Capstone week 4

Recruitment

Recruitment - additional muscle fibers brought to task Slow twitch fibers - aerobic Fast twitch fibers - anaerobic Muscle motion - Contraction - moves insertion of muscle towards origin (fixed) Levers - 1 st class lever - fulcrum between force and resistance 2 nd class lever - resistance between fulcrum & force 3 rd class lever - force is between the resistance & fulcrum

Quadriceps

Rectus femoris Vastus lateralis Vastus intermedialis Vastus medialis Muscles of Trunk Abdomen Rectus abdominus External oblique Internal oblique Transverse abdominis Muscles of erection Iliocostalis Longissimus Spinalis Muscles of respiration Diaphragm External intercostals Internal intercostals

Reflex arc

Reflex arc - impulse received into spinal cord on afferent neuron, passed along by associative neuron, and motor response back out on efferent neuron without going to brain for response

Synaptic cleft

Synaptic cleft - space between the transmitting nerve and the receiving nerve Synaptic vesicles - in terminal branch, contains neurotransmitters such as acetylcholine (specific to skeletal muscle) Receptor - receives neural impulse by way of the neurotransmitters

Nervous System

Nervous System Neurons Irritability & conductivity Simplest component of nervous system Efferent (motor) neuron, descending tract, anterior horn Association neuron, intermediary, between the two Afferent (sensory) neuron, ascending tract, posterior horn Composed of: Dendrites - receive stimulus & pass it to cell body Cell body -- Axon - carries impulse to terminal branch Myelin sheath - fatty covering on axons, enhances impulse speed Nodes of Ranvier - gaps in myelin sheath, enhances speed of impulse Schwann's cell - covering of myelin sheath Terminal branch - end of nerve, interfaces with another nerve at the synaptic cleft

Proprioception

Proprioception - pass along information regarding status of joints

Muscles of TMJ

Muscles of TMJ Temporalis Masseter Medial pterygoid Lateral pterygoid

Chiropractic: Principles/Philosophy

1904-Palmer extrapolated concepts into the "Innate Intelligence" and "Educated Intelligence" of human organism. Positing Innate Intelligence as a fraction of Universal Intelligence (God), chiropractic theory served to unite the "material and the immaterial," contrast to atheism of medicine • Final theory of chiropractic preserved vitalism-through-the-nerves idea that proposed skeletal misalignment caused nerves to be stretched/slackened altering vibrationally mediated nerve impulses sent to end organs

Chiropractic: Principles/Philosophy

1904-Palmer extrapolated concepts into the "Innate Intelligence" and "Educated Intelligence" of human organism. Positing Innate Intelligence as a fraction of Universal Intelligence (God), chiropractic theory served to unite the "material and the immaterial," contrast to atheism of medicine • Final theory of chiropractic preserved vitalism-through-the-nerves idea that proposed skeletal misalignment caused nerves to be stretched/slackened altering vibrationally mediated nerve impulses sent to end organs • Principles favored by Chiropractors are: • Chiropractors often express their holistic beliefs by asserting a reciprocal relationship between the structure and function of the body • As well, chiropractors have traditionally adhered to belief that patient, rather than disease should be focus of doctor's concern • Chiropractors have drawn distinction between the "allopathic subluxation" and "chiropractic subluxation", which involves some impact upon the function of nerves passing through or otherwise influenced by associated joint structures

APPLIED KINESIOLOGY

APPLIED KINESIOLOGY • Triad of Health -- • structural, • chemical, and • mental or spiritual factors • explain the cause of health problems. • AK practitioners integrate their treatment of patients with these other specialties. Although health problems usually develop on one side of the triad of health, over time the initial problem usually involves the other two sides. APPLIED KINESIOLOGY • Some of the stimuli that change muscle function are as follows: • Myofascial dysfunction (microavulsion and proprioceptive dysfunction) • Peripheral nerve entrapment • Spinal segmental facilitation and deafferentation • Neurologic disorganization • Viscerosomatic relationships (aberrant autonomic reflexes) • Nutritional inadequacy • Toxic chemical influences • Dysfunction in the production and circulation of cerebrospinal fluid • Adverse mechanical tension in the meningeal membranes • Meridian system imbalance • Lymphatic and vascular impairment

ASIAN BODYWORK TECHNIQUES

ASIAN BODYWORK TECHNIQUES Channels or meridians are pathways for Qi or energy to flow • Flow through all parts of body, inside and out • 12 primary channels, 8 extraordinary vessels, other energy networks identified in Chinese medicine • Channels flow through body according to natural, rhythmic cycle • 365 classical pressure or acupoints located along major energy channels • Acupoints -- Places where Qi can collect, be influenced by applying pressure • Used for diagnosis, treatment of energy imbalances • ABT systems use pressure on points, applied with thumb, fingers, or elbow ASIAN BODYWORK TECHNIQUES - TUI-NA • Tui Na, literally "pushing and pulling," refers to a system of massage, manual acupuncture point stimulation and manipulation. • Components of Chinese Massage • The idea of qi is extremely broad, encompassing almost every variety of natural phenomena. • • A distinct aspect of Tui Na is the extensive training of the hands necessary for clinical practice. The practitioner's hands are trained to accomplish focused and forceful movements that can be applied to the various areas of the body. Techniques such as pushing, rolling, kneading, rubbing, and grasping are practiced repetitively until they become second nature. ASIAN BODYWORK TECHNIQUES - ACUPRESSURE INTEGRATION Acupressure: form of Asian Bodywork Therapy (ABT) that stimulates acupoints along energy meridians by applying manual pressure Acupressure massage integration (AMI) combines principles, techniques of acupressure with standard Western massage • To apply massage techniques region by region along major energy pathways feeling for signs of kyo (deficiency) or jitsu (excess), pressing important acupoints • Areas needing attention require appropriate techniques to restore energy balance, flow • Practitioner must keep intention in mind to guide energy as needed — energy follows intention ASIAN BODYWORK TECHNIQUES - ACUPRESSURE INTEGRATION Experience suggests that kyo or jitsu point left untouched will turn into myofascial trigger point • 72% of trigger points (TrP) are on acupoint sites Use combination of classic Western massage, Asian bodywork techniques • Any number of technique variations may be effective for AMI • Rather than follow precise protocol, keep in mind intent of techniques, choose those that accomplish goals • Essential in AMI to apply techniques specifically to energy meridian pathways, acupoints ASIAN BODYWORK TECHNIQUES - QI GONG Qi Gong is relevant to medicine in three specific areas. • Cultivate the demeanor and stamina to enable him to perform the strenuous activities of Tui Na, • to sustain the constant demands of clinical practice, • to quiet the mind to facilitate diagnostic perception. Cultivating the practitioner's ability to safely transmit qi to the patient. Patients may be taught to do sp Patients may be taught to do specific Qi Gong practices that are useful for their illnesses. • Address relaxation of the body, regulation or control of breathing, and calming of the mind. E

ASIAN BODYWORK TECHNIQUES

ASIAN BODYWORK TECHNIQUES • Tui-Na - One of the eight branches of TCM • An-Ma • Acupressure Integretation • Qi Gong Different systems of Asian Bodywork Therapies (ABT) evolved over centuries, but all share same underlying theory • China: acupressure (stimulation of acupoints), tuina (traditional Chinese massage) • Japan: anma (traditional Japanese massage), shiatsu (finger pressure) • Scope of ABT includes assessment, treatment of energetic imbalances according to Chinese medicine theories ASIAN BODYWORK TECHNIQUES ABT techniques include • Touching • Pressing • Holding along meridians and/or on acupoints • Stretching • Application of medicinal plant foods • Application of heat or cold • Dietary methods Roots in Chinese Medicine • Qi (life energy, • meridians (channels of energy), • acupoints (points of contact with Qi) ASIAN BODYWORK TECHNIQUES Spread beyond Asia • Arrived in Europe in 13th century via The Travels of Marco Polo • Jesuit missionaries returning from Imperial China to Europe in 17th century • Immigrants from Asia brought knowledge of Chinese medicine throughout world • 1950s: Toru Namikoshi brought shiatsu to US • 1970s: number of teachers introduced different forms of ABT into US, other Western countries ASIAN BODYWORK TECHNIQUES Yin and Yang illustrate connection to universe; Yin/Yang symbol depicts movement, change in universe • Yin is (relative to Yang) dark, deep, dense feminine, interior, still, cool, contracting • Yang is (relative to Yin) light, energetic, ethereal, masculine, exterior, moving, warm, expanding • opposition, interdependence, consuming/ supporting relationship, intertransformation, infinite divisibility QI: Continuous form of energy in material form when it condenses, nonmaterial when it disperses • Chinese character for Qi is rice cooking in pot with stream escaping • Life energy extracted from food, air • Transformed into Qi that circulates through network of channels in body

AYURVEDA BODYWORK

AYURVEDA BODYWORK Ayur (life) + Veda (science/knowledge) = The knowledge of life Maybe the oldest complete health system Principles and Philosophy • Ayurveda is the art of daily living in harmony with the laws of nature. The objective of Ayurveda is to correct imbalance and maintain a continual state of balance. • Ayurveda moves beyond the mechanic model and sees life as more than a series of successive cause-and-effect events. It recognizes the importance of consciousness and the role that consciousness plays in the process of healing. AYURVEDA BODYWORK Treatment • Ayurveda's aim is to achieve balance of the four fundamental aspects of life: dharma - duty or correct action; artha-material success or wealth; kama-positive desire; and moksha-spritual liberation. The foundation underlying these four aspects of life is health. • Westerners commonly equate Ayurveda with herbal medicine. In fact, Ayurveda also emphasizes pathya apathya (dietary changes), asanas (yoga exercises), meditation, spiritual healing, surgery, and a highly refined variety of bodywork techniques. Ayurvedic practitioners believe that prevention is better than cure. AYURVEDA BODYWORK • Ayurvedic healers work with an energetic concept of the body rather than a material one. This life energy or life force is conceptualized as a dosha in Ayurveda, but it has many synonyms around the world • Ayurvedic bodywork shares many common elements with osteopathic techniques used in the United States. In fact, when American osteopaths began practicing in Britain, English physicians immediately compared them with Ayurvedic practitioners. • Westerners often try to box Ayurveda into the allopathic paradigm of a "diagnosis and treatment plan," and thus miss the essence of the Ayurvedic healing process. AYURVEDA BODYWORK Enhances the flow of energy through at least three types of subtle channels. • Sira vessels carry the doshas. • Nadi channels collectively form a fine network of 72,000 subtle nerves, through which pranic and psychic energy flow. • Srota channels are innumerable. They connect the marma points to the internal organs. Soft-tissue Techniques • Ayurvedic massage enhances the flow of energy through the sira vessels (and their intersections, the marma points), nadi channels (and their intersections, the marma points), nadi channels (and their intersections, the marma points), nadi channels (and their intersections, the seven shakras), and srota channels. • Massage is usually performed with medicated oils. Dry massage is rarely administered, sometimes used for afflictions of extreme kapha. Marma Therapy - treats marma points, which are comparable with Chinese acupuncture points. Joint Articulation and spinal thrust - rarely use vertebral thrust techniques (the high-velocity, low amplitude techniques used by chiropractors and osteopaths). These techniques seem to be the purview of barbers in India and Nepal, who thrust cervical vertebrae after cutting a person's hair. Cranial Work - The craniosacral mechanism is not recognized in traditional Ayurvedic medicine. POLARITY THERAPY Purpose: to release obstructions to free flow of energy through body to support health, healing Polarity techniques involve simple touching, gentle movements (rhythmic pressing, rocking) Comprehensive approach to polarity therapy also involves exercises, nutrition, love Developed by Randolph Stone (1890-1981) in mid-1900s

Autoimmune Diseases

Autoimmune Diseases - a disordered immune system that targets the cells, tissues, organs of one's own body. Lupus Multiple sclerosis Crohn's disease Diabetes mellitus, type 1 HIV/AIDS - body is unable to protect itself against pathogens. Human immunodeficiency virus. Research models for Alternative Healthcare Observational research - documented case studies; considered to be a weak line of evidence because of the many uncontrolled variables; first indication that a cause/effect relationship exists. Nerve endings are embedded in the tissues of the immune system Changes in the central nervous system alter immune responses Changes in hormone and neurotransmitter levels alter immune activity and vice versa Lymphocytes can produce both hormones and neurotransmitters Activated lymphocytes produce substances recognized by the central nervous system - interleukins & interferons Psychosocial factors alter the susceptibility or expression of autoimmune and infectious diseases Stress can influence immunologic reactivity (negatively) Psychoactive drugs and drug abuse influence immune function Stress can interfere with the effectiveness of an immunization program Hypothalamus also releases endorphins (feel good hormones) Negative personality Type A -- free-floating hostility Type C Personality - Helplessness is the key trait/risk factor for course of cancer treatment; observers, not participants Type D - anxiety, pessimism, despair, anger, inhibited self-expression Pessimistic Poor social support system suppresses the immune system Lower levels of immunoglobulin (in saliva) under stress Less capable of fighting cancer Higher level of complications in pregnancy Higher level of neonatal complications Less effective bonding with newborns Development of cancer, mental illness, suicide Absence of attachment Leading cause of pre-mature death in every disease category, especially heart disease Decreased immunity -- ↓ B cells, ↓T cells Excessive amount of cortisol - suppresses immune system Loneliness creates neuroendrocrine changes that lead to atherosclerosis. Divorce Simple interventions/activities can support/improve immune function, mood, health. Relaxation techniques, hypnosis, biologically target imagery can influence immunologic activity (positively) Relaxation techniques have been effective with: Reducing anxiety Reducing chemotherapy-induced nausea/vomiting Lowering hypertension Decreasing depression Decreasing headache frequency & intensity Decreased menstrual and back pain Classical conditioning can modulate immunological reactivity Responses can be conditioned by exposure to certain: conditions - taste, tough, heat chemicals - immunosuppressives events - emotionally meaningful/traumatic Solomon & Moos - autoimmunity may be related to immunologic incompetence which in turn may be related to emotional stress associated with elevated adrenal cortical steroid hormones. Ader's research with immunosuppressive drugs followed Chemotherapy induces anticipatory physiologic and immunologic conditioning The ability of placebos to act as stimuli The use of taste and imagery as stimuli as been tested in lupus erythematosus The effects of conditioning have been studied in MS Meditation - wakeful, hypometabolic state Most common types - Transcendental meditation (Maharishi Mahesh Yogi) Respiratory one (Herbert Benson) Clinically standardized meditation (Carrington, et.al.) Mindfulness meditation (Buddhist form) Physiological Effects, short-term - Deep state of restfulness Elicits different physiologic responses that vary by technique and time Oxygen consumption decreases Heart & respiratory rates decrease Galvanic skin resistance lowers Hormone levels are modulated EEG pattern altered Physiological effects, long term - Reduced health care costs Strengthened immune function Modulated anxiety, depression Lower blood pressure Reversed some components of cardiovascular disease Reduced frequency/duration of epileptic seizures Increased coping skills for chronic pain Lower rates of substance abuse Contraindications - History of schizophrenia or psychosis Hypersensitivity to meditation May unveil traumatic memories or emotions Biofeedback - information about one's self is used to modify, correct, strengthen processes within one's self; monitors one's physiologic processes/responses to be modified by one; uses the patient's own resources (not medications) to develop conscious control of biological responses to stimuli. General approach - best for individuals who are experiencing conditions that involve excessive/heightened arousal; stuck in fight/flight mode. Primary tools - muscle tension, skin temperature, sweatgland Treatment combines one or more allied relaxation-based approaches to alter one's physiological responses. Feedback is provided to the patient of the effectiveness of the effort; thus reinforcing the effort. Specialized tools - EEG, heart rate variability, blood volume pulse; require more extensive training to elicit changes in these measurements. Important to: Identify appropriate candidates for biofeedback Take a thorough history Establishment baseline levels of symptoms and physiology Monitor patient's training for compliance with technique Contraindications - Individual who cannot actively participate Individual incapable of learning Individuals taking muscle relaxants, vasoconstrictors, stimulants (Ritalin) Music therapy Laughter Writing/talking about traumatic events Group support for patients with cancer & chronic illnesses Group support for care-givers Positive personality Type B Self-healing Optimistic A fighting spirit Stress Resilience Strong social support system enhances immune system Stronger immune system Higher mortality, lower death rates from all causes Fewer complications in pregnancy Fewer neonatal complications More effective bonding with newborns Overall positive feeling, sense of self-esteem, stability, control over one's environment More problems are taken to friends than to physicians ↑immunity -- ↑WBCs, ↓ phagocytes, ↓ T cells ↑ recovery from surgery ↓ medications needed ↓ effects of stress ↑ treatment compliance Marriage Hypnosis - a state of attentive, focused concentration with suspension of some peripheral awareness; include absorption, alteration of attention, dissociation, and suggestibility History - Predates written language Trance states of mysticism Shamanic practices Imagery and healing techniques used by Egyptians & Greeks Franz Anton Mesmer - animal magnetism James Esdaile - a surgeon, performed surgery without pain and no anesthesia, reduced death rate post-surgery to 5% Milton Erickson, psychiatrist - emphasized the necessity for studying the process, state, and products of hypnosis Philosophy - Neodissociation model - hypnosis activates subsystems of control which have psychologic and physiologic counterparts resulting in an altered state of consciousness. Social psychologic model - suggestibility, attitudes, expectations Susceptibility to hypnosis is individual Best induced when taking advantage of the natural waking trance that occurs during a natural 90 minute ultradian rhythm cycle Highly effective for Surgical anesthesia Speeds surgical recovery rates Reduce pain from cancer, burn, and others Reducing duodenal ulcers, irritable bowel syndrome Reduces anticipatory nausea, pregnancy induced nausea Reduces anxiety, insomnia, obesity Smoking cessation Contraindications - Epileptic seizure disorders Depression Imagery - the thought process that invokes and uses the senses of vision, sound, smell, taste, movement, position, touch. Images produce physiologic, biochemical, and immunologic changes that affect health outcomes Types of images used for clinical intervention Diagnostic - provides the information needed to design individualized/meaningful imagery sessions for a patient. Mental-rehearsal - used to prepare the patient for medical procedures End-state - intended to produce a specific physiologic/biologic change in the body Effective in treating Eczema Acne Diabetes Breast cancer Arthritis Migraine and tension headaches Severe burns Improve lactation in mothers of premature infants Increased coping skill with birth pain Pain, regardless of source Is capable of altering Blood flow Changing inflammatory process Specific immune parameters Hormonal responses Recovery from injury Immune cell migration Assess treatment effectiveness for Cancer Spinal pain Diabetes Predictor of treatment outcomes Contraindications - Epileptics Unstable diabetics Chronic severe depression Other Healing Forces

Appendicular Skeleton - Pelvic Girdle

Appendicular Skeleton - Pelvic Girdle Iliac bones (2) Ischium (2) Pubis (2) Femur (2) Patella (2) Fibula (2) Tibia (2) Tarsals (7 x 2) Metatarsals (5 x 2) Phalanges (14 x 2) Joints - Fibrous - articulating bones joined by dense collagen fibers that have little elasticity and allow no empty spaces between the surfaces. Synarthrosis - no movement Suture - two flat bones meet side to side Syndesmosis - bones joined by long fibrous connective tissue, allow small amount of movement Gomphosis - root of tooth attaching to either maxilla or mandible Cartilaginous joints - has a gel-like quality, lacks calcium, fibrous tissue, flexible, strong. No empty spaces between surfaces. Cartilage types: hyaline, elastic, and fibrocartilage Synchondrosis - cartilaginous joint during growth years, absorbs calcium and loses flexibility as one ages; becomes synarthrotic Symphysis - greater elasticity/flexibility; allows movement between bones; aka amphiarthrotic joint Synovial joints - most common; freely moveable; allows for high degree of motion; aka diarthrotic. Contains synovial structures Hinge - concave surface on a convex surface Pivot - one bone rotates on a fixed landmark Condyloid - oval condyle fits into elliptical groove Saddle - each bone concave in one direction and convex in the other Ball & Socket - round sphere fits into a cup Gliding - two semiflat surfaces face one another Synovial joint structures: Articular cartilage - hyaline cartilage covering ends of bones Joint cavilty - empty space between two bones Joint capsule - enclosed sac surrounding the structures of the joint Synovial membrane - thin inner lining of the joint capsule Synovial fluid - secreted by synovial membrane into joint cavity Meniscus - cushion of fibrocartilage, generally circular Bursa - small fluid-filled sac providing padding for tendons near joint Tendon sheaths -long, thin, cylinder filled with fluid Labrum - fibrocartilage located at a ball/socket joint, deepening the socket Muscle - attaches outside the joint capsule; reinforces the joint

B cells

B cells - produce defensive proteins called antibodies; facilitate antibody-mediated immunity. Antibodies circulate in blood & lymph. These are immunoglobulins (IgA, IgG, IgE, IgM); specific to antigen(s) Mucosal/local immunity - defense proteins (antibodies) produced in tissues underlying the linings of the digestive & respiratory tracts Cell-mediated immunity - phagocytes engulf/partially digest pathogens; then T cells destroy both the phagocyte & pathogen. Anamnestic response - memory cells; helps recall invaders previously encountered; triggers special memory cells; result of actively acquired immunity, i.e. natural infection or vaccination. Cytotoxic T cells aka killer T cells - first to recognize that other body cells are infected. Recognize specific antigens. Complicated and requires co-stimulatory cytokines. Much research in this area. Perhaps cytokines are enzymes? Routinely cells of the body degrade internal cellular proteins (deteriorates, incorrectly folded, normal cell metabolism); broken into short peptides which eventually appear on the cell surface. Those from one's one body are called self-antigens. Same happens to a virus or other pathogen that is infecting a cell. The pathogen also produces proteins (called antigens) and these are nonself-antigens.

Body Awareness/Fundamentals of Anatomy & Movement

Body Awareness/Fundamentals of Anatomy & Movement Anatomic Position - Face forward with arms at sides and palms facing forward. All directions regarding the body start from here. Cardinal planes divide the body into sections: sagittal, frontal aka coronal, transverse aka horizontal, oblique Human skeleton is composed of bone Basic compounds in bone: calcium salts, organic matrix (composed of collagen fibers) Tensile strength - ability to withstand compressive forces without being crushed Types of bone tissue - Compact aka cortical -- dense Cancellous aka spongy - breadlike appearance Protected by periosteum Functions - Force-resistant framework Mineral storage Muscle attachment Protection Fat storage/blood cell production Filtration Shapes - long, short, irregular, flat, sesamoid Axial Skeleton Cranium (8) - frontal, sphenoid, parietal (2), temporal (2), occiput, ethmoid Face (14) - maxilla (2), zygomatic (2), nasal (2), vomer, lacrimal (2), palatine (2), inferior nasal conchae (2), mandible Hyoid bone Vertebral column (28) - cervical (7), thoracic (12), lumbar (5), sacral (5, ossify to 1), coccyx (4, ossify to 1) Ribs (12 pair) Sternum Appendicular Skeleton -- Pectoral Girdle Clavicles (2) Scapula (2) Humerus (2) Radius (2) Ulna (2) Carpals (8 x 2) Metacarpals (5 x 2)

Central Nervous System

Central Nervous System Brain Cerebrum Frontal lobes - contraction of voluntary muscles, critical thought, motor control of speech Parietal lobes - receipt of sensory infParietal lobes - receipt of sensory information, comprehension of language Temporal lobes - sensory information interpreted, language comprehension Occipital lobe - control of vision, processing of visual information Basal Ganglia - control of voluntary motor function Thalamus - directs sensory information within the brain Hypothalamus - regulates internal functions, i.e., body temperature, appetite, GI, hormone release from pituitary, emotions (love, fear) Cerebellum - processes sensory and motor information regarding control of posture, repetitive motion, accuracy of skeletal movement Pons Medulla - control of involuntary functions

Chiropractic means

Chiropractic is a Greek word meaning done by hand. Palmer School of Chiropractic was created that year and so was the start of the profession. It was not until D.D. Palmer's son B.J. Palmer began to practice that the public awareness was raised

Clinical research

Clinical research - tests the effects of stress, conditioning on physiology and the immune functions; clinical interventions may be tested for their ability to induce, alleviate, treat disease.

Construction

Construction - Unipolar - one entry/exit, typically afferent nerves Bipolar - as both an entrance and exit, sensory, associated with senses Multi-polar - many dendrites, typically efferent neurons

Defenses against Infection

Defenses against Infection Nonspecific defenses - do not target a specific pathogen. Barriers - skin, mucous membranes, nasal hairs, cilia Secretions - tears, saliva, mucus, gastric juices, urine Body processes - coughing, sneezing, vomiting Nonspecific immune defenses - do not target a specific pathogen -- inflammatory response - redness, warmth, swelling, pain Phagocytes - cells that engulf/consume invaders Interferons - proteins secreted by infected cells that limit the harmful effects of viruses Specific immune defenses - specialized responses target specific invader Immune Modulators -- aka cytokines - chemical messengers of the immune cells Lymphocytes - specialized WBCs, concentrate in lymph; store in white pulp of spleen T cells - mature in thymus; transported throughout the body; facilitate cell-mediated immunity B cells - produce defensive proteins called antibodies; facilitate antibody-mediated immunity. Antibodies circulate in blood & lymph. These are immunoglobulins (IgA, IgG, IgE, IgM); specific to antigen(s) Mucosal/local immunity - defense proteins (antibodies) produced in tissues underlying the linings of the digestive & respiratory tracts Cell-mediated immunity - phagocytes engulf/partially digest pathogens; then T cells destroy both the phagocyte & pathogen. Macrophages engulf and partially digest, retaining the nonself-antigens that alert T cells to destroy. Antibody-mediated immunity - lymphocytes produce antibodies that travel to target and neutralize specific pathogen Anamnestic response - memory cells; helps recall invaders previously encountered; triggers special memory cells; result of actively acquired immunity, i.e. natural infection or vaccination. Cytotoxic T cells aka killer T cells - first to recognize that other body cells are infected. Recognize specific antigens. Complicated and requires co-stimulatory cytokines. Much research in this area. Perhaps cytokines are enzymes? Routinely cells of the body degrade internal cellular proteins (deteriorates, incorrectly folded, normal cell metabolism); broken into short peptides which eventually appear on the cell surface. Those from one's one body are called self-antigens. Same happens to a virus or other pathogen that is infecting a cell. The pathogen also produces proteins (called antigens) and these are nonself-antigens

ENERGETIC TECHNIQUES - HEALING TOUCH AND THERAPEUTIC TOUCH

ENERGETIC TECHNIQUES - HEALING TOUCH AND THERAPEUTIC TOUCH Healing Touch Therapeutic Touch Abbrevition HT TT Devloped by Janet Mentgen Dorlores Krieger Date(s) In the early 1980s In the early 1970s Abiltites Facilitate healing of others, seeing auras Research in Healers, Dora Kunz (seer); Oskar Etebany Development Established healing practice; Taught at community college; Developed additional levels of courses; Added biofeedback; Added other techniques Developed and taught class in Master's program at NYU Credentialed by: American Holistic Nurses Association Within accredited nursing/master's degree programs Taught to Worldwide; all people who affect healthcare Worldwide through universities and professional organizations Goals Promotes self-healing for the individual's highest good; the focus is the facilitation of selfhealing and growth, restoring balance and harmony in the human energy system Intent of enabling the person to repattern their energy in the direction of health; works with the individual to facilitate healing. ENERGETIC TECHNIQUES - HEALING TOUCH AND THERAPEUTIC TOUCH Healing Touch Therapeutic Touch Code of Ethics Heart-Centered; Caring relationship; non-judgmental Provide treatment process as taught, with integrity; based on client's needs; respecting client's rights; obtain permission; fee notification; non-exploitiveness; confidentiality; strengthen abilities Treatment sessions Can treat anyone, as long as the client's highest good is the intent; Only the energy need will be available Does not usually exceed 30 minutes Differences Uses a greater variety of techniques for specific purposes Actually more touching Usually shorter sessions Protocol Interview (treatment goals) Assess energy field Select appropriate technique(s) Confirm that touch is o.k.; may use light touch on certain areas (e.g. the joints, chakras, or problem area) Centering Assessment Unruffling Directing & modulating the transfer of energy Knowing when to stop ENERGETIC TECHNIQUES - HEALING TOUCH AND THERAPEUTIC TOUCH Healing Touch Therapeutic Touch Practitioner Centers self Focuses on client's highest good Provides treatment full body, then specific Evaluates outcome Holds hand 2 to 4 inches from client; passed from head to toe, both front and back. Use rhythmic, sweeping movements Gently touch Evaluates outcome Techniques Chakra connection Magnetic unruffled Chakra spread "Ultrasound" Pain drain Wound sealing Unruffling and pain ridge Levels of Practice Level I Level IIA Level IIB Level III Beginner Intermediate Advanced

Essence of Spirituality

Essence of Spirituality Is inclusive. It is the deepest sense of belonging and participation. We all participate in the spiritual at all times, whether we know it or not. There is no place to go to be separated from the spiritual. . . The most important thing in defining spirit is the recognition that spirit is an essential need of human nature. There is something in all of us that seeks the spiritual. This yearning varies in strength from person to person, but it is always there is everyone. And so healing becomes possible Altruism Volunteerism Faith Hope

ENERGETIC TECHNIQUES - REIKI

ENERGETIC TECHNIQUES - REIKI The Usui system of natural healing • Reiki, which is translated from Japanese as universal life energy. • Reiki requires no particular religious orientation, no physiologic or anatomic knowledge, and no training in body manipulation techniques such as massage. Levels of Reiki • First degree (Reiki I) is often erroneously referred to as Beginning Reiki. • Second degree (Reiki II) Class in some schools is referred to as Advanced Training. • Third degree Reiki or Master Training, and may last as long as a year. ENERGETIC TECHNIQUES - REIKI Principals, Philosophy, and Diagnosis • Reiki has a unique relationship with disease and pain - it supports healing only of what needs to be healed rather than what the practitioner intends to be healed. • Teaches a system of touching, part of its effectiveness can be attributed to the body's response to gentle, appropriate contact between practitioner and client. Energy -- Hawayo Takata, the energetic woman who brought the teaching and use of the Usui System out of Japan, stated that "this power (Reiki) is unfathomable, immeasurable, and being a universal life force, it is incomprehensible to man. Yet every living being is receiving its blessings daily, awake and asleep." Many compare the feeling of receiving Reiki to the sensation felt when praying, meditating, singing, walking in the woods, or in any other way actively seeking God. When a practitioner places hands on a client, both the practitioner and the client observe sensory changes around or under the hands of the practitioner. These changes include the sensations of warmth, tingling, cold, extra fullness, and electrical charge. Reiki is often described as working on the root cause of a disease or imbalance.

Energetic Techniques:

Energetic Techniques: • Reiki

Epidemiologic research

Epidemiologic research - pursues retrospective (past events) or prospective (future events) correlations between physical and psychological stress factors and the development of disease; uses survey data, physiologic, biochemical, psychological assessments.

FELDENKRAIS METHOD

FELDENKRAIS METHOD • An organic learning process. The FM helps a person to spontaneously move more easily in fundamental human movements like rolling, turning, speaking, writing, and walking. It also on occasion, significantly changes, the person's sense of self as the person is able to move more easily than he or she though possible. Athletic performance issues such as improving skiing skills or tennis swing; recovery from limitations acquired from an accident or stroke; facilitation of basic developmental learning such as in clients with Down syndrome or cerebral palsy, communication and cognitive learning issues such as in the aftermath of closed head injury with children known as autistic; and improvement of seemingly physiologic functions such as vision, hearing, circulation, and blood pressure. • Feldenkrais' first book about his evolving theories on human self-direction, Body and Mature Behavior, was published in England in 1949. FELDENKRAIS METHOD Basic Principles - • Habits, Images, and Spontaneity -- Nervous reorganization occurs spontaneously to recreate a workable homeostasis that adapts to the present circumstances. • Brain created by experience - we are not born with our brains intact. This formation of individual patterns of self-direction is viewed as the source of many of the difficulties humans encounter. It is also an enormous untapped potential as all patterns of human self-direction are learned through experience. • Organic Learning -- the learning that occurred within an individual on the basis of his or her own sensory experience • Individuality of the human homunculus -- the very growth of the brain's cellular structure is strongly influenced by the experience of the person. • Individuality of human movement patterns -- Organic learning occurs spontaneously to create patterns of self direction from the sensory experience of and responses to unique internal and external environment. The pattern of a person's action is not only the representation of identity to that person but also the representation of that person to others. • Self Image -- includes • The totality of the person's kinesthetic and proprioceptive sensations concerning the experienced interrelationship of all physical body parts • The experience throughout life of the ability to effect change in the environment. • Beliefs about what can or cannot be done effectively. FELDENKRAIS METHOD Basic Principles, Contd. • Excluded parts of the self -- self-imposed limits of self-image and skill development that emerge in the course of growing up. • Infant Learning Model -- Learning the "special movements of our repertoire" is what typical infants do so beautifully in the first years of life, and then undo in unconsciously learned habits or muscular tension as they experience "promise of great reward or intense punishment". • Movement as the avenue to self-improvement - includes simultaneous thinking, feeling, sensing, and acting. He saw sensing and acting (moving, self-direction) as the clearest avenues for change and improvement. • Inherently connected processes --These processes are inherently interconnected and overlapping in the human experience. • Attention - a person's alertness to one's own sensory experience, presumes discrimination. • Discrimination - the spontaneous function within the human nervous system that compares the current sensory experience with all others previously experienced to determine whether the information is the same or different. • Differentiation -- occurs when a person's nervous system separated the sensation of one part of the body from another. • Integration -- occurs when recognition of the separateness or the relatedness among different parts of the body occasions a new movement configuration and skill. FELDENKRAIS METHOD Movement - • Act-ure -- Although the human upright position in relationship to the gravitational field is usually called posture, Feldenkrais sometimes referred to it as act-ure to focus attention on Neurologic readiness for action. • Skeletal Conductivity of movement -- ways to use a person's sensory experience of the skeleton for neurologic learning is a unique contribution to the field of sensory-motor learning. • Skeletal support, muscle tension, stability, and flexibility -- A reciprocal relationship is presumed between the experiences of skeletal support and the mobilization of muscle tension. Strategies of Practice • To create the conditions for learning for the individual who seeks improvement. • Gentle and conservative with very little risk involved.

Hip & Lower Extremity

Hip & Lower Extremity Gluteals Maximus Medius Minimus Hamstrings Biceps femoris Semitendinosus Semimembranosus

Golgi tendon organs

Golgi tendon organs - pass along information regarding status of tendons

History of Massage

History of Massage Massage therapy is one of the oldest forms of health practice. 2500 years ago, this text includes information on Tuina, an ancient form of Massage. Pehr Henrik Ling and Johann Mezger (1776-1839) developed four systems of movement described in his treatise. His passive movements were described as shaking, hacking, pressing, stroking, pinching, kneading, clapping, vibrating, and rolling. • The mechanics used to explain the benefits of massage are the followings: • Mechanical - compressing, stretching, shearing, and broadening tissues • Physiologic - cellular, tissue, and organ system effect • Reflex - pressure and movement in one body part affecting another • Body-mind interactions - between mind and the emotion and disease processes • Energetic - flow of our life energy or chi

Samuel Hahnemann,

Homeopathy, established by Samuel Hahnemann, MD offered a gentler alternative to Rush's choice. Hahnemann's theory of "similars" of homeopathic doctors prescribed weak dilutions of substances that produced symptoms like those of the disease to be treated

Immune System Disorders

Immune System Disorders Allergies, aka hypersensitivity - immune system response to generally a harmless substance. Antibodies are produced for these assumed antigens Autoimmune Diseases - a disordered immune system that targets the cells, tissues, organs of one's own body. Lupus Multiple sclerosis Crohn's disease Diabetes mellitus, type 1 HIV/AIDS - body is unable to protect itself against pathogens. Human immunodeficiency virus.

Impulse Transmission

Impulse Transmission By way of sodium/potassium pump Threshold stimulus received, sodium/potassium exchange relationship along nerve, causing depolarization to pass impulse down the axon Resting potential - the state of being polarized, natural state of nerve Repolarization - the reseting of the sodium/potassium relationship In myelinated nerves, the polarization jumps from node of Ranvier to next node of Ranvier. Called Saltatory conduction

Daniel David Palmer

In 1895 Daniel David Palmer founded Chiropractic profession in Davenport, Iowa. He is known as The Father of Chiropractic (image to your left) D.D. Palmer, was a magnetic healer and discovered Chiropractic by accident focusing on the nervous system as his rationale for spinal adjustment, and taught a specific adjustment of a particular segment to correct a specific subluxation. At about the same time in history the profession of Osteopathic Medicine, was developing by Andrew Still in the late nineteenth century, theorized that blood flow or the lack of blood flow was decisive in causing or curing disease. Osteopathy considered the body as a machine and the physician as an engineer

Muscle fiber

Muscle fiber - formed of many myofibrils wrapped in endomysium Fascicle - many muscle fibers, wrapped in perimysium Muscle -- many fascicles, wrapped in epimysium Tendon - formed by epimysium co-joining; attaches to periosteum of bone

Muscle spindle

Muscle spindles - pass along information regarding muscle length, speed of contraction, quantity of stretch

MASSAGE THERAPY

MASSAGE THERAPY Definition -- the intentional and systematic manipulation of the soft tissues of the body. Massage seems to stimulate and strengthen one's natural healing capacities. History of Massage Massage therapy is one of the oldest forms of health practice. 2500 years ago, this text includes information on Tuina, an ancient form of Massage. Pehr Henrik Ling and Johann Mezger (1776-1839) developed four systems of movement described in his treatise. His passive movements were described as shaking, hacking, pressing, stroking, pinching, kneading, clapping, vibrating, and rolling. Pehr Ling Johan Mezger MASSAGE THERAPY, CONTD. • The mechanics used to explain the benefits of massage are the followings: • Mechanical - compressing, stretching, shearing, and broadening tissues • Physiologic - cellular, tissue, and organ system effect • Reflex - pressure and movement in one body part affecting another • Body-mind interactions - between mind and the emotion and disease processes • Energetic - flow of our life energy or chi MASSAGE THERAPY, CONTD. • The mechanics used to explain the benefits of massage are the followings: • Mechanical - compressing, stretching, shearing, and broadening tissues • Physiologic - cellular, tissue, and organ system effect • Reflex - pressure and movement in one body part affecting another • Body-mind interactions - between mind and the emotion and disease processes • Energetic - flow of our life energy or ch

MODERN NEUROMUSCULAR TECHNIQUES (AKA TRIGGER POINT THERAPY)

MODERN NEUROMUSCULAR TECHNIQUES (AKA TRIGGER POINT THERAPY) • Definition -- a therapeutic intervention to treat injury and repetitive trauma, and for post surgical rehabilitation. It is also a preventative procedure for assessing and removing the potential sources of myofascial dysfunction. • Addresses a number of factors that are commonly involved in causing or intensifying pain, influencing the perception of pain and its spread throughout the body, and maintaining dysfunctional conditions. • Factors that affect locally dysfunctional states, such as hypertonia, ischemia, inflammation, trigger points (TrPs), and neural compression or entrapment are more obvious to manual practitioners. • Biomechanical factors include myofascial TrPs, which are hyperirritable nodules found in taut bands of myofascial tissue. TrPs form in muscle bellies or in tendinous or periosteal attachments

MODERN NEUROMUSCULAR TECHNIQUES (AKA TRIGGER POINT THERAPY)

MODERN NEUROMUSCULAR TECHNIQUES (AKA TRIGGER POINT THERAPY) • Two branches: • American - Dr. Raymond Nimmo • The treatment tools that remain "tools of the trade" of neuromuscular therapy are a set of pressure bars, first introduced in the work by Dr. Raymond Nimmo and associated with his receptor tonus techniques. • European - Dr. Stanley Lief and Dr. Boris Chaitow, cousins trained in chiropractic and naturopathy. • Variable ischemic compression is a distinguishing feature of European NMT. European NMT offers a variation that applies deep pressure (sufficient to produce referred pain symptoms) for approximately 5 seconds, followed by an easing of pressure for 2 to 3 seconds. This is repeated until the local or referred pain diminishes (or, rarely, until either pain increases) or until 2 minutes have elapsed. • A final absolute requirement, regardless of the method used to release the trigger, is to stretch the tissues to help them regain their normal resting length. Biochemical factors are factors that influence local and body-wide chemistry. They include localized ischemia, dehydration, nutrition, endocrine function (or dysfunction), chemical exposure, medication, inflammatory processes, and carbon dioxide levels (pH). • Nutritional factors include ingestion, digestion, absorption, and assimilation of nutrients necessary for cellular metabolism, repair and normal reproduction of cells and tissues. • Psychosocial factors, emotional well being, and stress management influence the musculoskeletal system. MODERN NEUROMUSCULAR TECHNIQUES (AKA TRIGGER POINT THERAPY) • Two branches: • American - Dr. Raymond Nimmo • The treatment tools that remain "tools of the trade" of neuromuscular therapy are a set of pressure bars, first introduced in the work by Dr. Raymond Nimmo and associated with his receptor tonus techniques. • European - Dr. Stanley Lief and Dr. Boris Chaitow, cousins trained in chiropractic and naturopathy. • Variable ischemic compression is a distinguishing feature of Euro • Two branches: • American - Dr. Raymond Nimmo • The treatment tools that remain "tools of the trade" of neuromuscular therapy are a set of pressure bars, first introduced in the work by Dr. Raymond Nimmo and associated with his receptor tonus techniques. • European - Dr. Stanley Lief and Dr. Boris Chaitow, cousins trained in chiropractic and naturopathy. • Variable ischemic compression is a distinguishing feature of European NMT. European NMT offers a variation that applies deep pressure (sufficient to produce referred pain symptoms) for approximately 5 seconds, followed by an easing of pressure for 2 to 3 seconds. This is repeated until the local or referred pain diminishes (or, rarely, until either pain increases) or until 2 minutes have elapsed. • A final absolute requirement, regardless of the method used to release the trigger, is to stretch the tissues to help them regain their normal resting length.

Macrophages

Macrophages engulf and partially digest, retaining the nonself-antigens that alert T cells to destroy. Antibody-mediated immunity - lymphocytes produce antibodies that travel to target and neutralize specific pathogen

Muscle & Movement

Muscle & Movement Shoulder & Upper Extremity Rotator Cuff Supraspinatus Infraspinatus Teres Major Subscapularis Hand Extrinsic muscles originate outside of hand Intrinsic muscles originate inside the hand

Muscle Fiber Innervation

Muscle Fiber Innervation - Excitability - ability to be stimulated and respond Polarized - muscle fiber at rest Depolarized - muscle under contraction Stimulated by motor neurons

Mind-Body Integration

Mind-Body Integration Alternative Healthcare recognizes that an individual is more than just a set of symptoms. A patient is composed of a body, mind, emotions, spirit. Alternative health techniques seek to re-establish the balance between the components of the whole person. The most important component is the mind-body connection. Psychoneuroimmunology - the study of the interactions between behavior, neural and endocrine function, and immune processes The mind and body communicate via interactions that occur among the nervous system, the endocrine system, and the immune system. These systems communicate by using two distinctive pathways: Sympathetic-adrenal-medullary axis (SAM) Most direct Activates the autonomic nervous system (ANS) Utilize neurotransmitters (language of nervous system) & neuropeptides (lower the reaction threshold of target neurons) Norepinephrine Epinephrine Substance P (enhances perception of pain) Vasoactive intestinal peptide Plus others Communicate directly with immune system to alter reactivity (ability to multiply, travel, kill invaders) Hypothalamic-pituitary-adrenal cortex axis (HPA) Secondary, indirect Signals endocrine system to release hormones Signals come from the brain via other hormones and immunomodulators Hypothalamus connects the emotional and visceral responses. Invokes fight/flight response to danger/stress Releases corticotrophin-releasing hormone to pituitary gland Pituitary Gland Releases adrenocorticotropic hormone to adrenal cortex Adrenal cortex Releases cortisol Mobilizes energy stores for immediate energy needs Enhances tissue sensitivity to other stressrelated neurohormones Inhibits immune and inflammatory responses When acute situation is corrected, homeostatis is restored

Motions of joints:

Motions of joints: Flexion Extension Hyperextension Lateral flexion Abduction Adduction Internal rotation External rotation Dorsiflexion Plantar flexion Ulnar deviation Radial deviation Pronation Supination Eversion Inversion Elevation Depression Protraction Retraction Opposition Reposition Circumduction

OSTEOPATHIC PRINCIPLES

OSTEOPATHIC PRINCIPLES • The osteopathic medical philosophy is defined as health care that embraces the unity of the living organism's structure (anatomy) and function (physiology). The following are the four major principles of osteopathic medicine: • The body is a functional unit. An integrated unit of mind, body, and spirit ("Man is Triune" - A.T. Still) • The body possesses self-regulatory mechanisms, having the inherent capacity to defend, repair, and remodel itself • Structure and function are reciprocally interrelated • Rational therapy is based on consideration of the first three principles • These principles are not held by osteopathic physicians to be empirical laws; they serve, rather, as the underpinnings of the osteopathic philosophy on health and disease. (Wikipedia, 2014) MASSAGE THERAPY Definition -- the intentional and systematic manipulation of the soft tissues of the body. Massage seems to stimulate and strengthen one's natural healing capacities.

POLARITY THERAPY

POLARITY THERAPY Developed by Randolph Stone (1890-1981) in mid-1900s • Disease is result of obstruction of flow of energy • Natural healing techniques effective because they support individual's innate healing capacity, balance flow of energy • Relying heavily on Ayurvedic theory, developed polarity therapy Pierre Pannetier helped spread practice of polarity therapy in 1973 after Stone's retirement • Different schools of polarity therapy evolved over the years • Health often equated with energy Objective changes that occur with polarity therapy • Techniques stimulate body's reflexes • Rocking techniques induce relaxation, lower muscle tension, reduce pain • Stimulating joints lowers muscle tone, increases circulation, stimulates endorphin release • Some rhythmic techniques induce a light hypnotic state, relaxation, moments of peace Energy • Rubbing palms together exercise to increase energy awareness • Partner exercise "plugging into" each o

PRINCIPLES OF CHIROPRACTIC

PRINCIPLES OF CHIROPRACTIC • The specific pathology that is the focus of chiropractic practice is known as the chiropractic subluxation or joint dysfunction • A subluxation is a health concern, which through complex anatomical and physiological relationships, manifests in the joints, affects the nervous system, and may lead to reduced function, disability, or illness • Typically, the symptoms of subluxation include one or more of the following: - Pain and tenderness; - asymmetry of posture, movement, or alignment; - range of motion abnormalities; - tone, texture and temperature abnormalities of the adjacent soft tissues

PRINCIPLES OF MANIPULATION

PRINCIPLES OF MANIPULATION The Chiropractic Adjustment High or low velocity Short or long levers High or low amplitude With or without recoil High Velocity, Low Amplitude, Short Lever

Paradigms of treatment intervention

Paradigms of treatment intervention • Relaxation paradigm - includes any practice that attempts to produce the relaxation response as a way to alleviate pain and other symptoms. • Corrective paradigm - aims at the symptomatic and piecemeal treatment of disease, pain, dysfunction, and structural problems. • Holistic or integrative paradigm - includes practices that aim at cultivating integration, balance, and harmony for the whole person. • Principles • Adaptability principle -- ability to adapt to and accept new options of selfperception, alignment, and motion. • Support principle -- specific application of the adaptability principle and is based on Dr. Rolf's understanding of the effects of gravity on structure. • Continuity principle -- further specification of the adaptability principle. • Palintonic principle -- recognizes that the success of any intervention or series of interventions is a function of appropriate spatial relationships. • Closure principle -- recognizes that when the patient has achieved the highest level of somatic and perceptual integration possible within his or her current set of limitations, treatment should be terminated.

Peripheral Nervous System

Peripheral Nervous System Cranial nerves - 12 pairs, exit brain and loop back in. Spinal nerves - 31 pairs Exit spinal cord at intervertebral foramen Myotome - muscle innervation Dermatome - sensory innervation Plexus - nerve network Autonomic nervous system Controls involuntary activities Visceral innervation Adjustments that are not thought about Efferent Sympathetic - prepares for defense; fight/flight Parasympathetic - calming influence The two work together to maintain homeostatis Somatic nervous system Innervates voluntary skeletal muscle Utilizes Muscle spindles - pass along information regarding muscle length, speed of contraction, quantity of stretch Golgi tendon organs - pass along information regarding status of tendons Proprioception - pass along information regarding status of joints Reflex arc - impulse received into spinal cord on afferent neuron, passed along by associative neuron, and motor response back out on efferent neuron without going to brain for respon

Physiological research

Physiological research - investigates specific biologic or biochemical connections between the mind and other body systems; defines the pathways that allow for physiologic modulations.

Principles favored by Chiropractors

Principles favored by Chiropractors are: • Chiropractors often express their holistic beliefs by asserting a reciprocal relationship between the structure and function of the body • As well, chiropractors have traditionally adhered to belief that patient, rather than disease should be focus of doctor's concern • Chiropractors have drawn distinction between the "allopathic subluxation" and "chiropractic subluxation", which involves some impact upon the function of nerves passing through or otherwise influenced by associated joint structures

RELAXATION RESPONSE

RELAXATION RESPONSE 1. Decreased oxygen consumption and metabolic rate, lessening the strain on energy resources. 2. Increased alpha brain waves associated with deep relaxation 3. Reduced blood lactates, which are associated with anxiety 4. Decreased blood pressure in some individuals 5. Decreased muscle tension 6. Increased blood flow to the limbs 7. Improved mood state 8. Improved quality of sleep

Research models for Alternative Healthcare

Research models for Alternative Healthcare Observational research - documented case studies; considered to be a weak line of evidence because of the many uncontrolled variables; first indication that a cause/effect relationship exists. Physiological research - investigates specific biologic or biochemical connections between the mind and other body systems; defines the pathways that allow for physiologic modulations. Epidemiologic research - pursues retrospective (past events) or prospective (future events) correlations between physical and psychological stress factors and the development of disease; uses survey data, physiologic, biochemical, psychological assessments. Clinical research - tests the effects of stress, conditioning on physiology and the immune functions; clinical interventions may be tested for their ability to induce, alleviate, treat disease

Research outcomes

Research outcomes - clearly identified a link between emotion, physiologic reactivity and immune competence. Research has shown the following:

Research outcomes

Research outcomes - clearly identified a link between emotion, physiologic reactivity and immune competence. Research has shown the following: Nerve endings are embedded in the tissues of the immune system Changes in the central nervous system alter immune responses Changes in hormone and neurotransmitter levels alter immune activity and vice versa Lymphocytes can produce both hormones and neurotransmitters Activated lymphocytes produce substances recognized by the central nervous system - interleukins & interferons Psychosocial factors alter the susceptibility or expression of autoimmune and infectious diseases Stress can influence immunologic reactivity (negatively) Psychoactive drugs and drug abuse influence immune function Stress can interfere with the effectiveness of an immunization program Hypothalamus also releases endorphins (feel good hormones) Negative personality Type A -- free-floating hostility Type C Personality - Helplessness is the key trait/risk factor for course of cancer treatment; observers, not participants Type D - anxiety, pessimism, despair, anger, inhibited self-expression Pessimistic Poor social support system suppresses the immune system Lower levels of immunoglobulin (in saliva) under stress Less capable of fighting cancer Higher level of complications in pregnancy Higher level of neonatal complications Less effective bonding with newborns Development of cancer, mental illness, suicide Absence of attachment Leading cause of pre-mature death in every disease category, especially heart disease Decreased immunity -- ↓ B cells, ↓T cells Excessive amount of cortisol - suppresses immune system Loneliness creates neuroendrocrine changes that lead to atherosclerosis. Divorce

Review of Immune System

Review of Immune System Lymphatic System - system of vessels transporting lymph fluid throughout body Lymph nodes filter lymph fluid; contain phagocytes and lymphocytes (develop in bone marrow) Thymus gland - located just above heart; develops T cell lymphocytes Spleen - two sections White pulp - stores lymphocytes Red pulp - filters and stores blood

SHIATSU

SHIATSU • The literal meaning of the Japanese word shiatsu (she AAHT sue) is finger pressure or thumb pressure. • The word massage comes from the Arabic word for stroke. The practice of massage dates back 3000 years to China. A tomb found in modern Egypt, determined to be from 2200 BC, depicts a man receiving a foot massage. SHIATSU Types of Shiatsu • Basic Shiatsu -- The basic practice remains simple, effective, and sage. Shiatsu techniques can be learned and safely applied by anyone. It can be performed anywhere, takes place fully clothed, and requires no special tools, machines, or oils. • Acupressure - A system of balancing the body's energy by applying pressure to specific acupoints to release tension and increase circulation. The many hands-on methods of stimulating the acupressure points can strengthen weaknesses, relieve common ailments, prevent health disorders and restore the body's vital life force. • Five Element Shiatsu -- The primary emphasis of Five Element Shiatsu is to identify a pattern of disharmony through the use of the four examinations and to harmonize that pattern with an appropriate treatment plan. • Japanese Shiatsu -- primarily pressure usually applied with the thumbs along the meridian lines; extensive soft tissue manipulation and both active and passive exercise and stretching may be part of the treatment. • Macrobiotic Shiatsu -- Founded by Shizuko Yamamoto and based on George Ohsawa's philosophy that each individual is an integral part of nature, Macrobiotic Shiatsu supports a natural lifestyle and heightened instincts for improving health. Assessments are through visual, verbal, and touch techniques (including pulses) the Five Transformations. • Shiatsu Anma Therapy -- utilizes a unique blend of two of the most popular Asian bodywork forms practiced in Japan. Dr. Kaneko introduces traditional Anma Massage Therapy based on the energetic system of Traditional Chinese Medicine in long form and contemporary pressure therapy which is based on neuro-musculo-skeletal system in sort form. • Zen Shiatsu -- characterized by the theory of Kyo-Jitsu, its physical and psychological manifestations, and its application to abdominal diagnos

Simple interventions

Simple interventions/activities can support/improve immune function, mood, health. Relaxation techniques, hypnosis, biologically target imagery can influence immunologic activity (positively) Relaxation techniques have been effective with: Reducing anxiety Reducing chemotherapy-i Reducing chemotherapy-induced nausea/vomiting Lowering hypertension Decreasing depression Decreasing headache frequency & intensity Decreased menstrual and back pain Classical conditioning can modulate immunological reactivity Responses can be conditioned by exposure to certain: conditions - taste, tough, heat chemicals - immunosuppressives events - emotionally meaningful/traumatic Solomon & Moos - autoimmunity may be related to immunologic incompetence which in turn may be related to emotional stress associated with elevated adrenal cortical steroid hormones. Ader's research with immunosuppressive drugs followed Chemotherapy induces anticipatory physiologic and immunologic conditioning The ability of placebos to act as stimuli The use of taste and imagery as stimuli as been tested in lupus erythematosus The effects of conditioning have been studied in MS Meditation - wakeful, hypometabolic state Most common types - Transcendental meditation (Maharishi Mahesh Yogi) Respiratory one (Herbert Benson) Clinically standardized meditation (Car

Spinal Cord

Spinal Cord Neural tissue exits brain through foramen magnum becoming the vertebral canal, extends to body of L2 Cauda equina is the collection of spinal nerves outside the spinal cord, inside the vertebral canal Spinal nerves exit as pairs at each spinal level Lubrication Cerebrospinal fluid - manufactured in ventricles by choroids plexus Protection Meninges - dura mater - tough outer layer arachnoid mater - contains cerebrospinal fluid pia mater - contains blood vessels of brain and spinal cord

Stress Response

Stress Response Strong emotions - anxiety, fear - can activate Both pathways become active Acute Increase blood flow to skeletal muscles Elevations in levels of hormones, proteins Increased blood pressure Increased heart rate, Sweating (galvanic skin response) Increase blood glucose levels, Increase coagulation time Increase muscle tension Can become chronic which results in: Increased muscle tension Decreased peripheral skin temperatures Hyperreactive response to acute stressor Stress can be Physiological Psychological

Stress Response

Stress Response Strong emotions - anxiety, fear - can activate Both pathways become active Acute Increase blood flow to skeletal muscles Elevations in levels of hormones, proteins Increased blood pressure Increased heart rate, Sweating (galvanic skin response) Increase blood glucose levels, Increase coagulation time Increase muscle tension Can become chronic which results in: Increased muscle tension Decreased peripheral skin temperatures Hyperreactive response to acute stressor Stress can be Physiological Psychological Review of Immune System Lymphatic System - system of vessels transporting lymph fluid throughout body Lymph nodes filter lymph fluid; contain phagocytes and lymphocytes (develop in bone marrow) Thymus gland - located just above heart; develops T cell lymphocytes Spleen - two sections White pulp - stores lymphocytes Red pulp - filters and stores blood Defenses against Infection Nonspecific defenses - do not target a specific pathogen. Barriers - skin, mucous membranes, nasal hairs, cilia Secretions - tears, saliva, mucus, gastric juices, urine Body processes - coughing, sneezing, vomiting Nonspecific immune defenses - do not target a specific pathogen -- inflammatory response - redness, warmth, swelling, pain Phagocytes - cells that engulf/consume invaders Interferons - proteins secreted by infected cells that limit the harmful effects of viruses Specific immune defenses - specialized responses target specific invader Immune Modulators -- aka cytokines - chemical messengers of the immune cells Lymphocytes - specialized WBCs, concentrate in lymph; store in white pulp of spleen T cells - mature in thymus; transported throughout the body; facilitate cell-mediated immunity Immune System Disorders Allergies, aka hypersensitivity - immune system response to generally a harmless substance. Antibodies are produced for these assumed antigens Autoimmune Diseases - a disordered immune system that targets the cells, tissues, organs of one's own body. Lupus Multiple sclerosis Crohn's disease Diabetes mellitus, type 1 HIV/AIDS - body is unable to protect itself against pathogens. Human immunodeficiency virus. Research models for Alternative Healthcare Observational research - documented case studies; considered to be a weak line of evidence because of the many uncontrolled variables; first indication that a cause/effect relationship exists. Physiological research - investigates specific biologic or biochemical connections between the mind and other body systems; defines the pathways that allow for physiologic modulations. Epidemiologic research - pursues retrospective (past events) or prospective (future events) correlations between physical and psychological stress factors and the development of disease; uses survey data, physiologic, biochemical, psychological assessments. Clinical research - tests the effects of stress, conditioning on physiology and the immune functions; clinical interventions may be tested for their ability to induce, alleviate, treat disease. Research outcomes - clearly identified a link between emotion, physiologic reactivity and immune competence. Research has shown the following: Nerve endings are embedded in the tissues of the immune system Changes in the central nervous system alter immune responses Changes in hormone and neurotransmitter levels alter immune activity and vice versa Lymphocytes can produce both hormones and neurotransmitters Activated lymphocytes produce substances recognized by the central nervous system - interleukins & interferons Psychosocial factors alter the susceptibility or expression of autoimmune and infectious diseases Stress can influence immunologic reactivity (negatively) Psychoactive drugs and drug abuse influence immune function Stress can interfere with the effectiveness of an immunization program Hypothalamus also releases endorphins (feel good hormones) Negative personality Type A -- free-floating hostility Type C Personality - Helplessness is the key trait/risk factor for course of cancer treatment; observers, not participants Type D - anxiety, pessimism, despair, anger, inhibited self-expression Pessimistic Poor social support system suppresses the immune system Lower levels of immunoglobulin (in saliva) under stress Less capable of fighting cancer Higher level of complications in pregnancy Higher level of neonatal complications Less effective bonding with newborns Development of cancer, mental illness, suicide Absence of attachment Leading cause of pre-mature death in every disease category, especially heart disease Decreased immunity -- ↓ B cells, ↓T cells Excessive amount of cortisol - suppresses immune system Loneliness creates neuroendrocrine changes that lead to atherosclerosis. Divorce Simple interventions/activities can support/improve immune function, mood, health. Relaxation techniques, hypnosis, biologically target imagery can influence immunologic activity (positively) Relaxation techniques have been effective with: Reducing anxiety Reducing chemotherapy-induced nausea/vomiting Lowering hypertension Decreasing depression Decreasing headache frequency & intensity Decreased menstrual and back pain Classical conditioning can modulate immunological reactivity Responses can be conditioned by exposure to certain: conditions - taste, tough, heat chemicals - immunosuppressives events - emotionally meaningful/traumatic Solomon & Moos - autoimmunity may be related to immunologic incompetence which in turn may be related to emotional stress associated with elevated adrenal cortical steroid hormones. Ader's research with immunosuppressive drugs followed Chemotherapy induces anticipatory physiologic and immunologic conditioning The ability of placebos to act as stimuli The use of taste and imagery as stimuli as been tested in lupus erythematosus The effects of conditioning have been studied in MS Meditation - wakeful, hypometabolic state Most common types - Transcendental meditation (Maharishi Mahesh Yogi) Respiratory one (Herbert Benson) Clinically standardized meditation (Carrington, et.al.) Mindfulness meditation (Buddhist form) Physiological Effects, short-term - Deep state of restfulness Elicits different physiologic responses that vary by technique and time Oxygen consumption decreases Heart & respiratory rates decrease Galvanic skin resistance lowers Hormone levels are modulated EEG pattern altered Physiological effects, long term - Reduced health care costs Strengthened immune function Modulated anxiety, depression Lower blood pressure Reversed some components of cardiovascular disease Reduced frequency/duration of epileptic seizures Increased coping skills for chronic pain Lower rates of substance abuse Contraindications - History of schizophrenia or psychosis Hypersensitivity to meditation May unveil traumatic memories or emotions Biofeedback - information about one's self is used to modify, correct, strengthen processes within one's self; monitors one's physiologic processes/responses to be modified by one; uses the patient's own resources (not medications) to develop conscious control of biological responses to stimuli. General approach - best for individuals who are experiencing conditions that involve excessive/heightened arousal; stuck in fight/flight mode. Primary tools - muscle tension, skin temperature, sweatgland Treatment combines one or more allied relaxation-based approaches to alter one's physiological responses. Feedback is provided to the patient of the effectiveness of the effort; thus reinforcing the effort. Specialized tools - EEG, heart rate variability, blood volume pulse; require more extensive training to elicit changes in these measurements. Important to: Identify appropriate candidates for biofeedback Take a thorough history Establishment baseline levels of symptoms and physiology Monitor patient's training for compliance with technique Contraindications - Individual who cannot actively participate Individual incapable of learning Individuals taking muscle relaxants, vasoconstrictors, stimulants (Ritalin) Music therapy Laughter Writing/talking about traumatic events Group support for patients with cancer & chronic illnesses Group support for care-givers Positive personality Type B Self-healing Optimistic A fighting spirit Stress Resilience Strong social support system enhances immune system Stronger immune system Higher mortality, lower death rates from all causes Fewer complications in pregnancy Fewer neonatal complications More effective bonding with newborns Overall positive feeling, sense of self-esteem, stability, control over one's environment More problems are taken to friends than to physicians ↑immunity -- ↑WBCs, ↓ phagocytes, ↓ T cells ↑ recovery from surgery ↓ medications needed ↓ effects of stress ↑ treatment compliance Marriage Hypnosis - a state of attentive, focused concentration with suspension of some peripheral awareness; include absorption, alteration of attention, dissociation, and suggestibility History - Predates written language Trance states of mysticism Shamanic practices Imagery and healing techniques used by Egyptians & Greeks Franz Anton Mesmer - animal magnetism James Esdaile - a surgeon, performed surgery without pain and no anesthesia, reduced death rate post-surgery to 5% Milton Erickson, psychiatrist - emphasized the necessity for studying the process, state, and products of hypnosis Philosophy - Neodissociation model - hypnosis activates subsystems of control which have psychologic and physiologic counterparts resulting in an altered state of consciousness. Social psychologic model - suggestibility, attitudes, expectations Susceptibility to hypnosis is individual Best induced when taking advantage of the natural waking trance that occurs during a natural 90 minute ultradian rhythm cycle Highly effective for Surgical anesthesia Speeds surgical recovery rates Reduce pain from cancer, burn, and others Reducing duodenal ulcers, irritable bowel syndrome Reduces anticipatory nausea, pregnancy induced nausea Reduces anxiety, insomnia, obesity Smoking cessation Contraindications - Epileptic seizure disorders Depression Imagery - the thought process that invokes and uses the senses of vision, sound, smell, taste, movement, position, touch. Images produce physiologic, biochemical, and immunologic changes that affect health outcomes Types of images used for clinical intervention Diagnostic - provides the information needed to design individualized/meaningful imagery sessions for a patient. Mental-rehearsal - used to prepare the patient for medical procedures End-state - intended to produce a specific physiologic/biologic change in the body Effective in treating Eczema Acne Diabetes Breast cancer Arthritis Migraine and tension headaches Severe burns Improve lactation in mothers of premature infants Increased coping skill with birth pain Pain, regardless of source Is capable of altering Blood flow Changing inflammatory process Specific immune parameters Hormonal responses Recovery from injury Immune cell migration Assess treatment effectiveness for Cancer Spinal pain Diabetes Predictor of treatment outcomes Contraindications - Epileptics Unstable diabetics Chronic severe depression Other Healing Forces

THE TRAGER APPROACH

THE TRAGER APPROACH • AKA Trager Psychophysical Integration • Developed by Milton Trager, MD, • Definition -- A unique method of movement reeducation. This is accomplished using the language of refined touch and movement to influence psychophysical patterns in the mind and body. • The purpose is to break up deep seated patterns and resulting psychophysical compensations that inhibit free-flowing movements, cause pain, and disrupt normal function in affected areas. • When blocks are released at the source (the mind), the client can experience long lasting release and relief from these fixed patterns. • The result is general functional improvements. THE TRAGER APPROACH • The client is viewed as a whole being with the focus on how this person, this body-being, can be better than he or she is. • One of the great benefits of this work is the experience of a sense of deep relaxation and peace that will be achieved during a session. • There is no actual technique with Trager work, no set formulas. It is an approach to being with the body. • With a combination of gentle shaking, rocking, jiggling, oscillations, and shimmering, the joints and tissues are explored. • Mentastics -- A very significant, active component of Trager work, consists of mind-guided movements. Derived from mental gymnastics.

THE VERTEBRAL SUBLUXATION

THE VERTEBRAL SUBLUXATION Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the Subluxation Complex By definition a Vertebral Subluxation Complex (VSC) is a physiological and neurological disturbance caused by two adjacent vertebrae pinching a spinal nerve. A Subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health A Subluxation is evaluated, diagnosed, and managed through the use of Chiropractic procedures based on the best available rational and empirical evidence

The Healing Power of the Spirit

The Healing Power of the Spirit Unifies physical, mental, emotional, social aspects Focus on a meaning in life Enables us to follow a set of ethical principles There is a God The Power of Prayer on Health Relaxation Response Forgiveness

CHIROPRACTIC

The Palmers (founders of the profession of chiropractic) used the word "adjustment" for their spinal manipulative technique, and gave it a precise meaning • Otherwise, "manipulation" is a generic term with a broader meaning than the chiropractic adjustment, and is not limited to the spine • Pre-chiropractic literature on spinal manipulation can be categorized in several ways: • Manipulative practices of primitive peoples • Manipulation by ancient Eastern civilizations • Manipulative healing in the Western world • Other manipulative healing movements such as osteopathy, naprapathy, manual medicine and physical therapy • In Western World Hippocrates described a technique of spinal manipulation in the fifth century, B.C • During Middle Ages Hippocrates' technique was diffused through the writings of Ambroise Paré • Traditions of folk healing or unschooled healers using manipulation coexisted with the manipulation of the urban practitioners for centuries • By middle of nineteenth century, urban practitioners viewed spinal manipulation with ambivalence, but continued to be championed by a few medical practitioners such as James Paget and Wharton Hood • Physicians began to believe that manipulation was dangerous, perhaps because of the widespread occurrence of tuberculosis

Harvey Lillard.

The first Chiropractic Manipulation performed by D.D. Palmer was on a janitor named Harvey Lillard.

D.D. Palmer

The first Chiropractic Manipulation performed by D.D. Palmer was on a janitor named Harvey Lillard. As the story is told Mr. Lillard was deaf for 17 years, reporting that he had lifted something at work and heard a snap in his neck; since then could not hear. After examination Dr. Palmer noticed a significant bump in Mr. Lillard's neck. Correlating the structural misalignment with a functional problem Dr. Palmer adjusted Mr. Lillard and his hearing was restored. And so started the profession of Chiropractic. Chiropractic is a Greek word meaning

osteopathy Andrew Taylor Still, MD, DO

The practice of osteopathy began in the United States in 1874. The term "osteopathy" was coined by Andrew Taylor Still, MD, DO. Still was a physician and surgeon, Civil War veteran, Kansas state and territorial legislator, a free state leader, and one of the founders of Baker University, [18] who lived near Baldwin City, Kansas at the time of the American Civil War. In Baldwin, he developed the practice of osteopathy. Dr. Still named his new school of medicine "osteopathy," reasoning that "the bone, osteon, was the starting point from which [he] was to ascertain the cause of pathological conditions." Still founded the American School of Osteopathy (now A.T. Still University of the Health Sciences) in Kirksville, Missouri, for the teaching of osteopathy on 10 May 1892. While the state of Missouri granted the right to award the MD degree,[21] he remained dissatisfied with the limitations of conventional medicine and instead chose to retain the distinction of the DO degree. In 1898 the American Institute of Osteopathy started the Journal of Osteopathy and by that time four states recognized osteopathy as a profession (Wikipedia, 2014.)

Muscles Types

Types Skeletal - voluntary muscle contraction, includes muscle contraction without conscious thought Cardiac - specialized, contracts in a rhythmic/sequential pattern; results in forceful propulsion of blood through heart and body; contractions sustained by constant internal electrical system. Smooth - involuntary contraction; the movement of substances through arteries, veins, stomach, intestines. Components - Sarcomere - composed of myofilaments actin & myosin, separated by Z line; collection is wrapped in sarcolemma to form myofibril Myofibril - formed by many sarcomere. "All or none" response

Types

Types - Muscle tone - slight, sustained contraction Isotonic - tone stays the same; length of muscle changes Concentric - pulling mobile attachment toward fixed attachment; shortening the muscle Eccentric - contracting against gravity, lengthening the muscle Isometric - muscle length remains the same, tone increases Isokinetic - movement in resistance to force Prime Movers aka agonist - primary initiator of action Synergists - helps the prime mover Fixators - stabilizes the skeleton Antagonists - opposes movement of prime mover

Variable ischemic compression

Variable ischemic compression is a distinguishing feature of European NMT. European NMT offers a variation that applies deep pressure (sufficient to produce referred pain symptoms) for approximately 5 seconds, followed by an easing of pressure for 2 to 3 seconds. This is repeated until the local or referred pain diminishes (or, rarely, until either pain increases) or until 2 minutes have elapsed. • A final absolute requirement, regardless of the method used to release the trigger, is to stretch the tissues to help them regain their normal resting length.

Introduction to Chiropractic

Western Manual Techniques: • Chiropractic • Osteopathy • Massage Therapy • Neuromuscular Technique aka Trigger Point Therapy • The Rolf Method of Structural Integration • Applied Kinesiology • The Trager Approach • Feldenkrais Method

Dr. Rolf

• Dr. Rolf asked the fundamental question: "What conditions must be fulfilled in order for the human body structure to be organized and integrated in gravity so that the whole person can function in the most optimal and economical way possible?" • To explain how we are able to remain upright, Dr. Rolf compared the body with a tent. Her understanding was similar to Buckminster Fuller's tensegrity model. She compared the poles with the bones and the guy wires and tent fabric with the myofascial system. What keeps the tent up is not the poles, but the equal pull of the guide wires and the fabric across the poles. • Because the entire body is connected through its fascial network, lines of stress and strain within any section of fascia can be immediately transmitted throughout the entire fascial network. A misaligned body is a body at war with itself and gravity. THE ROLF METHOD OF STRUCTURAL INTEGRATION • Paradigms of treatment intervention • Relaxation paradigm - includes any practice that attempts to produce the relaxation response as a way to alleviate pain and other symptoms. • Corrective paradigm - aims at the symptomatic and piecemeal treatment of disease, pain, dysfunction, and structural problems. • Holistic or integrative paradigm - includes practices that aim at cultivating integration, balance, and harmony for the whole person. • Principles • Adaptability principle -- ability to adapt to and accept new options of selfperception, alignment, and motion. • Support principle -- specific application of the adaptability principle and is based on Dr. Rolf's understanding of the effects of gravity on structure. • Continuity principle -- further specification of the adaptability principle. • Palintonic principle -- recognizes that the success of any intervention or series of interventions is a function of appropriate spatial relationships. • Closure principle -- recognizes that when the patient has achieved the highest level of somatic and perceptual integration possible within his or her current set of limitations, treatment should be terminated.

Manual Therapies

• Eastern Manual Techniques: • Shiatsu • Ayurvedic Bodywork • Polarity Therapy