Network Spinal Analysis (NSA)

https://www.epienergetics.org/research-resources/

Clinical Trials

https://www.activator.com/research/

https://quiropractica-aeq.com/pdf/Dossier-Noviembre-2019.pdf

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The following is a list of peer-reviewed publications involving Network Spinal Analysis Care. Further information regarding Network Spinal Analysis Research currently in process or programs where information on Network Spinal Analysis Research has been presented is available at www.wiseworldseminars.com

Stationary versus bifurcation regime for standing wave central pattern generator.

R. Martin del Campo, E. Jonckheere. Biomedical Signal Processing and Control 32 (2017) 57–68

The purpose of this research is to show that the correlation analysis on surface electromyographic (sEMG) signals that originally confirmed existence of a standing wave central pattern generator (CPG) along the spine are reproducible despite evolution of the entrainment technique, different hardware and data collection protocol. Moreover, as major novelty of the present research, it is shown that this CPG can undergo “bifurcations,” here revealed by signal processing extrapolated towards the period-halving dynamical interpretation. The visually intuitive manifestation of the bifurcation is statistically confirmed—using bootstrap analysis—by a shift in the cross power spectral densities, consistently with the standing wave occurring on different subbands of the Daubechies DB3 wavelet decomposition of the sEMG signals.

Resolution of Panic Disorder and Improved Quality of Life in a Patient Receiving Network Spinal Analysis and Somato Respiratory Integration Care: A Case Report

Lucks C, Lucks L. Annals of Vertebral Subluxation Research. October 17, 2016. pp 111-117

Objective: To present the clinical outcomes of Network Spinal Analysis (NSA) chiropractic care and Somato Respiratory Integration (SRI) exercises in an adult female suffering from anxiety, panic attacks, and comorbid somatic complaints. Clinical Features: A 49-year-old woman presented to a wellness based chiropractic clinic suffering from anxiety and panic attacks with associated chest pains for a period of eight months with no improvement. The presenting complaints began following a three-year period of prolonged stress. The patient’s history revealed past episodes of extreme stress and trauma. Interventions and Outcomes: A program of Network Spinal Analysis chiropractic care was employed to improve Spinal and Neural Integrity (SNI), including the reduction of Adverse Mechanical Cord Tension (AMCT) and vertebral subluxations. Somato Respiratory Integration exercises were utilized to enhance somatic awareness and provide greater internal safety. AMCT was assessed and measured using a Heel Tension Scale. Quality of life improvements were measured using a self-rated Health, Wellness, and Quality of Life (HWQL) survey. A steady reduction of anxiety and panic attacks was achieved during the first six weeks of care with significant quality of life improvements. Resolution of a panic disorder was achieved within fourteen weeks of care. Conclusion: Network Spinal Analysis and Somato Respiratory Integration care was associated with the resolution of a panic disorder with significant quality of life improvements in this case. Further research is recommended to explore the role of chiropractic care combined with Somato Respiratory Integration exercises for the management of anxiety disorders and/or other stress related conditions that may be mediated through the spine.

The Network Spinal Wave as a Central Pattern Generator Senzon S, Epstein D, Lemberger D. The Journal of Alternative and Complementary Medicine. July 2016, 22(7): 544-556. doi:10.1089/acm.2016.0025.

Objectives: This article explains the research on a unique spinal wave visibly observed in association with network spinal analysis care. Since 1997, the network wave has been studied using surface electromyography (sEMG), characterized mathematically, and determined to be a unique and repeatable phenomenon.

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Methods: The authors provide a narrative review of the research and a context for the network wave’s development. Results: The sEMG research demonstrates that the movement of the musculature of the spine during the wave phenomenon is electromagnetic and mechanical. The changes running along the spine were characterized mathematically at three distinct levels of care. Additionally, the wave has the mathematical properties of a central pattern generator (CPG). Conclusions: The network wave may be the first CPG discovered in the spine unrelated to locomotion. The mathematical characterization of the signal also demonstrates coherence at a distance between the sacral to cervical spine. According to mathematical engineers, based on studies conducted a decade apart, the wave itself is a robust phenomenon and the detection methods for this coherence may represent a new measure for central nervous system health. This phenomenon has implications for recovery from spinal cord injury and for reorganizational healing development.

Stationary regime for Standing Wave Central Pattern Generator Martin del Campo R, Jonckheere E. GlobalSIP 2015 — Symposium on Signal Processing and Mathematical Modeling of Biological Processes with Applications to Cyber-Physical Systems for Precise Medicine. Orlando, Florida, USA December 14–16 2015

The purpose of this research is to show that the spatio-temporal analysis on surface Electromyographic (sEMG) signals that originally confirmed existence of a standing wave Central Pattern Generator (CPG) along the spine are reproducible under less than ideal conditions and despite evolution of the entrainment technique, different hardware and data collection protocol. This analysis reveals a coherence at a distance between sEMG signals, which because of its large scale reproducibility could become a test for properly functioning Central Nervous System.

Reorganization of the Cervical Curve & Improved Quality of Life Following Network Spinal Analysis Care: A Case Study Knowles D, Knowles R, Burnier B. Annals of Vertebral Subluxation Research. December 7, 2015. pp 217225

Objective: The objective of this study is to report on the reorganization of the cervical curve in a patient undergoing Network Spinal Analysis chiropractic care. Clinical Features: The patient is a 31-year-old male who presented for Network care with complaints of arthritis in his neck, stabbing pain in ribs and numbness/tingling in both hands. Radiographs were taken which demonstrated an Atlas Plane Angle measurement of 14.7° indicating loss of cervical lordosis. Intervention and Outcomes: Chiropractic care plan consisted of Network Spinal Analysis care. Based on initial spinal assessment, low force spinal adjustment contacts were applied to enhance spinal and neural integrity and increase somatic awareness. The patient received a total of 61 adjustments over a period of 6 months. After 6 months surface electromyography, thermal scan, radiology and patient’s subjective assessment demonstrated significant improvement. Lateral cervical film showed increase in Atlas Plane Angle to 30° and the restoration of the patient’s lordotic cervical curve. Conclusion: This case study reports on the increase of the cervical lordosis in a patient undergoing Network Spinal Analysis care. Improvement in the patient’s objective outcomes indicates that while under Network care, the patient’s body has undergone reorganization. This case study adds to subluxation-based chiropractic research focused on the restoration of the cervical curve. Further research is warranted to determine the relationship between Network Spinal Analysis adjustments and improvement in the cervical curvature.

Resolution of Abdominal Migraines & Improvements in Concentration & Learning in a 6Year-Old Girl Following Network Spinal Analysis Care: A Case Study Lucks C, Lucks L. J. Pediatric Maternal & Family Health – Chiropractic. Volume 2015, Issue 4. pp 140-148

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Objective: To report on the improvements in a child with difficulties in concentration, learning, and abdominal migraines while receiving Network Spinal Analysis (NSA) chiropractic care. Clinical Features: A 6-year-old girl presented with difficulties in concentration and learning since beginning school more than twelve months earlier. She also suffered from severe stomach pain for over two months diagnosed as abdominal migraines. She received NSA care over a period of six weeks. Spinal and neural integrity (SNI) was assessed and measured weekly through palpation, visual postural analysis, and heel tension scales. Results: Improvements were seen in concentration and learning along with a complete resolution of abdominal migraines. These improvements were consistent with greater SNI (including the reduction of adverse mechanical cord tension (AMCT) and vertebral subluxation) achieved through NSA care. Conclusion: The results documented in this case suggest comorbidity between difficulties in concentration, learning, and abdominal migraines. NSA chiropractic care was found to be of clinical benefit in this case by improving SNI. Further research is needed to investigate the relationships between SNI and co-occurring stress related conditions.

12th International Research and Philosophy Symposium (IRAPS) Sherman College of Chiropractic Spartanburg, SC October 10-11, 2015 Various Authors. Annals of Vertebral Subluxation Research. November 27, 2015. pp 184-212.

Includes: • Radiological changes in lateral cervical spinal curves seen across a retrospective case series of chiropractic patients utilizing Network Spinal Analysis care

Improvements in Mood, Posture and Balance in an Older Patient Receiving Chiropractic Care: A Case Study Bredin M, Putt K. Annals of Vertebral Subluxation Research ~ May 21, 2015 ~ Pages 125-129

Objectives: To report on and discuss the changes in a 72 year old male who presented for chiropractic care suffering from multiple health complaints. Case History: A 72 year old male presented to a private chiropractic practice in Auckland, New Zealand suffering from severe postural alterations, mild depression, low back pain, balance disturbances, perpetual tiredness and mild depression. Interventions and Outcomes: Over a nine week period, a specific and conservative chiropractic care plan was provided to the patient. The care plan involved Network Spinal Analysis (NSA) adjustments and the frequency of care was altered throughout this period based on both subjective and objective measures. A complete health history and physical examination was completed prior to care. A full posture analysis (Posture Pro 8 posture analysis system), and surface electromyography (sEMG) scans were performed at baseline and were then monitored regularly over the nine week period. Subjective measures were also monitored during each adjustment visit. Significant improvements were noted in postural and sEMG findings as well as in subjective measures of health over the 9 week period. Conclusions: While under chiropractic care, improvements in both self-reported subjective and objective measures were noted in a patient with severe postural alterations, low back pain, balance disturbances, perpetual tiredness and a mildly depressive state of mind. These improvements include overall physical, mental, and emotional well-being of the patient.

11th International Research and Philosophy Symposium (IRAPS) Sherman College of Chiropractic Spartanburg, SC October 16-19, 2014 Various Authors. Annals of Vertebral Subluxation Research ~ April 24, 2015 ~ Pages 48-98

Includes:

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• Pilot Study, Results of Reorganizational Healing Meta Model Applied to Adult Females during InResidence Addition Recovery • Inter and Intra Reliability of Heel Tension Scale • The Network Spinal Wave as a Central Pattern Generator • Improvement of a Functional Movement Disorder in a Patient Receiving Network Spinal Analysis and Somato Respiratory Integration Care: A Case Report • The Effects of Short-term Network Spinal Analysis Care on Stress, Anxiety, and Quality of Life in College Students: A Prospective Pilot Study

Improvement of a Functional Movement Disorder in a Patient Receiving Network Spinal Analysis and Somato Respiratory Integration Care: A Case Report Lucks C, Lucks L. Annals of Vertebral Subluxation Research. April 9, 2015. pp 26-33

Introduction: A 36 year-old female presented to a wellness based chiropractic clinic suffering from uncontrollable hyperkinesia, featuring myoclonic jerks and tics. A neurologist made the diagnosis of a functional (nonorganic) movement disorder and referred the patient to a psychiatrist for treatment of a suspected psychogenic movement disorder. She chose not to see a psychiatrist and instead began chiropractic care. Methods: Network Spinal Analysis (NSA) and Somato Respiratory Integration (SRI) care was delivered over a period of twenty weeks. The patient was evaluated for indicators of Adverse Mechanical Cord Tension (AMCT), including vertebral subluxation and spinal defense patterns, according to the NSA protocol. Spinal and neural integrity (SNI) was assessed through static and motion palpation, postural and neurological assessments, and surface electromyography. Results: Significant improvements in SNI were achieved, as were other wellness based outcomes of NSA and SRI care as reported by the patient. These improvements coincided with the steady improvement of all signs and symptoms of a FMD, with a complete resolution of all hyperkinetic movement, myoclonic jerks, and tics by 20 weeks of care. Conclusion: NSA and SRI care was found to be of promise for restoring neurological function in a patient with a FMD. The findings in this case could support further research into the relationships between SNI, vertebral subluxation, and FMD’s.

The Seasons of Wellbeing as an Evolutionary Map for Transpersonal Medicine Epstein D, Senzon S, Lemberger D. International Journal of Transpersonal Studies, 33(1), 2014, pp. 102130.

The four Seasons of Wellbeing (Discover, Transform, Awaken, and Integrate) refer to distinct rhythms, periods, and factors that influence the accessibility of an individual’s resources during the journey of life. Each season is explicitly and implicitly related to an individual’s experience, focus, and capacity for selforganizational states. Each can be used to understand, organize, and foster behavior change, positive growth, transformation, and human development. A genealogy of the seasons is described, emphasizing the empirical and theoretical foundations of Reorganizational Healing and its roots in models such as Grof ’s Systems of Condensed Experiences (or COEX Systems) and Wilber’s Integral Theory and Pre/Trans Fallacy. In the context of transpersonal medicine, the seasons offer a framework through which various levels and states associated with an individual’s growth can be mapped and utilized for personal evolution. In this context, seasons are applicable for practitioners and clients who have used transpersonal states to avoid painful emotions or difficult actions. The seasons can guide transpersonal medical clients on a path towards transpersonal being and integration of various states leading to a higher organizational baseline. As a practical tool, the seasons have pertinence in the development of “transpersonal vigilance,” a term defined in this article. The seasons offer resources to practitioners to support clients toward transpersonal being, in a reorganizationally informed or reorganizational way.

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Improved Language Development Following Network Spinal Analysis in Children Diagnosed with Autism Spectrum Disorder Lumb K, Feeley K. J. Pediatric, Maternal & Family Health – November 3, 2014. pp 70-75

Objective: To describe the care of two children diagnosed with Autism Spectrum Disorder and the documented changes in their language skills while receiving Network Spinal Analysis (NSA) chiropractic care. Clinical Features: Two children, under the age of 4 diagnosed with autism spectrum disorder, received NSA care for one year. The specific outcome that was measured was the Preschool Language Scale-4 (PLS-4). The PLS-4 was given four times over a one year period. Results: Expressive and receptive language delays were assessed before, during, and after NSA care. These children saw an average increase of 24 months of language development in one year, while under NSA care. Conclusions: The progress documented in this report suggests that NSA care may have positively affected the language development of these children. We support further research in this field.

Improvement in Meniere’s Disease, Balance, Coordination and Quality of Life Following Network Spinal Analysis Care Feeley K, Kemp A. Annals of Vertebral Subluxation Research. November 25, 2013. pp 107-119

Objective: To report on multisystem health changes of a patient diagnosed with Meniere’s disease while under a long term chiropractic care program utilizing Network Spinal Analysis (NSA). Clinical Features: A 56 year old white male presented to a chiropractic clinic with a complaint of bilateral carpal tunnel symptoms, numbness in both feet after sitting, and pain and fullness in the left ear. The left ear pain and fullness was also accompanied by dizziness and progressive hearing loss experienced over the past twenty years. Physical examination revealed significant structural and neurological imbalances. Spinal subluxations were identified at multiple levels of the spine. The patient had been managing his symptoms with ten different medications prescribed for various complaints including: blood pressure, anxiety, muscle spasms and fluid retention. Auditory evaluations had shown progressive degeneration of hearing in his left ear, along the whole range of frequencies tested. Intervention and Outcomes: The patient received NSA care, basic workshop style education about stress, simple range of motion exercises, and beginning Somato-Respiratory Integration exercises. The first reevaluation showed positive changes in symptomatology and lifestyle. His auditory exam four months from the start of care showed improvements especially with lower frequencies. These changes in hearing continued to improve, and then were maintained over the course of treatment. Conclusions: In this case, an individual diagnosed with Meniere’s disease had improved hearing as well as reduction of other symptoms while enrolled in an NSA care program.

Reduction of a Lumbar Scoliosis & Improved Cervical Curve in a Geriatric Patient Following Network Spinal Analysis™ Care: A Case Study Ray K, Knowles D, Knowles R. Annals of Vertebral Subluxation Research. June 10, 2013. pp 18-28

Objective: This case describes the reduction of a lumbar scoliosis and improvement in the cervical curve in a 75 year old male patient under Network Spinal Analysis™ (NSA) care. Possible mechanisms for structural change through a low-force, tonal chiropractic adjustment technique are discussed. Clinical Features: The patient was a 75 year old male who presented for wellness based chiropractic care. He also had a complaint of mild to moderate shoulder pain. A lumbar scoliosis with a Cobb Angle of 11 degrees was found on a standing radiograph, as well as a kyphotic cervical curve and reduced atlas plane line. Intervention and Outcomes: The patient received NSA care under standard protocols for a two year period. The patient was also asked to do two rehabilitative stretches for home care. The Cobb Angle reduced to three degrees at one year, and less than one degree at two years. The atlas plane angle increased from 6

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degrees to 22 degrees. The patient’s subjective findings reflect these changes. Conclusions: Network Spinal Analysis™ care, and other low force techniques, may be effective in reorganizational change by addressing structural deformities in the spine and in restoring normal spinal curves. More research is needed in this area.

9th Annual International Research and Philosophy Symposium Sherman College of Chiropractic Spartanburg, South Carolina October 20-21, 2012 Various Authors. Journal of Philosophy, Principles & Practice of Chiropractic ~ December 31, 2012 ~ Pages 55-111

Includes: • The Effects of Network Spinal Analysis on Children Diagnosed with Autism Spectrum Disorder with Accompanying Speech and Language Deficits • Restoration of the Cervical Curve and Improvement in Neurological Function in a Patient Following Network Spinal Analysis

Improvement in Vision in a Patient with Diabetic Retinopathy Following Network Spinal Analysis Care Irastorza M, Knowles D, Knowles R. Annals of Vertebral Subluxation Research. February 16, 2012. pp 25-30

Objective: To describe the reorganization and reduction of intraocular pressure (IOP) in a chiropractic patient with diabetic retinopathy and concurrent loss of vision undergoing Network Spinal Analysis (NSA) care. Clinical Features: A 46-year-old male with type I insulin dependent diabetes presented for chiropractic care. His complaints included numbness in both arms and fingers of the left hand, and diabetic retinopathy with total loss of vision for the past five years. Intervention and Outcomes: The patient received NSA care 221 times over three years. After 8 months of care, he reported seeing shapes and colors through his left eye only for the first time in 5 years. He also reported a drop in intraocular pressure from an initial 50 mm Hg down to 18 mm Hg. Conclusion: The patient in this case experienced improved intraocular pressure and vision following Network Spinal Analysis care. More research is warranted to better understand this link between Network Spinal Analysis care, chiropractic and the diabetic patient.

Reorganizational Healing as an Integrally Informed Framework for Integral Medicine Senzon S, Epstein D, Lemberger D. Journal of Integral Theory and Practice, 2011 6(4), 113-133.

Reorganizational Healing (ROH) is explored as an integrally informed methodological framework to be utilized within the emerging field of Integral Medicine. ROH assists individuals to discover who they are in their current situation, symptom, life challenge, or life evolution. Transformation and awakening are accessed in ROH in terms of the individual’s readiness to change as well as various energetic typologies of change and resource availability (biological, emotional, mental, and spiritual). Developing an ROH map assists both healer and patient in understanding how they change; what energetic intelligences are available as resources; and what “season” one is in, in terms of discovery, transformation, awakening, or integration. The history of ROH, which has developed over the past 30 years, is also recounted.

Restoration of the Cervical Curve and Improvement in Neurological Function in a Patient Following Network Spinal Analysis Rohrbach T, Knowles D, Knowles R. Annals of Vertebral Subluxation Research. September 15, 2011. pp 99103

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Objective: To describe the restoration of a cervical curve following Network Spinal Analysis™ (NSA) chiropractic care in a patient with neck pain. Clinical Features: The patient presented with a chief complaint of neck pain. Radiographs were taken and demonstrated an Atlas Plane Angle measurement of 12° and a cervical Absolute Rotation Angle (ARA) of 10°, representing a cervical kyphosis. Intervention and Outcomes: The patient received NSA care that consisted of Network adjustments entailing light contact to specific regions of the patient’s spine. Follow up radiographs were taken after one year of care. The radiographs demonstrated significant sagittal curve improvement with an Atlas plane line measurement of 32° and an Absolute Rotational Angle (ARA) of -27°. Conclusion: Successful chiropractic care was described in this case by improved measurements in the cervical curve. The Atlas plane line improved by 18° and the Absolute Rotation Angle improved by 37°. More research is warranted in this area.

Editorial: Seeds of Meaning, Transformations of Health Care, and the Future Senzon SA. Journal of Alternative and Complimentary Medicine. December 2010;16(12):1239-1241. DOI: 10.1089/acm.2010.0785

No Abstract Available.

On a standing wave Central Pattern Generator and the coherence problem Jonckheere E, Lohsoonthorn P, Musuvathy S, Mahajan V, Stefanovic M. Biomedical Signal Processing and Control 5 (2010) 336–347. doi:10.1016/j.bspc.2010.04.002

An electrophysiological phenomenon running up and down the spine, elicited by light pressure contact at very precise points and thereafter taking the external appearance of an undulatory motion of the spine, is analyzed from its standing wave, coherence, and synchronization-at-a-distance properties. This standing spinal wave can be elicited in both normal and quadriplegic subjects, which demonstrates that the neuronal circuitry is embedded in the spine. The latter, along with the inherent rhythmicity of the motion, its wave properties, and the absence of external sensory input once the phenomenon is elicited reveal a Central Pattern Generator (CPG). The major investigative tool is surface electromyographic (sEMG) wavelet signal analysis at various points along the paraspinal muscles. Statistical correlation among the various points is used to establish the standing wave phenomenon on a specific subband of the Daubechies wavelet decomposition of the sEMG signals. More precisely, ∼10 Hz coherent bursts reveal synchronization between sensory-motor loops at a distance larger, and a frequency slower, than those already reported. As a potential therapeutic application, it is shown that partial recovery from spinal cord injury can be assessed by the correlation between the sEMG signals on both sides of the injury.

Improvement in Cystic Fibrosis in a Child Undergoing Subluxation-Based Chiropractic Care: A Case Study Warhurst C, Warhurst R, Gabai A. Journal of Pediatric, Maternal & Family Health – Chiropractic ~ Volume 2010 ~ Issue 4 ~ Pages 172 -180 Objective: The objective of this report is to retrospectively document subluxation-based chiropractic care provided to an 8 year old male who was seen for a year and a half. Clinical Features: An 8 year old male presented for care with complains of recurring infections, inability to sleep, and inability to participate in age-appropriate sports. He was diagnosed with cystic fibrosis at birth. Intervention & Outcomes: The course of care involved chiropractic spinal adjustments, Network Spinal Analysis care, and trigger point therapy. Improvements were observed in the patient’s resistance to recurrent infection, activity level, sleep ability, and overall quality of life. Conclusion: With previous studies examining the relationship between subluxation reduction and autonomic function, immune function and somatovisceral reflexes, this case suggests that more research is

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needed to examine the short and long-term impact of subluxation-based care for those children with cystic fibrosis.

Reorganizational Healing: A Paradigm for the Advancement of Wellness, Behavior Change, Holistic Practice, and Healing Epstein DM, Senzon SA, Lemberger D. Journal of Alternative and Complimentary Medicine. May 2009;15(5):461-64. PMID: 19450165

Reorganizational Healing, (ROH), is an emerging wellness, growth and behavioral change paradigm. Through its three central elements (the Four Seasons of Wellbeing, the Triad of Change, and the Five Energetic Intelligences) Reorganizational Healing takes an approach to help create a map for individuals to self-assess and draw on strengths to create sustainable change. Reorganizational Healing gives individuals concrete tools to explore and use the meanings of their symptoms, problems, and life-stressors as catalysts to taking new and sustained action to create a more fulfilling and resilient life.

Editorial: Reorganizational Healing: A Health Change Model Whose Time Has Come Blanks RH. Journal of Alternative and Complimentary Medicine. May 2009;15(5):461-64. PMID: 19450161

No Abstract Available.

Letter to the Editor: Network Spinal Analysis Jonckheere EA. Journal of Alternative and Complimentary Medicine. May 2009;15(5):469-70. PMID: 19450163

No Abstract Available.

Improvement in Attention in Patients Undergoing Network Spinal Analysis: A Case Series Using Objective Measures of Attention Pauli Y. Journal of Vertebral Subluxation Research, August 23, 2007; 1-9

Objective: Anecdotal preliminary evidence suggests that chiropractic care may be of benefits for individuals suffering from ADHD. This case series presents the improvement in attention experienced by 9 adult patients undergoing Network Spinal Analysis.

Methods: Nine adult patients are presented (4 male, 5 female) with a mean age of 40.4 years (range 22 – 58 years old). All patients were evaluated with the Test of Variable of Attention (TOVA) before receiving Network Spinal Analysis (NSA) care and at 2 months into care. The nine patients received level 1 NSA care for two months, as taught by the Association for Network Care. Neurospinal integrity was evaluated with palpation, as well as surface electromyography. Cognitive process of attention was objectively evaluated using a continuous performance test, the Test of Variables of Attention (TOVA).

Results: We evaluated our patient cohort before and after Network care using sEMG and variables from the continuous performance test (TOVA). Before care, all patients had an abnormal ADHD score with a mean of -3.74 (range: – 8.54 to -1.89). After 2 months of care, all patients had a significant change in ADHD score (p=0.08) and 88% completely normalized the ADHD score. 77% and 66% of patients experienced significant change in reaction time and variability score, respectively. All patients experienced a significant reduction in sEMG pattern of activation (p=0.08). We discuss possible mechanisms by which spinal care may have enhanced the function of the prefrontal cortex, thereby resulting in improved attentional capacities

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Conclusion: In this case series the nine adult patients experienced significant improvement in attention, as measured by objective outcomes, after receiving two months of Network Spinal Analysis. The progress documented in this report suggests that NSA care may positively affect the brain by creating plastic changes in the prefrontal cortex and other cortical and subcortical areas serving as neural substrate for the cognitive process of attention. These findings may be of importance for individuals suffering from attention deficit. Further research into this area is greatly needed.

Quality of Life Improvements and Spontaneous Lifestyle Changes in a Patient Undergoing Subluxation-Centered Chiropractic Care: A Case Study Pauli Y. Journal of Vertebral Subluxation Research, October 11, 2006; 1-15

Purpose of Study: This case study is to report the improvement in quality of life experienced by a patient undergoing subluxation-centered chiropractic care.

Clinical Features: A 36 year old male presented with primary health concerns of stress, eye pain and left leg pain of 14 years duration radiating to the foot and secondary complaints of gastritis, ulcers, nervousness, depression, lack of concentration and general loss of interest in daily life. The patient also smokes, does not exercise, eats a sub-optimal diet and rated his family and friends support, as well as job satisfaction as sufficient.

Intervention and Outcome: We discuss the various analyses employed to evaluate vertebral subluxations, including paraspinal surface electromyography and thermography. Adjustive care included a combination of Network Spinal Analysis, Torque Release Technique and diversified structural adjustments to correct vertebral subluxations over a six month period. We used visual analog scales, open-ended questions and selected items from the Self-Rated Health and Wellness Instrument to monitor health changes, as well as the positive improvements in quality of life as perceived by the patient himself.

Conclusion: This case study demonstrates that the correction of vertebral subluxations over an 11 month period was associated with significant improvements in the quality of life of the patient.

Chiropractic Care of a Battered Woman: A Case Study Bedell L. Journal of Vertebral Subluxation Research, July 20, 2006; 1-6

Objective: This case study documents the chiropractic care of battered woman struggling with Intimate Partner Violence (IPV). Chiropractic offers battered women a unique service, it is the only profession trained and licensed to detect and correct vertebral subluxations. The relationship between the stresses of abuse and vertebral subluxation, as well as the subsequent changes during chiropractic care, are described.

Clinical Features: A Caucasian, 23-year old female presented with headaches, neck pain, and upper back pain. The initial complaint noted sharp, knife-like pains into the medial scapular borders, worse on the right side. Tingling extended into the right hand, most severe in the 2nd, 3rd, and 4th fingers.

Chiropractic care and outcome: Protocols of both Torque Release and Activator techniques were utilized to evaluate vertebral subluxations. Subjective quality of life issues were evaluated through a Network Spinal Analysis (NSA) Health Status Questionnaire. After commencing chiropractic care, this woman suffered a cervical spine hyper-extension/hyper-flexion type injury from an automobile accident. For the first 30 days after, adjustments were applied twice weekly. Acute exacerbations of symptoms unrelated to the original complaints were displayed and progress became irregular. During the next 60 days, there were various unexplained falls and severe flare-ups of painful symptoms, and she finally admitted to being battered by her husband. Referrals to counselors and programs dealing with domestic violence were provided. Once the physical battering stopped, consistent progress was noted in both clinical symptoms and quality of life issues.

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Conclusion: As a battered woman must receive emotional and social support to improve her situation, it is important for chiropractors to recognize the “red flags” of IPV. Chiropractors re-evaluate regularly for changes in vertebral subluxation patterns and can recognize inconsistent responses. They may also be the first caregivers to offer a vitalistic approach; considering a woman’s physical, chemical, and emotional quality of life; a perspective that offers significant connection and trust. This article serves as a foundation on the topic of IPV and chiropractic, for use in both communities.

Wellness lifestyles II: Modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis. Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):357-67. PMID: 15165417

OBJECTIVE: Empirical application of a theoretical framework linking use of Network Spinal Analysis (NSA; a holistic, wellness-oriented form of complementary and alternative medicine [CAM]), health lifestyle practices, and self-reported health and wellness. DESIGN: Cross-sectional self-administered survey study. RESPONDENTS: Two thousand five hundred and ninety-six (2596) patients from 156 offices of doctors who were members of the Association for Network Chiropractic (currently titled Association for Network Care); estimated response rate was 69%. MEASURES: Exogenous variables entered into the structural equation model include gender, age, education, income, marital status, ailments, life change, and trauma. A wellness construct consisted of calculated difference scores between two referents, “presently” and “before Network” care, for self-reported items representing wellness domains of physical state, mental-emotional state, stress evaluation, and life enjoyment. Positive reported change in nine items assembled into dietary practices, health practices, and health risk dimensions serve as indicators of the construct of changes in health lifestyle practices. The NSA care construct consisted of duration of care in months, awareness of energy and awareness of breathing since beginning Network care. RESULTS: Of the exogenous variables only gender, age, and education remain in the final parsimonious structural equation model in these data. Reported wellness benefits accrue to individuals along a direct path from both self-reported positive lifestyle change (0.22), and from NSA care (0.43). The path (0.65) from NSA care to positive health lifestyle changes indicates that NSA care also has an indirect effect on wellness through changes in health lifestyle practices.

CONCLUSIONS: The Structural Equation model tested in these analyses lends support to our theoretical framework linking wellness, health lifestyles, and CAM. This study provides further evidence that our measurements of health and wellness are particularly appropriate for investigating wellness-oriented CAM. There is a positive relationship between the experience of NSA care and self-reported improvements in wellness as well as self-reported changes in lifestyle practices. NSA care users tend toward the practice of a positive health lifestyle, which also has a direct effect on reported improvements in wellness. These empirical links are discussed relative to the sociodemographic characteristics of this population and show that use of NSA care is an aspect of a wellness lifestyle.

Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine. Schuster TL, Dobson M, Jauregui M, Blanks RH. Journal of Alternative and Complimentary Medicine. April 2004;10(2):349-56. PMID: 15165416

Scholarship concerning complementary and alternative medicine (CAM) practices within the United States could benefit from incorporating sociological perspectives into the development of a comprehensive research agenda. We review the literature on health and wellness emphasizing definitions and distinctions, the health lifestyles literature emphasizing issues of both life choices and life chances, and studies of CAM suggesting utilization as an aspect of a wellness lifestyle. This review forms the foundation of a new theoretical

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framework for CAM research based on the interrelationship of CAM with health promotion, wellness, and health lifestyles. To date, few studies have sought to bring these various elements together into a single, comprehensive model that would enable an assessment of the complexity of individual health and wellness in the context of CAM. We argue that attention to literatures on health measurement and health lifestyles are essential for exploring the effectiveness and continuing use of CAM.

The Transition of Network Spinal Analysis Care: Hallmarks of a Client-Centered Wellness Education Multi-Component System of Health Care Delivery Epstein D. Journal of Vertebral Subluxation Research, April 5, 2004; 1-7

Network Spinal Analysis TM (NSA) care has been transitioned from a health care system with the objective of correction of two types of vertebral subluxation, to a multi-component system of health care delivery with emphasis on wellness education for participating clients. NSA care is now delivered and communicated in discrete Levels of Care with emphasis on client participation through self-evaluation. Emphasis on wellness education will be introduced into NSA practice through training via a Certificate Program currently under development. This paper considers some hallmarks that delineate a wellness education, patient (client)centered practice. The concepts presented relative to this wellness model of health care delivery are believed to be applicable to any approach with similar practice objectives. The perspective presented considers that the major aspects of a patient-centered, wellness education health care delivery system is multi-dimensional. Hallmarks include differentiating terms, and establishing a wellness mentality. Substantiation of the discipline must be established through credible published research regarding its efficacy and safety as well as a consistent and valid means of measuring progressive outcomes derived from the care received. The relationship of NSA to other disciplines is discussed.

Successful In Vitro Fertilization in a Poor Responder While Under Network Spinal Analysis Care: A Case Report Senzon SA. Journal of Vertebral Subluxation Research, September 14, 2003; 1-6

Objective: This case report describes the successful in vitro fertilization (IVF) of a 34 year old female who had one previous aborted IVF attempt prior to Network Spinal Analysis (NSA) care. This case report is being presented to add to other case reports that show positive physiological changes in patients receiving NSA care.

Clinical Features: The IVF was attempted due to her partner’s azoospermia. The first IVF attempt was on 3/26/02. The patient had a poor follicular growth after the standard hyper-stimulation process of the ovaries, including pre-treatment with Mircette (birth control pills) and 1mg/0.2ml of Lupron (a gonadotropin releasing hormone agonist), and 3-6 amps of Gonal-F (a recombinant fsh) starting on cycle day 3. Her baseline day 3 estradiol and LH levels were only 21.2pg/me and 5.0 I.U./L respectively. On cycle day 8, estradiol was only 56% and LH was 6.6 I.U./L. The Gonal-F was increased to 6amps. This first attempt was canceled due to the poor follicle growth. Only 3-4 follicles of insufficient size between 10-14mm each were found.

Chiropractic Care and Outcomes: On 4/11/02, the patient commenced regular NSA care. The second IVF attempt began on 6/6/02. The change in IVF protocol was the addition of Repronex (also a gonadotropin a combination of LH and fsh). The total increased dose of Gonal-F and Repronex was 6amps, compared to the first attempt of only 3amps which was then increased to 6amps of Gonal-F only.

Conclusion: On the second IVF attempt, estradiol was 1001pg/ml on day 8, and 2019pg/ml on day 11, with LH at 9.3. The Oocyte retrieval after the second attempt was 10 eggs, each approximately 18mm. A successful aspiration of eggs was completed on 6/17/02, and a successful pregnancy followed. The patient is still under NSA care, and is now in her second trimester with normal fetal heart sounds. The possible role of NSA care in the vigorous follicular growth and other health benefits is discussed.

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Insult, Interference and Infertility: An Overview of Chiropractic Research Behrendt M. Journal of Vertebral Subluxation Research, May 2, 2003; 1

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Chaotic Modeling in Network Spinal Analysis: Nonlinear Canonical Correlation with Alternating Conditional Expectation (ACE): A Preliminary Report Bohacek S, Jonckheere E. Journal of Vertebral Subluxation Research, December 1998; 2(4): 188-195

Abstract – This paper presents a preliminary non-linear mathematical analysis of surface electromyographic (sEMG) signals from a subject receiving Network Spinal Analysis (NSA).The unfiltered sEMG data was collected over a bandwidth of 10-500 Hz and stored on a PC compatible computer. Electrodes were placed at the level of C1/C2,T6, L5, and S2 and voltage signals were recorded during the periods in which the patient was experiencing the “somatopsychic” wave, characteristic of NSA care. The intent of the preliminary study was to initiate mathematical characterization of the wave phenomenon relative to its “chaotic,” and/or nonlinear nature. In the present study the linear and nonlinear Canonical Correlation Analyses (CCA) have been used. The latter, nonlinear CCA, is coupled to specific implementation referred to as Alternating Conditional Expectation (ACE). Preliminary findings obtained by comparing canonical correlation coefficients (CCC’s) indicate that the ACE nonlinear functions of the sEMG waveform data lead to a smaller expected prediction error than if linear functions are used. In particular, the preliminary observations of larger nonlinear CCC’s compared to linear CCC’s indicate that there is some nonlinearity in the data representing the “somatopsychic” waveform. Further analysis of linear and nonlinear predictors indicates that 4th order nonlinear predictors perform 20 % better than linear predictors, and 10th order nonlinear predictors perform

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30% better than linear predictors.This suggests that the waveform possesses a nonlinear “attractor” with a dimension between 4 and 10. Continued refinement of the ACE algorithm to allow for detection of more nonlinear distortions is expected to further clarify the extent to which the sEMG signal associated with the “somatopsychic” waveform of NSA is differentiated as nonlinear as opposed to random.

Reduction of Psoriasis in a Patient under Network Spinal Analysis Care: A Case Report Behrendt M. Journal of Vertebral Subluxation Research, December 1998; 2(4): 196-200

This case report describes the progress of a 52 year old male with chronic psoriasis, first diagnosed in April of 1992. After the condition exacerbated over a five year period, he was placed on 12.5 mg/week methotrexate, and oral immunosuppressant medication in October of 1997.After commencing the medication, the condition reduced from 6% body coverage, with flares of 15-20%, to a body coverage of 5%. Following a cessation of the oral medication in February, 1998, the condition recurred at the previous uncontrolled level within one month. The patient was again placed on 12.5 mg/week methotrexate, and subsequently the condition reduced to 5% body coverage. The patient’s dose was reduced to 10 mg/week, and later to 7.5 mg/week, with the psoriasis remaining at 5% coverage. On 5/18/98, the patient commenced regular NSA care. He reported a reduction in the psoriasis condition on 6/3/98, and was taken off the oral medication on 6/25/98. The reduction continued, and the patient was advised by his medical physician on 7/01/98 to continue the cessation of oral medication. As of 9/30/98 the psoriasis had decreased to 0.5% to 1.0 % of coverage, and prior plans to initiate ultraviolet-A therapy were canceled. As of 11/98, a five month period since cessation of methotrexate, the patient has remained under regular NSA care, with no recurrence of psoriasis body coverage greater than 1%, the only medication being a topical ointment. This is contrasted to the recurrence after one month, following the patient’s first cessation of methotrexate, and prior to NSA care. The possible role of NSA care in the reduction of the patient’s psoriasis, and other health benefits is discussed.

Changes in Digital Skin Temperature, Surface Electromyography, and Electrodermal Activity in Subjects Receiving Network Spinal Analysis Care Miller E, Redmond P. Journal of Vertebral Subluxation Research, June 1998; 2(2): 87-95

A preliminary study was conducted to evaluate changes in digital skin temperature (DST), surface electromyography (sEMG), and electrodermal activity (EDA) in a group of twenty subjects receiving Network Spinal Analysis (NSA) care. Data, simultaneously derived from all three parameters, were considered to be indirect correlates of sympathetic nervous system activity. Subjects, including a group of five controls, were assessed for a period of 17 minutes. The continuous assessment period included a baseline interval of 4.5 minutes, followed by a 12.5 minute period which was divided into five 2.5 minute intervals. Care was administered to the NSA recipient group immediately after the baseline period, whereas controls received no intervention following baseline. Results revealed no significant differences in DST either within or between the two groups. Surface EMG readings were relatively constant over the five intervals following baseline in the NSA group, while controls showed significant (p < 0.05) increases in sEMG at the second through fifth intervals relative to the first interval following baseline activity. Electrodermal activity was significantly decreased (p < 0.01) in the NSA group in the second through fifth intervals compared to baseline. Moreover, decreases varied between intervals, but exhibited a leveling from the third through fifth interval. Control subjects, alternatively, exhibited an increase in EDA in all intervals following baseline. The extent of increase resulted in EDA activity significantly greater than the NSA group at the third through fifth intervals. It was concluded that the increase in EMG activity in the control groups may have reflected an increasing level of anxiety due to the duration of the recording period. Since the NSA group expressed constancy in sEMG activity during the same period, coupled to significant decreases in EDA, a “sympathetic quieting effect” was postulated to occur in subjects receiving NSA care. This conclusion is consistent with hypothesized neurological pathways linked to responses observed during NSA care, as well as other reports of selfreported improvements in mental/emotional state and stress reduction in patients receiving Network Chiropractic Care.

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Functional Magnetic Resonance Imaging: About the Cover (cover picture) Journal of Vertebral Subluxation Research, 1998; 2(1): Cover

About the Cover: Functional Magnetic resonance Imaging (fMRI), which measures the relative presence of oxy-hemoglobin, has gained attention as a non-invasive medium through which high resolution images of the brain and other tissue may be acquired. This technology may provide a useful assessment of cortical changes following chiropractic intervention. Images of the patient depicted on the cover, on the left, reflect cortical activity (lighted areas in the parietal cortex, frontal cortex areas 9, 10; visual association areas 19, 37, and 39) associated with the learning process of a “novel” muscular maneuver of the foot. Images on the right reflect cortical activity following a Network Spinal Analysis (form of chiropractic) adjustment session, taken approximately 20 minutes after the first set of images, involving the same activity. The decrease in “lighted” areas before and after the adjustment session suggests that less cortical “planning” or “activity” is associated with the “novel” foot maneuver. Thus, the ability of fMRI to visualize changes in cortical activity may play a significant role in elucidating the consequences of vertebral subluxation correction on neurological function.

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care Graham R, Pistolese R. Journal of Vertebral Subluxation Research, 1997; 1(4): 41-48

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma “attacks” in the 30 day period prior to the study, the number of “attacks” decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic “attacks.” The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

[Note: NSA care was one of the chiropractic approaches used in this study supported by the Michigan Chiropractic Council]

A Retrospective Assessment of Network Care Using a Survey of Self-Rated Health, Wellness and Quality of Life Blanks RH, Schuster TL, Dobson M. Journal of Vertebral Subluxation Research, 1997; 1(4): 15-31

The present study represents a retrospective characterization of Network Care, a health care discipline within the subluxation-based chiropractic model. Data were obtained from 156 Network offices (49% practitioner participation rate) in the United States, Canada, Australia, and Puerto Rico. Sociodemographic

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characterization of 2818 respondents, representing a 67-71% response rate, revealed a population predominately white, female, well-educated, professional, or white collar workers. A second objective of the study included the development and initial validation of a new health survey instrument. The instrument was specifically designed to assess wellness through patients’ self-rating different health domains and overall quality of life at two “time” points: “presently” and retrospectively, recalling their status before initiating care (“before Network”). Statistical evaluation employing Chronbach’s alpha and theta coefficients derived from principle components factor analyses, indicated a high level of internal reliability in regard to the survey instrument, as well as stable reliability of the retrospective recall method of self-rated perceptions of change as a function of duration of care. Results indicated that patients reported significant, positive perceived change (p < 0.000) in all four domains of health, as well as overall quality of life. Effect sizes for these difference scores were all large (>0.9). Wellness was assessed by summing the scores for the four health domains into a combined wellness scale, and comparing this combined scale “presently” and “before Network.” The difference, or “wellness coefficient” spanning a range of -1 to +1, with zero representing no change, showed positive, progressive increases over the duration of care intervals ranging from 1-3 months to over three years. The evidence of improved health in the four domains (physical state, mental/emotional state, stress evaluation, life enjoyment), overall quality of life from a standardized index, and the “wellness coefficient,” suggests that Network Care is associated with significant benefits. These benefits are evident from as early as 1-3 months under care, and appear to show continuing clinical improvements in the duration of care intervals studied, with no indication of a maximum clinical benefit. These findings are being further evaluated through longitudinal studies of current populations under care in combination with investigation of the neurophysiological mechanisms underlying its effects.

Network Spinal Analysis: A System of Health Care Delivery Within the Subluxation-Based Chiropractic Model Epstein, D. Journal of Vertebral Subluxation Research, August 1996; 1(1): 51-59

The theoretical basis and clinical application of Network Spinal Analysis (NSA) is described. NSA delivers health care within the subluxation-based chiropractic model and seeks to contribute to the distinction of the various techniques and methods within the profession by describing and discussing its major characteristics. In this regard, clinical observations relative to the application of the Network Protocol have been described in relation to the monitoring of patient and practitioner outcomes. Relevant research from a separate Network Care retrospective study, which impacts on its characterization, profiles the patient population as predominantly female. Other data indicates that Network Care is widely and consistently practiced. Additionally, patients report significant, positive changes in health-related quality of life measures linked to certain clinical components of Network Care.

For more info on NSA please check out this website:

https://epienergetics.com/

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A HISTORICAL PERSPECTIVE ON NETWORK SPINAL ANALYSIS CARE: A UNIQUE INSIGHT INTO THE SPINE’S ROLE IN HEALTH AND WELLBEING

ABSTRACT A review of the history of Network Spinal Analysis care, developed by Donald Epstein, reveals a novel understanding of the role of the spine and spinal cord in healthcare. Epstein’s unique contributions to functional assessment and applications of the spine and nervous system are explored, as well as broader health related quality of life dimensions. The integration of spinal and neural integrity, with evidence-based functional healthcare, is suggested as a vehicle towards Reorganizational Healing and improved health outcomes. (Chiropr J Australia 2017;45:304-323) Key Indexing Terms: Chiropractic; Stress; Spine; Wellness; Health-Related Quality Of Life.

INTRODUCTION Understanding the development of Network Spinal Analysis (NSA) care may offer novel insights and clinical options for health care. NSA developed from Network Chiropractic, which originally began as an integration by Donald Epstein of several chiropractic methodologies and theoretical models. [1, 2] Epstein recognized there was a uniqueness to his approach, especially regarding its ‘stress busting’ effects.[3, 4] He embarked on a multi-decade odyssey of research, application, and refinement of principles and practices. This ultimately gave rise to modern NSA care and the paradigm of Reorganizational Healing. [5-7] Epstein’s clinical protocols evolved through sequenced light touches to the spine, primarily at the ends of the spine in areas where the dura attaches. The protocols and theoretical models originally developed within the context of achieving repeatable phenomenon associated with the clinical application of his work. These phenomena include dissipation of tension from the spinal subsystems, non-local states of consciousness, the emergence of increased quality of life, spontaneous development of wellness lifestyles, increased somatic and self-awareness, and the development of novel reorganizational sensorimotor processes, most notably a respiratory and spinal wave. [17] Each of these elements associated with NSA have potential to impact healthcare. Epstein proposed that the spine has global and local responses to stress. [3] These responses are predictable and central to anchoring long-term chronic stress within the anatomical structures of the spine. Acute and chronic stress lead to stretching and torquing of the tissues of the spinal cord. [4] This leads to what Breig called adverse

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mechanical cord tension (AMCT). [8] Epstein further proposed that AMCT could become embedded into the neurological wiring at a very early age as a form of sensorimotor learning. The spine and spinal cord may remain in a defensive posture for decades, storing energy as tension rather than dissipating it. This perpetuates the chronic stress response and may fixate the individual’s sense of self into a narrow range of emotional, psychological, and even spiritual expression. [3, 4] A unique spinal wave is associated the NSA protocols. [9] It is a repeatable phenomenon demonstrated through clinical observation as well as empirical and qualitative research. The spinal wave may be seen visibly as the spine gently undulates in various ranges of motion. It is also observable with surface electromyography. [10] The wave may create a temporary instability of the tension pattern and act as a reorganizing force in the body. New levels of health and wellbeing are believed to emerge as a result. [6] Three decades of research and clinical findings related to NSA suggest an important role for the spine in how an individual maintains stability amidst change[11], more readily deals with stress, stays well,[12] and achieves higher levels of living and wellness characterized as Reorganizational Healing. [7, 13] These findings include the dynamics of the spinal wave as a central pattern generator[10], the development of a respiratory wave visibly rocking every vertebra of the spine[14], the stress-busting effect of NSA Care[15-17], and the emergence of increased patient self-reported quality of life with statistically significant impacts on wellness lifestyles. [18, 19] In order to effectively demonstrate how NSA care may contribute to healthcare, a history of the development of NSA care is required. The protocols and theoretical models, as well as the research and refinements of theory and application over the course of thirty years, point to a very complex topic. Thus, a historical approach was adopted in order to assist the reader to grasp the depth of this work one step at a time. We hope this approach will allow practitioners, researchers, and the lay public to more readily integrate the findings.

DISCUSSION Emergence of a New Methodology (1982-1986) In 1982, Epstein recognized that the classic approach to chiropractic vertebral subluxation assessment and spinal adjustment was more complex in its nature and ramifications than previous generations of chiropractors had described. Practitioners trained internationally in Epstein’s methodology were encouraged to view the physiological processes of the body as non-linear, multi-directional, and functional. By 1983 Epstein wrote about his initial theories, describing multiple spinal cord tension patterns and started teaching his clinical system in post-graduate programs. [1, 2]

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The development of the protocols and theoretical models was driven by the clinical experience of patients. As spinal cord tension patterns were reduced and self-regulated, individuals reported that aspects of the perceived stressful events or trauma were recalled in various somatic, emotional, psychological, and spiritual ways. The body-mind system was observed to revisit prior adaptive, energetic, informational, and structural states. Some of the initial stories of patient responses were documented in the book, The Twelve Stages of Healing. [20] The most profound clinical observation was how individuals developed more energetically resourceful and efficient physical states. This was associated with a net improvement of spinal behavior, posture and alignment, as well new embodied perceptions of the self and environment. It was evident to Epstein that health was a nonlinear phenomenon related to the tension and tone of the spine and spinal cord. The Spinal Meningeal Functional Unit Tension In the mid-1980s, Epstein developed the concept of the spinal meningeal functional unit (SMFU) by integrating his clinical findings with Ward’s spinal model,[21] Breig’s biomechanics of spinal cord tension,[8] and models of neurophysiology influenced by Speransky and Ukhtomsky. [22, 23] The anatomy and physiology of the meningeal system were understood as a critical determinant of health. According to Breig, “the spinal canal undergoes considerable changes in length between the extremes of flexion and extension, particularly in the cervical and lumbar regions. The total change is of the order of 5-7 cm, and is greater on the posterior than the anterior aspects. Similarly, on lateral flexion, the canal is lengthened on the convex side and shortened on the concave.” [8] (p.11) Epstein suggested that this type of stretching and torquing of the pons-cord tract may be linked to emotional and chemical stressors, which may ‘overload’ the neuronal circuitry. This overload adversely changes the meningeal tone and affects the brain and spinal cord. [3] The clinical intervention at this time was developed to dissipate the tension from the spinal cord system. Some of the health outcomes included a global decrease in stress and vigilance for the patient. Stress and Spinal Posture Epstein proposed that the forces of physical, chemical, and emotional stress impact posture. Adding these postural changes to gravitational pull increases the pons-cord tract tension. The head moves toward the midline, shoulders go anterior, and in the more pronounced postural adaptations, fists clench and the positioning of the spine and body take on an air of threat or fear.[3] He introduced a diagram to emphasize the new theory. The spinal cord is depicted as a fishing line being wound up at the cervical spine and hooked at the coccyx. (Figure 1) This also was a way of describing how mechanical forces from elongation of the spine associated with cervical cord tractioning have a significant consequence on lumbar

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aggregate tension.[3] According to Breig the tension from the cervical spine was magnified 20-30X in the lumbosacral spine. [8]

Figure 1. Depiction of spinal cord as a wound up fishing reel hooked at the coccyx. [3] Epstein hypothesized that the mechanoreceptors and proprioceptors in the cervical spine, which transmit postural information to the brain in relation to head, neck and torso positioning, may be deleteriously affected by pons-cord tract tension. [24] Breig showed that this tension also decreased conductivity of the nerve tissues. [8] This aberrant stretching of the cord’s structures could lead to errors in communication within the nervous system. [24] Epstein suggested that this postural response to stress affects information about the relationship between the body and the environment. Postural distortions related to mechanical loads on the spinal structures in relation to stress and strain on the human frame were found by additional researchers and clinicians as well. [21, 25-27] Epstein observed that these postural changes are increased by the physiological changes associated with stress, such as adrenal stimulation for increased release of glucose for energy use, increased blood supply to the skeletal muscles, an increase in tension of the tendons as preparation for action, and an increase in metabolic rate. If such a posture continues even after a threat has abated, the dangers of long-term chronic stress and the experience of embodied stress increase. [3] Additionally, he observed that the longitudinal muscles of the spine become hypertonic. Prolonged hypertonicity in the spinal muscles reveals temporal information about the body’s long-term state of stress. Epstein found that it commonly took from four to six months to assist people to reorganize these patterns in the nervous system and begin to develop effective somatic spinal strategies to deal with stress. Stress Adaptation and Hyper-Vigilance In 1986 [3], Epstein proposed that the stretching of the cord in response to stress affects the cognitive appraisal of current and future stress adaptation. He writes, “The hypothesis presented is that the spinal meningeal functional unit adapts to stress through a precise, reproducible mechanism. The relative degree of tone,

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and its recovery from that tonal quality, of the spinal meningeal functional unit (SMFU) determines the manner of response of the organism, and the degree of cognitive adaptation to stress.” [28](p. 58) When individuals remain in a state of hyper-vigilant posture with indications of intersegmental meningeal tension Epstein noted that the filter, or lens, through which that person views the world is one of competition and threat (even at a low-level longterm stress). [3] Epstein postulated a spinal learning in relation to the stress response. Feedback between the spinal cord, lower brain, midbrain, and higher cortical centers interact to respond to the threat. This occurs in relationship to the pons-cord tract tension, drawing upon past similar experiences and emotions, and imprinting the current threat/experience for future circumstances. The tension on the SMFU affects the way the person perceives the stimulus of a future threat. This may lead to a nonlinear and deleterious feedback between the individual and the environment. [3] Epstein suggested that stress occurs when there is a mismatch between the initial response of the spinal system and the cortical interpretation. Depending upon the individual threshold, the converging facilitated SMFU pathways may override effective cognitive and pre-cognitive appraisal. The more the person can draw upon the higher cortical responses to modulate, or effectively condition the lower brain and other more primitive reactions and responses, the more creatively and strategically the individual can negotiate and grow through life’s stressors. [3] This concept was refined in recent years to include available energy and efficiency in the system. The available energy determines the threshold and quality of the response. This is linked to dynamic self-regulation of energy and information. Pathological Dominance and Stress Patterns in the CNS (1987-1990) During the next period of development, Epstein integrated findings from the Russian neurophysiology literature along with other interdisciplinary approaches to the body’s self-regulation of stress and pain patterns, including Korr’s facilitation hypothesis and Sherrington’s pluri-segmental discharge model. Theories were integrated with the clinical application and new refinements emerged. All of this led to some novel approaches to the role of stress in the central nervous system, which became the foundation for modern NSA and its potential influence on healthcare. [4, 29, 30] Palpating for Stress Patterns in the Spinal Musculature In 1987, Epstein expanded upon his first hypothesis and suggested that viewing the central nervous system as the central mediator of the stress response updates Selye’s theory, which emphasized the hormonal system. [4, 22] The CNS develops a set point of postural stress. This is learned from the most severe stress the individual has experienced, habituating the lower brain to a fight or flight type of reaction. Epstein proposed that such reactions require even greater meningeal tension to elicit a similar

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reaction to future stimuli. Fear, panic, and crisis may be the end results of this CNS mediated habitual stress response system. These findings were based in part on the integration of stress into previous chiropractic theory. For example, Homewood wrote, “chiropractic has been concerned with the anatomy of stress, and Dr. Selye with the endocrinology of stress.” [31](p.224) Homewood also noted that structural changes to the spinal musculature after prolonged stress became ‘stringy.’ Epstein would later teach this ropey nature of musculature as a way to palpate for somatic evidence of prolonged emotional overload related to facilitated pathways. [29] In order to help describe the physiological and anatomical processes of the SMFU in terms of tension, Epstein combined two concepts. [4] The first was Korr’s concept of facilitation of the spinal musculature and the role of the spinal cord in organizing pathological processes. [32-34] This was combined with Sherrington’s concept of plurisegmental discharge resulting from lowered threshold excitatory states. [35] The facilitated musculature remains in an excited state, which responds to low intensity stimulus. From this, Epstein understood an input with low intensity can trigger a very large intersegmental response. Epstein found that the lowered threshold may be utilized to assist the system to go from lower brain survival functioning to higher cortical awareness of the overall patterns. [4] Thus a new feedback system may develop, one that redirects the cortex in its entire focus. The spinal wave that emerged from Epstein’s protocols was viewed as a new self-regulating feedback system. Once the self-regulation process begins, the higher order awareness is no longer required. The spinal wave begins to oscillate on its own although it can be consciously stopped. Epstein taught that different connective tissue tension patterns or structural tones in the musculature indicate various types of stressors.[29] The primary structural and muscular tones related to facilitated patterns associated with mental, emotional, and chemical stresses. This evolved into a complex system to analyze, mainly through palpation, for stress physiology as a form of pathological dominance in the CNS. [29] (Figure 2) The SMFU was soon named meningeal subluxation and later facilitated subluxation.[29, 30] Drawing upon Ukhtomsky’s theory of dominance in the central nervous system, Epstein proposed the body/mind, mediated through the CNS, remembers this state of readiness which may persist for many years. [22, 29]

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Figure 2. Muscle Palpation for Tension and Tone.[29] The Spinal Cord and Stress Epstein proposed a theory of adrenal exhaustion, which establishes an even deeper fixation in the postural response to stress on the spinal cord. [4] The feedback mechanism involved in getting to such a state was integrated with Breig’s observations of the contractile nature of collagen fibers, Uktomsky’s pathological dominance in the CNS, and Korr’s facilitation hypothesis. Breig observed that not only are the skeletal (postural) muscles made of collagen, but the attachment of the denticulate ligament with the dura mater is a rhomboid collagen network.[8] (Figure 3) The rhomboid network in the pia mater is created by the intersections of fibers along the axial and transverse planes, which affects the directions of elongating, shortening, and kinking the viscous and elastic spinal cord. The epipia is the main structural support for the cord pulp. During transverse or axial traction, the angles of intersections change based on direction. The change in angle results in different vectors of mechanical tension. [8] Epstein proposed that the release of calcium in the system as a result of other physiological mechanisms of stress causes the collagen fibers to contract even more.[4] Minimal mechanical tension on neurologic structures impairs sensory, motor, and

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autonomic function. Severe sustained tension of the meningeal system could predispose the acceleration of pathophysiological processes. [8] Thus, Epstein concluded that the tension increases from stress, which, if not checked by the higher cortical functions, may initiate an even more intense pathological feedback mechanism. [4] Epstein looked to Speransky’s concept of neurodystrophic processes and Korr’s facilitation hypothesis to further explain the implications for such irritations to the spinal meningeal functional unit. According to Speransky and Korr, such a state could exist for a very long time without obvious symptomology and remain independent of the original insult.[36, 37]

Figure 3. Dura Mater – cord anatomy (from Gray) and Micrograph of a stretched spinal cord coronal section from the cervical cord fixed in situ, with channels containing blood vessels, with the two uppermost channels demonstrating the rhomboid fiber network (reprinted with permission from Michael Shacklock, copyright holder). [38, 39] Epstein utilized these findings in a clinical setting to establish principles and practices. The results furthered his models and led to increasingly refined protocols and models such as the point of critical tension and the point of facilitated focus. These are

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neurological phenomena that could be detected by practitioners to assess for pathological dominance in the CNS. Critical Tension Epstein found that the clinical application of a light force touch to the spine dissipated the dominant pathological pattern by recalibrating the nervous system, a process of selfawareness, and release of tension. The more specific this point was the greater the dissipation. Epstein initially explained the concept of critical tension as the point on the spine that responds to the least amount of force, in the proper direction, to reduce the adverse tension on the spinal cord, removing interference to the CNS by decreasing tension on the SMFU. [4] He suggested this may lead to the formation of a more plastic, dynamic, and adaptable CNS. Due to the heightened threshold of excitability associated with facilitated subluxation, sensory information to the area is not adequately processed. Thus, the area around the point of critical tension is characterized as having lost “awareness” and “self-identity.” [30](p.6) The point of critical tension was proposed as an access point into the CNS. Facilitated Focus Epstein proposed that the point of facilitated focus was a place of facilitation in the musculature acting as a pirating mechanism converging the waves of excitation of the dominant defensive pattern into a focused point. [30] This theory integrated the experimental findings of Korr and Uktomsky, the anatomical findings of Breig, with Epstein’s own clinical findings. The area of facilitated focus is a place of referred tension and energy and is the focus of the adverse tension on the cord. This point of facilitated focus unlike the point of critical tension has a lowered threshold of sensory input because it is “switched ‘on’ consistently.” (p.6) Thus stimulus to this area will cause an exaggerated response and an increase in cord tension. Any additional physical, emotional or chemical stressors to the system will heighten the point of facilitated focus and further elongate and torque the spinal cord, and reinforce the dominant pattern as a central identity. [30, 40] The facilitated focus is often associated with a presenting symptom. Epstein recognized that the pons-cord tract tension increases with new stressors. He suggested that practitioners use clinical procedures that would not increase pathological dominant patterns by over stimulating this area. This was especially because of the predisposition to alter perception and thus perceive new input through preparedness for fight or flight. [30, 40] All of these clinical indicators related to stress and adverse mechanical cord tension may be integrated by healthcare practitioners to more fully understand the defense patterns in patients, some of which may be related to other pathophysiological processes.

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A Retrospective View of the NSA Spinal Wave Before continuing the historical perspective on the development of NSA and the unique findings associated with it in terms of health, wellbeing, and personal transformation, it is important to emphasize the distinct spinal wave. All of the subsequent development of Epstein’s clinical and theoretical models were driven by the health outcomes associated with the emergence of the wave. The waves that develop in NSA care are visible oscillations of the spine, which have been objectively and mathematically verified using surface electromyography (sEMG) signals. [41] As the wave progresses during NSA care, it is reminiscent of a central pattern generator (CPG). [42] The network wave may be the first CPG apart from locomotion (walking, swimming) found in the human spine,[10] and demonstrates coherence at a distance. [43] Oscillation is a frequency of variation between two poles, like the attachments of the spinal cord to the dura on two ends. In-phase oscillation is synchrony between subsystems or within subsystems such as two vertebrae demonstrating coordinated movement. Out of phase oscillation is asynchronous. Oscillation as a factor in biological coordination and thus became central to the development of NSA care. As the wave progresses, a self-organizing signal is detected in the sEMG signal, which grows increasingly coherent and is linked to an increase of frequency entrained spinal oscillators. [9, 44] Systems Approaches to the Spine System (1995-1996) During the mid-1990s, Epstein incorporated systems approaches to understanding the spinal and wave dynamics. These approaches included Panjabi’s subsystem model of the spine, Holstege’s emotional motor system, and Haken and Kelso’s models of selforganizing dynamics. This new integration of diverse approaches led to new protocols and an analysis system based on an increasing complexity of spinal and health indicators. These became the hallmark of the NSA levels of care protocols. Passive, Active, and Neural Control Subsystems In 1996, Epstein incorporated Panjabi’s 3 stabilizing subsystems of the spine into the analysis. [45] The subsystems are defined as passive, active, and neural control. [46] The passive system consists of vertebra, discs, and ligaments. These structures act as transducers to external stressors. The active subsystem consists of muscles and tendons. Muscles provide the forces of stability in the system, while tendons act as signal transducers regarding the magnitude of the forces. [46] The deep muscles of the spine play an important role in defense posture. [47] The muscles act through the neural control subsystem, which receives various input about positioning, stress, load, and forces from the environment. Epstein added the meninges to Panjabi’s neural control subsystem[46] by integrating Breig’s findings that the meninges act as a passive transducer. [8]

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Breig suggested that the pons-cord tract tension exhibits a force dynamic best explained by Saint-Venant’s principle.[8] This classic principle derived from mechanical engineering describes elasticity between 2 geometrically short distances. Distribution of stress or load will be weaker the farther apart they become. Pulling on the dura of the cervical spine acts in a similar manner and therefore creates a stretching of the dura in the lumbar spine. [8] More extension of the spine equates with a more relaxed ponscord tract. [8, 45] Clinically, practitioners were taught to assess for various indicators demonstrating outcomes for each subsystem.[5] (Figure 4) For example, the passive subsystem will be assessed by palpation of the vertebra for lack of compliance. This may also relate to torquing of the fascia and connective tissue. Increased compliance may indicate greater energy efficiency and information availability. Each system was individually and uniquely assessed for energetic efficiency and integrity.

Figure 4. Spinal Assessments for Degrees of spinal and neural integrity and indicators of AMCT. [47]

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The Network wave phenomenon demonstrates how the neural subsystem affects adaptive changes in the bony and muscular subsystems, through dissipation of energy and the creation of waves. Epstein proposed that bones and ligaments oscillate and couple to the sensory components of muscles and tendons and connective tissue, which further couple with higher brain centers. The dissipation of energy is important to spinal stability. When these subsystems are not dissipating energy, the overall system is heading towards a static equilibrium state, which is an entropic loss of subsystem integrity. Greater integrity is found in systems that are far from thermodynamic equilibrium, and therefore more dynamic and adaptable to external conditions. The Emotional Subsystem of the Spine Epstein proposed there is a fourth subsystem of spinal stability called the emotional subsystem, which combines the physiology of psychoneuroimmunology with the anatomy of the emotional motor system. [5, 48, 49] Neuropeptides are ubiquitous throughout the body and mediate between the mind, body, and emotion. [50, 51] The dorsal horn of the spinal cord and the brain have large concentrations of neuropeptides. [48, 51, 52] These concepts influenced Epstein to use the term somatopsychic in describing the unique wave process and includes theories from psychoneuroimmunology along with his models of spinal and neural integrity. [48] The emotional motor system was described by Holstege as diffuse pathways from the limbic system throughout the length of the cord[49, 53], acting as a third motor system, distinct from the somatic motor system and premotor neurons. The diffuse descending systems travel from the limbic system, including the hypothalamus, mesencephalon, amygdala, and the prefrontal cortex, through the spinal cord influencing emotional behaviors, as well as “gain setting systems including triggering mechanisms of rhythmical and other spinal reflexes.” [49] (p.77) The pathways of the emotional motor system are so diffuse that they do not regulate specific motor movements but rather “they have a more global effect on the level of activity of the motor neurons.” [49](p.69) The projections affect motor neuron excitability and facilitation, locomotion, nociception, lordosis, blood pressure, vocalization, head turning, and pupil dilation. The impact of the emotional motor system on vocalization is particularly important because it demonstrates how the active and emotional subsystems may dissipate tension through sound. The specific pathway goes from the Limbic system to the Periaqueductal Gray (PAG) to the Nucleus Retroambiguus (NRA), to the motor neurons innervating: abdominal muscles, larynx muscles, pharynx muscles, peri-oral muscles, and mouth opening muscles. [49] Projections from the mediolateral organization of the limbic system pathways through the brainstem and spinal cord suggest further implications for functional impact in processes as varied as respiration, sympathetic and parasympathetic innervations, as

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well as “level setting” of sensory and motor systems in the caudal brainstem and the spinal cord.[49](p.76) Integration of 4 Spinal Subsystems Epstein proposed that instability of any of the other 3 spinal subsystems may lead to pathophysiological processes of those specific systems and trigger compensation from the other systems, leading to an impairment of the emotional subsystem. [45] By including the emotional motor system as part of the emotional subsystem, Epstein linked spinal stability anatomically and physiologically to emotion. Dissipating tension from the emotional system was clinically observable. Indicators included increased respiratory wave and energy release from the passive system to the active system through movement and vocalization. Epstein observed that the vocalizations, which sometimes accompanied the Network wave, dissipate defensive tension from all of the subsystems. [47] This observation suggests a synergy and a depth of interconnectedness within the body, emotions, and mind. [47] The emotional subsystem is different from the others because it is not associated with a specific location. (Figure 5) Rather, it is a functional system, which is physiologically and anatomically embedded throughout the body. Epstein proposed that the emotional subsystem tension inhibits effective and efficient distribution and dissipation of emotional energy. The voluntary and involuntary motor systems store the excess tension, which creates a feedback loop. The tension loads carried by the passive, active, and neural control systems overload, which may predispose the individual to injury and illness. Epstein also proposed that local tension is modulated in conjunction with a restricted range of micro-oscillation of tissues and energy. An increase in this range leads to an increase in emotional experience and expression.[47]

Figure 5. Subsystems Contributing to the Maintenance of Spinal Integrity.[47]

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Levels of Care The NSA care protocol developed into 3 levels of care in 1995. Each level with unique measures of clinical outcomes, as well as self-reported, quality of life indicators. The first level targeted an initial self-regulation of spinal cord tension and the development of a unique spinal respiratory wave, which developed within the initial weeks of care. The second level targeted a development of new emergent somato-spinal strategies, which are characterized by dissipation of energy and the formation of 2 entrained spinal oscillators The third level focused on higher level strategies associated with wellness, growth and three entrained spinal oscillators. Questionnaires were designed for each level of care to allow the individuals to document any changes in somatic awareness and overall quality of life.[6] Epstein proposed that each level of care is associated with new baselines of higher order states. Each dominant pattern of defense exists in a narrow threshold of energy keeping the defense system in existence. As these thresholds are exceeded and bound energy gets redistributed, the need or ability to reproduce the experience of stress as a linked behavioral, structural and perceptual system may no longer be necessary. The more energy efficient states are more plastic and better able to adapt to the environment and replace the dominant patterns of defense. Wellness Lifestyles and Social Science Research on NSA care (1994-2004) In 1994, a concerted effort to document the social science components of health and wellness benefits of the care was undertaken. The unique sensorimotor and wellness phenomenon associated with Network care led to a wellness survey instrument. The instrument was developed to characterize, a “wellness coefficient.” The survey instrument was based on a combined wellness scale including 4 domains of health: physical state, mental/emotional state, stress evaluation, life enjoyment, as well as overall quality of life. (Figure. 6) The instrument was designed and applied in a retrospective format, for patients to self-rate wellness prior to Network Care and ‘presently.’ The retrospective study of 2,818 people demonstrated a clearer picture of the sociodemographic characteristic of the population base as well as positive significant changes in each domain studied including an improved wellness coefficient of perceived change in over 76% of respondents. Wellness coefficients improved from as early as 13 months of care, and extend into 3 years or more, demonstrating no ceiling to the wellness benefits. This retrospective study along with the follow-up longitudinal study demonstrated the unique wellness indicators associated with NSA Care, all of which point to a “greater capacity to cope with stressful situations,” [18](p.2), or a stress “busting” effect. [14, 18, 19, 54, 55] One important impact of this research on the subsequent development of NSA care protocols was the finding that factors regarding NSA care (duration of care, awareness of the respiratory wave, and awareness of the spinal wave) [19] were predictors of increased quality of life and a higher wellness coefficient. Additionally, the longer an

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individual was in care and the greater awareness of the spinal wave, the higher the levels of wellness that were self-reported. [6, 18, 19] These relationships were explored through structural equation modeling, demonstrating that NSA care is a predictor of improved wellness lifestyle choices, which demonstrated a different pathway to wellness from lifestyle choices alone. [19]

Figure 5. Self-Rated Health Scales.[18] The wellness outcomes associated with the Network wave suggest that a spinal Reorganizational Healing phenomenon is occurring. [7, 56] The technology and mathematical analysis developed to measure the increasing coherence of the electromagnetic signal associated with the Network spinal wave may one day be used as part of the neurological suite.[9] We have proposed that these phenomena associated with NSA care suggests an endogenous reorganizational system.[41]

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An endogenous reorganizational system in the body may exist on the functional edge between the stress system and the relaxation system.[41] This reorganizational system may be mediated by the spinal stabilizing subsystems and linked to innate pathways of the body to ‘break-out’ of stuck and defensive patterns and emerge or reorganize wellbeing.

CONCLUSION Over the course of 30 years, Epstein developed the NSA protocols and a new functional perspective on the spine, which included its role in stress, health, and reorganizational wellbeing. Starting as in integration of several models of chiropractic applications, the clinical outcomes led to an integration of several disciplines such as the osteopathic literature on facilitation, the spinal cord research of Breig, the Russian neurophysiology inspired by Speransky and Ukthomsky, Panjabi’s subsystem model, as well as other systems approaches from Kelso to Pert and anatomical models such as Holstege. The integration of these many diverse fields in clinical practice led to a robust research agenda, which continues to produce a body of work that is unique and demonstrates important applications to healthcare. Future research to explore this phenomenon could emphasize the role of the spinal cord in oscillation, brain responses, and overall changes in each individual’s life as it relates new and emergent levels of health in relation to stress responses. The many developments described in this article further evidence the relation of the spine and nervous system to overall health and wellbeing, as valuable in evidence based chiropractic and healthcare practice. Disclosure Statement No competing financial interests exist.