TECHNICAL PAPER

Written by Laura Henson, D.C. in collaboration with Dr. John in 1993.

Abstract:

Directional Non-Force Techniquer Chiropractic, also known as D.N.F.T. is an original chiropractic technique developed by the late Richard Van Rumpt, D.C. He strongly asserted that his technique was chiropractic in nature and fundamental and true to the founding principles of our profession.

The technique is now being researched, developed, and taught by Dr. Christopher F. John, the successor to Dr. VanRumpt. D.N.F.T. chiropractic utilizes a challenge and "leg reflex" in locating subluxations, and a light thumb thrust in administering adjustments. One important claim of doctors who use D.N.F.T. Chiropractic is that their patients recover fast and hold their adjustments longer as subjectively compared with many other forms of chiropractic.

Statement of Purpose:

The purpose of this article is to inform readers on the history, philosophy, methods and results of D.N.F.T. chiropractic

History of the Technique:

Dr. Richard Van Rumpt was known as a forceful adjuster while he was a student at the National College of Chiropractic. One day, in 1923, a regular patient of his was late for her treatment. Dr. Van Rumpt only had enough time to perform digital pressure on her. The next day she returned to tell him that she had never felt better. Subsequently, Dr. Van Rumpt's curiosity was aroused.

He also held a fascination with the phenomenon of a leg pull-up. Dr. Van Rumpt spent the next fifteen years experimenting with light force corrections and leg pull-ups to create the foundation for the idea of D.N.F.T. chiropractic Eventually Dr. Van Rumpt felt his discovery had to be shared. He began teaching D.N.F.T. chiropractic in the late 1930s in New York and throughout the country from the early 1940s until 1986. Since his discovery of D.N.F.T. Chiropractic in 1923, the technique has undergone many changes and refinements.

D.N.F.T. Philosophy:

Find the subluxation, fix it, leave it alone to allow the body to heal.

Any one subluxation, anywhere on the body, can be corrected in one visit. This generally remains permanent unless and until a new subluxation producing factor may arise.

The body's innate intelligence is the governing principle in diagnosis and correction, and through the analysis we can distinguish between involvement(s) of vertebrae, ribs, discs, muscles, ligaments. The challenging of different types of structures which are all related to a discreet spinal level has revealed that on different occasions and on different patients, the D.N.F.T. leg reflex will yield a positive test on different combinations of those structures. For example, the vertebrae, disc, and rib at one level could be involved in a dorsal subluxation complex, while the related muscles (attached there) will not appear as a positive test. On other occasions, a disc might appear as being a positive test, while the adjacent vertebral rotation may not be positive on the test (implying that the rotation is not responsible for the nerve interference). This is how D.N.F.T. testing can differentiate the source of the nerve interference.

Fixations and distortions are protective mechanisms on the part of the body which protect the nervous system against further irritation from the subluxation. They should not be directly thrust upon since they will resolve themselves once the true subluxation is corrected. While treating fixations may give temporary relief and temporary increased range of motion, such results are short-lived unless the subluxation has been completely corrected.

X-rays, although they have clinical and diagnostic significance in many respects, are not a reliable means of determining nerve-interference producing subluxations.

The rationale for utilizing light force in adjusting is as follows: D.N.F.T. chiropractic, through the "leg reflex" can determine specifically how a bone, muscle or ligament is misaligned. Once these specific vectors have been analyzed, it is theorized that only a light force is necessary to correct the misalignment.

Innate Intelligence has been described by Dr. VanRumpt as the inborn intelligence within the body. The concept of Innate as being a reflection of Universal Intelligence is consistent with the founding premises set forth by D. D. and B. J. Palmer. In D.N.F.T. chiropractic, the Intelligence is thought to be utilized in the leg check in that it is the body itself (and not any other theory or paradigm) which is the indicator for location and direction of corrective thrust. To quote from Dr. VanRumpt, "it is the intelligence of the patient's body directing the approach as opposed to the 'educated mind' of the doctor."

The proposed biologic model is consistent with the homeostatic nature of the body; if there is neurodysfunction, there is associated bio/electro/magnetic imbalance. In D.N.F.T., it is felt that these associated imbalances can be detected through the process of challenging and leg measuring.

Materials and Methods:

Materials utilized in D.N.F.T. chiropractic

Shoes which are specially tailored to be suitable for the procedure of performing the "leg reflex" are necessary for accuracy and reliability in D.N.F.T. diagnosis. It is best not to use the patient's shoes since the heels are often uneven.

A thumb cot is used in performing the thumb toggle so that there is no slippage on the patient's skin.

Two wooden dowels, referred to as "plexors," are used for the adjustment of posterolateral intervertebral disc subluxations. Used at C7 to L5. In rest of the cervical spine and for all anterolateral discs, the thumb is used.

A part of D.N.F.T. chiropractic is the use of copper during the diagnostic procedures. A small copper rod is held by the patient and the doctor puts a copper square in his/her pocket during treatment. When Dr. Van Rumpt was researching the leg reflex, he discovered that sometimes he would get "false pull-ups." By false pull-up it is meant that the leg would pull-up every time any structure was challenged, or in too many directions on one structure. Put another way, he would get false positives. He theorized that the leg was pulling up in reaction to the patient's external environment. He felt that the patient was reacting to external "allergens" in a way that mimicked subluxations. Dr. Van Rumpt then discovered that by using copper the effect of the external allergens was neutralized, the incidence of false leg pull-ups diminished, and his results greatly improved. Although not scientifically documented. this effect has been corroborated by many D.N.F.T. field doctors.

A 100% white cotton gown is utilized for two reasons: One, access to the spine is necessary for accurate treatment; and two, patients do not exhibit allergic reactions to it since it seems to be a neutral material.

Method of D.N.F.T. Analysis and Correction:

A. Definitions:

Challenge:

The theory used in D.N.F.T. chiropractic is that when pressure is applied to a tissue there is an immediate response by the body against the invading force. For example, when a vertebrae is subluxated and then pushed even further into its direction of subluxation, the body will react in some way. One way it may react is to contract the muscles on the side of the body on which the challenge occurred. This would then produce a "leg pull-up." The leg that pulls-up in D.N.F.T. chiropractic is termed the "reactive leg.

The leg reflex:

The leg reflex cannot be defined as either "normal" or "abnormal" in the general population. The leg reflex is a phenomenon which every living person possesses; the reflex may exist either on the right or left side of the body and its presence is not a pathological or neurological indicator. It's reason for existence can only be theorized at the present time.

The reactive leg:

The reactive leg is defined as the leg that pulls up when performing the leg reflex. A description of the leg reflex is as follows:

The doctors hands evert both of the patients feet (with properly tailored D.N.F.T. shoes) simultaneously to full range of movement. The movement closely, although not exactly, most resembles the orthopedic nomenclature of "eversion" in that it is a movement about the mortise joint of the foot. This first step allows the chiropractor to determine if there is any static leg length deficiency; at this point, whether the deficiency is anatomic or functional is unimportant. The doctor inserts a heel lift into the shoe of the deficient leg (if one exists) in order that accurate D.N.F.T. leg measuring may proceed. The reason for this will become clear below.

One leg is then selected for testing. The foot of this selected leg is now "everted" to only 50% of its range of motion at the same time that the opposite foot is "everted" fully. If there is a pullup or shortening of the "half-everted" foot, then the determination is that it is, in fact, the reactive leg. This "pullup" is generally between 3/8 to 1 1/2 inch. If no such pullup or shortening takes place, then the doctor must continue the reactive leg determination procedure by performing the step below.

Procedure "b" is now applied to the patient's other foot to ascertain if, when it is half-everted at the same time that the opposite is fully-everted, there occurs a pullup or shortening of that leg. If so, then the doctor has now determined the side of the reactive leg.

As a general point of clarification, every individual has a reactive leg on one side or the other. There can only be one reactive leg phenomenon at any one time. It is impossible that both legs could exhibit the pullup. The phenomenon of the reactive leg pullup is exhibited each and every time it is applied in the absence of "challenging." This is the process which has been described above. Once the process of challenging of structures for subluxation is employed, then the reactive leg will exhibit a pullup only if a tissue has been challenged into the direction in which it is subluxated. In other words, a negative test (absence of subluxation) will be seen as the lack of the pullup of the reactive leg.

Every application of the under-over style of eversion is a discreetly separate test and is not influenced by any previous testing. The feet must be completely released after each test to return to their normal position in order for this to be so.

In order that practitioners have the ability to perform the D.N.F.T. leg measuring, they must be trained personally by Dr. John at a D.N.F.T. seminar. The reason for this is that the mechanics of the eversion must be performed in an exacting manner; any departure from the D.N.F.T. method can produce visual error in leg measuring. No written description of the procedure can result in proper performance of the leg measuring.

Clinical Findings:

Clinical findings have repeatedly shown a high correlation with symptomatic relief as well as improvement in range of motion, orthopedic, and neurological tests. This has been well documented in the clinic records of many D.N.F.T. practitioners. These patient files document patient progress (with patient's written report on each visit) with the subluxation analysis of each visit.

The leg reflex is an indicator of the presence and direction of subluxation only; it is not a procedure which can distinguish different diagnoses which could possibly result from the same complex of subluxations. An example of this would be that the leg check would not, in itself, differentiate between low back pain and sciatica. Such differential diagnosis would be the result of application of standard orthopedic and neurological tests.

The D.N.F.T. leg reflex cannot be used to diagnose a clinical condition. The role of the D.N.F.T. leg reflex is to determine where in the body subluxation is present. Often, the general location of subluxation will correlate to the level or location of the diagnosed condition; but the actual diagnosis will consist of the appropriate clinical, Xray, and/or laboratory tests and procedures.BASIC PROCEDURE OF D.N.F.T. chiropractic:

Patient preparation:

The D.N.F.T. patient removes all jewelry and only wears a 100% white cotton gown. Dr. Van Rumpt and other D.N.F.T. doctors have observed in their clinical practices that the purity of white cotton prevents any allergic reactions from occurring, thus preventing any false reactive leg pull-ups. In addition, the patient also holds a piece of 100% copper as does the doctor. This is done for the same reasons as stated above. Finally the patient wears a pair of specially tailored D.N.F.T. shoes appropriate for observing the leg reflex.

Determining the reactive leg:

The leg reflex is utilized to determine the reactive leg. See earlier descriptions for details. Once the reactive leg is determined it is used to analyze subluxations in the body. The reactive leg is used throughout the treatment and only changes during an office visit under two instances: 1) when a major structural alteration has occurred through correction or 2) after cranial analysis and correction. Concerning the former, an example would be when an area has been corrected which caused a major alteration in the structure of the body, thus producing a switch in the reactive leg to the opposite leg. See the next paragraph for an explanation of cranial involvement.

Cranial Analysis and Corrections:

Before any D.N.F.T. patient can be treated, he/she must have any or all cranial subluxations corrected. It is believed that the cranials have compensated for other biomechanical problems of the body and only after correcting the cranials will the true subluxations in the body show up. Correction of the cranial subluxations may cause the reactive leg to switch to the opposite leg.

Subluxation Analysis:

The body is then examined via challenges and the leg reflex for subluxations in certain areas, depending on the patient's complaint.

Musculoskeletal subluxations: All involved musculoskeletal areas are checked for subluxations as described above. In some areas of the body certain patterns must be used in analysis. For instance, to challenge and correct deeper structures, the superficial structures must first be challenged and corrected for subluxation (if they are indeed subluxated).

Disc subluxations: Disc subluxation has been defined within the context of D.N.F.T. chiropractic as an abnormal wedging, bulging, or herniation of the nucleus pulposus and annulus fibrosis. The ability to distinguish between a slight bulge and a frank herniation or prolapse is not within the ability of the challenge and reactive leg reflex to distinguish. A positive test with D.N.F.T. chiropractic will reveal whether any of the above are present and (more importantly) if they are actively producing nerve interference.

D.N.F.T. Adjusting:

Despite the fact that Dr. Van Rumpt named D.N.F.T. chiropractic a non-force technique, it is, in reality, a low force technique. It is high speed, low amplitude, and impulse in nature.

Musculoskeletal adjusting: This is performed by contacting one thumb on the tissue to be corrected (taking tissue slack in the proper direction) reinforcing with the other thumb, applying a slight force on the contact to hold tissue slack, bending the knees while approximating the elbows, and finishing with a quick bringing of the elbows together in a "snapping" motion. A thumb cot is worn on the segmental contacting thumb to prevent slippage.

Disc adjusting: Wooden plexors are used for disc adjusting. The plexor contacts the intervertebral joint space, taking tissue slack in the proper direction, and a quick, shallow thrust is done in the direction of correction. The only exception is the cervical spine, where the thumb tip is used as opposed to a plexor.

The reduction of a herniated disc has been clinically documented in at least one case study by Dr. John. In one example of a postero-lateral and postero-central C5-6 disc herniation, it was demonstrated on both MRI and CATSCAN that the disc almost completely filled the IVF and indented the thecal sac. After approximately two months of treatment when then patient underwent surgery (in spite of 80-90% symptomatic improvement), the surgeon was unable to visually discern even slight bulging, much less herniation of that disc. As this is so uncommon, the surgeon spent over three hours in attempting to uncover some bulging, to no avail. These findings are the subject of a case study that is under preparation.

Other clinical evidence of D.N.F.T. disc herniation reduction is presently being collected for future publication. The above referenced case study is available upon request.

An incorrect adjustment with any technique, including D.N.F.T. chiropractic, will not result in a negative D.N.F.T. challenge and leg check test (which would indicate lack of subluxation). However, it is possible to create a new subluxation by thrusting in a previously clear area.

Outcome of Treatments:

It has been clinically demonstrated for many years by experienced and proficient D.N.F.T. practitioners that one properly executed sequence of correction upon a subluxated segment alleviates the need for any further correction. This is demonstrated by a negative D.N.F.T. test on future examinations on the same patient. Possible exceptions to this general rule could include:

A true disc herniation:

A segment in the lumbar or dorsal which was previous part of a (larger) "pattern." The second appearance of this segment is not considered a repeated correction as the context of the subluxation is different. This is a more complex concept which can only be appreciated with considerable background explanation. Even with this rare exception, however, the level of subluxation is not experienced more than two times.

The leg check assessment correlates near perfectly with the abatement and relief of symptoms, given that the inflammatory response has subsided with sufficient passage of time. Upon examination on a follow patient visit, the absence of a positive D.N.F.T. test at a particular level has very high correlation with the abatement of symptoms.

The correction, as measured by D.N.F.T., is permanent until trauma or other subluxation producing factors are encountered. Experience with reports by patients of cessation of the symptom complex have suggested extremely high correlation between the duration of relief and duration of a negative reactive leg test.

The use of D.N.F.T. is in the realm of misalignments which produce nerve interference; this we have previously defined as subluxation. Directly or indirectly the correction of subluxation can lead to the improvement of health in many areas such as; absence of headache, sinus problems, menstrual pain, etc.

These improvements have traditionally been thought of as being a result of the work of our profession; i.e. normalization of the nervous system's functioning by improving the relationship of structure and function.

It has been the opinion of both Dr. VanRumpt and his designated successor, Dr. John, that D.N.F.T. chiropractic possesses the highest success rate in chiropractic if one considers the following statistics:

The length of time and/or numbers of visits required to correct a given condition.

The degree of relief of a given condition.

The permanency of relief of a given condition.

The permanency of relief without the need for frequent follow up treatments.

Dr. John has indicated his willingness to loan a videotape with over two hours of patient testimonials which relate their experience with various types of chiropractic techniques in comparison to their experience with D.N.F.T. chiropractic

Scientific Research Involving D.N.F.T. Chiropractic:

Although Dr. Van Rumpt spent over sixty years of his life perfecting D.N.F.T. chiropractic, he never published any of his clinical findings. This has left some who have not experienced D.N.F.T.r chiropractic personally confused and skeptical. There is no published efficacy of D.N.F.T. chiropractic, nor is there even much of a written explanation.

A non-profit organization for the sole purpose of performing scientific research on D.N.F.T. chiropractic has been formed. Dr. Laura Henson is the president of this non-profit scientific research association which has the name: Association for Scientific Research on Directional Non-Force Technique Chiropractic. The acronym for this is A.S.R.D.N.F.T.

This organization is in the initial stages of the first scientific research study. It is entitled "Low Back Pain and Directional Non-Force Technique Chiropractic."

To get updated information or information on the organization and its research, phone the D.N.F.T. Seminars automated voice mail number 310-657-2338 and select the choice for Scientific Research.

There are many aspects of D.N.F.T. chiropractic which bring up questions. It is the ultimate goal to not only show the effectiveness of D.N.F.T. chiropractic but also explain the mechanisms that govern it.