AK issue n.16 - Fall 2003


Articles - Abstract

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EDITOR'S NOTE

For years kinesiologists have been treating a wide variety of childhood conditions with astounding success, such as otitis media, colic, fever, headache, gastric upset, torticollis, bed-wetting, learning disability, and many other problems. An impressive list of treatments and solutions begs the question: Why aren't more kinesiologists involved in infant and child care? We hope that the answer to this is increased education on pediatric approaches. In this issue we are very grateful to Doctors Gerald Weiss, Scott Cuthbert, Dawn Duffy, George Goodheart, George Georgiou, William Maykel, Michael Barras, the ICA, and the ICPA for their contributions.

For everyone who has followed The International Journal of Applied Kinesiology and Kinesiologic Medicine since 1998, a new change in format may be noticed. Instead of including all three languages (English, Italian, German) in one journal, we are now at the stage where we are able to have two separate editions, an English-German version and an Italian version.
While overall printing and production costs will remain relatively unaltered, we will now be able to serve our supporting associations and advertisers in a more efficient manner. First, we will be able to print on a schedule that allows each country to receive its journal during certain time periods that best suit our readers. Secondly, we will save on shipping costs, since most of our bulk orders to kinesiology associations all over the world are based on weight, thus saving precious funds that can be used to cover all other cost increases related to keeping the Journal top quality.

Our advertisers will be happy that with decreased costs, we will be allowed to print and distribute more journals in each country allowing for more product exposure. This is a very difficult period for the publishing and advertising industries but we feel that we have been very fortunate not to have been forced to decrease the quality of the Journal for financial reasons.

But the ultimate aim of the Journal will be to serve our readers. We will continue to provide original, authoritative, peer-reviewed information that can be used by the clinician in the advancement of a professional career and to deliver the best patient care available.


THE DEVELOPMENT OF THE SKELETON AS AN AID TO EXPLAIN THE CRANIOSACRAL RELATIONS AS AN AID TO EXPLAIN THE CRANIOSACRAL RELATIONS

By Gerald Weiss, MD

Both craniosacral therapy and AK use the empirically determined connections between skeletal structures (particularly the cranium and pelvis) for diagnosis and treatment of lesions.
References that appear in literature (eg, Lovett Brother connection between the symphysis pubis and symphysis menti) are not always applicable. In addition, an explanation will be proposed for these empirically found references from the embryological development of the skeleton. For this it is necessary to first provide a comprehensive understanding of the development.
The head and neck are developed very early. They are the first existing body parts of the human. From this point on, the embryo grows very distinctly in a caudal direction (ie, neck, chest, lumbar, and sacral region) and less distinctly rostrally to develop the prechordal parts of the head. The chorda dorsalis acts as an organizer of the head and the brain.
The sclerotomes of the four-and-a-half cranial somites fuse at the basio-occiput to form an osseous ring that surrounds the foramen magnum. At the same time the muscles of the tongue, pharynx, and neck develop from the same dermatomyotome (hence the AK challenge for a lateral occiput of tongue protruded to the right or left).
The boundary between the head and neck extends through the fifth somite. The caudal half of the fifth somite and the cranial part of the sixth somite form the pro-atlas, but it usually does not persist in the human. Its material forms the tip of the dens and possibly furnishes cells to the occipital condyle. The caudal part of the sixth somite joins with the cranial part of the seventh somite to form the dens and altas.

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MATERNAL ADRENAL STRESS DISORDER AND THE EFFECTS ON THE UNBORN CHILD

By Dawn D Duffy, DC, DICCP

Applied kinesiologists commonly encounter and manage patients with Adrenal Stress Disorder (ASD). This article is directed towards giving the reader a greater insight into the effects of stress on the pregnant female and subsequently her unborn child.
Stress as defined by Seyle involves physical, chemical, mental, and thermal factors (1). Applied kinesiologists are well equipped to diagnose and manage ASD and it will be shown to be of paramount importance to the unborn child to identify and correct all stressors in the pregnant female. Part of stress management is educating the mother on how stress affects her and her developing baby, with possible lifelong ramifications. Examples of physical stress are: trauma, illness, injury, pain, structural strain, occupational requirements/long hours of work, physical abuse during pregnancy, and heavy physical work. Examples of chemical stress are: poor diet, refined food (sugar, grain), caffeine, nicotine, alcohol, food additives, artificial sweeteners, drugs (prescription or illicit), environmental poisons, change in oxygen levels, and type of delivery (induction, anesthesia/analgesia, C-section). An example of thermal stress is recurring exposure to extremes of temperature. Physical, chemical, and thermal stressors are of 10 times easier to identify than emotional stressors, which may require more questioning of the mother with possible referral for counseling if appropriate. The following emotional stressors are particularly important to delineate in the pregnant female: daily hassles, life-event changes, depression, pregnancy related anxiety, family problems, monetary problems, violence during pregnancy in the form of physical and/or emotional abuse, single parent pregnancy, and unwanted pregnancy (2).
The second stage of the General Adaptation Syndrome as defined by Seyle is "resistance", where the stressor continues and the adrenals begin to hypertrophy in order to continue to meet the demands of the stressor (1). This is seen clinically in the common pattern of an elevated cortisol with decreased DHEA level in salivary testing. Although the placenta protects the unborn child by inactivating cortisol as it crosses the placenta, this protection is limited (3). If maternal cortisol crosses the placenta in excessive amounts and for prolonged periods of time, the developing brain of the unborn child is primed to react in fight-or-flight mode, even when inappropriate. This effect is observed throughout a lifetime (2).

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APPLIED KINESIOLOGY AND DOWN SYNDROME: A STUDY OF FIFTEEN CASES

By Scott Cuthbert, DC

INTRODUCTION
I have been very fortunate this year to know 15 families who have children with Down syndrome. This essay will describe these children's histories, their clinical findings, and their evaluation and treatment using applied kinesiology methods.
"Down syndrome" is a term formerly used to describe these cases, but that is not the proper terminology. The Down syndrome does not define these children or adults. It is not their identity. We do not say "a Down syndrome child" any longer, we say "a child with Down syndrome".
There are encounters in a doctor's life that grant him/her an intimate vision of life and calling and offer a more direct route to the soul of a doctor's work. After these encounters, the doctor's soul is not the same as it was before. The child with Down syndrome will reveal a dimension of spiritual and emotional tenderness that are all too often hidden for most of us under the pressures of modern life. These patients with Down syndrome and their families reconnected me to my calling as a physician. The gratitude the physically and mentally challenged can feel for even a little improvement in their state will enrich your practice. What to your normal patients seems of little consequence or taken for granted become, to those who wish with all their being to feel and think and move more normally, the greatest gifts of all.
Parents of children with Down syndrome will immediately identify with the applied kinesiology concepts about the causes of neurologic disorganization. The signs and symptoms of neurologic disorganization or "switching" (clumsiness, mixed dominance, perceptual and motor development delay) are understood very clearly by the parents of children with Down syndrome.
Down syndrome is the most common readily identifiable cause of intellectual disability, accounting for almost one-third of all cases. It occurs equally in all races with an overall incidence of approximately one in 800 births (1). This is much lower than the actual conception rate due to a high incidence of spontaneous and surgical abortion. Congenital heart disease affects 40% of these babies (1). Severe congenital heart disease remains a major killer of children with Down syndrome, despite advances in surgical treatment. In the absence of a congenital heart defect, the majority of children can expect to live into their sixth decade. Up to 15% of children with Down syndrome will have radiological evidence of instability of the atlanto-axial joint (1), but in only a handful of cases will this instability result in an impingement of the spinal cord with resultant neurological signs. Many reasons have been proposed in the literature about the causes of the improper cell division that leads to Down syndrome (Trisomy 21), but genetic predisposition, maternal age, hormonal abnormalities, X-ray exposure, immunologic problems, potent drugs, and viral infection may be involved in these patients' histories.

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CONCLUSION
Any child who has struggled with distorted functions owing to impairments of structure may need training to teach him how to correctly use his reformed mechanism. The tongue thrusting frequently found in children with Down syndrome may need myofunctional therapy. Adjunct therapies, such as vision and auditory training, tutoring and a well-balanced diet of whole, natural foods with carefully selected supplements will then be far more effective.
Children with Down syndrome will be developmentally slower than their siblings and peers and have intellectual functioning in the moderately disabled range, but the range is enormous and the distance from their peers is the crucial factor where our chiropractic therapeutics can make a profound difference.
The ability we possess to repair the neurological disorganization in these children can be affected rapidly with the proper treatment to the cranial-sacral mechanism. Parents are frequently amazed at the speed with which this happens. Once the cranial mechanism is repaired and it begins to move freely, the child becomes a new creature with his/her potentialities greatly improved for normal function. The cranial mechanism must be included in the practice of chiropractic care for the physically and mentally challenged because it is in fact the headquarters for all the functions that operate within the child. This is the part of the body with the greatest disturbances in these cases and should not be ignored.
People with mental and physical disabilities are the largest minority group in the United States. They outnumber Latinos, African-Americans, and Asians. People with Down syndrome are now living at home within our communities. They are growing up with their peers at school and at play, working, dating, living independently, and growing old. Their lives now present new opportunities and challenges for themselves and for those who work and live with them. People with physical and mental disabilities are going to be seen, increasingly, as the individuals they are, with individual abilities that are going to be nurtured and enhanced. With our gifts in the evaluation and treatment of neurologic disorders, chiropractic and other holistic physicians with skills in the cranial arts should be on the front lines of the coming renaissance for these people. If you can make contact with a few of these patients or their advocates in your community and increase their level of health by your service, you will open a doorway that will increase your reputation and your practice.

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AK CLASSIC CASE MANAGEMENT ...ENURESIS

By George J Goodheart, DC, DIBAK

Many doctors and many parents are deeply concerned with the problems that enuresis produces in the children under their care. Attempts have been made to ascribe this troublesome condition to psychic or emotional causes. Efforts have been made to use conditioned reflexes and elaborate moisture sensing devices to alleviate the problem of bed-wetting.
Spontaneous cessation of the symptoms sometimes occurs as the child grows older. Fluid restriction and interruption of the child's sleep by the parent to allow the child to void any accumulation of fluids is good management of the situation. This is a physical, functional, structural problem associated with disturbances of the segments, not at the kidney and bladder areas of the spine, but at C3, which is associated with the innervation of the phrenic and intercostals nerves.
The respiratory center is located in the lower brain stem and consists of two division, an inspiratory and an expiratory center. This respiratory center is powerfully affected by changes in the CO2 content of the blood, in that, as the CO2 level rises, the respiratory center is stimulated. It vents off or washes out the accumulating CO2 by increasing the depth or frequency of respiration or both. This increase in the depth or the frequency of the respiration must be accomplished by an increased excursion of the diaphragm, and this action must be accomplished by the phrenic nerve, which is basically derived from the segments at cervicals 3, 4, and 5, principally at cervical 3.
The depth of sleep varies with children and adults on two distinct curves. In most adults, sleep deepens rapidly to the end of the first hour, then sharply shallows out, and then gradually shallows its curve until the person awakens. In the child the sleep curve is different.
There are two periods of deepest sleep in children. The initial period occurs in the first one or two hours. There is a second deep sleep curve at the eighth and ninth hour, following which the curve sharply shallows, as does the adults' curve, as the child nears awakening. It is these different patterns of sleep that are sometimes responsible for the oft told admonition "not to worry", that the child will outgrow the condition. This is occasionally true but is only sheer chance and unpredictable to say the least. As the child sleeps, either at the first deep period or at the second deep period, and as the sleep deepens, there is an occasional sighing respiration as the CO2 is vented off by action of the respiratory center. If the nerve control to the diaphragm is normal, there is no interruption of sleep nor is there any involuntary voiding or urine.

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There are no new models of the human anatomy. The principals that were true in the time of the ancients, who practiced our profession, are still true today. We live in AD time with BC bodies-all that has changed is the implementation of knowledge about the body. Use this whole body concept to further advance yourself, your practice, and your profession.


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