Another article I would like to get through quickly is a very important one is a very exciting one from last year, and this has to do with, "Changes in vertebral artery blood flow following various head positions and cervical spine manipulations." One of criticisms over the years has been that we may not damage the artery with the adjustment, but we cause an abnormal blood flow, abnormal pattern of blood flow and if you are familiar with Bernoulli Principle, that we create an alteration in the blood flow that creates turbulence and greater pressure after the fact and that damages the artery or can damage the intimal and set up a thrombogenic environment. Well, if we look at this paper [backwards 00:24:28] now, this is from a group of CMCC and involve people like [Jay Triano 00:24:33] and people that have been in this area of inquiry for a longtime, they essentially took a series of real-time MRI studies that assessed blood flow before, during, and after an adjustment and before, during and after range of motions. Their conclusions or findings, "The side to side differences between ipsilateral and contralateral vertebral artery velocities was not significant for either velocities or flows throughout the conditions." In the pre adjustment, adjustment, post adjustment range of motion environment, there was not a significant change in the flows or the velocities before during or after. The conclusion, "There were no significant changes in blood flow or velocity in the vertebral arteries of healthy male adults after various head positions or cervical spine manipulation." What's the most accretive and most critical word in that? "Healthy." The subjects that were involved in this were in their 20's. They were all healthy and so on. We have to be careful about how far we can extrapolate this information, but this is very important fundamental physiological activity that we haven't had a good handle on up until just recently with this work. Let's look at the one of the conclusions statements. It says, "Furthermore, only two trials have examined the effect of cervical manipulate therapy on human vertebral artery blood flow. Licht et al examined peak velocity in the vertebral artery after CSM on 20 students with biomechanical cervical spine dysfunction in a randomized controlled trial using Doppler ultrasound. Similar to the MRI data reported here, there were no significant changes of peak velocity between the CSM group and that on a controlled sample. In another randomized controlled trial, color-coded duplex sonography, Licht and colleagues found no
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