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» Chiropractic Reduces Falling Risk in the Elderly
» Noticing More Joint Pain Lately? Blame It on Stress
» Headaches Affect Nearly Half Of All Adults
» More Green Tea, Less 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


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Noticing More Joint Pain Lately? Blame It on Stress

What most everyone already knows is that the recent pandemic was stressful, and what a lot of people are noticing is more joint pain as of late. What most don't realize is that this stress could be connected to their joint pain.

Pandemic or not, stress can result in or contribute to joint pain. The good news is that chiropractic care can help with joint pain, and even help your body let go of stress.

How Stress Triggers Joint Pain

Back in the day, stress was a survival mechanism. Nowadays? Not so much. We're so caught up in having to work, pay bills and manage our household (including kids, pets, spouse, etc.) that all that stress energy doesn't have enough of an outlet to get expended. When we’re stressed, we can develop headaches, stomach issues, sleep issues and yes, even joint pain.

What's happening is that stress makes you tense up. Your body primes itself for fight or flight even though there isn't a saber-toothed tiger that’s about to try and eat you. When there’s no fight or flight to expel that energy (or a good workout regimen), stress remains in your body, alters your posture, and can physically manifest in many ways, including joint pain.

How Chiropractic Care Can Help with Joint Pain

Since every patient has unique healthcare needs, chiropractors will evaluate your health history and current state to determine the best course of action for your joint aches and pains. 

A chiropractor's goal is most commonly multifaceted–reduce stiffness and tension, return normal flexibility and function, and restore blood flow as well as reduce pain. By identifying and treating those problem areas, stiffness and limited joint motions can be restored and normal function and blood flow can be returned. 

The better we feel the more we tend to move. The more we move, including the movement of those affected joints, the more blood and nutrients flow throughout our body and into our joints. As a result, the body can begin to relax, range of motion improves and pain can begin to dissipate. In fact, many patients report immediate pain relief.

How Chiropractic Care Can Help with Stress

Chiropractors aren't a replacement for counselors or psychotherapists. Instead, they strive to help your body physically release and reduce stress. Oftentimes, reducing and removing the physical effects of stress can help reduce and remove the stress itself. 

So while there is a strong emotional side to stress, remember that there's a physical side as well, and your favorite chiropractor is here to help. 

Author: ChiroPlanet.com
Source: ChiroPlanet.com


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Headaches Affect Nearly Half Of All Adults

The World Health Organization (WHO) has reported that headaches have enormous costs to society and are hugely widespread throughout the world. According to the report, 47 percent of all adults have some sort of headache disorder. In the European Union (EU) alone, it's estimated that 190 million days are lost from work annually, solely due to migraine headaches. One in six women and one in twelve men are affected by migraines making it the most expensive brain disorder in the United States and EU with an estimated total annual cost of $229 billion. Doctors of chiropractic are highly trained to diagnose and treat a number of headache related disorders. In fact, many causes of headaches are soft-tissue based and can be successfully managed with safe, natural chiropractic procedures. If you experience headaches, no matter how severe or subtle, don't continue to suffer. Call your licensed doctor of chiropractic today for a professional, thorough consultation and/or examination.

Author: ChiroPlanet.com
Source: Reuters. May 3, 2011.


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More Green Tea, Less Cancer?

A recent medical study published in the American Journal of Clinical Nutrition suggests that women who drink green tea at least three times a week enjoy an overall 14% reduction in risk of colon, stomach and esophageal cancers. The study, conducted by the Vanderbilt University School of Medicine in Nashville, followed 69,000 Chinese women for over a decade. Women who drank green tea often and for long periods of time experienced lower cancer risks. Those who said they'd regularly had green tea for at least 20 years were 27% less likely than non-drinkers to develop any digestive system cancer and were 29% less likely to develop colorectal cancer. While the exact reasons the beverage may help resist cancers is unknown, researchers point out that green tea contains a compound known as EGCG and other antioxidant chemicals that may help cells resist the damage that can lead to cancer and other diseases. However, the study discounted a direct cause and effect relationship between green tea consumption and lowered incidences of cancer, pointing out that the test subjects were generally more health-conscious. None of the participants smoked or drank regularly and nearly all of them exercised regularly. The researchers conclude that clinical studies would be required to prove causation, and suggest that anyone considering green tea as part of an anti-cancer regimen consult first with their doctor.

Author: ChiroPlanet.com
Source: Am J Clin Nutr November 2012 Vol. 96 No. 5 1056-1063


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