by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Chiropractic Journal of Australia : CJA March 2012
21 Chiropractic Journal of Australia Volume 42 Number 1 March 2012 INTRODUCTION The period of a child’s life is characterised by dynamic changes in his or her neuromusculoskeletal (NMS) system. Physical growth and neurodevelopment proceeds in a sequential and predictable manner that is intrinsically (i.e., genetic determinants) and extrinsically (i.e., environment factors such as socioeconomics, parents and siblings, etc.) determined and reflected in the child’s developmental milestones. Given its complexity, it is not surprising that the potential developmental problems befalling a child are many. As such, NMS complaints are common in childhood. According to Foster and Cabral,1 4% to 30% of children and adolescents in the community have NMS complaints and account for 3% of paediatric day-case non-elective admissions. The Chiropractic Care of an Infant “Bottom Shuffer:” A Case Report and Review of the Literature MARIA BERNARD and JOEL ALCANTARA ABSTRACT: Objective: To describe the successful chiropractic care of a toddler with an abnormal crawling pattern and review the literature. Clinical Features: An 11 month female infant was presented by her mother with concerns regarding her daughter’s inability to cross-crawl. The infant was described as a “bottom shuffer”. The infant's unusual locomotion began at 8 months of age. Intervention and Outcome: Chiropractic examination identifed sites of subluxation at the upper cervical spine and sacro-iliac joint. Chiropractic adjustments were applied using the Activator Instrument and sacral-occipital technique. The patient's mother reported that within a few hours after the frst visit, the patient began crawling on all fours, in a cross-crawl manner. She was confdent to crawl upstairs. Conclusion: This case study demonstrates the possibility, that chiropractic care may alter abnormal biomechanical function, affecting developmental milestones such as ambulation. We support further research in the care of similar patients. INDEX TERMS: (MeSH): CHIROPRACTIC; PEDIATRICS. (Other): BOTTOM SHUFFLER. Chiropr J Aust 2012;42: 21-4. Maria Bernard, DC Private Practice of Chiropractic Cabramatta West, NSW, Australia Joel Alcantara, DC Research Director, International Chiropractic Pediatric Association Media, PA. USA Chair of Pediatric Research, Life Chiropractic College West, Hayward, CA, USA This study was funded by the International Chiropractic Pediatric Association, Media, PA and Life Chiropractic College West, Hayward, CA Confict of Interest Statement: In the capacity as Research Director and Chair of Pediatric Research, Dr Alcantara receives funding and/or support from the International Chiropractic Pediatric Association and Life Chiropractic College West. Received: 26 October 2011, accepted with revisions: 16 December 2011. Given the popularity of NMS complaints by adult patients to chiropractors2 and that parent-CAM (complementary and alternative medicine) users are 3-5 times more likely to use CAM for their child,3, 4 a common motivation or presenting complaint for children to attend chiropractic care may be associated with problems involving the NMS.5-7 In the interest of evidence-based practice, we present the chiropractic care of a child with problems involving the NMS. CASE REPORT An 11-month female infant was presented by her mother with concerns regarding the child’s inability to crawl on her hands and knees. Rather than observe her daughter move on her hands and knees, then begin to push off with her knees to propel herself forward with the “cross-crawl” pattern commonly observed in infants of similar age, her daughter adopted an unusual form of crawl called a “bottom shuffer.” The following is a description of this particular ambulation: the infant would sit on her bottom, she would have her left knee and hip in moderate fexion and hip in external rotation. Her lower left limb was in mild internal rotation, the foot mildly inverted. Her right leg was kept out in front, with the knee only mildly fexed. She would sit with her left hand out to her left side next to her left hip and the right one balanced on her right anterior thigh. She would then propel herself forwards and backwards, on her bottom and unilateral hyper-fexed hip and knee, in the pose described above, to move. According to the infant’s mother, the patient’s “abnormal crawling” pattern began at 8 months of age. The patient’s parents consulted an early childhood nurse and were not given any explanation of the nature of their child’s mobility, or provided an “organic” cause to their infant’s abnormal crawling pattern. Out of concern and the need for an “alternative” opinion her parents decided to take their child to a chiropractor.
CJA June 2012