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

September 2017 Health Newsletter


Current Articles

» Chiropractic Reduces Falling Risk in the Elderly
» Mindfulness-Based Stress Reduction Could Help Your Low Back Pain
» Slow and Steady Is the Best Way to Lose Weight

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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Mindfulness-Based Stress Reduction Could Help Your Low Back Pain

If you struggle with back pain, you may be surprised to learn that there’s a very popular, nonintrusive practice that could help you realize real relief. Mindfulness-based stress reduction (MBSR) programs have grown in popularity lately, but they’ve been in use all over the world for decades. As a mind-based approach to the problem, MBSR can also be used as a complement to other physical methodologies for improving back pain.

What Is MBSR?

MBSR is a mental practice whereby people discipline themselves to only focus on the present moment, not the past or future. It’s an offshoot of mindfulness meditation that shares certain tenets with cognitive behavioral therapy. Practitioners use meditation to practice “staying present” and then incorporate this ability into their everyday lives. This form of treatment usually involves some version of yoga, as well.

Does MBSR Work?

Dennis Anheyer of the University of Duisburg-Essen in Germany and a team of researchers looked at seven previously published studies on MBSR. In total, these studies involved 864 patients. They concluded that participants enjoyed small improvements after MBSR treatments for short periods of time. Some studies even resulted in patients experiencing meaningful improvements to their mobility, though they didn’t necessarily last for the long term. When MBSR was paired with yoga, the results for those with disabilities and other physical limitations were even better than when MBSR was used on its own. Dr. Judith A. Turner from the University of Washington in Seattle has also studied MBSR’s benefits. She points out that, compared to other low back pain treatments (e.g. opioid medication and surgery), MBSR involves minimal risks. It can also teach patients new ways to approach their chronic pain that can help lower its perceived severity. While more research into MBSR may be necessary, there’s certainly no reason not to try it. Countless other people have over the past several decades and, as Dr. Anheyer mentioned, it’s certainly safe. He did add, though, that if you meditate or exercise, you should do so regularly.

Spinal Manipulation Helps Relieve Back Pain

Another way you can definitely experience pain relief in your low back – or any area surrounding your spinal column – is to visit your local chiropractor. Spinal manipulation is proven to work, so, after just a single adjustment from a chiropractor, many experience reduced pain and improved mobility, in many cases even after struggling with chronic pain for years.

Author: ChiroPlanet.com
Source: Annals of Internal Medicine, online April 25, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Slow and Steady Is the Best Way to Lose Weight

We all know about the story of the tortoise and the hare and how steady and consistent pacing wins the race.  Well it turns out that applies to long-term weight loss as well. Individuals who lose small amounts of weight over a consistent period of time show more sustained overall weight loss than those who crash diet.

Successful Dieters Lose Consistent Amounts of Weight Weekly

Researchers out of Drexel University in Philadelphia, PA examined data on 183 overweight and obese adults who were participating in a weight loss program. The program offered meal replacement and structure for calorie monitoring and exercise. Over the course of the two-year program, the most successful dieters were those who showed a steady, consistent weight loss in the first three months, as opposed to those participants who had more variable weight loss on a week-to-week basis.

According to psychology researchers at Drexel, some participants go into the program trying to lose as much weight as possible right way. However, despite showing big losses one week, they are typically hungry and anxious and unable to sustain the diet program for more than a week or so. Frustrated, they regain some of the weight, get upset and try to lose as much as they can again, creating a cycles of losing and gaining.

Those dieters who set more modest goals typically were able to sustain their calorie and exercise goals over a prolonged period of time, leading to greater weight loss and improved health.

Consistent Behavior May Be the Key to Success

The study further showed that participants who were emotional eaters, binge eaters, or preoccupied with food at the beginning of the program tended to have greater weight loss variability and generally lost less weight overall. This suggests that effectively losing weight may have more to do with steady consistent behavior than changing one’s relationship with food.

While sometimes the best you can do is get back on track, it may be better in the long run to set modest, attainable goals rather than try to completely change beliefs and ideologies in the pursuit of improved health.

Author: ChiroPlanet.com
Source: Obesity. September 2017. Volume 25, Issue 9, Pages 1461–1640.
Copyright: ProfessionalPlanets.com LLC 2017


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