SENIOR CARE
 
   

Senior Care

This section was compiled by Frank M. Painter, D.C.
Send all comments or additions to:
  Frankp@chiro.org

If there are terms in these articles you don't understand, you can get a definition from the Merriam Webster Medical Dictionary. If you want information about a specific disease, you can access the Merck Manual. You can also search Pub Med for more abstracts on this, or any other health topic.


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Chiropractors as the Spinal Health Care Experts
A Chiro.Org article collection

Enjoy these articles about chiropractors as first-contact Spinal Health Care Experts.

Chiropractic Care For Veterans
A Chiro.Org article collection

Chiropractic care has been adopted by the military at veterans' centers and military bases around the country. Learn more now.

The Vertigo, Balance and Chiropractic Page
A Chiro.Org article collection

Enjoy this collection of articles that detail how chiropractic care may support dizziness, vertigo and related balance disorders.

Pain Management and Chiropractic
A Chiro.Org article collection

Explore this collection of articles that discusses the relationship between tissue injury and various pyschosocial factors that may contribute towards developing chronic pain.

Best Practices for Chiropractic Care for Older Adults: A Systematic Review
and Consensus Update

J Manipulative Physiol Ther 2017 (May);   40 (4):   217229 ~ FULL TEXT

A total of 199 articles were found; after exclusion criteria were applied, 6 articles about effectiveness or efficacy and 6 on safety were added. The Delphi process was conducted from April to June 2016. Of the 37 Delphi panelists, 31 were DCs and 6 were other health care professionals. Three Delphi rounds were conducted to reach consensus on all 45 statements. As a result, statements regarding the safety of manipulation were strengthened and additional statements were added recommending that DCs advise patients on exercise and that manipulation and mobilization contribute to general positive outcomes beyond pain reduction only.
This is an update of the 2010 Consensus Document titled:
Recommendations for Chiropractic Care for Older Adults: Results of a Consensus Process

Adverse Events Among Seniors Receiving Spinal Manipulation and Exercise
in a Randomized Clinical Trial

Man Ther. 2015 (Apr);   20 (2):   335341 ~ FULL TEXT

Non-serious AE were reported by 130/194 participants. AE were reported by three times as many participants in supervised plus home exercise, and nearly twice as many as in SMT with home exercise, as in home exercise alone. The majority of AE were musculoskeletal in nature; several participants associated AE with specific exercises. One incapacitating AE occurred when a participant fell during supervised exercise session and fractured their arm. One serious adverse event of unknown relationship occurred to an individual who died from an aneurysm while at home. Eight serious, non-related AE also occurred. Musculoskeletal AE were common among elderly participants receiving SMT and exercise interventions for NP. As such, they should be expected and discussed when developing care plans.

Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans:
A Prospective, Randomized, Placebo-Controlled Trial

Geriatric Orthopaedic Surgery and Rehab. 2014 (Dec);   5 (4):   154164 ~ FULL TEXT

This is an interesting, but disappointing study. On a quick read-through, it appears to suggest that chiropractic adjusting (spinal manipulative therapy, or SMT) is no more effective than a placebo. My first reaction (OH NO!) was that this is just another study to fall into the black hole of previous placebo studies, in which both groups improved (and in this case, SMT did fare slightly better) but are difficult to distinguish between groups at 12-weeks. (8-weeks after the care had ended).

On closer examination, the actual breakdown of treatment was: Of the 69 patients randomized to the SMT group,

19   (28%)   underwent HVLA spinal manipulation,
57   (83%)   underwent flexion distraction, and
29   (42%)   underwent mobilization.
A-Ha! So, LESS THAN 13 of these patients actually received SMT, while one-half of then received mobilization.   That means that this paper should have concluded that mobilization (or flexion distraction) of the spine appears to be no more effective than placebo.

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain
Spine J. 2014 (Sep 1);   14 (9):   18791889

Spinal manipulative therapy (SMT) with home exercise resulted in greater pain reduction after 12 weeks of treatment compared with both supervised plus HE and HE alone. Supervised exercise sessions added little benefit to the HE-alone program.

The Role of Chiropractic Care in Older Adults
Chiropractic & Manual Therapies 2012 (Feb 21);   20 (1):   3 ~ FULL TEXT

While there is already substantial published research to assist the evidence-based DC in his/her care plan for the older adult, there is a need for well designed clinical trials and large observational studies to identify the most beneficial treatments, particularly for complementary and alternative interventions such as manual therapy including, but not limited to, spinal manipulative therapy and acupuncture.

Geriatric Chiropractic Care as a Health Promotion and
Disease Prevention Initiative: Focus on Fall Prevention

Topics in Integrative Health Care 2010 (Dec 30);   1 (2) ~ FULL TEXT

The chiropractic profession is well positioned to align itself with the principles of health promotion and disease prevention championed by the World Health Organization. As a means to explain how chiropractic practice models and the WHO position statements can converge, this article will use the example of fall prevention. This article will discuss the epidemiology, risk factors, patient assessment tools and preventive strategies of falls prevention for older patients.
There are more articles like this at our Vertigo, Balance and Chiropractic Page

Best Practices Recommendations for Chiropractic Care for Older Adults:
Results of a Consensus Process

J Manipulative Physiol Ther 2010 (Jul);   33 (6):   464473 ~ FULL TEXT

By 2030, nearly 1 in 5 US residents is expected to be 65 years or older. [1] Chiropractors commonly provide care to older adults in the United States, with approximately 14% of chiropractic patients being 65 years or older. [2] With musculoskeletal conditions cited as a leading cause of disability in this population, [3] it is important that the large body of evidence for the effectiveness of chiropractic care be examined for relevance to the geriatric population. This is particularly important given the statements made by the American Geriatric Society (AGS) in their clinical practice guidelines for the management of chronic pain in older adults. The 1998 AGS report made the following recommendation on chiropractic (based on the single study available at that time): [4]
These recommendations have been updated by the 2017 article:
Best Practices for Chiropractic Care for Older Adults: A Systematic Review and Consensus Update

Assessment of Balance and Risk for Falls in a Sample
of Community-dwelling Adults Aged 65 and Older

Chiropractic & Osteopathy 2006 (Jan 27);   14:   3 ~ FULL TEXT

A total of 101 participants enrolled in the study. Advertising in the local senior newspaper was the most effective method of recruitment (46%). The majority of our participants were white (86%) females (67%). About one third (32%) of participants had a baseline BBS score below 46, the cut-off point for predicting risk of falling. A mean improvement in BBS scores of 1.7 points was observed on the second visit. For the subgroup with baseline scores below 46, the mean change was 4.5 points, but the group mean remained below 46 (42.5).
There are more articles like this at our Vertigo, Balance and Chiropractic Page

Chiropractic Patients in a Comprehensive Home-Based Geriatric Assessment,
Follow-up and Health Promotion Program

Topics In Clinical Chriopractic 1996 (Jun):   3 (2):   4655

Coulter et al performed an analysis of an insurance database, comparing persons receiving chiropractic care with nonchiropractic patients. The study consisted of senior citizens >75 years of age. Recipients of chiropractic care reported better overall health, spent fewer days in hospitals and nursing homes, used fewer prescription drugs, and were more active than the nonchiropractic patients.



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