Peter Gibbons - Academia.edu (original) (raw)

Papers by Peter Gibbons

Research paper thumbnail of Coupled Motion: Relationship to Joint Assessment

Journal of Orthopaedic Medicine, 1997

We construct families of curves which provide counterexamples for a uniform boundedness question.... more We construct families of curves which provide counterexamples for a uniform boundedness question. These families generalize those studied previously by several authors in [Ulm14b], [BHP + 15], and [CUV12]. We show, in detail, what fails in the argument of Caporaso, Harris, Mazur that uniform boundedness follows from the Lang conjecture. We also give a direct proof that these curves have finitely many rational points and give explicit bounds for the heights and number of such points.

Research paper thumbnail of Manipulación de la columna, el tórax y la pelvis: una perspectiva osteopática

Research paper thumbnail of Manipulation of the spine, thorax and pelvis : an osteopathic perspective

... 91 8.3 Atlanto-axial joint C1–2: Chin hold; patient supine; rotation thrust. . . . . 95 8.4 A... more ... 91 8.3 Atlanto-axial joint C1–2: Chin hold; patient supine; rotation thrust. . . . . 95 8.4 Atlanto-axial joint C1–2: Cradle hold; patient supine; rotation thrust. . . . . 99 8.5 Cervicalspine C2–7: Up-slope gliding; chin hold; patient supine . . . . . ...

Research paper thumbnail of The relation between thoracic paraspinal tissues and pressure sensitivity measured by a digital algometer

Journal of Osteopathic Medicine, 2004

The relationship between palpation of thoracic paraspinal tissues and pressure sensitivity measur... more The relationship between palpation of thoracic paraspinal tissues and pressure sensitivity measured by a digital algometer.

Research paper thumbnail of HVLA thrust techniques: What are the risks?

International Journal of Osteopathic Medicine, 2006

... 62 , 63 , 64 , 65 and 66 The evidence linking vertebral artery narrowing or occlusion with ce... more ... 62 , 63 , 64 , 65 and 66 The evidence linking vertebral artery narrowing or occlusion with cervical spine extension and rotation positioning contributed to the development and subsequent use of many pre-manipulative tests for VBI. ...

Research paper thumbnail of Student and patient perspectives on the interaction between supervisors, students and patients during the clinical teaching experience at a university out-patient clinic: a descriptive pilot study

Journal of Osteopathic Medicine, 2002

Study objective: To determine student and patient perspectives orl clinical teaching in an outpat... more Study objective: To determine student and patient perspectives orl clinical teaching in an outpatient setting. Design: Questionnaire using fixed-response, 5-point Likert scales, yes/no response and open comments.

Research paper thumbnail of Pain management in osteopathic medicine: The efficacy of flotation REST as an adjunct to spinal manipulation for acute non-specific low back pain. A case report

Journal of Osteopathic Medicine, 2001

... I McDowell and C Newell, Measuring Health: A Guide to Rating Scales and Questionnaires, Oxfor... more ... I McDowell and C Newell, Measuring Health: A Guide to Rating Scales and Questionnaires, Oxford Press, London (1987). ... In: JJ Sanchez-Sosa, Editor, Health and Clinical Psychology 1985, Elsevier Science, New York, NY (1985). ...

Research paper thumbnail of The short term effect of atlanto-axial high velocity low amplitude manipulation with cavitation on Edge Light Pupil Cycle Time

International Journal of Osteopathic Medicine, 2005

BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated... more BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated via the autonomic nervous system (ANS). ELPCT is a measurable constant, unaffected by eye measured (i.e. left versus right eye), gender, visual acuity, refractive error, eye colour and pupil size. Previous research suggests that spinal manipulation techniques can produce distant effects mediated in part by

Research paper thumbnail of From Small Acorns

Kristian Birkeland, 2005

... No abstract is available. To read the body of this article, please view the Full Text online.... more ... No abstract is available. To read the body of this article, please view the Full Text online. PII: S1746-0689(05)00008-8. doi:10.1016/j.ijosm.2005.02.003. © 2005 Published by Elsevier Inc. « PreviousNext »International Journal ...

Research paper thumbnail of Patient positioning and spinal locking for lumbar spine rotation manipulation

Manual Therapy, 2001

High velocity low amplitude (HVLA) thrust techniques are widely used by many manual therapists to... more High velocity low amplitude (HVLA) thrust techniques are widely used by many manual therapists to treat low back pain. There is increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain. HVLA thrust techniques are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophyseal joint. This audible release distinguishes these techniques from other manual therapy interventions. When using long lever HVLA thrust techniques spinal locking is necessary to localize forces and achieve cavitation at a specific vertebral segment. A critical factor in applying lumbar spine manipulation with minimal force is patient positioning and spinal locking. A knowledge of coupled movements of the lumbar spine aids an understanding of the patient positioning required to achieve spinal locking consistent with maximal patient comfort and cooperation. Excessive rotation can result in pain, patient resistance and failed technique. This masterclass presents a model of patient positioning for the lumbar spine that minimizes excessive use of rotation to achieve spinal locking prior to the application of the thrust.

Research paper thumbnail of Inter-examiner and intra-examiner agreement for assessing sacroiliac anatomical landmarks using palpation and observation: pilot study

Manual Therapy, 2000

Despite the paucity of research into the reliability of static palpation, it is still employed ex... more Despite the paucity of research into the reliability of static palpation, it is still employed extensively as a diagnostic tool by manual medicine practitioners. This study tested the inter-and intra-examiner agreement of ten senior osteopathic students using static palpation on ten asymptomatic subjects. Four assessments of the posterior superior iliac spine (PSIS), sacral sulcus (SS), and the sacral inferior lateral angle (SILA) on every subject by all examiners resulted in 1200 assessments in total. Kappa (Kg) yielded intra-examiner agreement that ranged between less-than-chance to substantial for the SILA (Kg 52 0.05 to 0.69; mean Kg 5 0.21), and slight to moderate for the PSIS (Kg 5 0.07 to 0.58; mean Kg 5 0.33) and the SS (Kg 5 0.02 to Kg 5 0.60; mean Kg 5 0.24), with 50% signi®cant beyond the 0.05 level. Inter-examiner agreement was slight (PSIS Kg 5 0.04; SILA Kg 5 0.08; SS Kg 5 0.07) and signi®cant at the 0.01 level. Intra-examiner agreement was greater than interexaminer agreement, which was consistent with existing palpation reliability studies. The poor reliability of clinical tests involving palpation may be partially explained by error in landmark location.

Research paper thumbnail of The relationship between palpation of thoracic paraspinal tissues and pressure measured by a digital algometer

Segmental paraspinal tissue texture change has been proposed to be an important diagnostic sign o... more Segmental paraspinal tissue texture change has been proposed to be an important diagnostic sign of intervertebral somatic dysfunction. The nature and existence of these regions is speculative. The aim of this study was to examine whether deep, medial, paraspinal regions identified as having abnormal texture by palpation are confirmed as being more sensitive to pressure measured by a digital algometer. An osteopath examined the thoracic regions of 32 subjects (26 asymptomatic, six with mild thoracic symptoms) to detect an abnormal to palpation and tender (AbPT) site in each individual. Three non-tender and normal to palpation (NT) regions (immediately above, below and opposite the AbPT site) were also located. A digital pressure

Research paper thumbnail of Efficacy of manipulation in low back pain treatment: The validity of meta-analysis conclusions

Journal of Bodywork and Movement Therapies, 2004

Research paper thumbnail of The Palpation Reliability Debate: the experts respond

Journal of Bodywork and Movement Therapies, 2002

In the October 2001 issue of JBMT the editorial raised questions as to the value, validity and ac... more In the October 2001 issue of JBMT the editorial raised questions as to the value, validity and accuracy of palpation methods in assessing musculoskeletal dysfunction. The reason for the topic of palpatory reliability being of current interest results from a steady series of published papers, which cast doubt on inter- and intra-rater reliability, and accuracy, in the performance of manual forms of assessment. The trigger for the exercise, which has resulted in this collection of responses on that theme, was an article by Comeaux et al. (2001), which noted relatively poor inter-rater reliability when three similarly trained practitioners evaluated the lower cervical and upper thoracic spine. In the interest of clarification JBMT invited a number of eminent clinicians and researchers to answer a series of questions, which had been compiled in consultation with various experts. Professions represented in the responses include medicine (David Simons and Karel Lewit), osteopathy (Peter Gibbons and Philip Tehan), chiropractic (Craig Liebenson and Don Murphy), physiotherapy (Joanne Bullock-Saxton and Dianne Lee) and massage therapy (Shannon Goosen).

Research paper thumbnail of Spinal manipulation: Indications, risks and benefits

Journal of Bodywork and Movement Therapies, 2001

High velocity low amplitude (HVLA) thrust techniques are widely used by many manual medicine disc... more High velocity low amplitude (HVLA) thrust techniques are widely used by many manual medicine disciplines to treat spinal dysfunction. Techniques of this type are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophyseal joint. This audible release distinguishes HVLA thrust techniques from other manual medicine interventions. Common indications for the use of HVLA thrust techniques are ‘joint fixation’, ‘joint locking’ and somatic dysfunction but various authors have also described other indications for the therapeutic use of these techniques. Despite a wide range of indications, there has been a decline in the use of HVLA thrust techniques. Concern regarding patient safety and the difficulty associated with gaining mastery of HVLA thrust techniques may be reasons for the decline in their use. While there are potential serious sequelae from the use of HVLA thrust techniques, the risks are low provided patients are thoroughly assessed and treated by appropriately trained practitioners. With increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain and some categories of neck pain and headache, there is a need to look critically at the indications for the use of HVLA thrust techniques as well as the actual risks and potential benefits of this therapeutic modality.

Research paper thumbnail of Scientist-practitioner training in osteopathic medicine

Focus on Alternative and Complementary Therapies, 2010

Objective The purpose of this study was to analyse the short-term outcomes of the introduction of... more Objective The purpose of this study was to analyse the short-term outcomes of the introduction of a scientist–practitioner model of education, comprising compulsory research, to the pre-registration training of osteopaths. Materials and methods Pre-registration training of osteopaths underwent a radical shift in 1994 with the commencement of osteopathic education at Victoria University. This new university programme used a scientist–practitioner model of education requiring that all students understand the scientific method, and develop skills in the analysis and conduct of clinical research. The programme comprised a double award: Bachelor of Science (Clinical Science) and Master of Health Science (Osteopathy). All students are required to complete research to the level of a Masters minor thesis prior to graduation. Cohort: Over the 1998–2001 academic years, Victoria University awarded 135 graduates with Master of Health Science (Osteopathy) degrees. This sample may be viewed as four subsamples (n = 23 graduates in 1998; n = 35 graduates in 1999; n = 35 graduates in 2000; and n = 42 graduates in 2001). Measures: Short-term outcomes of the scientist-practitioner education model were measured in terms of peer-reviewed publications and graduate employment pathways. Results All graduates completed theses/treatises assessed as ‘passed’ at the Masters level. Twenty-six progressed their work to peer-reviewed publication, comprising 21 peer-reviewed journal articles, 11 conference presentations, one conference poster presentation, and one book contribution (data used in development of a book chapter). Nine graduates published their work in more than one forum. Two graduates produced a combined publication. Presently, all graduates work at least part-time in private osteopathic practice (manual therapy). Two, and until recently three, graduates have permanent part-time employment in academia in osteopathic education. Many others contribute to the educational life of osteopaths, and other complimentary therapists (e.g. naturopaths) as sessional/casual teachers. Two graduates are employed full-time as rehabilitation officers for third-party providers (insurers). One graduate has commenced further research as a doctoral candidate. Conclusion The scientist–practitioner model of osteopathic education has led to increased research activity and subsequent peer-reviewed publication in osteopathy, and has broadened practise opportunities for graduates. It is noteworthy however that the vast majority of graduates seek, and obtain, full time employment in osteopathy (manual therapy), and engage in no research or publication in the years immediately following university graduation and osteopathic registration.

Research paper thumbnail of Referencing and quotation accuracy in four manual therapy journals

Manual Therapy, 2004

The aim of the study was to investigate the reference and quotation accuracy in four peer-reviewe... more The aim of the study was to investigate the reference and quotation accuracy in four peer-reviewed manual therapy journals. A stratified random sample of original research (n=7) was collected from each of the journals spanning the years January 2000 to December 2001. A further random selection of 80 references from each journal paper sampled was then reviewed (Total N=320) for citation and quotation accuracy. Numbers of citations with errors were determined, then classified as either major or minor and categorized by bibliographic headings (author, title, journal, year, volume, page and irretrievable). Each quotation was individually assessed for accuracy and judged to be either correct or incorrect. A quotation was deemed correct if it accurately substantiated and reported the original authors assertions. One hundred and fifteen citations across all journals contained errors (35.9%). Some citations exhibited multiple major and minor errors. Bibliographically classified errors for all journals showed 61 author, 51 title, 6 journal, 4 year, 12 volume and 25 page errors. JMPT showed the lowest referencing error rate (20%) while JBWMT recorded the highest (58.8%). The total number of quotation errors across all journals was 69 (12.3%). JMPT showed the lowest quotation error rate of 6 (4.7%), MT had 12 errors (7.3%), JOM produced 21 errors (13.3%), while JBWMT recorded the highest error rate with 32 (27.6%). Poor citation and quotation is a reflection on the scholarly work of the authors and the journal. The trend for errors in quotation is more worrying than citation errors as it reflects poor diligence on the part of the investigators.

Research paper thumbnail of The Amelioration of Atlanto-Axial Rotation Asymmetry Using High Velocity Low Amplitude Manipulation: Is the Direction of Thrust Important?

Journal of Osteopathic Medicine, 2001

40 asymptomatic subjects (mean age=28) who displayed a persistent unilateral passive atlanto-axia... more 40 asymptomatic subjects (mean age=28) who displayed a persistent unilateral passive atlanto-axial rotation asymmetry of 8° or more were randomly allocated to one of three treatment groups. The first group (n=14) received a single HVLA manipulation to the atlanto-axial ...

Research paper thumbnail of Short-term effects of cervical manipulation on edge light pupil cycle time: A pilot study

Journal of Manipulative and Physiological Therapeutics, 2000

Edge light pupil cycle time (ELPCT) is one of the eye's light reflexes. Studies have show... more Edge light pupil cycle time (ELPCT) is one of the eye's light reflexes. Studies have shown ELPCT to be a measurable constant, unaffected by visual acuity, refractive error, eye color, pupil size, or sex. Control of this reflex occurs through the autonomic nervous system. Various authors suggest that spinal manipulative techniques can produce distant effects mediated in part by alterations in autonomic tone after intervention. To investigate the effects of a C1-2 high-velocity, low-amplitude manipulation on ELPCT. A single-group, randomized pilot study without a control group. Thirteen men (mean age 24.2 years) without a history of eye disease or central or autonomic nervous system pathologic conditions had their ELPCT measured before and after manipulation. The manipulation comprised a high-velocity, low-amplitude rotatory thrust, localized to the C1-2 joint on the left (n = 6) or right (n = 7) eye, determined randomly. ELPCT measures demonstrated a significant difference for both eyes before and after manipulation (P = .002; the right eye, P = .027; the left eye, P = .046). This suggests that ELPCT, which is mediated through the autonomic nervous system, can be directly influenced by high-velocity manipulation to the upper cervical spine.

Research paper thumbnail of The short term effect of atlanto-axial high velocity low amplitude manipulation with cavitation on Edge Light Pupil Cycle Time

International Journal of Osteopathic Medicine, 2005

BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated... more BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated via the autonomic nervous system (ANS). ELPCT is a measurable constant, unaffected by eye measured (i.e. left versus right eye), gender, visual acuity, refractive error, eye colour and pupil size. Previous research suggests that spinal manipulation techniques can produce distant effects mediated in part by

Research paper thumbnail of Coupled Motion: Relationship to Joint Assessment

Journal of Orthopaedic Medicine, 1997

We construct families of curves which provide counterexamples for a uniform boundedness question.... more We construct families of curves which provide counterexamples for a uniform boundedness question. These families generalize those studied previously by several authors in [Ulm14b], [BHP + 15], and [CUV12]. We show, in detail, what fails in the argument of Caporaso, Harris, Mazur that uniform boundedness follows from the Lang conjecture. We also give a direct proof that these curves have finitely many rational points and give explicit bounds for the heights and number of such points.

Research paper thumbnail of Manipulación de la columna, el tórax y la pelvis: una perspectiva osteopática

Research paper thumbnail of Manipulation of the spine, thorax and pelvis : an osteopathic perspective

... 91 8.3 Atlanto-axial joint C1–2: Chin hold; patient supine; rotation thrust. . . . . 95 8.4 A... more ... 91 8.3 Atlanto-axial joint C1–2: Chin hold; patient supine; rotation thrust. . . . . 95 8.4 Atlanto-axial joint C1–2: Cradle hold; patient supine; rotation thrust. . . . . 99 8.5 Cervicalspine C2–7: Up-slope gliding; chin hold; patient supine . . . . . ...

Research paper thumbnail of The relation between thoracic paraspinal tissues and pressure sensitivity measured by a digital algometer

Journal of Osteopathic Medicine, 2004

The relationship between palpation of thoracic paraspinal tissues and pressure sensitivity measur... more The relationship between palpation of thoracic paraspinal tissues and pressure sensitivity measured by a digital algometer.

Research paper thumbnail of HVLA thrust techniques: What are the risks?

International Journal of Osteopathic Medicine, 2006

... 62 , 63 , 64 , 65 and 66 The evidence linking vertebral artery narrowing or occlusion with ce... more ... 62 , 63 , 64 , 65 and 66 The evidence linking vertebral artery narrowing or occlusion with cervical spine extension and rotation positioning contributed to the development and subsequent use of many pre-manipulative tests for VBI. ...

Research paper thumbnail of Student and patient perspectives on the interaction between supervisors, students and patients during the clinical teaching experience at a university out-patient clinic: a descriptive pilot study

Journal of Osteopathic Medicine, 2002

Study objective: To determine student and patient perspectives orl clinical teaching in an outpat... more Study objective: To determine student and patient perspectives orl clinical teaching in an outpatient setting. Design: Questionnaire using fixed-response, 5-point Likert scales, yes/no response and open comments.

Research paper thumbnail of Pain management in osteopathic medicine: The efficacy of flotation REST as an adjunct to spinal manipulation for acute non-specific low back pain. A case report

Journal of Osteopathic Medicine, 2001

... I McDowell and C Newell, Measuring Health: A Guide to Rating Scales and Questionnaires, Oxfor... more ... I McDowell and C Newell, Measuring Health: A Guide to Rating Scales and Questionnaires, Oxford Press, London (1987). ... In: JJ Sanchez-Sosa, Editor, Health and Clinical Psychology 1985, Elsevier Science, New York, NY (1985). ...

Research paper thumbnail of The short term effect of atlanto-axial high velocity low amplitude manipulation with cavitation on Edge Light Pupil Cycle Time

International Journal of Osteopathic Medicine, 2005

BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated... more BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated via the autonomic nervous system (ANS). ELPCT is a measurable constant, unaffected by eye measured (i.e. left versus right eye), gender, visual acuity, refractive error, eye colour and pupil size. Previous research suggests that spinal manipulation techniques can produce distant effects mediated in part by

Research paper thumbnail of From Small Acorns

Kristian Birkeland, 2005

... No abstract is available. To read the body of this article, please view the Full Text online.... more ... No abstract is available. To read the body of this article, please view the Full Text online. PII: S1746-0689(05)00008-8. doi:10.1016/j.ijosm.2005.02.003. © 2005 Published by Elsevier Inc. « PreviousNext »International Journal ...

Research paper thumbnail of Patient positioning and spinal locking for lumbar spine rotation manipulation

Manual Therapy, 2001

High velocity low amplitude (HVLA) thrust techniques are widely used by many manual therapists to... more High velocity low amplitude (HVLA) thrust techniques are widely used by many manual therapists to treat low back pain. There is increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain. HVLA thrust techniques are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophyseal joint. This audible release distinguishes these techniques from other manual therapy interventions. When using long lever HVLA thrust techniques spinal locking is necessary to localize forces and achieve cavitation at a specific vertebral segment. A critical factor in applying lumbar spine manipulation with minimal force is patient positioning and spinal locking. A knowledge of coupled movements of the lumbar spine aids an understanding of the patient positioning required to achieve spinal locking consistent with maximal patient comfort and cooperation. Excessive rotation can result in pain, patient resistance and failed technique. This masterclass presents a model of patient positioning for the lumbar spine that minimizes excessive use of rotation to achieve spinal locking prior to the application of the thrust.

Research paper thumbnail of Inter-examiner and intra-examiner agreement for assessing sacroiliac anatomical landmarks using palpation and observation: pilot study

Manual Therapy, 2000

Despite the paucity of research into the reliability of static palpation, it is still employed ex... more Despite the paucity of research into the reliability of static palpation, it is still employed extensively as a diagnostic tool by manual medicine practitioners. This study tested the inter-and intra-examiner agreement of ten senior osteopathic students using static palpation on ten asymptomatic subjects. Four assessments of the posterior superior iliac spine (PSIS), sacral sulcus (SS), and the sacral inferior lateral angle (SILA) on every subject by all examiners resulted in 1200 assessments in total. Kappa (Kg) yielded intra-examiner agreement that ranged between less-than-chance to substantial for the SILA (Kg 52 0.05 to 0.69; mean Kg 5 0.21), and slight to moderate for the PSIS (Kg 5 0.07 to 0.58; mean Kg 5 0.33) and the SS (Kg 5 0.02 to Kg 5 0.60; mean Kg 5 0.24), with 50% signi®cant beyond the 0.05 level. Inter-examiner agreement was slight (PSIS Kg 5 0.04; SILA Kg 5 0.08; SS Kg 5 0.07) and signi®cant at the 0.01 level. Intra-examiner agreement was greater than interexaminer agreement, which was consistent with existing palpation reliability studies. The poor reliability of clinical tests involving palpation may be partially explained by error in landmark location.

Research paper thumbnail of The relationship between palpation of thoracic paraspinal tissues and pressure measured by a digital algometer

Segmental paraspinal tissue texture change has been proposed to be an important diagnostic sign o... more Segmental paraspinal tissue texture change has been proposed to be an important diagnostic sign of intervertebral somatic dysfunction. The nature and existence of these regions is speculative. The aim of this study was to examine whether deep, medial, paraspinal regions identified as having abnormal texture by palpation are confirmed as being more sensitive to pressure measured by a digital algometer. An osteopath examined the thoracic regions of 32 subjects (26 asymptomatic, six with mild thoracic symptoms) to detect an abnormal to palpation and tender (AbPT) site in each individual. Three non-tender and normal to palpation (NT) regions (immediately above, below and opposite the AbPT site) were also located. A digital pressure

Research paper thumbnail of Efficacy of manipulation in low back pain treatment: The validity of meta-analysis conclusions

Journal of Bodywork and Movement Therapies, 2004

Research paper thumbnail of The Palpation Reliability Debate: the experts respond

Journal of Bodywork and Movement Therapies, 2002

In the October 2001 issue of JBMT the editorial raised questions as to the value, validity and ac... more In the October 2001 issue of JBMT the editorial raised questions as to the value, validity and accuracy of palpation methods in assessing musculoskeletal dysfunction. The reason for the topic of palpatory reliability being of current interest results from a steady series of published papers, which cast doubt on inter- and intra-rater reliability, and accuracy, in the performance of manual forms of assessment. The trigger for the exercise, which has resulted in this collection of responses on that theme, was an article by Comeaux et al. (2001), which noted relatively poor inter-rater reliability when three similarly trained practitioners evaluated the lower cervical and upper thoracic spine. In the interest of clarification JBMT invited a number of eminent clinicians and researchers to answer a series of questions, which had been compiled in consultation with various experts. Professions represented in the responses include medicine (David Simons and Karel Lewit), osteopathy (Peter Gibbons and Philip Tehan), chiropractic (Craig Liebenson and Don Murphy), physiotherapy (Joanne Bullock-Saxton and Dianne Lee) and massage therapy (Shannon Goosen).

Research paper thumbnail of Spinal manipulation: Indications, risks and benefits

Journal of Bodywork and Movement Therapies, 2001

High velocity low amplitude (HVLA) thrust techniques are widely used by many manual medicine disc... more High velocity low amplitude (HVLA) thrust techniques are widely used by many manual medicine disciplines to treat spinal dysfunction. Techniques of this type are associated with an audible release in the form of a pop or cracking sound that is widely accepted to represent cavitation of a spinal zygapophyseal joint. This audible release distinguishes HVLA thrust techniques from other manual medicine interventions. Common indications for the use of HVLA thrust techniques are ‘joint fixation’, ‘joint locking’ and somatic dysfunction but various authors have also described other indications for the therapeutic use of these techniques. Despite a wide range of indications, there has been a decline in the use of HVLA thrust techniques. Concern regarding patient safety and the difficulty associated with gaining mastery of HVLA thrust techniques may be reasons for the decline in their use. While there are potential serious sequelae from the use of HVLA thrust techniques, the risks are low provided patients are thoroughly assessed and treated by appropriately trained practitioners. With increasing evidence that spinal manipulation produces positive patient outcomes for acute low back pain and some categories of neck pain and headache, there is a need to look critically at the indications for the use of HVLA thrust techniques as well as the actual risks and potential benefits of this therapeutic modality.

Research paper thumbnail of Scientist-practitioner training in osteopathic medicine

Focus on Alternative and Complementary Therapies, 2010

Objective The purpose of this study was to analyse the short-term outcomes of the introduction of... more Objective The purpose of this study was to analyse the short-term outcomes of the introduction of a scientist–practitioner model of education, comprising compulsory research, to the pre-registration training of osteopaths. Materials and methods Pre-registration training of osteopaths underwent a radical shift in 1994 with the commencement of osteopathic education at Victoria University. This new university programme used a scientist–practitioner model of education requiring that all students understand the scientific method, and develop skills in the analysis and conduct of clinical research. The programme comprised a double award: Bachelor of Science (Clinical Science) and Master of Health Science (Osteopathy). All students are required to complete research to the level of a Masters minor thesis prior to graduation. Cohort: Over the 1998–2001 academic years, Victoria University awarded 135 graduates with Master of Health Science (Osteopathy) degrees. This sample may be viewed as four subsamples (n = 23 graduates in 1998; n = 35 graduates in 1999; n = 35 graduates in 2000; and n = 42 graduates in 2001). Measures: Short-term outcomes of the scientist-practitioner education model were measured in terms of peer-reviewed publications and graduate employment pathways. Results All graduates completed theses/treatises assessed as ‘passed’ at the Masters level. Twenty-six progressed their work to peer-reviewed publication, comprising 21 peer-reviewed journal articles, 11 conference presentations, one conference poster presentation, and one book contribution (data used in development of a book chapter). Nine graduates published their work in more than one forum. Two graduates produced a combined publication. Presently, all graduates work at least part-time in private osteopathic practice (manual therapy). Two, and until recently three, graduates have permanent part-time employment in academia in osteopathic education. Many others contribute to the educational life of osteopaths, and other complimentary therapists (e.g. naturopaths) as sessional/casual teachers. Two graduates are employed full-time as rehabilitation officers for third-party providers (insurers). One graduate has commenced further research as a doctoral candidate. Conclusion The scientist–practitioner model of osteopathic education has led to increased research activity and subsequent peer-reviewed publication in osteopathy, and has broadened practise opportunities for graduates. It is noteworthy however that the vast majority of graduates seek, and obtain, full time employment in osteopathy (manual therapy), and engage in no research or publication in the years immediately following university graduation and osteopathic registration.

Research paper thumbnail of Referencing and quotation accuracy in four manual therapy journals

Manual Therapy, 2004

The aim of the study was to investigate the reference and quotation accuracy in four peer-reviewe... more The aim of the study was to investigate the reference and quotation accuracy in four peer-reviewed manual therapy journals. A stratified random sample of original research (n=7) was collected from each of the journals spanning the years January 2000 to December 2001. A further random selection of 80 references from each journal paper sampled was then reviewed (Total N=320) for citation and quotation accuracy. Numbers of citations with errors were determined, then classified as either major or minor and categorized by bibliographic headings (author, title, journal, year, volume, page and irretrievable). Each quotation was individually assessed for accuracy and judged to be either correct or incorrect. A quotation was deemed correct if it accurately substantiated and reported the original authors assertions. One hundred and fifteen citations across all journals contained errors (35.9%). Some citations exhibited multiple major and minor errors. Bibliographically classified errors for all journals showed 61 author, 51 title, 6 journal, 4 year, 12 volume and 25 page errors. JMPT showed the lowest referencing error rate (20%) while JBWMT recorded the highest (58.8%). The total number of quotation errors across all journals was 69 (12.3%). JMPT showed the lowest quotation error rate of 6 (4.7%), MT had 12 errors (7.3%), JOM produced 21 errors (13.3%), while JBWMT recorded the highest error rate with 32 (27.6%). Poor citation and quotation is a reflection on the scholarly work of the authors and the journal. The trend for errors in quotation is more worrying than citation errors as it reflects poor diligence on the part of the investigators.

Research paper thumbnail of The Amelioration of Atlanto-Axial Rotation Asymmetry Using High Velocity Low Amplitude Manipulation: Is the Direction of Thrust Important?

Journal of Osteopathic Medicine, 2001

40 asymptomatic subjects (mean age=28) who displayed a persistent unilateral passive atlanto-axia... more 40 asymptomatic subjects (mean age=28) who displayed a persistent unilateral passive atlanto-axial rotation asymmetry of 8° or more were randomly allocated to one of three treatment groups. The first group (n=14) received a single HVLA manipulation to the atlanto-axial ...

Research paper thumbnail of Short-term effects of cervical manipulation on edge light pupil cycle time: A pilot study

Journal of Manipulative and Physiological Therapeutics, 2000

Edge light pupil cycle time (ELPCT) is one of the eye's light reflexes. Studies have show... more Edge light pupil cycle time (ELPCT) is one of the eye's light reflexes. Studies have shown ELPCT to be a measurable constant, unaffected by visual acuity, refractive error, eye color, pupil size, or sex. Control of this reflex occurs through the autonomic nervous system. Various authors suggest that spinal manipulative techniques can produce distant effects mediated in part by alterations in autonomic tone after intervention. To investigate the effects of a C1-2 high-velocity, low-amplitude manipulation on ELPCT. A single-group, randomized pilot study without a control group. Thirteen men (mean age 24.2 years) without a history of eye disease or central or autonomic nervous system pathologic conditions had their ELPCT measured before and after manipulation. The manipulation comprised a high-velocity, low-amplitude rotatory thrust, localized to the C1-2 joint on the left (n = 6) or right (n = 7) eye, determined randomly. ELPCT measures demonstrated a significant difference for both eyes before and after manipulation (P = .002; the right eye, P = .027; the left eye, P = .046). This suggests that ELPCT, which is mediated through the autonomic nervous system, can be directly influenced by high-velocity manipulation to the upper cervical spine.

Research paper thumbnail of The short term effect of atlanto-axial high velocity low amplitude manipulation with cavitation on Edge Light Pupil Cycle Time

International Journal of Osteopathic Medicine, 2005

BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated... more BackgroundEdge Light Pupil Cycle Time (ELPCT) is a measure of the pupillary light reflex mediated via the autonomic nervous system (ANS). ELPCT is a measurable constant, unaffected by eye measured (i.e. left versus right eye), gender, visual acuity, refractive error, eye colour and pupil size. Previous research suggests that spinal manipulation techniques can produce distant effects mediated in part by