4th SOT Research Conference (2012) Abstracts
The 2012 Conference Proceedings offers 3 invited commentaries and 15 full text abstracts relating to topics such as SOT, cranial techniques, chiropractic manipulative reflex technique, occipital fiber diagnosis, and dental chiropractic co-treatment of TMD. Over 130 pages. The proceedings has information regarding research, evidence informed healthcare, how to produce a poster presentation and more. This book can be purchased through the SOTO-USA bookstore by clicking here.
All presentations from this conference can be viewed for free – 4th Annual SOT Research Conference Presentations – Videos.
The following are the Abstracts from the 4th Sacro Occipital Technique Research Conference, listed alphabetically by author, that took place in Atlanta, Georgia on May 3, 2012.
Benner CD, Gardiner D, Blum CL. SOT chiropractic and acupuncture for SLAP tear: A case report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 9-17.
Introduction: While arthoscopic surgery is a common occurrence with SLAP lesions the purpose of this paper was to investigate whether conservative care, which utilized sacro occipital technique (SOT) chiropractic care and acupuncture, could facilitate recovery with a patient presenting with a SLAP lesion.
Case History: 42 year old male, in good overall health, injured right shoulder while doing boxing training on an ‘upper-cut bag’. An MRI was taken which revealed a SLAP tear which was unresponsive to prior conservative care interventions for 8 months.
Methods/Intervention: Chiropractic SOT and acupuncture were instituted to treat kinematic chain asymmetry and improve shoulder healing.
Results: By the first treatment an immediate improvement in range of motion and a substantial decrease in pain were found. Following 5-visits over a 2-month period of time the patient was able to return to prior boxing training and had full shoulder strength and flexibility.
Conclusion: The chronicity of the patient symptoms, over 8 months, and the temporal relationship between treatment and response to care is of interest. Research should be taken to evaluate whether a subset of patients may be better suited for this alternative method of care or whether this case was an anomaly.
Blum CL. Chiropractic and Dentistry– The Need for Mutual Understanding of TMD Co-treatment: A Case Report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 18-26.
Introduction: A 19-year-old male presented with a history of attempting a back flip on a trampoline but landed on his head and compressed his neck. While taking the case history his parent noted that he also had persistent and intense bruxism at night creating significant sounds that would waken others near his room at night.
Methods/Intervention: Evaluation revealed decreased cervical range of motion, category two sacroiliac joint sprain and significant TMJ related findings, relating to a dental class III (protruded) occlusion and concurrent class II (retruded) condylar position. He was treated with sacro occipital technique (SOT) category two block placement, cervical stairstep adjusting, and SOT cranial/TMJ related care.
Results: The cervical spine range of motion and pain improved immediately following the treatment. However the dental presentation suggested a referral to a dentist familiar with functional orthodontics and trained within a dental chiropractic co-treatment methodology.
Conclusion: The purpose of this case report was to illustrate a working treatment program where both chiropractic and dentistry can play an integral part in an attempt to improve patient care and outcomes. It is essential for the chiropractic profession to understand the limitations of chiropractic care for patients with TMD.
Boro WJ. Treatment of Low Back Pain by Cranial Adjustment: A Case Report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 27-33.
Introduction: The purpose of this case report is to examine if there could be a possible clinical connection between lower back pain and dysrelationships of the cranium.
Case History: In July of 2011 a 39-year-old male patient was involved in a work related altercation, with knee trauma and due to limping experienced lower back pain (LBP). His LBP became constant and unresponsive to rest or physical therapy.
Methods/Intervention: Sacro occipital technique evaluation procedures and analysis were used in conjunction with methods developed by Van Rumpt, most particularly an anterior cranial distortion pattern. Various muscles were tested to determine if a positive functional change could be found clinically following care.
Results: Post-treatment the patient noted his LBP was improved and the next day, he reported a sustained reduction of LBP that allowed him to walk without a limp for the first time in over a month.
Conclusion: In this case, it appears that a “Van Rumpt style” cranial adjustment offers a therapeutic benefit to an adult with chronic lower back pain. Further research is needed to help determine the best subset of individuals with lower back pain who might be best served by this type of cranial adjustment.
Feenstra H, Blum CL. Integrating temporal-sphenoid reflexes, sacro-occipital technique procedures, and reflexology for treatment of chronic cervical cervical pain and reduced range of motion: A report of two cases. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 121-132.
Introduction: The purpose of the following two case studies was to investigate how a combination of temporal sphenoidal (TS) reflexes, chiropractic manipulation, viscerosomatic reflexes, and foot reflexology could have a positive effect on cervical spine range of motion.
Case Series: Case #1 involved a 38-year-old female with chronic (17-years duration) neck and low back pain. Case #2 involved a 43 year old male presenting with chronic (6-months) neck and low back pain with limited cervical range of motion.
Methods/Intervention: Treatment utilized sacro occipital technique (SOT) protocols, TS reflexes, cervical manipulation, and foot reflexology to treat chronic cervical pain associated with limited range of motion.
Results: Case #1, following the first treatment noted full range of motion in all directions and the presenting pain reduced from an 8 to a 3 on a pain scale of 1-10. Case #2 received 11 treatments over a 3-4 week period of time and by the 11th office visit right lateral flexion was full and presenting pain was reduced from an 7 to a 2-3, all other motions were full and pain free.
Conclusion: Further research is indicated with a larger sample and more outcome assessment tools to further investigate this method of care.
Gerardo RC, Shirazi D, DDS, Blum CL. Chiropractic and dental care of a patient with temporomandibular and sacroiliac joint hypermobility: A case report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 34-41.
Introduction: The purpose of this case report is to share a novel protocol for the treatment of chiropractic and dental treatment of a patient with TMD that presented with hypermobility of the sacroiliac joint (sacro occipital technique – category two) and TMJ.
Case History: A 47-year-old female patient presented with chief complaints of pain when chewing, jaw pain, limited mouth opening range of motion, and TMJ crepitus. Following dental evaluation and delivery of dental orthotics the patient was referred for concurrent chiropractic, which found indicators of a category two.
Methods/Intervention: Following orthotic and chiropractic care at 8-weeks, the capsulitis of TMJ was no longer present and procaine injections were initiated at one month intervals, followed by prolotherapy. Chiropractic and dental care was continued over a 10-month period.
Results: Following concluding treatment the patient is free of most pain, has full range of motion in the cervical and lumbar spine, negative sacroiliac hypermobility findings, and can open her mouth greater than 42mm (initially presented with 28mm opening) with normal joint tracking and translation.
Conclusion: Concurrently her sacroiliac joint hypermobility syndrome and related soft tissue tension patterns in the lower extremity, cervical spine, and jaw region have also significantly improved.
Getzoff H. A study of the nature of SOT occipital line fibers: A retrospective case series of 65 patients. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 42-47.
Introduction: The purpose of this retrospective study of 65 patients, gathered over a 5 year period, to discuss occipital fiber techniques (OCT), their historical perspective, relevance as well as basis of clinical application of SOT’s occipital fiber reflex analysis and treatment. OCT involves vertebral adjusting as well as treatment of non-musculoskeletal presentations,
Selection Criteria: Selection criteria included that: (1) the patient was adjusted at this office for more than five consecutive years, (2) the patient received at least ten adjustments per year in each of the last five years, and (3) at each office visit the patient’s occipital fibers were examined and the related vertebrae noted and recorded in the individual’s chart notes.
Results: While all 65 patients maintained clinical improvement they still presented at each office visit with an occipital fibers reflex and a related vertebral subluxation. Some were no longer experiencing soft tissue (visceral reflex) palpation sensitivity. All felt improvement from their initially stated symptoms. All patients understood the meaning of the OCT and participated with their care in respect to nutritional and dietary modification.
Conclusion: Based on this study, greater investigation into occipital fiber analysis and treatment and its relationship to patient care is warranted.
Getzoff H. Sitting disc technique and the relationship to the straight leg raise: A retrospective case series of thirty patients. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 48-51.
Introduction: The purpose of this study was to determine if a chiropractic intervention, the sitting disc technique (SDT), could be used in coordination with a common orthopedic/neurological test, the straight leg raise (SLR).
Case Series: A retrospective study of 30 sequential patients treated at one practitioner’s office that, following assessment and evaluation, were determined to have a positive SLR bilaterally, and then were adjusted with the SDT and then reassessed utilizing the SLR (measured with a flexometer). To qualify for the study all 30 patients had to have similar SLR findings on both leg lifts, pain in the lumbosacral area with some pelvic area pain, unilateral lower extremity pain but not below the knee, and with pain localizing to the leg contralateral to their antalgic lean.
Results: Improvement immediately followed care in 27 or 30 cases with the least improvement by 4 patients at 5°, maximum at 35° by one patient and the majority showing improvement between 10-25°.
Conclusion: The SLR appeared to be a helpful method to monitor the functional improvement of the lumbar spine after successful SDT adjustments. The SLR also appeared to parallel positive symptomatic changes that accompanied lumbar spine improvement following the SDT applications.
Herbert V. SOT Chiropractic in Luxembourg. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 52-54.
Working as a chiropractor in Luxembourg is pioneering work. Very few know what chiropractic is and what a chiropractor does. Some people have heard about it, but only by word-of-mouth which has led to misperception of the chiropractic care. Therefore, while patient education is very important this is also true for health practitioners, such as general practitioners, physiotherapists and dentists. Some of them might have heard about chiropractic, but nothing more. Unfortunately, some physiotherapists/orthopaedists are taking weekend courses in ‘chiropractic’ and think they practice chiropractic.
Since I am a SOT chiropractor, I have started to contact dentists here in Luxembourg. I think dentists and chiropractors should work together because this type of interdisciplinary care can be very beneficial for a lot of patients, especially TMD (temporomandibular disorder) patients.
Approaching healthcare practitioners and explaining to them why it is beneficial for them to work together with a ‘real’ chiropractor is crucial because most don’t know what education chiropractors have and how we are practicing. Once we have explained to them what we do and they understand how it can be beneficial to the work they do, chances are higher we can develop a cooperative relationship.
Kierstyn S. Secrets of Back Pain,..Including Fibromyalgia. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 55-56.
Sunny Kierstyn, RN, DC has spent 12 years working as the Chief Chiropractic Officer for the Fibromyalgia Care Center of Oregon, and has found clinical successes treating patients with fibromyalgia. As a means to communicate with the public at large she has written a book that describes sacro occipital techniques (SOT)’s category two (sacroiliac joint instability syndrome) from a structural and nutritional viewpoint.
Based on her clinical experiences, evolution of the category II misalignment patterns and their relationship to the development of fibromyalgia is explored. During years of patient stories, a separation between a ‘faux’ or acquired fibromyalgia and true fibromyalgia was found with the faux actually being a SOT category two or chronic sacroiliac joint syndrome.
This book uses a series of patient case histories and discussion of their process while under care with Dr. Kierstyn to present anatomy and physiology relating to fibromyalgia as well as to discuss general tenants of musculoskeletal health and dysfunction. While valuable for the lay person this book also may offer the doctor some insight into how to explain this complex clinical phenomena to their patients.
McCoy M. Research, Scholarship, and the Future of the Chiropractic Profession. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 57-59.
How could one professor say subluxations didn’t exist while another could lecture for days about its nuances? It was that night (or perhaps I remember it as one night) that I realized it was going to be up to me to figure this out for myself because the contradictions could be overwhelming.
When I started as an editor over a decade ago little did I think I’d be doing what I’m doing now. The need for chiropractic research and scholarship has never been greater and over the next 15-20 years the need is only going to increase. This research and scholarship is needed to ensure our rightful place within healthcare and its needed to provide current and future chiropractic students with the background and ammunition they will need to confront an increasingly hostile faction of our profession that would like to see lifetime, family wellness, subluxation centered chiropractic go away.
Vertebral subluxation is the cornerstone of our great profession and it remains the cornerstone of my own clinical and research interests. But ultimately the existence of a journal does not in and of itself mean much if there are no contributions to the scholarship.
Annals of Vertebral Subluxation Research
Journal of Pediatric, Maternal & Family Health – Chiropractic
Journal of Upper Cervical Chiropractic Research – JUCCR
Dialogues – The Journal of Philosophy, Principles and Practice of Chiropractic
So please take this as a Call for Papers to each one of the journals and a call to subscribe. If at the very least your contribution to the research infrastructure in this profession is through your subscription to a scholarly journal then you have done more than most. My hope is that 20 years from now I am writing an Editor’s Perspective that reports on a massive cultural change within the profession through the embracing of research and scholarship.
Pine D. Is Sacroiliac Joint Hypermobility an Overlooked Syndrome in Chiropractic?: Designing a Survey Based Research Investigation. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 60-64.
Introduction: The purpose of this study is to determine if sacroiliac joint (SI) hypermobility is an overlooked syndrome in Chiropractic. This survey will explore the possibility that a doctor’s analytical bias may predispose to view a patient’s presentation in a specific manner.
Methods/Intervention: An online survey will record clinical observations made by chiropractors who: (1) utilize SOT indicators and treatment protocols in their practice (Group 1) and (2) chiropractors who do not. The project is more concerned with frequency of SI joint hypermobility/fixation observed rather than individual patient presentation data.
Anticipated Results: It is hoped this survey will illustrate so the stratification of information gathered cannot yet be organized into various categories and properly analyzed.
Discussion: Also to properly understand the concept of hyper- versus hypomobility of the SI joint form force closure patterns anterior and posterior force closure by way of myofascial slings, and form force closure assessment and corrections will be discussed in relative detail.
Conclusion: Investigating diagnostic and therapeutic aspects of all manual healthcare are challenging due to the gray region between art and science or objective and subjective doctor/patient interactions. How a doctor views possible outcomes may well influence how they diagnose and treat their patients.
Powers L. Rotator cuff conservative care utilizing sacro occipital technique (SOT) and supportive taping: Two case reports. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 65-70.
Introduction: This case study suggests that the shoulder and SI joint can be a related part of the myofascial kinematic chain.
Case Series: Case #1 is a 60-year-old male injured his shoulder working with his wood and was only able to move his arm up to 90° flexion and abduction. Case #2 is a 90-year-old male initially seen for low back pain who could not extend or abduct his shoulder over 90°.
Methods/Intervention: The treatment focused on sacro occipital technique (SOT)’s use of category two pelvic block placement and flexible cotton based adhesive tape to support the SI joint instability. The patients were treated for a slipped bicipital tendon and tape was also applied to support the shoulder.
Results: Case #1: Following 6-weeks of weekly treatment the patient had shoulder range of motion to 170° flexion and abduction and able return to stacking firewood without discomfort. Case #2: Following 3-weeks of biweekly care the patient was able to raise his arm up to about 160° flexion and abduction without discomfort.
Conclusion: Further study should be performed to investigate whether the finding of this case may influence the treatment of patients with rotator cuff disorders unresponsive to other methods of care.
Rosen MG. SOT chiropractic care of a 47 year-old female with left-sided sciatica caused by a 16mm left paracentral disc extrusion: A case report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 71-81.
Introduction: The purpose of this paper is to demonstrate how conservative SOT chiropractic care safely, effectively, and efficiently helped a patient with sciatica believed caused by a 16mm left paracentral disc extrusion return to normal functional capabilities in a relatively short period of time with no negative side effects.
Case History: A 47-year-old female, entered my office stating that 3 days ago she began to feel pain in her low back and left leg and has progressively gotten worse. She described the pain as a 9-10 on a pain 1-10 pain scale with 10 being most painful pain imaginable.
Methods/Intervention: Sacro occipital technique (SOT) specific protocols were used to determine the appropriate treatment protocols and the patient was treated with category three protocols for disc compression and sciatica.
Results: After the initial two weeks of care the patient showed marked improvement in her symptomatology and functional ability. The patient continued to make excellent progress and continued to resume normal activities of daily living without pain or discomfort, by June of 2010 was able to play golf.
Conclusion: It is significant that the patient had reduction of pain and improved function, while still having a L5-S1 16mm left paracentral epidural mass.
Serola R, Blum CL. Pregnancy, sacroiliac support belts, and active straight leg raise (ASLR): Incorporating new diagnostics into sacro occipital technique. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 82-90.
Introduction: This paper will discuss the use of the ASLR test as a potential part of sacro occipital technique’s diagnostic regimen for the treatment of pregnancy-related SIJ disorders. In addition, this paper will review the literature concerning the use of the sacroiliac support belt as both a diagnostic and treatment modality for this common presentation.
Use of the Arm-Fossa Test (AFT) in Sacro Occipital Technique, PPLP or SIJ Disorders in Pregnancy: In sacro occipital technique, the arm-fossa test (AFT) is commonly used to analyze the need for treatment as well as the effectiveness of care for SIJ instability.
Active Straight Leg Raising Test: While sacro occipital technique’s test (AFT) for SIJ instability has some degree of validity, the active straight leg raise (ASLR) test has shown reliability and validity for the evaluation of SIJ disorders, particularly in pregnancy.
SIJ Support Belts for Diagnosis and Treatment: The SIJ compression caused by the doctor’s hands, a SIJ support belt, or the pelvic blocks may offer a good opportunity to use the ASLR as a means to study the need for SIJ treatment and the efficacy of the treatment rendered.
Conclusion: Simple tests such as the ASLR may offer good options to monitor pre- and post-treatment of PPLP and SIJ in this specific subset of patients.
Shaneyfelt D. Styloid process sensitivity in a patient with low back pain and radicular syndrome: A case report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 91-95.
Introduction: A 57 year-old right-handed white male, presented in our offices with a chief complaint of acute sudden onset left jaw pain. The patient gave a history of a three day episode of jaw, neck and ear pain, with no known cause.
Methods/Intervention: Evaluation note that with palpation marked sensitivity of the left styloid as well as exquisite sensitivity along the right sciatic track with a positive straight leg raise at 45 degrees. The patient was treated with sacro occipital technique (SOT) category three orthopedic blocking which utilizes the left styloid process as a guide to possible related L5/S1 discopathy affecting sciatic nerve irritation.
Results: As treatment was provided, the sensitivity to the styloid process was rapidly eliminated. Concurrently the right sciatic pain and related muscle tension in the right thigh significantly diminished.
Discussion: Part of any differential diagnosis with a patient that presents with significant styloid process pain could include determining if there is concurrent low back pain related to L5 involvement.
Conclusion: Further studies are needed to determine what subset of the population has a relationship between low back pain and styloid sensitivity so that interdisciplinary communications between dental and chiropractic fields could help facilitate improved patient differential diagnosis.
Shelley JR. Latent sciatic technique and cervical traction test: A DeJarnette discovery and case report. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 96-100.
Introduction: In the early stages of chiropractic research many of the chiropractic pioneers , such as M. B. DeJarnette, DO, DC utilized discussions with his students to share “new” procedures to students to test and report their experience if a method was helpful or not. One such method, “latent sciatic” (LS), was determined with sensitivity upon palpation in the patient’s posterior calf, thigh and/or gluteal region, believed a condition of sciatic irritation with no subjective presentation of pain in the leg or buttock.
Case History: A 38-year-old male presenting with a history of low back pain resolved with SOT category two treatment yet still continued for years to have irregularity of the bowels (constipation) and erectile dysfunction.
Methods/Intervention: Palpation of the patient while prone found LS indicators present on right lower (calf) and right upper (gluteal) regions. Patient was treated with SOT disc decompression, leg traction, and lumbar orthopedic block adjusting.
Results: Patient was treated 5-times in 3-weeks by which time the LS indicators were eliminated and concurrently reported regularity of his bowel and other body functions.
Conclusion: The Latent Sciatic developed by DeJarnette can be a valuable tool to guide patient care particularly in cases with resistant sciatica findings.
Thompson JE, Bockhold H, Blum CL. Sacro Occipital Technique: Occipital Fiber Technique and CMRT for Treatment of Canine Fecal Incontinence. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 101-106.
Introduction: This study investigated whether the occipital fiber technique (OFT) could be found in canines and whether a treatment based on OFT would yield any response.
Case History: A 12-year-old neutered male German Shepard mix with daily fecal incontinence which was unresponsive to prior interventions presented for chiropractic care.
Methods/Intervention: Occipital fiber analysis and treatment was performed by a chiropractor trained in SOT and veterinary chiropractic care on the canine in a standing position with his head slightly flexed for analysis. L5 was treated with spinal manipulative therapy and chiropractic manipulative reflex technique (CMRT) was performed after neutralization of the occipital fiber.
Results: During the days that followed the treatment the dog’s fecal incontinence was reduced to eight times in 20 days after the first treatment, and then two times a month for the next three months. Prior to this treatment the dog had not any sustained relief from any other modality, including traditional chiropractic care.
Conclusion: The owner’s interpretation of the dog’s response before and after treatment, concurred that a significant positive change had occurred. Due to these findings further investigation into the use of OFT and CMRT for canines and possibly other animals is warranted.
Thompson JE, Bockhold H, Blum CL. Sacro Occipital Technique: Occipital Fiber Technique (OFT) on Equine with Shortness of Breath and Chronic Sinusitis. 4th Annual Sacro Occipital Technique Research Conference Proceedings: Atlanta, GA. 2012: 101-106.
Introduction: This study investigated whether the OFT could be found in equines and whether a treatment based on OFT would yield any response.
Case History: AB, a 12-year-old Dutch Warm Blood began having shortness of breath during work as a level-3 Dressage competitor. She was diagnosed with a sinus infection and for months as treated multiple times with a variety of antibiotics which only provide short periods of relief. She could not perform due to her condition and euthanasia was considered.
Methods/Intervention: Occipital Fiber analysis and treatment was performed while the horse was standing for analysis. Occipital Fiber 2, line 2, was found and corresponded to a tender Thoracic-3 nodule. T3 was adjusted and chiropractic manipulative reflex technique (CMRT) was performed after neutralization of the occipital fiber.
Results: 30-hours post treatment the horse threw her head one more time and a large amount of dark thick mucus came out of her mouth and nose and 5-days later the horse was able to return to work as a level-3 Dressage competitor.
Conclusion: Due to these findings it is reasonable to assume that further investigation into the use of OFT and CMRT for equines and possibly other animals is warranted.
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