Chiropractic Therapy

Standards of Education & Practice

Alberta Association of Complementary Equine Therapy (AACET)

 

Education and Practice Standards for Chiropractic Therapy

 

Glossary of Terms:

 

Standard:

A standard is a description of a minimum level of performance one is required to demonstrate in the achievement of a task.

A standard is stated in observable and measurable terms.

It must be precise and clear to the therapist who is held accountable for accomplishing it.

It must also be clear to the clients and to the public (who are assessing the therapist's ability to accomplish a task as measured by the required standard).

Standards include one or more of the following measures:

● Technical Quality

● Interpersonal Quality

● Safety

 

Client:

The use of the word client will pertain to the animal owner or caretaker.

 

Patient:

The use of the word patient will pertain to the equine to which the therapy is being provided.

 

Chiropractic:

Chiropractic refers to a health profession concerned with the identification, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation.

 

Vertebral misalignment:

Vertebral misalignment is the physiological and neurological disturbances caused by two adjacent vertebrae pinching a spinal nerve and related structures.

 

Treatment:

The method with which the practitioner will correct a vertebral misalignment and/or any soft tissue problem that they find while working with a patient.

 

Treatment protocol:

The complete plan that the practitioner feels is appropriate to provide the desired outcome for the patient.


Standards of Practice:

 

AACET has approved  the education and practice standards created by its equine chiropractic therapists.

Through the development and use of these standards, AACET continues to display it’s commitment to serving its members while  promoting the highest possible quality of chiropractic therapy performed in a safe and ethical manner.

 

The AACET standards of practice for chiropractic therapy, were developed to assist the equine professional Chiropractic Therapist to:

- provide safe consistent care

- determine the quality of care provided

- provide common base to develop a practice

- support/preserve the basic rights of the clients and professional Chiropractic Therapist

- assist the public in understanding what to expect from a professional Chiropractic Therapist

 

This document allows the professional Chiropractic Therapist to evaluate and adapt performance in his/her equine chiropractic practice. The professional Chiropractic Therapist can evaluate the quality of his/her practice by utilizing the standards of practice in conjunction with the AACET’s Code of Conduct, Bylaws and policies, as well as the precedents set by the AACET Incident Inquiry sub committee and the Board of Directors.

 

The standards of practice have been developed to describe the expected conduct as well as all treatment protocols that the professional Chiropractic Therapist is required to perform while operating within the respected scope of practice. These standards have been created to reflect the specific high expectations of AACET and the public. This live dynamic document will evolve as changes in practice require it to and or as AACET’s Bylaws require.

 

It will serve as a reference tool for:

- the professional Chiropractic Therapist  to better understand their job requirements

- educators to address as objectives in curriculum design

- AACET members

- complaints investigations

- discipline hearings

- quality assurance

- client relations

- the public

Scope of Practice:

 

The scope of practice in chiropractic therapy is:

In their practice,professional Equine Chiropractic Therapists will perform one or more of the following:

1. Assess the skeletal system of the equine patient.

2. Treat the misalignment with the intent of producing a therapeutic outcome, as well as providing preventative care.

3. Throughout the session discuss with the client the findings and treatment as well as any preventive care and maintenance that may assist the future of the equine’s wellbeing and health.

4. Suggest referrals to other professionals, when deemed necessary and appropriate in the best interests of the patient.

5. Release of information regarding a client or patient,to any person except as required or allowed by law is considered to be misconduct. in an effort to facilitate a diagnosis or  treatment, involvement of  associated therapists or a veterinarian may be required. this is permissible only with prior client or caretaker  consent.

 

EDUCATION STANDARDS

 

Equine course based in chiropractic therapy with a minimum of 320 instructional hours.

AACET’s minimum CE hours are sufficient.

 

The chiropractic therapists must have an understanding of the following:

- equine vitals including respiration rate, pulse rate and temperature

- contraindication as it relates to chiropractic therapy

- basic conformation and biomechanics

- basic hoof anatomy and function

- the phases of misalignment

- joint articulations and imbrication of the spinous process

- origin and insertion points of soft tissue, i.e tendons, ligaments

- growth plate closure rates

- joint function and range of movement including spinal joints


PRACTICE STANDARDS

 

Contraindications:

 

1. Safety - for you, the equine and the client

2. Working alone - another person MUST be present

3. Never work beyond Scope of practice and/ or your level of education

4. Fractures - known or obvious

5. Recent Trauma - when suspicion of underlying contraindications may exist or immediately

after a traumatic event

6. Stress - which compromises vital stability

7. Vascular conditions - know, obvious or when suggested by vitals

8. Tumors - known or obvious

9. Bone Infections - obvious

10. Nerve Damage - known or obvious

11. Old surgical scars - requires investigation

12. Profuse Joint swelling - if not located in lower limbs (client should be referred to vet regardless of location)

13. Skin Lesions - known or obvious

14. Medications - which would compromise the practitioner’s safety or interfere with the assessment of the patient

15. Neurological/Ataxia - if movement is indicative of neurological deficits (proprioceptive ability) or if mechanism of injury suggests it

 

Communication Standards:

 

The following is required to be discussed with the client:

1. Fees

2. Patient Information including breed, age, sex, discipline (prior & previous), pertinent past history, medical conditions, dental and hoof care as well as any other information that may assist the practitioner in their assessment.

3. Chief Complaint including mechanism of injury, onset, what provokes or quiets issue, any interventions that have already been provided.

4. The practitioner’s determination as to if Chiropractic Therapy is needed or if referral to another modality or a veterinarian is alternately required.

5. The practitioner’s treatment plan and the steps required to carry out the treatment.

6. Any suggested post treatment owner care for preventive measures and maintenance.


Operation Standards:

 

1. The practitioner will ensure the safety of themselves, the patient  and the client, to the best of their abilities, throughout the duration of the appointment.

2. The practitioner will obtain a complete patient history as well as any other relevant information.

3. The practitioner will obtain written consent or signed authorization ,and that all medical information to be up to date and true. (To be provided by client or caretaker.)

4. The practitioner will note any issues related to conformation, evident injuries, abnormal posture/stance abnormalities.

5. The practitioner will perform a static balance analysis.

6. The practitioner will obtain a complete gait analysis including movement at the walk, trot, and backing up. If the practitioner feels it is necessary and appropriate they will also analyse movement while circling, while under saddle, or while performing any other movement where there may be cause for concern.

7. The practitioner will assess joints using the following techniques:

- Static Palpation - stationary balance assessment to assess possible misalignment (displacement) of joint

- Motion Palpation - pressure palpation of joints to assess healthy function

- Muscle Palpation - checking for rigidity, tenderness and heat etc

- Set up - prepare to deliver the thrust and load the joint

- Perform adjustment

8.The practitioner will use their hands and body weight alone to deliver a high velocity, low amplitude thrust to correct vertebral and joint misalignments. The use of tools or instruments, of any kind, to deliver an adjustment are prohibited.

9. Direction of spinal adjustment must reflect the imbrication/angulation of the spinous process.

10. The practitioner will incorporate soft tissue therapies and stretching throughout the treatment, as they see fit, to complement and assist their adjustments. The practitioner will  ensure that any stretching they perform is within the abilities of the patient and is performed with respect to joint function and capabilities.

11. The practitioner will observe the patient movement post treatment.

 

Ethics Guidelines:

 

Although the practice of these guidelines are not required, it is highly recommended that all Chiropractic Therapists adopt and incorporate them in their treatment regime whenever possible.

1. Always act as an advocate for the patient.

2. Advise clients to avoid riding (loading the spine) and/or trailering the patient for approximately 48 hrs post treatment. Meaning unless extreme circumstances warrant it, treatments should be performed and provided at the horses location.

3. Assess saddle fit for the patient or refer to a saddle fitter if suspicion of saddle related injury/trauma exists.

4. Prioritize primary care issues such as hoof care and dental care above the need for chiropractic therapies when the case requires it.