October 2020 Health Newsletter

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» Chiropractic Reduces Falling Risk in the Elderly
» Get 'Active and Adaptive' During National Chiropractic Health Month
» Cardiovascular Health May Begin with Breakfast
» Women: Want to Avoid Heart Failure? Try Walking

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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Get 'Active and Adaptive' During National Chiropractic Health Month  

During this October's National Chiropractic Health Month (NCHM), the American Chiropractic Association (ACA) and chiropractors nationwide are encouraging the public to get "active and adaptive" to maintain their musculoskeletal health and function in the wake of the COVID-19 pandemic.  Since March, many people have incorporated changes into their daily routines to reduce their potential exposure to the novel coronavirus: avoiding crowded public spaces, working from home, forgoing air travel for long car trips, ordering food and supplies online, and avoiding gyms and health clubs.  Because of this new normal, many are moving less and experiencing musculoskeletal pain.  Polls conducted by ACA confirm that chiropractors are seeing an increase in musculoskeletal conditions such as back pain, neck pain, and headaches since the beginning of the pandemic. When asked what they believe is contributing most to these conditions, ACA members cite lack of movement, stress and poor posture as key factors.  During NCHM, chiropractors are encouraging the public to choose healthy ways to adapt to the new normal by getting enough movement during the day, being aware of posture and ways to improve it, getting adequate rest, and managing stress naturally.  Learn more by visiting Hands Down Better and follow the conversation on social media with the hashtag #ActiveAdaptive.  "Inactivity has been a growing problem worldwide, even before the pandemic.  While the coronavirus may limit our options, finding ways to incorporate more physical activity, as well as improved posture, throughout the day can benefit our health now and into the future," said ACA President Robert C. Jones, DC.  National Chiropractic Health Month (NCHM) is a nationwide observance held each October.  NCHM educates the public about the importance of musculoskeletal health and raises awareness of the benefits of chiropractic care and its natural, patient-centered and drug-free approach to pain management, health and wellness.

Author:American Chiropractic Association
Source:Acatoday.org, September 9, 2020.
Copyright:American Chiropractic Association 2020


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Cardiovascular Health May Begin with Breakfast  

There are several ways to lower the risks of heart attack, cardiovascular disease, blood vessel diseases, and stroke. Although it is important to watch the kind of food that goes into the body, many studies have shown that it may be equally as important to pay attention to the timing of meals. Here are three ways to boost cardiovascular health:
1. Meal Planning. According to a statement released by the American Heart Association, planning the meals and snacks that you have throughout the day can help lower the risks of cardiovascular disease. This is due to the metabolic rates of the body throughout the day.
2. Eating Breakfast Daily. Several studies have found correlations between increased cardiovascular health and people who consume breakfast regularly. There is a much lower risk of high cholesterol and high blood pressure associated with those who consume breakfast daily.
3. Lowering Food Consumption in the Evening. At night it is harder for the body to digest and process various foods. Many studies have shown that this may be due to a decreased metabolic rate in the evening. For this reason, lowering the amount of food eaten in the evening can lead to better cardiovascular health.
Using these methods to carefully plan meals and snacks for each day can help reduce the many risk factors surrounding cardiovascular disease including high blood pressure, high cholesterol, obesity, and insulin complications such as insulin resistance.

Author:ChiroPlanet.com
Source:Circulation, online January 30, 2017.
Copyright:ProfessionalPlanets.com LLC 2017


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Women: Want to Avoid Heart Failure? Try Walking  

New research suggests that women who exercise regularly, including walking, may lower their risk for heart failure. The study from researchers at the University of Buffalo in New York looked at over 137,000 women aged 50-79, of which over one-third had high blood pressure and other heart disease risk factors such as smoking and diabetes. After a follow-up period of 14 years, researchers found that the women who got some form of physical activity were less likely to suffer from heart failure (11%). Women with the highest levels of physical activity, meanwhile, were the least likely to suffer from heart failure (35%), as compared to women who got no exercise at all. In addition, women who got the most physical activity were the least likely to develop a sub-type of heart failure called reduced ejection fraction (32%) as compared to women who never exercised. 33% of the same group of women were also the least likely to develop another sub-type of heart failure called a preserved ejection fraction. One of the biggest findings from the study, however, is that walking works just as well as other forms of exercise, including more vigorous types. To discover how much exercise the women got, researchers studied answers to a questionnaire about exercise that every participant completed. As it turns out, walking was the most common type of physical activity reported.

Author:ChiroPlanet.com
Source:JACC: Heart Failure, online September 5, 2018.
Copyright:ProfessionalPlanets.com LLC 2018


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