Chiropractic neurology

Chiropractic neurology, also called functional neurology, is a pseudoscience subspecialty that uses manipulations and other interventions to address what the practitioner perceives as dysfunction in the neuraxis that is believed to be the root cause of the disease being treated.[1] It is considered to be a pseudoscience by the vast majority of doctors due to the lack of reliable evidence demonstrating its efficacy.[2]

Description

The Ohio Department of Health defines chiropractic neurology as, "the field of functional neurology that engages the internal and external environment of the individual in a structured and targeted approach to affect positive changes in the neuraxis and consequent physiology and behavior."[1] Chiropractic neurology relies on neuroplasticity in order to use chiropractic body manipulations to rewire the brain to address injured or diseased brain structures. Specific treatments include joint adjustments, muscle therapies, physical exercises, balance and vestibular rehabilitation, light, sound, smell and touch stimulations, eye exercises, cognitive training, and nutritional and supplement recommendations.[3]

Critics have pointed to the lack supporting evidence from independently published articles in peer-reviewed journals to back these claims.[4][5] According to physician Mark Crislip, of the small number of publications on the subject in the Pubmed database, none address the competency or efficacy of chiropractic neurologists in the diagnosis and treatment of brain injuries and there were no clinical trials to demonstrate its efficacy. He concluded that "there is no reason, based on known anatomy and physiology," to suspect that there would be a benefit to chiropractic neurology treatment, which he refers to as "pseudo-medicine."[2]

Neurologist Steven Novella said that the claims made by chiropractic neurologist are not supported by scientific research. According to Novella, "Chiropractic neurology appears to me to be the very definition of pseudoscience."[4]

Harriet Hall, a retired family physician, said that the only formal study on the topic was published in an obscure journal, did not demonstrate rigorous methodology, and all of its authors had a significant professional and financial stake in the conclusions reported by the study.[5]

Board certifications and professional associations

Currently, the two credentialing boards of chiropractic neurology in the US are the American Chiropractic Neurology Board (ACNB)[6] and the International Board of Chiropractic Neurology (IBCN).[7] The ACNB approves certifications in chiropractic neurology[6] while the IBCN approves "diplomate status" to qualified applicants.[7] Both credentials are recognized by the International Board of Chiropractic Specialties (IBCS).[8] However, the American Chiropractic Association (ACA) only recognizes ACNB certifications.[6] In addition to these credentialing agencies, the International College of Chiropractic Neurology (ICCN) exists as a professional association for chiropractic neurologists.[9]

Mark Crislip expressed concern about the minimal amount of post-doctoral training required to be certified in chiropractic neurology (40 days of internet classes or 300 classroom hours) compared to the amount required for a doctor of medicine or a doctor of osteopathy to become a real neurologist (3 years of residency and over 8,000 hours).[2]

American Chiropractic Neurology Board[6]

ACNB offers subspecialty certifications in electrodiagnosis, vestibular rehabilitation, and childhood developmental disorders, all considered to be fringe science by the majority of doctors. Most insurance policies that cover chiropractic care do not cover all of the practice areas considered by the ACNB to be within the scope of chiropractic neurology, such as childhood developmental disorders.[10][11][12] For example, Aetna's medical clinical policy considers chiropractic manipulation experimental or unproven "when it is rendered for non-neuromusculoskeletal conditions (e.g., attention-deficit hyperactivity disorder, dysmenorrhea, epilepsy; and gastro-intestinal disorders, not an all inclusive list) because its effectiveness for these indications is unproven."[12]

International Board of Chiropractic Neurology

The IBCN was established in 1997.[8] Their responsibility is to "examine candidates and confer diplomate status to those who successfully pass their diplomate examination."[13] The board approves diplomate status to individuals who have earned a doctor of chiropractic or equivalent degree plus 300 continuing education units in chiropractic neurology from a CCE approved institution or equivalent and have passed a three-part examination (one practical and two written portions).[14] There have been questions about the extremely short time that it takes to get a degree.

International College of Chiropractic Neurology

The ICCN was established in 2015 by chiropractic neurology diplomates of the various current and former credentialing boards.[15] The objective of the ICCN is to provide training in evidence based neurology and an evidence-informed forum to promote advancement in the field of chiropractic neurology.[9]

References

  1. 1 2 Chiropractic Diplomate in Neurology (PDF), Ohio Department of Health, 2015
  2. 1 2 3 Crislip, M (Feb 2016), "Chiropractors, Naturopaths, Concussions and Senate Bill 1535", Science-Based Medicine, retrieved 2 Apr 2016
  3. ↑ Your Functional Neurology Treatment, Functional Neurology Society, retrieved 16 November 2015
  4. 1 2 Novella, Steven (Nov 2011), "Chiropractic Neurology", Science-Based Medicine, retrieved 2 Apr 2016
  5. 1 2 Hall, Harriet (Sep 2010), "Brain Balance", Science-Based Medicine, retrieved 2 Apr 2016
  6. 1 2 3 4 American Chiropractic Neurology Board, ACNB, retrieved 30 Mar 2016
  7. 1 2 International Board of Chiropractic Neurology, IACN, retrieved 30 Mar 2016
  8. 1 2 Chiropractic Diplomates and Certifications, CE Cruncher, retrieved 30 Mar 2016
  9. 1 2 ICCN Strategic Plan, ICCN, retrieved 30 Mar 2016
  10. ↑ "Provider Manual for Chiropractic Services" (PDF). North Dakota Department of Human Services. State of North Dakota.
  11. ↑ NHS Leeds West CCG Assurance Committee (2014-01-02). "Complementary and Alternative Therapies Evidence Based Decision Making Framework" (PDF). leedswestccg.nhs.uk. Retrieved 2015-06-30.
  12. 1 2 "Chiropractic Services - Policy", Aetna, retrieved 29 March 2016
  13. ↑ IBCN Board of Examiners, IACN, retrieved 30 Mar 2016
  14. ↑ http://www.chiropracticspecialist.org/International-Board-of-Chiropractic-Neurology
  15. ↑ Empowering resolution: Resolution to Establish the International College of Chiropractic Neurology, ICCN
This article is issued from Wikipedia - version of the Tuesday, May 03, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.