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Chiropractic Journal of Australia : CJA December 2013
Chiropractic Journal of Australia Volume 43 Number 4 December 2013 131 INTRODUCTION Some have questioned the hypotheses justifying chiropractic involvement in the management of paediatric patients, as well as those with so-called visceral conditions.1-4 This topic was raised recently in a television program by Demasi.5 It is acknowledged that chiropractic constructs have been outside the traditional or orthodox models of understanding. However, there is a major contradiction regarding manipulative management of visceral and paediatric care due to the adoption of those very concepts by other areas of medicine -- namely manipulative medicine. 6-9 In particular, European medical doctors have published refereed papers on these very topics involving spinal manipulation in medical journals and medical textbooks for some decades.10 (Table 1) In an apparent contradictory development, it is primarily English language medical authors and other sources that seem to have attracted critics who direct their reservations at the principles espoused by chiropractors, but not to their European medical colleagues who are proponents of spinal manipulation.11 It is also curious that osteopathic manipulative therapy does not appear to attract the same degree of debate and reservations despite the similarities. There are at least three medical textbooks which include the topics of paediatric manipulative care and the manipulative management of visceral disorders.6-8 One such medical text is totally devoted to paediatric manual therapy.6 INFANTS Perhaps the most obvious medical evidence supporting the intervention of spinal manipulative care of infants is the textbook edited by Biedermann.6 First published in Medical Management of Pediatric and Non-Musculoskeletal Conditions by Spinal Manipulation PETER L. ROME ABSTRACT: There is a well established precedent by medical doctors, particularly in Europe, of managing infant, paediatric and other patients for so-called organic conditions by spinal manipulation. There are also claims that chiropractic should not be involved with this form of management for so-called visceral disorders because it does not quite meet the current orthodox theories. This seems contradictory if not hypocritical when there is noted evidence in the medical literature itself of not only the rationale supporting these concepts, but evidence of medical doctors carrying out the same procedures for the same purpose on the same conditions. PL Rome DC Melbourne Australia German in 1999, it became available in English in 2004. Biedermann was originally a surgeon and subsequently moved to "Conservative Orthopedics" (sic). The textbook is dedicated to manipulative care of paediatric patients and comprises over twenty contributing authors including some ffteen medical doctors. He frst published papers on the topic in a medical journal in 1995 -- over 20 years ago.12 Some may question why an infant would require manipulation. However, chapter 8 of this text deals specifcally with spinal “Birth trauma and its implications for neuromotor development." 13 In addition, in witnessing a birth, one is immediately aware of the potential for cervical spine strains and sprains, even in those where forceps are not used - situations well noted by Sacher.13 Another medical doctor, Lewit, has published on the topic of spinal manipulation with specifc notes on the manipulation of children. This textbook has been published in at least seven languages following his original Czech edition in 1966. His text notes the importance of the craniocervical junction in new-born babies.7 One can assume that infants also suffer headaches, especially cervicogenic ones. An often rapid positive response noted by parents of an unsettled infant to a careful neck manipulation, can be apparent. The chiropractic literature is also replete with such anecdotal observations and case reports.14-16 PAEDIATRICS Not only does Biedermann's text of 334 pages comprehensively explore the manipulation of children when indicated, he also specifcally notes a manipulative role for infants. The contributing authors also cite numerous references covering a wide variety of conditions.6 In other references dating back to 1956, Lewit also presents a discussion on the manipulation of children in his text. He INDEX TERMS: (MeSH): CHIROPRACTIC; MANIPULATION, CHIROPRACTIC; MANIPULATION, ORTHOPEDIC; MANIPULATION, MUSCULOSKELETAL; MANIPULATION, SPINAL; PEDIATRICS; EVIDENCE BASED MEDICINE. (Other): MEDICAL MANIPULATIVE THERAPY. Chiropr J Aust 2013; 43: 131-6.
CJA September 2013