Questions to answer after watching (videos 1-5) Foundations of

Chiropractic Practice: Updating Ourselves by Dr. John J. Triano.

In KIRO, CP 2203, click on ShareStream Pick-n-Play (left side menu)
Please answer the following before coming to the Flip Class on January 26 th
John Triano TEP Presentation Part 1
1. How is treating a patient like going through the scientific method?
When we treat a patient, we need to start with a hypothesis and then using
tests to rule out different hypotheses.
2. Why should we study the mechanisms of manual therapy?
We need to study mechanism to identify individuals who best benefit from
chiropractic care, and from this we can optimize our results to be better
practitioners.
No point in RCT if you dont know mechanism
Know the mechanism, target population, and know that treatment is going to
work
3. What do we tell the patient we do?
We tell the patients that their pain can be a result of a disease of
mechanotransduction.
Normalize and optimize function
Health care discipline that focuses on prevention of disease and maintenance
and improvement of health related to mechanical disorders, especially MSK
We treat aberrations (problems) of health and wellbeing that either are due to
movement problems
4. Where is our entry to health? Where do chiropractors fit in?
Our entry to health is through normalization of movement. Chiropractors
primarily deal with helping people get a full return of movement.
Normalize movement to reset the dysfunction
John Triano TEP Presentation Part 2
View only
John Triano TEP Presentation Part 3
1. Fill in the dysfunctional model (Outline provided)
FIND SLIDE IN POWERPOINTS
2. How did Hartman in 2014 demonstrate the connection between
mechanotransduction and mechanotransduction disease? What experiment
did he do?
The experiment was to take tissue from an animal, and then put this tissue
within a machine to measure mechanotransduction in those cells within the
tissue in different movements. This looked at movement at the cellular level.
Axial torsion with flexion and extension should that it was pro-inflammatory in
all spinal tissues. Where you apply the stress is where the tissue responds.
Mechanotransduction disease results from where the stress hit the hardest

that causes the change, and not the process itself that causes the disease.
Altered segments drive pro-inflammatory responses.
3. What did the studies by Drs. Stephen Injeyan and Julieta Teodorczyk-Injeyan
on SMTs effects on chemical mediators (immunoregulatory, proinflammatory, anti-inflammatory) in LBP patients find, regarding acute and
chronic LBP group responses?
Inflammatory mediators have different levels and responses depending on
acute, chronic and asymptomatic. Acute and chronic LBP showed different
levels and types of inflammatory mediators.
Acute LBP showed that the chemokine production is attenuated after SMT.
Chronic LBP showed inflammatory cytokines were suppressed after SMT.
John Triano TEP Presentation Part 4
1. What 3 levels of the dysfunctional movement model does manual therapy
act, based on the current evidence?
Changing local tissue stress
Changing nocioceptor, sensory receptor perception
Changing the way the nervous system centrally responding
John Triano TEP Presentation Part 5
1. Does technique matter?
Yes. Optimise technique based on position of patient using a specific
technique and changing the rate.
2. Do chiropractors use too much force during cervical SMT?
No.