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October 2017 Health Newsletter


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» Chiropractic Reduces Falling Risk in the Elderly
» Walking and Cycling Linked to Reduced Risk of Being Hospitalized with Sciatica
» Mindful Coffee Consumption Can Lead to Better Health

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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Walking and Cycling Linked to Reduced Risk of Being Hospitalized with Sciatica

Perhaps youíre already aware that a number of lifestyle factors increase a personís risk of developing sciatica, including smoking and obesity. However, new research reveals that cycling and walking could have an equally effective opposite effect. A recent study followed a group of over 35,000 people for up to 30 years. It discovered that the risk of being hospitalized for sciatica was increased by 33% if people smoked or were obese, while regularly commuting to work by bicycle or on foot lowered their risk by 33%.

The Risks Involved in Developing Sciatica
The study reported that up to 5% of people suffer from sciatica, an often painful condition. Sciatica normally originates from a compressed nerve root and herniated disc, which causes shooting pains along the sciatic nerve. This extends from the lower back right down the back of a personís legs. Even though it rarely leads to hospitalization or surgery, itís often considered a more severe and long-lasting source of low back pain. Four long-term studies were analyzed by the team in Finland, with a total of 1,259 hospitalizations for sciatica occurring during the follow-up time of 12-30 years. The researchers looked at various risk factors, including occupation, education, sex, age, obesity, body mass index, and smoking, along with the duration, intensity, and frequency of physical activity. Although smokers saw an increased risk of 33%, former smokers didnít share this same risk. Furthermore, the risk of hospitalization was increased by 36% in obese patients Ė with abdominal fat increasing the risk to 41%. However, regardless of any other activity or the body weight of the patient, commuting to work via bicycle or on foot reduced their risk by 33%.

Overcoming Sciatica
Speaking about the study, lead author, Dr. Rahman Shiri, said they were surprised to see that no effect on hospitalization was witnessed by any other form of leisure time physical activities. However, they believe this may be due to the fact that regular, moderate activities like cycling and walking donít add strain to the back as opposed to higher-intensity exercises that will. Although the study was limited by the fact that it only used self-reported data and couldnít verify additional health factors for sciatica hospitalization, it does emphasize the benefits of moving around frequently, maintaining a healthy weight, and not smoking. Furthermore, studies have indicated that sciatica patients noticed a significant improvement when they underwent a number of treatments, including spinal manipulation. This process is carried out by a licensed doctor of chiropractic to reduce the nerve irritability that causes pain, muscle spasm, inflammation, and other symptoms associated with sciatica. If your sciatica is causing you discomfort and pain, contact your local chiropractor today.

Author: ChiroPlanet.com
Source: American Journal of Medicine, online July 24, 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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Mindful Coffee Consumption Can Lead to Better Health
Mindfulness is a popular concept these days, and it is often used as a way to help individuals make better life and health choices. And while itís no secret that reducing your sugar consumption can help with weight loss and general improvement in health, both are often easier said than done. A recent study conducted at the University of Minnesota has shown that mindfully consuming your coffee without sugar may help with not only weight loss but also a more focused approach to choices.

Drinking Unsweetened Coffee Can Lead to Mindfulness
Participants in the University of Minnesota study were divided into three groups. One group went cold turkey and immediately began drinking unsweetened coffee. A second group was allowed to gradually reduce the amount of sugar they added to their coffee. A third group was taught how to discern different flavors and tastes in coffee, and was instructed to mindfully drink their sugar-free brew by focusing on the sensations and the different flavors that were present in the beverage. They learned how to be mentally present to the action of drinking coffee, and in some cases to enjoy the beverage more than they had in the past.† After one month, the mindfulness group drinkers were more likely to enjoy their coffee and the drinking experience. They also continued to drink coffee sugar free more often than the other two groups who immediately eliminated or gradually reduced the amount of sweetener they added to their coffee.

Reducing Sugar Intake can Help Promote Food Awareness
Researchers suggest that the combination of reducing sugar intake as a tool to promote health, in conjunction with being mindful about the action, may lead to a longer-term healthier lifestyle. It is believed that making a conscious decision, in this case eliminating sugar in coffee, focuses attention on actions and being a participant in the choice, which can lead to mindfulness in other life choices. In an interview one of the researchers noted that beginning a lifestyle change is relatively easy, but sustaining change is very challenging. Researchers anticipated that most participants would go back to adding sweetener to their coffee, yet the majority of participants in the mindfulness group continued drinking their coffee sugar-free.

Author: ChiroPlanet.com
Source: J Health Psychol 2017.
Copyright: ProfessionalPlanets.com LLC 2017


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