Modes of Adjustive Care
RECOMMENDATION – Unchanged
Attempts have been made by certain regulatory and licensing agencies, state boards, insurance companies and managed care organizations to categorize certain chiropractic technique systems as more efficacious than others. These categorizations are then used to disallow the use of the technique, deny entrance into a managed care program or sanction the chiropractor for utilizing such a technique. Many times these categorizations are based upon such items as whether they are part of the regular educational program at chiropractic institutions and/or are substantiated by the existence of peer reviewed literature.
Since the Missions of chiropractic educational institutions and programs are not uniform, it is unrealistic to expect that all institutions would expose their students to specific techniques. Further, additional techniques are offered through the postgraduate programs of many chiropractic institutions, state association conventions and various other educational programs affiliated with the profession.
Since there are purported to be over 300 named techniques in use within the profession it is unrealistic to expect that every chiropractor would be proficient in each of these techniques. Lastly, these 300 plus techniques have not been compared to one another in such a fashion that any individual or group could ascertain that one technique is more efficacious than another.
Given the state of research regarding the efficacy of techniques and technique systems the best empirical evidence suggests that direct and indirect measures of outcome related to vertebral subluxation and its components are the manner to best determine efficacy of technique application. Examples of these include various health outcomes, physical, biomechanical and physiological measurements – many of which are discussed in these guidelines.
Conclusion - Unchanged
_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision