June 2017 Health Newsletter

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» Chiropractic Reduces Falling Risk in the Elderly
» Shock Treatment for Migraines vs. Chiropractic Care
» U.S. Schools Are Missing Opportunities to Protect Children from UV Rays
» Hundreds of Millions of Dollars in Healthcare Costs Linked to Tanning Beds

Chiropractic Reduces Falling Risk in the Elderly

 

Chiropractic Care Improves Senses and Reduces Risks of

Falling in the Elderly Population

 

By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP

William J. Owens DC, DAAMLP

 

As our population ages, our most senior are being told that their heart diseases or cancers won’t be as likely to cause death as sequella from a fall. Therefore, doctors are urging that sect of population to rely more and more on canes, walkers and other devices to help offer greater support when balance issues become even slightly problematic. According to Holt et. Al (2016) “Falls account for more than 80% of injury related hospital admissions in people older than 65 years and they are the leading cause of injury related death in older adults. Approximately 30%-40% of community-dwelling older adults suffer from at least 1 fall per year.” (pg. 267)

 

Holt et. al. listed the following risks associated with falls

  1. Lower limb weakness
  2. Recent History of Falling
  3. Gait Deficits
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

 

The National Institute of Health (NIH) expanded the list of risk factors in older adults to include:

  1. Muscle weakness
  2. Balance and gait
  3. Blood pressure drops
  4. Postural hypotension
  5. Reflexes slower
  6. Foot problems
  7. Sensory problems
  8. Vision issues
  9. Confusion
  10. Medications

(http://nihseniorhealth.gov/falls/causesandriskfactors/01.html)

 

Comparatively speaking, both the Holt et. Al. and the NIH are in agreement that falling can be a multifactorial issue with often no single cause or solution. However, if an older person, who has one or more of the above risk factors can minimize those risks, the likelihood of falling can be decreased and potentially extend their life. Holt et. al. continued “There is however, a growing body of basic science evidence that suggests that chiropractic care may influence sensory and motor systems that potentially have an impact on some of the neuromuscular risk factors associated with falling.” (pg. 268) In short, the evidence has suggested that chiropractic can reduce the risk of falling in older adults.

 

Holt et. al. found that the mechanisms where chiropractic may influence sensorimotor functions are:

  1. Neuroplastic processes in the central nervous system through altered afferent input.
  2. Pain and altered cognition as a result with respect to attention focus and physical function
  3. Muscle strength and muscle activity patters
  4. Deterioration of the sensorimotor system that occurs regularly with normal aging

Looking at those neuroplastic processes or effects of chiropractic on the central nervous system, Gay et al. (2014) reported, “…pain-free volunteers processed thermal stimuli applied to the hand before and after thoracic spinal manipulation (a form of MT).  What they found was that after thoracic manipulation, several brain regions demonstrated a reduction in peak BOLD [blood-oxygen-level–dependent] activity. Those regions included the cingulate, insular, motor, amygdala and somatosensory cortices, and the PAG [periaqueductal gray regions]” (p. 615). In other words, thoracic adjustments produced direct and measureable effects on the central nervous system across multiple regions, which in the case of the responsible for the processing of emotion (cingulate cortex, aka limbic cortex) are regarding the insular cortex which also responsible for regulating emotion as well has homeostasis. The motor cortex is involved in the planning and execution of voluntary movements, the amygdala’s primary function is memory and decision making (also part of the limbic system), the somatosensory cortex is involved in processing the sense of touch (remember the homunculus) and, finally, the periaqueductal gray is responsible for descending pain modulation (the brain regulating the processing of painful stimuli).

 

This is a major step in showing the global effects of the chiropractic adjustment, particularly those that have been observed clinically, but not reproduced in large studies.  “The purpose of this study was to investigate the changes in FC [functional changes] between brain regions that process and modulate the pain experience after MT [manual therapy]. The primary outcome was to measure the immediate change in FC across brain regions involved in processing and modulating the pain experience and identify if there were reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity” (Gay et al., 2014, p. 615). 

 

Coronado et al. (2012) reported that, “Reductions in pain sensitivity, or hypoalgesia, following SMT [spinal manipulative therapy or the chiropractic adjustment] may be indicative of a mechanism related to the modulation of afferent input or central nervous system processing of pain” (p. 752). “The authors theorized the observed effect related to modulation of pain primarily at the level of the spinal cord since (1) these changes were seen within lumbar innervated areas and not cervical innervated areas and (2) the findings were specific to a measure of pain sensitivity (temporal summation of pain), and no other measures of pain sensitivity, suggesting an effect related to attenuation of dorsal horn excitability and not a generalized change in pain sensitivity” (Coronado et al., 2012, p. 752).These findings indicate that a chiropractic spinal adjustment affects the dorsal horns at the root levels which are located in the central nervous system.  This is the beginning of the “big picture” since once we identify the mechanism by which we can positively influence the central nervous system, we can then study that process and its effects in much more depth.    

 

One of the main questions asked by Corando et al. (2012) “…was whether SMT (chiropractic adjustments) elicits a general response on pain sensitivity or whether the response is specific to the area where SMT is applied. For example, changes in pain sensitivity over the cervical facets following a cervical spine SMT would indicate a local and specific effect while changes in pain sensitivity in the lumbar facets following a cervical spine SMT would suggest a general effect. We observed a favorable change for increased PPT [pressure pain threshold] when measured at remote anatomical sites and a similar, but non-significant change at local anatomical sites. These findings lend support to a possible general effect of SMT beyond the effect expected at the local region of SMT application (p. 762).

 

The above mechanisms take the effects of chiropractic care out of the realm of theory and validates the processes through which chiropractic works based upon the scientific evidence (literature).

 

 

Holt et. Al found that outcomes measured for both sensorimotor and quality of life increased with chiropractic care. The primary outcomes of improvement choice stepping reaction time (CSRT)and sound-induced flash illusion. The CSRT involves feet placement in a timed scenario and sound-induced flash illusion involves multisensory processing to ascertain reaction to perceived illusions. Both have been significantly related to older populations and falling. Although the results of this study has its limitations, as many studies do. Holt concluded” The results of this trial indicated that aspects of sensorimotor integration and multisensory integration associated with fall risk improved in a group of community-dwelling older adults receiving chiropractic care. The chiropractic group also displayed small, statistically significant improvements in health-related quality of life related to physical health when compared with a “usual care” control. These results support previous research which suggests that chiropractic care may alter somatosensory processing and sensorimotor integration.” (pg. 277)  

 

As with many of our articles from here forward, I would like to leave you with a last and seemingly unrelated statement.  I felt it was important to add this at the end since many of our critics negatively portray the safety of chiropractic care.  This statement shall put that to rest leaving only personal biases left standing. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects and after the unqualified subjects had been removed from the study, the total patient number accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon et al., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.

 

References:

  1. Holt K., Haavik H., Lee A., Murphy B., Elley C., (2016) Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial, Journal of Manipulative and Physiological Therapeutics, 39(4) 267-278
  2. Falls and Older Adults, Causes and Risk Factors (n.d.) National Institute of Health, retrieved from: http://nihseniorhealth.gov/falls/causesandriskfactors/01.html
  3. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2014). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain.Journal of Manipulative and Physiological Therapeutics, 37(9), 614-627.
  4. Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M. D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: A systematic review and meta-analysis, Journal of Electromyography Kinesiology, 22(5), 752-767.
  1. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.

Author: Mark Studin DC, FASBE(C), DAAPM, DAAMLP and William J. Owens DC, DAAMLP
Source: US Chiropractic Directory
Copyright: 2016 2016


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Shock Treatment for Migraines vs. Chiropractic Care

If you suffer from migraines, you already know all about their debilitating pain. These headaches can easily sideline you for an entire day while you wait for them to finally go away. While chiropractors have been successfully treating migraines without drugs or invasive techniques, traditional medicine is still searching for cures. Some of these new technological approaches might seem a bit...shocking.  For example, a new device is showing promise as a method for easing migraine pain. How does it work? Believe it or not, the device reduces pain by delivering mild electric shocks to your arm.  The Future of Migraine Relief? The experimental device, which you control through your smartphone, is called the Nerivo Migra. It consists of electrodes that attach to your arm, a patch with a battery, and a computer chip that wirelessly connects to your mobile device. When activated, the device stimulates nerves under the skin of your arm, which, in turn, blocks pain signals from traveling to the brain. In the past, similar attempts at blocking pain signals applied mild shocks to the person’s head. By focusing on the arm instead, researchers are hoping the device will be discrete and convenient enough to use in public without anyone noticing. A Recent Study Put Nerivo Migra to the Test Researchers examined the effects of Nerivo Migra on 71 participants who suffer from episodic migraines that occur two to eight times a month. They had not taken any medication to prevent their attacks for at least two months. Most were women in their mid-to-late 40s who also experienced “aura,” which is a visual disturbance that sometimes affects other senses. Participants had a total of 299 migraine occurrences during the course of the study. They were instructed to apply the device to their upper arms immediately after the start of an attack and use it for 20 minutes. The device was programmed to emit one of five pulse widths: 50, 100, 150, 200, or a placebo. When the 50-width pulse rate is excluded, the results show that 64% of participants reported at least a 50% pain reduction two hours after using the device. For the control group, that number was just 26%. At the 200-width pulse rate, 58% of participants said they had little or no pain after a migraine that was moderate to severe. Chiropractic Migraine Treatment You Can Experience Right Now While the Nerivo Migra seems promising, it will likely be years before the public is ever able to use it. And you might be understandably a bit wary of using electric shock as a way to treat a headache. However, if you’re suffering from migraines right now, your local chiropractor can help.  A study conducted by Duke University showed that chiropractic spinal adjustments can produce almost immediate improvements in those suffering from migraines. The relief also lasted longer with fewer side effects than prescription headache medication.  So don’t live with the pain migraines cause. Your local chiropractor will have you feeling better with just a single visit.

Author: ChiroPlanet.com
Source: Neurology, online March 1, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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U.S. Schools Are Missing Opportunities to Protect Children from UV Rays

Parents rely on the school system to educate and protect their children. Recent studies have shown that when it comes to skin cancer, U.S. schools are missing an opportunity to do just that. Children are just as susceptible to skin cancer as adults. Some children have conditions that predispose them to skin cancer. Diligent efforts need to be taken to protect these children. However, some schools refuse to allow children to protect themselves with sunglasses and hats, even after legislation has passed. Another missed opportunity comes from tiny steps that could easily be put into practice. Schools could do more to promote the use of protective equipment, such as hats, sunglasses, and sun screen. Another important step that can be taken is to restrict the amount of time kids spend in the sun. While some sun exposure is important – everyone needs a healthy dose of Vitamin D, after all – it's essential to keep kids out of the sun during the brightest times of day. According to KidsHealth.org, it is believed that Melanoma is closely associated with severe sunburns from UVA and UVB rays before the age of 20. Melanoma is the most dangerous type of skin cancer. Recent research, reported on by Reuters, found that only 13% of classrooms have sunscreen on-hand. And only 28% of teachers allow children the time to apply the product. When it comes to sun exposure and children’s health, there is still much to be done. If you want to do more, talk to your school or your local board of education.

Author: ChiroPlanet.com
Source: JAMA Dermatology, online March 3, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Hundreds of Millions of Dollars in Healthcare Costs Linked to Tanning Beds
Tanning has never been more popular. Whether its because studies have shown that darker regularly gets rated as more attractive, or that popular celebrities the world over continue to radiate a golden brown glow, the tanning trend shows no sign of slowing down. Unfortunately, lying in a tanning bed has been linked to skin cancer. In fact, Reuter's reported on new research that shows up to $343 million dollars in healthcare costs have resulted because of the adverse effects of tanning beds. Some experts say that the cost of not only medical bills, but workforce productivity and early deaths, will raise that price to over $120 billion dollars over the patients’ lifetime. In 2015, tanning bed use resulted in nearly 9,000 melanoma cases, over 165,000 squamous cell carcinoma cases, and over 85,000 basal cell carcinoma cases. According to StatNews.com, 30 million people use tanning beds each year, and a quarter of those are teens. It’s estimated that a young woman who uses a tanning bed are at greater risk – up to 75% greater – of developing melanoma. The numbers are staggering. And while excess natural sun exposure can result in melanoma, squamous cell carcinoma, and basal cell carcinoma, tanning beds can actually increase the likelihood of getting these types of cancers. The culprits are the UVA and UVB rays. The UVA rays damage DNA, while the UVB rays burn the skin. Why take the chance of ruining your health? Save money and heartache by avoiding tanning beds.

Author: ChiroPlanet.com
Source: Journal of Cancer Policy, online February 28, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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