Research at PCC Research Institute Ronald Rupert, Director of Research Basic Science Research...

Research at PCC Research Institute

•Ronald Rupert, Director of Research

•Basic Science Research–Xuejun Song, M.D., Ph.D., Director

–Dong Xu, M.D.–Zhengbei Wang, M.D.

•Clinical Science Research–Dwain M. Daniel, D.C., Director

–Cheryl McKenzie, M.S.–Murray Raymond, D.C.

•Basic Science

• “Neuropathic Pain Produced by Peripheral Nerve Injury, Spinal Ganglion and Dorsal Rhizotomy”– Experimental compression may be useful for

investigation of the cellular basis for pain and hyperalgesia in humans

•Basic Science

• “Effects of Vitamin B’s in the Chronic Pain Produced by Nerve Injury and Spinal Ganglion Compression”

– Administration of B1 and B12 reduced excitability of sensory neurons

– Administration of B1 and B12 reduces injury to the DRG and to some extent protects cells from death during chronic compression

•Basic Science

• 6 other studies pertaining to compression of the dorsal root ganglion underway

•Clinical Science• Dr. Rupert has had two studies published

that pertain to “Chiropractic Wellness”

• Other studies underway– “Heart Rate Variability as a Measure of

Wellness in the Chiropractic Model”– “Reliability of Motion Palpation to Locate

Fixation Subluxations”– “Success Surveys”

•Performance and Electrical Safety Status of Therapeutic

Ultrasound Utilized by Chiropractic Physicians

• Daniel, DM

• Rupert, RL

Background

• 70.3% of chiropractic physicians utilize ultrasonic therapy (UST)

• 34.3% of their patients receive UST

• 1,000,000 applications of UST weekly in chiropractic offices

Background

• Investigations in Canada (1987) and Scotland (1992) show calibration failure rates of 66%+ in physical therapy offices

• High dosage of UST, due to thermal effect, can cause tissue damage

• Low dosage of UST can result in little more than placebo effect

Methods and Material

• Cross sectional study of 31 chiropractic offices in Dallas and San Antonio, Texas

• 45 machines tested

Results

• 37.8 % failed calibration

• 15.5% failed safety inspection

• Combined failure rate 44%

• Five units had no power at the most common therapeutic setting although unit did indicate output

• Failure rate was age dependent (p<.05)

• 100 % of units over 15 years failed either safety tests or calibration.

• Units over 15 years old represented 17.8% of total machines.

Discussion

• Only one D.C. visited had had regular yearly checks on his equipment

• 66% of units had never been tested

• Only 2 of 45 machines had been tested in the past 12 months

Conclusion

• For effective and safe treatment of the patient, yearly inspections of all physical therapy equipment should be performed

• If chiropractors do not become more aware of their responsibilities in calibration and safety, surely state and national regulatory agencies will.

Preserving a Chiropractic Heritage: Historical Treatment

Methods for Visceral Problems: A Qualitative Study

• Rupert, RL, Daniel, DM, Langlois, JK, Parrish, RH

Background

• Percentage of patients treated for other than neuromusculoskeletal conditions– 1979: 21%– 1985: 13%– 1998: 5.3%

Purpose

• To contact chiropractors licensed prior to 1951 to record their collective wisdom and protocols used in the treatment of visceral conditions

• To identify visceral conditions which respond well to chiropractic management and develop further studies in those areas

Methods

• Qualitative

• Focus groups with 4 senior D.C’s

• Individual interviews with 6 senior D.C’s

Results

• All D.C’s between 70 and 94 years old

• Major themes– Confidence as a healer– History and philosophy– Independence– Patient/doctor relationship– Therapeutics

Colleges attended

• TCC

• Seckler’s CC

• Richmond University

• Lincoln CC

• Palmer

• Carver CC

Conditions reported treated with good results

• Malaria• Fever• Dysmenorrhea• Vision problems• G.I. Problems• Polio• Epilepsy• Sinusitis/Allergy• Diabetes

The Effect of a Unique Nutritional Supplement on

Memory and Other Cognitive Functions: A Randomized

Clinical Trial

Dwain Daniel, Cheryl McKinzie, Ronald Rupert, W. Paul Jones

Introduction

• “Cognitive Revolution” began in 1950’s

• Resulted in increased study of how the brain processes information

• Relationship of nutrition and cognitive function is a continuation of this process

Methods

• Medline, MANTIS and CINAHL searches

• Double blind, randomized, controlled clinical trial

• 103 subjects recruited, 68 began study, 54 completed study

• Test instruments: RBANS, DOT and Sternberg tests

Results

• When comparing treatment to placebo only figure copy was statistically significant p<.03

• When comparing 22 separate outcome measures of placebo to baseline and treatment to baseline, treatment reached statistical significance in 10 of 22 measures while placebo did in 5 of 22 measures

Discussion

• Blinding difficult

• Treatment period should have been longer

• Older subjects would have been better

• Overall the treatment did appear to out perform placebo, but additional research is needed to confirm the treatment effect

Opportunities in Chiropractic Research

National Institute of Health

• Postdoctoral Funding– Maximum of three years support– 40 hours per week– $26,916 to 42,300 + $4000

Training and Career Awards

• Mentored research and training

• Up to $50,000 per year + fringe benefits

• Up to $20,000 for tuition, research expenses and technical personnel

Foundation for Chiropractic Education and Research

• Has funding programs for MPH and Ph.D programs.

• Two MPH programs offered in the Dallas area

• SALARIES FOR TOP LEVEL CHIROPRACTIC RESEARCHERS APPROACH $100,000 PER YEAR

Scholarships

• Academy of Chiropractic Colleges– $7500 for student research project

• SOT– $500 for student project

Other funding sources

• Journal of Neuromusculoskeletal System offers $1000 for accepted research articles

• American Specialty Health offers a yearly $15000 scholarship for a 2500 to 3000 word essay

• Paid P/T positions are available at the Research Institute.

Other research opportunities

• Research Agenda Conference, March 2003, New Orleans. Cost of attendance is $60.

• Residency program planned in research by September 2004

• An advanced research course is offered. Upon completing this course each student will have completed a study that can be published.

Summary of Chiropractic Research

• Less than 100 full time chiropractic researchers

• Pfizer has 12,000 full time researchers

• Total budget for chiropractic research is $4 million/year

• Harvard received over $700 million from NIH last year for research

• Need for additional researchers and doctors performing practice based research