CHIROPRACTIC SCIENCE

Most chiropractors are aware that the fi rst x-ray image was created by Wilhelm Röntgen in Germany in 1895, and that same year DD Palmer gave the fi rst chiropracti c adjustment. Within a short ti me, the medical profession realized its usefulness and started using x-ray to help diagnose and treat pati ents with more effi ciency and bett er outcomes. In 1910, BJ Palmer not only introduced x-ray into the chiropracti c profession, but he also championed its use for spinal imaging.

What is CBCT? Cone Beam Computed Tomography is a relati vely new technology that provides a low dose, pulsed, cone shaped beam. With one or two rotati ons around the pati ent taking 20-60 seconds, a highquality 3D image is produced. Initi ally used for denti stry, collaborati on 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 practi ti oner a high-resoluti on 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 distorti on and can be analyzed in any directi on by slicing through any plane to create the desired projecti on; this allows for chiropractors to view and analyze not only the external structures of the spine, but the internal as well.

CBCT’s imaging fi les can be displayed as a 2D sagitt al, coronal, and axial plane slice in standard x-ray views. More exciti ngly is the 3D multi plane reconstructi on (MPR) or anatomical reconstructi on mode that allows a groundbreaking perspecti ve 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 rotati ons around the pati ent. 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 installati on quite seamless as compared to the requirements of a standard radiology suite.

Criti cal for the reader to know, is that this technology has not been approved for chiropracti c use in all jurisdicti ons at the ti me of publicati on. If you would like to understand the status of approval for CBCT use in your geographical zone, please contact the authors of this arti cle. 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 diff erent perspecti ves.” CBCT may yet serve as a bridge within our profession to develop new ways of looking at things and closing the gap on the possibiliti es for preventati ve care in spinal health by

allowing us to uti lize sub-groupings of pathoanatomic clinical predicti on markers that previously were not att ainable. The future is bright in a chiropracti c profession that embraces a technology that lowers the dose to pati ents as well as allows for improved pati ent outcomes via bett er 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 Chiropracti c College West is to provide chiropracti c care that is wellnessfocused and supports opti mal human vitality and performance. While numerous biomarkers assess health status in the disease state, their performance in the non-disease porti on of the healthcare conti nuum is largely unknown (Fig. 1). Life West Research has been compiling scienti fi c literature that identi fi es wellness biomarkers with good potenti al for use as wellnessfocused clinical outcome assessment tools to add to the body of research on the effi cacy of the chiropracti c adjustment. This has enabled the Life West research team to evaluate the best candidates for vitalisti c and wellness biomarkers and technology that are suitable for applicati ons in our human performance and clinical research programs.

Heart Rate Variability (HRV) is a measure of the variati on in ti me between heartbeats. An opti mal level of variability is criti cal to the inherent flexibility and adaptability or resilience that characterizes healthy functi on and well-being. Because HRV is under moment-to-moment autonomic control, it provides a noninvasive way to monitor dynamic changes in the sympatheti c and parasympatheti c 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 acti vity infl uences most body systems and is known to be acti ve along the full range of the health spectrum. Acti graphy is the assessment of physical acti vity or moti on. Acti vity monitoring devices (acti graphs), contain accelerometers and internal memory to record weeks to months of data.

Several studies have reported strong correlati on between sleep, opti mal performance, and wellness. Life West researchers recently performed a Proof of Concept study of 24-hour HRV (24-HRV) coupled with rest/acti vity monitoring (Acti graphy) for assessing the durati on and quality of sleep. The biomarker recordings using Holter (DVS myPatch®) and wrist-worn (Acti Watch®) technology (Fig. 2) are being analyzed now alongside data from the research subjects' sleep diaries marking start and end of “bedti me” and wake-up periods, (Fig. 3 and 4).

This Life West Research study has been accepted for presentati on at the July 2022 ACCRAC to report our preliminary analyses of objecti ve data from twenty four hour HRV and acti graphy recordings concurrent with subjecti ve self-reported sleep diaries, comparing morning, mid-day, evening, and sleep ti me periods.

Human Performance Research Lab

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

Life West student Alexis Griffi th operates the technology and ERP protocols (Evoked Response Potenti als) for recording EEG brain scans. Alexis is a Research Honors candidate interested in chiropracti c care for opti mizing brain health.

(Figure 1)

(Figure 2) 24-hr HRV monitor DVS myPatch® and wrist-worn acti graphy device (Acti Watch®)

(Figure 3) Acti Watch output-one research subject

(Figure 3) Acti watch Output-One Research Subject