As always, after reading Dr. Faye's article on "Motion Palpation and the Research", contact Dr. Faye at (ljfaye@ljfaye.com) and let him know your thoughts.

For the past ten years, it has become more and more evident, that inter-examiner reliability studies of motion palpation, as described by Henry Gillet, Adrian Grice, myself and others, has not been shown to have very good inter-examiner reliability. Proving inter-examiner reliability is not an easy task. Studies conducted on blood pressure readings, x-ray interpretation, and muscle strength evaluation, deep tendon reflex grading, all show poor inter-examiner reliability. All continue to be used because we know high blood pressure, x-ray findings, weak muscles and slow reflexes exist in patients. None of these tests are stand-alone tests; they are part of a diagnostic work up on a patient.

Spinal hypomobilities exist, and in the opinion of many, these "fixations" are the manipulable component of the spinal or extremity joint dysfunction. Those biased against the dynamic concepts that we taught as part of the paradigm shift from the static concepts and procedures, have concluded too much from the inter-examiner reliability studies. The fact remains that a spinal motion unit of two vertebrae must be free to rotate around the three orthogonal axes, in a positive and negative theta direction.

These movements are commonly called flexion, extension, rotation and lateral flexion. Because we are not very good at agreeing on the exact determination of these hypomobilities, does not detract from their significance in spinal manipulation therapy. Biomechanically, audible chiropractic adjustments have been shown to increase the spinal ranges of motion. It is logical to try to determine the hypomobile joints and apply the adjustments into the direction of decreased motion. Since the spinal column is part of a closed kinematic, locomotor system, I believe we should analyze for the dynamic dysfunction and not the curves observed on x-rays that represent an instant of a particular posture. These are two different paradigms.

For me the subluxation is a heuristic model and for the x-ray analysis person it is a mis-alignment that can be measured. I struggle to devise methods to reveal malfunction and they struggle to produce from randomly selected retrospective studies a significant change in the mis-alignment, or to produce prospective studies that show consistent changes in the improved patients.

I wonder how a static curve can change, if the motion units don't move. Movement has to occur first, before the curve can change. It is for this, and many other reasons, I concentrated my study on the detection of biomechanical hypomobilities, to help me direct the adjustive forces. Changing a hypomobility to mobility changes the kinematics of the whole closed kinematic system of the spinal column. Dysfunction anywhere in the system can influence the resting, erect posture of the cervical spine.

The spine is always in dynamic compensation to its' own hypomobilities and pathology. The spine has to be considered an organ with multiple joints controlled by the responses to the afferent neural input to the CNS, from the joints.

The concept of physically trying to adjust curves to a new shape by thrusting into the direction of the so called normal curve, does not fit with the physiological facts that are important to the doctor interpreting from the dynamic paradigm. Medical doctors look at the same set of facts and use what they need to satisfy their paradigm. Pathology exists and creates a need for medical procedures at certain stages of the pathogenesis.

Success!!!!

Dr. Leonard J. Faye.
alias"L John"