cover the administrative fees of research. This has been truly a year of hard work and triumph.
Benesh Corporation Donates Anatometer II Plus to Life College West
Earlier this year, the Benesh Corporation, a long time NUCCA supporter and manufacturer of the Anatometer, generously donated an Anatometer II Plus, their most advanced model for clinical training, to Life Chiropractic College West in Hayward, California. Eve Benesh, Corporate Secretary and Managing Director, says the donation was made “because of Life West’s unique role in training students in the NUCCA methods and in the use of the Anatometer within those protocols. We made the donation to honor our father, Peter Benesh and his long commitment to seeing the NUCCA method validated and attain widespread use.“
Peter Benesh, who passed away over two years ago worked closely with Dr. Ralph R. Gregory to develop the Anatometer.
Our work continues to be the subject of prominent news media and praise! Please click the links below to review the articles and videos reporting on the profound health benefits resulting from the upper cervical NUCCA procedure and its application.
NUCCA Technique/Hypertension Pilot Study: A brief history
Written by Marshall Dickholtz Sr., DC
The beginnings of the hypertension study can be traced back to 1968 when Bruce Bell, a medical doctor in Barrington, Illinois, first discovered the effectiveness of adjustments on several of his patients by my use of the National Upper Cervical Chiropractic Association protocol (NUCCA technique). Over the next 25 years, Dr. Bell referred more than six thousand patients to my Chicago office. In time, Dr. Bell realized that 32 of the problems seen in his referred patients that were successfully addressed by the upper cervical procedure, were autonomic in nature. One of these problems was hypertension.
Dr. Bell contacted Dr. George Bakris, an MD who, at the time, was at Rush Presbyterian St. Lukes, one of Chicago’s largest teaching hospitals. (Today Dr. George Bakris is director of the hypertension clinic at the University of Chicago’s Pritzker School of Medicine.) Dr. Bell was able to get Dr. Bakris to head a pilot study, the protocol of which was subsequently submitted to and approved by the Western Internal Review Board. To fund the pilot study, Dr. Bell spearheaded the formation of the Barrington Atlas Research Corporation – now known as the Atlas Research Foundation – and enlisted business professionals such as George Schueppert, Norval Stephens, and Keith Hanson as directors.
Dr. Charles Woodfield, who is now in the research department of Parker College of Chiropractic realized that the study had to be exceptionally well done to appear in The Journal of Human Hypertension, the third most prestigious medical journal focusing on hypertension. To that end, only patients who had Level I hypertension, a short or contractured leg, and had no pain were recruited into the study. The criterion of “no pain” was critical because, if there was pain, then potential critics could argue that blood pressure dropped because pain was alleviated. In addition, that criterion of “no pain” also concurrently placed these patients out of the mainstream chiropractic paradigm that focuses on spinal manipulation, range of motion, and site of pain. If there is no site of pain, then where would mainstream chiropractic adjust? (What percentage of your new patients have no pain?)
The short or contractured leg is a necessary criterion in diagnosing the existence of a C-1 misalignment. NUCCA protocol only requires postural distortion for a person to qualify as a new patient; pain is not a necessary symptom. Using Level I hypertension patients ensured that patients were not that far removed from the blood pressure of the normal “healthy” population and provided an additional level of safety when removed from medication. All of the subjects in the study came from the practice of Dr. Bell.
The original 50 subjects, in the study, were randomly divided into two groups of 25 each. The control group received a placebo “adjustment.” This was possible for two basic reasons: 1) because the “adjustment” is so light and 2) because the head could be braced and the adjusted vector controlled so well that no measurable change would take place in the misalignment.
The treatment or experimental group received an equally light adjustment but the vector used and the head placement were specific for each subject based on NUCCA’s “understanding” of the presenting biomechanics as interpreted from X-rays for that particular patient. Patients were blinded as to whether or not they had received the sham “adjustment” or had received the real adjustment. The nurse taking the blood pressure readings was not aware of which subjects had been given the real adjustment. Hence, in this sense only, the pilot study was a double-blind study. With regard to posture measurements, X-rays, and adjustments the chiropractor was, of course, not blinded.
Posture measurements in this study included both supine leg check (non-load bearing) and standing (load-bearing) pelvic inclination (frontal plane) as measured on the anatometer as well as bilateral weight distribution, pelvic distortion in the transverse plane (“rotation”) and lateral displacement of C-7 off a vertical axis. A laser light system was used to make measurements more readable. All patients were blindfolded for anatometer measurements and a digital camera recorded the posture of all 50 participants.
A standard cervical X-ray series was used and this consisted of lateral, nasium, and vertex views. Lead filters helped to minimized exposure to individuals. Atlas laterality and atlas rotation were measured and used in the calculus for determining the adjustic vector.
Three time events were of critical importance in measurement. Just before actual adjustment, just after adjustment, and eight weeks after adjustment; this sequence was identical for the placebo group. All patients had been off their medications two weeks prior to adjustments and randomization. All patients had all measurements taken at each of these three time events. In addition, all patients had blood pressure measurements taken weekly for eight weeks.
Of the 25 subjects in the treatment group, 15 had an average systolic blood pressure drop of 28 mm of Hg relative to the placebo group while the other 10 did not basically change. The treatment group (n=25) therefore had an average of 17 mm of Hg drop. Twenty-one patients had only one adjustment during the study. Future research will take a close look at why one portion of the treatment group (n=15) responded and the other portion of the treatment group (n=10) did not respond in a lowering of systolic blood pressure.
Papers are being written for publication by Dr. Woodfield, with partial financial support from the Upper Cervical Research Foundation (www.ucrf.org), showing that the VAS scores were basically “zero” for both the control and the treatment groups throughout the study, and that for the treatment group the SF-36 scores improved in all eight categories of well-being.
The NUCCA Technique is taught at Palmer College as an elective and is in the curriculum at Life Chiropractic College West. Canada has about three dozen NUCCA doctors. The hypertension article appeared in the Journal of Human Hypertension (May 2007) under the title: Atlas vertebrae realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study.1 Additional information in supporting future research can be found by going to www.ucrf.org.
Many thanks to Professor James Palmer for editing this article.
1) Bakris, G., Dickholtz M. Sr, et al. Atlas vertebrae realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J. of Human Hypertension, May 2007, 21(5): 347-52.
Currently practising in Chicago, Illinois, Dr. Dickholtz Sr. has been in practice for 51 years. He is a former president of the National Upper Cervical Chiropractic Association (NUCCA) and the lead researcher for NUCCA. Dr. Dickholtz is a recipient of the Daniel David Palmer Scientific Award, the R.R. Gregory Award and chiropractor of the year of the Illinois Prairie State Chiropractic Association in 2007. For additional information regarding this research project, you may contact Dr. Dickholtz at 773-267-0020 or 847-677-7253, or visit the website www.nuccadickholtzsr.com.
Since the publication of this feature, Dr. Dickholtz has been awarded the prestigious Chirpractor of the Year Award by the International Chiropractic Association. Dr. Charles Woodfield is now employed by life Chiropractic College West.
OF NOTE: ATLAS ALIGNMENT AND THE NEED FOR X-RAYS
One of the significant observations in the study was that when placebo-group subjects were carefully placed in position for X-rays at all three time events, atlas laterality and atlas rotation measurements were constant; in the treatment group the atlas laterality and atlas rotation measurements were constant in the post adjustment phase. In conclusion, if the patient placement is the same, then the measured misalignment on X-rays is constant over time; if the correction holds, then the X-ray listing – set of measurements – is constant over time. (125 sets of X-rays are involved in these constant-over-time measurements.)
This is not necessarily saying that the atlas is locked in position; it is certainly not locked in flexion or extension. When coupled with other research, these observations are consistent with the hypothesis which suggests an abnormal set of “ locked-in” paths for a misaligned atlas and a normal set of “locked-in”paths for an aligned atlas for a subject moving their head and neck. (One can see on X-rays other parts of a given path for both cases of aligned and misaligned upper cervicals, if the patient placement is not consistent!) What this does support is the validity of using X-rays for determining a vector for adjustment if, and only if, the practice protocol requires consistent patient placement for X-rays. If the misalignment were different on every day of the week, even when the same patient was consistently positioned, then one could relatively easily argue for a random vector, or for no “known vector,” to be used in a spinal manipulation. Thus X-rays for determining a vector would not be necessary – unless only the vectored alignment process consistently resulted in a correction that held over a reasonable time period.
Of even more importance is that an aligned set of upper cervicals is found to be in alignment over time. If the time frame for maintaining alignment were only on the order of a day or two, then the chiropractor would have to be doing spinal manipulations several times a week. Certainly it would be prohibitive to the health of the patient to X-ray each visit. (In-house research has shown that any re-misalignment tends to be in the same pattern – basic type – over time.)
It is important to understand that there is only a very small range of neurological alignments possible – one necessary requirement is that atlas laterality be less than 0.75 degrees – whereas there is a very large range (orders of magnitude larger in number) of neurological (and biomechanical) misalignments possible.
Dr. Marshall Dickholtz, Sr. Named ICA Chiropractor of the Year!
Congratulations to Dr. Marshall Dickholtz, Sr., a recently elected Fellow of the International Chiropractic Association (ICA), who was also named recipient of its prestigious 2008 Chiropractor of the Year Award!
During the ICA Fellows meeting on June 21, 2008 in Anaheim, CA, Dr. Gerry Clum, President of Life Chiropractic College West, nominated Dr. Dickholtz as a Fellow of the organization and for the candidacy as Chiropractor of the Year. In addition, Dan Murphy, D.C. , the current ICA Vice President and well known lecturer, also spoke in support of Dr. Dickholtz’s nomination which was especially meaningful because Dr. Murphy was also nominated for 2008 Chiropractor of the Year. According to attendees, Dr. Murphy thanked everyone for the nomination and then asked them to vote for Dr. Dickholtz, to recognize his lifelong efforts on behalf of the profession, NUCCA, and research.
Dr. Dickholtz is the lead researcher for the Upper Cervical Research Foundation and has been offering his dedication and unwavering passion to advancing the science, research and education of chiropractic for more than fifty years. His work with the widely recognized hypertension study using the NUCCA procedure has clearly validated chiropractic’s place in healthcare.
Dr. Dickholtz, who celebrated his 85th birthday this month, said he is greatly honored by the award and the acknowledgement of his work.
TAO Foundation Donates Major Gift to FEM Study
Mr. and Mrs. Lorne and Pat Gordon, directors of the Tao Foundation, based in Calgary, Alberta, generously donated $52,000 USD to the Upper Cervical Research Foundation for the specific purpose of supporting the Finite Element Model study which is currently in progress at the University of Toledo. Their gift is being used to fund a major portion of the project’s first two years which enables the Upper Cervical Research Foundation to begin raising funds for an additional two years of study involving more complex influences on the Spinal Model and the related evaluations.
UCRF Remarks on Good Morning America Feature and Blood Pressure Study
NUCCA doctors realize there is scientific, medical, and chiropractic exposure resulting from the blood pressure study that has now reached the national media through ABC's Good Morning America's segment : "Hypertension: A Pain in the Neck". [Tuesday March 25 (2008)]
The NUCCA Director of Research believes that ABC's Dr. Tim Johnson assessment of the study is correct. It is "very intriguing", "important" and "absolutely deserves more study" but this was a study involving only one Chicago certified NUCCA doctor and a small number of people. Scientists call such a study a pilot study. No one knows the long- term, single- adjustment effect because the study only kept track of patients for 8 weeks after the adjustment. When asked why it works, Dr. Johnson said "We don't know why." And NUCCA research does not know the answer to "why" either although we certainly have some educated guesses. Dr. Johnson stated that the area of the brainstem where the atlas vertebra is located is involved with regulation of blood pressure.
Both Tim Johnson, MD, (Boston) and George Bakris, MD, (Chicago & lead author of the study) realize that there was a "very significant drop in blood pressure" and realize the importance of future research to determine which people can benefit from this procedure.
NUCCA has developed a highly advanced hand-adjustment procedure that is an extremely precise and gentle technique unlike any other kind of chiropractic care. NUCCA chiropractic addresses mechanical spinal injuries (trauma) primarily in the neck and head region. These injuries cause neurological, postural, and spinal imbalances.
The tool of the NUCCA doctor is the upper cervical adjustment. The purpose of the adjustment is to mechanically return the head and neck to its normal position. By returning the head and neck to its balanced position, neurological stress is reduced and body posture is returned to normal.
Each patient's chiropractic adjustment experience and healing response is unique. One thing is universal: the light touch of the adjustment will set your body in the direction for achieving optimum health.
NUCCA requires the existence of postural problems to qualify as a patient; all of the people in the pilot study had postural problems. NUCCA doctors do not claim what they do should substitute for standard medical practice nor do they necessarily take people as patients on the basis of symptoms or pain.
The Upper Cervical Research Foundation is currently seeking financial support for the continuation of this important research.
Co-op America Declares UCRF
What does it mean to be green? According to Co-op America (the nation's long time leader on the path to healthy, sustainable living), green organizations operate in ways that solve - rather than cause - social and environmental problems. These organizations are innovative and adopt principles, policies, and practices that improve the quality of life for their customers, employees, and communities - both locally and globally.
As the result of a detailed screening process that looks at organizational commitments and accomplishments, The Upper Cervical Research Foundation has been recognized and certified by Co-op America as a green business and has been admitted to the national Green Business Network. Members of Co-op America's Green Business Network have made extraordinary contributions to promoting healthy communities, preserving the environment, and delivering quality services to consumers.
UCRF is now also listed in the National Green Pages among other organizations that are value-driven and dedicated to socially responsible practices. To learn more about social responsibility and Co-op America, please visit their website at www.coopamerica.org.
STANDARD PROCESS SUPPORTS UCRF RESEARCH
The Upper Cervical Research Foundation launched 2008 with a terrific boost as it earned the recognition and support of Standard Process, the widely respected whole food supplement company.
Standard Process has been working with health care providers since 1929 to strengthen and enhance well-being for countless people of all ages. Their commitment to the ongoing development of healthy living inspired support of UCRF’s Spinal Modeling project which is in progress at the University of Toledo Spine Center with internationally renowned researcher, Dr. Vijay Goel. The generosity of Standard Process greatly assists UCRF in meeting the needs of this groundbreaking multi-year research program.
Blood Pressure Study Makes Headlines!
Recent results of a Chicago-area study of 50 people with a misaligned atlas vertebra and high blood pressure showed that after a one-time specialized chiropractic adjustment using the NUCCA technique, blood pressure decreased significantly. The study's lead author is George Bakris, M.D., director of the hypertension center at the University of Chicago Medical Center. Patients in the study were referred for assessment and participation to Chicago NUCCA practitioner Marshall Dickholtz Sr, D.C., founding member of the Upper Cervical Research Foundation Board of Directors.
To read a few of the articles reporting on the study results, go to:
To view the Chicago Tonight PBS television program discussing the Hypertension Study click here.
Racecar Driver Tony Schumacher Makes Dramatic Recovery
Watch the Discovery Health Channel program reporting on the remarkable recovery of severely injured racecar driver Tony Schumacher. After a lengthy and discouraging recuperation from a near fatal racing accident, Mr. Schumacher was left with debilitating physical conditions. He was eventually referred to and treated by UCRF board member Dr. Marshall Dickholtz, Jr., and as a result, Schumacher’s innate good health was completely restored. He’s now racing again!