Chiropractic care for older people may reduce deaths and injuries from falls according to researchers taking part in a study by Auckland University and the Chiropractic Research Centre (CRC) at the New Zealand College of Chiropractic on the neurophysiological effects of chiropractic on the brain.
According to chiropractor, PhD candidate and principal investigator of the study Dr Kelly Holt, falls often occur due to a decline in nervous system function with advancing age. This can lead to a loss of balance, or poor control of the limbs, which dramatically increases the risk of falling.
Dr Holt says: `Already it is estimated that in New Zealand slips, trips and falls cost almost $300 million per year in treatment and rehabilitation costs and as the population ages this will likely get worse.’ He says that ‘falls result in approximately 450 deaths per year in New Zealand and for older adults in particular, a fall can lead to a downward spiral that involves a loss of confidence, a cessation of day to day activities and eventually increased frailty and even death.’
ABSTRACT: The Effects of Manual Therapy on Balance and Falls: A Systematic Review
Journal of Manipulative and Physiological Therapeutics March/April 2012, Holt et al
The purpose of this study was to review the scientific literature on the effects of manual therapy interventions on falls and balance.
This systematic review included randomized and quasi-randomized controlled trials that investigated the effects of manual therapy interventions on falls or balance. Outcomes of interest were rate of falls, number of fallers reported, and measures of postural stability. Data sources included searches through June 2011 of Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, PsycINFO, Allied and Complimentary Medicine, Current Controlled Trials, Manual Alternative and Natural Therapy Index System, Index to the Chiropractic Literature, National Institutes of Health (USA), and Google Scholar.
Eleven trials were identified that met the inclusion criteria. Most trials had poor to fair methodological quality. All included trials reported outcomes of functional balance tests or tests that used a computerized balance platform. Nine of the 11 trials reported some statistically significant improvements relating to balance after an intervention that included a manual therapy component. The ability to draw conclusions from a number of the studies was limited by poor methodological quality or very low participant numbers. A meta-analysis was not performed due to heterogeneity of interventions and outcomes. Only 2 small trials included falls as an outcome measure, but as a feasibility study and a pilot study, no meaningful conclusions could be drawn about the effects of the intervention on falls.
A limited amount of research has been published that supports a role for manual therapy in improving postural stability and balance. More well-designed controlled trials with sufficient participant numbers are required to draw meaningful clinical conclusions about the role that manual therapies may play in preventing falls or improving postural stability and balance.