Chiropractic’s Neural Efficiency Index

A practical guide for using CLA instrumentation to

“look deeper” into a patient’s spine and nervous system.
Dr. David Fletcher, DC, FRCCSS (C)
CEO and President, CLA
CORESCORE: Chiropractic’s Neural Efficiency Index

Table of Contents
3 CLA’s Mission and Core Values

4 Using the CORESCORE™

6 Heart Rate Variability (neuroPULSE)

8 Surface Electromyography neuroCORE assessment

10 Thermograhic Analysis (NT) using the NeuroTHERMAL™

12 Inclinometry (spineROM)

13 Pressure Algometry (SpineSENSE)

14 Conclusion

TABLE OF CONTENTS 2
CLA’s Mission and Core Values

OUR MISSION is that every chiropractic office has INSiGHT™ Technology at the hub of their practice
to create a standard of care for chiropractors to measure and communicate their results with certainty.

When you invest in us, you invest with our team that is made up of experts who are:

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THE DRIVING FORCE in health care right AS A PROFESSION, we are perfectly

now is centered around the protection and healing positioned to capitalize on this next trend in public
of the effects of stress on the body and the health. To support chiropractor’s everywhere,
mind. People are informed enough to search for CLA has invested the past 5 years to create the
chiropractors who can speak their language about profession’s most advanced platform of cloud-
stress, tension, and neural performance – this shift based reporting and patient engagement. Join us
has launched us into the neuroAge of Chiropractic. on our journey to support healthier communities.

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Using the CORESCORE™

Using the
be used to identify patterns of change in the spinal-
neural complex. These included paraspinal motor and
thermal activity along with global and localized ROM

CORESCORE™ discrepancies. Together a spectral “disorder” known

as the subluxation was advanced in the literature and a
variety of models of the subluxation were developed to
Welcome to the next generation of spinal-neural describe this emergent health and wellness challenge.
scanning. By choosing the Insight Analysis System, All models of subluxation connect the interplay
better known as the Subluxation Station™, you have between the spinal function and the neural function.
access to the most powerful technology in the When compared to a normative database of healthy,
chiropractic profession for acquiring clinical data on well-adjusted individuals, a NM system of a subluxated
the subluxation process as it affects the spine, the patient shows reactions and variations in the symmetry
functional nervous system and the sensitivity of the and amplitudes of those biomarker measurements.
surrounding tissues. The evolution of CORESCORE™
reporting has changed how chiropractors and A commitment to restorative and wellness care means
patients communicate with one another. The ease of that a series of spinal neuralscan measurements
interpretation combined with the highly visual report should be initiated. An entry, baseline scan series and
allows instant recognition of immediate problems. CORESCORE™ forms the basis for discussing historical
Patients can now make the connection between their accumulation of unhealthy stress within the spinal core.
symptoms and deeper health issues immediately. Care However, the most important protocol in scanning is
planning and inspired goal setting has never been the commitment to interpret change on subsequent
easier or more effective. scans and create a living portfolio that demonstrates this
change. Of even greater interest is to detect regions or
This guide will give you the necessary training to use levels of disturbed function that DO NOT change. This
the CORESCORE™ in everyday practice. It is designed pattern analysis is best performed over three scans, with
to help you have a condensed learning experience that a commitment to continual scanning thereafter. The first
you can revisit many times. As you get more involved scan represents the baseline scan. The next or interim
with scanning and interpretation, we encourage you scan is used to check for CHANGEABILITY and finally
to dig deeper into our training tools and continue to the third scan looks to see if TRENDS are emerging.
be more engaged in the applications of the various
technologies. New research is constantly emerging The worst scenario occurs when change is not evident,
on the benefits of spinal-neural scanning or Heart indicating that the patient is locked into a destructive,
Rate Variability testing. It’s exciting and powerful to hardened-in habit, affecting neural and spinal control
develop the certainty so that you can position the functions.
Insight Analysis System as the clinical assessment and
reporting hub of your practice. Scanning biological systems can be challenging.
Designing protocols that limit the influencing factors is
A comment on patterns, reproducibility and paramount. The sensitivity and accuracy of the sensors
must be research-grade reliable. The scan acquisition
commitments to change must be standardized and easily applied. Reporting
must limit the influence of personalized interpretations.
Biological systems are always adapting. Adaptation CLA has used the past two decades to refine every
represents change and so changeability is the hallmark aspect of this collection and reporting system. The
of adaptability. In fact, systems that are not changing INSiGHT Scanning System can be relied upon to
or have lost their inherent ability to adapt and change deliver the accurate results for a doctor to report on.
are at risk of mal adaptation and eventual breakdown.
Chiropractors recognized that certain bio markers could

USING THE CORESCORE 4

Using the CORESCORE™

Since biology is ever adaptive, a clinician must not get of the results from the three scans allows the index to
caught up in the good, bad or worse relationship with reflect the deepening effects of the subluxated state.
the scan colors or numbers on the graphs. The initial When the scan data from the other two technologies
goal is to search for changeability and then observe in the Insight Analysis System are added in, a more
subsequent scan series for trends. It’s important to complete CORESCORE+™ report can be generated.
recognize that patients have been mal-adapting By using the inclinometer (ROM) and/or pressure
for years before they seek care and that powerful Algometry (SpineSENSE) with the other three sensors,
adjustive care can ignite new NM activity and a shift a thorough evaluation of the Neuro-Spinal efficiency
in ANS control. The art of chiropractic care planning can be obtained. This is an ideal protocol when spinal
is to use the scans to observe, track and inspire the symptoms are dominant or if documentation of spinal
patient to understand the value of lifetime chiropractic function is necessary.
care. The CLA databases are constructed to help the
clinician aim at reasonable and attainable outcomes
that are not limited to an average response. Well IN CONCLUSION:
adjusted, chiropractic patients live longer,healthier and
happier lives. The goal is to raise your patients’ scores Whether you use 3, 4 or 5 sensors in your exam,
to become a part of this powerful group of wellness the results will determine the efficiency of the
explorers. neural processing and generate a score that
represents the efficiency and function of the
What is the CORESCORE™ report? spinal-nerve system.

The name, CORESCORE™ was originally developed It should also be noted that each individual
as the Neural Efficiency Index. The title was changed technology generates its own visual report that
so that patients could easily relate and discuss their can be discussed with the patient. The individual
score with family members, friends and others. As you scan results can be used separately at any time.
learn more about this score, remember the original The CORESCORE™ calculate the global function
name as it speaks to the intent of the calculations. If of the motor, autonomic and sensory nervous
you consider how the CORESCORE™ is calculated, system and allow streamlined reporting and care
based on the accumulation of damaging stress on the planning.
functioning nervous system, you could make a case
that this score is the most important health number a The Versatility of the Insight Analysis System can’t
patient could know and follow. be understated. The NeuroTHERMAL™ can be
used to evaluate pre and post adjustment results,
The CORESCORE™ was designed to combine the tableside. sEMG and NT results can be combined
data from 3 or 5 scan protocols and generate a ONE- for use in pediatrics. HRV can be used separately
NUMBER report that a patient could easily understand at any time to evaluate the stress load or level
and use to track their progress. The most common of neurological “reserve”.ROM is a standard tool
application of the CORESCORE™ is when the“big three” to measure spinal function in post-traumatic
scans, Surface EMG (sEMG), Heart Rate Variability situations. SpineSENSE is especially useful to map
(HRV) and Thermographic analysis (NT-Neural Therm) inflamed or painful regions associated with trauma
are combined. This allows the clinician to identify or fibromyalgia.
regions of nerve disturbance but more importantly,
the combined score describes the efficiency of neural
control. As more stress accumulates and affects spinal
nerve function, the efficiency of the entire functional
nervous system is impacted. A proprietary “weighting”

USING THE CORESCORE 5

THE SPECIFICS: Heart Rate Variability

Heart Rate Variability (neuroPULSE) rhythms and spacing of the inter beat timings, a ratio
of S/PS can be obtained. This data, in turn,can then
• Simply put, HRV measures the amount of reserve be plotted on a chart to reveal the symmetry and
that a person has to deal with the stressors in their amplitude of the autonomic nervous system.
lives. The balance between the divisions of the • Under stressful situations, the S nerves will produce
autonomic nervous system (ANS): the Sympathetic (S) more neurotransmitters and the heartbeat will increase.
and Parasympathetic (PS) must be maintained within This is a necessary and effective strategy in “fight or
a reasonable range or a fatiguing of the neurological flight”situations. The PS system should react, in turn, to
response will occur. This imbalance and loss of neural calm down and re balance the heartbeat to its natural
acuity can be associated with morbid health states such range within a reasonable time frame.
as cardiovascular disease, immune insufficiencies and
• Imagine if persistent lifestyle stressors keep the S
a variety of psychological disorders. Most importantly, it
nerves turned on. Now imagine if the “vagal braking”
has been found that chiropractic adjustments designed
system responds poorly (remember the Vagus nerve is
to reduce subluxation, help restore the balance within
situated in close proximity to the upper cervical region).
the ANS.
There will be a tendency for the HRV scoring to be
• An ECG collection protocol, designed by CLA and skewed to the S side of the graph as this “adrenergic”
known as a Pulse Wave Profile(PWP) accurately state emerges. Now imagine that this new S dominant
captures the beat-to-beat intervals of the heart. The state becomes the norm. The PWP equip menth as
heart rate is used to determine the balance and control a built in “anxiety meter” known as galvanic skin
of the S and PS nervous systems. Briefly, the sino-atrial response (GSR). As the ECG is being done a GSR
(SA) node in the heart is fed by the upper thoracic reading is also being taken to ensure a low anxiety or
sympathetic(S) nerve fibers which accelerate the heart calm state is maintained during collection. Lets put this
rate. It is also fed by the PS nerve fibers from the Vagus together: The patient is in are sting, calm state yet they
Nerve (cranial nerve X). continue to react as if they are under stress and duress.
• A natural rhythmic beat is maintained by the This pushes the plot on the graph to the left of the
symmetrical yet fractionally variable firing of the SA centerline,(S-skew) indicating that this is now the new,
node. It is the slight variations in the timing of the accelerated normal. Unfortunately, this is a common
SA node firing that can be used to detect unhealthy finding as many people have stress-oriented lifestyles
stress responses. The R-R interval in the heartbeat which are keeping them turned “up” all the time.
is not supposed to be evenly spaced. Perhaps you • Over time this accelerated S usage depletes the vagal
have taken a pulse and measured 60 beats/minute. braking response and a general fatiguing of autonomic
The timing of each beat was not exactly at one- activity begins to occur. The HRV graph has a green box
second intervals. When measured in the hundredths situated above the mid line of the vertical axis, extending
of seconds, these inter beat timings are designed to to the left and right of the centerline. This is a CLA-
be fractionally variable (too much variability and you designed graph that was constructed from chiropractic
have an arrhythmia).An Innate design feature uses patients’ data. Unlike other HRV collection graphs,
this slight variability to reduce the wear and tear on this was created using chiropractic data so that true
the heart chambers and coordinate the breathing chiropractic comparisons can be made on baseline and
responsiveness. A naturally elevated degree of subsequent tests. It also has three color coded, parabolic
variability corresponds to a high rate of adaptability. regions surrounding the green box. These 3 regions
More simply put, the higher the HRV the greater the represent “Category 1, 2, and 3 Stress Reactions”,making it
adaptability of the organism. easier to understand and report the HRV results.
• The frequency of the S and PS systems can be • The “healthy and well-adjusted” people in the
uniquely identified with PWP technology. When community live in the green box. Others, whose
complex mathematical formulas are applied to the stress response is continually turned on, plot in the

HEART RATE VARIABILITY 6

Heart Rate Variability

different categories. The HRV is designed to look at “morbidity shift”. As the drift continues from Category
the stress response as a lagging indicator. In other 1-2-3 the patient becomes more susceptible to illness
words, HRV measures the habit of stress. Because or acute, stressful events. Because this represents a
of the spineSENSErithms and calculations of the diminished reserve, the patient has difficulty responding
different neural frequencies in play, HRV is the perfect to immediate stress, which can lead to catastrophic
technology to detect emerging and advancing chronic consequences. In the early stages of chiropractic care
stress states. Acute stress can shift HRV but it must it is advisable to recheck the HRV, even before the
be extreme (a gun being pulled on you or right after a prescribed Progress exam, if there is a Category 3
difficult workout) to register. morbidity shift in play.
• In terms of the athletic training, we have found that the • An uncommon situation is to see a patient’s plot deep
plot on the CLA graph can move quite dramatically to within Category 3 but skewed far to the right of the
the left and score the lowest 12.5 reading if there is a centerline. This represents a very diminished state of
blunted recovery after workouts or after an immediate well-being referred to, by CLA clients, as “dormancy”.
induced stressor. Typically the healthy system under Very low autonomic activity with an over compensated
duress and with poor recovery rates will plot far left PS shift means that there is little reserve for the patient
but high on the vertical scale. We recommend that to draw upon and little activity of the adrenergic system.
the HRV testing be performed again the next day or They are in a sluggish,more vegetative state. More
later that day to ensure that recovery is in play. Also, commonly are those that plot in Categories 1 and 2with
we recommend that HRV be performed after waiting a skew to the right or PS side. It has been determined
approximately 3 hours after a workout. HRV is an that these patients most likely have a diminished
ideal instrument and analysis to assist athletes and responsiveness to stress and as such, this could
people involved in fitness. It is not uncommon to have represent lower adrenal activity.
reasonably fit people score well on their sEMG, NT • HRV is an accurate and reliable method of identifying
and ROM but have a perpetually lowered HRV. This and tracking the cumulative effects of lifestyle stress in
indicates a poor recovery response and can be related our patients. Two distinctive studies by Zhang confirmed
to over-training or underlying, undetected chronic that chiropractic alone could shift the results of HRV
stress. (Think about the high-stress executive that works towards a more adaptable state. It is also widely accepted
out and believes all is well) The good news is that with that modification of lifestyle habits can accelerate that
proper adjusting and advice on training and recovery, shift towards wellness as much as persistent stress can
this S-plot can normalize. deteriorate the adaptive response. The CORESCORE™
• A typical movement in the usual HRV plotting is to calculations use an HRV value that is derived from the
have the patient “fall out” of the green box and shift data of both the autonomic activity and balance. Much is
to the S or left side of the centerline. This usually has being learned about the interplay of chiropractic adjusting,
happened long before they enter into chiropractic care. stress reactivity, lifestyle modification when HRV is added
As this highly stressed response becomes the norm, to the Insight Analysis System.
the PS vagal braking becomes exhausted. This in turn
precipitates an even greater left-shift and triggers a
downward slide of the plot. A lower plot on the vertical
Synopsis: HRV is the gold standard for determining
axis represents a critical loss in the person’s ability
adaptability. When interpreted by a chiropractor
to maintain a healthy reserve. Lowered autonomic
the level of adaptability relates to the amount of
activity is related to diminished immunity and resistance
vital reserve a patient can rely upon to stay well
along with a general decline in vital responsiveness.
and maximize their potential. Reorganizational
The patient is more susceptible to the compounded
healing is at its greatest when there is maximal HRV
effects of the three-dimensional stressors. (Physical,
indicating maximal coherence in complex systems.
Biochemical and Psychological) This downward shift to
the left of the centerline is referred to, by CLA, as the

HEART RATE VARIABILITY 7

Surface Electromyography neuroCORE assessment

Surface Electromyography within normal (white) range or if they exceed the normal
amount of energy usage. To make it easy to observe
neuroCORE assessment
and report these are color-coded as follows: Green = 1
standard deviation above normal; Blue =2SD and Red =
• sEMG measures the minuscule amounts of electrical
3SD. An aberrant Black bar represents that the reading
activity in muscles. The motor division of the CNS
is greater than the view setting and does not indicate
generates this electrical activity. A motor neuron,
normal or any deviations from normal.
ultimately connected to the pre-central gyrus of the
cerebral cortex, propagates and distributes a signal to • The importance of this form of graphic report is when
activate a neuro-muscular (NM) response. The more it is interpreted with respect to energy expenditure.
active muscle is the more electrical activity can be Lets review the examining protocol: We have asked a
measured within it. Muscle tone is related to the amplitude patient to sit and engage gravity. We can determine
and the symmetry of the signal. It is widely understood where there is an over usage of NM energy when
that a change is muscle tone is associated with the performing this standardized test. This tells the clinician
subluxation process. Excessive and diminished activity that through habit, injury or subluxation, the spinal-
along with asymmetrical distribution can be examined and neural system is over utilizing NM energy to perform
compared with the Insight Analysis System. this simple task. Sperry’s work in the late 60’s garnered
a Nobel prize for looking at the amount of energy it
• We are perpetually under the influence of gravitational
takes to mange gravity as a human being. A staggering
forces. The motor system must recognize this need
> 80% of consumed energy goes to maintain posture
and respond. The afferent portion is fed via the
and locomotion. If a patient in a static, seated posture
proprioceptive receptors, which trigger an efferent
is wasting energy then just imagine the energy use
reaction, allowing muscle contraction. A significant
when a dynamic task is performed. The patient would
amount of NM energy is expended to maintain position
exhaust more rapidly. It’s no wonder that patients who
and motion at rest, in our gravitational environment.
are subluxated and maintaining poor postural and
CLA has created databases, specific to asymptomatic,
movement control are exhausted. Conversely, patients
well-adjusted subjects, which ascertain the normative
report improved energy and less fatigue as they
amount of NM energy needed to maintain seated,
respond to chiropractic care.
upright posture. The use of a seated protocol is
paramount when developing a reproducible scan • This is how the term Dysponesis came to be used
sequence. sEMG scanning can be done in any posture in the subluxation vernacular. sEMG was used by
and on any active muscle group. However, to use sEMG behaviorists in the late 60’s to see how NM exhaustion
in a clinical protocol that can be accurately reproduced, was associated with emotional and behavioral states.
the issue of stochastic sway must be addressed. It describes a reversible, pathophysiologic state that
Standing protocols make reproducibility difficult as is triggered by persistent physical, biochemical and
the sway response affects the NM activity. Certainly psychological stressors. Chiropractic in a nutshell! We
a standing protocol for an individual scan can show all know that subluxations exhaust the individual and
loading patterns however the importance of creating now there is a method to track that.
a scan sequence to understand NM efficiencies is the • Hypotonic muscles are also present in subluxated
ultimate outcome. states. Too little energy getting to muscle group
• The seated patient is instructed to sit upright without compared to the norm could be distinct problem. These
slumping. This activates a postural response that are represented by yellow coding on the graph. If there
measures a number of levels along the spine. CLA’s is chronic shutdown as in fibrosis of the muscles or
software offers three interpretive graph options along if there is temporary use of muscle relaxants and the
with a normative, comparative graph. In the traditional contractibility of the muscles is affected. It should also
bar graph, the patient’s values are compared to the be noted that obesity is a challenge as the surface
normative database and then rated whether they are electrodes can sometimes have difficulty detecting the

SURFACE ELECTROMYOGRAPHY 8
Surface Electromyography neuroCORE assessment

electrical signal when there is an overabundance of • The most important graph to consider with sEMG is
adipose tissue. the pattern graph. It represents the flow and distribution
of the NM signal. Rather than being measured against
a normative database, the signals are plotted in
reference to the amount of energy being used at each
level. A white area in the shape of a vase represents
the acceptable range of distribution throughout the
spine. However, an ideal distribution plot is in the
middle of the white zone from top to bottom on both
sides. If a symmetrical plot at every level should occur,
there is 100% efficiency in distribution.
Anything less than that and they are operating in
a lower percentile of NM efficiency. The degree of
asymmetry, measured at every level is also calculated.
An energy index is also included. Again, if there is
100% distribution, the energy score would be 100.
• Another feature of sEMG scanning is the asymmetry Many times, when scanning young people, there is
graph. Using the data from the bar graph, the software good symmetry and pattern but the activity is very high.
will produce a chart on how the “tug and pull” of excess They would have a > 100 score inferring dysponesis.
NM action as it is directed to the spine. Persistent It is a common finding for there to be an elevated
asymmetry that has higher amplitude can cause energy score in youth. It is postulated that this could
regional distortion resulting in pain and fixation. This is be associated with growth and development as well
a useful graphic to highlight the connection between as (hopefully!)lesser amounts of adipose tissue. It is
postural shift and active subluxations. A note regarding desirable to aim at all three scores approaching 100.
scoliosis and the asymmetry graph: The seated,static
protocol fixes the ischial tuberosities and can artificially
balance the sacrum. This means that there could
be low, symmetrical activity. As well, many scoliosis Synopsis: Think energy expenditure and
are rigid and compensated. This could mean that exhaustion when interpreting sEMG. It can be
the muscle tone is compensated as well. This under used to identify regional muscle activity but it is far
activity may not show up on the asymmetry graph. A more practical to use it to identify the exhaustive
suggestion to see how active a scoliosis is: Perform a nature of being subluxated. The term dysponesis
standing sEMG and review the asymmetry graph. is used to describe this inefficient energy usage.
Motor neural measurements are an essential
component in vertebral subluxation analysis.

SURFACE ELECTROMYOGRAPHY 9
Thermograhic Analysis (NT) using the NeuroTHERMAL™

Thermograhic Analysis (NT) clinician can now see what the “normal” set point is
and compare the “heat” of inflammation at other areas.
using the NeuroTHERMAL™
This feature is excellent in qualifying and quantifying
an inflammatory reaction and is useful in impairment
• From the early days of the 20th century chiropractors
assessments and clinical updates.
have used thermal instrumentation to identify the
relationship of regional autonomic disruption associated • The sympathetic motor system originates throughout
with spinal subluxations. Palmer College leased the the thoracic spinal nerve region. Pre-ganglionic
famous Neurocalograph beginning in the 1920’s so that fibers associate with one another as they exit the
doctors could determine where the “hotboxes” were IVF through the Recurrent Meningeal Nerve (RMN).
along a spine. Thermal scanning became the bridge These associations mean that a disturbance at one
between spinal health and whole-body health care. In particular level can affect 2-3 levels above or below the
today’s world the term hotbox has long been replaced actual segment where there is a primary interference.
by a variety of neural disturbance concepts. Yet, the From the IVF, the preganglionic fiberscoalesce in the
original Latin descriptors of inflammation,rubor, tumor, sympathetic ganglionic chain. From there, the post-
dolor and calor are still relevant today. It is well known ganglionic fibers connect to the end organs. When you
that persistent sympathetic tone associates with a pro- consider the impact of regional dysautonomia,think of
inflammatory state. Inflammation is at the foundation of the term dysregulation and remember that this neural
most disease states. It is important, however to note system regulates the blood vessels, glands and organs.
that the NeuroTHERMAL does not detect areas of • Sympathetic motor fibers release adrenaline-like
inflammation directly. It certainly will uncover temperature substances to affect vasoconstriction and vasodilation in
variations from region to region but it is used to detect response to overt stress. If the stressors should be come
asymmetrical temperature variation at individual spinal persistent, as in a subluxation, this switching mechanism
levels. Example: L5-S1 may be palpably inflamed. is altered and the blood flow is affected. This can and
When scanned, it shows no thermal asymmetry. This is does happen unilaterally at all levels of the spinal nerves
because it was equally “hot” on both sensors placed on when reacting to persistent stress. Because blood flow
either side of the spine. Another example to consider: is associated with temperature shifts, an asymmetrical
A Red bar arises at the same L5-S1 region on the RHS. reading along the spine correlates to dysautonomia.
You may think that the RHS is hotter than the LHS. Not This imbalance can be rated and color coded as it is
necessarily. It could mean that the one side is cooler in the sEMG. Uematsu et. al., from John Hopkins wrote
than the other. The software is designed to associate the gold standard paper on dysautonomia and thermal
temperature differentials from LHS to RHS as that is what asymmetries. The research confirms the end organ
the studies indicate being associated with dysautonomia. association between paraspinal thermal variances.
An actual segmental thermal vs. NeuroTHERMAL scan
can be very useful in comparing region to region. • The NeuroTHERMAL™ is a wireless device that
One of the outstanding features of the INSiGHT TM uses a calibrated rolling mechanism to accurately
software is the ability to compare the NCM readings to convert speed and distance when tracking along
the DTG readings. NCM stands for NeuroCalometric the spine. Accelerometers detect speed while the
and it is associated with the segmental, Left to Right NeuroTHERMAL™ calculates the distance from the
comparisons. The DTG readings(Dermo Thermographic) wheels movements. Beginning at S1 a rolling scan up
are based readings compared to S1. This means that to and including C1 bilaterally, takes only seconds to
each segment can be evaluated as to whether it is complete. The data is displayed in 2 formats. The line
“hotter” than S1. This is particularly useful when we are graph is ideal for overlay studies to detect pattern
identifying inflamed areas. The NCM may actually show breaks. An ideal scan would show a back and forth
no active reading as there is no segmental imbalance; activity very close to the centerline. Any thermal
both sides are equally “hot” when bilaterally or centrally variance greater than the acceptable variance as noted
inflamed. On the other hand, with a DTG reading the by Uematsu will record as a color-coded asymmetry.

THERMOGRAHIC ANALYSIS (NT) USING THE NEUROTHERMAL™ 10

Thermograhic Analysis (NT) using the NeuroTHERMAL™

that baseline temperature. Certain techniques use DTG

protocols as part of their analysis. CLA recommends
the use of the NCM setting as your primary default.

Synopsis: Asymmetrical thermal control in the

paraspinal region is a remarkable window into
the regulation of end organs, blood vessels
and glands. The sympathetic motor system can
be viewed as it regulates vasoconstriction and
vasodilation. A shift in sympathetic balance alters
the thermal regulation, which can help the patient
understand the connection between spinal care
and whole body health care.

• It is common to see a clumping of the results. The

color bars will clump together and there can be a
“crescendo effect” the center reading will be the
highest with a lessening at 2 or 3 levels on either side.
As we discussed earlier, the RMN travels 2-3 levels
above and below the original site of dysautonomia.
Therefore, we believe it is best to interpret the scans in
terms of the ganglia rather than on an individual spinal
level. The software allows for the line graphs to be
overlaid on one another. This allows a greater ease in
determining pattern analysis.
• The NeuroTHERMAL™ uses infrared, thermopile
technology. It is extremely accurate and is used
in research and industrial application worldwide.
Two engineered sensor cases ensure that ambient
environmental temperature changes are minimized. The
sensors’ positions are controlled by setscrew, which
allow any size of spine to be assessed accurately. The
wireless application and the touchscreen capabilities
built into the software allow tablets or laptops to be used
in tableside or screening situations. NeuroTHERMAL™
offers incredible versatility and accuracy.
• The software allows two settings for NeuroTHERMAL™
data collection. The most common setting is NCM-
Neurocalometric. It measures level-to-level symmetries
and compares them to the internal database. The DTG-
dermothermograph identifies a baseline temperature
at S1 and then compares the readings at each level to

THERMOGRAHIC ANALYSIS (NT) USING THE NEUROTHERMAL™ 11

Inclinometry (ROM)

Inclinometry (spineROM) after the other. The software prompts the examiner,
which ROM is next to be measured. In a very short time
• Engineers have always pondered the question of all cardinal ranges can be evaluated.
whether structure governs function or vice versa. Spinal • The examiner has the choice of two databases to
motion is accomplished by the action of muscles on compare the results with. Validated clinical databases
joints. For motion to occur a neural signal (CONTROL) from Spine and the AMA are available in the software.
must initiate a muscle (ACTIVE) to contract,allowing The most common choice is the AMA database.
the spine (PASSIVE) to move and respond. Postures
• Adding the Inclinometry scores to the CORESCORE™
and spinal functions are a result of this triad, which
allows the clinical team to generate a CORESCORE+™.
came from Kapanji’s research into kinesiology. When
This score was originally named the Neuro-Spinal
the control system is altered, the active system under
Functional Index (NSFi). It is an advanced approach to
performs and there is a shift in alignment of the passive
the CORESCORE™ as it adds the components of spinal
system. This model of asserts function governing
motion and sensory inputs (SpineSENSE). Many teams
structure but, because neurology is embedded in the
use the CORESCORE+™ as the baseline assessment for
passive joints as proprioceptors,the altered position
patients exhibiting spinal symptoms,restricted and painful
and motion becomes an added stressor to the control
motion or are in need of added quantification as in
system. In essence, a closed loop of persistent
motor vehicle injuries or any other trauma. Typically, the
malfunction has developed. This endless loop of altered
SpineSENSE is added as a fifth sensor score when there
control and motion is known as dyskinesia. The resultant
is a need or desire to map painful or sensitive regions.
effect can be a subluxation if this triad is in the spine
and neural control is associated with CNS function. • In restorative and wellness care models, spinal
Dyskinesia is noted as a component in all models of function generally responds quickly to chiropractic care
subluxation. A method of assessing dyskinesia is to when compared to neural re-habituation. Many teams
measure regional ranges of motion (ROM). who begin with the CORESCORE+™ baseline move over
to the more convenient 3-technologyCORESCORE™
• Range of motion has been a cornerstone of the
assessment as care progresses.
chiropractic examination procedure from the earliest
days. It is a simple yet validated measurement that • ROM is perhaps the most easily understood and
quantifies functional ranges of motion. ROM looks at the experienced improvement is spinal-neural care. It is a
global activity of regions of the spine. g., Cervical spine, valuable tool for helping patients recognize how well
Lumbar spine. The global ROM is ideal to show patients function is returning. Accountability to exercise and
how a spinal region has become guarded as it protects postural retraining is more evident when ROM is used.
against added insult or injury. As joints and muscles
remain restricted,deterioration in the ROM is likely. As the
neural tension is reduced while under care the guarded
Synopsis: Inclinometry (ROM) is a foundational
response is no longer necessary and a recovery of the
exam procedure in chiropractic offices.
ROM begins. As restorative movements and exercise are
Dyskinesia is both a cause and an effect of
added into the care plan, the ROM measurement can
the subluxation process. DualInclinometry is a
indicate both rehabilitation and re-habituation.
fast and simplified procedure that can easily
• Dual Inclinometry is an accurate and reliable way show the patient how function and control
to wirelessly and digitally record spinal ROM. A base are returning as the guarded response to the
unit is affixed to the inferior portion of the measurable subluxation is reduced. Using Inclinometry
region using a convenient Velcro strapping system. A allows the clinical team to report the spinal
satellite unit is affixed, using Velcro straps again, to the neural functional improvements using the
caudal portion of the measurable region. A sequence CORESCORE+™.
of prescribed movements are then performed, one

INCLONOMETRY (SPINEROM) 12
Pressure Algometry (SpineSENSE)

Pressure Algometry (SpineSENSE) • SpineSENSE can be added into the CORESCORE+™.

This score can be generated without the use of
• There are three divisions to the CNS: Motor, SpineSENSE. If the patient is asymptomatic and
Autonomic and Sensory. The subluxation process is a perhaps initiating wellness care, the CORESCORE+™
global event with regional reactions. The entire CNS is records the SpineSENSE portion as 100%, as the
affected as the subluxated state of the patient persists protocol considers there to be no sensory derivation.
and emerges. A complete assessment of the patient Because the SpineSENSE is a simple test to apply, we
includes and evaluation of the sensitivity and symptom recommend the use of SpineSENSE whenever the
profile. The gradual loss of control and function can ROM scoring is included in the testing. This ensures a
be a mostly silent process. However, as more change more accurate CORESCORE+™.
occurs, an increase in symptoms can emerge. The
recognized method for assessing sensitivity is to use
pressure Algometry (SpineSENSE). Synopsis: Pressure Algometry is a subjective test,
• Unlike the other objective tests used in the which adds to the calculation and the accuracy
CORESCORE™, SpineSENSE is a subjective test. Pain of the CORESCORE+™. It maps out the sensitive
and sensitivity can be rated by the individual and then areas and can help detect inflamed regions
compared on subsequent tests. Paraspinal pain can be paraspinally. Improved SpineSENSE results inspire
linked to the inflammatory process and so SpineSENSE the patient and can be used in inter-professional
is useful in creating a pain map of the extent of the discussions.
inflamed tissues. However,the greatest value of an
SpineSENSE test is for the patient. It confirms the level
and extent of the pain they are experiencing. They are
able to literally view a map of their spinal pain.
• Performing a SpineSENSE test is straightforward. It
can be performed in a seated posture or lying prone.
The area of chief complaint (AOCC) is noted by the
examiner. The examiner then moves 3-4 segments
away from the AOCC and presses in the paraspinal
tissues, bilaterally, to record a normative baseline. The
patient is instructed to either push a hand held button
or tell the examiner, “when the pressure changes to
pain”. The SpineSENSE records the amount of pressure
at that instant. The examiner then goes to the AOCC
and performs the test bilaterally again. Generally the
painful are aresponds to less pressure before pain
occurs. The software calculates the difference and
then graphs the results in three categories: mild (green)
moderate (blue) or severe (red). More than one region
of the spine can be examined at the same time.
• Oswestry pain mapping is a standardized and
recognized method of subjective pain rating. The use
of SpineSENSE is useful in much the same way. Insurers
and other health professionals can easily interpret and
use this data. As well, the patient is motivated as their
pain maps change and improve.

PRESSURE ALGOMETRY (SPINESENSE) 13

Conclusion

BY CLA

Conclusion:
The chiropractic message has always been centered entire nervous system. Every thought, action or feeling
on the principle of “arousing Innate”. The body/mind acts through the interface of the CNS as it responds and
is a remarkably intelligent system that can recognize reacts to the demands of the moment.
its environmental needs and adapt instantly IF there Using the CORESCORE is the ideal approach to
is an efficient nervous system in play. Its repair and creating a care plan that is responsible and allows goal
regulation features are always directed towards adapting setting and tracking of results. Using accurate and
and working efficiently. Wellness goes far beyond this reliable instruments and reporting with ease makes
simple adaptability and is organized around creativity. chiropractic practice an exciting and fulfilling adventure,
The human experience is reflected by the tone of the each and every day.

CONCLUSION 14
 CLA provides scanning technologies that introduce
chiropractic as it is meant to be. There is no better way
to showcase your office than to do community and
corporate screenings.

Contact CLA today to find out how easy it is to

use the neuroTHERMAL, the CORESCORE, and
other precision instruments in your practice

702-848-SCAN (7226) or Info@InsightCLA.com

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