January 2019 Health Newsletter

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» Chiropractic Reduces Falling Risk in the Elderly
» How Chiropractic Care Can Help Relieve “Forward Head Posture”
» Kids Aren’t the Only Ones Who Need Less Screen Time
» Over One-Quarter of the Entire World’s Population Doesn’t Get Enough Exercise

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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How Chiropractic Care Can Help Relieve “Forward Head Posture”

If you spend a lot of time at the computer or looking down at your smartphone, you may be dealing with "forward head posture." Fortunately, this condition can be corrected with the right chiropractic care which often includes therapeutic exercises and stretches. 
What Is Forward Head Posture?
Forward head posture refers to when our head is not positioned properly over the body and is too far forward. This is typically caused by too much screen time in today’s computerized world although spending too much time at a desk or writing by hand, knitting or sewing could also cause an issue over time. Our head should be balanced on the top of our neck. This is often described as how a golf ball sits on top of a tee. The ears should be in line with the shoulders, not in front. The neck has a natural "C" curve when viewed from the side when the head is in the proper position. When the head is too far forward, that natural "C" curve can be reduced or lost increasing the tension on the structures of the neck and upper back. This can cause the upper back to become excessively curved in it's natural reversed "C" shape resulting in a condition called "kyphosis." When forward head posture becomes the norm for your body, it can lead to chronic neck pain, headaches, and spinal disc problems.
The Solution for Forward Head Posture
Fortunately, chiropractic care can significantly help. Additionally, many chiropractors not only utilize chiropractic-specific spinal adjustments to help correct these postural abnormalities, but additionally employ the use of in-office and/or at home therapeutic exercise regimen. If you are suffering from headaches, neck pain, or shoulder pain or discomfort, contact us today for a no-obligation evaluation.

Author: ChiroPlanet.com
Source: JMPT: July–August, 2018 Volume 41, Issue 6, Pages 530–539.
Copyright: ProfessionalPlanets.com LLC 2019


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Kids Aren’t the Only Ones Who Need Less Screen Time

A new doctor-authored resource for parents has some surprising news: Parents should limit their own screen time as well as their kids'. Here's why: Kids often mirror their parents' words and actions. According to Dr. Jenny Radesky, a co-writer of the resource in JAMA Pediatrics, this includes how parents interact with their smartphones – and how often. Dr. Radesky's research on the subject has revealed that parents preoccupied with their phones typically engage in less one-on-one interactions with their children, have more parent-child conflicts, and run into more behavioral issues with their kids. She also cites previous studies on TV-watching and parenting with similar results – parents who watched more television had kids who watched more television. Luckily, the parental resource Radesky co-authored with Dr. Megan Moreno has some suggestions for limiting your screen time and strengthening your family relationships. For instance, they recommend stepping back from your phone in instances where you would usually turn to it for stress-relief, distraction, or to avoid conflict. Instead, try something else, like breathing deeply. Engage with those around you and give them your full attention. The doctors promote establishing specific times when the whole family can unplug and do a single activity together. They also advise avoiding behaviors you wouldn’t want your kids to learn, like looking at your phone while driving your car, or ignoring others while using your phone.  In short, if you want your kids to learn good phone etiquette and safety, model it for them.

Author: ChiroPlanet.com
Source: JAMA Pediatrics, online August 27, 2018.
Copyright: ProfessionalPlanets.com LLC 2019


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Over One-Quarter of the Entire World’s Population Doesn’t Get Enough Exercise

About 1.4 billion people around the globe – about one-quarter of all the adults on earth – aren't getting enough physical activity in their day-to-day lives. According to a study from the World Health Organization, people who don't exercise enough daily are at higher risk for cancer, type 2 diabetes, and cardiovascular disease, to start. To keep healthy, you need a minimum of 150 minutes of moderate activity or 75 minutes of vigorous, strenuous activity every week. According to the 2016 study, only one-third of women and one-fourth of men were not getting the recommended amounts.  The countries with the highest rates of inactivity were mostly Middle Eastern, including Saudi Arabia, Kuwait, and Iraq, as well as American Samoa. Over 50% of adults in these areas were not getting enough physical activity. Meanwhile, 40% of all U.S. adults, 14% of Chinese adults, and 36% of British adults were not active enough. In addition to the high rates of inactivity, the study found that these rates are staying stagnant despite growing research that proves how vital exercise is to health. In fact, inactivity is twice as high in richer countries versus poorer ones, and even increased during the years 2001-2016 by 5%. One big reason may be because sedentary occupations are becoming the norm in richer countries, while poorer countries have more active occupations.

Author: ChiroPlanet.com
Source: Lancet Glob Health 2018; 6: e1077–86.
Copyright: ProfessionalPlanets.com LLC 2019


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