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Unravelling functional neurology: a scoping review of theories and clinical applications in a context of chiropractic manual therapy

Overview of attention for article published in Chiropractic & Manual Therapies, July 2017
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Title
Unravelling functional neurology: a scoping review of theories and clinical applications in a context of chiropractic manual therapy
Published in
Chiropractic & Manual Therapies, July 2017
DOI 10.1186/s12998-017-0151-1
Pubmed ID
Authors

Anne-Laure Meyer, Amanda Meyer, Sarah Etherington, Charlotte Leboeuf-Yde

Abstract

Functional Neurology (FN), a seemingly attractive treatment approach used by some chiropractors, proposes to have an effect on a multitude of conditions but some of its concepts are controversial. A scoping review was performed to describe, in the context of chiropractic manual therapy, 1) the FN theories, and 2) its clinical applications (i.e. its indications, examination procedures, treatment modalities, treatment plans, and clinical outcomes) using four sources: i) one key textbook, ii) the scientific peer-reviewed literature, iii) websites from chiropractors using FN, and iv) semi-structured interviews of chiropractors using FN. The scientific literature was searched in PubMed, PsycINFO, and SPORTDiscus, completed by a hand search in the journal Functional Neurology, Rehabilitation and Ergonomics (November 2016 and March 2017, respectively). The only textbook on the topic we found was included and articles were chosen if they had an element of manual therapy. There was no restriction for study design but discussion papers were excluded. Websites were found in Google using the search term "Functional Neurology". Chiropractors, known to use FN, were invited based on their geographical location. Theories were mainly uncovered in the textbook as were all aspects of the clinical applications except treatment plans. The other three sources were used for the five aspects of clinical applications. Results were summarized and reported extensively in tables. Eleven articles were included, five websites scrutinized, and four semi-structured interviews performed. FN is based on the belief that reversible lesions in the nervous system are the cause of a multitude of conditions and that specific clusters of neurons can be positively affected by manipulative therapy, but also by many other stimuli. Diagnostic procedures include both conventional and unusual tests, with an interpretation specific to FN. Initial treatment is intense and clinical outcomes reported as positive. FN gives the impression to be a complex alternative to the old variant of the chiropractic subluxation model, in which the vertebral subluxation is replaced by "physiological lesions" of the brain, and the treatment, spinal adjustments, are complemented by various neurological stimuli. Both models purport to treat not the symptoms but the cause. We conclude there is a need for more scientific documentation on the validity of FN.

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Geographical breakdown

Country Count As %
Unknown 79 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 18%
Lecturer 6 8%
Other 5 6%
Unspecified 5 6%
Student > Ph. D. Student 5 6%
Other 23 29%
Unknown 21 27%
Readers by discipline Count As %
Medicine and Dentistry 18 23%
Nursing and Health Professions 16 20%
Unspecified 5 6%
Neuroscience 4 5%
Agricultural and Biological Sciences 3 4%
Other 11 14%
Unknown 22 28%