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Research Timeline

Note: all papers published in The Upper Cervical Monograph unless specifically noted in bold.) Many papers in the early days were authored by R.R. Gregory, D.C., but no attribution given at the time.

October 6, 1971
National Upper Cervical Chiropractic Research Association is formed in Monroe, Michigan as a non-profit organization.

December 1973
First publication by NUCCRA of The Upper Cervical Monograph.
Research terms redefined, nomenclature clarified.
Research by Dr. Dickholtz, Sr. conducted to allow proper alignment and collimation of x-ray equipment.
First discussion of the Anatometer by Seemann.

March 1974
Elucidation of vertebral excursions, horizontal resultant, notch-transverse resultant, parallel forces, direction and force.

June 1974
Neurologic model of the subluxation published by Sittinger.

October 1974
Clinical research regarding performance of the adjustment resulting in decrease in errors by the adjustor.
Case study published.

January 1975
Further examination of the performance of the adjustment focusing on the 'settleback'.

May 1975
Examination of 'normal' as a concept and address of criticism.
Paper published by Seemann analyzing patient compliance and patient education.
Further examination of the adjustment regarding base of support, weight distribution, stability.
Case study published.

October 1975
Reduction pathway, neurological integrity discussion.
Case Study published.
Examination of errors in the adjustment specifically, in the turn-in-phase.
Paper published by Seemann further examining patient compliance behavior.
Discussion of four year research project involving the Anatometer.

January 1976
Case study published.
Examination of adjustic errors in the arch phase.

June 1976
Patents applied for Anatometer. (Note: cost for the research up to this point in time, in excess of $100,000.)
Examination of errors in the Roll-In phase of the adjustment.
Don Newman, Ph.D, Armed Forces Radiobiological Research Institute, lectures at conference.

September 1976
Paper published by Harriet G. Williams, Ph.D., University of Toledo, "An Anatomical-Functional Review of Selected CNS Motor Control Structures".
Case Study published.
Examination of Anatometer in clinical practice. (Pond).
Daniel C. Seemann, Ph.D elected Executive Director of NUCCA.
Examination of adjustic errors in the conversion phase.

January 1977
"The Biomechanics and Neurological Aspects of the Atlas Subluxation Complex", (Seemann).

June 1977
Examination of adjustic errors in the pelvic lever phase.
Philosophical examination of the concept of 'innate' (Seemann).

January 1978
Further elucidation of the biomechanics of the upper cervical spine, discussing lever systems. (Seemann).
Examination of adjustic errors in the triceps' pull phase.

November 1978
Examination of leg length inequality, and pelvic distortions in the Atlas Subluxation complex. (Seemann). -Finds a causal relationship between a C1 subluxation, short leg and pelvic distortion.
Further examination of the cervical biomechanics, including orientation planes, axes of motion, 'normal', fixations, angular rotation, unit movement, production of subluxation, ASC as producer of stress, center of gravity of the skull, C1 base of support.

February 1979
Elucidation of various clinical aspects of the supine leg check. (Gregory)
Discussion regarding direction of future research.

July 1979
Examination of the upper cervical chiropractic perspective by Gregory and Seemann.
"The Concept of Self Healing: Our Natural System of Defense." Eileen Metress, Ph.D.
University of Toledo.
"Neurological Foundations of the Upper Cervical Subluxation" Zoe Backman, Ph.D.
First discussion of research by Dr. Chung-Ha Suh, University of Colorado. Regarding three dimensional views of a moving spine.

January 1980
"Patient Alignment for Upper Cervical X-Rays" (Dickholtz).
Discussion of application of measurement to the subluxation and a neurologic rationale. (Gregory).

July 1980
Report of research (pilot study) regarding the center of gravity of the skull. (Seemann).
"Athropometry and Spinal Biomechanics" R.T. Anderson, Ph.D.
Anderson and Seemann presented papers at the NUCCA conference.

January 1981
Examination of the "basic types" of atlas subluxation complex misalignments.(Gregory).
"Initiating Anatometer Research", R.T. Anderson, Ph.D. Director of Research Pacific States College, Professor of Anthropology , Mills College.
Elucidation of the double pivot point system using the cephalometer. (Gregory).

June 1981
Discussion of criticisms of vectored adjusting. (Gregory)
"A Kinesiological Basis for the C-1 Adjustment". (Gregory)
"Report of Research and Training", Amerigo Biollo, D.C., R.T. Anderson, Ph.D., A report on the progress in the teaching program at the college for the NUCCA work, also discussion of current research projects at the college including Anatometer research, and center of gravity of the skull research.

December 1981
Reevaluation of the lever system in upper cervical adjusting. (Seemann) Report on new understandings in the biomechanics.
"The Cranial Center of Gravity", Jean-Paul Martinet, D.C. Life Chiropractic College-West. Summary of research by Anderson, et al., regarding mensuration of 48 specimens, 15 of which were appropriate for study.
"The Position of the Atlas: Rotation and Laterality in Pre-Adjustive Patients". R.T. Anderson, Ph.D, A. Biollo, D.C., Life Chiropractic College-West. A clinical study using x-ray analysis findings of 808 patients.

April 1982
Discussion of concept of 'normal' as relating to measurement. Problems with use of symptoms to define normal. (Gregory)
New Glossary published defining technical terms.

October 1982
"Mechanics of the C1 Adjustment". (Gregory) An overview of current understandings from a mechanical viewpoint.
Announcement of initiation of research project with Texas Chiropractic College using the Anatometer and other chiropractic clinical instruments.

January 1983
"Center of Gravity Influence in the Performance of the C1 Adjustic Motor Skill". (Gregory)
"Magnification: How much of a Problem in Spinographic Analysis?" (Dickholtz) Clinical research by Dr. Dickholtz regarding scatter radiation and use of rotatory measurement instead of linear measurement.
Announcement that an Anatometer was placed at Texas Chiropractic College and that research is underway. Findings to be discussed at the next conference by Dr. Addington.

July 1983
"Mechanical and Manual Adjusting: A Comparison". (Gregory) Discussion of hand versus instrument adjusting.
"Geometric Factors in Radiology". J. Palmer, M.S. University of Toledo.
Certification Program initiated by NUCCA.

January 1984
"An Evaluation of the Objectivity and Reliability of the Anatometer". (Seemann)
"Errors in the Performance of the C1 Motor Skill". (Gregory)

June 1984
"Some Hypotheses as to How Rotations are Produced with Cervical Subluxations".(Seemann).
"Some Basic Concepts of Mechanics" (Palmer)(Includes discussion of terms, including vectors, types of motion, torque, closed kinetic chain, etc.)
"Updating the Four Basic Types". (Gregory) Addressing the basic types of misalignments in the cervical spine and skull.
"Overcoming C1 Subluxation Resistance". (Gregory) mechanics of the triceps pull.

January 1985
"More on the Triceps Pull". (Seemann, Gregory)
NUCCRA purchases a Cal Comp 9000 series Digitizer- an electronic grid capable of sensing position of a cursor to (plus or minus) 0.0001 inch. Software to duplicate the analysis being developed. NUCCA computer upgraded.

June 1985
EMG study in progress to help explain the relationship between the biomechanical component and the neurological component. Neural imbalance in the extra-pyramidal motor tracts is thought to cause spasticity. Pilot study completed. Larger study scheduled for Fall 1985.
Pelvic Biomechanics- Anatometer study results in some answers and raises more questions.
Work continues on the digitizer.
Preliminary work underway to design a teaching instrument capable of measuring both magnitude and direction of adjustive force.
"Neurological Mechanisms of the Atlas Subluxation Complex". R. Cockwill.
Overview published in the Monograph concerning all research including: Double Pivot-Point System, Vertical Axis concept, Classifications of the Atlas Subluxation Complex, Skull Center of Gravity, Atlas Rotation, Leverage Systems in Upper Cervical Adjusting,
Vertebral Resistances to Adjustic Forces, The Multiple Support Headpiece, Anatometer Studies, Neurological Causes of Spinal Distortion, Observer Reliability and Objectivity Suing Rotatory Measurement on X-Rays, X-Ray Alignment and Patient Alignment, Digitizer Studies, Triceps Pull Adjustment, Supine Leg Check.

January 1986
"The Ponticulus Posticus of the Atlas Vertebra and Its Significance." H.S. Crowe, Sr., D.C.
"Observer Reliability and Objectivity Using Rotatory Measurements on X-Rays". (Seemann)
"Manipulate or Adjust-Is There a Difference?" (Gregory)

June 1986
"Adjusting: The Human Component". (Seemann) -discusses the notch-pisiform distance and its relationship with the horizontal resultant and the notch-transverse resultant. (Early discussion of the Reduction Pathway concept.)
Continued work on the adjustic teaching prototype continues. S. Marosi now lead developer of the prototype.
Digitizer work continues. Now working with Datagraphic Systems of Plymouth, Michigan. Feasibility study (cost $50,000) upcoming.
"The Chiropractic Challenge: Manipulate or Adjust". (Gregory) -making a significant distinction between adjustment and manipulation.
Dr. Gregory given Presidential Citation (from Ronald Reagan) for twenty years of research and dedication to the advancement of Chiropractic Science. (April 7, 1986).

January 1987
"Computerized Modeling of the Occipital-Atlanto-Axial Spine: Comments on methodology and basic physics." (Palmer) Discussed computer modeling project focusing on the geometrial (Geometrical/inertial) properties of the occipital condyles, C-1 and C-2.
"An Analysis of the Lateral Cervical X-Ray". (Seamann).study of curves, s-line, change in curve after adjustment.
""The C1 Subluxation Syndrome" (Gregory) Elucidation of the body wide effects of the ASC.
Palmer College approves the NUCCA work (Basic and Advanced) to be taught at the school.

1987
Daniel David Palmer Chiropractic Scientific Award, Honorus Causa given to Dr. Ralph R. Gregory from the Faculty and Trustees of Palmer College of Chiropractic for his vast contributions to the profession of Chiropractic.

June 1987
"The Predominant Factor Theory Reexamined". (Seemann). Study examining the relationships between the measured (on x-ray) cervical misalignment with the postural distortion of the entire body (as measured with supine leg check and the Anatometer).
"A Review of Non-Chiropractic Literature Having Importance for Upper Cervical Practitioners." (Palmer) -Over view of current findings in the literature to upper cervical doctors.
"Some Biomechanical Aspects of Chiropractic". (Gregory). Discussion of force, resistance, depth, acceleration, functional reversibility of the triceps, potential for harm, bodily stability, and biomechanical stability.
"Chiropractic Adjustment Force Transmission Mechanics". C.D. Ingram, DC. -a discussion of wave transmission and adjustic force.
"Computerized Modeling of the Occipital-Atlanto-Axial Spine". Denton, K., Palmer, J. Fourth Annual Upper Cervical Conference, Life Chiropractic College, Marietta, Georgia, 1987.

January 1988
"Posterior Rotations". (Seemann) -retrospective study examining rotation of C1 in the misalignment pattern.
"Some Considerations on Instrument and Manual Adjusting". (Palmer) discussion of proportionality in the adjustment.
"Biomechanics of C1 Subluxation Production". (Gregory). - extensive discussion of the biomechanical factors that produce or influence the production of the C1 subluxation complex.

June 1988
"A Model for Understanding the Difference Between Mythology, Theory, and Science". (Seamann) -discusses the different levels of understanding that we have about the truths of the universe.
"Three Dimensional Computerized Modeling of the Occipital-Atlanto-Axial Spine." Levy, MS, Palmer, JF. 1987 Advances in Bioengineering (BED-Vol.3; DE-Vol.12)
(This paper was reproduced in the Monograph). The work was supported by NUCCA. The scanner was provided by the Medical College of Ohio at Toledo, while the University of Toledo's Computer Aided Design and Engineering and Manufacturing Facility was used for the analysis.)

"The Evolution of the NUCCA Adjustment". (Gregory). Discussion of the changes in the adjustment as more knowledge has been gained.
NUCCA now being taught at Palmer College Davenport as an elective. Dr. Hess, Clinic Director at Palmer spoke at the conference.

January 1989
"Debate and Protocol vs Measurement and Openness, A Chiropractic Issue". (Palmer) -A frank discussion of openness (and lack thereof) within the chiropractic profession to publication of work about upper cervical chiropractic.
"Stabilizing the C1 Subluxation Complex". (Gregory) A discussion of stability relating to the basic type misalignments.
"Anatometer Update-1988". (Seemann). Review of previously published papers regarding the Anatometer and new considerations regarding its use.

June 1989
"Predicting the Short Leg Using X-Ray Listings" (Seemann).-previous studies used computer analysis of data files from 1984, 1987 and 1988. (N=1000). However certain data (plane line, cervical curve, head position) were not recorded. A new study (N=100) was conducted using 18 pieces of data from each set of films. A comparison was made.
"An Investigation into the Validity of Laterality". (Palmer). A comparison of patient files was made between Grostic (1948, 1949, 1950, 1963 totaling 523 cases) and Gregory (1958, 1982 totaling 108 cases).
"Comments and Concerns re X-ray Radiation (A Guide for Upper Cervical X-Ray) (Dickholtz). Discussion of ionizing radiation, average technique dosages, filters, grids, processors, minimizing dosages.
Dr. Kern, President of Palmer College of Chiropractic addressed the conference.

        Dr. Ralph R. Gregory died March 1, 1990.

January 1990
"Exploring the Relationship Between Anatometer Measurements and X-Ray Listings". (Seemann) -a continuation of the papers on the predominant factor theory.
"Some Comments on Atlas Laterality". (Palmer) publication of statistics for atlas laterality pre and post adjustment. The author notes that in his opinion, the precision of measuring atlas laterality changes is no more in doubt.

"Cessation of a Seizure Disorder: Correction of the Atlas Subluxation Complex". Goodman RJ, Mosby JS. J Chiropr Res Clin Invest, 1990; 6(2):43-46.

August 1990
"Identifying and Locating the Transverse Process of C1". A. Berti, D.C. -describes process of identifying the transverse process on the lateral film using identification of structures in the nasium and vertex views.
"A Clinical Investigation into Upper-Cervical Biomechanical Stability: Part 1". Palmer, T, Denton, K, Palmer J. a retrospective study to determine the degree of stability or instability of upper cervical misalignment factors.
"Manipulation or Adjustment: Direction, Force and Direction in the Cervical Spine". (Seemann). -discussion of force and potential for trauma in the cervical tissues.
"A Review of Biomechanics". (Denton) -in depth review of the biomechanics of the four basic types of misalignment in the cervical spine.

1991
Anatomter II developed. Patent #5,088,504, a machine that measures and records in terms of the orientation planes of motion, the presence of, the location of, and the severity of postural distortion-stress effects of C1 subluxations on the human body.

March 1991
"Errors in the Taking of Cervical X-Rays and their Effect on Analysis". (Dickholtz)
"Structure and Function: Embryologic Development and the A.S.C." (Gregory-Trust)
"Upper Cervical Influence on the Reticular System". Crowe, HS, Kleinman T.
"Dentate Ligament-Cord Distortion Hypothesis" Grostic JD.
"A NUCCA Database for 17 Parameters for both Pre-Adjustment and Post-Adjustment". Nigron, L.
"Occipital-Axial Relationships". Goodman, S.

September 1991
"Biomechanical Problem: Out of Pattern Type II Subluxation". (Berti)
"Leg Length Inequality in the Chiropractic and Medical Literature". Thomas, MD. A literature review of anatomical and function leg length inequality.
"A Comparison of Weight Differential Between a Group that had a History of Spinal Problems or had Been Under Care and a Group that has Neither a History of Spinal Problems nor Been Under Care". (Seemann)
"Radiology Case Report". (Thomas)
"Optimizing Port Size for Cervical Films". (Dickholtz) -clinical research report to diminish ionizing radiation to the patient and improve film quality.

1992
James Palmer is editor for NUCCA's submission to the Conference for the Establishment of Guidelines for Chiropractic Quality Assurance and Standards of Practice, chaired by Dr. S. Haldeman (Mercy Center San Francisco, CA. January 25-30, 1992.

"Upper Cervical Adjustments May Improve Mental Function". Thomas MD, Wood J. J Manual Medicine (1992) 6:215-216.

"Hypertension and the Atlas Subluxation Complex". Goodman, RJ. J Chiropr Res Clin Investigation, 1992; 8(2):30-32.

April 1993
"Thermocouple Heat Differential Instrument Examination and Findings in Correlation with the Supine Leg Check and X-Ray Findings". (Berti)
"NUCCRA Database". (Palmer) -data supporting clinical effectiveness.
"Locating the C-1 Transverse Process Using Surface Lead Markers". (Dickholtz) -clinical research to optimize contact placement on patient.
"Locating the C-1 Contact Point" Cripe, GE.
"A Pilot Study to Determine the Reliability and Efficacy of Using Palpation of the Mastoids to Locate C-1 Transverse Processes". Yardley, L.
"Using the Inter-Mastoid Line for Central Skull Line Reliability". Fitzpatrick, V.

1994
Presentation of Daniel David Palmer Chiropractic Scientific Award from Palmer College of Chiropractic to Dr. Marshall Dickholtz, Sr. for his extensive body of research work in chiropractic.

Sept/Oct 1994
"Total Quality Management in a Chiropractic Organization: A Process of Evolution". Palmer, J.F. Digest of Chiropractic Economics. (36:5)40+, Mar/Apr 1994.

"Board Certified: A Quality Control Program in a Chiropractic Organization". Palmer, J.F., Digest of Chiropractic Economics. (37:2):30-31, Sep/Oct 1994.

November 1994
"A Method to Determine the True Head Tilt When Taking a Nasal X-Ray". (Dickholtz)
"A Reliability Study Using a Positive Nasium to Establish Laterality" (Seemann)
"Attention Deficit Disorder (ADD) and the Atlas Subluxation Complex". Goodman, RJ. -a case study.

May 1995
"Aids for Control in the Adjusting Procedure". Schrock, L.
"Filters for Specific Upper Cervical X-Rays". (Dickholtz)
"NUCCA Assessment Outline". (Palmer) -an outline of the NUCCA technique including a brief bibliography of evidence of efficacy.

May 1996
"Magnetic Resonance Angiography (MRA) Analysis Offers Explanation of Possible Mechanism of Stroke Relating to Critical Neck Positions". Stein E.
"Angular Measurement of the Upper Cervical Spine in the Neutral and Laterally Flexed Positions". Cockwill, RG.
"Locating and Measuring the Spinous Process of C-2 from the Vertex Film". (Berti)
"Angle of the Mastoid, a Study." Crowe, HL, Trujillo, MM.
"Standards: Patient Safety and Terms of Acceptance". NUCCA Standards Committee.

May 1997
"Working with the Digital Inclinometer". (Dickholtz)
A Review of "Comparisons of Lordotic Cervical Spine Curvatures to a Theoretical Ideal Model of the Static Sagittal Cervical Spine," an article by Donald D. Harrison, T.J. Janik, S.J. Troyanovich, and B. Holland. Spine, Vol.21, No.6, March 15, 1996. (Palmer) (this paper was republished in corrected form in April 1999).
NUCCA Standards of Care and Practice Guidelines, Multiple authors. National Upper Cervical Chiropractic Association. Monroe, Michigan. 1997.

1998
Presentation of Headache Study. North American Cervicogenic Headache Society, Toronto, Ontario, Canada, by Dr. Marshall Dickholtz, Sr.,October 1998.
Presentation of Research Projects. Canadian Memorial Chiropractic College, Toronto, Ontario, Canada by Dr. Marshall Dickholtz, Sr., October 1998

April 1999
"Elements of a Publishable Case Report". (Palmer)
"Summary of Biomechanical Principles". Cripe G.

May 2000
"How Does Axis Spinous Affect the Cervical Spine?" McDonald, SN.
"Understanding Torque". McDonald, SN.
"Is the Basic Type One the Most Common Subluxation?" Johnson, KL.
"The Anatometer 1971-2000". Palmer J., Palmer TA.
"Anatometer Measurements: A Field Study Intra-and Inter-Examiner Reliability and Pre to Post Changes Following an Atlas Adjustment". (Seemann)

September 2000
Outcomes of Chronic Fatigue Syndrome Subjects Adjusted by a Specific Chiropractic Technique. Platform Presentation by Marshall Dickholtz, Sr. at the FCER International Conference on Spinal Manipulation, Minneapolis, MN, September 22, 2000.

May 2001
"Some Implications Regarding Tensegrity and the Upper Cervical Adjustment". (Thomas)
"Revisiting the Coordinator: Is there a more efficient way for students to train?" Scholten, J.
"Out-of-Pattern Biomechanics". (Denton)
"Errors in the Taking, Markling, and Comparing Pre and Post Cervical X-Rays". (Dickholtz)
"Case History of Flexion-Extension Spinal Trauma with Closed Head Injury via Motor Vehicle Accident Treated with NUCCA Procedure for Spinal Correction". Groover, TD.

NUCCA Protocols and Perspectives: A Textbook for the National Upper Cervical Chiropractic Association. Thomas MD, editor. First Edition. 2002. Published by The National Upper Cervical Chiropractic Research Association, Monroe, Michigan. -Seventeen contributors extensively explain the NUCCA work.

September 2002
"Protocol for Biomechanics Using the Multiple Support Headpiece". Brooks, R.
"Protocol for Adjusting the ASC with the Head Stabilized.". Brooks, R.
"Subject Head-Clamp Placement for Vertex Film and a Proposed New Method for Measuring Atlas Rotation". (Dickholtz)
"Lead Markers for More Accurate Interpretation of Cervical X-Rays". (Dickholtz)

September 2004
Special issue of Monograph examining historical and current issues in the profession with responses from the profession. Edited by Thomas MD, Scholten J.

November 2006
"Specific Biomechanics: Obtaining Consistent OPM Corrections Using 3-Dimensional Headpiece Placement to Develop a Repeatable Point of Application For the Calculated Vector." Friedman R.
"Intra-examiner Reliability of National Upper Cervical Chiropractic Radiographs- a Necessity for Further Upper Cervical Research". (Dickholtz)
"Observation on a Patient Showing a Close Relationship Between Dental Alignment and the ASC". Hasick, DG.

March 2007
"Achievement of Blood Pressure Goal with Atlas Realignment". Bakris GL, Dickholtz, Sr. M., Meyer, P., Kravitz, G., Avery E., Miller, M., Brown, J., Bell, BM. Preventive Medicine, Rush University Medical Center, Chicago, IL. The Journal of Clinical Hypertension. Suppl. A Vol. 8, No. 5. Mar 2007

April 2008
"A Brief History of the Modus Operandi of Measuring and Correcting the Atlas Subluxation Complex Syndrome and the Role of Posture in the National Upper Cervical Chiropractic Asociation (NUCCA) Standard of Care." Palmer, J, Creswell, K.

"Upper Quarter Finite Element Modeling Proposal for NUCCRA". Palmer J.

"Clinical Effectiveness (Precision and Reliability) Update on NUCCA Adjusting: Atlas Laterality and Rotation." Palmer J, Palmer J. Cord.

"Three Cases of TMD". Palmer JF, Creswell K, Dickholtz, Sr., M., Palmer J. Cord.

"Practice based Research-A Solution for Evidence". Woodfield, HC.

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