The Association of Chiropractic Colleges (ACC) is releasing a DVD titled "Cervical Spine Adjusting and Vertebral Artery Issues." The culmination of three years of work by the ACC to summarize research and clinical experiences on the topic, the 105-minute lecture is delivered by Dr. Gerard Clum, president of Life Chiropractic College West and member of the ACC board of directors.
The DVD presentation is designed to accomplish several specific things, according to the ACC. It will "increase the ability of the chiropractor to better recognize a patient in the process of an arterial dissection upon presentation. In addition, the information presented in this lecture will provide the chiropractor with current information about the demographics and incidence data of Vertebral Artery Dissection (VAD) in general and as it relates to the practicing chiropractor. Finally, this lecture will provide up-to-date information on the proper management of a patient who is experiencing a VAD to minimize morbidity, mortality and related issues of professional liability."
The DVD was first conceptualized at the ACC's annual meeting in March 2004. The association set a goal of providing all chiropractors with the latest information on the relationship, if any, between cervical spine adjusting and injuries to the vertebral artery (cerebrovertebral accidents - CVA). To accomplish this, an ad-hoc committee, known as the ACC CVA Committee, was formed, with Dr. Clum as chair.
The committee began the process of developing a presentation regarding concerns and issues related to the subject.
"Members of the ACC felt a presentation offered on behalf of the entire academic community would almost immediately result in a change in the standard of practice in chiropractic," said then-ACC president Dr. Jean Moss, president of Canadian Memorial Chiropractic College. "The ready accessibility of the latest data provides chiropractors with greater confidence in the delivery of care. Patients' clinical presentation will be better understood and potential complications can be avoided."
After a two-year development period, representatives of the ACC's member institutions reviewed a draft of the presentation and provided feedback. A revised version was then submitted to the clinic deans/directors of the association's member institutions and programs. Following their feedback and input from other interested parties within the chiropractic profession, a final version of the lecture was presented in May 2006 at the annual meeting of the Federation of Chiropractic Licensing Boards.
According to the ACC, while excellent printed publications and online courses address the subject of cervical spinal manipulation, the vertebral artery and CVA, a coordinated effort on the part of the chiropractic educational community was necessary to bring this information to the field. It was important that to maximize the value of the DVD to chiropractors, it present the most current clinical and research information and concurrently hit the right pragmatic balance. The reality that a presentation offered on behalf of the entire academic community of the profession would almost immediately result in a change in chiropractic standards of practice also conveyed the need to work diligently to bring this information to the practitioner.
"It is very clear that procedures once thought to be helpful no longer provide clinically relevant value, and it is equally clear that the issue associated with chiropractic care has shifted from one of perceived causation to one of evaluation and recognition" commented Dr. Clum. "Every chiropractor, regardless of when they graduated, the school or college they graduated from, the technique used or the type of patient population served, needs to review and understand this information."
A consensus was reached that to increase the chances of the information reaching all practicing chiropractic clinicians, it be made accessible in every possible format. To that end, plans are underway for the lecture to be available online in the form of either a "Webinar" or as streaming video. The content will be available for viewing at no cost, but will not be available for download. Various colleges also are offering live presentations of the lecture.
"We knew from the beginning that this effort needed to be presented in lecture format in person, on DVD and online," said Dr. Clum. "It wasn't going to be enough to publish a book or to develop an online course. We felt the need to be creative and meet the needs of today's diverse learning styles, and to offer the lecture in various formats, to increase the potential for complete exposure."
To order the DVD online, visit www.chirocolleges.org/cva_ordering.html. A $10 shipping and handling charge applies. As of press time, more than 50,000 advance orders have been placed for the soon-to-be-released DVD. The majority of the orders are from chiropractic colleges and programs planning to make the information available to their alumni, faculty and students.
The ACC thanks Drs. Alan Terrett, John Triano, Scott Haldeman and Greg Kawchuk for their work on this project. The association also acknowledges the National Chiropractic Mutual Insurance Company (NCMIC) for its most recent 2006 publication, Current Concepts in Spinal Manipulation and Cervical Arterial Incidents, related to this subject; and for seed funding for the initiation of the project.
"The response of the educational community of the profession as well as the practicing community to this effort is quite gratifying," said Dr. Clum. "This is truly a win-win opportunity. Chiropractors armed with this new data can proceed with greater confidence when providing chiropractic care. Patients' clinical presentations will be better understood with the new research findings and therefore, potential complications can be avoided."
