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HEALTHBEAT SHOW NOTES .... Episode #114 - Recorded September 14, 2007

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and informational Podcast.

In this week’s news:  We’ll Look At –

• Self Efficacy and Pain

• HIPAA, Health Insurance and Unhealthy Employees

• Autonomic Nervous System and Pain

• And Finally we Discuss Updated Physical Activity Recommendations for Older Adults

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #114, recorded September 14, 2007.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

This week’s Episode is sponsored by DaVinci Laboratories.  Please surf to our web site at www.ChiropracticRadio.com and click on the DaVinci link for your Health and Nutritional needs.

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And Now for some news ….

Self Efficacy and Pain

• Self-Efficacy – refers to the belief in your ability to change and to reach a goal / Locus of Control – refers to the sense of being in control of your life.

A study published in the October 2007 issue of the European Journal of Pain tried to determine whether self-efficacy beliefs mediated the relation between pain-related fear and pain, and between pain-related fear and disability in CLBP patients who exhibited high pain-related fear.

In a cross-sectional design, 102 chronic low back pain (CLBP) patients completed measures for pain, disability, self-efficacy and pain-related fear (fear of movement and catastrophizing).

Multistep regression analyses were performed to determine whether self-efficacy mediated the relation between pain-related fear and outcome (pain and/or disability).

Self-efficacy was found to mediate the relation between pain-related fear and pain intensity, and between pain-related fear and disability.

Therefore, this study suggests that when self-efficacy is high, elevated pain-related fear might not lead to greater pain and disability. However, in instances where self-efficacy is low, elevated pain-related fear is likely to lead to greater pain and disability.

In view of these findings, the authors concluded that it is imperative to assess both pain-related fear and self-efficacy when treating CLBP patients with high pain-related fear.

Surf to our Show Notes for a link to this study - http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WF3-4MSR8Y5-1&_user=10&_coverDate=10%2F31%2F2007&_rdoc=1&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%236783%232007%23999889992%23664740%23FLA%23display%23Volume)&_cdi=6783&_sort=d&_docanchor=&view=c&_ct=12&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=77908207e29307c9e273814fc353f331

HIPAA, Health Insurance and Unhealthy Employees

According to an eNews message from the National Council on Strength and Fitness, for years, companies have offered incentives to employees to engage in wellness programs. Now, by new federal regulations, companies can start charging employees more for their health insurance if they let health risks go unchecked.

Clarin Health of Indianapolis, which employs over 13,000 people, has controlled health benefit costs by assessing $5 per paycheck for each un-met standard. Minimum standards are required for body mass index, cholesterol, blood glucose, blood pressure, and the abstinence of tobacco. At Clarin, employees are conditionally subjected to a $25 assessment if all minimum standards are not met.

Effective on July 1, 2007 fines are permitted within the final rules of the Health Insurance Portability and Accountability (HIPAA) Act to ensure wellness programs fall in line with non-discrimination provisions.

According to this news item, it is debatable whether or not incentives or reprimands for employees will have a more pronounced effect on behavior and health care costs.

Surf to our Show Notes for a link to a related HIPAA FAQ - http://www.dol.gov/ebsa/faqs/faq_hipaa_ND.html

http://www.ncsf.org/

Autonomic Nervous System and Pain

A study in the October 2007 issue of the European Journal of Pain looked at Psychosocial stress as a risk factor for musculoskeletal pain.  However, the authors point out that how stress affects musculoskeletal pain is poorly understood.

This study was set up to examine the relationship between low-grade autonomic activation and stress-related pain in patients with fibromyalgia and localised chronic shoulder/neck pain.

Twenty-three female patients with fibromyalgia, 29 female patients with chronic shoulder–neck pain, and 35 healthy women performed a stressful task lasting 60 min.  The increase in diastolic blood pressure and heart rate in response to the stressful task were smaller in fibromyalgia patients compared with the healthy controls.

Furthermore, fibromyalgia patients had reduced finger skin blood flow at the end of the stressful task compared to healthy controls. The study also found an inverse relationship between the heart rate response and development and recovery of the stress-related pain in fibromyalgia patients.

The study’s conclusion found abnormal cardiovascular responses to a 60 min long stressful task in fibromyalgia patients. Furthermore, the authors found a negative association between the heart rate response and the pain which developed during the stressful task in the fibromyalgia group, possibly a result of reduced stress-induced analgesia for fibromyalgia patients.

Surf to our Show Notes for a link to this study - http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WF3-4MV1H7W-1&_user=10&_coverDate=10%2F31%2F2007&_rdoc=4&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%236783%232007%23999889992%23664740%23FLA%23display%23Volume)&_cdi=6783&_sort=d&_docanchor=&view=c&_ct=12&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=f5232065b10729f21a8871b81a93c485

Updated Physical Activity Recommendations for Older Adult

Updated physical activity recommendations were identified in recent publications from the American College of Sports Medicine (ACSM) and American Heart Association (AHA).

New recommendations actually clarify the previous physical activity recommendations set in 1990’s from the Centers for Disease Control & Prevention (CDC) and ACSM to identify the types and amounts of physical activity needed for healthy adults in improving overall physical fitness.

The recommendations for adults and older adults were specifically changed and clarified in several facets:

• One example includes specific recommendations toward moderate-intensity physical activity as being done five days a week rather than the generalized most days;

• Other changes involve clarification in the application of vigorous-intensity physical activity, health benefits of moderate- and vigorous-intensity, the emphasis of more physical activity as a viable means in the promotion of extended benefits, clarification of loose recommendations on short or long bouts, as well as the added muscle-strengthening section which makes specific declaration over previous generalities that were, at best, unsubstantiated in the previous publication.

Changes are designed to provide a more comprehensive recommendation for adults specifying how, by engaging in regular physical activity they will reduce the risk of chronic disease and death, while promoting the maintenance of health.

As always, COT’s HealthBeat recommends discussing all Exercise related questions with a qualified healthcare professional.

Surf to our Show Notes for a link to the ACSM updated recommendations - http://www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=7764

As always, please surf to our Podcast Show Notes at ChiropractiRadio.com for a full listing of web references mentioned in today’s show.

And remember - COT’s Healthbeat always recommends discussing any nutritional or exercise lifestyle modifications with a qualified healthcare professional.

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Finally, I leave you with the following quote:

"He who knows only his own side of the case, knows little of that."
– John Stuart Mill

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.

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