2nd SOT Research Conference (2010) Abstracts

Introduction: Sacro occipital technique (SOT) has long discussed that the anterior and posterior aspects of the sacroiliac (SI) joint are completely different in both their anatomy and function. A small sampling survey was taken of SOT practitioners (N=53) and some practitioners not familiar with SOT (N=11). From this preliminary survey, it was found that SOT chiropractors commonly found patients with hypermobile SI joints, chiropractors without an SOT bias, like most manual therapy healthcare practitioners, more commonly treated the SI joint as being fixated.

Discussion: If there is an entity such as a hypermobile SI joint, it would behoove chiropractic and manual therapy healthcare providers to be cognizant of this syndrome and see if appropriate tools can be developed to further help differentiate between a hypermobile and a fixated SI joint.

Conclusion: Since patients have varying levels of threshold regarding ligament strength, myofascial support, and pain, it is not unlikely that more than one type of treatment might prove efficacious for their care. However, it seems reasonable that greater accuracy and precision in diagnosis and treatment would likely lead to less iatrogenesis and greater patient response to treatment. Greater research by the SOT community into SI joint dysfunction differentiation is indicated.

Introduction: Bilateral symmetry, in the sagittal plane, will divide an organism into roughly mirror image halves, (with respect to external appearance). In musculoskeletal variations in symmetry can be observed. One type “fluctuating asymmetry,” measures around 1% of trait size and is not readily visible whereas another type “conspicuous,” is readily visible. Most of the asymmetries chiropractors find clinically seem closer to the subtle variety and need to be examined carefully using a defined process.

Background: Asymmetry is one of the five diagnostic criteria for spinal dysfunction defined in 1993 by Bergmann in the PARTS joint assessment procedure accepted by the ACC Technique Committee in 2004. Another assessment procedure, developed by Pederick, the “BLAST” – Bi-Lateral Asymmetry/Symmetry Tests, may also facilitate improved clinical decision making.

Discussion: Developing a method to evaluate pelvic torsion or asymmetry (using pelvic blocks) as well as determining possible reversal of this condition and associating it with improvement in function and reduction in pain may be one step towards improving chiropractic clinical outcomes.

Conclusion: Methods of assessment such as PARTS or BLAST could be used along with SOT symmetry analysis or as independent pre and post treatment assessment tools to improve therapeutic applications.

Introduction: The field of chiropractic is attempting to encourage the concepts of evidence-based care to chiropractors in clinical practice. This desire is to help support the ethics and integrity of chiropractic while at the same time protecting the public from any harm physically or financially. One avenue of this concern involves what a chiropractor might advertise on their website.

Conclusion: (1) TMJ diagnosis and treatment are part of chiropractic college curriculums and within the chiropractic profession. (2) Based on college curriculum, postgraduate studies, and the chiropractic evidence base the diagnosis and treatment of TMJ disorders is part of the chiropractic scope of practice. (3) Chiropractor’s that have both undergraduate and postgraduate training in the diagnosis and treatment of TMJ disorders should be able to share on their website a description congruent with their expertise in a reasonable and ethical manner. (4) There is extensive evidence in the published literature regarding chiropractic diagnosis and treatment of TMJ disorders. (5) In the CAM field chiropractors have been an active part of TMJ related treatment and this care is patient driven. One way of communicating expertise and availability of care is on a doctor’s website.

Introduction: The field of chiropractic is attempting to encourage the concepts of evidence-based care to chiropractors in clinical practice. This desire is to help support the ethics and integrity of chiropractic while at the same time protecting the public from any harm physically or financially. One avenue of this concern involves what a chiropractor might advertise on their website regarding expertise in the care of children or field of pediatrics.

Conclusion: Within the chiropractic community chiropractic pediatrics is a mandatory course within the chiropractic undergraduate program. Doctors are exposed to chiropractic pediatric post-graduate seminars and the majority of chiropractic published literature supports chiropractic care of children. Chiropractic care of children is safe and offers a conservative option to more invasive and higher risk alternatives. Parents and the public, in general, are looking for alternative care and chiropractic care is one of the large groups represented in the field of complementary alternative medicine (CAM). It is both reasonable and incumbent upon chiropractors trained in pediatrics to have a vehicle where they can share with the public their expertise, and their website should be an appropriate and acceptable venue.

Introduction: Asthma is a multifactorial dysfunction which may need interdisciplinary care for comprehensive treatment. The patient is a 63-year-old active female, 5′3″, 112 lb rating her general health level as a 9/10, with her only discomfort being a long history of asthma and shortness of breath.

Treatment/Interventions: Chiropractic interventions involved sacro-occipital technique category one treatment, reduction of costal torsion (T3-6), diaphragm and craniofacial balancing. Acupuncture treatment focused on the lungs, points to “open the chest,” and master empirical points for the head, neck and sinuses were also used. Points needled over the course of treatment included the following: Lung 1, Ren 6, 12 and 17, Large Intestine 4 and 20, Yin Tang, Ear Shen Men, Spleen 6, Stomach 36 and Kidney 3.

Results: Following treatment patient could return to her full activities of daily living, elimination of medication, and ability to respond to stressful situation without asthma flare-ups. With maintenance care the patient’s symptoms were controlled with flare-ups occurring when length between care exceeded more than 4-6 weeks.

Conclusion: With the worsening of the condition prior to care and an improvement following care along with periodic lapses in stability occurring in conjunction with lapses in treatment, a correlation is compelling.

Introduction: Obstructive sleep apnea (OSA) relates to an obstruction to the continuum of airway expressed as sleep-disordered breathing associated with multiple co-morbidities and societal implications. A 56-year-old female patient presented for chiropractic and dental care with symptoms of sleep apnea, short term memory loss, foggy-headedness, TMJ pain, chronic myofascial neck and shoulder pain, fatigue, and vertigo.

Methods/Intervention: Cranial-dental exam revealed a dental class II, narrow arches and premature anterior contacts with evidence of clenching and bruxism. The sleep study revealed a Respiratory Disturbance Index of 17.1 and Apnea Hypopnea Index of 16.3, with the lowest oxyhemoglobin saturation of 89% during sleep. Treatment consisted of six sacro-occipital technique (SOT) chiropractic cranial-dental treatments incorporating SOT intra-oral cranial adjustments and spheno-maxillary craniopathy in conjunction with occlusal balancing by a lower flat plane splint by Dr. Rahimi. The treatment was performed over a 3-4 week period of time.

Results: Following treatment the patient reported significant reduction of all symptoms with improved O2 saturation, reduced TMJ, chronic myofascial neck and shoulder along with greater day-time functioning.

Conclusion: With this case pre and post-sleep study findings showed objective change and the patient did report significant clinical improvement relating to reduced pain and function.

Introduction: This study is questioning whether a clinical relationships exists between sleep apnea and (prior undiagnosed) anemia. The following case represents characteristic similar to a subset of patients seen in this office who have presented with history of sleep apnea. A 66-year-old female presented with chronic fatigue (5-year duration), cervical spine, and TMJ dysfunction along with sleep apnea.

Methods/Treatment: Due to her complex presentation laboratory analysis was performed noting elevated glucose levels, elevated hemoglobin A1C, low RBC count, low hemoglobin, and low hematocrit, iron levels were on low side, low neutrophils, and elevated lymphocytes. Sacro-occipital technique (SOT) cranial sutural TMJ care was utilized including category two treatment and cervical stairstep adjustments. The patient co-treated with a dentist and was using a day and nighttime dental appliance.

Results: Patient’s fatigue improved significantly within two-weeks of beginning treatment. While the cervical spine and TMJ dysfunction improved at the two week mark she did not have complete resolution until one-month, initially seen twice a week for three-weeks. Her anemia improved showing increased RBC production, hemoglobin, and hematocrit findings.

Conclusion: The relationship may be between sleep apnea and anemia is unclear but maybe related to a hypoxia and erythropoietin feed-back loop.

Introduction: This case report discusses a novel use of manual muscle testing to evaluate postural challenges to the foot and its arches. A method of using sacro-occipital technique (SOT) pelvic blocks to stress the foot in various positions is described. 69-year-old female patient presented to this office for left hip pain since early 2010 with multiple medical conditions necessitating extensive medications.

Methods/Interventions: Following one-office visit treating the patient for SOT category two syndrome she reported 90% reduction in her left hip pain, however following a vacation involving extensive walking her condition had returned. A specific evaluation revealed bilateral rear-foot eversion with concurrent forefoot inversion. Treatment followed a novel whole body approach to the craniospinal system.

Results: Following treatment the patient was asked to challenge the treatment by increased walking and prior triggers such as yoga, however even one-month post treatment the left hip pain had not returned.

Conclusion: While clinically these tests have been used successfully with many patients, this is the first case report written to share this with other healthcare practitioners. Greater study across patient population groups is indicated along with determining specific subsets of patients who would benefit from this type of care.

Introduction: The objective of this study was to determine the efficacy of specific chiropractic types of care for children with learning difficulties and neurosensory integration disorders related to retained subcortical primitive reflexes (RPR).

Methods and Intervention: This retrospective pilot study was performed in France, involving 30 children 6-16 years-of-age who received chiropractic care for 12-months. Selection criteria focused on 10 cases of children who received only chiropractic care. RPR evaluation included the Moro reflex, asymmetric tonic neck reflex, and spinal Gallant reflex for the presence of RPRs. Low-force full spine and sacro occipital technique cranial adjustments were given with a prevalence of upper-cervical corrections. Viscerosomatic reflex imbalance was treated in a few cases with chiropractic manipulative reflex technique.

Results: By the 12th-office-visit the “RPRs” progressively diminished to full extinction, their posture improved verticality in both sagittal and coronal planes, and visual coordination improved significantly corroborated by parent, relatives and teachers.

Conclusion: From this retrospective analysis of 10-pediatric patients, it does appear that chiropractic adjustments may act to contribute or as a catalyst for proper neural function and maturation. Possibly chiropractic care may contribute to the normal postnatal development of the nervous system by facilitating specific connections from primitive to postural reflex.

Introduction: The purpose of this case report is to investigate whether there is a possible correlation between chiropractic care and a reduction of fussiness and vomiting in a 5-month-old female. The patient presented for chiropractic care by their parent for treatment gastro-esophageal reflux, as well as multiple medications for reflux, daily regurgitation, fussiness, poor weight gain, constipation, and frequent colds.

Method and Intervention: Palpatory tenderness was indicated by patient squirming or crying upon palpation at C2, T6 and the sacrum along with local hypertonicity, tenderness and decreased intersegmental motion. Cranial examination revealed right temporal-parietal bone overlap. The patient was treated 19-times over the course of 2-months, with “light-force” chiropractic and cranial care. Formula modification and belly massage to aid digestion and reduce constipation were recommended.

Results: Following 10-treatments the patient had reduction of vomiting, normal bowel movements, sleeping longer, improved eye contact, reduction of flaccid muscular tone and no colds or illnesses. Thermographic scans revealed less heat (inflammation) and greater symmetry.

Conclusion: Further research in the non-musculoskeletal conservative chiropractic care in pediatrics should be performed to determine whether more children with vomiting, gastro-esophageal reflux, fussiness, frequent colds, and poor weight gain might be helped without the risk of pharmaceutical or surgical interventions.

Introduction: A 34-year-old woman presented to office June 2010 with a primary complaint of chronic inner ear congestion of 17-year duration. Of interest is that she had other conditions as well: Ehlers-Danlos syndrome (HT-EDS), Type II diabetes, migraines, polycystic ovarian syndrome, celiac disease, and general disorientation.

Intervention/Methods: Examination sacro-occipital technique (SOT) indicators diagnosed a sacroiliac joint hypermobility syndrome with pelvic torsion (category two). Palpation sensitivity at C4-7, T6-9, and L3. Cranial palpation revealed sphenoid, right maxilla, and left occiput imbalance.

Treatment: Specific SOT psoas release techniques, trapezius fiber analysis, and category two block placement. Cranial therapeutic treatment focused on the sphenoid as well as balancing of dural membrane tensions and CSF pulsations.

Results: Within 20-minutes following office visit the patient reported that her “ear opened up” for the first time in seventeen-years. The condition was stable for at least one-week and the patient was did not return for care.

Discussion: It is possible that spinal meningeal tensions were balanced through SOT and cranial method of treatment may have helped modulate her vascular system and autonomic nervous system affecting inner ear pressures.

Conclusion: Further study is indicated particularly with complex cases that have chronic conditions, which respond dramatically to a therapeutic application.

Introduction: A 3-week-old girl with sagittal craniosynostosis was brought to this office for chiropractic care. Digital palpation revealed the posterior fontanel as fused and the anterior fontanel as small and diamond-shaped with a slight bulging that measured approximately 1cm in diameter.

Interventions and Outcomes: The patient was treated with diversified adjustment modified for the patient’s immature neuromusculoskeletal system along with cranial therapy.

Results: Following 6-visits, the patient’s cranial diameter measured 39.2cm compared to 34.5cm at birth, with the anterior fontanel remaining open. Long-term follow-up revealed the patient’s cranial development progressing without the need for surgery.

Discussion: To what extent competing explanatory variables (i.e., placebo effect) occur in a 3-week-old infant or on the part of the parent (i.e., demand characteristics and subjective validation) remains to be determined. The correction of cranial dysfunction (i.e., cranial tissue alignment) may possibly augment the optimum tissue level strains in the sutures to influence osteoblastic activity.

Conclusion: This case report suggests that in this case it is possible that chiropractic may have been helpful for this patient with deformational craniosynostosis. More research is indicated to evaluate whether this case was a novel presentation or may offer options offering low-risk and benefit for children with similar conditions.

Introduction: A 3-month-old male presented with congenital torticollis with cervical motor impairments. Post birth, he was unable to lift or turn his head to the left.

Interventions and Methods: The patient demonstrated no left cervical rotation and an antero-posterior (A-P) cranial strain pattern, consistent with non-synostotic deformational plagiocephaly. Hypertonicity of the left SCM and bilateral suboccipital muscles was also observed. Chiropractic adjustments were made to the right hip, left atlas, T1, TMJ, and right S2. Sacro occipital technique (SOT) cranial corrective techniques were utilized for the A-P strain and left internal temporal bone distortion pattern.

Results: After the initial adjustment, the patient gained 30° of right cervical rotation. After the next adjustment, he was able to lift and turn his head to the right from the prone position. After the third adjustment, the cranial strain appeared resolved and he recovered full cervical ranges of motion. The parents reported that the child was no longer waking up with vocalizing distress.

Conclusion: This case report demonstrated a resolution of congenital torticollis with concurrent deformational plagiocephaly via SOT, cranial, and chiropractic treatment. SCM spasm and rigidity associated with spinal and cranial strain may be a suggested mechanism for delayed cervical motor skills.

Introduction: A 2-month-old underweight female presented with nutritive sucking dysfunction since a complicated birth as reported by her mother. Since the child had limited sucking capacity, she was taken by the mother for two visits to an osteopath before seeking chiropractic care at this office.

Interventions/Methods: Visual analysis of the patient revealed a head tilt, left sided flattening of the skull, orbital dimension (small left eye), flattened left ear, and some TMJ dysfunction. SOT cranial corrective techniques were utilized for the correction of left mandible condyle, left malar, left temporal bone and left greater wing of sphenoid. The activator instrument was utilized to assist in correction of left lateral atlas and left TMJ.

Results: Within minutes following initial treatment, the child’s sucking strength improved significantly. Five days later, the baby returned and sucking strength had sustained.

Discussion: Proper nutritive sucking reflex in infants allows for proper growth, development and a multitude of secondary conditions, and even affects the health of the mother.

Conclusion: Her improvement following a chiropractic and cranial corrective technique, suggests a relationship between cranial strain, TMJ dysfunction and a craniocervical syndrome, which may have adversely affected this infant’s nutritive sucking reflex.

Introduction: The parents of a 4-day-old male infant presented their child for chiropractic evaluation and possible care with a chief complaint of a “twisted” face.

Intervention and Methods: Digital palpation of the right TMJ dysfunction with increased masseter muscle tension along with a left deviation on the hyoid bone. When placed supine the child could not laterally bend the patient’s body to one side without having him turn his head in the opposite direction. Hypertonic paraspinal muscles were noted throughout the cervical spine and the right SCM muscles. The patient was cared for with cranial therapy in combination with Logan Technique and soft-tissue therapy.

Results: The first treatment improved trunk lateral flexion and increased bowel movement frequency. On the third visit, a more uniform facial symmetry was noted and the patient’s head posture improved slightly with improved masseter and hyoid muscle activity. By the 8th treatment improved spinal balance and function was noted and at 14-months, the patient’s facial asymmetry was improved.

Conclusion: The parents were pleased because the patient responded well to the care rendered without any adverse reactions and greater facial symmetry cosmetically and improved function of the spinal joints and related myofascial balance.

Introduction: The purpose of this study is to attempt to meet this challenge through manipulation of the enteric nervous system (ENS) by utilizing a new field in bioengineering, Enteric Structural Mechanics© (ESM), in chiropractic care. A 32-year-old male presented to an engineer for assistance with anxiety, depression and addictive tendencies in January 2007.

Interventions/Methods: Using ESM tools, the individualized growth process for this patient was defined and mapped. The patient was referred to an SOT chiropractor for concurrent cranial, spinal, and pelvic treatment and the treatment.

Results: By the time treatment was concluded (4-months) the patient’s visual analogue scale improved with a decrease in pain from 5/10 to a 0/10. His antalgic posture and his left lateral pelvic deviation both returned to midline with significant improvement of anxiety, depression, and addictive tendencies.

Conclusion: With the subtly and diffuse nature of autonomic somatic reflex relationships a sensitive tool such as the ESM may help uncover subclinical conditions which may have been missed through other protocols. Understanding and being able to predict a patient’s cyclical body patterns may help give both the chiropractor and patient a sense of comfort during the period of time when psychogenic components surface somatically within the body.

Introduction: A 32-year-old female presented for chiropractic care for chronic neck pain, misaligned rib cage, and a diagnosis of a unicornuate uterus and infertility since October 2002. Her Oriental Medical Doctor (OMD) was treating her for infertility for 3-months referred her to this chiropractic office. When the patient began chiropractic care, she chose to discontinue her herbal infertility treatments prescribed by her OMD.

Methods and Interventions: The patient was seen at this office for care at 3 times a week for 12 weeks. She had tonal, low-force specific chiropractic spinal and cranial manipulative therapies.

Results: Improvements were seen, with decreased neck pain and improved quality of life scores. Objective results were seen with subsequent Surface EMG scans on every twelfth visit, indicated by greater muscle symmetry patterns. The patient conceived after 3-months of chiropractic SMT and delivered at 38-weeks gestation.

Conclusions: Based on the finding from this case report, further study is warranted to determine the role of chiropractic in helping women with a unicornuate uterus and infertility, and how chiropractic may serve as a part of an early intervention team for women with uterine anomalies and reproductive challenges.

Introduction: An 11-week-old male with Down Syndrome (DS), fluid in both ears, having failed all allopathic model auditory tests and only able to track light and dark was presented to this office by his mother for chiropractic care. His mother noted that he did not respond to her coming near him when crying and appeared completely unresponsive to sounds.

Methods: Treatment was performed by two doctors working together at a clinic in close communication regarding evaluation and treatment protocols. Patient was treated with low-force, specific, full-spine and cranial chiropractic manipulative therapy.

Results: Immediately following the 1st-treatment, patient showed improvement in focus and pupillary constriction and dilation (alternating mydriasis) slowed from every few seconds to more responsive to environment. By the 5th treatment the allopathic visual retesting indicated tracking at age-appropriate levels at that point. Mother also reported he was beginning to consistently respond to loud noises, such as a door slamming, where prior to care he had no response. Also of significance, his cooing and smiling had notably increased.

Conclusion: With proper differential diagnosis and working in an interdisciplinary relationship, chiropractic could become a valuable partner in a team of healthcare practitioners treating children with these complex and diverse conditions.

Introduction: A 73-year-old male presented with subjective complaint of acute lower back pain with bilateral (grade one) upper thigh and gluteal radicular pain. Radiographs of the lumbar spine revealed osteoarthitic degenerative changes at the L4/5 and L5/S1 disc spaces, with significant bilateral foraminal stenosis at the L4/5 level.

Methods/Treatment: Patient was analyzed and treated utilizing sacro occipital technique (SOT) and determined to be a category three with a bilateral psoas contracture and piriformis muscle syndrome. Active release technique (ART) was utilized in conjunction to his superior hamstring origin, superior gluteal origin, latissimus dorsi, and psoas iliacus.

Results: Following the first treatment the patient’s low back pain and disability had reduced approximately 75%, with elimination of bilateral gluteal/thigh pain and anterior antalgia. He was seen twice the first-week and then once-a-week for two weeks and then two weeks later for a total of five treatments. By the 5th-office visit he was 95% improved based on pain reduction, body function, and activities of daily living.

Conclusion: Integrative chiropractic care may a chiropractor’s capability to treat various patient presentations as demonstrated by this case report utilizing a combination of ART and SOT to treat a patient with severe low back pain and stiffness.

Introduction: A 2-1/2 year-old female during a routine physical examination at age 6-months by her pediatrician was determined to have adolescent idiopathic scoliosis and two hemivertebra.

Methods: Ultrasound, x-rays, MRI, and Moire study(s) performed noted a 35° thoracic curve. Due to the progression of the scoliosis an orthopedic consult was made who suggested a surgical spinal fusion. Prior to surgery the patient was examined and treated at this office using specific sacro-occipital technique (SOT) and cranial protocols. The patient was put on a six-week intensive care program at 2 visits-per-week for the first 6-weeks.

Results: Six-weeks after her initial chiropractic adjustment the patient was re-examined by the orthopedic surgeon and the evaluation and follow-up Moire study revealed a significant reduction in the scoliosis. Surgery was postponed and the orthopedic surgeon directed follow-up Moire studies every six months for four years. Her last Moire study showed almost complete resolution of her scoliosis, kyphosis and lordosis.

Conclusion: During those periods of time when the medical physician is only monitoring the patient or preparing for possible surgical intervention, this would provide the optimal opportunity for a trial period of conservative chiropractic care.

Introduction: Due to the scarcity of published literature relating to the chiropractic treatment of nonmusculoskeletal conditions, particularly of pediatric patients, this paper attempts to facilitate a glimpse into a clinical practitioner’s office where these conditions are routinely being treated.

Methods: For the purposes of this case series, children treated (2000-07) for nonmusculoskeletal symptoms (n=37) out of those who responded to the questionnaire were used for this case series. All pediatric patients were treated by the same clinician. In all cases active chiropractic care consisted of sacro-occipital technique and cranial pediatric treatments.

Results: Of the 37 (17 male, 20 female) nonmusculoskeletal pediatric patients, 5 were treated for immune function, 7 for developmental delays/dysfunction, 9 for birth trauma, 1 for seizure activity, 4 for learning problems, 3 for endocrine problems, 3 for migraines, 2 gastrointestinal issues, 2 for fussiness/agitated/anxiety, and 1 for enuresis.

Conclusion: Since it does appear from this case series that both pediatric nonmusculoskeletal conditions may benefit from SOT and cranial pediatric adjustive techniques, there is a greater need to investigate whether these responses to care are individualized to one practitioner or can be generalized to the chiropractic profession.

Introduction: A 58-year-old male was seen four-years post-partial replacement of left hip. Following surgery, lower and upper back and neck pains and restrictions increased compromising his walking, sitting, and driving. By the third-year post-surgery, routine suboccipital headaches established and shingles appeared across the back below the thoracolumbar transition.

Interventions/Methods: Clinic examination reveals lumbosacral discopathy, sacroiliac joint instability, restriction at mid-cervical spine, and TMJ dysfunction. Pre-surgical partial hip replace noted the right femur’s head-neck-axis was longer than the left and post surgery the left was consistently longer than the right.

Treatment: Treatment averaged approximately 1-2 visits per weeks for 6-weeks decompress the lumbosacral disc and related joints by SOT category three methods. Then category two corrections to support sacroiliac stability were performed along with myofascial balancing, cervical stairstep procedures and TMJ treatment.

Results: At six-weeks, the patient was free from complaints and had increased activities. With category two corrections over the year, the femoral head comparison angle became more symmetrical radiographically.

Conclusion: This study examined a 4-year post surgery partial hip replacement and how it may have been the cause of a secondary sacroiliac joint instability due to the anatomical and functional asymmetry of the surgically repaired hip joint.

Introduction: Three cases presented with jaw pain, limited cervical range of motion, and some related headaches. Patient A was a “cervical primary,” Patient B was a primary “temporomandibular joint (TMJ) and cranial,” and Patient C was a “TMJ primary.”

Patient A: The dentist prescribed a nighttime deprogramming orthotic. The chiropractor focused on sacro occipital technique (SOT) and cranial/TMJ treatments. Six-months post-treatment commencing the patient no longer had any jaw pain or had TMD, improved posture, and improved CO/C1/C2 space.Patient B: The dentist prescribed a daytime and nighttime deprogramming orthotic. The chiropractor focused on SOT and cranial/TMJ treatments. Five-months post-treatment was initiated the patient had no TMJ pain and improved stability with improved spinal posture and reduced cervical spine pain. Patient C: The dentists prescribed a daytime and nighttime deprogramming orthotic. The chiropractor focused on SOT and cranial/TMJ treatments. Five-months post-treatment commencing treatment the patient had no TMJ pain and improved stability with greater cervical posture and no headaches.

Discussion: In these three cases each patient presented with jaw, head, and neck pain but with each case the treatment varied.

Conclusion: This study suggests that patient’s with both musculoskeletal and dental issues may need a referral for co-treatment.

Introduction: A 38-year-old female with Down syndrome was brought to this office by her mother to see if chiropractic treatment might assist her daughter’s ability to function, thrive, and possibly improve her cognitive abilities. She had previously tried various medical interventions which were unhelpful. The patient appeared to be mentally at the level of a five year old, could not read or write, independently dress, bath, or wash her own hair.

Intervention and Methods: Initially DeJarnette (Exhalation Fault Cranial Adjustment) was used to increase general cranial function into its inhalation or flexion phase. When the patient had an adverse reaction to the treatment on the following visit the opposite cranial treatment was used to increase general cranial function into its exhalation or extension phase.

Results: Almost immediately following the second adjustment the patient became calmer and more responsive to her environment. At 20-office visits over 4-6 months, she began recognizing words such as store signs and billboards, learning how to write, dress and wash her hair without assistance.

Conclusion: It is interesting to note that the cranial adjustment itself had a significant effect both when performed inappropriately and appropriately so that experience and skill in application of cranial techniques are suggested.

Introduction: A 59-year-old female suffering facial pain for 25 years occurred soon after her amalgum fillings were removed and her occlusion was iatrogenically modified.

Treatment: Treatment involved correction of the cranial lesions using a cranial therapeutic procedure to release the distorted tension within the structures. Following the cranial balancing the diaphragm was relaxed and a bonded occlusal support was applied to balance the occlusion. The pronation was corrected by placement of a pair of flexible 3.5mm forefoot insoles as discussed by Rothbart.

Results: At the patient’s initial office visit the patient stated that her pain level was a 7 on a scale of 1- 10 where 10 was the worst. Immediately following treatment the patient’s pain level was reduced from 7 of 10 to zero and she has remained pain free since January 19, 2010. The patient also reported that her posture improved and that she felt an overall sense of relaxation and occlusal comfort for the first time in 25 years.

Conclusion: Greater study is indicated to determine what subset of patients best fit the criteria for this type or diagnostic and treatment method.

Introduction: Two sisters, Sister A, a 2-year-old and Sister B, a 1-year-old, were brought to our office for chiropractic evaluation and care. They had both been suffering from acute otitis media (AOM) type infections since birth. Both girls were on inhalers and allergy medicine, and were sick every week, according to their mom.

Method: The girls were both seen once a week for nine weeks and then every other week for eight weeks. The chiropractor assessed the children using motion palpation to assess sacroiliac joint position and/or fixation and then using the findings to direct treatment. Sacro-occipital technique (SOT), toggle recoil, activator, and Logan Basic techniques were used.

Results: After the first three-visits, the patients’ mother reported noticing that both girls had less mucus coming out of their noses and their eyes seemed clearer. At 13-office visits the patients’ conditions had completely resolved for the first time without medications.

Conclusion: Due to the increasing incidence of antibiotic-resistant bacteria, other options should be researched and offered for parents before prescribing antibiotics for AOM. Greater study is needed into chiropractic conservative care for the treatment of AOM to discern which children may be good candidates for low-risk interventions.

Introduction: Chiropractic care in the field of veterinary medicine is something that has taken place for years although with limited research.

Case Report: 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 treated multiple times with different antibiotics. She could not perform due to her condition.

Methods and Intervention: Occipital Fibers were analyzed on a 12-year-old Dutch Warm Blood and their relationship to corresponding spinal levels was verified. Chiropractic manipulative reflex techniques (CMRT) were used including lung massage, intercostal massage and a diaphragm release.

Results: Following the occipital fiber analysis and CMRT the horse took a deep breath of air and began to relax. The occipital fiber was no longer swollen and boggy. Thirty-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 five-days post treatment the horse was put back into work.

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.

Introduction: Clinically a relationship has been found with patients that relates to incontinence disorders and low back pain.

Case History: A 13 year old female with a prior history that included sprained right and left ankles, attention deficit disorder (ADD – inattentive type), rare occasion bed wetting at age 3 and 4 (fully toilet trained at age 2). The patient’s incontinence worsened the summer prior to the office visit following a fall from a swing onto her back and into a lake.

Interventions/Methods: Examination and patient’s presenting symptoms suggested a relationship between her incontinence (urgency) and a sacroiliac joint sprain. Sacro-occipital technique treatments, soft tissue balancing and Carver techniques were used.

Results: While the patient was clearly still having incontinence during treatment, of importance for the patient and parent was that the incidence of incontinence and frequency of occurrences were clearly lessening. There appeared to patient and her parent to be a clear relationship between reduced low back pain secondary to the patient’s category two with the decrease in incontinence and urgency.

Conclusion: Future research is required with a larger sample size to determine if SOT treatment might have a significant effect on incontinence or urgency.

Introduction: In this study, we investigated the link between jaw clenching/bruxism and temporal bone movement associated with multiple sclerosis (MS).

Intervention/Methods: Twenty-one subjects participated in this study (10 patients with MS and 11 controls). To quantify the change in intracranial diameter between the endocranial surfaces of the temporal bones during jaw clenching, an ultrasonic pulsed phase locked loop (PPLL) device was used. A sustained jaw clenching force of 100lbs was used to measure the mean change in acoustic wavelength (ΔL) as measure of intracranial distance.

Results:In the control subjects the mean ΔL was 0.27mm ± 0.24. In subjects with MS the mean ΔL was 1.71mm ± 1.18 (p < 0.001). The increase in magnitude of bi-temporal bone intracranial expansion was approx. six times greater in subjects with MS compared to controls.

Conclusion: Therefore, jaw clenching/bruxism is associated with more marked displacement of the temporal bones and expansion of the cranial cavity in patients with MS than in control subjects.

Introduction: Sensory Processing Disorder (SPD) is a complex neurological disorder that impedes integration and processing of the five senses, vestibular system, and/or proprioception.

Method: A case report of a 3-year-old male that presented to Kentuckiana Children’s Center with SPD, speech delay, constipation, and poor sleep. Physical examination revealed vertebral subluxations in the cervical, lumbar, and sacral regions of the spine and tension along the coronal and temporal suture. Initial treatment plan included chiropractic adjustments twice a week for 4-weeks, then once a week for 4-weeks, and chiropractic cranial therapy once a week for 8-weeks.

Results: At the 8-week re-evaluation, the child was having regular bowel movements every day. The child’s mother also reported fewer tantrums and an easygoing demeanor. Sleep had improved, as well, and the child was sleeping through the night 4 of 7 nights. Speech was also improved, and he was using three- to four-word sentences. At 7-months after onset of treatment the patient’s condition stabilized and was improving.

Conclusion: Chiropractic adjustments and cranial therapy utilized may be a primary factor in the resolution of chronic constipation and poor sleep in a child who also had SPD and speech delay.