Cox® Technic
a discussion place for spinal pain management with Cox® Technic

Workshops for Hands-on Practice with Cox Technic

January 18, 2012 21:43 by juliecoxcid
Cox Technic Hands-On Workshops are great for doctors and even students who want to learn and/or finetune their application of flexion distraction. Small groups - no more than 6 attendees - allow you to treat and be treated, ask questions for how to apply Cox Technic for specific conditions, experience Cox Technic like your patients do. You'll really enjoy the hands-on training you receive in this small group setting.
Cox Technic Workshops are offered in Indiana, California and Chicago, are lead by Drs. Cox, Kruse and Hazen. The 2012 schedule of Cox Technic flexion distraction workshops is now available. Check the schedule, then register today!

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Boston Cox Seminar A Success

July 27, 2011 10:52 by juliecoxcid

Twenty-two chiropractic doctors and students joined at the beautiful Hyatt Boston Harborside Hotel for a weekend of hands-on and academic experience. Lead by Dr. Ralph Kruse, the doctors from Norway to Illinois to Connecticut to Canada heard about the history of Cox Technic, saw videotaped cases of Dr. James Cox, the developer of Cox Technic Flexion Distraction and Decompression spinal manipulation, applying Cox Technic protocols from the spinal manipulation to ancillary therapies and exercise, gained insights into the biomechanics of flexion distraction based on federally funded HRSA grant studies and the clinical outcomes of flexion distraction, and felt how the proper application of Cox Technic should feel as both the doctor and patient. Always an amazing finding is how small the motion is to get the desired effect. One to 2 inches of motion from the treatment starting point is all it takes. There is no need or desire for 16° of flexion when applying flexion distraction properly. Further, dropping intradiscal pressures on the DRG is important. Pain is when there is more than 20mm of pressure on the DRG nerves according to Takahashi.

You get the latest research presented in concise form, as well as individual hands-on with the technique that is invaluable. When’s the last time a seminar day flew by? Good stuff.”

– Boston Part I (7/11) attendee comment on evaluation form

So consider joining the next Cox Technic Part I Certification Course in San Diego on September 9-10, 2011. You’ll be amazed at today’s 21st century, gentle, evidence-based, effective clinical protocols of Cox Technic that have evolved since you took it in school or heard about it from a colleague!

Check the website for more information on Cox Technic and on the seminars we offer. Then, contact us with any questions.


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New Video About Cox Technic

July 11, 2011 08:06 by juliecoxcid

Just posted to the website and on YouTube, a new video about Cox Technic Flexion Distraction and Decompression with its developer, Dr. James Cox, is ready. Highlighting a demonstration of the proper protocols of Cox Technic, the video also emphasizes the research, the educational opportunities to learn more about it for doctors and patients, the tools availables to enhance the use of flexion distraction as well as the referral directory to certified Cox Technic physicians.

Check out the video today!


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Flexion Distraction Used by 63.7% of Chiropractors

June 24, 2010 20:50 by juliecoxcid

The 2009 National Board of Chiropractic Examiners Survey results have been published. Survey participants reported that 63.7% use flexion-distraction.

Past years' surveys revealed

1991    53.7%   (It is termed "Cox flexion-distraction" in the list of techniques.)

1998    58.0%   (It is termed "Cox flexion-distraction" in the list of techniques.)

2003    56.5%   (It is termed "Cox flexion-distraction" in the list of techniques.)

2009    63.7%   (It is termed "flexion-distraction" in the list of passive adjunctive procedures.)

* from Practice Analysis of Chiropractic 2010, page 134.


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Cox Technic Flexion-Distraction Studied in $2.8 Million Study

June 24, 2010 19:12 by juliecoxcid

June 23, 2010

For release:    Immediately

Contact:          Lori Leipold, Media Relations; Palmer College of Chiropractic; phone (563) 884-5726; fax (563) 884-5225; e-mail lori.leipold@palmer.edu; College website at www.palmer.edu

 

Palmer College of Chiropractic, Loyola University, Hines VA researchers and Dr. James Cox work together to understand Cox® distraction procedure for neck pain

 

In a ground-breaking study, medical and chiropractic researchers are joining efforts to study the effects of a form of non-surgical treatment for neck pain, more specifically Cox distraction manipulation. This study is one of three projects that are part of a four-year, $2.8 million grant awarded in 2008 to the Palmer Center for Chiropractic Research (PCCR), headquartered on the Palmer College of Chiropractic campus in Davenport, Iowa. The grant is from the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine to establish a multidisciplinary Developmental Center for Clinical and Translational Science in Chiropractic, and the principal investigator is Christine Goertz, D.C., Ph.D., who also serves as Palmer’s vice chancellor for Research and Health Policy. Co-leaders of the Cox distraction manipulation project are M. Ram Gudavalli, Ph.D., PCCR, and Avinash G. Patwardhan, Ph.D., Loyola University Stritch School of Medicine and Edward Hines Jr. Veterans Affairs Hospital.

This study is in progress and funded through May 30, 2012. It combines the efforts of medical doctors, chiropractors, biomechanists and clinical researchers, in order to document the effects of the Cox distraction chiropractic procedure on neck pain and develop sham and active treatment parameters for conducting clinical studies.

The project, titled Cervical Distraction Sham Development: Translating from Basic to Clinical Studies, consists of three main parts. After completing the pilot studies, the formal basic research study began in March 2010 on the Cox distraction procedure for neck pain at Edward Hines VA Hospital and Loyola University Stritch School of Medicine. This study is a collaborative effort between researchers at these facilities, researchers from Palmer College of Chiropractic, clinicians who perform this technique in their practices, and Dr. James Cox, the originator of the procedure. 

“As the manipulation procedure is performed, we are measuring the variability between four different clinicians trained in this procedure by measuring the loads and the controlled displacements of the table using a basic science approach as well as a clinical approach,” said Dr. Gudavalli from Palmer. “According to practicing doctors of chiropractic, this chiropractic procedure has provided relief for musculoskeletal conditions such as neck pain. However, there is a need for studies that provide information on the biomechanical characterization of such therapies, the biomechanics of normal and pathological joint and muscle systems, and the development of new technologies that study such biomechanics in real time. In other words, what physiological effect does the procedure have that is responsible for its clinical successes?”

The results of this study will aid in the planning and development of controlled procedures in the clinical setting, and test the validity of delivering the controlled procedures by conducting clinical studies and obtaining patients’ perception on the controlled intervention. This knowledge has the potential to guide the future conduct of clinical research in this area and impact training of students and doctors in the chiropractic profession.

- end -

Lori Leipold

Media Relations Manager

Palmer College of Chiropractic

Office: (563) 884-5726

Cell: (563) 343-0665


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Cox® Seminar in Hawaii - February 2011

June 8, 2010 10:54 by juliecoxcid

More details will come, but the date has been set.

February 19-20, 2011 at the beautiful Hyatt Regency Maui Resort & Spa where millions of dollars of renovations are to finish up by December 2010, just in time for our visit!

Plan to join Dr. James Cox as he makes a unique weekend presentation on current clinical and research topics influential to your Cox® spinal pain practice.

Check this link for the latest news and details on the Cox® Technic Seminar in Maui, Hawaii.

         


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Cox® Technic Relieves Radiculopathy Better

May 18, 2010 21:54 by juliecoxcid

Cox® Technic (aka flexion-distraction) clinical outcomes published in European Spine Journal. Flexion-Distraction provided more low back pain relief than did medical conservative active exercise. 

Patients with radiculopathy (leg pain) did significantly better with flexion-distraction than active exercise. 

 

article link: http://www.springerlink.com/content/f32603l877144k77/?p=1ba95a15a905467b8ed4080941ee22e6&pi=4


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Cox® F/D Helpful Tool for Thoracic Kyphosis

April 22, 2010 10:51 by juliecoxcid
THORACIC KYPHOSIS SEVERITY INCREASES RISK OF VERTEBRAL FRACTURE. THORACIC KYPHOSIS INCREASES OVER A 3 YEAR PERIOD. 

comment from James M. Cox DC DACBR: If for no other condition than hyperkyphosis of the thoracic spine, f/d decompression is worth having in the doctor’s treatment bag. Posture control coupled with f/d is an excellent addition to thoracic kyphosis care when you consider the possible complications as described in the report by Roux et al.

(from Roux, C; Fechtenbaurn, J; Kolta, S; Said-Nahal, R; Briot, K; Benhamou, CL.  Prospective Assessment of Thoracic Kyphosis in Postmenopausal Women With Osteoporosis. JOURNAL OF BONE AND MINERAL RESEARCH 25 (2). FEB 2010.  p.362-368)

 The relation of thoracic kyphosis, its influence on incident fractures and quality of life over three years in postmenopausal women with osteoporosis and the effect of strontium ranelate on thoracic kyphosis progression was studied on women with postmenopausal osteoporosis.  Vertebral fractures were assessed on lateral thoracic radiographs performed at baseline and at three years according to standardized procedure. Kyphosis index (KI, %) was defined as the percentage ratio between the maximum depth of thoracic curvature and the height measured from the T4 to the T12 vertebrae. Baseline characteristics of the 3218 patients (1594 strontium ranelate, 1624 placebo) were mean age 73.3 years, spine bone mineral density (BMD) T-score (1-2-4)-3.1, femoral neck T-score -3.0, and KI 25.4%.   In the placebo group, patients with the highest baseline KI experienced significantly more vertebral fractures than those with medium KIs or the lowest KIs. There was no difference in the risk of nonvertebral fractures according to baseline KI. Three-year changes in quality-of-life physical scores reflected significantly better status for patients in the lowest tertile of KI compared with those in the highest at baseline. Over three years, the kyphosis index increased for all patients, indicating worsening of thoracic kyphosis, whatever the presence of prevalent or incident vertebral fractures. This KI progression was lower in the strontium ranelate group than in the placebo group. Thoracic kyphosis is a risk factor for vertebral fractures over three years and influences physical capacity changes in postmenopausal women with osteoporosis. Thoracic kyphosis progression over three years is lower in a subgroup of strontium ranelate-treated patients compared with placebo-treated patients. 


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Cox® Technic Seminars Teach Flexion-Distraction Protocols

March 19, 2010 09:47 by juliecoxcid

Cox® Seminars teach the biomechanics, examination, diagnosis and treatment of spinal pain conditions. Treatment is focused on Cox® flexion-distraction and decompression protocols performed by chiropractic physicians who use their hands and their palpatory skills to adjust the spine. Cox® Seminars emphasize the role of the chiropractic physician and his/her trained hands in caring for spinal pain conditions.

60% of chiropractors reported to the National Board of Chiropractic Examiners that they use Cox® Technic.

Chiropractic research projects funded by various organizations from NIH to HRSA to FCER continue to investigate chiropractic flexion distraction. Projects are underway at Palmer Research Center (Gudavalli et al), National University of Health Sciences (Gudavalli & Cambron), New York College of Chiropractic (Dougherty) among others. These projects' goals and outcomes as available are shared.

Cox® Seminars teach the proper application of flexion-distraction protocols. Attending doctors are often taken aback at the low amount of force and at the depth of flexion that is actually required (only 1 to 2 degrees when the protocol is applied correctly). There is nothing like hands-on experience training to really grasp what a technique is all about.

For more information on Cox® Seminars, please click here.

 


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Flexion-Distraction Is Decompression

February 24, 2010 03:17 by juliecoxcid

Cox® Technic Flexion-Distraction and Decompression Adjusting is doctor-administered and doctor-controlled spinal manipulation.  Certified chiropractic physicians in Cox® Technic are trained to treat patients using defined protocols which stem from carefully observed and documented  outcomes.

In federally funded research studies (conducted between chiropractic and medical research centers:

  • National University of Health Sciences
  • Palmer College of Chiropractic Research Center
  • Loyola Stritch School of Medicine
  • Auburn University (grad student)
  • University of Iowa
  • University of Illinois
  • Hines VA Hospital
  • etc.),

 flexion-distraction (F/D) has been shown to

  • drop intradiscal pressures to as low as -39mmHg to -192mmHg, and
  • increase the foraminal area by 28%.

F/D is a chiropractor-administered adjustment, delivered to the specific spinal level required. This is necessary to deliver the spinal decompression and chiropractic adjustment to the specific segment involved and to relieve the hypomobility and altered segmental dysfunction of disc herniation and spinal stenosis condition.

Consider this paper on "decompression traction" and compare to F/D clinical outcomes:

source: Schimmel, JJP; de Kleuver, M; Horsting, PP; Spruit, M; Jacobs, WCH; van Limbeek, J. No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy. EUROPEAN SPINE JOURNAL 18 (12). DEC 2009. P.1843-1850

Intervertebral Differential Dynamics Therapy (IDD therapy) was compared to sham treatment. IDD Therapy consists of intermittent traction sessions in the Accu-SPINA device (Steadfast Corporation Ltd, Essex, UK), an FDA approved, class II medical device. The intervertebral disc and facet joints are unloaded through axial distraction, positioning and relaxation cycles. In a single blind, single centre, randomized controlled trial; 60 consecutive patients were assigned to either the SHAM or the IDD Therapy. All subjects received the standard conservative therapeutic care (graded activity) and 20 sessions in the Accu-SPINA device. The traction weight in the IDD Therapy was systematically increased until 50% of a person's body weight plus 4.45 kg (10 lb) was reached. The SHAM group received a non-therapeutic traction weight of 4.45 kg in all sessions. The main outcome was assessed using a 100-mm visual analogue scale (VAS) for LBP. Secondary outcomes were VAS scores for leg pain, Oswestry Disability Index (ODI), Short-Form 36 (SF-36). All parameters were measured before and 2, 6 and 14 weeks after start of the treatment. Fear of (re)injury due to movement or activities (Tampa Scale for Kinesiophobia), coping strategies (Utrecht Coping List) and use of pain medication were recorded before and at 14 weeks. A repeated measures analysis was performed.

The two groups were comparable at baseline in terms of demographic, clinical and psychological characteristics, indicating that the random allocation had succeeded. VAS low back pain improved significantly from 61 (+/- 25) to 32 (+/- 27) with the IDD protocol and 53 (+/- 26) to 36 (+/- 27) in the SHAM protocol. Moreover, leg pain, ODI and SF-36 scores improved significantly but in both groups. The use of pain medication decreased significantly, whereas scores for kinesiophobia and coping remained at the same non-pathological level. None of the parameters showed a difference between both protocols. Both treatment regimes had a significant beneficial effect on LBP, leg pain, functional status and quality of life after 14 weeks. The added axial, intermittent, mechanical traction of IDD Therapy to a standard graded activity program has been shown not to be effective.

 

For more information on chiropractic, hands-on F/D Outcomes, please click www.coxtechnic.com/research/articles.html.

compiled with information from Dr. James Cox


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