CHIROPRACTIC SCIENCE

Most chiropractors are aware that the first x-ray image was created by Wilhelm Röntgen in Germany in 1895, and that same year DD Palmer gave the first chiropractic adjustment. Within a short time, the medical profession realized its usefulness and started using x-ray to help diagnose and treat patients with more efficiency and better outcomes. In 1910, BJ Palmer not only introduced x-ray into the chiropractic profession, but he also championed its use for spinal imaging.

What is CBCT? Cone Beam Computed Tomography is a relatively new technology that provides a low dose, pulsed, cone shaped beam. With one or two rotations around the patient taking 20-60 seconds, a highquality 3D image is produced. Initially used for dentistry, collaboration between professions has made it possible for CBCT to find its way into the chiropractic profession in recent years.

Why is this a big deal? CBCT is a much lower dose form of 3D imaging that is quick and safe, and it gives the practitioner a high-resolution 3D picture of the hard structures of the skull and cervical spine. In this 3D imaging, boxes of data known as voxels replace pixels, and the depths of the data contained in each box can be increased or decreased depending on the needs of the clinician. The image avoids distortion and can be analyzed in any direction by slicing through any plane to create the desired projection; this allows for chiropractors to view and analyze not only the external structures of the spine, but the internal as well.

CBCT’s imaging files can be displayed as a 2D sagittal, coronal, and axial plane slice in standard x-ray views. More excitingly is the 3D multiplane reconstruction (MPR) or anatomical reconstruction mode that allows a groundbreaking perspective when compared to typical spinal x-ray imaging. This imaging is not to be confused with typical medical planar

CT which is higher dose (10-20X higher) due to its use of a constant, spiral beam that totals anywhere from 60 to 300 rotations around the patient. Believe it or not, CBCT technology doesn’t even require lead lining in the walls, just six feet of distance and a regular 110 volt plug to power the machine! This increased accessibility makes installation quite seamless as compared to the requirements of a standard radiology suite.

Critical for the reader to know, is that this technology has not been approved for chiropractic use in all jurisdictions at the time of publication. If you would like to understand the status of approval for CBCT use in your geographical zone, please contact the authors of this article. We hope that soon enough, this amazing technology will be readily available to all clinicians.

One of our late great chiropractors, Dr. Robert Brooks, famously said: “Truth was put in a box, and holes were poked in it for us all to see it from different perspectives.” CBCT may yet serve as a bridge within our profession to develop new ways of looking at things and closing the gap on the possibilities for preventative care in spinal health by

allowing us to utilize sub-groupings of pathoanatomic clinical prediction markers that previously were not attainable. The future is bright in a chiropractic profession that embraces a technology that lowers the dose to patients as well as allows for improved patient outcomes via better analysis.

CBCT – WHY YOU SHOULD BE AS EXCITED AS WE ARE!

Tyler Evans, DC., DCCJP., and Jeff Scholten, DC., FCCJP

CBCT may yet serve as a bridge within our profession to develop new ways of looking at things and closing the gap on the possibilities for preventative care in spinal health by allowing us to utilize sub-groupings of pathoanatomic clinical prediction markers that previously were not attainable.

LIFE WEST RESEARCH ON OPTIMAL HUMAN VITALITY

Monica Smith, DC, PhD

A primary focus of Life Chiropractic College West is to provide chiropractic care that is wellnessfocused and supports optimal human vitality and performance. While numerous biomarkers assess health status in the disease state, their performance in the non-disease portion of the healthcare continuum is largely unknown (Fig. 1). Life West Research has been compiling scientific literature that identifies wellness biomarkers with good potential for use as wellnessfocused clinical outcome assessment tools to add to the body of research on the efficacy of the chiropractic adjustment. This has enabled the Life West research team to evaluate the best candidates for vitalistic and wellness biomarkers and technology that are suitable for applications in our human performance and clinical research programs.

Heart Rate Variability (HRV) is a measure of the variation in time between heartbeats. An optimal level of variability is critical to the inherent flexibility and adaptability or resilience that characterizes healthy function and well-being. Because HRV is under moment-to-moment autonomic control, it provides a noninvasive way to monitor dynamic changes in the sympathetic and parasympathetic balance of the autonomic nervous system. Therefore, HRV provides an important means for studying autonomic balance.

Rapid autonomic responses enable us to adapt to changes that occur frequently in our environment. Moreover, autonomic activity influences most body systems and is known to be active along the full range of the health spectrum. Actigraphy is the assessment of physical activity or motion. Activity monitoring devices (actigraphs), contain accelerometers and internal memory to record weeks to months of data.

Several studies have reported strong correlation between sleep, optimal performance, and wellness. Life West researchers recently performed a Proof of Concept study of 24-hour HRV (24-HRV) coupled with rest/activity monitoring (Actigraphy) for assessing the duration and quality of sleep. The biomarker recordings using Holter (DVS myPatch®) and wrist-worn (ActiWatch®) technology (Fig. 2) are being analyzed now alongside data from the research subjects' sleep diaries marking start and end of “bedtime” and wake-up periods, (Fig. 3 and 4).

This Life West Research study has been accepted for presentation at the July 2022 ACCRAC to report our preliminary analyses of objective data from twenty four hour HRV and actigraphy recordings concurrent with subjective self-reported sleep diaries, comparing morning, mid-day, evening, and sleep time periods.

Human Performance Research Lab

Life West Research is advancing our understanding of chiropractic using biomarker technology in our Human Performance Research Lab. Our inhouse portfolio of research equipment includes devices for measuring HRV as well as EEG technology.

Life West student Alexis Griffith operates the technology and ERP protocols (Evoked Response Potentials) for recording EEG brain scans. Alexis is a Research Honors candidate interested in chiropractic care for optimizing brain health.

(Figure 1)

(Figure 2) 24-hr HRV monitor DVS myPatch® and wrist-worn actigraphy device (ActiWatch®)

(Figure 3) ActiWatch output-one research subject

(Figure 4-Right) Sleep-related HRV pattern-six subjects monitored over a 24-hour period. (Figure 3) Actiwatch Output-One Research Subject