March 2017 Health Newsletter

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» Chiropractic Reduces Falling Risk in the Elderly
» Chiropractic Care Is an Effective Alternative to Medicine
» Are Arthritis Sufferers Hesitating to Pursue Relief?
» Are Non-Chemical Methods Better for Treating Cancer Fatigue?

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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Chiropractic Care Is an Effective Alternative to Medicine

When a person suffers from back pain, one of their first instincts may be to treat the issue with medication. While this can help in some cases, it rarely has the type of long-term effect that users would hope for. Add to this the fact that both over-the-counter and prescription medicines can cause bothersome side-effects, and it is easy to see why sufferers of back pain are seeking other options. A study published in Annals of the Rheumatic Diseases looked to measure the effect of drugs on spinal pain. Namely, the research was geared toward determining whether NSAIDs (non-steroid anti-inflammatory drugs) had any substantial impact on spinal pain. Not only were these drugs proven to be less-than-effective, they were found to increase a userís risk of gastrointestinal disorders substantially. Since back pain is a very common type of disability, sufferers around the world have sought alternative ways to treat their condition. Chiropractic services are a non-invasive and non-chemical alternative option which people can use to treat their pain. In fact, millions of people visit chiropractors every year to pursue long-term solutions for their back pain. This can help a person get relief for their pain without subjecting themselves to, in certain cases, devastating side effects.

Author: ChiroPlanet.com
Source: Annals of the Rheumatic Diseases Online; Feb. 2, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Are Arthritis Sufferers Hesitating to Pursue Relief?

Arthritis is a serious and frustrating condition that affects tens of millions. This type of ailment can make a personís daily routine much more difficult than it should be. Those afflicted with arthritis may have trouble lifting things, and they may even be inhibited from being mobile without facing serious pain. According to the CDC, more than 54 million adults in the US suffer from arthritis. The total number of afflicted individuals has increased by about 20 percent over the past 15 years. Not only is the condition's widespread prevalence concerning to the medical industry, but the lack of attention given to arthritis' status as a serious disability is also alarming.† One of the main reasons that people may be holding off on pursuing solutions for this condition is that the way to handle it can sometimes result in more pain in the short-term. A healthy amount of physical activity has been proven to help reduce arthritis pain. However, since exercise can be painful for someone who is already suffering from arthritis, some people avoid it altogether.† Though movement can be difficult for a person with this type of disability, it can be used to help ease the severity of the issue. The growing number of sufferers indicates that people are holding off on pursuing relief, though doing so could benefit them in the long-term.

Author: ChiroPlanet.com
Source: CDC, online March 7, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Are Non-Chemical Methods Better for Treating Cancer Fatigue?
Cancer patients deal with a number of symptoms as a result of their condition, one of which is fatigue. This type of issue can be debilitating and frustrating, which causes many people to seek out treatments. While medication is one of the first options most people consider, a study by The JAMA Network suggest other methods may be more effective. During a study involving over 11,500 cancer patients, the effects of drugs and exercise/psychotherapy were observed. In some cases, patients were given both. The results showed a 9 percent reduction in fatigue for those who used medication and a 26-30 percent reduction for those who exercised or received psychotherapy.†† While the exact reasons that these methods seem to be more effective than drugs is not completely clear, experts do suggest that sufferers of cancer fatigue try these methods before opting for pharmaceutical solutions. While some types of exhaustion can be treated simply by getting more sleep, cancer fatigue is different. The study seemed to indicate that factors like the type of cancer had little effect on the results. The same can be said of the age and gender of the patients. While it has long been known that exercise and psychotherapy were effective in treating cancer fatigue, this study (which examined data from over 100 previous studies) indicates these methods may indeed be superior than medicinal options.

Author: ChiroPlanet.com
Source: JAMA Oncology, online March 2, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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