Table Of ContentConcepts and Mechanisms
of Neuromuscular Functions
An International Conference on Concepts
and Mechanisms of Neuromuscular Functions
Edited by Ph. E. Greenman
With 30 Figures and 9 Tables
Springer-Verlag
Berlin Heidelberg New York Tokyo 1984
International Conference held at Michigan State University,
East Lansing, 1980
Prof. Philip E. Greenman, D.O.
Associate Dean
Office of the Dean
College of Osteopathic Medicine
Michigan State University
East Fee Hall, East Lansing,
Michigan 48824-1316, USA
ISBN-13: 978-3-540-13470-1 e-ISBN-13: 978-3-642-69779-1
DOl: 10.1007/978-3-642-69779-1
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Preface
Manipulation as a treatment modality dates at least to the time of Hippocrates,
(Schiotz and Cyriax, 1975). It has continued to be used intermittantly thereaft
er. In the late nineteenth century manipulation became a fundamental part of a
new school of medicine founded by Andrew Taylor Still, M. D. (Northup,
1966). Osteopathy was presented to the medical world in 1874, and the first for
mal education began in 1892 in Kirksville, Missouri. Another school of prac
tice, chiropractic, was founded in 1896 by D. D. Palmer in Davenport, Iowa
(Janse, 1975). While both of these new professions utilized structural diagnosis
and manipulative therapy, osteopathic medicine sought to incorporate these di
agnostic and therapeutic tools within the practice of medicine and surgery,
while chiropractic limited its practice to spinal analysis and adjustment.
Orthodox medicine has also had its advocates for the use of manipulation
(Mennell, James, 1948; Mennell, John, 1964; Cyriax, 1978; Maigne, 1972;
Bourdillon, 1973). In the mid 20th century formalized organizations of individ
uals interested in manipulation were formed throughout the world. The Inter
national Federation of Manual Medicine, a confederation of associations of
manual medicine from 20 countries, holds an international congress every
three years. The North American Academy of Manipulative Medicine was
founded in the early 1960s and sponsors conferences and conventions through
out the United States and Canada.
In addition to the three professions of allopathic medicine, osteopathic
medicine, and chiropractic, the physiotherapy profession has many practition
ers. Within the physiotherapy group there are many who have become skilled
and proficient in specific joint manipulation (Maitland, 1977; Grieve, 1981).
While most physiotherapists work under the supervision of physicians, and
usually in institutional situations, there is an increasing trend toward the pri
vate practice of physiotherapy.
With the increasing interest in manipulation, a series of conferences were
held during the 1970s (Goldstein, 1975; Buerger, Tobias, 1977; Korr, 1978).
Each of these conferences sought to better understand the field and particu
larly the research which might provide a better understanding of the mecha
nisms involved.
With an ever increasing worldwide interest in manipulation by practitioners
of many disciplines, and with each group presenting strong positions support
ing their concepts, structural diagnostic procedures, and manipUlative therapy
interventions, it is easy to understand the confusion that occurs in people new
to the field, let alone those who have been practitioners of it for many years.
VI Preface
Found within the field are a number of conceptual models and constructs each
of which have strong advocates, and each undoubtedly contributing to a better
understanding of what occurs during a manipulative therapeutic intervention.
It was the purpose of the International Conference on Concepts and Mecha
nisms of Neuromuscular Function, September 8-10, 1980, at Michigan State
University to explore some of the models and constructs, the basic and applied
research, and clinical research within the field. Participants included represent
atives of the German Federation of Manual Medicine, the North American
Academy of Manipulative Medicine, the American Academy of Osteopathy,
and included skilled allopathic, osteopathic, and chiropractic practitioners of
manipulation, joined together with anatomists, physiologists, biochemical engi
neers and medical educators. The papers found within this volume were pre
sented during the three-day conference and bring together examples of the
neurologic, respiratory-circulatory, biomechanical, and sociological models of
manipulation. The purpose is not to emphasize one model over the other, but
to attempt to understand the commonalities rather than the differences. The re
search papers are presented not to prove or disprove any of the conceptual
models, but to assist the reader in a better understanding of some of the re
search approaches utilized within the field.
Acknowledgements and special thanks go to the members of the Planning
Committee for this conference, Myron C. Beal, D. 0.; Philip E. Greenman,
D. O. (Program Chairman); Robert P. Hubbard, Ph. D.; Sandra Kilbourn,
M. A.; Dorothy T. Thullen; and Robert C. Ward, D. O. A special thanks for as
sistance in manuscript preparation to T. Reid Kavieff and to Connie Burch,
Helen Head, Joyce Kolomyjec, and Beth Stephens for editorial assistance.
Philip E. Greenman, D.O., F. A. A. O.
Editor
References
Bourdillon, J., Spinal Manipulation, Second Edition. William Heinemann Books Ltd., Lon
don, 1973.
Buerger, A. A. and Tobias, J. S., Eds., Approaches to the Validation of Manipulation Therapy,
Charles C Thomas, Springfield, Illinois, 1977.
Cyriax, J., Textbook of Orthopedic Medicine, Vol. 1, Diagnosis of Soft Tissue Lesions, 7th
Edition, London, Baillier Tindall, 1978.
Goldstein, M., Editor, The Research Status of Spinal Manipulation Therapy, NINCDS, Mon
ograph No. 15, U.S. Department of Health, Education and Welfare, PHS/NIH, Bethesda,
Maryland, 1975.
Grieve, G.P., Common Vertebral Joint Problems, Churchill Livingstone, Edinburgh, London,
Melbourne and New York, 1981.
Janse, J., History of the Development of Chiropractic Concepts; Chiropractic Terminology,
The Research Status of Spinal Manipulation Therapy, Goldstein, M., Editor, NINCDS
Monograph No. 15, U.S. Department of Health, Education and Welfare, PHS/NIH, Be
thesda, Maryland, 1975.
Preface VII
Korr, I.M., Editor, The Neurobiologic Mechanisms in Manipulative Therapy, Plenum Press,
New York, New York, 1978.
Maigne, R., Orthopedic Medicine, A New Approach to Vertebral Manipulation, Charles C
Thomas, Springfield, Illinois, 1972.
Maitland, G.D., Vertebral Manipulation, Fourth Edition, Butterworths, London, Boston,
1977.
Mennell, James, The Science and Art of Joint Manipulation, Volume II, The Spine, 1948.
Mennell, John, Joint Pain, Little, Brown and Company, Boston, Massachusetts, 1964.
Northup, G.W., Osteopathic Medicine: An American Reformation, American Osteopathic
Association, Chicago, Illinois, 1966.
Schiotz, E.H., and Cyriax, J., Manipulation Past and Present, William Heinemann Medical
Books Ltd., London, 1975.
Table of Contents
Hyperactivity of Sympathetic Innervation: A Common Factor in Disease
(Irvin M. Korr) ............................... 1
Pain Physiology as a Neurological Model for Manipulation
(Scott Ha,ldeman) ...................... . 9
The Respiratory-Circulatory Model: Concepts and Applications
(Fred L. Mitchell, Jr.) ..................... . 19
Biomechanics Modeling and Concepts (Robert William Little) 34
Human Behavior: The Influence of Perceptions on Neuromuscular
Problem Solving (Robert C. Ward) ................. 37
Stereoradiographic Measurement and Analysis of Three-Dimensional
Body Movement (Herbert M. Reynolds) . . . . . . . . . . . . . . . .. 42
Mechanical Behavior of Connective Tissue (Robert P. Hubbard) 47
Kinematic and Myoelectric Analysis of Symmetric and Asymmetric
Cervical Function (Joseph Vorro) . . . . . . . . . . . . . . . .. ... 55
Structural and Functional Concepts of Cranio-Sacral Mechanisms
(Ernest W. Retzlaff) . . . . . . . . . . . . . . . . . . . . . . .. .... 58
The Cranio-Sacral System: Clinical Applications and Research
(John E. Upledger) ........................ .... 66
Somatic Dysfunction: Palpable Findings and Conceptual Models
(William L. Johnston) . . . . . . . . . . . . . . . . . . . . . . . . 71
Structural Diagnosis and Manipulative Management of Patients with
Chronic Obstructive Pulmonary Disease: Development of a Model
Protocol (John P. Goodridge) ...................... 78
Randomized Clinical Trials in the Validation of Cervical and Lumbar
Manipulation (M.H. Branson, AA Buerger) .............. 90
x Table of Contents
Peripheral Sensory Problems (Robert E. Kappler) 106
The Theory of Joint Play: Distance and Coherence (H.D. Wolff) 108
Diagnosis and Treatment of Pelvic Girdle Lesions (H.D. Neumann) 111
Subject Index ............................... 119
List of Contributors
Branson, Michael H., Ph.D.
Associate Professor, Department of Community Health Science, College of Os
teopathic Medicine, Michigan State University, East Lansing, Michigan 48824,
USA
Buerger, Alfred A., Ph.D.
Research Associate, Department of Community Health Science, College of Os
teopathic Medicine, Michigan State University, East Lansing, Michigan 48824,
USA
Goodridge, John P., D.O., F.A.A.O.
Professor, Department of Family Medicine, College of Osteopathic Medicine,
Michigan State University, East Lansing, Michigan 48824, USA
Haldeman, Scott, M.D., Ph.D., F.R.C.P.(C)
Assistant Adjunct Professor, Department of Neurology, University of Califor
nia-Irvine, 18672 Dodge Avenue, Santa Ana, California 92705, USA
Hubbard, Robert P., Ph.D.
Associate Professor, Department of Biomechanics and Department of Metal
lurgy, Mechanics, and Material Science, Michigan State University, East Lans
ing, Michigan 48824, USA
Johnston, William L., D.O., F.A.A.O.
Department of Family Medicine, College of Osteopathic Medicine, Michigan
State University, East Lansing, Michigan 48824, USA
Kappler, Robert E., D.O., F.A.A.O.
Professor and Chairman of Osteopathic Medicine, Dean of Clinical Sciences,
Chicago College of Osteopathic Medicine, Chicago, Illinois 60615, USA
Korr, Irvin M., Ph.D.
Associate Director, Center of Osteopathic Research and Education, Texas Col
lege of Osteopathic Medicine, Forth Worth, Texas 76107, USA
Soutas-Little, Robert, Ph.D.
Chairman and Professor, Department of Biomechanics, College of Osteopathic
Medicine, Michigan State University, East Lansing, Michigan 48824, USA
XII List of Contributors
Mitchell, Fred L., Jr., D.O., F.A.A.O.
Professor, Department of Family Medicine, College of Osteopathic Medicine,
Michigan State University, East Lansing, Michigan 48824, USA
Neumann, H.D., M.D.
Past President, International Federation of Manual Medicine, Buhlertalstr. 45,
D-7580 Buhl, West Germany
Retzlaff, Ernest W., Ph.D., M.P.H.
Professor, Department of Biomechanics, College of Osteopathic Medicine, Mi
chigan State University, East Lansing, Michigan 48824, USA
Reynolds, Herbert M., Ph.D.
Associate Professor, Department of Biomechanics, College of Osteopathic
Medicine, Michigan State University, East Lansing, Michigan 48824, USA
Upledger, John E., D.O., F.A.A.O.
Chief of Staff, Unity Center for Health, Education, and Research, 1957 South
Flagler Drive, West Palm Beach, Florida 33401, USA
Vorro, Joseph, Ph.D.
Associate Professor, Department of Anatomy, College of Osteopathic Medi
cine, Michigan State University, East Lansing, Michigan 48824, USA
Ward, Robert C., D.O., F.A.A.O.
Professor, Department of Biomechanics, College of Osteopathic Medicine, Mi
chigan State University, East Lansing, Michigan 48824, USA
Wolff, H.D., M.D.
Secretary, German Federation of Manual Medicine, Gartenfeldstrasse 6, 5500
Trier, West Germany
