ICA Files Brief Against PT
The International Chiropractors Association (ICA) has filed a court brief in Arkansas to halt the efforts of the physical therapy profession to expand into chiropractic’s territory. The case, Teston v Arkansas Board of Chiropractic, which is an appeal by Michael Teston, PT, was filed on September 14, 2004. The Arkansas Board of Chiropractic found he was performing spinal manipulations for which only chiropractors are licensed. The defendant was found to be in violation of the Chiropractic Practice Act and was fined $10,000 by the Board. The ICA filed its amicus curiae brief after the PT appealed the decision.

“This is a historic and important case since the professional boundaries between physical therapy and chiropractic are being challenged by physical therapy in an extralegislative and sophisticated manner,” said Henry Rubinstein, DC, JD. “The ICA wants chiropractors, who have endured decades of harassment, to achieve and maintain the recognition they deserve for the benefits they bestow the public that PTs want to claim as their own.”

ICA’s brief spoke to the intent behind the case, to expand the scope of physical therapy, without following the traditional legislative path.

In its brief, the ICA told the court, “The ICA cannot sit idly by while organized medicine incorporates chiropractic techniques into its branch of physical therapy in hopes of making chiropractic moot in the eyes of insurance companies, federal programs, and the unsuspecting public.”

The PT’s argument is that there is no statutory difference between spinal manipulation and other procedures authorized under state law for the physical therapy profession, who have argued that the vagueness of the statute gave the PT the leeway to perform high-velocity thrust procedures with his physical therapy license. The State of Arkansas Board of Examiners and the ICA pointed out that this is incorrect and the only time spinal manipulation is mentioned in the physical therapy statute is a specific passage excluding PTs from being authorized to perform these procedures. The Arkansas Code that defines the practice of physical therapy (17-93-102(6)(B)(i)(c)) gives PTs authority to only provide “manual therapy techniques, including soft tissue massage, manual traction, connective tissue massage, therapeutic massage, and mobilizations.”

“This brief is a historic and extraordinary piece of legal scholarship and every chiropractor should take the time to read these documents,” says ICA President CJ Mertz, DC. “[It is] important that there is a clear understanding of the boundaries between the professions.”

ICA’s position is that the Board followed due process and acted correctly in this matter.

DoD Awards TCC $750,000 to Fund Research
The US Navy Bureau of Medicine and Surgery (BuMed) has coordinated a $750,000 award with Texas Chiropractic College as the executive component of the Department of Defense (DoD) project allocation for fiscal 2004.

The award will fund research proposed by James Giordano, DC, to study demographic use and attitude profiles, clinical outcomes, and integrative efficacy of chiropractic care provided to active-duty navy personnel.

“This project is important for several reasons,” says Giordano. “First, it provides a high level of fiscal and programmatic support for evidence-based research to validate the role of chiropractic in a strongly multitiered medical setting.

“Secondly, it increases the visibility and research-based employment of chiropractic within the military model of integrative medicine. Third, it provides a basis for further studies and increases the attractiveness of TCC to additional avenues of extramural subsidy.”

The study serves as a first step in developing ongoing projects to assess the efficacy and mechanisms of chiropractic care in military and occupational-medical environments.

The research will employ mixed quantitative and qualitative methods that are aimed at identifying the effectiveness, broad-scope benefits, limitations and delimiting factors, and viable parameters of use of chiropractic therapeutics within the US Naval medical system. The data will provide a basis for integrating chiropractic to both the US Naval health care system into other medical systems that are becoming progressively multidisciplinary. The studies will focus on chiropractic care to reduce objective and subjective features of acute, postacute, and chronic low back pain.

Genetics May Contribute to Osteoarthritis
The first large sibling study of knee osteoarthritis shows that siblings of people with osteoarthritis in their knees are twice as likely to develop the same condition.

“This finding held true even after osteoarthritis risk factors, such as age, smoking, gender, and weight, were taken into account,” says RL Neame, MD, and colleagues of the academic rheumatology department of City Hospital in Nottingham, England. Osteoarthritis is the most common type of arthritis, which causes a degeneration of joints and loss of joint cartilage, leading to inflammation, bone pain, and limited joint mobility. Many factors lead to increased risk of osteoarthritis, including the normal aging process, trauma, and obesity.

The researchers analyzed data from 490 knee-osteoarthritis patients needing total knee replacement surgery and 737 of their siblings, who were full-blood relatives and at least 40 years old. They also included 1,729 people in the Nottingham area who had consulted doctors about knee pain.

After x-rays of the siblings and comparison group members, researchers looked for signs of structural damage caused by osteoarthritis.

“The study adds to the growing body of evidence that there is a genetic contribution to common forms of osteoarthritis,” say the researchers.