| DOLAK FAMILY CHIROPRACTIC Dr. Joseph Dolak Chiropractic Biophysics |
Chiropractic Biophysics Technique
By Donald D. Harrison, D.C., Ph.D.
Chiropractic biophysics is a system of chiropractic spinal analysis and care
developed by Donald D. Harrison, M.S., DC, M.S.E., Ph.D., and Glenn
Harrison, B.S., DC The approach to improved patient well-being, as
designed by these doctors, is a mechanistic one.
To some extent, these mechanistic concepts are justified in that the spine
and nervous system have many machinelike qualities. The spine is
composed of bones, muscles, blood vessels and neural networks which
resemble beams, motors, hydraulics and computers, respectively. Ball and
Carlson1 have stated, "The use of engineering modeling in biological
systems is now commonly accepted as a logical means of approaching
highly complex mechanisms."
The Rationale for CBP
CBP applies the sciences of mathematics, physics and biophysics to the
practice and theory of chiropractic. While the simple analogies of a bone
"stuck" or "out of place" may serve doctors well when communicating
with patients regarding spinal adjustments or some form of therapy, they
hardly reflect the degree of sophistication which is necessary in
communicating with the rest of the scientific community. The plight of our
profession can be simply summed up in the following statement from the
report of the New Zealand Commission of Inquiry Into Chiropractic: "The
exact nature of such defects (subluxations) has not yet been demonstrated;
nor has the mechanism by which its apparent effects are produced." The
1975 NINDS workshop on the status of spinal manipulative therapy made
the observation that "there was no quantitative or qualitative reproducible
description of subluxation."
Chiropractic biophysics is addressing these shortcomings by combining the
discipline of science, the foundational principles of chiropractic and the
application of technical skills to attempt to elucidate the truth about what
we do, how we do it and how we can do it better. CBP attempts to
understand and apply the universal laws which govern the behavior of
matter and energy and their interactions in biological systems. The result
of over 12 years of development is an ever-expanding and evolving base
of work and literature relating to the science of what chiropractic is and
does. Currently, the CBP technique represents a full spine and pelvis
corrective/rehabilitative procedure having a firm foundation in the
sciences of mechanics and physics and providing both a qualitative and
quantitative model of chiropractic practice.
The overall goal of the CBP technique is to restore normal three-
dimensional human posture. Methods include "mirror image" posture
adjustments, rehabilitative exercises, cervical extension traction and manual
procedures. In CBP, the overall posture or global positioning of the spinal
column is targeted for correction, as opposed to individual spinal segments.
In CBP, the optimum static position of the upright human spine is
established with the Harrison spinal model. A subluxation is considered to
be any postural deviation from this mathematical norm. The model
represents the most complete chiropractic effort to date to establish what
constitutes "normal."
Although not perfect, the Harrison model is a starting point and a
reasonable clinical objective for corrective care. It is expected that as our
knowledge expands, so too will the model expand and evolve.
Protocol of Care
The CBP protocol of care begins with the initial patient encounter and a
case history. The patient is then analyzed for abnormal posture in every
possible degree of freedom of the skull, thoracic cage and pelvis. Next, an
exacting series of radiographs is performed which are then analyzed using
geometry to obtain information for formulating care plans and later to
serve as an objective standard against which to evaluate the efficacy of
care.
Following careful consideration of pertinent clinical findings, especially
the correlation of the patient’s three-dimensional posture with its two-
dimensional X-ray image, a patient’s case is either accepted or referred to
an appropriate specialist. Patients who are accepted for care are generally
assigned to one of two regimens (i.e., acute or corrective care). Factors,
which might influence the appropriate type of care, could be numerous,
such as the nature of their specific complaint, the magnitude of their
postural distortions and the degree of pathophysiology associated with
subluxation degeneration.
Patients who are selected for acute care would receive a program of care
perhaps not unlike that of many non-CBP offices. They would undergo
"diversified"-type adjustments (both long- and short-lever) to restore
segmental mobility, cryotherapy to reduce localized inflammation, passive
and active stretching and massage as indicated to reduce spasm and
myofascial involvement. Acute care programs may also apply to corrective
care patients who enter the office symptomatic.
The CBP corrective care regimen includes the use of drop table and upper
cervical instrument-assisted adjustive procedures, as well as a variety of
corrective extension traction procedures and corrective postural exercises.
It is not the methods themselves, which are unique to CBP, but rather the
rationale behind their use and the way in which these tools are employed
to accomplish stated clinical objectives.
The following is a summary of basic methods currently in use.
Mirror Image Adjusting
In chiropractic biophysics, abnormal human posture is analyzed and
corrected be means of what is termed "mirror-image" adjustments.
Basically this is done by first analyzing the standing posture in three
dimensions and then stressing the patient’s abnormal posture into its exact
opposite, or "mirror," image. Once the patient has been pre-stressed into
the mirror image, a light adjustive force is applied.
Adjustive forces are generally applied to the atlas transverse process with
either a toggle—type adjustment or by means of a cervical adjusting
instrument. Adjustive forces may also be introduced to the lower back area
by the use of a drop table adjustment with force applied to the sacroiliac
or femur head areas. The purpose of mirror image adjustment is to
introduce mechanical stimulation to proprioceptors and encourage the
brain to reconsider the faulty postural patterns which have become
habituated overtime. It is precisely these habituated postural patterns
which are a major source of chronic spinal dysfunction and which result in
spinal resistance to correction which all practitioners have experienced.
Mirror image adjustments may be performed with the patient in either the
prone, supine, side posture or standing positions. Correction to normal
posture is then verified by pre- and post-adjustment postural examinations.
Rehabilitative Exercise
Since adaptation of muscular structures is a process that takes place over
an extended period of time, repetition of positive forces into the affected
tissues is necessary to effectively achieve and maintain postural correction.
These simple techniques alone can often be quite effective, as
demonstrated in a 1986 study by Klein and Sobel of neck pain patients, in
which 59 percent received significant long-term relief from performing
postural exercises for their conditions.
Harrison’s mirror image exercises are set up individually, based on the
patient’s particular abnormal posture configuration, unlike many generic,
"one-size-fits-all" exercise programs. Mirror image exercise procedures
effectively reeducate the body by targeting those muscle groups and their
associated global movements, which effect a more permanent correction of
the patient’s subluxated posture.
Extension Traction
One of the most common postures, which presents in the chiropractic
office is that of cervical hypolordosis/kyphosis with the patient’s head in
an anterior weight-bearing position. In chronic cases, ligaments will have
creeped shorter and adapted to the abnormal postures. Due to their
specific mechanical properties, ligamentous tissues do not often respond
well to the rapid loading forces which constitute the chiropractic
adjustment. Anyone familiar with the sigmoid-shaped load-deformation
curves obtained from testing spinal ligaments realizes that rapid loading
forces affect only the elastic range of the ligaments. Loads must be applied
over 20 to 30 minutes to affect the viscous and plastic regions of the load-
deformation curves.
Consequently, the primary purpose of cervical extension traction is to
provide a long duration or slow adjusting force to those soft tissues that
have contracted over time and therefore tend to perpetuate the patient’s
subluxated state.
A variety of traction methods are currently being employed by CBP
practitioners. Performed in the office, these methods may require times
that range from 10 to 20 minutes, according to the doctor’s discretion and
patient tolerance. Many patients also receive a home traction device so that
they may actively participate in their recovery program.
By use of these methods, CBP field practitioners are experiencing great
success in restoring cervical curves. As evidence of the success of this
approach, a recent controlled clinical trial demonstrated an average
increase of the cervical lordosis of 13.5 degrees versus no statistically
significant change in the control group.
Conclusion
The chiropractic biophysics technique is unique for several reasons. It
provides a specific therapeutic goal (the Harrison model of ideal upright
posture). It correlates the patient’s three-dimensional posture with precise
radiographic analysis to help eliminate much of the false data, which are
inherent in analysis based on X-rays alone. It effectively addresses the
overall posture of the patient by means of mirror image adjustive
procedures, and it seeks to rectify long-term soft tissue changes by means
of extension tractioning and rehabilitative exercise programs which are
tailored individually for each patient. Through the application of
knowledge borrowed from the fields of physics and mathematics and
university biophysics, we are bringing clinical results into line with our
philosophical tenets.
About the author
Donald D. Harrison, D.C., is the developer of the CBP technique. He
holds BS and MS degrees in mathematics, masters in mechanical
engineering, and also holds a PhD in math in addition to his Doctor of
Chiropractic degree. He is the publisher of the American Journal of
Clinical Chiropractic, which is published quarterly.
company whose products are geared toward the CBP practice. For more
information on the CBP technique, call (800) 346-5146.
References
1.Ball, L.D., and Carlson, L.E., Experimental Mechanics of the Spine, 6th Annual Biomechanics
Conference on the Spine, Boulder, Cob.t Univ. of Colorado, 1975.
2.Harrison, D.D., "Abnormal Postural Permutations Calculated as Rotations and Translations
From an Ideal Normal Upright Static Spine," chapter 6, In:Chiropractic Family Practice, J.
Sweere, Ed., Gaitherburg, Md.: Aspen Publishers, 1992.
3. Cochran, C., A Primer of Orthopedics Biomechanics, Churchill Livingstone, 1982.
4. White, A.A., and Panjabi, M.M., Clinical Biomechanics of the Spine, Philadelphia: 1.8.
Lippincott Co., 1978.
5. Chasal, J., Tanguy, A., Bourges, M., Caurel, C., Escande, G., Cuilbot, M., and Vameuville, C.,
"Biomechanical Properties of Spinal Ligaments and a Histological Study of the Supraspinal
Ligament in Traction," I. Biomechanics 3:167-176,1985.
6. Chow, D.H.K., Luk, K.D.K., Leong, J.C.Y., and Woo, C.W., "Torsional Stability of the
Lumbosacral Junction: Significance of the Iliol Ligament,"
Spine 14:611 -615, 1989.
By Donald D. Harrison, D.C., Ph.D.
Chiropractic biophysics is a system of chiropractic spinal analysis and care
developed by Donald D. Harrison, M.S., DC, M.S.E., Ph.D., and Glenn
Harrison, B.S., DC The approach to improved patient well-being, as
designed by these doctors, is a mechanistic one.
To some extent, these mechanistic concepts are justified in that the spine
and nervous system have many machinelike qualities. The spine is
composed of bones, muscles, blood vessels and neural networks which
resemble beams, motors, hydraulics and computers, respectively. Ball and
Carlson1 have stated, "The use of engineering modeling in biological
systems is now commonly accepted as a logical means of approaching
highly complex mechanisms."
The Rationale for CBP
CBP applies the sciences of mathematics, physics and biophysics to the
practice and theory of chiropractic. While the simple analogies of a bone
"stuck" or "out of place" may serve doctors well when communicating
with patients regarding spinal adjustments or some form of therapy, they
hardly reflect the degree of sophistication which is necessary in
communicating with the rest of the scientific community. The plight of our
profession can be simply summed up in the following statement from the
report of the New Zealand Commission of Inquiry Into Chiropractic: "The
exact nature of such defects (subluxations) has not yet been demonstrated;
nor has the mechanism by which its apparent effects are produced." The
1975 NINDS workshop on the status of spinal manipulative therapy made
the observation that "there was no quantitative or qualitative reproducible
description of subluxation."
Chiropractic biophysics is addressing these shortcomings by combining the
discipline of science, the foundational principles of chiropractic and the
application of technical skills to attempt to elucidate the truth about what
we do, how we do it and how we can do it better. CBP attempts to
understand and apply the universal laws which govern the behavior of
matter and energy and their interactions in biological systems. The result
of over 12 years of development is an ever-expanding and evolving base
of work and literature relating to the science of what chiropractic is and
does. Currently, the CBP technique represents a full spine and pelvis
corrective/rehabilitative procedure having a firm foundation in the
sciences of mechanics and physics and providing both a qualitative and
quantitative model of chiropractic practice.
The overall goal of the CBP technique is to restore normal three-
dimensional human posture. Methods include "mirror image" posture
adjustments, rehabilitative exercises, cervical extension traction and manual
procedures. In CBP, the overall posture or global positioning of the spinal
column is targeted for correction, as opposed to individual spinal segments.
In CBP, the optimum static position of the upright human spine is
established with the Harrison spinal model. A subluxation is considered to
be any postural deviation from this mathematical norm. The model
represents the most complete chiropractic effort to date to establish what
constitutes "normal."
Although not perfect, the Harrison model is a starting point and a
reasonable clinical objective for corrective care. It is expected that as our
knowledge expands, so too will the model expand and evolve.
Protocol of Care
The CBP protocol of care begins with the initial patient encounter and a
case history. The patient is then analyzed for abnormal posture in every
possible degree of freedom of the skull, thoracic cage and pelvis. Next, an
exacting series of radiographs is performed which are then analyzed using
geometry to obtain information for formulating care plans and later to
serve as an objective standard against which to evaluate the efficacy of
care.
Following careful consideration of pertinent clinical findings, especially
the correlation of the patient’s three-dimensional posture with its two-
dimensional X-ray image, a patient’s case is either accepted or referred to
an appropriate specialist. Patients who are accepted for care are generally
assigned to one of two regimens (i.e., acute or corrective care). Factors,
which might influence the appropriate type of care, could be numerous,
such as the nature of their specific complaint, the magnitude of their
postural distortions and the degree of pathophysiology associated with
subluxation degeneration.
Patients who are selected for acute care would receive a program of care
perhaps not unlike that of many non-CBP offices. They would undergo
"diversified"-type adjustments (both long- and short-lever) to restore
segmental mobility, cryotherapy to reduce localized inflammation, passive
and active stretching and massage as indicated to reduce spasm and
myofascial involvement. Acute care programs may also apply to corrective
care patients who enter the office symptomatic.
The CBP corrective care regimen includes the use of drop table and upper
cervical instrument-assisted adjustive procedures, as well as a variety of
corrective extension traction procedures and corrective postural exercises.
It is not the methods themselves, which are unique to CBP, but rather the
rationale behind their use and the way in which these tools are employed
to accomplish stated clinical objectives.
The following is a summary of basic methods currently in use.
Mirror Image Adjusting
In chiropractic biophysics, abnormal human posture is analyzed and
corrected be means of what is termed "mirror-image" adjustments.
Basically this is done by first analyzing the standing posture in three
dimensions and then stressing the patient’s abnormal posture into its exact
opposite, or "mirror," image. Once the patient has been pre-stressed into
the mirror image, a light adjustive force is applied.
Adjustive forces are generally applied to the atlas transverse process with
either a toggle—type adjustment or by means of a cervical adjusting
instrument. Adjustive forces may also be introduced to the lower back area
by the use of a drop table adjustment with force applied to the sacroiliac
or femur head areas. The purpose of mirror image adjustment is to
introduce mechanical stimulation to proprioceptors and encourage the
brain to reconsider the faulty postural patterns which have become
habituated overtime. It is precisely these habituated postural patterns
which are a major source of chronic spinal dysfunction and which result in
spinal resistance to correction which all practitioners have experienced.
Mirror image adjustments may be performed with the patient in either the
prone, supine, side posture or standing positions. Correction to normal
posture is then verified by pre- and post-adjustment postural examinations.
Rehabilitative Exercise
Since adaptation of muscular structures is a process that takes place over
an extended period of time, repetition of positive forces into the affected
tissues is necessary to effectively achieve and maintain postural correction.
These simple techniques alone can often be quite effective, as
demonstrated in a 1986 study by Klein and Sobel of neck pain patients, in
which 59 percent received significant long-term relief from performing
postural exercises for their conditions.
Harrison’s mirror image exercises are set up individually, based on the
patient’s particular abnormal posture configuration, unlike many generic,
"one-size-fits-all" exercise programs. Mirror image exercise procedures
effectively reeducate the body by targeting those muscle groups and their
associated global movements, which effect a more permanent correction of
the patient’s subluxated posture.
Extension Traction
One of the most common postures, which presents in the chiropractic
office is that of cervical hypolordosis/kyphosis with the patient’s head in
an anterior weight-bearing position. In chronic cases, ligaments will have
creeped shorter and adapted to the abnormal postures. Due to their
specific mechanical properties, ligamentous tissues do not often respond
well to the rapid loading forces which constitute the chiropractic
adjustment. Anyone familiar with the sigmoid-shaped load-deformation
curves obtained from testing spinal ligaments realizes that rapid loading
forces affect only the elastic range of the ligaments. Loads must be applied
over 20 to 30 minutes to affect the viscous and plastic regions of the load-
deformation curves.
Consequently, the primary purpose of cervical extension traction is to
provide a long duration or slow adjusting force to those soft tissues that
have contracted over time and therefore tend to perpetuate the patient’s
subluxated state.
A variety of traction methods are currently being employed by CBP
practitioners. Performed in the office, these methods may require times
that range from 10 to 20 minutes, according to the doctor’s discretion and
patient tolerance. Many patients also receive a home traction device so that
they may actively participate in their recovery program.
By use of these methods, CBP field practitioners are experiencing great
success in restoring cervical curves. As evidence of the success of this
approach, a recent controlled clinical trial demonstrated an average
increase of the cervical lordosis of 13.5 degrees versus no statistically
significant change in the control group.
Conclusion
The chiropractic biophysics technique is unique for several reasons. It
provides a specific therapeutic goal (the Harrison model of ideal upright
posture). It correlates the patient’s three-dimensional posture with precise
radiographic analysis to help eliminate much of the false data, which are
inherent in analysis based on X-rays alone. It effectively addresses the
overall posture of the patient by means of mirror image adjustive
procedures, and it seeks to rectify long-term soft tissue changes by means
of extension tractioning and rehabilitative exercise programs which are
tailored individually for each patient. Through the application of
knowledge borrowed from the fields of physics and mathematics and
university biophysics, we are bringing clinical results into line with our
philosophical tenets.
About the author
Donald D. Harrison, D.C., is the developer of the CBP technique. He
holds BS and MS degrees in mathematics, masters in mechanical
engineering, and also holds a PhD in math in addition to his Doctor of
Chiropractic degree. He is the publisher of the American Journal of
Clinical Chiropractic, which is published quarterly.
company whose products are geared toward the CBP practice. For more
information on the CBP technique, call (800) 346-5146.
References
1.Ball, L.D., and Carlson, L.E., Experimental Mechanics of the Spine, 6th Annual Biomechanics
Conference on the Spine, Boulder, Cob.t Univ. of Colorado, 1975.
2.Harrison, D.D., "Abnormal Postural Permutations Calculated as Rotations and Translations
From an Ideal Normal Upright Static Spine," chapter 6, In:Chiropractic Family Practice, J.
Sweere, Ed., Gaitherburg, Md.: Aspen Publishers, 1992.
3. Cochran, C., A Primer of Orthopedics Biomechanics, Churchill Livingstone, 1982.
4. White, A.A., and Panjabi, M.M., Clinical Biomechanics of the Spine, Philadelphia: 1.8.
Lippincott Co., 1978.
5. Chasal, J., Tanguy, A., Bourges, M., Caurel, C., Escande, G., Cuilbot, M., and Vameuville, C.,
"Biomechanical Properties of Spinal Ligaments and a Histological Study of the Supraspinal
Ligament in Traction," I. Biomechanics 3:167-176,1985.
6. Chow, D.H.K., Luk, K.D.K., Leong, J.C.Y., and Woo, C.W., "Torsional Stability of the
Lumbosacral Junction: Significance of the Iliol Ligament,"
Spine 14:611 -615, 1989.
