March 2021 Health Newsletter

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» Chiropractic Reduces Falling Risk in the Elderly
» Studies Show Chiropractic “Maintenance Care” Beneficial for Back Pain
» Drink Water, Prevent Kidney Stones
» Curb the Bacon: Why Your Favorite Processed Meats Might Lead to 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


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Studies Show Chiropractic “Maintenance Care” Beneficial for Back Pain  

The American Chiropractic Association (ACA) states that approximately 31 million Americans suffer from back pain at any given time. This adds up to over $50 billion in healthcare costs annually. And then that price tag more than doubles when you factor in lost wages and decreased job productivity.

For decades, chiropractors have not only been saying chiropractic maintenance care for back pain is beneficial, it’s also cost effective. A research project called "The Nordic Maintenance Care Program" was launched with the aim to increase knowledge regarding maintenance care, utilizing chiropractors in Denmark, Sweden, Finland and Norway. A leading chiropractic publication, Chiropractic Economics, explained that this team put in hard work from 2008-2018 with four objectives:

  1. To define the concept of maintenance care and the indications for its use.
  2. To describe chiropractors’ belief in maintenance care and patients’ acceptance of it.
  3. To establish the prevalence with which chiropractors use maintenance care and possible characteristics of the chiropractors associated with its use.
  4. To determine its efficacy and cost-effectiveness for various types of conditions.

Maintenance

One study specifically investigated the patient perspective of maintenance care; patients were interviewed and asked to explain why they would visit their chiropractor on a regular basis. Patients stated that the purpose was:  

  • To prevent recurrences (78%);
  • To remain pain-free (68%);
  • Maintenance care as a wellness approach (17%).

Regarding the spacing of maintenance care treatments, most visits were scheduled by patients within a range of 1-3 months.

Cost-Effectiveness

A health-care register-based study found that health care use was smallest among the patients who received maintenance care from a chiropractor as opposed to those receiving care from other health care professionals.

A 2015 study by Simon Dagenais, et. al., gathered data from over 1300 studies. They discovered that compared to private health plans, chiropractic health care costs were lower. There are a lot of variables to control, but the bottom line is chiropractic maintenance care can be more effective and less costly than other forms of back pain care.

Author:ChiroPlanet.com
Source:PLoS One. 2018; 13(9): e0203029
Copyright:ProfessionalPlanets.com LLC 2021


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Drink Water, Prevent Kidney Stones  

New guidelines released from the American College of Physicians indicate that preventing kidney stones may be as simple as drinking more water.  Experts suggest drinking enough fluids to generate two liters of urine daily in order to keep kidney stones at bay. Kidney stones are formed from solid crystals in the urine and increasing the consumption of water dilutes the solids and decreases their abilities to form into stones. It should be noted that drinking any fluids does not generate the same benefits of drinking water alone. Certain fluids such as sodas, especially those containing phosphoric acid, can actually increase the formation of kidney stones. Stick with water and consume two to three liters daily with the goal of generating 2 liters of clear urine daily. If the urine is yellow, you're likely not consuming enough fluids.

Author:ChiroPlanet.com
Source:Ann Intern Med. 2014;161(9):I-24.
Copyright:ProfessionalPlanets.com LLC 2014


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Curb the Bacon: Why Your Favorite Processed Meats Might Lead to Cancer  

Experts have been debating bacon for years, but could this delicious food really lead to cancer? According to a study by the World Health Organization (WHO), there's a link between the regular consumption of bacon, along with other processed meats like hot dogs, and the risk for contracting colorectal cancer, which is cancer of the bowels.  WHO's International Agency for Research on Cancer also found a link between prolonged processed meat consumption and the risk for both pancreatic and prostate cancer as well. The IARC report estimated that for every 1.8 ounce of bacon consumed per day, the risk for bowel cancer rises by 18%. The findings from this report led WHO to deem processed meats as true carcinogens, just like tobacco. But not everyone is buying the argument that processed meat is as bad as tobacco. Almost a million deaths a year are caused by smoking cigarettes. While experts agree that over consumption of processed meats isn't healthy, bacon and other meats can be enjoyed in moderation without concern according to the National Resources Defense Council. The advocacy group also urges people to avoid the processed meat section and to buy fresh meat from high-quality sources instead.

Author:ChiroPlanet.com
Source:Reuters. October 27, 2015.
Copyright:ProfessionalPlanets.com LLC 2015


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