Dr. Peter Bablis has been a Chiropractor and specialist health care professional practicing in Sydney for the past 21 years. He has post-graduate qualifications in Acupuncture, Sports Medicine, Clinical Nutrition, Naturopathy, Homeopathy, Medical Herbalism, Iridology and Kinesiology. He is currently completing his PhD. at Macquarie University in Psychosomatic Medicine.
Dr. Peter Bablis is a Chiropractor and specialist health care, wellness and fitness professional, practicing from past 21 years in Sydney. Dr. Peter Bablis is helping people live healthier lives.
Dr. Peter Bablis has been a Chiropractor and specialist health care professional practicing in Sydney for the past 21 years.
Peter Bablis
Peter Bablis is a kinesiologist, homeopath, chiropractor, acupuncturist and life saviour! He has post-graduate qualifications in Acupuncture, Sports Medicine, Clinical Nutrition, Naturopathy, Homeopathy, Medical Herbalism, Iridology and Kinesiology.
Peter Bablis
Peter Bablis has been a Chiropractor and specialist health care professional practicing in Sydney for the past 21 years. PSP Evening Seminar presented by Peter Bablis, through this evening session, Peter Bablis will shed light on a mind-body therapy that appears to integrate an individual’s physiology with their psychology.
Peter Bablis
Peter Bablis is a kinesiologist, homeopath, chiropractor, acupuncturist and life saviour! He has post-graduate qualifications in Acupuncture, Sports Medicine, Clinical Nutrition, Naturopathy, Homeopathy, Medical Herbalism, Iridology and Kinesiology.
Peter Bablis
Dr. Peter Bablis has been a wellness and fitness professional practicing in Sydney for the past 21 years. He has post-graduate qualifications in Acupuncture, Clinical Nutrition. He is currently completing his PhD. at Macquarie University in Psychosomatic.
Chiropractic care for children can have dramatic results. A child's developing spine protects the nervous system, which coordinates every process between the mind and body. Birth is one of the most traumatic events that we will ever have to endure, and can cause the vertebrae in the spine and the bones of the skull to become misaligned. A child's spine continues to receive the daily stresses and traumas of life as they grow. These forces distort the positioning of the spine and may cause slight pressure on the spinal cord, thus reducing the flow of communication between the mind and the body. These misalignments,known as subluxations, alter how well the nervous system functions and thus how well your child's mind and body function develops.
The Benefits:- Paediatric chiropractic improves common childhood symptoms of colic, asthma, and ear infections. Spinal misalignments or abnormalities such as scoliosis can be detected at a very early age thus minimising future problems. Children generally sleep better, so parents can too.
Published by Peter Bablis Henry Pollard, Rod Bonello Macquarie University, Sydney, NSW, Australia
Purpose: To investigate the effect of Neuro Emotional Technique (NET) in a randomised controlled trial (RCT) and to test the procedures of the proposed RCT for the management of chronic low back pain. Procedures include the recruitment of participants, attainment of assessment data, refinement of treatment and sham protocols.
Relevance: Low back pain is the most common presentation to chiropractic practitioners [1]. Pain is defined as “the unpleasant sensory and emotional experience associated with actual or potential damage or expressed in terms of such damage [2]. Recent evidence suggests that much chronic LBP is associated with physical and psychosocial components [3]. The biopsychosocial model of pain acknowledges the biological, psychological and social dimensions of the pain experience [4]. The emerging importance of such a model in chiropractic has previously been discussed [5]. This model recognizes amongst other variables that disability often results from an inability to perform activities due to the pain, or due to the fear of future pain. Disability is therefore a function of the pain and a response to it. The consequences of avoiding pain, and pain inducing activities, have been demonstrated to be deleterious [6]. Fear avoidance results in decreased social contact and causes a loss of roles in the family and the community and may lead to invalid status [7].
The mind-body approach attempts to integrate the psychosocial dimensions of the person into therapy. It essentially makes the process more active (with patient participation) rather than relying on the totally passive (doctor based) approaches of pharmacological medicine, surgery or manual therapy. The move toward a more active model of care has been brought about by the knowledge that the predictors of chronicity include: lack of exercise, invalid mentality, prolonged rest, litigation, workers compensation and other reward systems, poor life expectations, relationship difficulties, and poor work satisfaction amongst others [8].
Some forms of manual medicine have begun an exploration of some “mind-body” treatments in the attempt to integrate the function of the mind with the body in both assessment and therapy. Despite these lofty goals, very few of these treatments have been scrutinized under controlled conditions. This pilot study provides preliminary evidence that a mind-body approach, identified as Neuro Emotional Technique, may be beneficial in the treatment of chronic low back pain.
Methods:
Participants: Seventeen participants were recruited via print media. They rang a research office mobile number, and underwent a telephone screening protocol for eligibility into the study. Inclusion criteria included participants suffering from low back pain ≥ than three months and VAS score of ≥ 5. Exclusion criteria included: acute low back pain (<3 months duration); < 18 years of age; currently undergoing other manual therapy or psychological intervention; presence of “red flag” conditions; pregnancy; abdominal pain; vascular disease; motor vehicle accident or falls in last 3 months; neurological signs and symptoms; organic kidney, urinary tract or reproductive disease; straight leg raise of < 30o; previous spinal surgery; and bowel, bladder or sexual dysfunction.
Upon inclusion into the study, participants were then randomised into a treatment or control group. Participants were allocated to either group, predetermined by random number generator. The participants were blinded to which group they were assigned, the assessors of data were blinded, however the therapists were not blinded to group allocation. This study received ethics approval, through Macquarie University, Sydney, Australia. Ethics approval number:-HE26SEPT2003-RO2600.
Outcome measures: Upon initial consultation, all participants completed a new patient questionnaire, as well as a written information and consent form. Scores for subjective outcome measures were obtained at baseline and at 1 month (after 8 treatments). Outcome measures assessed included visual analog scale (VAS), the Modified Somatic P erception Questionnaire (MSPQ) score of the Distress and Risk Assessment Method (DRAM), Oswestry Disability Index (ODI) and Short Form McGill Pain Scale (SF-MPQ). Treatment (Neuro Emotional Technique)
Group: Participants who were assigned to the treatment group underwent a course of NET, as followed by the protocol outlined by Walker [9]. NET has been described as a 15 step, multi-modal intervention that incorporates principles of muscle testing, general semantics, Traditional Chinese Medicine, acupuncture, the meridian system and chiropractic principles in its application to manage patients. A major goal of NET is to achieve a reversal (or extinction) of classically conditioned distressing emotional responses to trauma related stimuli, stimuli that have the characteristic ability to reproduce or augment pain and other signs of disease without the original tressor(s) being present. Treatment was prescribed at a frequency of 2 sessions per week for one month, followed by 1 session per month for 2 months.
Sham Group: Participants who were assigned to the control group underwent a sham protocol of NET. The participants were administered an enthusiastic treatment of muscle testing and semantic testing which did not pertain to any emotional complex. Treatment was prescribed at a frequency of 2 sessions per week for one month, followed by 1 session per month for 2 months.
Statistical Analysis: A repeated measures analysis with a power model for the correlation over time, obtained using GenStat using a Linear Mixed Model (Residual Maximum Likelihood). There is some evidence that the variance of score data was not constant in this pilot study. Unfortunately, the small numbers prevented an in-depth check on this potential problem. All analyses were performed in Microsoft Excel or in GenStat (Version 9).
Published by Peter Bablis , Assoc Prof Rod Bonello and Dr Henry Pollard
Trigger points have been defined as discrete, hyperirritable foci usually located within a taut band of skeletal muscle [1]. The point is a well-circumscribed area in which pressure produces a characteristic referred pain, tenderness and autonomic phenomena [1]. Trigger points are considered an essential defining part of the myofascial pain syndrome, in which widespread or regional muscular pain is a cause of musculoskeletal dysfunction [2], as well as being associated with hyperalgesia, restriction of daily function or psychological disturbance [3]. Upon clinical presentation, trigger points are classified depending on certain characteristics. An active trigger point is defined as one with spontaneous pain, or pain in response to movement. It is tender on palpation, and may present with a referral pattern of pain, not at the site of the trigger point origin. A latent trigger point is a sensitive spot that causes pain or discomfort only in response to compression. Trigger points are reported to occur more frequently in cases of mechanical neck pain than in matched controls [4].
Patients may only become aware of pain when pressure is applied to a muscular point of restriction or weakness. The pathogenesis of trigger points is not clear, but it is believed they arise from more than one cause [5]. Fischer has suggested that trigger points are due to the sensitisation of nerves and the tenderness results from the decrease in the pain pressure threshold. He further opines that the tissue damage associated with injury causes the release of inflammatory products that increase the sensitivity of the nerve to stimulation. These substances include bradykinins, 5-HT and prostaglandins, though a recent study found tender points in the trapezius muscle of patients with tension-type headache were not sites of ongoing inflammation [6]. Trigger points are also thought to arise from acute trauma or repetitive microtrauma, such as lack of exercise, poor nutrition, postural imbalances, vitamin deficiencies, sleep disturbances and joint problems [7].
One study suggests overloading of muscle fibres may lead to involuntary shortening, oxygen and vitamin deficiencies and increased metabolic demand on local tissues [8], and trigger points have been suggested as decreasing the extensibility and contractile efficiency of muscles, and possibly causing muscle fatigue [9]. This is yet to be confirmed by research. Trigger points have been shown to be active in fibromyalgia [10,11], as well as somatic tenderness secondary to visceral dysfunction [2], migraine and other forms of nonpathological headache [12], shoulder [13] neck [14] and back pain [15]. Specifically, Rosomoff and co-workers [15] demonstrated that approximately 97% of persons with chronic intractable pain have trigger points, and of these, 45% have a non-dermatomal referred pain.
Furthermore, Rosomoff's team demonstrated that 100% of neck pain sufferers possessed the presence of trigger points and almost 53% of them had non-dermatomal referral [15]. However, it is worthy of note that no evidence describes the prevalence of trigger points of the neck and face in a normal population. Indirect evidence presented in the equine model suggests there to be significant differences between active trigger points and control points [16]. The diagnosis of a trigger point involves physical examination by an experienced therapist using a set of cardinal signs (Table 1) [1]. There have been many studies focused on the assessment of the reliability of detecting trigger points. Lew et al. [17] found that both inter and intra-rater reliability, using two highly trained examiners was poor, while Gerwin et al [18] found that extensive training of four clinicians together resulted in improved reliability for the identification of trigger points. Reeves et al. [19] demonstrated a moderate degree of intra and inter examiner reliability in determining the location of trigger points. In older studies values ranged from r = 0.68 to r = 0.86 [19].
In a study by Delaney and McKee [20], interclass correlation co-efficient (ICC) revealed inter-rater reliability to be high (values ranged from ICC = 0.82 to ICC = 0.92), and intra-rater reliabilities to be high (values ranged from ICC = 0.80 to ICC = 0.91) for the use of a pressure threshold meter in measuring trigger point sensitivity. In both clinical and experimental practice, a device such as the pressure algometer would be of great value for reliable quantification of trigger point sensitivities, once manually located. Fischer [5] demonstrated that the use of algometry in the detection of trigger points was a reliable procedure. He assessed the pressure threshold of deep tenderness in soft tissues, before and after various forms of treatment such as physiotherapy and drug therapy. In addition, Reeves et al. [19] reviewed studies that demonstrated the reliability of the pressure algometer.
He found that an experimenter was able to reliably obtain similar measurements on two occasions, as well as produce similar scores to independent experimenters. He also noted that agreement was found between two experimenters when locating unmarked trigger points and measuring their sensitivity, but did stress the importance that experimenters were experienced and trained. In patients who present to manual therapists, the use of algometry can be used to reliably quantify the tenderness associated with a trigger point and can be used to diagnose their location as well as to qualify the degree of pressure sensitivity.
Trigger points are potential outcomes of dysfunction in a region, and conventional treatment is based around the release of this taut band of skeletal muscle. Manual therapy [21], chiropractic treatment [1,22], electric therapy [23], local anaesthetic [24] and active therapy [25] have all been claimed to provide relief of trigger point sensitivity. Injection therapies involved the use of local anaesthetic and saline, while it is postulated that massage and myofascial release aim to increase local circulation, improve mobility and relieve subcutaneous tightness. Furthermore, the presence of trigger points has been frequently associated with signs and symptoms in addition to pain [26], and these syndromes may be in found in disorders associated with chronic psychosocial factors [27].
Whilst it is likely the pathogenesis has at least a partly central mechanism, most approaches to the management of the trigger point phenomenon utilise only peripheral approaches to the points themselves. Therapy for trigger points requires an approach that enhances the central inhibition through pharmacological or behavioural techniques, and reduces the peripheral inputs to the maintenance of the reflexes by utilising physical therapies such as exercise [28], needling and digital pressure [29]. Offenbacher & Stucki [30] have also suggested that a combined approach to therapy would be warranted for patients exhibiting myofascial (as well as other) symptoms in conditions such as fibromyalgia. It was the specific aim of this research to investigate whether a new mind body technique called Neuro Emotional Technique (NET) could significantly relieve pain sensitivity of trigger points presenting in a cohort of neck pain sufferers.
This study investigated the effects of Neuro Emotional Technique (NET) on the sensitivity of trigger points presenting in regions of the neck including the suboccipital region, levator scapulae region, sternocleidomastoid insertion region and temporomandibular region, in a cohort of chronic neck pain sufferers. The results of the study could provide useful information or the treatment of cervical pain and related psychosocial problems.
Published by Peter Bablis Henry Pollard, Rod Bonello Macquarie University, Sydney, NSW, Australia
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Peter Bablis
