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September 2008

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Pregnancy-Related Low Back Pain Helped with Chiropractic

A review of previous studies on the effectiveness of chiropractic for pregnant women with lower back pain was published in the July  2008 edition of the Journal of Manipulative and Physiological Therapeutics (JMPT).  This study looked at previously published works on this subject to review the body of evidence for the effectiveness of chiropractic care.

The JMPT report starts off by noting that between 50% and 80% of pregnant women suffer from low back pain (LBP) during their pregnancy. They noted that a review of previous work showed that from 68% to 85% of pregnant women with back pain during pregnancy do not look for any care for their lower back pain. The authors theorize that this is because most pregnant women consider back pain to be a normal part of the pregnancy.

 In reviewing all the scientific literature on the subject of chiropractic for low back pain in pregnancy, the authors of the JMPT review narrowed their selection down to 6 studies that met their specific criteria. The results of the various studies showed a high percentage of pregnant women did get relief from their lower back pain through chiropractic.

In one reviewed study 84% of the 25 subjects reported relief of their lower back pain.  In a larger study of 103 patients who received chiropractic care during their pregnancy, all of the women reported greater than 50% decrease in back pain on a questionnaire.  In yet another case series where 120 pregnant women with LBP underwent an average of 15 chiropractic treatments, the results showed that 25% had complete remission of their back pain, 50% reported feeling very well, 15% were feeling better, and 10% noted no change in condition.

Interestingly, none of the studies reviewed for the JMPT report indicated any adverse effects or evidence of harm to either the pregnant woman or unborn child from the chiropractic care.  The authors of the JMPT report noted that there was a need for more comprehensive studies involving control groups, but they did note that all studies they included reported positive results for the subject under chiropractic care. They noted in their conclusion, "Results from the 6 included studies showed that chiropractic care is associated with improved outcome in pregnancy-related LBP."

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Walking Boosts Brainpower

The above headline comes from WebMD on September 2, 2008.  It is based on a study published in the September 3, 2008 issue of the Journal of the American Medical Association (JAMA).   The WebMD article starts off by stating, "Older adults who take a brisk stroll just three times a week could boost their brainpower and reduce the risk of memory-robbing illnesses such as Alzheimer's disease."

The study conducted between 2004 and 2007, in Perth, Western Australia reviewed the results of 138 participants, in the study who completed an 18 month assessment. The participants in this study were all 50 years of age and older and reported some degree of memory problems, but did not meet the criteria to be classified as having dementia. The average age of the participants was 69 years.

Participants were placed into one of two groups.  One group, which researchers called the "usual care group", was given education while those assigned to the activity program exercised 142 more minutes each week, or 20 more minutes per day, than those in the usual care group.  Walking was the most frequently recommended type of activity.

Those in the walking group scored higher on cognitive tests and had better delayed recall.  Researchers also found lower Clinical Dementia Rating scores among those who were in the more physically active group.  Lead author, Nicola T. Lautenschlager, MD, of the University of Melbourne, Australia commented, "Unlike medication, which was found to have no significant effect on mild cognitive impairment at 36 months, physical activity has the advantage of health benefits that are not confined to cognitive function alone, as suggested by findings on depression, quality of life, falls, cardiovascular function, and disability." He also noted that, "At 6 months, participants in the physical activity group were walking about 9,000 steps a week more than the usual care group."

A similar study was conducted at the University of Zurich in Switzerland, and published in the August 2006 issue of the scientific journal Stroke. The stroke study was reported on in the September 8, 2008 LA Times.  This study was conducted on stroke victims where half of those in that study were given walking exercises on a treadmill while half were only given stretching exercises. These stroke victims  were later re-evaluated using functional MRI tests and revealed intensified activity in certain portions of the brain in the walking group, while the stretching group showed no change at all.  These researchers commented, "We found that change can not only happen in the superficial layers of the brain, but in the deeper brain levels as well."

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Chiropractic Care Helping Disabled War Veterans Realize Their Potential in Triathlon Series

An article in the September 4, 2008 Market Watch by the The Foundation for Chiropractic Progress reported on how chiropractic care was helping disabled war veterans competing in the Escape from Alcatraz Triathlon Series. The group of disabled veterans, known as "Team Semper Fi," came forward to validate the value of chiropractic care in improving their ability to compete against able-bodied athletes.  The event involved swimming against the fierce currents from Alcatraz Island to San Francisco; biking 18 miles; and running eight miles in a triathlon.

The article notes that Team Semper Fi is a sports program designed to help rehabilitate injured Marines and Sailors. Each month, team members compete in triathlons, venture races, marathons, and 10k races. They compete against a variety of professional athletes, amateurs, and beginners, both disabled and able-bodied athletes.

Iraq war veteran, Eric Frazier, the team's leading hand cyclist who suffered a paralyzing injury to the spinal cord and now uses his hands and arms to propel his cycle, commented, "Competing in these events has actually made my life ten times better and has given me tremendous self-worth. After any race, my upper body is in pain because I do it all with my hands and arms. Following chiropractic care, I find that I perform better."

Dan Lasko, who lost his left leg below the knee in two IED (Improvised Exploding Device) roadside explosions while serving in the U.S. armed forces during the war on terror in Afghanistan, added, "With my injury and a prosthetic leg, my back is always in pain. But when it comes to triathlons, chiropractic has helped out tremendously, I see my chiropractor before the event and a few days later, it just makes me a better athlete overall."

Dr. Morgan, a chiropractor who cares for these athletes and is the staff chiropractor for the National Naval Medical Center, Bethesda, Maryland, and affiliate chiropractor at Walter Reed Army Medical Center in Washington, DC, showed his respect by saying, "I salute the brave fighters who have overcome so much to compete in these athletic events. I can think of no greater honor than to provide care for those injured while in the service of their country."

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Healing Takes Time and Repetition

Time and repetition are the key components to chiropractic helping people with headaches, neck and upper back pain. These are essentially the findings of a study published in the August 21, 2008 edition of the scientific periodical, the Journal of Vertebral Subluxation Research. 

Over the years critics of chiropractic and insurance companies attempting to maximize profits at the expense of good patient care, have attempted to limit the number of chiropractic visits claiming that more than 6 to 12 visits are not needed.  While it is accepted that every individual under chiropractic care will respond differently, a comprehensive study was done to see if there was any legitimacy to the attempts to limit chiropractic to a certain number.

Researchers in this study looked at published "Randomized Clinical Trials" (RCTs) to determine if there was any validity to the 6 - 12 visit argument. In total 47 chiropractic studies were found involving 2,069 patients with headaches, neck and upper back pain. The data from these RCTs was analyzed by reviewing the total number of subjects in these 47 studies, the average number of visits, the total initial pain score, the total follow-up pain score and the percent of improvement. Averages were then calculated to see the number of visits needed for resolution of the symptoms of headaches, neck and upper back pain.

The results for individuals will most certainly vary.  And the number of visits for total correction of spinal structures and subluxations was not looked at in this review.  However, for relief and stabilization the number of average visits projected according to the researchers calculations was 24 for patients suffering from headaches, neck and upper back pain. The study judged progress on these patients as helping the individual patient achieve a return to normal, which they defined as, range of motion within normal limits and activities of daily living within the normal range.

Dr. John Maltby, president of the International Chiropractors Association and researcher on this study commented,  "Every patient is a unique individual and will respond differently to chiropractic care.  However, in reviewing the data, the evidence shows that placing an arbitrary limit of 6 to 12 on the number of visits for chiropractic care falls outside the averages and is not in the best interest of good patient care. Each patient has a unique spine and will respond differently."

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Chiropractic Safe for Children, Retrospective Study Shows

From the July 2008 issue of the scientific periodical, the Journal of Manipulative and Physiological Therapeutics (JMPT) comes a 3-year retrospective study of pediatric case files from the Anglo-European College of Chiropractic (AECC) teaching clinic practice in Bournemouth, England.  This JMPT study reviewed 781 pediatric cases of children younger than 3 years of age to see if there were any adverse side effects of chiropractic care on children.

The authors of this study also reviewed previous literature to look for reports of any adverse events related to chiropractic care for patients under the age of 18.  In this review they found a total of 9 events of problems that could have been related to chiropractic care for all the years between 1969 to 2001.  Using the number of children under care in that time period and the number of chiropractic visits for those children the authors estimated that the risk of an adverse effect was 1 in 250 million.

In their more current review, the authors of the study looked at 781 cases of children younger than 3 years of age between January 2002 to December 2004 that received care at the Anglo-European College of Chiropractic (AECC) teaching clinic.  Each of these cases was reviewed and information was recorded on how many chiropractic adjustments were received, the type of care rendered, the outcome of care, and whether any negative side effects were reported.

The study noted that of the 781 pediatric patients who presented for examination, 462 (59.15%) were male and 319 (40.85%) were female. Most (73.5%) patients were 12 weeks or younger of age (n = 574). The most common age group was between 5 and 8 weeks of age. They also reported that most infants were brought in for care by their parents because of problems with colic or irritability that was attributed to birth trauma. 

In this review 699 (89.5%) received chiropractic care, and 82 (10.5%) were referred out to seek help elsewhere. Of the 699 initial children, a follow up was made on 697. Of these children, the parents of 594 (85.22%), reported an improvement in their child's original symptoms.  One hundred three (14.78%) parents reported that there was no change in their child's symptoms.  Of the total of 697 pediatric patients whose parents reported outcomes to care, there were 7 cases in which the parents reported some form of an adverse reaction to care. This translates into approximately 1% of patients experiencing some form of a negative side effect.

The study noted that all of these negative reactions were mild and required no medical care.  The study also noted that there were no serious complications resulting from chiropractic care. The researchers stated in their conclusions, "This study provides evidence that chiropractic treatment is a safe form of therapy for children younger than the age of 3 and documents that there were no serious complications resulting from chiropractic manipulation in this group of children of this age range."

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Chiropractic Care of a Child Following a Jumping Injury - Case Study

In the August 11, 2008 issue of the scientific periodical the Journal of Vertebral Subluxation Research is a case study of a 17-month-old male infant who was injured and brought in for chiropractic care.  In this case the little boy was brought in for chiropractic care with foot pain. 

The evening before the chiropractic visit the child had jumped off his father’s back while he was lying on the floor. Immediately after this event, his parents noticed that he stopped walking and seemed to grab his right foot as if he was in pain. Because of their concern, the parents brought their child to the emergency care facility for treatment.  X-rays were taken and the mother was told that her son must have, “done something to his foot and just needs to rest it.”

In looking for a better answer, the parents brought their child to a chiropractor the next day. The young boy was carried into the chiropractic office and was holding his leg in pain. He would not stand and was scared to let anyone touch his leg.   Upon chiropractic examination there was much pain, but no unusual findings for the foot, knee or hip of the young boy.

Upon checking the spine and pelvis it was determined that the boy had subluxations of the top bone of the neck, (atlas) and the right pelvic bone.  Chiropractic adjustments were initiated to correct the subluxations.

In the next few days the parents brought the child to medical doctors and an orthopedic specialist who said the child had a knee strain and a hip problem and told the parents just to rest the child.  The boy's parents were confused by the conflicting suggestions but decided to continue the chiropractic care.

On the 4th visit the mother reported that her son had begun to walk again, but was limping and using furniture to get around.  By the fifth visit the child was walking fine in the morning but limping by the afternoon, and was starting to run at times. By the tenth visit, the mother reported the child was walking just fine and did not seem to have any additional problems walking.

In the conclusion, the author wrote, "This case provides supporting evidence on the effectiveness of chiropractic adjustments in decreasing pain and improving function in the lower extremities in a child less than 2 years old following a fall."

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