This year’s Research Agenda Conference (RAC) 7 was a memorable event, to some degree, due to the inclusion of the Association of Chiropractic Colleges (ACC) Conference 9. This year both organizations teamed up to put on, to me, by far the most informative, interactive, and interesting conference to date.
A chiropractic colleague sent me an email inquiring about, “Hey, how are you doing at that egghead conference you are at?” I replied that I was doing well, and guessed that on some level we all have a little egghead in all of us. At least those of us who choose to question, “shoot the breeze”, challenge concepts commonly accepted, and enjoy the whole process. That was what interested me in Sacro Occipital Technique (SOT) when I had first attended my first SOT conference in 1979. While being a part of the audience at the RAC/ACC conference, though I found discussions can be intimidating or daunting, I found that often the very questions that need to be asked are those that might come from practitioners in the field.
There were so many fabulous presentations available, so my not mentioning one, should not in any way diminish the unbelievable efforts and information shared by all the researchers and presenters. There were tracks running simultaneously and I had personal time constraints that precluded my attending all sections. There was a wonderful poster presentation section (SOTO-USA was represented) organized by Dr. Claire Johnson, which was one part of the ACC contribution. For a complete listing of all the abstracts of the paper and poster presentations please see: Abstracts of ACC Conference Proceedings, The Journal of Chiropractic Education, 2002 (Spr): 16(1): 1-125.
Four specific presentations caught my attention and I thought I would share what I took personally from each. As usual, Dr. Dana Lawrence gave an informative presentation on “Writing for Peer Review Journals.” He gave five specific guidelines that an author should consider before and during writing a paper for a peer review journal.
1. What do I have to say? What will be the nature of my article -- a research paper, case report, review article, or commentary?
2. Will the paper be worth writing? Will this add to our base of knowledge?
3. What is the right format for the message -- a case report, literature review, or research report?
4. Who is the audience? Scientist to scientist (bench research), scientist to clinician (rigorus trial), clinician to scientist (case report and case series), or clinician to clinician (review article).
5. What is the right journal for your article? What is the scope of the article, who is the audience, what would be the acceptable format, and lastly if you want it published quickly what is the frequency of publication
Embarrassingly or whimsically what I think I took most out of his presentation was his last three admonitions:
a. Numbers are written as 1,2,3… except when starting a sentence
b. Chiropractic is not capitalized unless when starting a sentence
c. There should only be one space after a period.
Drs. David Sikorski and Jaroslaw Grod did a follow up study to the paper they had authored along with Dr. Joseph Keating entitled, “The unsubstantiated claims of the largest state, provincial and national chiropractic associations and research agencies” Journal of Manipulative and Physiological Therapeutics, 2001 (Oct); 24(8): 514-9. This follow up study was a poster presentation entitled, “The unsubstantiated website claims of chiropractic colleges in Canada and the United States.” Speaking with Dr. Sikorski at the conference he emphasized that we need to be careful that we do not overstate or misrepresent what we know about chiropractic or what our research can justify. He said that often all that would be needed is the addition or subtraction of a single word for a statement to be considered a “substantiated claim.”
As president of Sacro Occipital Technique Organization (SOTO) –USA I cringe to think if a review was made of what is written by all our chiropractic technique publications as well as lecturers at most technique seminars. I think it is not an issue of “minding what we say” or “walking on eggs,” but more to the point, being accurate and understanding what we do know and can justify and what we cannot. SOTO-USA is and will continue to strive for intellectual honesty in its publications and teaching.
Another interesting presentation in particular for SOT practitioners was an exploratory study of provacation testing using pelvic wedges or SOT blocks, by Dr. Anthony Lisi. He sought, using SOT blocks under the pelvis, to create lumbosacral torsion (category one right and left short leg – orthopedic block placement) and to create lumbosacral flexion or extension (SB+ or SB-). He was trying to study whether using an algometer for tenderness he could determine if there might be a directional preference to block placement. He concluded, “Measuring changes in tenderness at one anatomical point in response to various pelvic blocking patterns appears promising as an examination method to determine directional preference.”
Dr. Stephen Perle using “slight of hand,” both figuratively and literally presented information, which illustrated that we cannot always trust our eyes, or what we believe or choose to perceive. His presentation, “Radiographically determined anatomical location of point of peak pressure during pisiform and hypothenar contact manipulation procedures: A pilot study,” opened the door for chiropractic practitioners to step back and contemplate with what part of their hand they are actually contacting, prior to a thrust.
Common practices in technique and in our office often go unquestioned, at least until one attends the RAC/ACC. Dr. Perle presented research which noted that while we might be fortunate or skilled enough to be able to locate a specific bony landmark, what isn’t clear is with what part of our hand or wrist are we contacting that specific landmark. He found that with the use of radiographic analysis what became clear was that when we make a curved hand contact (e.g., toggle recoil) we actually will be contacting the part of the bone in question with our pisiform (as advertised). However when we use a flat hand contact (e.g., double transverse) the part of our wrist that is coming in contact with the part of the bone in question appears to the our hamate. The significance is that this might change our contact point, our location of contact, and possibly even our method of thrust.
One characteristic about all those at the conference, particularly the multi-published and celebrated researchers, is the common theme of how little we all know and how much there is to learn and investigate. My deepest gratitude goes to Drs. William Meeker and Claire Johnson for all their efforts in putting together this amazing event. Also thanks goes to all the moderators, presenters, peer reviewers, administrators, and attendees.
Charles L. Blum, DC
Sacro Occipital Technique Organization - USA