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Reproduced with permission, from
the Canadian Chiropractor - February and March 1999
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______________________________________________________________________
by
Donald Epstein, D.C. and Anthony Posa, D.C.
"Network Spinal Analysis ™,
developed by Donald M. Epstein, D.C.,1
is an approach to health and wellness utilizing long standing chiropractic
methods and employing certain principles of quantum mechanics 2,
neuroanatomy, and neurophysiology, 3,
4, 5 psychoneuroimmunology 4,
and changing perspectives in health care." 5,
8
It is founded on the premise
that individuals free from the complex of factors precipitating from, or leading
to vertebral subluxations, experience a greater range of inherent adaptability
and hence, a greater sense of relative health or wellness.
INSPIRED BY D.D. PALMER
Network Spinal Analysis ™
is
inspired by D.D. Palmer's concept of tone being associated with tension on the
neuroskeleton and of consciousness being associated with nerve vibration. 9
It is also consistent with Bar's model of multiple cord pressures, and the
relationship of the meninges to the vertebral subluxations 10,
and his model of vertebral subluxation including the element of mental impulse.
At the core of its vertebral subluxation model is the categorization of
vertebral subluxations into two categories: a) facilitated b) structural.
PRIORITY SYSTEM
OF ADJUSTING
Once the type of subluxation has
been identified, a priority system of adjusting is initiated. This sequencing of
adjustments is termed the Phasing system.
The specific order of adjusting
suggested by the phasing system is applied over time. The point of critical
tension is sought. This refers to the site from which the adverse spinal cord
tension and nerve interference is generated. The regions of facilitation and
fixation are generally seen as adaptations to this region. Particular types of
force applications and characteristic outcome assessments evolve over a series
of Levels of Care. 11
LEVELS OF CARE
All Levels of Care utilize
aspects of contemporary chiropractic techniques and share the following
features:
a) Assessment of the patient's
spinal and neural integrity and health through a case history which includes
various lifestyle and stress history profiles, and physiologic and chiropractic
examination
b) Determination of progress
through periodic reassessments and questionnaires to monitor patient and
practitioner outcomes
c) Modification of any Level of
Care deemed to be ineffective or inappropriate to a level which more accurately
parallels the changes observed in the patient This article will explore these
concepts, along with the somatopsychic responses produced by the body in its
self corrective process.
REACTIVE, RESPONSIVE NERVOUS
SYSTEM
An objective of care is for the
central nervous system to be more self reflective, increasing its capacity to
detect and resolve areas of spinal tension, interference and subluxation.
Through a program of care the body appears to increase its energy efficiency in
achieving reduction of adverse mechanical spinal cord tension, and its
associated vertebral subluxations. The clinical perspective is on the body's
self-corrective, self-organizing strategies. Both the doctor and patient are
striving for a more reactive, responsive nervous system which is more capable of
automatically utilizing formally invasive experiences and forces in constructive
self corrective fashion.
GENTLE ADJUSTMENT IS GIVEN
Corrections are made by the
body's own movement, respiration and modulating tension patterns. Gentle
adjustments are given to directly correct vertebral subluxations in the context
of enhanced spinal and neural integrity. As the patient progresses through the
Levels of Care a greater awareness of one's body, its tension patterns, its
self-correcting capacity and enhanced quality of life is anticipated.
INCREASED FLEXIBILITY OF THE
SPINE
"Network Care evokes
spontaneous self-perpetuating contractions of the paraspinal musculature. The
movements may be subtle, barely perceptible, or very obvious and may involve the
arms and legs. Over a period of several months, physiological and psychological
changes have been observed clinically, including increased flexibility of the
spine, increased range of motion, improved mood, and sense of relaxation, self
reported "wellness" and greater capacity to cope with stressful
situations. These observations provide the basis for considering that Network
Care involves body-mind interactions. 12
WAVE PHENOMENA DEVELOP
Two characteristic wave
phenomena develop with NSA. They are the Respiratory and Somatopsychic waves ™,
which are suggested to be an effective means of dissipating energy, from the
subsystems which maintain spinal integrity." The Respiratory wave is
associated with a spontaneous breathing pattern involving a deepening and
rhythmic expansion of the thorax with rocking of the cranio-sacral system. This
wave progresses upwards from the sacrum, the passive sub system of the spine has
the opportunity to increase its motion, breaking down the negative feedback loop
that may exist between the spinal integrity subsystems.
QUALITY OF LIFE IS ENHANCED
A most common consequence of
this is the reduction of elimination of facilitation and spinal fixation. The
somatopsychic wave ™ progresses in a sine wave fashion, specifically moving as
muscular undulations of spine. It rocks segments through their motion, often
coupling individual vertebral oscillators. Patients have reported a significant
enhancement of their health and quality of fife once they have experienced these
wave processes.
CURRENTLY BEING EVALUATED
These waves are of such
considerable interest that they are currently being evaluated at the University
of Southern California, Department of Engineering in a research project titled
Chaotic Modeling in Network Spinal Analysis ™. A population of patients receiving
NSA care is being used to mathematically define the wave and its potential
benefits to determine how living systems self organize.
ADDRESSED THROUGH THE PHASING
SYSTEM
The concept of adverse
mechanical cord tension is introduced in relationship to the facilitated
subluxation. This is consistent with Alf Breig, M.D.'s model of elongation of
the spinal cord in the planes of flexion-extension and lateral bending with
pathophysiologic consequences 14.
The facilitated subluxation is addressed prior to the correction of the
structural (inter-segmental) distortion. The facilitated subluxation is
consistent with concepts of multiple cord tensions and is theorized to be in
relationship to dural tension. The occiput through sixth cervical, sacrum and
coccyx subluxations are addressed through the Phasing system. It is the
vertebral meningeal attachment that is of considerable concern as aberrant
mechanics at these levels are often in relationship to a more generalized
facilitation of the central nervous system and the musculature.
INITIATES CHANGE
It is commonly observed that a
contact taken on one end of the spine can initiate changes at a remote part that
visit. For example a specific sacral "notch" contact taken medially
may immediately influence the thoracic musculature to dissipate tension, develop
a full and deep full spinal respiration, and rock a specific cervical segment
through its precise range of motion as predicted by the chosen adjustment.
As spinal segments synchronize
their motion, or oscillate, improvements may be seen in spinal hypertonicity,
vertebral alignment, posture, and indicators for vertebral subluxation.
Evaluation of parameters such as
extremity tension seen as resistance to flexion-extension or lateral bending of
the heels, impaired movement of spinal segments in association with respiration,
paraspinal musculature hypertonicity, and postural adaptations are a few of the
indicators suggesting such a disturbance. 15
Spinal and Neural Integrity is
associated with the ability of four sub systems to remain highly reactive to
change, and able to share energy and information between one another. These sub
systems include the Passive (vertebrae, ligaments, discs), Active (spinal
muscles and tendons) and Control (Nervous system) of Panjabi. Epstein suggests
the meninges as a part of the Control system including adverse mechanical cord
tension within this system.
LOSS OF SPINAL AND NEURAL
INTEGRITY
In addition, Epstein adds a
fourth Emotional Subsystem. This subsystem is composed of the composite of
tissue tension and a restriction within its range of oscillation or movement.
When tissues of the spine including the connective tissue can not move through
its full range of motion or oscillate effectively this is associated with a loss
of spinal and neural integrity.
When the spinal tissues can more
freely oscillate and or release their tension, then there is a dissipation of
tension from the emotional sub system significantly enhancing spinal and neural
integrity 16.
This may be accompanied by a cathartic expression of emotion, or by large
paraspinal muscle movement, and an enhanced respiration. Reduction of the
effects of vertebral subluxation are a common consequence.
SPARKED ACADEMIC INTEREST
As adverse mechanical cord
tension is resolved through the application of NSA, coordination of spinal
oscillators occur. This means that individual segments will entrain their
rocking in a synchronous fashion. The entrainment of coupled oscillators is a
prominent topic in current neurophysiologic research as it applies to
spontaneous pattern generation. This progressive spontaneous entrainment of
spinal oscillators has sparked the interest of a variety of academic
researchers.
No specific structural
adjustments are initiated until the individual segments are rocking through
their own range of motion with the appropriately entrained segment.
DISSIPATE TENSION
In Level One of care, the spinal
structures learn how to dissipate tension and reduce chronic facilitation. In
Level Two of care, the body develops two entrained spinal oscillators with a
resulting correction of chronic vertebral subluxations. In Level Three the
patient is even more participatory in the corrective process as the body learns
through the use of positioning and long lever arm maneuvers to spontaneously
self correct the transitory subluxations in the absence of chronic distortion.
Progressive coupling of
oscillators tends to amplify the signal exchanged between them, suggesting a
more self-attentive nervous system. The more frequency entrained oscillators
there are within a system the more difficult it is to interrupt by external
stimuli, and the more stable the relationship between the two synchronized
elements (vertebrae) may become.
STATE OF READINESS
NSA does not adjust the segments
of maximum fixation, discomfort or pain. It suggests adjustments once the
central nervous system appears to have a better awareness of the segment, and
can initiate its gentle rocking through its motion with respiration. This must
be accompanied by a state of readiness of the spine in assisting the body to
correct the subluxation. With progression through subsequent Levels of Care the
body increases its ability to recognize tension, distortion and subluxation
patterns and generate subtle movements, and respirations to spontaneously self
correct.
PRODUCE VERTEBRAL CORRECT10N
It is common for audible
releases to occur as articulations release their distortion in response to
gentle contact adjustments distal to the contact. Eventually utilizing subtle
long lever arm maneuvers such as positioning die arm or leg body's a precisely
will initiate the own self corrective waves to produce vertebral correction
including a noticeable articular release.
VERTEBRAL SUBLUXATIONS ARE
RESOLVED
It has been suggested that the
inability of the cortex to effectively, perceive a stressor results in a limbic
and spinal response recirculating the energy which was not fully experienced.
Adverse mechanical spinal cord tension is proposed by Epstein to be a mechanism
for storing the energy often in relationship to vertebral subluxations. As the
central nervous system becomes more refined in its ability to be aware of
tension and energy patterns from which it has been segregated, the facilitation
patterns reduce, and spinal compensations including vertebral subluxations are
resolved.
LARGEST STUDY OF HEALTH AND
WELLNESS OUTCOMES
Network Care has been studied
through the Department of Anatomy and Neurobiology, Department of
Otolaryngology-Head and Neck Surgery, College of Medicine, Department of
Sociology, at the University of California, Irvine. 17.
This was the largest epidemiological study of chiropractic patients to date. It
was also the largest study of health, and wellness outcomes for a chiropractic
population. It was amongst the largest studies of any population for self
reported evaluations of health and well being. It also established the initial
validity of a health and wellness and quality of life instrument for a
non-medical discipline.
BENEFITS ARE EVIDENT
The study included 2,818
patients from 156 participating offices of members of the Association for
Network Chiropractic. "The evidence of improved health in the four domains
(physical state, mental/emotional state, stress evaluation, life enjoyment)
over-all quality of life from a standardized index, and the "wellness
coefficient" suggests that Network Care is associated with significant
benefits. These benefits are evident from as early as 1-3 months under care, and
appear to show continuing clinical improvements in the duration of care
intervals studied, with no indication of a maximum clinical benefit." This
indicates that for the population studied clinical benefits accrued over time,
with no ceiling. These findings are being further evaluated through longitudinal
studies of current populations under care in combination with investigation of
the neurophysiological mechanism underlying its effects.
POSITIVE CHANGES IN OVERALL
HEALTH
The study concludes with
"These initial findings show that Network Care is associated with
significant improvement in all indicators of health evaluated, and demonstrate a
strong association between Network Care and self reported, positive changes in
overall health/wellness."
LEADING EDGE OF BODY-MIND
DISCIPLINES
In summary, the self-recognition
of the presence of an impediment to one's health with the ability to
self-correct the offending pathophysiology is a high ideal for any form of
health care. NSA combines a vitalistic, holistic system of precise outcome
assessments for spinal and neural integrity and improvements in health and
quality of life.
Although some research projects
have been performed within our profession, few have specifically documented the
long-term health and wellness benefits of chiropractic, as a non-medical
discipline. The research to date, along with the ambitious projects underway,
and a scholarly textbook in preparation is helping to position NSA at the
leading edge of the body-mind disciplines. A base of enthusiastic support from
the academic community in the fields of neuroanatomy, neurobiology, sociology,
immunology, biochemistry, psychology, radiology, engineering, physics,
endocrinology and mathematics has developed.
"Within the boundaries of
the study design, these findings provide substantial evidence that Network Care
should be included among those practices with established health benefits".18
References
- Epstein, D., The Association
for Network Chiropractic, 444 Main Street, Longmont. Colorado 80501
(return to text) (top
of page)
- Prigogine
L., Order out of
Chaos. New York: Bantam Books, 1994:226-290 (return
to text) (top of page)
- Breig A., Adverse mechanical
tension in the central nervous system. New York: John Wiley & Sons, 1978
(return to text)
(top of page)
- Sunderland
S., Meningeal
neural relations in the intervertebral foramen. J. Neurosurgery 1992;
40:756-761
(return
to text) (top of
page)
- Pert
CB. Neuropeptides, the
emotions and bodymind. Noetic Sciences Review, 1987; 2:13-18
(return to text) (top
of page)
- Black
PH.,
Psychoneuroimmunology: brain and immunity: Scientific American 1995 (Dec.):
16-25 (return to text)
(top of page)
- McGinnis L., Alternative therapies. Cancer
1991;67:1788-92
(return
to text) (top of page)
- Kenny
FW, The consumer's view
of health. J Adv Nurs 1992; 1992;17(7):829-34
(return
to text) (top of page)
- Palmer, DD., The Chiropractor
Beacon Light Press, Los Angeles, Calif. 1914, 1969 edition 17-21
(return to text)
(top of page)
- Boone, WR., Dobson, GJ., A
Proposed Vertebral Subluxation Model Reflecting Traditional Concepts and
Recent Advances in Health and Science. Journal of Vertebral Subluxation
Research Aug. 1977, 1 (1) 19-21 (return
to text) (top of
page)
- Epstein, D.,
Network Spinal Analysis
™: A system of Health Care Delivery Within the Subluxation Based
Chiropractic Model, Journal of Vertebral Subluxation Research, August 1997
1(]) 53-56 (return to text)
(top of page)
Blanks, RH, Schuster, T,
Dobson, M., A Retrospective Assessment of Network Care Using a Survey of
Self-Rated Health, Wellness and Quality of Life., Journal of Vertebral
Subluxation Research 1 (4) 15-16 (return
to text) (top of page)
Epstein, D., Theoretical
Basis and Clinical Application of Network Spinal Analysis™ (NSA), September
1996, VIII. Innate Intelligence, Inc. p 9 (return
to text) (top of
page)
Breig
A., Adverse mechanical
tension in the central nervous system, New York: John Wiley & Sons, 1978
(return to text)
(top of page)
Epstein, D.,
Network Spinal Analysis™: A system of Health Care Delivery Within the Subluxation-Based
Chiropractic Model, Journal of Vertebral Subluxation Research, August 1997
1(1) 53-56 (return to text)
(top of page)
Epstein, D., Theoretical
Basis- and Clinical Application of Network Spinal Analysis™ (NSA), September
1996, VIII Innate Intelligence, Inc. p 9-10 (return
to text) (top
of page)
Blanks, RH, Schuster, T,
Dobson, M. A Respective Assessment of Network Care Using a Survey of
Self-Rated Health, Wellness and Quality of Life. Journal of Vertebral
Subluxation Research 1(4) 15-30 (return
to text) (top of page)
ibid
p.28 (return to text)
(top of page)
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