Cox Technic Flexion Distraction and Decompression is respected for its research and documentation. It is even talked about for its science-based and evidence-based explanations. This is not by accident. Though the body has its mysteries, researchers and clinicians ably strive to uncover the clues that lead to better care of the body, especially with chiropractic Cox Technic.
Researchers around the United States are conducting studies involving chiropractic flexion-distraction from its biomechanical influences on the spine and body to its clinical outcomes for Southern New Hampshire chiropractic patients with varied spine pain conditions.
Biomechanical Outcomes - Lumbar Spine
The first federally funded study involving flexion-distraction documented what happens during the procedure:
- Reduces the pressures inside the disc to a -192 mm Hg
- Increases disc height
- Increases spinal canal foramen size up to 28% making more room for spinal nerves
For more lumbar spine biomechanical details, please click here.
Biomechanical Outcomes - Cervical Spine
The NIH (National Institutes of Health) funded chiropractic research involved chiropractic researchers alongside medical researchers at Palmer Research Center, Hines VA Hospital (Chicago), and Loyola Stritch School of Medicine. It revealed these factors about the chiropractic flexion distraction Cox Technic for cervical spine as used at New Hampshire Spine and Sport:
- Cervical spine flexion distraction protocols lower C4-C7 intradiscal pressures as much as 96 to 1583 mmHG pressure depending on the level. (4)
- Physicians can apply the prescribed forces to the cervical spine 97% of the time using a visual feedback system. (5)
- Researchers verify an effective way to compare higher with lower forces using chiropractic manual cervical distraction (f/d). (6)
Clinical Outcomes - Low Back
The European Spine Journal published the outcomes of the US Government's Health Resources & Services Administration (HRSA)-funded comparison study of chiropractic flexion-distraction care and medical conservative care for low back pain. Its findings are that
- "Overall, flexion-distraction provided more pain relief than active exercise [the medical conservative approach]; however, these results varied base on stratification of patients  with and without radiculopathy [extremity/leg pain/sciatica] and  with and without recurrent symptoms."
- "Patients with radiculopathy [leg pain] did significantly better with flexion-distraction."
Clinical Outcomes - Cervical Spine
In a case of a 60 year old man with cervical spine stenosis and radiculopathy, significant relief of pain by the patient's own report as well as in his clinical exam tests is documented. This relief came after prior medication and physical/occupational therapy did not work for him. (1)
In a study of 39 patients who had cervical spine pain that radiating into their arms, data was collected about their response to care with flexion distraction and adjunctive therapy modalities. It was found that the mean number of treatments was 13 to achieve a statistically significant reduction in pain. The range of treatments was 6 to 37 treatments total. Relief was attained non-surgically and satisfactorily for these patients. (2)
In a federally funded neck pain patient comparison study of flexion-distraction alone, medical conservative care alone, and a combination of both, pain relieving results for all groups were clinically significant. The combination group - flexion distraction and medical conservative care - had the most significant pain relief which is clinically understood. In the clinical setting, flexion-distraction is typically combined with other modalities in the treatment plan. (3)
Supporting Federal and Other Funded Research Studies
National University of Health Sciences enjoyed the initial HRSA grants regarding flexion-distraction. Under the guidance of Dr. Gudavalli, the first biomechanical study was done with Loyola Stritch School of Medicine, University of Illinois, Hines VA Hospital staff, and Auburn University graduate student program.
The second study was a clinical comparison study of low back pain patients cared for with chiropractic flexion-distraction versus medical physical therapy treatment conducted at National University of Health Sciences with Loyola Stritch School of Medicine.
The third study was a clinical comparison study of cervical spine pain patients
cared for with chiropractic flexion-distraction versus medical physical therapy treatment conducted at National University of Health Sciences
with Loyola Stritch School of Medicine and Palmer Center for Research.
In 2003, a chiropractic research grant (funded by the Health Resources and Services Administration and Berman Center for Outcomes and Clinical Research) was awarded. The purpose of this randomized clinical trial is to assess the relative effectiveness of three conservative treatment approaches for seniors with chronic low back pain
: 1) chiropractic manual treatment plus home exercise, 2) supervised exercise plus home exercise and 3) home exercise alone.
In 2004, a grant (funded by Health Resources and Services Administrationb 4) was awarded to do a comparison study of flexion distraction (low velocity variable amplitude), chiropractic (HVLA) and medical care of elderly patients’ low back pain. Under its principal investigator, Dr. William Meeker, it was completed at Palmer Center for Research in cooperation with the University of Iowa.
In 2004, the fifth federal grant (funded by NIH, the National Institutes of Health) was awarded for predicting low back pain patients response to spinal manipulation (chiropractic HVLA & flexion distraction LVVA). Under its principal investigator, Dr. William Meeker, it is also underway at the Palmer Center for Research in cooperation with the University of Iowa.
In 2006, a grant (funded by FCER) was awarded for the study flexion-distraction for stenosis. Under its principal investigator, Jerrilyn Cambron DC MPh, it is underway at National University of Health Sciences, University of Illinois Medical Center (Chief of Geriatric Medicine).
In 2008, a grant (funded by National Institutes of Health) was awarded for this project. Under its principal investigators, M. Ram Gudavalli, Ph.D., and Avinash G. Patwardhan, Ph.D., this developmental study is a collaboration between the investigators at Palmer College of Chiropractic Research Center (PCCR) and investigators at Loyola University Stritch School of Medicine (LUSSM) and Edward Jr. Hines Veterans Affairs (VA) Hospital. The biomechanics of flexion-distraction are being studied in preparation of more study. This is a project under the Developmental Center for Clinical and Translational Research in Chiropractic (DCRC I) Grant funded by the National Institutes of Health. #U19 AT004137-03
In 2009, a grant (funded by Palmer College of Chiropractic and National Institute for Health's National Center for Complementary and Alternative Medicine) was awarded for this project. Under its principal investigator, Dr. Christine Choate at Palmer
, the objective of this study is to assess the effects of high-velocity low-amplitude spinal manipulation and low-velocity variable amplitude spinal manipulation
on three types of sensorimotor abilities in patients with low back pain.
In 2008, a grant (funded by Department of Veterans Affairs) was awarded. The research is to determine the effectiveness of chiropractic management for treatment of chronic lower back pain in older adults. It is underway at VA Western NY Healthcare System at Buffalo and VA Medical Center in Canandaigua, NY. Paul Dougherty, DC, of the New York College of Chiropractic, is the principal investigator.
In this project (funded by HRSA R18HP07641) titled "Spinal Manipulative Therapy versus Active Exercise Therapy for chronic lower back pain: A randomized clinical trial with subgroup analyses," the researchers are comparing the effectiveness of spinal manipulative therapy with active exercise therapy in chronic pain patients
. Paul Dougherty, DC, of the New York College of Chiropractic, is the principal investigator.
With Cox Technic, research leads the way...to healing, to control of pain, and to a life you can enjoy.
Contact New Hampshire Spine and Sport today.