all stages. Minimally, care should be recom-mended on an exam-to-exam basis. If we expand our parameters in the early stages of care from relief to release outcomes, we can realign the goals towards a more potent wellness outcome. This is where it gets ex-citing as we expand the perspective of the adjustment to incorporate core neurology. which evidence is adding increasing weight, is the adjustment’s potential to impact non-spinal health issues. Patients need to be made aware of the powerful effects that adjustments can have beyond the musculoskeletal system. Altering the pressure or tension within a spinal nerve creates a cascading effect that engages the Using technologies that pinpoint areas of change, while continuously re-examining the patient along their path to wellness, confirms the value of progressive care planning. WHAT IS A RELEASE OUTCOME? Release implies liberation from tension. Musculoskeletal tension and neural ten-sion can be benchmarked as a care plan begins. Sensors can be used to detect varia-tions in the tension within the different aspects of the spinal core. For example, gravitational forces cause the muscle sys-tems along the spine to work. If chronic stress or overwork has altered the sym-metry and amplitude of the firing along the motor pathways, then fatigue and the loss of normal tension can be identified using safe and reliable surface EMG. This evidence-based approach gives the clini-cian a validated benchmark to which other exams can be compared as the continuum of care progresses. Instead of trying to use the data from this test to locate hypertonic muscle groups, the interpretation can be focused on a more global perspective. The overall expenditure of neuromuscular en-ergy can exhaust the individual. Dyspone-sis is a term that can be applied to EMG interpretation as it describes the “reversible physiopathologic state consisting of errors in energy expenditure, which are capable of producing functional disorders. Dyspo-nesis consists mainly of covert errors in ac-tion potential output from the motor and premotor areas of the cortex and the con-sequences of that output.” 1 This allows the clinician to correlate the existence of overworked core muscle func-tion with an overall loss of energy and gener-alized fatigue in the patient. Instead of being limited to an outcome of back or neck relief, the patient and the doctor can focus on the restoration of the patient’s vitality while moni-toring spinal balance and tension. THINKING OUTSIDE OF THE SPINE The jewel of the chiropractic story, to 32 • Canadian ChiropraCtor | SEptEMBEr 2012 sensory, motor and autonomic nervous systems. 2 The ability to regulate blood vessels, organs and glands falls under the responsibility of the autonomic portion of the nervous system. Another sensor that looks through the window of the paraspinal sympa-thetic motor system is thermography. Vasoconstriction is associated with mal-adapted tension in this division of the spinal-neural array. Using calibrated thermal sensors, a fast, reliable and re-producible test gives the clinician a snap-shot of which spinal regions are out of sympathetic balance. The consequence of unmanaged autonomic imbalance is widely connected to end-organ malfunc-tion and can be viewed as a precursor of chronic disease states. 3,4 Chiropractic has always been linked to the improvement of patients’ organic health and now there is a validated procedure that allows the practitioner to observe the release of this noxious tension. An exciting advancement in instru-ment-based examination in the chiro-practic field is Heart Rate Variability (HRV). 5,6,7 This non-spinal test is viewed as a marker of a patient’s overall adapt-ability. This is a procedure that is widely used in other disciplines – it is relied upon in cardiology, exercise physiology and psychology to observe reactive states in a person’s overall autonomic function. A clinically valid test can be performed in a quiet, unattended setting in less than six minutes. The detailed calculations inher-ent in the testing can determine whether a patient is locked into a sympathetic or parasympathetic state while assessing how much “reserve” the patient has in his or her stress management system. As spinal-neural tension is released through adjustments, and new strategies are re-built, HRV can help track autonomic activity and balance; both are indicators of performance and overall well-being. Because HRV looks at the cumulative effects of stress over time, successive HRV tests can indicate the path of recovery within the patient. The results seen with this testing in a chiropractic research set-ting confirm the power of an adjustive care plan. 8,9 Studies published on HRV indicate that chiropractic care, alone, is a powerful modulator of HRV results. This becomes an invaluable procedure when the parameters of care are extended from the relief of spinal dysfunction towards the expression of wellness. Armed with the new care plan para-digm and an array of technologies that are relevant for the chiropractic setting, chiro-practors can now begin to do as orthodon-tists do, that is, develop and propose a care plan with certainty. Recommended out-comes are aligned with the measurable re-lease of spinal-neural tension. As the spine is improving, so is the capacity of the cen-tral nervous system to become more adapt-able. Together, these improvements relate to increased performance, a heightened sense of body awareness, comfort and, of course, a re-energized state of coherence. Furthermore, the goal of the care plan can now exceed the limits of spinal well-being. It can now be crafted to improve the pa-tient’s overall state of wellness. The goal of wellness-based care is in-credibly appealing to patients who have struggled with declining spinal func-tion and an overall increase in an array of stress-related symptoms. Handling a patient’s immediate spinal needs can be an incredible starting point to discuss the damaging effects of stress, subluxations and the power of the adjustment. How -ever, today’s chiropractors can be armed with the finest training and knowledge in managing beyond the limits of the spine. Using technologies that pinpoint areas of change, while continuously re-examining the patient along their path to wellness, confirms the value of progressive care planning. The concept of using an adjustment to revitalize a patient can be so much more appealing than striving to reach the imposed ceiling of maintenance care. • To view this article with references, please visit the Current Issue page at www.canadianchiropractor.ca. www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor September 2012: Page 32
