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Principles and Philosophy IV- #22040


 

 
Mary M. Tuchscherer, D.C., Ph.D.
2.0
30
2.0
0.0
Discussion of current scientific literature regarding chiropractic principles and philosophy of the subluxation model. Neuromusculoskeletal and visceral conditions are discussed with the subluxation model of facilitation and adaptation in mind. Particular emphasis is placed on evidence related to the reciprocal influence between dysfunction of the neuromusculoskeletal system and related dysfunction in other systems. The influences of subluxation and the effects of chiropractic care and adjustment on the health of the entire body are also stressed.
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    Graduates will acquire, appraise and apply scientific information. Graduates will contextually organize and synthesize relevant information to address an issue or problem.
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    Graduates will demonstrate competence of appropriate depth and scope for one's discipline.

Course Objectives
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  1. Define, discuss, and explain scientific validation/principles of: subluxation, subluxation complex, subluxation syndrome, adjustment, manipulation, somatovisceral reflexes, and viscerosomatic reflexes.
  2. List and describe the clinical reasons or presentations necessary to warrant adiographic study of the patient. Further, the student will have explored and discussed various chiropractic techniques and the pros and cons of radiographic examination
  3. Explain the neurology of referred pain, neurogenic inflammation, the functioning of the muscle spindle and golgi tendon organs, and the relationship between the nervous endrocrine and immune system. Further, the student should be able to discuss the relevance of these concepts to the practice and validation of chiropractic.
  4. Discuss the chiropractic philosophies of the major figures in chiropractic: D.D. Palmer, B.J. Palmer, Ralph Stevenson, W. D. Harper, Solon Massey Langworthy, Oakley Smith, Minora Paxson, Willard Carver, A. Earl Homewood, C.O. Watkins, Joseph Janse, Fred Illi, Henry Gillet, Herbert Junghanns, C. Gonstead, G. Goodheart, F. Grostic, and any others brought up in discussion.
  5. Define the traditional chiropractic theories and be able to discuss what scientific or clinical studies support or refute attributes of each
  6. Present their philosophy of chiropractic and its practice in written and visual form. They will present to the class a pamphlet suitable for presentation to new patients inquiring about the type of practice the student envisions. Class discussion will critique all aspects of the pamplet.
  7. Listen to, and critically appraise all view points regarding chiropractic presented in class and incorporate the outcome of their appraisal into a growing and developing personal philosophy of chiropractic.
Materials
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A. Required Text(s):
  • Subluxation Secon Edition, Meridel Gatterman
  • Class notes: The Neurobiology of Pain: Integration with Touch, Motor Systems, and the Immune System, Dr. Mary M. Tuchscherer
  • Class notes: A Brief Review of the Chiropractic Theories and Their History, Dr. Mary M. Tuchscherer
  • Various research papers as provided
    B. Recommended Text(s):
  • Leach: The Chiropractic Theories, Fourth Edition
    C. Required Materials for Lab:
  • NA
    • Assignments
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    A. The student will prepare a pamphlet describing the student's current "ideal" practice, suitable for public dissemination. It should include a practice name, location, and hours; brief philosophical statement; description of the techniques employed by the practitioner; and other details as suit the practice's unique qualities and characteristics.

    B. The student will submit a brief review of one or two research articles outlining the specific chiropractic hypothesis/es being tested. Also, the student will write a brief review of the article for patient consumption.

    C. The student will participate in creating a group Power Point presentation of a Chiropractic RCT. The details of this project will be handed out in class.
    Attendance
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    Attendance is required at all class sessions, attendance must be proven at at least 80% of the term's meetings.
    Grading Criteria
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    1. Midterm Projects: A and B in the Assignment list.
    2. Final Examination: TBA
      Short answer/essay format - Open resources available
    3. Up to twenty percent of the students' grade may be deducted based on the subjective criteria of participation in class discussion and respectful behavior around peers and the instructor.
      4. Disposition of such points is made solely by the instructor and is final.

    Guaranteed grades are as follows:

    A = Greater than 90%
    B = 80-89.5%
    C = 70-79.5%
    D = 65-69.5%
    F = Less than 65%
    Course Competencies
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    -1. The student will demonstrate competency in both written and verbal assignments. Writing and speech will be assessed by the instructor.

    -2. The student will demostrate, in writing and speech, the ability to articulate clear ideas about chiropractic philosophy and their own personal opinions and thoughts about the philosophical viewpoints.

    COGNITIVE DOMAIN


    In this course, the student will be responsible for the following:

    1. Identifying and giving the definitions of subluxation given by allopathic medicine and chiropractic medicine.
    2. Identifying, defining, and discussing the terms: adjustment, manipulation, and mobilization.
    3. Giving rationale for the use of specific terms like subluxation and adjustment.
    4. Defining the normal structure attributes of the joint, particularly the joints of the spine.
    5. Identifying those parts of the structural joint (especially spinal joints) involved in subluxation.
    6. Defining the normal neurophysiological attributes of the joint, especially joints of the spine.
    7. Identifying those neurophysiological components of a joint that are altered in subluxation.
    8. Define the major differences between subluxation and subluxation complex.
    9. Define normal neurological reflexes and give examples of each: somatosomatic, somatovisceral, viserosomatic, and visero-visceral reflexes.
    10. Explain in both scientific and lay terms how subluxation may affect the reflexes described above.
    11. Ciite current literature of scientific principles which support arguments linking subluxation in certain disease manifestations such as: otitis media, gastric ulcer, asthma, IBS/IBD, infertility, endometriosis, stress incontinence.
    12. Discuss the chiropractic philosophy of health and disease.
    13. Define innate intelligence as it relates to health of the body.
    14. Define quantum physics and discuss its interpretation of what innate is.
    15. Define the major chiropractic theories and the main person or persons articulating each of the theories: facilitation, somatoautonomic disfunction, and alteration of axoplasmic flow.
    16. Define the historical chiropractic theories and discuss how these have been incorporated into the modern concepts of segmental and regional dysfunction: spinal irritation and fixation concepts.
    17. Define the four models of chiropractic subluxation as discussed by Robert Mootz in Gatterman: Biomechanical, neurogenic, trophic, and psychosocial models.
    18. Define the neuroendocrine and neuroimmune systems.
    19. Define what is meant by psychoneuroimmunology.
    20. Define stress as discussed by Hans Selye and define the endrocrine system model of the effects of stress on the body.


    Conditions:
    -
    Clinical
    Condition    		 Etiol. &
    Epidem         		Patho-physio Nat. History
    & Course    		 Exam &
    Dx     		RX/Mgmt
    Asthma
    2
    2
    2
    1,2,3,4
    1,6
    Carpal Tunnel
    syndrome
    2
    2
    2
    1,2,3,4
    1,6
    CA, metastatic
    bone
    1
    1
    1
    1,2,3,4
    1,6
    Colds
    2
    2
    2
    1,2,3,4
    1,3
    Colic, infantile
    2
    2
    2
    1,2,3,4
    1,6
    Endometriosis
    1
    2
    2
    1,2,4
    1,3,5,6
    Gastric ulcer
    1
    2
    2
    1,2,3,4
    1,2,5,6
    H, C-tension
    2
    2
    2
    1,2,3,4
    1,6
    HA, migraine
    1
    1
    1
    1,2,3,4
    1,6
    IBS/IBD
    1
    2
    2
    1,2,4
    1,3,5,6
    IVDS
    3
    3
    3
    1,3,5,6
    1,6
    Lumbalgia
    2
    2
    2
    1,6
    1,6
    Otitis media,
    serous
    2
    3
    3
    1,3,5,6
    1,3,5,6
    Radiculopathy
    3
    3
    3
    1,2,3,4
    1,6
    Sciatica
    2
    2
    2
    1,2,3,4
    1,6
    Stress
    Incontinence
    1
    2
    2
    1,2,4
    1,3,5,6

    The following codes refer to the depth of coverage for Etiology and Epidemiology;Pathophysiology, and; Natural History and Course:

    0 No coverage or content
    1 Introduction, without test items
    2 Moderate class discussion and/or handout material, with test items
    3 Extensive discussion and/or handout material, with test items


    For Exam and Diagnosis, the following numbers indicate which aspects of exam and diagnosis of each condition are taught in this course:


    1 Presenting SX: Presenting symptoms related to condition are discussed
    2 History findings: Relevant personal and family history are discussed
    3 Exam findings: General physical exam findings are discussed
    4 Chiro. findings: Posture, subluxation, muscle tone and length, trigger points
    5 Lab findings: Blood, urine, CSF
    6 Imaging findings: Normal, CT, CAT, MRI
    7 Special test: eg-sweat test for cystic fibrosis, spirometry for asthma


    For Treatment/Management, the following numbers indicate which aspects of treatment and management of each condition are taught in this course:


    1 Chiropractic: Adjustments, soft tissue techniques
    2 PT: Physical therapy modalities of all types
    3 Nutrition/Supplement: Diet and supplement recommendations
    4 Exercise: Stretching, strengthening, aerobic exercise recommendations
    5 Lifestyle Management: Stress reduction, smoking cessation, allergen avoidance
    6 Medical: Drugs, antibiotics, surgical procedure, radiotherapy
    7 Other: Acupressure/puncture, massage, homeopathic or herbal Rx...
    8 Guidelines: If published, dp you refer to them regarding this condition?


    The following codes refer to the depth of coverage for Etiology and Epidemiology; Pathophysiology, and Natural History and Course:

    0 No coverage or content
    1 Introduction, without test item
    2 Moderate class discussion and/or handout material, with test items
    3 Extensive discussion and/or handout material


    For Exam and Diagnosis, the following numbers indicate which aspects of exam and diagnosis of each condition are taught in this course:

    1 Presenting SX: Presenting symptoms related to condition are discussed.
    2 History findings: Relevant personal and family history are discussed.
    3 Exam findings: General physical exam findings are discussed.
    4 Chiro. findings Posture, subluxation, muscle tone and length, trigger points.
    5 Lab findings: Blood, urine, CSF...
    6 Imaging findings: Normal. CT, CAT, MRI...
    7 Special test: eg-sweat test for cystic fibrosis, spirometry for asthma.


    For Treatment/Management, the following numbers indicate which aspects of treatment and management of each condition are taught in this course.

    1 Chiropractic: Adjustments, soft tissue techniques
    2 PT: Physical therapy modalities of all types
    3 Nutrition/Supplement: Diet and supplement recommendations
    4 Exercise: Stretching, strengthening, aerobic exercise recommendations
    5 Lifestyle Management: Stress reduction, smoking cessation, allergen avoidance..
    6 Medical: Drugs, antibiotics, surgical procedure, radiotherapy..
    7 Other: Acupressure/puncture, massage, homeopathic or herbal Rx...
    8 Guidelines: If published, dp you refer to them regarding this condition?


    PSYCHOMOTOR DOMAIN


    Enter text here.

    AFFECTIVE DOMAIN


    In this course the student is expected to use respectful, professional language and behavior in discussing a variety of philosophical and personal opinions regarding the science and art of chiropractic. It is the objective and goal of the course director to stimulate meaningful and lively discussion around rather controversial aspects of chiropractic science and philosophy. Therefore, the long term goal will be to allow the respectful practice of professional argument, cause and effect and conjecture based on sound basic science principles.
    Weekly Calendar of Learning Objectives
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    Week Dates Topics/Learning objectives
    Week 1 - Review of the definitions of subluxation and adjustment, using chapter 1 in the Gatherman text and other resources as needed. Review the definitions of subluxation given by the allopathic and chiropractic establishment. Identify differences and similarities. Review the definition of adjustment and compare contrast with terms manipulation and mobilization. Discuss the question: " Why does chiropractic use these words to define what it treats and how it treats it?"
    Week 2 - Discuss the various aspects of the chiropractic subluxation; structural dysfunction/dysrelationship; physiological dysfunction; neurophysiological dysrelationship. Review normal joint physiology and PNS/CNS features maintaining joint function. DIscuss the difference between subluxation and subluxation complex.
    Week 3 - Continue discussing the various aspects of chiropractic subluxation: neurological reflexes involved: somato-somato reflexes, somato visceral reflexes, osomatic reflexes, viscero visebral reflexes. Various conditions will be discussed in order to demonstrate these reflexes. Acute otitis media, autonomic response to acute trams, possible involvement od subluxation in the etiology of gastric ulcer, asthma and IBS/IBD; relationship of subluxation to various reproductive and pelvic visceral dysfunction-PMS/Dysmenorrhea, infertility, endometriosis and stress incontinence.
    Week 4 - Continue Week 3 objectives. Answer the question: "What about the chiropractic view of health and disease is different from the allopathic view of health and disease?"
    Week 5 - "What is the innate intelligencea? Where does this concept come from?" We will briefly introduce quantum physics and relate this to the roots of chiropractic "metaphysics". Discussion of early 20th century thought regarding health, disease and the place of soul will be compared to what was going on in basic mechanistic science models.
    Week 6 - Quantum physics as discussed by Deepak Chopra, MD. We will listen to a tape by Dr. Chorpa and discuss its relevance to the chiropractic philosophy of health and disease.
    Week 7 - MIDTERM EXAMINATION
    Week 8 - Reviewing the literature, classic and recent, validating the chiropractic view of subluxation theory. Using Gatterman, Chapter 3, and other resources from the notes, we will look at the major theories of chiropractic and discuss basic science studies to support their claims.
    Week 9 - Continue week 8 objectives, adding discussion of Compression hypothesis, axoplasmic flow, hypothesis and somato autonomic reflex hypothesis. Discussion of the hiopotheses and the current understanding of segmental and regional spinal dysfunction. Discuss the models; bromechanical, neurologic trophic, psychological.
    Week 10 - Discuss the global effects of subluxation on the body. Review normal neuro endocrine and neuroimmune system relationships. Begin to look at the relationship of emotion to disease.
    Week 11 - Discussion of psychoneuroimmunology and the work of Patricia Brenman and Jay Traino using well controlled models of chiropractic adjustment on specific immune function. Discuss how stress influences the endrocrine system. How is subluxation a stressor? Discussion of Selye's definition of stress.
    Week 12 - View tape by Patch Adams, MD. Discuss his view of health and disease and how it relates to chiropractic.
    Week 13 - Review of the concepts discussed since the midterm. Using examples of patient presentation, discuss which hypothesis of subluxation best explain the patient's condition and how adjustment will help correct the problems.
    Week 14 - FINAL EXAMS
    Week 15 - FINAL EXAMS
    Please Note
    This schedule of lecture and lab topics and quizzes and exams may be changed during the course of the trimester as circumstances require. Whenever possible, such changes will be announced in class before the date and time in question. You are responsible for anything that transpires during lectures and labs, even when you are unable to attend. In the event that you miss a class session, make sure you check with a classmate about any announcements or schedule changes which may have been made. Makeup exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.
    Maintained by Northwestern College of Chiropractic
    Last updated:10 January 2007
     

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