Asia-Pacific Chiropractic Journal
We celebrate those who do the work to build our collective knowledge base by researching and writing their PhD thesis. Here are some of the best:
We start with the first doctoral thesis undertaken examining subluxation. This English translation is a gift on Dr Gary Bovine. Known just as 'Hieronymi' the thesis is the work of Johannes Henricvs Hieroymi, an obscure 18th Century figure about whom little is known. Like so many other theses written by new physicians, he relied on earlier works written on luxation and subluxation, citing Heister, Pare, etc. Hieronymi gives a good outline of the signs to recognise subluxation.
Hieronymi was a physician who, as a requirement for his graduation, was required to write a thesis. He chose to explore 'subluxation'. It is very much to our shame that more Chiropractors today are not choosing to write their PhD thesis on this vital topic.:
Cite: Hieronymi JH. De luxationibus et subluxationibus [thesis] Jena University: 1746.
Hieronymi
We start with the first doctoral thesis undertaken examining subluxation. This English translation is a gift on Dr Gary Bovine. Known just as 'Hieronymi' the thesis is the work of Johannes Henricvs Hieroymi, an obscure 18th Century figure about whom little is known. Like so many other theses written by new physicians, he relied on earlier works written on luxation and subluxation, citing Heister, Pare, etc. Hieronymi gives a good outline of the signs to recognise subluxation. Hieronymi was a physician who, as a requirement for his graduation, was required to write a thesis. He chose to explore 'subluxation'. It is very much to our shame that more Chiropractors today are not choosing to write their PhD thesis on this vital topic.
Cite: Hieronymi JH. De luxationibus et subluxationibus [thesis] Jena University: 1746.
Demystifying Contemporary Chiropractic Professional Identity
TANJA GLUCINA: The establishment of a clear professional identity within the chiropractic field is of paramount importance to facilitate effective collaboration, streamlined communication, and the realisation of a unified vision for the future. The utilisation of a validated instrument such as the 15-item CPIES, either as a comprehensive unidimensional scale, or by employing its component subscales to assess various aspects of CPI, can significantly expedite this process. The profound implications of gaining a deeper understanding and assessing CPI extend to enhancing career success and overall satisfaction for chiropractic professionals. This research ultimately contributes practical solutions and innovative insights into the complicated construct of CPI with far-reaching implications for practitioners, educators, and the chiropractic profession as a whole.
Cite: Glucina T. Demystifying Contemporary Chiropractic Professional Identity. [Thesis]. Auckland University of Technology. 2024. At http://hdl.handle.net/10292/18260
Daniel David Palmer's heritage and his legacy of tone to Chiropractic
DONALD McDOWALL: This investigation concluded that: influenced by his heritage, Palmer used well-thought-out strategies to promote his work which enabled chiropractic to expand exponentially; Palmer’s analogy of music to help others understand tone, has been largely overlooked; although chiropractic has flourished from its inception, the concept of tone began to wane from 1903 and by 1961 was of limited interest. This research determined that Palmer, the founder of chiropractic, is an important individual from the past who was influenced by his heritage. While Palmer’s principle of tone was the foundation for chiropractic, by 1961 his concept of tone had been largely lost, even though chiropractic continued to thrive.
The meaning and value of vitalism in Chiropractic
DENNIS RICHARDS: This study explored what vitalism means to chiropractors and what value it might offer in addressing current global prevalence of non-communicable lifestyle-related conditions. A mixed methodology design of qualitative and quantitative research methods involved interviews of 18 international key informants followed by online surveying of chiropractors in Australia and New Zealand. To a majority, vitalism meant innate intelligence, a traditional form of vitalism, a guide to a good life, and an essence of the identity of chiropractic. It offered great value in addressing non-communicable lifestyle related conditions. To a minority, vitalism meant an obsolete and unscientific doctrine of no value.
The effect of Chiropractic manual therapy on the spine, hip and knee
HENRY POLLARD: This thesis examined the effect of commonly used manual therapy protocols on the range of motion (ROM) of the hip joint. I have demonstrated that the two stretching treatments both increased hip ROM but only the spinal group was significant. These results help to document for the first time the effect of several clinical protocols used by manual therapists to increase the ROM at the hip joint. I conclude that manipulation of the hip should be considered in protocols trying to achieve increased hip ROM, and that treatment of the spine demonstrated an improvement in peripheral joint function of the hip.
The measurement and correction of sacral obliquity
JOHN DULHUNTY: The study developed, tested and validated algorithms to calculate true dihedral angles from angles measured on radiographic images. The algorithms were designed for when the protocols developed to ensure reliable measurement of angular relationships were not met or were unable to be adhered to. The measurement of sacral obliquity on radiographic images was to develop algorithms to calculate the amount of correction needed to level the sacral base in upright standing and sitting postures.
Upper Cervical spine kinematics at the intersegmental level and the role of the Alar Ligaments
ANA ISABEL LORENTE CORELLANO: The objectives of this thesis were (1) to provide the intersegmental range of motion (ROM) of the upper cervical spine in lateral bending, axial rotation, and flexion-extension, (2) to analyze the effects of an alar ligament injury on the intersegmental mobility (with a unilateral ligament transection), (3) to assess the screening of this injury with in vitro manual tests (side-bending stress test and rotation stress test), and (4) to quantify how limiting the C0-C1 mobility influences the C1-C2 mobility.
This thesis has provided new insights related to two clinical tests (side-bending and axial stress tests) and has deepened the understanding of the biomechanics behind the effect clinically observed in C1-C2 mobility with C0-C1 mobilizations.
Normal neck motion
Keith Harvey CHARLTON: This thesis reveals sufficient differences in values in enough joints for the three different age cohorts representing the commonest age groups presenting with neck pain and related disorders, and in both genders, to render current catalogues of normal motion somewhat unsatisfactory. For normal sagittal plane local joint motion from C2-3 to C6-7 in the human neck, for rotation amplitude values, the Null Hypotheses that no such data in neck kinematics can show differences in values from age cohort to age cohort and/or from gender cohort to gender cohort are rejected. The Null Hypotheses for Instantaneous Axes of Rotation are confirmed.
Further, the thesis produces sufficient new evidence to propose more accurate ranges that can be considered as clinically relevant normals as the basis for investigations into clinical causes and assessment of treatment results for mechanically implicated neck pain and related disorders.
Developing chiropractic students clinical practice skills - elements of best practice : a qualitative exploratory descriptive study
Navine HAWORTH: Embedding evidence-based practice within curricula and clinical training for educators and students are necessary to ensure this becomes a part of clinical practice. Conclusion This thesis posits best practice in chiropractic clinical education consists of the following: (a) using a scaffolded longitudinal clinical program, (b) varying clinical placements and case mix, (c) supervision and mentoring from multiple clinical educators, (d) educating the clinical educator, (e) curricula designed around industry standards and desired graduate attributes and capabilities, (f) an evidence-based practice approach in the curricula and clinical context, (g) aligning business skills, knowledge and practices with the professional context and (h) interprofessional learning and practice opportunities. Although this study has made a contribution to scholarly discourse, there remain many gaps in our knowledge where further studies are needed.
Cite: Haworth N. Developing chiropractic students' clinical practice skills - elements of best practice : a qualitative exploratory descriptive study. [Thesis]. Federation University. 2021. At http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/176916
Managing Low Back Pain in older adults: A multi-country observational study
Alan David JENKS: Chapter 3 examines the validity, reliability, and responsiveness of three commonly used disability questionnaires (Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale) in older adults undergoing chiropractic care for LBP. Findings indicate that all three indexes have sufficient reliability and validity, though each has unique strengths and limitations.
The final chapter presents the principal findings of the thesis, discussing their implications for clinical practice and future research. The strengths and limitations of the study are reviewed, and recommendations for optimizing chiropractic care for older adults with LBP are provided. Overall, this thesis contributes valuable real-world evidence on the clinical course, treatment outcomes, and healthcare utilization associated with chiropractic care for older adults with LBP. It underscores the importance of personalized, multidisciplinary care strategies to enhance the quality of life for this growing population.
Cite: Jenks A.D. Managing Low Back Pain in Older Adults: A Multi-Country Observational Study. [Thesis]. Health SciencesAMS - Musculoskeletal HealthAmsterdam Movement SciencesHealth Economics and Health Technology Assessment. At https://research.vu.nl/en/publications/managing-low-back-pain-in-older-adults-a-multi-country-observatio/
The efficacy of cervical adjustments (toggle recoil) for chronic cervicogenic headaches
Wayne WHITTINGHAM: A randomised controlled clinical trial was used to investigate the chiropractic management of chronic cervicogenic headaches. Particular attention was paid to: O evaluating the efficacy of adjusting the atlas (Cl) and/or axis (C2) vertebrae only, using the ‘Toggle Recoil’ adjustment and placebo control; © assessing the diagnostic usefulness of self-report questionnaires for evaluating psychosocial behavior, neck disability, area of head and neck pain, and pain intensity; © assessing the diagnostic usefulness of objective measurements, for evaluating cervical range of motion and pressure algometry recordings; © assessing short and long term patient satisfaction with the chiropractic management of chronic cervicogenic headaches. DESIGN A five phase randomised crossover design was employed with each phase being conducted over a three week period.
The first phase consisted of a baseline assessment, followed in the second phase by either a placebo treatment (group 1) ora toggle recoil treatment (group 2). The third phase consisted of a toggle recoil treatment for group 1 or a washout (no treatment) for group 2. The fourth phase consisted of a washout for group 1 or a placebo treatment for group 2. The fifth phase was post treatment follow up. At the initial consultation each subject was examined using cervical x-rays and objective measurements, and was then requested to complete self-report questionnaires. Each subject was instructed to monitor their headaches on a daily basis and record their experience in a diary. Objective and subjective measurements were conducted at the end of each phase of the trial. An 8 and 24 month post treatment questionnaire was sent to each volunteer.
Cite: Whittingham W. The efficacy of cervical adjustments (toggle recoil) for chronic cervicogenic headaches. [Thesis]. School of Health and Biomedical Sciences, RMIT University. 2000. At https://doi.org/10.25439/rmt.27579747
Chiropractic and male adolescent low back pain: a Victoria perspective
Phillip EBRALL: This thesis was initiated by an awareness of the impact of low back pain in Western society in general and Australian society in particular. The studies and experiments in this thesis contribute towards an understanding of chiropractic as a professional entity in Victoria and the nature of its clinical practice. The issue of male adolescent LBP has been explored and in addition to an epidemiological description of this clinical entity, its anthropometric dimensions have been documented. The point and sample prevalence of LBP in a population of suburban male adolescents is described and shown to be similar to those found in comparable Western societies. The data for a sample of traditional Australian male adolescents describes the LBP experience for the first time in such a population and emphasises the wide variance between societies which is now being identified in the literature.
The LBP experience of a typical suburban Australian male adolescent is identified and described in terms of chronicity, frequency and episode duration. Typically the male adolescent with LBP has a chronic (> 90 d) problem with frequent episodes of pain (from 2 or 3 times a month to 2 or 3 times week) which last a few hours. The pain is a little limiting but allows the performance of the Activities of Daily Living. While some limitation of general sporting activity due to pain is experienced, school attendance is generally not compromised.The anthropometric study tests the broad null hypothesis that the mean of specific anthropometric dimensions would be equal among samples of male adolescents drawn from the Australian population. The actual groups are a Melbourne 'Pain' group, a Melbourne 'No Pain' group, and a 'Traditional No Pain' group. The pain group reported either current LBP or a positive history of LBP, while the 'no pain' groups denied either current or historical LBP.
The alternate hypothesis will be shown to be proven for the dimensions 'sitting height', 'upper body' length, 'pelvic height', and the ratio of the 'upper:lower' body segment in a population of male adolescents with idiopathic or mechanical LBP.
The fact that a number of anthropometric dimensions are detectable in adolescence may allow the development of appropriate screening programs which in turn may lead to the design and introduction of suitable prophylactic interventional programs for persons found to be potentially prone to idiopathic or mechanical LBP, at the least reducing the severity and at most reducing the onset of this expensive problem in adulthood. The ratio of the upper body segment to the lower body segment would appear to be most appropriate indicator; it is robust in that it is a prime dimension, easily accessible, and with a low level of measurement uncertainty. Most importantly it would appear to hold validity throughout adolescence as it does not have a linear relationship with age.
Cite: Ebrall, Phillip (1999). Chiropractic and male adolescent low back pain: a Victoria perspective. RMIT University. Thesis. https://doi.org/10.25439/rmt.27575802
