Zeronacold laser treatments for fat reduction. Is this “cosmetic” or “therapeutic”? Until this review is completed chiropractic physicians may not use or advertise this device as current policy prohibits use of lasers for cosmetic purposes, except the four clinics with these expensive devices may continue to treat existing patients in this interim period. The ETSDP Committee recommended this be accepted as investigational with moderate risk, along with advertising standards and informed consent.

However, the OBCE is still concerned that this is more “cosmetic” than therapeutic. A full discussion of this issue will occur at the Board’s July 15, 2010 meeting in public session. The OBCE web site has more information on this issue.

Breast Thermography Standards On March 18, 2010, the OBCE adopted standards for use of breast thermography by chiropractic physicians. This followed review by the ETSDP Committee and lengthy discussions at board meetings. The Board approved this as an investigational procedure with moderate risk and determined this is an adjunctive procedure to mammography, MRI and clinical exam. A specific and comprehensive informed consent is required. The standards and the informed consent document are found as Appendix C in the Guide to Policy and Practice Questions. Currently two Oregon chiropractic physicians are actively providing breast thermography services.

Dry needling The OBCE has received pro and con testimony as to whether dry needling could be used by chiropractic physicians as a physiotherapy modality. Advocates say this is distinct from acupuncture since the needle application is to trigger points and not to traditional acupuncture points. At their March meeting, the OBCE heard from representatives of the Medical Board’s Acupuncture Committee and the Acupuncture state association in strong opposition saying this is all acupuncture. The Oregon Physical Therapy Board has said dry needling is an advanced physical therapy technique, but would require additional training and certification. Currently no U.S. chiropractic college teaches dry needling as part of their core curriculum, though one or two sponsor a CE course. The OBCE’s current position is this should be taught in chiropractic college core curriculum prior to being accepted in the Oregon scope of practice.

Zyto (& other EPFX-SCIO type devices) The OBCE receives periodic inquiries regarding so-called “energy” medicine devices which purport to use: “quantum mechanics” or “quantum biofeedback” or “nano-technology” or claims in any way to have thousands of “preprogrammed scenarios and library references organized into defined groups, which create quick and manageable patient assessments.”

These are presumed to be outside the Oregon chiropractic scope of practice until such time the specific device is reviewed by the OBCE under the provisions of OAR 811-015-0070 (ETSDP rule) and determined to be either standard or investigational.

This includes the “Zyto” device, Quantum QXCI Bio-Resonance Device, and any other devices which are similar in operation to the EPFX-SCIO device (which was previously evaluated and found to be unacceptable).

Cryoprobe This device uses compressed nitrous oxide gas to freeze to a depth of 5mm on the human skin. On March 18, 2010, the OBCE approved this (and similar devices) as standard in a minor surgery procedure.

Ellman SS Pelleve (or similar units) This is a high frequency low temperature radiowave unit, “utilized to tighten collagen within the skin non invasively.” Although this is not a laser procedure, it may be similar to the laser treatments for cosmetic purposes. On March 18, 2010, the OBCE referred this issue to the ETSDP committee for review, pending an application from proponents. Previously in September 2009, the OBCE determined a similar device, Lam Probe 4000, was not to be used.

Contact Reflex Analysis (CRA) CRA was reviewed in 2009 and its current position as standard was not changed. It was noted the CRA manual said this was an “adjunctive” procedure. The Board also said that any technique is not a stand-alone procedure.

NOTE: ETSDP stands for Examinations, Treatments, Substances, Devices and Procedures, see Oregon Administrative Rule 811-015-0070. The OBCE evaluates ETSDPs to determine if they are standard, investigational or may not be used. The ETSDP application is found on the OBCE web page as Appendix A of the Policy & Practice Question Guide.