3rd SOT Research Conference (2011) Abstracts

Introduction : A 34-year-old female patient presented with a history of low back pain (dull, achy, non-radiating) that has been present for nearly two-years.

Methods : The patient reported complete relief of her chronic low back pain with her eyes closed or in a darkened room, whereas the pain would return when opening her eyes and particularly in a lightened room, with or without eyeglasses.

Treatment : Osteopathic manipulative therapy (OMT) to the full body and cranium was applied with the patient’s eyes opened, closed, and eyeglasses on and off. Modifications were made to the optometric prescription and eyeglasses to optimize body and cranial function as well as to reduce her low back pain.

Results : The patient noted considerable relief in her low back pain with the new eyeglass prescription, and this relief was sustained regardless of eyes open or closed, and particularly with her eyeglasses on.

Conclusion : This case study illustrates that a subset of patients may present with a clinical condition that either affects vision or the vision affects the condition called a visual somatic strain. This demonstrates how collaborative efforts might be made to develop co-treatment opportunities between osteopaths, chiropractors, ophthalmologists, and other allied professionals.

Introduction : Three adult case studies (79 and 60 years old females) and (60 year old male) were selected to demonstrate maxillary morphogenesis. These patients were treated for maxillary underdevelopment which can affect occlusion and airway space due to tongue hard palate relationship.

Treatment and Intervention : Each patient wore the Homeoblock appliance for a minimum of twelve months. The Homeoblock™ consists of “Adams clasps” on the bicuspids with a baseplate that incorporates a palatal expansion jack screw. The appliance is relieved from the palatal tissues. Flap springs rest on the anterior teeth and a Hawley archwire extends from left to right canine. A bite block is placed on the second bicuspid and first molar on the less developed side.

Results : Improved tongue position, tone, and the resulting increased pharyngeal airway size were found with each patient.

Discussion : Once nurture seemed clearly distinct from nature. External influences seem to be able to influence a network of chemical switches within our cells collectively known as the epigenome.

Conclusion : These three cases demonstrated how modifications of tissues in the craniofacial region can occur with adult patients in their 6th and 7th decade of life.

Introduction : A 31-year-old female patient presented initially to this office for low back and foot pain 5 years prior and wanted preventative wellness care. Approximately 5-years into care, February 2008, the patient discussed the possibility of utilizing acupuncture to help her cope with an irregular menstrual cycle, having only light periods (1-2 days) 2-3 times a year for over 10-years or more.

Methods/Intervention : The patient was assessed and treated using sacro occipital technique (SOT) chiropractic, chiropractic manipulative reflex technique, and acupuncture protocols.

Results : Following one-year of integrating sacro occipital technique (SOT) chiropractic manipulative reflex technique (CMRT) for liver (T8), adrenals (T9), and acupuncture her condition has been consistently improving and her cycle has been regulating with periods of monthly cycling and with only 3 months of amenorrhea one-time during a time of high stress and anxiety.

Conclusion : The chronicity of the patient symptoms, over 10 years, and the temporal relationship between treatment and response to care is of interest. It is also of interest that the patient was receiving chiropractic care on an ongoing preventative basis but not until the treatment changed to include CMRT and acupuncture was there a change in her symptomatolgy.

Introduction : Since its inception, the chiropractic profession has had patients report improvement of non-musculoskeletal complaints with the care rendered. However, the fact that a minority of patients currently seek wellness care from chiropractic providers may have more to do with consumers’ current understanding of chiropractors’ actual scope of practice than with the acceptability of chiropractors as wellness practitioners. Therefore, the chiropractic approach of the doctor may have some influence on the types of patients that may seek their care and sacro occipital technique appears to offer a “complete system of healing.”

Methods/Outcome : A survey questionnaire sent to parents of an active group of pediatric patients (2000-07) (n=127) elicited 37 responses from active patients under age 12 who had presented for treatment of nonmusculoskeletal complaints. In all cases active chiropractic care consisted of sacro occipital technique and cranial pediatric treatments. Significant improvement was reported in 36 of the 37 patients receiving predominately sacro occipital technique chiropractic care.

Conclusion : The evidence is slowly emerging to confirm chiropractic care does appear to be a reasonable intervention for some non-musculoskeletal type patient presentations particularly when weighing its low-risk versus the higher risks of medications or surgery.

Introduction : Hyperhidrosis (HH) affects approximately 3% of the population. Currently the most common therapies starting from least invasive to most invasive are: (1) psychological, biofeedback, and hypnosis; (2) tap water and possibly dry-type iontophoresis; (3) botulism toxin A injections; and (4) thoracoscopic sympathectomy.

Methods : Sacro occipital technique (SOT) attempts to have rules that help generalize patient presentations however caution must be exercised so we do not lose sight of normal variants and the commonly diffuse somatovisceral and viscerosomatic innervations. With excessive sympathetic stimulation it may be necessary to find various ways to stimulate the parasympathetics. Also since the parasympathetics originate from the cranial (cranial nerve parasympathetics) and sacral (nervi erigentes) regions, any nerve entrapment, dysafferentation, or localized dysfunction in these regions should be evaluated and treated.

Discussion : Some novel methods described by DeJarnette may contribute to stimulation of the parasympathetic nervous system and ultimately help balance the autonomic nervous system to improve the symptomatic picture for a patient with HH.

Conclusion : Low risk procedures that may offer benefit to a specific segment of the patient population should be investigated, particularly with patients presenting with HH.

Introduction : The patient presented as a 66-year-old female with significant pain and stiffness in her neck and crepitus when using her jaw. Her dentist referred her to this office for cranial and sacro occipital technique (SOT) treatment for conditions interrelated to her TMJ disorders. She could not tolerate cervical manipulation.

Methods/Intervention : Evaluation of patient’s cervical range of motion was found to be reduced by 30 % of normal and radiographic analysis revealed moderate degenerative joint disease in the lower cervical spine from C4-C6. Treatment consisted of cervical traction utilizing the Pronex Cervical (non-mandibular) Traction, SOT procedures; particularly cervical stairstep corrections and cranial therapeutic techniques for the TMJ.

Results : Following treatment the patient had a marked increase in cervical range of motion (normal levels) and a 90% decrease in pain and tension on palpation. The ability to treat the cervical spine also appeared to aid the treatment for TMJ related tension and pain.

Conclusion : The purpose of this case was to explore the efficacy of using cervical traction without pressure to the jaw to support chiropractic treatment as well as to facilitate a patient’s ability to receive care for neck and jaw pain and stiffness.

Introduction : The purpose of this study was to investigate whether chiropractic care, specifically sacro occipital technique (SOT) chiropractic manipulative reflex technique (CMRT) for the upper gastrointestinal system could be an effective method of care for patients presenting with dyspetic signs or gastritis.

Methods : The sample was composed of fifteen subjects, medically diagnosed with gastritis randomly divided into three groups of five: one group was the control which received no treatment, one group was treated with traditional pharmaceutical interventions, and one group was treated with chiropractic. Endoscopy evaluation was performed before and after the chiropractic treatment and a clinical outcome assessment questionnaire was used to determine any changes in a subject’s clinical symptoms.

Results : While the control group had some decrease of endoscopic gastritis signs, compared with traditional pharmacological treatment and control group, the chiropractic group had the greatest positive clinical response with improved endoscopic and quality of life findings.

Conclusion : Further research with large study samples are needed to determine if there is a subset of patients with gastritis or dyspepsia that may respond to CMRT care and mitigate the need for medications or more invasive procedures that offer risk.

Introduction : Patient pain patterns and spinal patterns in conjunction with Sacro Occipital Technique (SOT) Step-Out-Toe-Out maneuver (SOTO) and the Straight Leg Raise (SLR) can be helpful in establishing and communicating an effective treatment plan.

Case Series : Scenario # 1 has a spinal lean with possible lumbosacral pain along with pain in the buttocks and the upper leg on the OPPOSITE SIDE OF THE LEAN. Scenario #2 has possible spinal pain with pain of the entire leg on the SAME SIDE OF THE LEAN. Pain is often elicited with the SOTO maneuver. Scenario #3 can have no spinal lean or curvature with no lower back, buttock or upper leg pain. The pain is severe in the calf and possibly the foot, and there is difficulty sleeping because of the pain. Commonly there will be no pain on SOTO.

Treatment : SOT category three procedures including Sitting Disc Technique (SDT) and SOTO maneuver. The SLR can be instantly retested in all three scenarios immediately after the SDT and show a marked improvement.

Conclusions : More observational pragmatic case studies that can yield predictable outcomes should be presented as a means to incorporating evidence and clinical experience into clinical practice.

Introduction : This paper presented a general overview of orthopedic testing and theorizes how SOT’s arm fossa test (AFT) can help diagnose treatment for the sacroiliac joint and the SOTO maneuver can help differentially diagnose lumbo pelvic problems, disc lesions and the degree of disc damage. Two case studies are presented that utilized the arm fossa test and SOTO maneuver to help direct chiropractic care.

Case Study Utilizing the Arm Fossa Test : A 62-year-old patient presented with neck pain posterior and lateral, three months duration, especially when lifting head and bringing head forward and head and jaw generalized pain. The arm fossa test and the supine leg deficiency were normal after the third adjustment.

Case Study Utilizing the Step Out Toe Out Procedure : A 75-year-old patient presented with pain at the left sacroiliac joint, posterior upper thigh, anterior lower thigh, and lower leg and foot. The SOTO maneuver became less painful with each application along with improved movement.

Conclusion : The AFT and SOTO tests are primarily based on body responses and a patient’s sensitivity to pain which can facilitate specific chiropractic adjusting procedures and can help direct predictable outcome assessment tools.

Introduction: Enteric Structural Mechanics (ESM) and Enteric Axial Harmonics (EAH) utilized in chemical engineering may provide the healthcare system with: 1) a greater understanding of how the human body operates individually and as a component within a family and community network, 2) greater confidence and less risk in patient analysis, diagnosis and treatment and, 3) standardization for conditions currently considered outside the chiropractic scope.

Case History : A 41-year-old female presented with temporomandibular pain, difficulty concentrating, and hamstring pain with a date of onset 13-weeks prior. Upon being introduced to this case the patient was referred to an SOT chiropractor for co-treatment.

Discussion : Thomas Meyers suggests, “We have stepped over the line from remediation of biomechanical inefficiency toward the realm of the somatic psychologist.” The author disagrees. ESM and EAH has found that patients with emotional and psychological somatic influences end up with a strong resistance to psychology and psychologists.

Conclusion : Patients with emotional and somatic presentations are very difficult to process through physical based manipulative therapy. This case is an example of how engineering and chiropractic care can be administered concurrently by a chiropractor without the use of complex mathematics.

Introduction : Manipulation of a tooth has been discussed in the literature over the past few decades yet without significant evidence based literature.

Case Series : A 5-year-old female, was treated for severe tooth pain with any pressure. A 68-year-old female, complained of tooth pain right upper molar without any overt dental pathology according to her dentist. A 58-year-old female first presented with right mastoid area pressure and pain as well as numbness of the right TMJ and right back teeth. A 60-year-old female she complained of tooth pain from a crown restoration to the left upper 2nd molar. A 31-year-old female complained of front upper tooth pain.

Treatment : Prior to any adjustment to the teeth all sacro occipital technique protocols and cranial/TMJ therapy was performed. The focus of the treatment determines a positional preference that can be directed to a tooth in a specific direction to relieve pain and improve occlusion.

Results : Significant improvement was noted in these 5-patient’s cases with reduction of tooth pain which had long-term effects.

Conclusion : It appeared that the condition was not responding to a wait and see approach and that there did not seem to be any related dental pathology or disorder.

Introduction: Chiropractic and the ancient system of Ayurveda share the common goal of facilitating complete and balanced transmission of life-force for the patient. A functional bridge maybe developed between the two systems to address Ayurveda’s background and principles, methods of analysis and diagnostics and finally methods of treatment. The paper will finally propose relevancy for integrating a bodywork component of Ayurveda (Marma Chikitsa) into the Sacro-Occipital Technique (SOT) form of Chiropractic.

Basic Concepts of Ayurveda : Ayurveda does not treat disease rather it balances and harmonizes internal and external forces in the body so that the patient will express a “complete” life force.

Ayurveda and Chiropractic : Ayurvedic physical applications, Marma Chikitsa, may be used as a bridging point for chiropractic, and particularly SOT’s chiropractic manipulative reflex technique (CMRT). This may serve to deepen the level of care with regards to better understanding etiological factors, visceral and psychosomatic implications and finally specific therapeutic techniques.

Conclusion : SOT and CMRT may make an ideal partner for interdisciplinary care; since it involves a multi-dimensional appreciation for neurophysiology, musculoskeletal as well as visceral relationships addressed in therapeutic protocols.

Introduction : A one-year-old female was seen at this office reported with esophageal reflux, hiatal hernia, not sleeping more that 1.5-hours at a time, would not eat solid food, did not crawl as an infant, would not lay prone/supine, ongoing vomiting, and was irritable and inconsolable.

Methods/Intervention : Analysis and treatment utilized Sacro Occipital Technique (SOT) spinal, cranial and chiropractic manipulative reflex technique (CMRT) adjusting protocols.

Results : After the first 3-4 visits the patient’s symptoms began to subside, she did not cry in pain as often, her reflux and vomiting reduced dramatically, she no longer needed to take the prescribed medications and she was able to sleep through the night and did not wake up crying in pain. After 4-weeks of care, the patient started crawling for the first time in her life and a couple months later began eating solid foods with any nausea.

Discussion: It is possible the child might have outgrown her condition the temporal nature of her response to care coincided with and ability to eat, sleep and not take medication.

Conclusions : The findings from this study suggest that a subset of pediatric patients with GER and HH may benefit from SOT, CMRT, and cranial care.

Introduction : 48-year-old male student presented with chronic fatigue syndrome (CFS). He had the condition for years, unresponsive to various interventions, and also had chronic low back discomfort.

Methods and Treatment : Treatment focused on balancing sacroiliac joint sprain (category two) findings and related regions along with upper cervical region.

Results : The patient reported improvement following treatment, however the relief would not last for more than a few days to a week. A specific occipital adjustment called the “triple occiput” was used which involved adjusting a posterior occiput on one side, then on the contralateral side, and then once again on the ipsilateral side. The initial side was the side of reduced rotation. Following this adjustment the supine category two treatment appeared to help stabilize pelvic torsion, facilitate eliminating category two indicators, and improve the patient’s long term relief of his chronic fatigue syndrome.

Conclusion : Patient with sacroiliac joint hypermobility syndrome with accompanying suboccipital tension may represent a subset of CFS patients that could be responsive to this specific type of chiropractic care. Greater study is needed to evaluate if there is indeed a subset of CSF patients with this pattern and if they are responsive to this form of care.

Introduction : A 45-year-old male patient who had had his left leg amputated ten years previously, as a result of severe injury from a car accident in South Africa, presented with low back pain with buttock and groin pain. This case report discusses a novel method of evaluating treatment utilizing pelvic blocks for a lower extremity amputee.

Intervention : Using Sacro Occipital Technique (SOT) diagnostic methods the patient’s condition was consistent with a sacroiliac sprain (category two) yet not having a left leg to compare to the right side, assessment of pelvic torsion and block placement was a challenge.

Treatment : Muscle testing was used as a functional assessment tool and a pre test had found that grasping the patient’s leg and testing the arm for strength, showed weakness when one leg was forced shorter, or the other leg was forced longer.

Results : The patient responded well to category two block placement with reduced pain, improved function and reduction of SOT indictors of a sacroiliac joint sprain.

Conclusion : In this study a method of “forcing” the leg longer or shorter and assessing muscle strength was used to determine proper supine pelvic block placement to successfully treat a sacroiliac joint sprain.

Introduction : Bruxism is one of the main causes of TMD, but it had been difficult to measure the correlation between various TMD symptoms and the quantity of bruxism that a patient exhibits. Even if the initial cause of bruxism can be identified and eliminated, the bruxism behavior may have become habitual and thus the behavior may not be eliminated by the elimination of the cause.

Intervention : The SleepGuard biofeedback headband is a self-contained biofeedback device worn on the head, which measures electromyographic signals (EMG) from the temporalis muscles.

Result : The first round of clinical trials to test the efficacy of using a biofeedback headband to reduce bruxism was used on 92 patients in the trial. Average nightly reduction in bruxism time was measured as the difference between the normalized average nightly clenching time during the three days of initial baseline measurement (this average was normalized to 1 for all patients), and the normalized average nightly clenching time during the last three days of the trial.

Conclusion : This clinical trial showed that about 75 percent of patients are able to reduce their nightly clenching substantially through ongoing use of the biofeedback headband.