portion of chiropractic research, the authors are analyzing outcome measures in patient populations following chiropractic
intervention without validation of what it is (subluxation) that
is being treated. Further, the improvement in the subluxation
is seldom documented with reliable/valid methods. With this
in mind, correlation of subluxation reduction to improvement
in a patient specific condition cannot be made.
CBP researchers did not want to ‘place the cart before the horse’
by studying patient outcomes without prior investigation of the
methods used in these studies. Therefore, in the mid 1990’s a
four tiered research outline or plan was laid out where each tier
utilizes information from the preceding one(s). The tiers are:
1. Establish a scientific definition of the ideal and/or average
human spinal alignment.
2. Define and investigate the existence of spinal subluxations.
3. Evaluate the reliability and validity of the assessment of
spinal subluxation types described in tier 2.
4. Develop interventions to reduce subluxation types in tier
2 using the assessment procedures in tier 3 and investigate
patient outcomes using these interventions.
Koch: What are the clinical goals of CBP in a nutshell?
DEED: The CBP is very straight forward. While many in
chiropractic are turning away from structural outcomes of care
to concentrate solely on pain reduction, improved ranges of
motion, and other functional based outcomes, in contrast, CBP
emphasizes optimal posture and spinal alignment as the primary
goals of chiropractic care while simultaneously documenting
improvements in pain and functional based outcomes. The
uniqueness of CBP treatment is in structural rehabilitation of
the spine and posture. This goal requires ( 1) a precise definition
of normal posture and ( 2) reliability and validity of postural
Koch: The level of corrective care you are discussing requires
an extensive course of care. Understanding that each case is different in terms of severity, chronicity, degenerative joint disease,
patients stress load and lifestyle, what might your recommendations for corrective care look like for a hypothetical middle aged
patient with a moderate degree of DJD and pain?
DEED: The CBP protocol of care recommends that relief
care (traditional chiropractic management) be separated from
structural rehabilitation of the spine and posture. In this regard,
the typical patient would receive an initial 3 weeks of care ( 4
times per week or 12 visits) aimed at improving segmental
and gross spinal range of motion and pain intensity/frequency.
After, the initial relief care, CBP structural rehabilitation procedures would begin and include exercises, adjustments, and
traction performed in the Mirror Image® (referred to as the
E.A. T protocol). The mirror image® posture positions are the
rotation and translation pairs in or about each coordinate axis.
The reason for postural mirror image® exercises, adjustments,
and traction procedures is to address all the tissues involved
in spine and posture alignment. Mirror image® exercises are
performed to stretch shortened muscles and to strengthen those
muscles that have weakened in areas where postural muscles
have adapted to asymmetric abnormal postures. Although
strength and conditioning exercise has not proven to correct
posture, postural exercises performed in the mirror image®
have shown initial promise in the reduction of posture and spinal
displacements. Recommendations for the corrective phase are
made in 36 visit increments as warranted by the individual case.
Koch: This is obviously a very comprehensive approach to
spinal correction. What equipment and procedures are involved?
DEED: You are right, Bill, we try to cover all the bases.
Postural adjustments as performed with drop table, hand-held
instrument, or even mirror image manipulation procedures
are performed for resetting the nervous system regulation of
postural muscle balance. Postural mirror image and extension traction for the sagittal curves provides sustained loading
periods of 10-20 minutes and is necessary to cause visco-elastic
deformation to the resting length of the spinal ligaments,
muscles, and discs.
Koch: One of the things that your work provides is a system
of rehabilitative care for the patient to do at home. Please tell
our readers about it.
DEED: We partnered CBP with Denneroll Industries of
Australia to provide a full product line of biomechanically
correct supports and orthotic devices for the rehabilitation of
Koch: Looking at your website and literature, I am impressed
The reason for postural mirror
image® exercises, adjustments,
and traction procedures is to
address all the tissues involved
in spine and posture alignment.