Case Studies - NUCCA

Chiropractor Everett Washington
NUCCA Technique & Hypertension Pilot Study: A brief history Excerpts by Marshall Dickholtz Sr., DC


The original 50 subjects, in the study, were randomly divided into two groups of 25 each. The control group received a placebo "adjustment." This was possible for two basic reasons: 1) because the "adjustment" is so light and 2) because the head could be braced and the adjusted vector controlled so well that no measurable change would take place in the misalignment.

The treatment or experimental group received an equally light adjustment but the vector used and the head placement were specific for each subject based on NUCCA's "understanding" of the presenting biomechanics as interpreted from X-rays for that particular patient. Patients were blinded as to whether or not they had received the sham "adjustment" or had received the real adjustment. The nurse taking the blood pressure readings was not aware of which subjects had been given the real adjustment. Hence, in this sense only, the pilot study was a double-blind study. With regard to posture measurements, X-rays, and adjustments the chiropractor was, of course, not blinded.

Posture measurements in this study included both supine leg check (non-load bearing) and standing (load-bearing) pelvic inclination (frontal plane) as measured on the anatometer as well as bilateral weight distribution, pelvic distortion in the transverse plane ("rotation") and lateral displacement of C-7 off a vertical axis. A laser light system was used to make measurements more readable. All patients were blindfolded for anatometer measurements and a digital camera recorded the posture of all 50 participants.
A standard cervical X-ray series was used and this consisted of lateral, nasium, and vertex views. Lead filters helped to minimized exposure to individuals. Atlas laterality and atlas rotation were measured and used in the calculus for determining the adjustic vector.
Three time events were of critical importance in measurement. Just before actual adjustment, just after adjustment, and eight weeks after adjustment; this sequence was identical for the placebo group. All patients had been off their medications two weeks prior to adjustments and randomization. All patients had all measurements taken at each of these three time events. In addition, all patients had blood pressure measurements taken weekly for eight weeks.

Of the 25 subjects in the treatment group, 15 had an average systolic blood pressure drop of 28 mm of Hg relative to the placebo group while the other 10 did not basically change. The treatment group (n=25) therefore had an average of 17 mm of Hg drop. Twenty-one patients had only one adjustment during the study. Future research will take a close look at why one portion of the treatment group (n=15) responded and the other portion of the treatment group (n=10) did not respond in a lowering of systolic blood pressure.

1) Bakris, G., Dickholtz M. Sr, et al. Atlas vertebrae realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J. of Human Hypertension, May 2007, 21(5): 347-52.

Chiropractor Everett WA
Cervicogenic Temporal Mandibular Disorder (CTMD)
Research Goals

This project is designed to provide an understanding of the interconnections between TMD and malposition of the atlas. In addition to providing an understanding between TMD and atlas malposition, this project is expected to determine the optimal way in which dentists and upper cervical chiropractors can work together for the benefit of the patient. The question to be answered is, "Does a malposition of the upper cervical spine change the dental occlusion or bite?" For example, if the atlas is corrected and not malpositioned, does that decrease the number of adjustments needed on dental occlusion and appliances? Clinical observations to date support the view that increased spinal stability and dental function are seen with patients using an integrated approach to dental care. The cervical spine-jaw-head modeling at the University of Toledo will be used to interpret what is seen dentally and chiropractically and will provide a biomechanical model relating TMD and misaligned cervical vertebrae.