Robert Leach's The Chiropractic Theories is now in its 4th edition. That in itself is an indicator. And when it's published by an outstanding company like Lippincott, Williams & Wilkins, then you know you are into a goodie. It must be selling for them to re-publish.
This book is Dr Charmaine Korporaal's favourite chiropractic book. Dr Korporaal is the principal of the chiropractic college at the Durban University of Technology, South Africa.
I had the pleasure and privilege to review the third edition of Dr. Leach's book in 1994, and I find myself privileged to review the fourth. Once again, the author has assembled an impressive array of contributors and an even more spectacular body of knowledge concerning the state of chiropractic theories and their research.
Critics of our profession who perpetually state that there is no research basis for chiropractic need only briefly skim the 463 pages of this edition to find there is an incredible amount of research that has been done, with admittedly, a significant amount yet to do, as acknowledged by Dr. Leach.
The book is divided into five sections.
The first section covers an introduction to subluxation theories. Depending on your chiropractic college and your reading of the literature, some of these theories may be new to you, but by reviewing them all, the author provides the framework for the remainder of the text. The chapters discuss the importance of theories to a profession; the history of the theories, beginning with manipulation prior to the development of the chiropractic profession; chiropractic terminology, including the differing definitions under which our profession operates; and philosophy as a foundation for theory development.
The second section is devoted to chiropractic research principles, beginning with a chapter on principles of measurement, research and statistics. This is an excellent primer on the language of research. For those of us never schooled in this topic, it provides us with the information to better read, understand and utilize the published research.
There is a chapter discussing the strategy for validation of subluxation theories, a proposed minimum process that outlines the consensus process, including guidelines that have been developed and the development of a research agenda for chiropractic. The last chapter in this section talks about research and the scientist practitioner model. Dr. Leach often refers to himself as a scientist practitioner, and in this chapter, he presents the concept of the chiropractor as a clinical observer and researcher in the practice setting. He outlines the types of outcome measures to be used and their reliability. It gives the interested chiropractor an invitation to join in the process and some of the tools to be used.
"That is the essence of science: ask an impertinent question, and you are on the way to a pertinent answer."
- Jacob Bronowski (mathematician)
Section three presents information on experimental and clinical evidence of the subluxation complex model. The chiropractic theories and hypotheses covered include inflammation, segmental dysfunction, instability, immobilization degeneration, neuropathology, somatoautonomic reflex, myelopathy, vertebrobasilar insufficiency, axoplasmic aberration and neuroimmune. No matter what your favorite hypothesis may be, you can be sure it is covered in detail and impeccable referenced. This section also has a chapter on the clinical aspects of manipulative effectiveness, encompassing both differentiated and undifferentiated disorders.
In section four, the topic of wellness is addressed, along with what a wellness model for chiropractic would include. A chapter on the social theory of chiropractic covers the concepts of health, disease, illness and chiropractic's role.
The fifth and final section of THE CHIROPRACTIC THEORIES is dedicated to the future of chiropractic research. In this section, Dr. Leach covers some of the disproven and untested chiropractic theories and hypotheses, and asks the question: Is there experimental and clinical support for VSC? The last chapter poses new questions and explores into what areas research may yet delve.
Overall, the book is very well-written, with tables, diagrams and illustrations that assist the reader in understanding topics not common for many chiropractors. Dr. Leach has done a masterful job in getting a grasp on a subject that grows monthly, and presenting it in a concise and readable fashion. This is a book that belongs on the bookshelf of every chiropractor and chiropractic student. It is a book the profession can be proud to use as a reference.
Stephen Savoie, DC
To purchase THE CHIROPRACTIC THEORIES by Dr Robert A Leach, DC
$76 for the fourth editiion at Amazon. $3 for older edition.
Absolutely core to the Chiropractic Theories is the relatively new understanding that, without adequate joint perfusion, joint cartilage rapidly begins to degenerate. Within thirteen hours in white mice. IMMOBILISATION ARTHRITIS ...
Also important of course is perfusion must be with fluids rich in adequate nutrients and oxygen. Smoking, for example reduces the partial pressure of oxygen in the blood by about 20%, making smoking the single most important factor in failed back surgery. In the Chiropractic management of low back pain too? That would make an interesting research study.
So too adequate nutrients. How is that strawberries can have a significant impact on arthritis? Interesting facts about Strawberries surely has to do at the very least with enhanced nutrition at the cellular level.
It would seem at first glance ridiculous to suggest that chiropractic can help with spinal stenosis. Medicine is focused on inflammatory changes and the presumed physical narrowing of the spinal canal. However, as this Spondylolysthesis CaseFile reveals, the careful, thorough chiropractic management has an enormous role to play. The Chiropractic Theories on the other hand focus on a dynamic spine and pelvis, the limbs...
So too new research has found that the gelatine, easily extracted in the
home from Chicken bones, has a significant impact on aging cartilage.
Whilst the mechanism is not fully understood, it most likely has to do
with perfusion of the cartialge by joint fluids rich in the required
Read more about the the effect on joint cartilage of Gelatine powder for arthritis.
Slowly but surely science is providing backup for the Chiropractic Theories, giving substance to what every chiropractor knows: Subluxations and fixations of joints not only lead to pain. They also result in degenerative arthritis.
For more information about the rationale for Chiropractic Therapy click here. CHIROPRACTIC THERAPY ...
Many insurance companies now only pay for physical therapists to provide a chiropractic adjustment; that's in the face of powerful research proving that inclusion of DCs to perform their own technique would save them a good deal of money. One has to conclude that political medicine has gone off on another tack to contain our profession.
It's being successful with some doctors of chiropractic quitting. Others become involved in some dodgy practices, like demanding that patients sign up for a whole year of treatment in advance, in order to stay in business.
In recessionary times, the going is tough when the insurance won't pay.
Is the day approaching for a new Wilk versus the AMA and the insurance companies?
The chiropractic profession has tried hard to stay on the moral high ground; those who stoop to unscrupulous practices need to be exposed and disciplined if we are not to stoop to the low blows that medicine has often resorted to contain and eliminate us.
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