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New study suggests Vitamin D recommendations miscalculated

Source CTV News

We need far more vitamin D than previously thought, according to two teams of researchers from Canada and the US.

The Recommended Dietary Allowance (RDA) for vitamin D is ten times lower than what we actually need, say two teams of researchers who have challenged the US’s National Academy of Sciences (NAS) and the Institute of Medicine (IOM), both responsible for the RDA.

“The error has broad implications for public health regarding disease prevention and achieving the stated goal of ensuring that the whole population has enough vitamin D to maintain bone health,” says Dr. Cederic Garland, an adjunct professor at University of California, San Diego.

Currently the RDA for vitamin D established by the IOM is 600 international units per day until we reach 70 years of age, and 800 IU per day thereafter.

A Canadian research team reviewed each of the 10 studies the IOM used to arrive at their RDA and their calculations revealed that 600 IU of vitamin D per day puts only half of the amount that they had assumed in the blood.

In scientific terms, that means that 97.5 per cent of individuals will have serum 25 values of vitamin D above 26.8 nmol/L rather than above 50 nmol/L as the IOM had thought.

To get a serum 25 value of vitamin D of at least 50 nmol/L, you could need up to 8895 IU per day, according to the study.

Dr. Garland’s team of US researchers wrote a letter confirming the Canadian team’s findings, in which they suggest a slightly more conservative RDA.

“We call for the NAS-IOM and all public health authorities concerned with transmitting accurate nutritional information to the public to designate, as the RDA, a value of approximately 7,000 IU/day from all sources,” wrote Dr. Garland and his colleagues.

Dr. Garland added that the number is well below the 10,000 IU currently considered safe by the IOM for teenagers and adults.

Two versions exist: Vitamin D2, known as ergocalciferol, and vitamin D3, also known as cholecalciferol, which is thought to be the more potent and favorable version of the two.

Fatty fish, such as salmon, tuna, sardines and cod liver oil contain hearty amounts of vitamin D3, yet most vitamin D3 is synthesized in the skin upon sun exposure, according to the World Health Organization.

Cereals, cheese and milk could be an important source of both types of vitamin D depending upon where you live yet because they are often fortified with synthetic versions and the amounts may vary.

Vitamin D is important for skin, bone and heart health and deficiencies can result in rickets and abnormal skin pigmentation, yet side effects of excess intake are rare and minimal, according to WebMD.

Both the study and the letter were published in the journal Nutrients.

 

Effects of Acupuncture, Cervical Manipulation and NSAID therapy on Dizziness and Impaired Head Repositioning of Suspected Cervical Origin

Effects of Acupuncture, Cervical Manipulation and NSAID therapy on Dizziness and Impaired Head Repositioning of Suspected Cervical Origin:
A Pilot Study

The Chiro.Org Blog


SOURCE:   Man Ther 2000 (Aug);   5 (3):   151–157

Heikkila H, Johansson M, Wenngren BI

Department of Otorhinolaryngology,
Northern Sweden University Hospital,
Umea, Sweden.
hannu.heikkila@psychiat.umu.se


In a single-subject experiment undertaken on 14 consecutive patients, the effects of acupuncture, cervical manipulation, no therapy, and NSAID-percutan application on kinesthetic sensibility, dizziness/vertigo and pain were studied in patients with dizziness/vertigo of suspected cervical origin. The ability to perceive position of the head with respect to the trunk was studied. The effects of different forms of therapy-and none-on dizziness and neck pain were compared, using a 100 mm visual analogue scale (VAS). Active head relocation by subjects with dizziness was significantly less precise than in the control group. Manipulation was the only treatment to diminish the duration of dizziness/vertigo complaints during the past 7 days and increased the cervical range of motion.

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Vertigo, Balance and Chiropractic Page

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Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension-type Headache: A Randomized, Controlled Clinical Trial

Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension-type Headache: A Randomized, Controlled Clinical Trial

The Chiro.Org Blog


SOURCE:   J Chiropr Med. 2014 (Mar);   13 (1):   4—13

Espí-López Gemma V., PhD, PT, and Gómez-Conesa Antonia, PhD, PT

Professor, Physiotherapy Department,
University of Valencia, Spain


OBJECTIVE:   The purpose of this study was to evaluate the efficacy of manipulative and manual therapy treatments with regard to pain perception and neck mobility in patients with tension-type headache.

METHODS:   A randomized clinical trial was conducted on 84 adults diagnosed with tension-type headache. Eighty-four subjects were enrolled in this study: 68 women and 16 men. Mean age was 39.76 years, ranging from 18 to 65 years. A total of 57.1% were diagnosed with chronic tension-type headache and 42.9% with tension-type headache. Participants were divided into 3 treatment groups (manual therapy, manipulative therapy, a combination of manual and manipulative therapy) and a control group. Four treatment sessions were administered during 4 weeks, with posttreatment assessment and follow-up at 1 month. Cervical ranges of motion pain perception, and frequency and intensity of headaches were assessed.

RESULTS:   All 3 treatment groups showed significant improvements in the different dimensions of pain perception. Manual therapy and manipulative treatment improved some cervical ranges of motion. Headache frequency was reduced with manipulative treatment (P < .008). Combined treatment reported improvement after the treatment (P < .000) and at follow-up (P < .002). Pain intensity improved after the treatment and at follow-up with manipulative therapy (P < .01) and combined treatment (P < .01).

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Headache and Chiropractic Page

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The First Research Agenda For the
Chiropractic Profession in Europe

The First Research Agenda For the
Chiropractic Profession in Europe

The Chiro.Org Blog


SOURCE:  Chiropractic & Manual Therapies 2014 (Feb 10);   22 (1):   9

Sidney M Rubinstein, Jenni Bolton, Alexandra L Webb, and Jan Hartvigsen

Department of Health Sciences,
Faculty of Earth and Life Sciences,
VU University, Amsterdam,
1081 HV Amsterdam, The Netherlands.
S.M.Rubinstein@VU.nl


BACKGROUND:   Research involving chiropractors is evolving and expanding in Europe while resources are limited. Therefore, we considered it timely to initiate a research agenda for the chiropractic profession in Europe. The aim was to identify and suggest priorities for future research in order to best channel the available resources and facilitate advancement of the profession.

METHODS:   In total, 60 academics and clinicians working in a chiropractic setting, and who had attended any of the annual European Chiropractors’ Union/European Academy of Chiropractic (ECU/EAC) Researchers’ Day meetings since their inception in 2008, were invited to participate. Data collection consisted of the following phases: phase 1 identification of themes; phase 2 consensus, which employed a Delphi process and allowed us to distill the list of research priorities; and phase 3 presentation of the results during both the Researchers’ Day and a plenary session of the annual ECU Convention in May 2013. In addition, results were distributed to all ECU member countries.

RESULTS:   The response rate was 42% from phase 1 and 68% from phase 2. In general, participants were middle-aged, male and had been awarded a Doctor of Philosophy (PhD) as well as chiropractic degree. Approximately equal numbers of participants had obtained their chiropractic degree from the UK/Europe and North America. The majority of participants worked primarily in an academic/research environment and approximately half worked in an independent institution. In total, 58% of the participants were from the UK and Denmark, collectively representing 44% of the chiropractors working in Europe. In total, 70 research priorities were identified, of which 19 reached consensus as priorities for future research. The following three items were thought to be most important:

1) cost-effectiveness/economic evaluations,

2) identification of subgroups likely to respond to treatment, and

3) initiation and promotion of collaborative research activities.

Continue reading The First Research Agenda For the
Chiropractic Profession in Europe

Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury

Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther 1995 (May);   18 (4):   203–210

Terrett AG

School of Chiropractic and Osteopathy,
Faculty of Biomedical and Health Sciences,
RMIT University,
Bundoora, Australia


This article is reprinted with the permission of National College of Chiropractic and JMPT.   Our special thanks to the Editor, Dr. Dana Lawrence, D.C. for permission to reproduce this article exclusively at Chiro.Org


You may also want to review Wenban’s recent article:

Inappropriate Use of the Title Chiropractor and Term Chiropractic Manipulation in the Peer-reviewed Biomedical Literature


OBJECTIVE:  This study was conducted to determine how the words chiropractic and chiropractor have been used in publications in relation to the reporting of complications from cervical spinal manipulation therapy (SMT).

STUDY DESIGN:  The study method was to collect recent publications relating to spinal manipulation iatrogenesis which mentioned the words chiropractic and/or chiropractor and then determine the actual professional training of the practitioner involved.

METHOD:  The training of the practitioner in each report was determined by one of three means: surveying previous publications, surveying subsequent publications and/or by writing to the author(s) of ten recent publications which had used the words chiropractic and/or chiropractor.

RESULTS:  This study reveals that the words chiropractic and chiropractor commonly appear in the literature to describe SMT, or practitioner of SMT, in association with iatrogenic complications, regardless of the presence or absence of professional training of the practitioner involved.

CONCLUSION:  The words chiropractic and chiropractor have been incorrectly used in numerous publications dealing with SMT injury by medical authors, respected medical journals and medical organizations. In many cases, this is not accidental; the authors had access to original reports that identified the practitioner involved as a non–chiropractor. The true incidence of such reporting cannot be determined. Such reporting adversely affects the reader’s opinion of chiropractic and chiropractors.

There are more articles like this @ our:

Stroke and Chiropractic Page


From the Full-Text Article:

INTRODUCTION

Among the health professions, chiropractic has an impressive safety record for its 99-yr existence [1, 2]. Chiropractors in Australia are aware that complications can occur after spinal manipulation therapy (SMT), and, as responsible professionals, they have investigated and instituted procedures to minimize their occurrence [2-19]. In fact “the incidence and mechanisms are better reported in the chiropractic literature than elsewhere” [20].


METHODS

Continue reading Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury

Happy St. Patricks Day (2015)

Happy St. Patricks Day (2015)

The Chiro.Org Blog


May the road rise up to meet you.
May the wind always be at your back.
May the sun shine warm upon your face,
and rains fall soft upon your fields.
And until we meet again,
May God hold you in the palm of His hand.


Hearing Loss, Otalgia and Neck Pain

Hearing Loss, Otalgia and Neck Pain:
A Case Report on Long-Term Chiropractic Care That
Helped to Improve Quality of Life

The Chiro.Org Blog


SOURCE:   Chiropractic Journal of Australia 2002 (Dec); 32 (4):   119-130

Robert Cowin and Peter Bryner

Robert Cowin, DC,
Private practice of chiropractic,
Wollongong, New South Wales


Our thanks to the Chiropractic Journal of Australia and the editor, Mary Ann Chance, DC, FICC for permission to reproduce this article exclusively at Chiro.org!


Objective:   To describe symptom reports, multiple chiropractic assessments and adjustments over 7 years with a patient experiencing neck pain and complex ear symptoms consistent with Meniere’s syndrome.

Clinical Features:   A 43-year-old female, injured years earlier in a motor vehicle collision, suffered recurrent exacerbations of otherwise continuous neck pain. Later she developed aural symptoms of severe otalgia, hearing difficulty, tinnitus and dizziness that increased and decreased in severity with her neck pain.

Intervention and Outcome:   The intervention was repeated application of chiropractic adjustments using a modified Pettibon adjusting device. Over 7 years of observation, the subject consistently reported reduction in symptom severity after adjustments, with relief lasting up to 2 months. Consistent with the natural history of Meniere’s syndrome, an overall deterioration was noted during the observation period. Hearing fluctuated in approximate synchrony with changes in angular displacements of upper cervical vertebrae during the treatment period.

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Case Reports Section and the:

Deafness and Chiropractic Page

Continue reading Hearing Loss, Otalgia and Neck Pain

Spinal Manipulative Therapy and
Somatosensory Activation

Spinal Manipulative Therapy and
Somatosensory Activation

The Chiro.Org Blog


SOURCE:   J Electromyogr Kinesiol. 2012 (Oct);   22 (5):   785–794

Joel G Pickar, DC PhD and Philip S Bolton, DC PhD

Palmer Center for Chiropractic Research,
Palmer College of Chiropractic,
Davenport, IA, USA.
pickar_j@palmer.edu


Manually-applied movement and mobilization of body parts as a healing activity has been used for centuries. A relatively high velocity, low amplitude force applied to the vertebral column with therapeutic intent, referred to as spinal manipulative therapy (SMT), is one such activity. It is most commonly used by chiropractors, but other healthcare practitioners including osteopaths and physiotherapists also perform SMT. The mechanisms responsible for the therapeutic effects of SMT remain unclear. Early theories proposed that the nervous system mediates the effects of SMT. The goal of this article is to briefly update our knowledge regarding several physical characteristics of an applied SMT, and review what is known about the signaling characteristics of sensory neurons innervating the vertebral column in response to spinal manipulation. Based upon the experimental literature, we propose that SMT may produce a sustained change in the synaptic efficacy of central neurons by evoking a high frequency, bursting discharge from several types of dynamically-sensitive, mechanosensitive paraspinal primary afferent neurons.


From the FULL TEXT Article:

INTRODUCTION

Manually-applied movement and mobilisation of body parts as a healing activity has been used for centuries (Wiese & Callender, 2005). A relatively high velocity, low amplitude force applied to the vertebral column with therapeutic intent, referred to as spinal manipulative therapy (SMT), is one such activity. It is most commonly used by chiropractors, but other healthcare practitioners including osteopaths and physiotherapists use it as well. Although SMT has been advocated for a wide range of health problems (Ernst & Gilbey, 2010), currently available best evidence suggests it has a therapeutic effect on people suffering some forms of acute neck and back pain particularly when it is used in combination with other therapies (Brønfort et al, 2004; Brønfort et al, 2010; Dagenais et al, 2010; Miller et al 2010; Walker et al 2010; Lau et al 2011). Its effect on chronic low back pain is less clear (Rubinstein et al 2011; Walker et al 2010).

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What is the Chiropractic Subluxation? Page

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Somatosensory Activation

Reflex Control of the Spine and Posture

Reflex Control of the Spine and Posture: A Review of the Literature From a Chiropractic Perspective

The Chiro.Org Blog


SOURCE:   Chiropractic & Osteopathy 2005 (Aug 9);   13:   16

Mark W Morningstar, Burl R Pettibon, Heidi Schlappi,
Mark Schlappi, and Trevor V Ireland

The Pettibon Institute,
Gig Harbor, WA 98335, USA.
morningstar@pettiboninstitute.org


OBJECTIVE:   This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth’s gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness.

BACKGROUND:   Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice.

METHOD:   We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: “posture, ” “ocular, ” “vestibular, ” “cervical facet joint, ” “afferent, ” “vestibulocollic, ” “cervicocollic, ” “postural reflexes, ” “spaceflight, ” “microgravity, ” “weightlessness, ” “gravity, ” “posture, ” and “postural.” Studies were selected if they specifically tested any or all of the postural reflexes either in Earth’s gravity or in microgravitational environments. Studies testing the function of each postural component, as well as those discussing postural reflex interactions, were also included in this review.

DISCUSSION:   It is quite apparent from the indexed literature we searched that posture is largely maintained by reflexive, involuntary control. While reflexive components for postural control are found in skin and joint receptors, somatic graviceptors, and baroreceptors throughout the body, much of the reflexive postural control mechanisms are housed, or occur, within the head and neck region primarily. We suggest that the postural reflexes may function in a hierarchical fashion. This hierarchy may well be based on the gravity-dependent or gravity-independent nature of each postural reflex. Some or all of these postural reflexes may contribute to the development of a postural body scheme, a conceptual internal representation of the external environment under normal gravity. This model may be the framework through which the postural reflexes anticipate and adapt to new gravitational environments.

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Forward Head Posture Page

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The Effect of Adding Forward Head Posture Corrective Exercises in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Study

The Effect of Adding Forward Head Posture Corrective Exercises in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Study

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2015 (Feb 19) [Epub ahead of print]

Ibrahim M. Moustafa, PT, PhD, Aliaa A. Diab, PT, PhD

Assistant Professor,
Basic Science Department,
Faculty of Physical Therapy,
Cairo University, Giza, Egypt.
ibrahiem.mostafa@pt.cu.edu.eg


Objective   The purpose of this study was to determine the immediate and long-term effects of a multimodal program, with the addition of forward head posture correction, in patients with chronic discogenic lumbosacral radiculopathy.

Methods   This randomized clinical study included 154 adult patients (54 females) who experienced chronic discogenic lumbosacral radiculopathy and had forward head posture. One group received a functional restoration program, and the experimental group received forward head posture corrective exercises. Primary outcomes were the Oswestry Disability Index (ODI). Secondary outcomes included the anterior head translation, lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, pelvic inclination, leg and back pain scores, and H-reflex latency and amplitude. Patients were assessed at 3 intervals (pretreatment, 10-week posttreatment, and 2-year follow-up).

Results   A general linear model with repeated measures indicated a significant group × time effect in favor of the experimental group on the measures of ODI (F = 89.7; P < .0005), anterior head translation (F = 23.6; P < .0005), H-reflex amplitude (F = 151.4; P < .0005), H-reflex latency (F = 99.2; P < .0005), back pain (F = 140.8; P < .0005), and leg pain (F = 72; P < .0005). After 10 weeks, the results revealed an insignificant difference between the groups for ODI (P = .08), back pain (P = .29), leg pain (P = .019), H-reflex amplitude (P = .09), and H-reflex latency (P = .098). At the 2-year follow-up, there were significant differences between the groups for all variables adopted for this study (P < .05).

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Mediterranean Diet and Telomere Length in Nurses’ Health Study

Mediterranean Diet and Telomere Length in Nurses’ Health Study: Population Based Cohort Study

The Chiro.Org Blog


SOURCE:   British Medical Journal 2014 (Dec 2); 349: g6674 ~ FULL TEXT

Marta Crous-Bou, Teresa T Fung, Jennifer Prescott, Bettina Julin,
Mengmeng Du, Qi Sun, Kathryn M Rexrode, Frank B Hu, Immaculata De Vivo

Channing Division of Network Medicine,
Department of Medicine, Brigham and Women’s Hospital
and Harvard Medical School, Boston, MA 02115, USA
Department of Epidemiology, Program in Genetic Epidemiology
and Statistical Genetics,
Harvard School of Public Health,
Boston, MA 02115, USA.


OBJECTIVE:   To examine whether adherence to the Mediterranean diet was associated with longer telomere length, a biomarker of aging.

DESIGN:   Population based cohort study.

SETTING:   Nurses’ Health Study, an ongoing prospective cohort study of 121,700 nurses enrolled in 1976; in 1989-90 a subset of 32,825 women provided blood samples.

PARTICIPANTS:   4676 disease-free women from nested case-control studies within the Nurses’ Health Study with telomere length measured who also completed food frequency questionnaires.

MAIN OUTCOME MEASURE:   Association between relative telomere lengths in peripheral blood leukocytes measured by quantitative real time polymerase chain reaction and Alternate Mediterranean Diet score calculated from self reported dietary data.

RESULTS:   Greater adherence to the Mediterranean diet was associated with longer telomeres after adjustment for potential confounders. Least squares mean telomere length z scores were -0.038 (SE 0.035) for the lowest Mediterranean diet score groups and 0.072 (0.030) for the highest group (P for trend = 0.004).

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All About Telomeres Page

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Beyond the Spine:
A New Clinical Research Priority

Beyond the Spine:
A New Clinical Research Priority

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2015 (Mar);   59 (1): 6–12

James Donovan, BSc, DC, J. David Cassidy, DC, PhD, DrMedSc,
Carol Cancelliere, DC, MPH, Erik Poulsen, DC, PhD,
Mette Jensen Stochkendahl, DC, PhD, Jørgen Kilsgaard, DC, MPH,
Marc-André Blanchette, DC, MSc, and Jan Hartvigsen, DC, PhD

Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Canada (Donovan, Cancelliere, Cassidy); Institute of Health Policy, Management and Evaluation, University of Toronto, Canada (Cancelliere, Cassidy); Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark (Stochkendahl, Poulsen, Hartvigsen), School of Public Health, University of Montreal, Montreal QC, Canada (Blanchette); KIApro Worklife Healthcare, Herlev, Denmark (Kilsgaard); Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark (Cassidy, Hartvigsen).


Over the past two decades, clinical research within the chiropractic profession has focused on the spine and spinal conditions, specifically neck and low back pain. However, there is now a small group of chiropractors with clinical research training that are shifting their focus away from traditional research pursuits towards new and innovative areas. Specifically, these researchers are now delving into areas such as brain injury, work disability prevention, undifferentiated chest pain, hip osteoarthritis, and prevention of pain in children and adolescents to name a few. In this paper, we highlight recent research in these new areas and discuss how clinical research efforts in musculoskeletal areas beyond the spine can benefit patient care and the future of the chiropractic profession.

KEYWORDS:   OA; brain injury; chest pain; chiropractic; research; work disability


From the FULL TEXT Article:

Introduction

Chiropractors with clinical research training have traditionally focused on the spine and its related disorders and especially neck and low back pain. Examples include the recent Decade of the Bone and Joint 2000–2010 Task Force on Neck Pain and Its Associated Disorders [1] as well as several excellent randomized trials of spinal manipulative therapy (SMT) for neck [2] and low back pain [3–5]. Despite these and many other research successes, from 1990 to 2010 disability from spine-related pain has significantly increased, with low back pain now the leading cause of global disability, affecting 10% of the population or more than 600 million people worldwide. [6] Over the same two decades, disability from other musculoskeletal disorders has also increased by 44.6% [7], and with an aging and increasingly sedentary society this trend is likely to continue and so too will the demand for improved care and prevention. Even patients seeking care for neck and low back pain rarely have pain isolated to just the spine and frequently report co-occurring non-spinal pain, not to mention other co-morbid diseases. [8] Chiropractors already commonly manage a variety of musculoskeletal disorders and at different anatomical sites, not just those related to the spine. Taken together, these facts provide a good basis to promote the growth of clinical research efforts in other non-spinal musculoskeletal areas.

Continue reading Beyond the Spine:
A New Clinical Research Priority

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

The Chiro.Org Blog


SOURCE:   Spine J. 2014 (Sep 1);   14 (9):   1879–1889

Michele Maiers, DC, MPH, Gert Bronfort, DC, PhD,
Roni Evans, DC, MS, Jan Hartvigsen, DC, PhD,
Kenneth Svendsen, MS, Yiscah Bracha, MS,
Craig Schulz, DC, MS, Karen Schulz, DC,
Richard Grimm, MD, PhD

Northwestern Health Sciences University,
Wolfe-Harris Center for Clinical Studies,
2501 W. 84th St, Bloomington, MN 55431, USA
mmaiers@nwhealth.edu


BACKGROUND CONTEXT:   Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy (SMT) and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors.

PURPOSE:   To assess the relative effectiveness of SMT and supervised rehabilitative exercise, both in combination with and compared to home exercise (HE) alone for neck pain in individuals ages 65 years or older.

STUDY DESIGN/SETTING:   Randomized clinical trial.

PATIENT SAMPLE:   Individuals 65 years of age or older with a primary complaint of mechanical neck pain, rated =3 (0-10) for 12 weeks or longer in duration.

OUTCOME MEASURES:   Patient self-report outcomes were collected at baseline and 4, 12, 26, and 52 weeks after randomization. The primary outcome was pain, measured by an 11-box numerical rating scale. Secondary outcomes included disability (Neck Disability Index), general health status (Medical Outcomes Study Short Form-36), satisfaction (7-point scale), improvement (9-point scale), and medication use (days per week).

METHODS:   This study was funded by the US Department of Health and Human Services, Health Resources and Services Administration. Linear mixed model analyses were used for comparisons at individual time points and for short- and long-term analyses. Blinded evaluations of objective outcomes were performed at baseline and 12 weeks. Adverse event data were collected at each treatment visit.

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Chronic Neck Pain and Chiropractic Page

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Is There a Role for Neck Manipulation in
Elderly Falls Prevention? – An Overview

Is There a Role for Neck Manipulation in
Elderly Falls Prevention? – An Overview

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2015 (Mar);   59 (1):   53–63

Julie C. Kendall, BAppSc, MClinChiro [1]
Jan Hartvigsen, DC, PhD [2]
Simon D. French, BAppSc(Chiro), MPH, PhD [3]
Michael F. Azari, BAppSc(Chiro), BSc(Hons), PhD* [1,4]

1 Discipline of Chiropractic, School of Health Sciences,
RMIT University, Melbourne, Australia

2 Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark and Nordic Institute of
Chiropractic and Clinical Biomechanics, Odense, Denmark

3 School of Rehabilitation Therapy, Queens University,
Kingston, Canada

4 Health Innovations Research Institute, RMIT University,
Melbourne, Australia


Many risk factors exist for falls in the elderly. Dizziness is an important risk factor for such falls. Spinal pain has also been identified as a risk factor for these falls. In this overview of the literature, we examine studies, including trials, of neck manipulation for neck pain, unsteadiness and falls risk relevant to the elderly. We also examine two related, but not mutually exclusive, mechanisms through which a putative beneficial effect may be mediated. These are the effects of neck manipulation on neck pain and on non-specific dizziness. We focus on the available evidence primarily in terms of clinical data rather than laboratory-based measures of balance. We conclude that chiropractors may have a role in falls prevention strategies in the subpopulation of the elderly that suffer from mechanical neck pain or dysfunction and non-specific dizziness. However, this role remains to be rigorously studied and properly defined.

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Vertigo and Chiropractic Page and our:

Chronic Neck Pain and Chiropractic Page


Introduction

Continue reading Is There a Role for Neck Manipulation in
Elderly Falls Prevention? – An Overview

Identification of Internal Carotid Artery Dissection

Identification of Internal Carotid Artery Dissection in Chiropractic Practice

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2004 (Sep);   48 (3):   206-210

Michael T Haneline, DC, MPH and Gary Lewkovich, DC

Palmer College of Chiropractic West,
Palmer Center for Chiropractic Research,
90 E. Tasman Drive,
San Jose, CA 95134
michael.haneline@palmer.edu


Internal carotid artery dissection (ICAD) is a condition involving separation of the artery’s intimal lining from its medial division, with subsequent extension of the dissection along varying distances of the artery, usually in the direction of blood flow. ICAD may produce cerebral ischemia due to occlusion of the involved artery. This occlusion may occur at or near the site of the dissection, or “downstream” as a result of embolization from a dislodged thrombus fragment. The problem any chiropractic physician faces in identifying ICAD patients is that the condition may present without any symptoms or the symptoms may appear benign (e.g., headache, neck pain or cervicogenic dizziness). Consequently, it may be impossible to identify some ICAD patients, especially in the early stages of the pathology. As the ICAD progresses and neural blood flow is compromised, the symptom picture typically manifests more completely. The chiropractic physician must be alert to characteristic findings of a progressing ICAD, since an immediate referral to a medical specialist may be required.

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Stroke and Chiropractic Page


From the FULL TEXT Article:

Continue reading Identification of Internal Carotid Artery Dissection