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» Chiropractic Reduces Falling Risk in the Elderly
» National Chiropractic Health Month: Take Steps to Better Musculoskeletal Health
» Vegetarians May Live Longer
» “BPA-Free” Plastics Potentially Worse

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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National Chiropractic Health Month: Take Steps to Better Musculoskeletal Health

The American Chiropractic Association (ACA) and chiropractors nationwide are encouraging the public to take simple steps toward better musculoskeletal (MSK) health during National Chiropractic Health Month (NCHM) this October. The MSK system is comprised of the spine as well as all the muscles, bones and joints of the body. Keeping this vital system strong is the focus of 2019’s "Strength. Stability. Success." campaign.

When the MSK system functions well, we feel stronger and healthier; however, when there's a problem we might experience pain and even disability. More than one in two adults report experiencing an MSK condition such as back pain, neck pain, joint pain, arthritis or osteoporosis. They are the most commonly reported medical conditions among those under age 65 and the second most common condition for people age 65 and older. Low back pain alone is the leading cause of disability worldwide.

"Chiropractors provide care that helps people improve musculoskeletal health and relieve conditions such as low back pain naturally, sometimes enabling them to avoid or reduce the need for riskier treatments such as prescription opioid pain medications and surgery," notes ACA President Robert C. Jones, DC.

This October, set yourself up for future stability and success by taking steps to improve the strength of your musculoskeletal system:

  1. Move more. Bones, muscles and joints need movement to stay healthy. The U.S. surgeon general recommends adults get at least 150 minutes weekly of moderate physical activity (such as walking, yardwork, recreational swimming) or at least 75 minutes of intense weekly activity (jogging, hiking uphill, basketball).
  2. Eat a balanced diet. Proper nutrition is just as important to musculoskeletal health as it is to overall health. Eat a balanced diet that includes whole fresh foods and try to avoid processed foods. Be sure to get enough calcium and vitamin D for your bones and lean protein to build and maintain strong muscles.
  3. Go outside. The sun helps our bodies produce Vitamin D, which in turn helps us to absorb calcium and strengthen bones.
  4. Do weight-bearing exercises. Walking, jogging and resistance exercises such as weightlifting can improve bone density. Planks and squats can also strengthen core muscles. (Non-weight-bearing exercises such as swimming and biking can benefit the MSK system as well, especially for people unable to walk or jog while recovering from back, hip or knee pain.)
  5. Stay hydrated. Drinking water makes muscles stronger by carrying oxygen to the cells of the body. It also helps lubricate and cushion joints.
  6. Quit smoking. Smoking contributes not only to cardiovascular disease but also osteoporosis and bone fracture as we age.
  7. Get adequate rest. A good night's sleep enables your body to repair muscles and joints that are strained or injured during the day.
  8. Don’t drink too much alcohol. Drinking alcohol excessively can lead to osteoporosis and bone fracture.

We can also reduce the risk of pain and injury to our MSK system by improving our posture and movement techniques as well the ergonomics of our work and home environments. Learn more at www.acatoday.org/NCHM.

Author: American Chiropractic Association
Source: Acatoday.org. September 10, 2019.
Copyright: American Chiropractic Association 2019


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Vegetarians May Live Longer

A five year study of people's eating habits suggests that people who limit or eliminate meat from their diets are less likely to die over time. Researchers at Loma Linda University in California studied data from over 70,000 participants and found that people who eat mostly fruits and vegetables enjoyed a reduced risk of heart disease and other diet-related causes of death. In the test group, 8 percent of subjects described themselves as vegans who didn't eat any animal products, 29 percent were lacto-ovo-vegetarians who didn't eat fish or meat but did eat dairy and egg products, and 15 percent occasionally ate meat and fish. The researchers found that while seven out of 1000 individuals died in any given period of time, the death rate among vegetarians and occasional meat-eaters dropped to five or six individuals in the same time period. However, the researchers were reluctant to attribute the effect solely to the test subject's diet choices. They pointed out that the vegetarians also generally worked out more, were better educated, less likely to smoke and weighed less, all of which contributed to their decreased mortality rate. Still, they concluded that the data suggests that reducing or eliminating animal products from your diet could lead to healthier overall outcomes.

Author: ChiroPlanet.com
Source: JAMA Internal Medicine, online June 3, 2013.
Copyright: ProfessionalPlanets.com LLC 2013


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“BPA-Free” Plastics Potentially Worse

If you’ve purchased plastic related drinking containers you’ve surely noticed many products touting their "BPA-free" status. BPA or bisphenol-A is a chemical used to harden plastic and has received much bad press over the recent years due to studies linking it to brain and behavior issues in children and infants, altered hormone levels, obesity and cancer, to name a few. Unfortunately, new research from Canada shows the replacement being used for BPA, BPS or bisphenol-S, has now also become a cause for concern. Researchers from the University of Calgary have now found BPS to cause changes in the brain development of zebra fish embryos at extremely low doses. Authors of the study state their findings are directly relevant to humans, especially for women in their second trimester of pregnancy.

Author: ChiroPlanet.com
Source: Proceedings of the National Academy of Sciences. Jan 12, 2015.
Copyright: ProfessionalPlanets.com LLC 2015


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