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Subluxation. Definitions and Component Models Philosophy IV Victor G. Strang, D.C. Palmer College of Chiropractic. SUBLUXATION ( structural dysrelationship with associated neurological dysfunction ). “ DIS-EASE”/INCOORDINATION

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subluxation

Subluxation

Definitions and

Component Models

Philosophy IV

Victor G. Strang, D.C.

Palmer College of Chiropractic

slide2

SUBLUXATION

( structural dysrelationship with associated neurological dysfunction )

“DIS-EASE”/INCOORDINATION

(alteration of homeostatic balance of body organs and systems)

May contribute to the onset or perpetuation of:

DISEASE/PATHOLOGY

what is a subluxation
What is a subluxation?
  • "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.”

ACC Position Paper, 1996

the stephenson definition mopi
The “Stephenson” definition: (MOPI)
  • “..a subluxation is the condition of a vertebra that has lost its proper juxtaposition with the one above, or the one below, or both; to the extent less than a luxation; and which impinges nerves and interferes with the transmission of mental impulses.”
slide5
“MOPI”
  • Misalignment/malposition
  • Occlusion/narrowing
  • Pressure/impingement
  • Interference
the homewood definition 1962
The “Homewood” Definition (1962):
  • “A subluxation in the chiropractic sense is not a partial dislocation (less than a luxation), but an alteration of the normal anatomical or physiological relationships, or dynamics, of contiguous structures.”
what is a subluxation1
What is a subluxation?
  • A subluxation is a misalignment, malposition or dyskinesia of any skeletal articulation within its active or passive range of motion.

(PCC draft, 2003)

what is a vertebral subluxation
What is a vertebral subluxation?
  • A vertebral subluxation is a subluxation of any weight- bearing spinal articulation that compromises neural integrity and may influence organ system function and general health.

(PCC draft, 2003)

gatterman 1995
Gatterman (1995:
  • “…a motion segment, in which alignment, movement integrity, and/or physiological functions are altered although contact between joint surfaces remains intact.”
wca practice guidelines for straight chiropractic 1993
WCA-Practice Guidelines for Straight Chiropractic (1993):
  • “..a misalignment of one or more articulations of the spinal column or its immediate weight-bearing articulations, to a degree less than a luxation, which by inference causes alteration of nerve function and interference to the transmission of mental impulses, resulting in a lessening of the body’s innate ability to express its maximum potential.”
what is the most generally accepted definition of a subluxation
What is the most generally accepted definition of a subluxation?
  • "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.”

ACC Position Paper, 1996

slide13
The subluxation (as a term generally in use by chiropractors) is becoming understood more as a process, than a “lesion.”
subluxation as a process
Subluxation as a process:
  • Conveys the idea of a beginning (onset), and time-related changes
  • “phases” or stages can be labeled
  • Different characteristics or findings at different points in time (as photographs of a person change over time)
  • Importance of chronicity in clinical approach to the process
slide15

The subluxation, as a process, is considered to involve multiple local tissues and multiple body systems which constitute “components” of the process.i.e.: how can we identify or localize the process in a person?

5 component model of vsc dishman faye flesia
5-Component Model of VSC (Dishman/Faye/Flesia)

1. Kinesiopathology

2. Myopathology

3. Histopathology

4. Neuropathophysiology

5. Biochemical changes

2 component model amalu tiscareno
2-Component Model (Amalu & Tiscareno):

1. Segmental aberrant spinal arthrokinematics

2. Neuropathophysiology

3 component model kent the three d s
3-Component Model (Kent):The three “D’s”:

1. Dyskinesia

2. Dysponesis

3. Dysautonomia

dysponesis
“Dysponesis:”
  • A reversible physiopathologic state consisting of unnoticed, misdirected neurophysiologic reactions to various agents (environmental events, bodily sensations, emotions, and thoughts) and the repercussions of these reactions throughout the organism. These errors in energy expenditure, which are capable of producing functional disorders, consist mainly of covert errors in action-potential output from the motor and pre-motor areas of the cortex and the consequences of that output.
slide20
The “Safety Pin” Cycle:(how the nervous system works normally, and “dysponesis” is what happens when it doesn’t)

“unnoticed” errors in input (afferent transmission) result in “covert” errors in output (efferent transmission), which has repercussions throughout the organism (“dis-ease” and “functional disorders”)