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Chiropractic Journal of Australia : CJA September 2013
110 Chiropractic Journal of Australia Volume 43 Number 3 September 2013 METHODS Subjects Subjects were 16 female patients between the ages of 36 and 71who met the following inclusion criteria: experiencing self-reported menopausal symptoms and willing and able to undergo both AK chiropractic physical examination and to conduct salivary hormone testing (for which the patient paid approximately $300). The subjects also had to be available for re-assessment 6-months after their initial care for menopause- specifc problems began. (Six subjects could not be reached, bringing the fnal patient cohort to 10.) Subjects were not included in this study if they had any contraindications to chiropractic treatment, or if they were currently on any steroid or hormone medication. Subjects then were educated on the protocol of the study, the possible benefts and risks of treatment, and both verbal and written informed consent was obtained before entry into the study. Intervention The protocol in this study was as follows: 1) Following the taking of the patient's history, the Menopause Rating Scale was completed by the patient. 2) The patient was physically examined with the focus upon the symptom history, particularly upon the function of muscles and related joints and refexes related in applied kinesiology to the organs most likely to be involved in menopausal dysfunctions.14-20 3) These muscles are the pectoralis major (sternal division), related to the liver; the sartorius, gracilis, and posterior tibialis, related to the adrenal glands; the adductors, gluteus medius and minimus, piriformis, and gluteus maximus, related to the sexual organs.14-20 4) If these muscles were initially strong, then the sensorimotor stimulation ("therapy localization" in AK) of their associated viscerosomatic refexes (i.e., Chapman's neurolymphatic and acupuncture meridian points) was implemented. If inhibition of the previously strong muscle occurred, this was noted. (Table 1) Therapy localisation is a diagnostic tool in AK that is combined with the other diagnostic fndings to arrive at a diagnosis.14-20 5) In each patient's initial examination, their blood pressure was tested in three positions, in addition to the subject’s pupillary refexes, Rogoff’s sign, and ligament stretch reaction. (The latter three indicators are physical signs in AKs examination regimen related to adrenal gland dysfunctions) (Figures 2-7) 6) All factors (structural, biochemical, psychosocial) that strengthened the manual muscle tests (in addition to the viscerosomatic refexes for the inhibited muscles) were addressed. Multi-modal chiropractic treatment included spinal adjustments, cranial treatments, nutritional interventions, Traditional Chinese Medicine refex stimulation, and soft tissue work. One or all of these methods may have been necessary to restore strength to these muscles and to correct therapy localisation to their associated viscerosomatic refex. 7) After the initial visit, the patient was instructed on how to perform the salivary hormone test. 8) Once the patient was believed to have reached MMI, subjects provided their assessment of their status in relationship to their menopausal symptoms. (Table 1, far-right column) 9) The MRS was completed by each participant 6 months later to evaluate the extent to which changes in the initial symptom pattern had occurred. (Table 3) For patients who were suspected to have adrenal stress disorder as a major factor in their condition (10 of 10 patients provided evidence of this) we advised them on stress reduction by explaining the four areas of cumulative stress (thermal, chemical, physical, and emotional) and how they might reduce these. To this effect, patients were given a "Stress" brochure to help them understand and overcome the problem.19 We explained how blood sugar levels stimulated increased adrenal dysfunction and how eating low glycemic foods at frequent intervals could reduce this problem. Accordingly, we provided patients with the glycemic index (and how to understand it), and a Blood Sugar Handling pamphlet recommending the appropriate nutrients. We treated any other areas that the patient displayed using the AK approach to structural, biochemical and psychosocial disorders. This included cranial work, treating the emotional refexes found to be related to muscular dysfunctions, spinal adjustments, and any other AK treatment modality necessary. Frequently, the viscerosomatic refexes (causing inhibition of the specifc organ-related muscle in AK) involved in insulin resistance were treated with chromium or vanadium or alpha-lipoic acid or other nutrients found to strengthen the inhibited muscles in AK examination. For each of the physical, biochemical, or psychosocial disturbances found, patient education in the form pamphlets and guidance was undertaken by the author (SC). Hormonal imbalances due to liver dysfunctions, thyroid disorders, digestive or gut issues -- and the treatment approaches given (manipulative, nutritional, lifestyle, etc.) -- were explained to the patient at the time of diagnosis. Liver phase 1 or phase 2 detoxifcation procedures were used when necessary to help the body normalize abnormal hormone levels.15,16,20 RESULTS The correlations between the patient's primary physical fndings relating to the menopausal symptomatology are described in Table 1 (3rd column). Additionally, the salivary hormone fndings that were abnormal are listed (Table 1, 4th column). The signs and symptoms that related to the patients menopausal pattern are described as well (Table 1, 5th column). Finally, their change in symptomatology is described (Table 1, 6th column). At the time maximum medical improvement (MMI) was reached (when the chiropractic and AK examination fndings were minimal or absent, and need for continuing treatment of menopausal syndromes was lacking), a judgment by the patient and the author/physician was made about the amount of improvement these treatments achieved. The self-reported symptom change described by the patients at the time of MENOPAUSE AND CHIROPRACTIC CUTHBERT • ROSNER
CJA June 2013
CJA December 2013