Real cases

Future potential
• At 1 governmental hospital:
Within 6 months: 100 patients with 800 visits

Patients: extremely painful with lots of severe injuries, finance not

affordable to pay for PERFECT treatment

NO one know about Chiro!!!! What happened

Case 1 history
• Female 54y • Patient forgot to tell at 3-4yrs she got
Polio, cant stand n walk abt 1y, but
• Hep nhe trung tam ong song cured totally by acupuncture n
L345,S1 physical therapy
• Thoai hoa Modic type II than Her recent condition is the
dot song L345,S1 complication of that: muscles weak on
Right side: outcome of rehab cant
• Mat nuoc DD at L345,S1 reach 100%: I told her
• TVDD L3/4: sau 3mm • Result of images/muscle/neuro tests:
• TVDD L4/5: sau-sang 2 ben not too bad for her to be so painful
9/10 scale & not to walk in the
2,5mm morning, cant walk normally as
• TVDD L5/S1: sau 4.5 mm before
• Ep bao mang cung, ep re L45,S1 • Lesson: Causes of symptoms not so
severe but patients so painful, cant
walk Think!!!
Symptoms
• So painful: cant stand it: go to • Always worst in morning: muscles
hospital as domestic patients at gluteal region only contract,
• Cant walk normally cant be released, cant walk
• No pain at Lumbar!!!!!!!!!!!!!! • Pain released gradually when
lying down at the end of day
• Only pain at 2 points on Right
side: • Long history for dull, ache whole
body, esp after giving birth to 1st
+ mid part at Gluteal Max toward
child at 30
laterally: which structure?which
muscles attach it? • Don’t have serious pathology
+ whole calf • Recent: the most painful: THINK
Analysing images
• Alignment/Lordosis:
+ gravity lumbar line
+ George’s line
+ L5/S1 angle
+ no spondylolisthesis
• Bone:
+ Osteophytes: degen III
+ Density: not too bad but still need to
test Osteoporosis
+ Remember: degen III + female+ over
50y: always check Osteoporosis: if yes:
SM/Activator/ajust with 2-3/10 force
+ if bn feel “nhuc toan than”, “te buot
khap nguoi”: key word: lack “chat dich
cho he khop”: drink “CAO” (learn from
3-4bn), pain released then do Chiro
• Cartilages:
+ disc spaces: most narrowed at
L345,S1
+ disc herniation: most severe at
L5/S1: 4,5 mm
+ posterior ligament
Soft tissue
Deepest layers of spinal muscles
• Scoliosis: C on Right, peak at L23
• Left ilium: higher: QL&Psoas?
TREATMENT
• PT/3 times: DX/KG/DTCA 2nd visit: do Chiro harder
• Pain released a bit: good sign
+ L5: PRS
Then add Chiro as last one
+ L3: RP
1st time: mainly ST and SM, prone &thurst + PEL: R-PI n L-AS
gentle P to A at S1 TUBERCLE
Trigger point at Gluteal n Piriformis
Can walk much better immed 0000000000000000000000000000
But cant keep it for next morning 0000000000000000000000
https://www.youtube.com/watch?
https://www.youtube.com/watch?
v=TBkZqFQP51E
v=TBkZqFQP51E
CASE 2
 Analysing images
• Lordosis/alignment:
+ Gravity line: forward head
+ George’s line: misalignment
+ ADI,SAC: c1c2 instability
Analysing images
• Bone:
+ osteophytes: degen grade 3
Analysing images
• Cartilage:
+ disc spaces: most narrowed at
C456
+ disc herniation: which grade?
Soft tissue
+ up trap
+ sub occi
• Lordosis: so straight: work on up
trap, splenis cap n cer
• Right occiput lift
• C2: PRS
TREATMENT
• https://www.youtube.com/watch?v=YRBtisJhKlw

• https://www.youtube.com/watch?v=3QGgbdz4u1I
• C1 on C2 mob and testing
• https://www.youtube.com/watch?v=wRc-c0ZLBBE
• Gonstead Chiropractic Adjustment C2 PRS
ELECTRIC
MALE 31Y
MALE 40

• https://www.youtube.com/watc
h?v=sZBBFFAvNqY
• https://www.youtube.com/watc
h?v=s5iDJc9k9SA
MALE 54
Chiro Biophysics (CBP)
• What Is CBP?
IN DECEMBER 1980,
CHIROPRACTIC BIOPHYSICS OR
CBP TECHNIQUE, WAS ORIGINALLY
NAMED BY DRS. DONALD
HARRISON, DEANNE HARRISON,
AND DANIEL MURPHY FOR
“PHYSICS APPLIED TO BIOLOGY IN
CHIROPRACTIC
HARRISON CHIROPRACTIC
GOALS OF CARE
+ emphasizes optimal posture and
spinal alignment as the primary
goals
+ simultaneously documenting
improvements in pain and
functional based outcomes
+ uniqueness of CBP is structural
rehabilitation of the spine and
posture
 Goals of CBP Care
+ Normal Front & Side View + Normal function
Posture • Improved Range of Motion and
Center of mass of head, rib cage & quality of movement
pelvis vertically aligned in Front • Improved muscle strength
and Side views. + Improved Health & Symptom
+ Normal Spinal Alignment Improvements
Front view: vertical alignment . Neck disability index
. Oswestry low back index
Side View: Harrison Ideal or
Average Spinal Model . SF 36 or Health Status
Questionnaire
IDEAL POSTURAL ALIGNMENT
+ Depicted in both the frontal and
side views.
+ In each view, the center of mass
of the skull, thorax, and pelvis are
in a vertical line with respect to
gravity.
+ In the frontal view, the spinal
column is vertically aligned-a
straight column- with respect to
gravity
IDEAL POSTURAL ALIGNMENT
• In the side view, the spine has three
primary curvatures which will be
described below:

• 1. Neck Curve – Cervical Lordosis,

• 2. Ribcage Curve – Thoracic Kyphosis,

• 3. Low back Curve – Lumbar Lordosis

IDEAL SPINAL ALIGNMENT:
HARRISON FULL SPINE MODEL
• an evidenced based model for
side view spinal alignment
• geometric path of the posterior
longitudinal ligament or the
backs of the vertebra from the
C1 to the bottom of the lower
back or top of the sacrum
• The cervical spine should have a
geometric shape that
approximates a ‘piece of a circle’
HARRISON FULL SPINE MODEL
+ thoracic spine should have a
geometric shape that
approximates an oval-elliptical
shape
+ lumbar spine should have a
geometric shape that
approximates an oval-elliptical
shape
HARRISON FULL SPINE MODEL

• full spine x-ray

• red-curved line represents the
Harrison spinal model and this
shows where the patient’ Spinal
vertebra should be lined up
• this patient has altered spinal
alignment as they do not fit even
close to the Harrison Idealized
Spinal Model.
Harrison Spinal Model in the Cervical
region
• GREEN line: normal curve
• abnormal curve: Red dashed line
X-RAY ANALYSIS AND UTILIZATION
• doctor must measure the • with measures of pain intensity,
displacements on spinal range of motion, and quality of
radiographs (segmental life, periodic assessment of
Subluxation) spinal structural alignment:
• Both lateral-side view and evaluate progress and
anterior to posterior (AP) or determine when maximum
frontal view patient improvement has been
reached.
• initial and follow-up spinal x-
rays: deemed necessary
CBP POSTURAL ANALYSIS
• The possible translation
postures (Tx, Ty, Tz) of the head,
rib cage, and pelvis are depicted
in 3-dimensions
• Abnormal postures were found,
these postures would be placed
into their Mirror Image® before
a force was applied with an
adjusting instrument, drop table,
exercise and/or traction.
CBP POSTURAL ANALYSIS
• The possible postural rotations
(Rx, Ry, Rz) of the head rib cage
and pelvis are depicted in 3-
dimensions
• Abnormal postures were found,
these postures would be placed
into their Mirror Image® before
a force was applied with an
adjusting instrument, drop table,
exercise and/or traction.
MIRROR IMAGE® POSTURAL
ADJUSTMENTS
• In March 1980, Dr. Don Harrison • Clinically, these adjusting set-ups
originated postural Chiropractic were found to result in postural
adjusting procedures: Mirror and spinal alignment
Image improvements verified with
follow up x-ray
MIRROR IMAGE® POSTURAL
ADJUSTMENTS
• Mirror Image adjustment
example for the head posture
• The patient has forward head
posture (translation)
• The posture is placed in its
opposite position and then a
Chiropractic adjustment is
performed.
• Done by Dr. Don Harrison
MIRROR IMAGE® POSTURAL
ADJUSTMENTS
• Dr. Don Harrison placed the
patient in their opposite posture
• Harrison Mirror Image® positions
can be described as “reflecting”
the patient’s head, rib cage,
and/or pelvis across the median-
sagittal plane in the AP view
• positioning the head, rib cage,
and/or pelvis across the mid-
frontal plane in the lateral view
MIRROR IMAGE® POSTURAL
ADJUSTMENTS
• Mirror Image adjustment
example for the ribcage posture
• The patient has right lateral
ribcage posture
• The posture is placed in its
opposite position and then a
Chiropractic adjustment is
performed.
MIRROR IMAGE® POSTURAL
EXERCISES
• The patient has an abnormal
forward head (translation)
posture
• one with just the patient’s
muscles and body as resistance
• the other with an elastic band
for increased contraction effort
• The patient actively maneuvers
their posture into the opposite
or Mirror Image position.
MIRROR IMAGE® POSTURAL
EXERCISES
• The patient has right lateral
ribcage posture (translation)
• one with just the patient’s
muscles and body as resistance
• the other with an elastic band
for increased contraction effort
• The patient actively maneuvers
their posture into the opposite
or Mirror Image position
MIRROR IMAGE® POSTURAL AND
SPINAL TRACTION
• In A, hypolordosis with mild
anterior head translation requires
compression extension traction in
B
• In C, slight kyphosis with posterior
head translation requires 2-way
non-compression traction in D
• In E, reversal of the upper cervical
curve with mild anterior head
translation requires compression
extension 2-way traction in F
MIRROR IMAGE® POSTURAL AND
SPINAL TRACTION
• In A, lumbar kyphosis with
anterior thoracic translation
requires 3-point bending
extension traction in B
• In C, slight lumbar kyphosis with
posterior thoracic translation
requires 3-point bending in D
• In E, hyper-kyphosis of the
thoracic curve requires 3-point
bending thoracic traction in F
FREQUENCY & DURATION OF CBP® TECHNIQUE CARE
 FREQUENCY & DURATION OF CBP® TECHNIQUE CARE

• started with relief care at a frequency of 4 times per week for 3 weeks or 12
visits
• After this 12 visit patient is re-evaluated to document improvements in initial
(visit 1) positive exam findings, pain scales, disability indices, health status, and
range of motion. Patient is transitioned into CBP® structural rehabilitative E.A.T.
procedures.

• To determine if the CBP® E.A.T protocol of corrective care for each individual
(based on his/her posture and spinal displacements), re-examinations are
suggested at 36 visit intervals

• In other words after 24 visits of CBP® E.A.T interventions added to the initial 12
visits of relief care.
FREQUENCY & DURATION OF CBP®
TECHNIQUE CARE
• to arrive at this 36 visit time period, one could use a frequency of 4
visits per week for 9 weeks or 3 visits per week for 12 weeks.
• the outcomes of chronic pain patients with CBP® Treatment
interventions, the average chronic pain patient achieved a 75-80%
improvement in their chronic pain and a 50% correction of their initial
subluxated (abnormal spine alignment) position towards ideal and
average spine alignment
• on average, a typical chronic pain patient may need 2 blocks of 36
visits of intensive structural rehabilitative care (defined as 3 or 4 visits
per week) to achieve as near normal spinal alignment as possible.
FREQUENCY & DURATION OF CBP®
TECHNIQUE CARE
• if a patient achieves near-normal posture and spinal alignment at the
36 visit re-evaluation, then a reduced frequency of treatment is
recommended for stabilization care (1-4 times per month depending
upon the case)
• However, if at the first corrective care re-evaluation, less than average
improvement is attained on comparative radiographs and postural
examination (PosturePrint™), then this is indication that another
block of 36 visits may be necessary for continued spinal correction
• https://www.youtube.com/watch?v=nKPcRroN7ak
Lateral Cervical Reliability
https://www.youtube.com/watch?v=YnUXjOGXZ_8
Compression Extension Traction
https://www.youtube.com/watch?v=lWdjUzxrk_8
Chiropractic BioPhysics Comprehensive Full Body Adjustment