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Computerized Spinal Exams
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Computerized Spinal Exams - November 8, 2006 7:16:00 AM
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coreconcepts
Posts: 68
Joined: April 13, 2005
From: Vancouver, BC
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What's the research on the effectiveness of surface EMG as a Dx tool?
Any help would be appreciated.
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Re: Computerized Spinal Exams - November 8, 2006 2:27:00 PM
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touchiba
Posts: 101
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From: PA
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Diagnostic or to show progress?
Diagnostically, I'm not so sure EMG is good for much. However, I have spoken to a few MDs that use it help show progress and help them win their PI and work comp cases.
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Re: Computerized Spinal Exams - November 8, 2006 3:22:00 PM
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coreconcepts
Posts: 68
Joined: April 13, 2005
From: Vancouver, BC
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Thanks BTDC,
It was done on a client of mine for the purpose of detecting subluxations - in an initial visit. Presumably it will be used again to show progress?
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Re: Computerized Spinal Exams - November 8, 2006 3:53:00 PM
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rwillcott
Posts: 435
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From: Canada
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I'm quite confident there is not reearch to support EMG to detect subluxations. Much less evidence to support subluxations in the first place. Try typing subluxations and EMG into Cinahl or Pubmed and you'll have your answer.
Rob
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Re: Computerized Spinal Exams - November 8, 2006 4:05:00 PM
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touchiba
Posts: 101
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From: PA
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It's more of a patient education tool than anything. It's something that can be shown to the patient versus just saying, "yeah, your muscles feel much more relaxed." As a chiro, I question it's validity and dont use it in my office.
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Re: Computerized Spinal Exams - November 9, 2006 5:14:00 AM
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proud
Posts: 944
Joined: March 22, 2006
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Well it's more of a device to convince the patient that something is "wrong"...when in fact there is likely nothing "wrong"...but that is what you want them to believe to convince them they need "your" help. It's fraud.
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Re: Computerized Spinal Exams - November 9, 2006 7:11:00 AM
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touchiba
Posts: 101
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From: PA
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I wouldn't call it fraud in all cases. As long as it correlates to symptoms and other findings, then I dont think it is all bad. I would not use it myself, but I'm not going to say everyone that uses it is committing fraud.
It can help with patient compliance, which in turn can help improve outcomes. It's different for us chiros. We dont have the luxury of having a script from an MD that says the patient must come to us 3 times per week for 6 weeks. People follow that without question. With direct access patients, there's a problem with most wanting to drop out of care as soon as they start to feel a little bit better or if they aren't cured in 1 visit. The surface EMG can help show them change.
Plus, like I mentioned, MDs are using it to win auto and comp cases by showing abnormal muscle firing and progress. Are they committing fraud?
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Re: Computerized Spinal Exams - November 9, 2006 9:02:00 AM
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proud
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Sorry. I shall clarify. Fraud if used to convince someone of a "subluxation".
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Re: Computerized Spinal Exams - November 9, 2006 12:50:00 PM
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proud
Posts: 944
Joined: March 22, 2006
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Steve,
Great little example of some pretty shoddy behavior...which we have all witnessed.
How about real time ultrasound for the rehabilitation of Tra and multifidus as an example of using an instrument with evidence supported therapeutic purposes.
My problem with any device is when it is utilized to provide patients with information that lacks any research to support the claims. Someone on here mentioned you could use EMG to show someone that their muscles are more relaxed...but how do we know that that has anything to do with their problem? Because they "feel better" with relaxed muscles? No kidding but I doubt it adds any value to patient care...more like "value" to the con artist convincing his/her patients...
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Re: Computerized Spinal Exams - November 9, 2006 4:04:00 PM
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rwillcott
Posts: 435
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From: Canada
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I assesed a patient today with chronic neck and back pain. He has been having chiropractic treatment over the past year which has provided short term relief. However, he stated that presently he is in the same amount of pain today as he was when he first started having chiropratic treatment.
Fortunately, his family doctor advised against the chiropractic treatment and recommended physiotherapy. His doctor had noted that his symptoms seem to be postural related and since he has never been given any exercises he would benefit from a PT assessment.
Ironically, he had a chiropractic treatment one week ago and the chiropractor perfomed some sort of "scan" of his spine. He stated that the results of this scan showed that there are areas of his spine that require more "adjustments"
I explained to the patient my findings and that they will involve some mobilizations and manipulations of his thoracic spine. More importantly I would be teaching him specific exercises to help stabilize his spine and correct his posture. I also made it clear to him that I would not treat him while he is being "adjusted" He seemed reluctant to give up the chiropractic treatment and wanted to think about it.
This is an example of a patient that has been led astray and brainwashed by these magical scans and devices used to scare patients. It's quite sad really since it is a patient that does not know any better and had put his trust in this chiropractor.
Rob
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Re: Computerized Spinal Exams - November 10, 2006 12:21:00 PM
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PainFree
Posts: 84
Joined: August 13, 2006
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I am a chiropractor and personally do not see the merit in my colleagues routinely using these procedures. I have had "scans" done on me at one clinic, drove to another and had different results 30 minutes later on yet another colleague's unit.
I have found it to be beneficial to have PT/ DC treatment occur simultaneously. I have co-managed more patients than I can even begin to bring to mind. However, it seems to me that you guys go out of your way to discourage it....which leads me to question whether the five or six clinics I work with ultimately feel the same way. Guess I will withdraw my referrals and spend the money to incorporate some of those procedures in-house.
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Re: Computerized Spinal Exams - November 10, 2006 3:09:00 PM
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proud
Posts: 944
Joined: March 22, 2006
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How about this diagnostic tool from a CMCC grad. Click on the interview with Mr.Sharda:
http://www.drsharda.com/home.html
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Re: Computerized Spinal Exams - November 10, 2006 3:20:00 PM
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dfjpt
Posts: 238
Joined: April 9, 2006
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I noticed this statement on the site:
"Your chiropractor is a doctor with over 7 years of university education in the art of hands-on healing. "
This is far from the case. To apply, candidates need to have completed 3 years of undergrad at uni. They do not have to have obtained a degree in anything.. it could be all 101 classes.. they just need to have attended and taken classes, passed them..
The next 4 years are at a private college, in English speaking Canada anyway. The school, CCMC, is in Ontario. It's a 4-year program. The government of Ontario has agreed (one can suppose after lots of lobbying) to let this school dish out "degrees", that the school claims are the "equivalent" of university degrees. Even though there is no degree bearing a seal from a recognizable university handed to a graduate chiropractor by a chancellor or bearing the seal of any university president, the students coming out of this program are declaring that they have "7 years of university-based training." The chiro TV ads are saying the same thing. Talk about stretching a point...
I know this is slightly off topic, but I want people to know about this distortion.
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Re: Computerized Spinal Exams - November 11, 2006 2:15:00 AM
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Jeep
Posts: 353
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From: USA
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DFPT-
It is YOU that is (shamelessly)"distorting"----And the "shameless" is, because, you know it!! That is dishonest.
>>>"They do not have to have obtained a degree in anything.. it could be all 101 classes.. they just need to have attended and taken classes, passed them.. "<<<
ALL "101 classes"? "just attended and taken"? Please provide your evidence to support this.
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Re: Computerized Spinal Exams - November 11, 2006 5:38:00 AM
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mcap56
Posts: 618
Joined: October 26, 2002
From: New York, NY
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Surface EMG, as far as I know, has not been used for diagnosis. Needle emg is a different story.
Even when used for laboratory research studies, under controlled conditions, surface EMG is very problematic. The problem is standardization. The readout gives you muscle activity. We know from studies that this activity is linearly related to muscle force. But so what? What does activity in any one patient tell you? Nothing. If the activity seems high, it could still be a lower percentage of the total activity available.
The work around for this is to standardize the activity as a percentage of maximal voluntary contraction. But how do you get the activity level for the MVC? Typically, this is done with a maximual isometric contraction or movement of a known weight. But...I really question whether that is peak output or standardized output.
Considering it's questionnable research application, I doubt it could be used effectively for any diagnostic purposes. EMG biofeedback however, can be a useful aid during rehab.
Best,
Marc
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Re: Computerized Spinal Exams - November 11, 2006 8:49:00 AM
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ONstudentPT555
Posts: 224
Joined: July 25, 2006
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I think what DFJPT was trying to say is that chiropractors saying they have 7 years of university is misleading because .. the 4 years of chiro school is not really university but a private career college.
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Re: Computerized Spinal Exams - November 11, 2006 3:32:00 PM
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dfjpt
Posts: 238
Joined: April 9, 2006
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Thank you ONstudent.
Here is what is on a chiro org webpage:
[QUOTE]Becoming a Chiropractor
Post-Secondary Requirements:
Chiropractic education in Canada is under the auspices of The Council of Chiropractic Education of Canada (CCE(C)). This body requires that before entering a chiropractic course of study, you must have successfully completed a minimum of three years of study in any discipline at a Canadian university or its equivalent. It is strongly recommended that you complete one full course with labs in organic chemistry and biology, a half course in introductory psychology, and at least one-and-a-half courses in humanities or other social sciences.[/QUOTE]Saying that it takes "7 years of uni-based training to be a chiropractor", in English speaking Canada anyway, is a deliberate distortion, by the look of things. It does not say anywhere that a candidate requires a degree or even a certificate of completion from an actual uni. Just take some classes there and come on over to our ..um... colledge, where we'll give you our "degree" when you graduate.
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Re: Computerized Spinal Exams - November 11, 2006 4:34:00 PM
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proud
Posts: 944
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Not to mention the diploma is not "uni".
So what we have is 3 years of under water basket weaving(potentially) and 4 years of compu college(in similair terms of not being a university).
And I am not taking anything away from compu collge. Intelligent people graduate from these collge programs. But they do not distort facts and claim 7 years of university training.
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Re: Computerized Spinal Exams - November 11, 2006 6:49:00 PM
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touchiba
Posts: 101
Joined: November 11, 2002
From: PA
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"To apply, candidates need to have completed 3 years of undergrad at uni. They do not have to have obtained a degree in anything.. it could be all 101 classes.. they just need to have attended and taken classes, passed them.."
Can anyone confirm that is the case for CMCC? In the states the pre-reqs are specific. They can not just be "all 100 level classes". What a truly ignorant statement. As I've mentioned before, I was on track to go to PT school, but when I changed my mind to chiro, I had to go back and take one or two additional classes to meet the chiro pre reqs. I believe CMCC is accredited by the CCE, so if that's the case, then the pre reqs for them would be the same too.
I have no idea what any of this has to do with surface emg. Taking cheap shots every chance you get, eh Diane?
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Re: Computerized Spinal Exams - November 11, 2006 7:18:00 PM
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dfjpt
Posts: 238
Joined: April 9, 2006
Status: offline
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No, claiming to have 7 years of university based training is a distortion. Hello? Stop trying to attack me, I'm not the bad guy here, the point is the distortion itself, and that it is being made bald-facedly to the public. It is not a "cheap shot" to point out that a distortion is being made that seems to be deliberate. Get over yourself.
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