Newsletter Archives > ChiroPlanet.com Monthly Health Newsletter: April 2017 Health Newsletter

April 2017 Health Newsletter


Current Articles

» Chiropractic Reduces Falling Risk in the Elderly
» For Low Back Pain, the ACP Recommends Drug-Free Treatments First
» Multi-Tasking Surgeons: What People Donít Know
» Research Shows Link Between Obesity and Developing 11 Types of Cancer

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


page toppage toppage top




For Low Back Pain, the ACP Recommends Drug-Free Treatments First
The American College of Physicians (ACP) recently released brand-new guidelines regarding treatment for low back pain.† The Annals of Internal Medicine published the ACP's updated guidelines, which are based on a "systematic review of the evidence." This means that a variety of studies were reviewed that examined the effectiveness of both non-drug and drug-based low back pain treatments. Overwhelmingly, non-drug treatments came out ahead.† The American Chiropractic Association (ACA) fully backs these new recommendations, as chiropractic champions treatments without drugs and conservative approaches to back pain. Likewise, the guidelines recommend trying treatments like acupuncture, massage, heat therapy, and others for relief. If these don't work, then patients can try treatments like muscle relaxants or over-the-counter pain medication, like ibuprofen.† For patients who still have pain after trying all of the above, prescription drugs like opioids should only be used as a final measure. The reason is that opioids are notorious for being highly addictive and come with a risk of overdose Ė negatives which make them highly undesirable and to be used in extreme cases as a last resort option. As the ACA notes, the ACP's guidelines push the current in the right direction, as chiropractic has been proven effective for a wide array of bodily pain. Common treatments include spinal manipulation, physical therapy, and a combination of healthy diet and lifestyle changes

Author: ChiroPlanet.com
Source: American Chiropractic Association, online Feb 14, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


page toppage toppage top




Multi-Tasking Surgeons: What People Donít Know

A recent study by the Journal of the American College of Surgeons looked at how many people had heard of something called "overlapping surgery." Overlapping Surgery is when a surgeon performs a critical part of an operation, then leaves a non-critical part to a different surgeon in training, or a physician's assistant, so they can head to a totally different surgery and do the same thing. A common scenario is when the main surgeon leaves closing incisions to an underling so they can move to a different procedure with a different patient. According to the study, although common practice, only a tiny margin of the people surveyed had heard of this practice (4% out of over 1,400 respondents). Almost all of the respondents thought that the patient should be informed of it before going under the knife. Specifically, they thought that patients should know who will perform what aspect of the surgery, including who would be in the room and the role of trainees. Therefore, if you or a loved one is going under the knife, ensure to thoroughly ask who will be involved with all aspects of the surgery so you remain fully informed.

Author: ChiroPlanet.com
Source: Journal of the American College of Surgeons, online Feb 11, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


page toppage toppage top




Research Shows Link Between Obesity and Developing 11 Types of Cancer

According to a recent review of research by The BMJ, the tie between obesity and 11 different types of cancers has been strengthened. According to Reuters, the review looked at a larger group of hundreds of studies published in the past that specifically examined the relationship between obesity and 36 types of cancers. Scholars looked for signs that the already-established link between cancer and obesity had been exaggerated, and in the process found a stronger correlation between obesity and 11 specific cancers. In particular, cancers of the organs in the digestive tract as well as womenís reproductive organs were found to have the strongest links to obesity. These include kidney, colon, pancreas, and rectal cancer as well as bone marrow, ovarian, and breast cancer. In addition to these findings, the research review also found a strong connection between a high BMI (body mass index, which measures the ratio of weight to height) and cancers in the pancreas, kidney, esophagus, liver, and bone marrow. Excess weight carried around the midsection also has risk factors for cancer, as women with extra weight and belly fat were found to have an increased chance of developing endometrial cancer. In fact, the risk increases the higher the waist-to-hip ratio (the measurement for belly fat). The takeaway? People can lower their risk for cancer by staying at a consistently healthy weight.

Author: ChiroPlanet.com
Source: The BMJ, online Feb 28, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


page toppage toppage top






Articles 1-4 of 4 << first < previous next > last >