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Phillip Ebrall


Subluxation, Systematic Review, Perspectival Truth


Objective: To report the outcome of a systematic review that provded no evidence for the clinical entity chiropractors call subluxation and to propose a meaning that explains the continued use of the term in conventional chiropractic practice.

Methods: A systematic review was conducted in accord with the Cochrane guidelines. The results present 1 possible means for conventional chiropractors to continue their use of the term subluxation.

Results: There are no evidence-informed quantitative data of subluxation in the context of its application in chiropractic. An explanation is given. This suggests that quantitative inquiry is unproductive in ‘proving’ subluxation exists and that the most informed reports of the meaning of subluxation may be found in the qualitative clinical literature of chiropractic. The profession’s academics and regulators must appreciate that for a great many chiropractors subluxation is a valid clinical construct underpinning daily practice in over 90 countries. I propose use of the philosophical tool of perspectival truth to assist our reconciliation of clinical behavior and patient outcomes in the absence of quantitative evidence.

Conclusion: A structured examination of the chiropractic literature did not return any quantitative evidence of subluxation; however, a knowledge of the literature shows the greater majority of chiropractors find clinical value in the inclusion of the concept in clinical practice. The philosophical tool of perspectival truth is one way of reconciling this conundrum.


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