Network Spinal Analysis – Research
The official definition of NSA is as follows:
Network Spinal Analysis: An approach to wellness that incorporates low force touch contacts, applied at Spinal Gateways to assist the body in developing new strategies for living and healing. Two spinal “healing” waves develop which help improve spinal and neural integrity, adaptability, and significantly advance wellness and quality of life. Care is advanced through a series of Levels, each producing specific new abilities to adapt to the environment, make healthier choices, enjoy life and develop a healthier spine. This outcomes assessment approach combines self reported wellness profiles with practitioner clinical assessment to help review the emerging options for healing and an enriched life.
Network Spinal Analysis is based upon “evidence based practice” and the practitioners at Funnell Family Chiropractic follow the Clinical Practice Guidelines of the Council on Chiropractic Practice.
The following is some information about research that has been conducted in this unique approach to healing:
The Epstein model of Spinal and Neural Integrity on top of which Network Spinal Analysis developed continues to be the focus of various disciplines in the academic community.
The Retrospective study of almost 3,000 patients in Network offices in the USA, Australia, Canada and Puerto Rico demonstrated "within the boundaries of this study design, these findings provide substantial evidence that Network Care should be included among those practices with established health benefits." Through this study a new instrument which allows for the much desired patient self reported assessment of health was designed and gain initial validity.
This questionnaire evaluated wellness through the patients own experience of changes in the following categories: Improved Physical State, Improved Mental/Emotional State, Improved Response to Stress, Improved Life Enjoyment, and Improved Overall Quality of life. Not only did Seventy-six percent of the patients studied report improved combined wellness changes in all categories assessed, but the longer the individuals were in care, the greater the level of improvement. After over 3 years of care, no limit or ceiling was found to the benefits. This is remarkable.
Findings from the retrospective study showed that all measured characteristics of care exerted a pronounced impact on perceived improvements in wellness. Individuals who had experienced significant "life stress (change in job, etc..)" and trauma were more likely to report perceived improvements in wellness than those with less stress or trauma.
Statistical analysis using multivariate regression has allowed the development of a "model" to analyse the influence of a number of factors on a given outcome. The influence of the variables on the outcome portion of the overall model is referred to as the R2. If only the variables considered account for all of the variance around a predicted outcome the R2 would be equal to 100%. Relative to the retrospective study, a number of factors were tested to find out the extent to which they influenced the outcome variable "wellness." When a patient reports a perceived change in their health a number of factors could be contributing to that change. A regression model tests what influence personality factors, social status factors, and other social conditions may have on a person’s perceived wellness. Through this process, it is possible to construct an overall model which shows what impact the actual care had on respondent’s perceived wellness independent of other demographic characteristics such as age, gender, income, lifestyle, and amount of stress due to change in life activities.
Following this logic, the retrospective study showed that socio-demographic factors such as age, gender, education, and income contributed very little to explaining the large change in "wellness" experienced by respondents under Network Care. However, the indicators of potentially "stressful" life circumstances such as change in marital status, job, residence, etc., or experiences of past trauma collectively explained 16% of the variance in improved "wellness." This is interpreted to mean that patients reporting a significant change in life circumstances and past traumatic experiences report a greater perceived improvement in wellness. This further suggests that those who "needed" stress buffering the most (holding all other variables constant) had the highest perceived benefit from Network Care. Interestingly, when duration of care, awareness of the wave, awareness of change in breathing , and whether or not respondent’s expectations were met, were added to this regression model, explained variance rose from 16% to 24%, a 50% increase. This suggests that even when holding other variables such as external social factors and interpersonal factors constant, Network Care had an additional effect on the respondent’s perceived
To understand the effect of lifestyle behaviours on present wellness, another regression model was constructed. This model showed that higher present wellness was predicted, (explaining 3% of the variance) by being younger, having a job, and being married. Moreover, when other variables such as having no ailments, reporting a higher emotional state score, and higher perceived prior wellness, the explained variability rose to 36%. When adding Network Care Characteristics; such as, time under care, awareness of the wave, awareness of breathing, and expectations met, the explained variance rose to 38%.
Patients were also asked about health promoting changes in lifestyle practices such as exercise, relaxation, meditation, yoga, diet, vitamins, vegetarianism; and health risking lifestyles such as smoking, beef and caffeine consumption. However, when change in lifestyle was included in a regression model predicting a perceived improvement in wellness (before care minus present wellness), it accounted for only 5% of the variance. Future analysis will likely explain the dynamic between lifestyle habits, the use of NSA, and perceived wellness. That is, does using NSA lead to a change in lifestyles, and if so, do these lifestyle changes, rather than NSA, account for the improvement reported by patients?
The Retrospective questionnaire is being utilized at the New Zealand School of Chiropractic, in Auckland. The Epstein model of spinal and neural integrity is part of the curricula at the school, as well as Network Spinal Analysis being taught as an elective at the school and practiced in their clinical program.
Two chiropractic colleges in the USA have showed an interest in utilize this revolutionary patient self reported wellness assessment tool.
A Longitudinal Study was performed, also at the Medical College of the University of California- Irvine, which tracked patients over time in care, with some patients still in care after one year. The questionnaire developed for the Retrospective study, was repeatedly completed. This study, soon to be submitted for publication appears to support the conclusion of the Retrospective study, further validating the questionnaire and the effectiveness of care. Interesting unique factors associated with care will be highlighted in this study.
A study by Miller and Redmond (1998), evaluated changes in digital skin temperature, sEMG, and electrodermal activity in subjects receiving NSA. The NSA group demonstrated a significant decline in electrodermal activity and constancy of sEMG activity compared to controls, thus prompting the authors to propose that a "sympathetic quieting effect" was in effect during the clinical application NSA. These authors also suggested that these findings were consistent with the self-reported improvements in mental/emotional state and stress reduction in patients receiving Network Care in the retrospective study.
A recent study by Behrendt h reported a significant reduction in psoriasis in a male patient who had been under medical care for about eight years. While under concurrent NSA care, although at times undergoing personal stress which a known exacerbating factor in psoriasis, the patient maintained a decrease in body coverage to approximately 1.0% in the absence of methotrexate, a common immunosuppressant medication given to control psoriasis. Prior to NSA, he mistakenly withdrew from the medication, only to experience "flares" of up to 15% body coverage. The patient also reported other quality of life improvements. The author proposes that concurrent NSA care may have been helpful to this patient, possibly by positively affecting psycho-neuro-immunological pathways.
Dynamical Non-linear Model
The actual neurophysiological processes which take place in patients under NSA care are under investigation. Two wave forms have been described to date. Specific changes have been reported by patients when expressing predominantly the "respiratory wave," while other benefits are reported during periods when patients are experiencing both the "respiratory wave," and the "somatopsychic wave." The time periods under care when these waves are most likely to be experienced has been described and identified relative to the Levels of Care, or clinical application of NSA.
It is visually apparent that a unique set of muscular contraction patterns are associated with the " somatopsychic wave," Thus, this neurophysiological phenomenon initiated through the clinical application of NSA was chosen for investigation Observation of the "somatopsychic wave" reveals that the muscular contraction patterns are unique to each individual, but the overall group of patterns exhibit characteristic movements that seem common to a wide range of individuals expressing the wave. It also has been observed that when a large group of people are expressing the "somatopsychic wave" that some of the movements of the larger muscle groups exhibit synchrony within the population. Moreover, while certain muscle contraction patterns are characteristic of the process, it is not predictable as to when a given pattern will be expressed by a patient, or if the pattern will be expressed at all. Additionally, the individual patient can consciously arrest the "somatopsychic wave" but not reproduce it consciously. This combination of characteristics led to the development of a research hypothesis that the neuromuscular process was not only non-linear, but dynamical (chaotic) as well.
Current investigation has provided preliminary information in support of this hypothesis.
That is, when surface electromyographic (sEMG) data was analysed by non-linear mathematical algorithms, a non-linear attractor estimated to be of an order between 4 and 10 was predicted. Future study in this area will focus on confirming the suspected "chaotic" non-linearity of the "somatopsychic wave," and depicting its respective attractor. If predictions hold true, the next step will be to differentiate the wave relative to Levels of Care to see if attractors specific to each Level of Care can be discerned. This would permit confirmation of patient progress as to their respective status relative to the Network Protocol. Patients have been sampled at different Levels of Care. Preliminary mathematics is promising in regards to a potential relationship between progression in NSA Levels of Care and organization state of the signal and therefore the nervous system
Milestone: The "somatopsychic wave" represents a consistent, readily repeatable physiological model for non-linear mathematical modelling. This characteristic should be of interest to a wide range of disciplines interested in the dynamics of human function.
A Functional MRI (brain scan without X-rays) in a pilot study of only one person suggested an extremely significant increase in brain efficiency via change in blood flow to the cerebral cortex (the thinking brain). This study was sufficient to have a grant awarded to a medical college for further study of the potential enhanced brain function in Network Care. It is hoped that this study will be expanded upon and will be performed at various international institutions
A study of immunologic function associated with NSA care is currently being developed in conjunction with a Professor of immunology at the University of Auckland.
Candace Pert, Ph.D., former chief of brain biochemistry at the Nation Institutes of Mental Health and currently Professor of Research at the department of Physiology and Biophysics, Georgetown University Medical Center is currently involved in developing a further research agenda studying monocyte selectivity for neuropeptide associated with various phases or states of spinal cord tension patterns proposed by Dr. Epstein. Dr. Pert and Dr. Epstein are entering into cooperation for a theoretical paper bridging the Pert model of neuropeptide (chemicals of emotion) and membrane research with the Epstein model of spinal and neural integrity and model of the Emotional subsystem. It is being proposed that the alteration of membrane tension at the spinal level may be associated with a predisposition to certain neuropeptide binding at the cell membrane. It is further proposed that the Somatopsychic wave seen in Network Care is associated with a change in this peptide-membrane relationship as tension is liberated from the nervous system and tissues regain flexibility and compliance.
NSA, through specific clinical methodology elicits an innate response, which through its apparent chaotic character can be surmised to involve inherent neurophysiological processes that are also chaotic in nature. This response appears to link the active, passive, neurological, and emotional subsystems, into a deterministic complex affecting spinal/neural integrity. The results of this process are reflected at the human perception level as improvements over a wide range of physical, mental, and emotional factors; all of which are believe to be components of health. These responses and expressions of improvement have been quantified as a wellness coefficient and measured through a non-medical health questionnaire format which has demonstrated a high level of internal and external validity.
Network Spinal Analysis
Network Spinal Analysis (NSA) is a technique through which the practitioner applies light pressure at precise points along the spine closely correlated to regions where dural attachments to the bony vertebrae and contiguous structures have been demonstrated. Although patient specific, within one to three months of care, the spine exhibits a spontaneous rocking motion which is not initiated voluntarily, but can be voluntarily ceased. Retrospective and longitudinal studies have indicated that the benefits of this type of care include enhanced flexibility and nicalphysical stability of the spine. This type of care also appears to relief adverse mechanical tensions in the spinal chord. Adverse Mechanical Tensions in the Central Nervous System is a theory developed by Alf Breig, a neurosurgeon from Lund University, Sweden.
During this rocking motion, a fair amount of surface electromyographic (sEMG) activity is present along the spine. The sEMG signals recorded at the cervical, thoracic, lumbar, and sacral levels show "bursts of EMG activity" appearing at random and lasting anywhere from a few seconds to a minute.
Our early attempt to achieve a better understanding of this neurophysiological phenomenon has been to perform a non-linear dynamical modelling of the sEMG signal during its "bursting" phase. The False Near Neighbour (FNN) approach, popularised in the chaos literature by Ruelle as a mean of estimating the dimension of an attractor, did not manage to reveal anything substantially different from a pseudo-random sequence. However, such proven techniques as the Non-linear Canonical Correlation Analysis (CCA) and the Alternating Conditional Expectation (ACE) did reveal the presence of non-linear phenomena and both techniques consistently pointed to a non-linear dynamics of a dimension somewhere around 6 or 7. The CCA reveals a subtle, but definite (i.e., jumping from 0.1 to 0.8), increase of the 3rd, 4th, and 5th canonical correlation coefficients under non-linear distorsion of the past and the future, while the ACE reveals some saturation in the regression functions predicting the future from the past. This saturation phenomenon, which is not surprising with this kind of neurophysiological events, further contributes to making the dynamics singular or of descriptor type, in the sense that the dynamical equations are implicit rather than explicit. A corollary of the singularity of the dynamics is that the motion appears to be flipping back and forth between two algebraic varieties.
Next, a "spatio-temporal" analysis of the collection of signals recorded at various points was developed to determine whether a "wave" pattern travelling along the spine is present. The method relies on the Canonical Correlation Analysis of the past of the signal at one point S (the "source") and a time-shifted version of the future of the signal at another point T (the "target"). More specifically, from the canonical correlation coefficients, the Akaike mutual information is computed versus the time-shift and, if the mutual information shows a maximum for a time-shift t_s, it can be concluded that it takes an amount of time t_s for the wave to travel from S to T. From this analysis, it appears that the "source" is the sacral area, for indeed, the correlation analysis shows an increasing amount of time for the wave to go to the lumbar, thoracic, and finally cervical area. The fact that the sacral area appears the "source" is probably related to the dura being attached to the bony structure in this area. Conversely, the correlation analysis did not reveal such a consistent pattern when the cervical area is viewed as the "source."
1. S. Bohacek and E. Jonckheere, "Chaotic modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A preliminary report," in Journal of Vertebral Subluxation Research, vol. 2(4), pp. 188-195, Dec. 1998.
2. E. Jonckheere, S. Bohacek, and P. Lohsoonthorn, "Dynamic modeling of spinal EMG activity," NSF Southwest Regional Workshop on New Directions in Dynamical Systems, University of Southern California, Los Angeles, Nov. 16-19, 2000.
Statement of Efficacy by Ralph Boone, Ph.D, D.C.:
Ralph Boone, Ph.D., D.C.,
He has served as president of an American chiropractic college, and is currently Executive Officer for Academics/Research for the New Zealand School of Chiropractic. He is the current editor of the peer-reviewed Journal of Vertebral Subluxation Research, and author or co/author of numerous publications.
Dr. Boone has been on several research teams at various academic institutions. Recently, as the Research/Education Director for the World Chiropractic Alliance (WCA), he was the representative of the WCA, which holds Non Governmental Organization holding recognition with the U.N. Department of Information (NGO/DPI), at the Seoul International Conference of NGOs where he presented a discussion session on "The Role of Chiropractic Care in Global Health."
Dr. Boone also serves as Vice President of the Council on Chiropractic Practice, and is involved with international education of chiropractic and other allied healing arts.
From the Desk of W.R. Boone, Ph.D., D.C.
Dr. Donald Epstein, Developer
Network Spinal Analysis October 27th, 1999
Dear Dr. Epstein:
Please feel free to use this letter pertaining to the efficacy and scientific scrutiny which surrounds Network Spinal Analysis (NSA). I offer the following comments based on my experience relative to non-chiropractic basic science research and education, chiropractic research, and chiropractic education.
I have been involved with the evolution of study relative to NSA for approximately five years. That time has permitted the accumulation of sufficient data to develop a sophisticated analysis of previous anecdotal reports concerning NSA care. To date, the system of care delivery associated with NSA has been studied from the perspective of its formal documentation, description, retrospective analysis, and longitudinal clinical outcomes. Moreover, its relationship to academic disciplines other than chiropractic has also occurred (notably non-linear systems mathematical analysis, and regression modelling relative to the social sciences). A publication history detailing the findings to date can be supplied. Three other manuscripts relative to the social sciences, and the longitudinal study are currently in preparation for publication submission. All articles published have been subjected to the peer-review process to ensure scientific quality and proper evaluation of the findings. As well, a current model of NSA based on these published findings is available.
Currently, the body of scientific information that has accumulated supports earlier reports regarding the efficacy of NSA as well as its positive health and wellness benefits to those receiving NSA care. Thus, in my opinion, it is appropriate to state that NSA has been thoroughly studied in terms of efficacy and benefits to its recipients. Some aspects of the unique "somatopsychic wave" associated with NSA escapes current neurological and physiological explanations relative to mechanism of action. However, this factor alone has been a principle attraction for those representing non-chiropractic disciplines to explore NSA relative to their respective areas of study.
Dr. Epstein is committed to a long-term research program, as should be expected for any technique or methodology, findings to date reveal that a significant number of individuals, spanning a wide spectrum of locations and life situations, respond essentially the same to the NSA care delivered. These findings are epidemiological in scope crossing both geographical and cultural boundaries. I know of no other chiropractic technique to which this level of scientific inquiry has been undertaken. Furthermore, because of the high level of consistency found across the populations studied, only the most rigorous statistical methods of analysis have been used to assess the data.
W. Ralph Boone, Ph.D., D.C.