Paediatric chiropractic has long been a complicated but important item on the to-do list. While academics grapple with the ethics requirements necessary to gain approval for paediatric studies, chiropractors grapple with the ethics of not having enough paediatric studies to adequately argue the case for continuing to serve our tiniest practice members.
While Australia, and specifically the state of Victoria, has been the frontline for this battle, the issue of paediatric chiropractic care remains a global priority. It’s something that Dr Jenna Deuhr has taken on in her recent work. She joined us for a research update recently, and filled us in on the important work she is undertaking. The chiropractic academic took on this work as she had a particular interest in caring for mothers and babies, but it had been a lifelong passion.
“I did my master’s in health science, and the research project for that was looking at chiropractic care in children with cerebral palsy,” said Dr Jenna. “When I was writing my thesis, I kept having this thought: it’s great that we can provide care for those kids and help maximise the body as it is then, but how amazing would it be if we could look at outcomes and those kids that are at risk of developing cerebral palsy or having cerebral palsy from a risky birth or whatever it is – preterm babies.”
“If we could provide chiropractic care as an early, early intervention and then track their outcomes over time, how cool would that be?” Dr Jenna’s standpoint came from a solid chiropractic philosophy that they would likely do better – but it was yet to be proven. Her big idea was to look at key outcomes if chiropractic interventions were given for pre-term babies.
However, the course of setting up a study like that is never simple. First, Jenna had to find a supervisor to take her on; one who was willing to take on not only a chiropractic project but one specifically for babies. While Dr Jenna is connected with the New Zealand College of Chiropractic, the college does not yet offer post-graduate meaning Masters and PhD degrees have to be done through another university. This is great in many ways, but it presents its own challenges.
Once the issue of a supervisor was solved, which was not without challenges when it came to knowledge of and willingness to look into chiropractic paediatric research, a new issue presented itself: that of how to measure changes in infants. The answer was relatively easy – use EEG and heart rate variability as two objective insights into the neurophysiology of the infant.
In theory, a simple proposition. In actuality, quite complicated. How do you get an infant to hold still for long enough to get a reading? If you use a parent to hold the infant, how does the co-regulation aspect of a parent-infant bond affect the pre-term infant’s parasympathetic/sympathetic balance?
“The first step for my research is to do a feasibility study, which is the one that ASRF is funding. That is to look at EEG in these babies and heart rate variability as a protocol. Can we actually measure any changes using EEG pre and post-chiropractic adjustment sessions?”
“The beginning of [the study] is about trying to understand the mechanism behind the adjustment. Is it the brain that’s changing? That’s what the EEG will hopefully tell us – that there are some changes in the brain. What I’m looking at in particular is the connectivity of the brain regions – are they talking to each other more after the baby is adjusted? That’s really important just in general, but also for brain development obviously.”
“The choice of the EEG is because we think that we’re going to find something in there about the chiropractic adjustment affecting how the brain is developing. Then, the heart rate variability really comes from your autonomic nervous system. Because the adjustment for an infant is not high velocity, low amplitude, despite what some may think, that gentle touch is a really different input into the system.”
How this data will be captured and analysed plays a big part in this feasibility study, but the next stage will be the main project for Dr Jenna’s PhD. This study will likely look at infantile postural asymmetry – babies who don’t want to turn properly.
“We’re going to look at them over that long kind of period of care and do a kind of combined study, looking at the basic science mechanisms, the brain changes, as well as looking actually how they posturally change under care, and also breastfeeding outcomes with it as well,” said Dr Jenna.
“We’re getting to use some really cool technology for this, which is called an automated infant pose recognition. It’s going to be a really great way of actually tracking those babies and getting some really solid data about how they change under care.”
Not only is this study so needed, it also shows how chiropractic research is evolving to work with artificial intelligence as it emerges. As it turns out, the New Zealand College of Chiropractic also has an in-house expert in Dr. Imran Khan Niazi, whose quiet achievements in research applications for AI have established him as a leader in this field.
Good things are happening in chiropractic, in paediatrics and in AI. For chiropractors, it’s all about how the adjustment changes lives in real time. But research is the empowering factor that enables us to justify and expand our practice. We can’t wait to see what emerges from Dr Jenna and team
