Newsletter Archives > ChiroPlanet.com Monthly Health Newsletter: September 2016 Health Newsletter

September 2016 Health Newsletter


Current Articles

» Chiropractic Reduces Falling Risk in the Elderly
» Heat-Related Sports Injuries: When Athletes Are At Greatest Risk
» Are Trampoline Parks Safe for Kids?
» Preventing Severe Traumatic Brain Injuries: Proof That Bike Helmets Really Work

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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Heat-Related Sports Injuries: When Athletes Are At Greatest Risk

Football season for high school and college students typically starts in September, one of the hottest months of the year around the US. A recent study conducted at the University of Georgia found that the likelihood of heat-related injury in athletes increased exponentially during this time of year. 

2 Times When the Risk of Sports Injuries Are the Highest

According to the study, researchers found that there were two times during training when athletes were at the highest risk for injuries.
 •  Within the first 3 to 14 days of practice, but the rate was much higher during the first three days
 •  On days seven and eight of pre-season training when athletes began practicing twice each day. 

Seventy-four percent of the college athletes evaluated suffered from heat cramps, while 26 percent suffered from a combination of heat syncope (fainting) and heat exhaustion. The highest risk came when outdoor temperatures were greater than 82 degrees. 

Common Symptoms of Heat-Related Sports Injuries

Coaches, trainers, parents and athletes should all be on the lookout for injuries related to higher temperatures. Symptoms include: 
 •  Heat Cramps: Involuntary spasms within the larger muscle groups. 
 •  Heat Exhaustion: Heat cramps, copious sweating, nausea, vomiting, headache and weakness. 
 •  Heat Stroke: Headache, rapid heart rate and breathing, nausea, vomiting, and altered behavior or mental state. 

Chiropractors: Helping Prevent Heat-Related Injury in Athletes

Chiropractors, as well as sports trainers, play an important role in preventing sports injuries during the summer training period. They can educate athletes on the importance of adequate hydration and rest. Additionally, they can demonstrate relaxation and flexibility techniques that can be used to relieve muscle spasms. When athletes and their sports medicine team, including chiropractors, work together they can prevent injuries and have a productive and healthy football season.

Author: ChiroPlanet.com
Source: Journal of Athletic Training, online August 9, 2016.
Copyright: ProfessionalPlanets.com LLC 2016


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Are Trampoline Parks Safe for Kids?

When a new trampoline park opens up, emergency rooms and pediatric centers nearby are sure to notice an increase in related injuries. The safety concerns of trampolines are no secret, accounting for over 100,000 injuries each year.1  These injuries can range from mild to severe, from sprains and bruises to life-threatening spine and neck injuries. There's even a recoil injury doctors are all-too-familiar with: it’s called a "trampoline fracture," which is a tibial fracture commonly caused by having more than one jumper on a trampoline at once.2 Bur recent research illustrates that trampoline parks create even more risk than their standalone counterparts. First, they are built to accommodate many jumpers, and although parks' rules dictate only one jumper per "section," these rules are often broken. The hard supports between sectioned components of the trampolines themselves pose a serious risk as well, and they are common culprits for high-impact injuries after a fall.  At trampoline parks, jumpers are more likely to collide with others, more likely to sustain dislocations, and more likely to require hospital admission than jumpers on home trampolines.3  If a child is going to jump on a trampoline, practicing good safety skills like supervised, netted jumping with only one jumper at a time, as well as appropriately managing any injuries in the event of an accident, is the best way to keep safe them during these activities. And over half of injuries sustained from trampoline activities are soft tissue injuries,4 highlighting the importance of proper injury treatment and care.  For non-life threatening spinal and soft tissue injuries, treatment by a doctor of chiropractic is an excellent, effective, and safe way to heal an injury, strengthen the body, and protect from re-injury.
References: 
1. http://www.livestrong.com/article/347980-statistics-on-trampoline-injuries/
2. http://radiopaedia.org/articles/trampoline-fracture
3. http://www.ncbi.nlm.nih.gov/pubmed/27482060
4. http://injuryprevention.bmj.com/content/early/2016/07/28/injuryprev-2016-042071

Author: ChiroPlanet.com
Source: http://injuryprevention.bmj.com/content/early/2016/07/28/injuryprev-2016-042071
Copyright: ProfessionalPlanets.com LLC 2016


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Preventing Severe Traumatic Brain Injuries: Proof That Bike Helmets Really Work

There has been a debate over the years about whether bike helmets really do that much to prevent injuries. Advocates claim that wearing a helmet while riding a bike can save lives. Skeptics, however, don’t think that this type of protective gear does that much to prevent head injuries, let alone death.  Recently, a study was conducted at the University of Arizona to determine just how effective helmet protection really was for riders.

3 Ways Bike Helmets Protect Riders

During the course of this study, over 6000 bike accident patients were evaluated. Researchers found that helmets did, in fact, protect riders in three important ways. Helmets protected riders from: 
1. Severe Traumatic Brain Injures (TBIs)
2. Facial fractures
3. Death, even after a brain hemorrhage.

The Great Debate: The Numbers Prove That Helmets Are Beneficial

The figures gathered during this study are proof that helmets do a good job of protecting riders. For instance, wearing a helmet reduced the odds of severe traumatic brain injuries by over 50 percent. The likelihood of death after a bike accident was reduced by almost 45 percent in helmeted riders. And, these riders were over 30 percent less likely to experience facial fractures.  While not all helmeted riders are going to avoid traumatic brain injuries after an accident, helmets can reduce the probability of severe injury and death. The numbers speak for themselves; helmets do much to protect the rider. 

Chiropractors Can Be Strong Advocates for Rider Protection

Chiropractors are promoters of health and want to do all they can to help their patients live a happy, injury-free lifestyle. One of the ways they do this is by educating their patients on injury prevention, which includes the use of bike helmets.

Author: ChiroPlanet.com
Source: The American Journal of Surgery, online July 29, 2016
Copyright: ProfessionalPlanets.com LLC 2016


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