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 (alteration of homeostatic balance of body organs and systems) DISEASE/PATHOLOGY May contribute to the onset or perpetuation of:

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.”"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) “..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.”

“MOPI” Misalignment/malposition Occlusion/narrowing Pressure/impingement Interference

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 subluxation? A subluxation is a misalignment, malposition or dyskinesia of any skeletal articulation within its active or passive range of motion.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? 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.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: “…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): “..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? "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 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

Is the subluxation a lesion, or is it a process? A pivotal question:

The subluxation (as a term generally in use by chiropractors) is becoming understood more as a process, than a “lesion.”

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

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?

1. Kinesiopathology 2. Myopathology 3. Histopathology 4. Neuropathophysiology 5. Biochemical changes 5-Component Model of VSC (Dishman/Faye/Flesia)

2-Component Model (Amalu & Tiscareno): 1. Segmental aberrant spinal arthrokinematics 2. Neuropathophysiology

3-Component Model (Kent): The three “D’s”: 1. Dyskinesia 2. Dysponesis 3. Dysautonomia

“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.

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”)