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

October 2016 Health Newsletter


Current Articles

» Chiropractic Reduces Falling Risk in the Elderly
» New Findings on Acetaminophen and Pregnancy
» Can Your Mental Workload Affect Your Muscles?
» Unsafe Drinking Water: Millions of Americans Exposed to Toxic Chemicals

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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New Findings on Acetaminophen and Pregnancy
During pregnancy, it's all about the healthy development of the mother and child. There is a host of medical providers and practitioners who focus on prenatal care through vitamins, check-ups, and health tips – including what to avoid.  It's no longer news that alcohol and tobacco are among the substances to avoid during pregnancy, but a new study suggests that acetaminophen, the active ingredient in certain painkillers, may be added to that list.  Last month, a new study was published in JAMA Pediatrics that explored the relationship between acetaminophen use during pregnancy and childhood behavioral problems. These findings concluded that while further investigations are needed to clarify the relationship between the pain medication and abnormal fetal neurodevelopment, children appear to be more at-risk of developing behavioral problems if the mother took acetaminophen while pregnant.  No matter the drug, healthcare providers suggest using the lowest effective dose or avoiding pain medications whenever possible during pregnancy.  It is very common for women to experience pains during pregnancy. In fact, 50 percent or more of women experience back pain while pregnant. Physical and hormonal changes can cause pain leading to stress and anxiety – both of which can negatively impact both the mother and the baby.  But with new research suggesting that pain medications may lead to potentially serious side effects for fetal neurodevelopment, mothers may wonder what to do about their pain. Fortunately, doctors of chiropractic have a solution.  Chiropractic care is a safe, gentle, and effective method of treating soft tissue and joint pains that arise during pregnancy. And as chiropractic treatment focuses on the source of pain rather than masking symptoms, doctors of chiropractic are important members of a pregnant mother's healthcare team to support her overall well-being both before and after childbirth.

Author: ChiroPlanet.com
Source: JAMA Pediatr. 2016;170(10):964-970. doi:10.1001/jamapediatrics.2016.1775
Copyright: ProfessionalPlanets.com LLC 2016


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Can Your Mental Workload Affect Your Muscles?

It's no secret that hard manual labor can have an effect on the body. But a new study suggests there may be a connection between musculoskeletal disorders and mental workload, too.  How does mental stress affect our bodies? Research published in the Journal of Manipulative and Physiological Therapeutics investigated bank workers' mental workload against pain throughout nine different musculoskeletal regions. The results demonstrated that the more subjective mental workload the employees experienced, the higher their musculoskeletal pain, particularly in the neck and back. Over time, we are beginning to understand the relationship between mental stress and musculoskeletal pain. Last year, a similar study was conducted on hospital nurses, revealing similar results, suggesting that increased mental stress leads to increased musculoskeletal pains.  For doctors of chiropractic, this research highlights a philosophy that chiropractic care has always embraced: the importance of holistic care. Exceptional and effective chiropractic care relies on a comprehensive approach that sees the body as a complete entity. Through a multifaceted approach including physical therapy, spinal manipulation, massage, nutrition, and more, chiropractic care helps individuals manage both their pain and their lifestyle to improve and eliminate discomfort from the source. Particularly for those with mentally stressful jobs, good posture can be easy to forget about, for instance. Emphasis and instruction on proper techniques and form for employees who stand or sit at a computer for long periods of time is an excellent example of preventing musculoskeletal aches and pains from developing. By taking appropriate breaks and learning tips and methods for minimizing physical and mental stress at work, a doctor of chiropractic can help guide stressed out workers towards a holistic method of resolving their mental and physical fatigue.

Author: ChiroPlanet.com
Source: J Manipulative Physiol Ther. 2016 Jul-Aug;39(6):420-6.
Copyright: ProfessionalPlanets.com LLC 2016


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Unsafe Drinking Water: Millions of Americans Exposed to Toxic Chemicals

There are three things humans need to survive: safe food, air and water. Unfortunately, with all of the pollutants in the environment, more and more people are being exposed to unsafe drinking water. A study conducted by Harvard researchers found that substances called PFASs (poly- and perfluoroalkyl substances) are showing up in drinking water. PFASs are used in fabricating commercial and industrial products, as well as aqueous film-forming foams (used in fire fighter training). These toxic chemicals are produced at industrial sites, military and fire rescue training facilities, wastewater treatment plants and airports. Over six million people live close to such facilities and are at risk for exposure. PFASs have been linked to testicular and kidney cancers, obesity, and the disruption of hormones. Because of their small size, toxic chemicals can quickly accumulate in a child’s body. Adults, on the other hand, need to be exposed to higher levels of toxins or exposed for longer periods of time before getting sick. Harvard researchers recently studied over 500 children, aged 13 years. They tested the concentration levels of PFASs, as well as tetanus and diphtheria antibodies. Children exposed to higher PFAS levels had a 25 percent decrease in antibodies. The theory is that PFASs interfere with a child’s immune function and reduce the effectiveness of vaccines. The best option is to purchase and use a quality water filtration system in your home, and maintain and change your filters as recommended. Then, simply pack water with you wherever you go within a PBA-free container. If purchasing bottled water, ensure you safely recycle all your plastic water bottles.

Author: ChiroPlanet.com
Source: Environmental Health Perspectives, online August 9, 2016.
Copyright: ProfessionalPlanets.com LLC 2016


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