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1.  THE NEED AND OPPORTUNITY FOR BASIC RESEARCH INTO CHIROPRACTIC 
PMCID: PMC2050808  PMID: 17987163
Chiropractic; basic science research
2.  CORRELATING MOTION PALPATION WITH FUNCTIONAL X-RAY FINDINGS IN PATIENTS WITH LOW BACK PAIN 
Objectives: To determine whether a correlation between motion palpation findings and abnormal coupling patterns, as viewed in lumbar functional X-rays, can be demonstrated in low back pain (LBP) patients.
Design: A prospective observational study of patients who present to a chiropractic clinic for assessment of low back pain.
Subjects: The sample population consisted of 27 consecutive patients presenting with LBP between the ages of 20-50 year old and who were capable of pain free lateral lumbar flexion.
Intervention: All subjects underwent motion palpation to determine whether a "fixation" at the L4/5 existed. All had lumbar spine X-rays in an anterior-posterior (AP) and bilateral AP lateral flexion position. X-rays were then analyzed to determine whether the coupling pattern at L4/5 was considered abnormal.
Results: In those patients with a perceived L4/5 motion restriction no coupling patterns where found in 6 cases (22.4%) and normal coupling patterns in 13 cases (48%). In those patients who presented with LBP and no motion findings at L4/5 no coupling was observed in 4 cases (14.8%) and normal coupling in another 4 cases (14.8%). The chi-squared test demonstrated no statistical differences (p>0.05) between the motion fixation at L4/5 and coupling patterns from lateral flexion X-rays.
Conclusion: It is of particular interest to note that the presence of the L4/5 fixation was not associated with abnormal coupling but conversely was frequently observed to be associated with normal coupling patterns. A simple correlation between a single motion palpation finding of a restriction at a L4/5 facet and an alteration in coupling patterns could not be supported.
PMCID: PMC2050639  PMID: 17989761
Chiropractic; lumbar X-rays; motion palpation; biomechanic
3.  EFFECTS OF FOCUS FILM DISTANCE (FFD) VARIATION ON ENTRANCE TESTICULAR DOSE IN LUMBAR-PELVIC RADIOGRAPHY 
Introduction: With the steady increase in public and professional concern regarding the biological effects of ionising radiation, there is a need for both the Chiropractic and Radiography professions to improve imaging techniques for the lowering of patient radiation doses. Lumbar radiographs are essential in chiropractic general practice for biomechanical diagnosis and postural analysis. Detailed anatomical measurements are taken from spinal radiographs for the determination of various biomechanical alterations for clinical purposes. The quality of spinal radiograph is dependent on a number of factors, including Focus Film Distance (FFD), magnification ratios, penumbra, contrast and density. Variation in FFD will vary magnification factor (MF) and Penumbra.
Objectives: The study aims to investigate the relationship between FFD and received radiation dose to patients, where the radiation dose to the testes may be significantly lowered whilst still maintaining acceptable image quality.
Methods: Radiographic images and dosimetry were obtained with a Seimans wall-mounted X-ray unit. All anterior/posterior (AP) and lateral lumbar-pelvic radiographs were taken of an anthromorphological phantom that resembles human tissues, at both 100cm and 200cm FFD. Five central beam air doses were measured for all parameters to demonstrate patient entrance doses.
Results: For AP lumbar-pelvic radiography, increasing FFD by a factor of two resulted in an approximately 30% decrease in entrance dose to the testes. For lateral lumbar-pelvic radiography a two fold increase in FFD resulted in a 70% reduction in entrance dose.
Conclusions: The study suggests for the first time that an FFD of 200 cm, which is largely utilised by the chiropractic profession, is an efficient method of minimising radiation dose to patient, during lumbar radiography.
PMCID: PMC2050622  PMID: 17987147
Chiropractic; radiography; focus film distance; lumbar spine

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