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HEALTHBEAT SHOW NOTES .... Episode #22 - Recorded December 9, 2005

In this week’s news:  We’ll Look At -

• Correction to HealthBeat Episode #21

• NJ Group Updates Scope of Practice

• Exercise and Stroke

• Doctors Spending Less Time With Patients

• Cochrane Review of Electrotherapy

• Chiropractic and Neck Pain

• Mouth and Heart Connection

For HealthBeat, This is Dr. Todd Eglow.

Welcome to HealthBeat Podcast #22, recorded December 9, 2005.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health. 

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And Now for some news ….

Correction to HealthBeat Episode #21

An Email from Dr. Brent Russell, advised us that our story concerning Accreditation should have address the college as Life University College of Chiropractic.

Thanks Brent!

NJ Group Updates Scope of Practice

According to a November 25, 2005 eNewsletter from the NJ Group, the ANJC, the ANJC Board voted 15-0 earlier in November in favor of a revised Chiropractic Scope of Practice that will have a dramatic effect on the way chiropractors can do business in New Jersey .

Although there have been some minor modifications to the chiropractic Scope of Practice act over the years since it was first drafted in 1920, the profession has worked with an extremely limited ability to care for patients.

The proposed scope continues to allow the subluxation-only practitioner to practice as they have been all along, secure in the knowledge that they can continue to adjust subluxations in the absence of symptoms. Nothing has changed as far as that is concerned.

However, chiropractors with a broader focus will be able to practice in their specific areas of interest and expertise, including nutrition, sports, rehabilitation and wellness care. Many of the gray areas under which chiropractors in New Jersey have operated for years have been clarified.

For more information, surf to www.anjc.info

Exercise boosts fitness, bone health after stroke

According to an October 2005 article from the Journal of the American Geriatrics Society, Canadian researchers have found that Older adults who've suffered a stroke may be able to improve their fitness and protect their bone mass with specially designed exercise classes.

Their study of 63 stroke survivors found that those who took part in a supervised exercise program became more fit, stronger and more mobile than those who participated in limited physical activity.

The researchers note that for stroke survivors, exercise could lower the risk of a repeat stroke, as well as heart disease. These are risks in the aftermath of a stroke partly because patients' cardiovascular fitness, which may have been poor already, may decline further.

After about five months, the study found, stroke patients who exercised more extensively showed greater gains in fitness, mobility and strength in their stroke-affected leg than their peers in the comparison group. The exercises also appeared to help them retain the bone mass in their hips.

That result, according to the researchers, offers the first evidence that regular exercise can protect hipbone health after a stroke.

They call for larger, longer studies to look at whether exercise can help prevent long-term stroke complications like heart disease, osteoporosis and falls.

As always, COT’s HealthBeat recommends discussing any Exercise recommendations with a Qualified Healthcare professional.

For more information, see our Show Notes - http://heart.healthcentersonline.com/newsstories/exerciseboostsfitnessbonehealthafter.cfm

Doctors Spending Less Time With Patients

According to a recent NY Times article, in an era where doctors are spending less time with each patient, some physicians are blatantly ignoring their requests.

Medical organizations say they fear that they are increasingly common - doctors, under pressure to see more patients, are spending less and less time with each one and are replacing long discussions with laboratory tests and scans - and that most problem doctors apparently have no idea of their patients' opinions of them.

Patients say the problems come in many guises. The arrogant or dismissive doctor. The impatient doctor with his hand on the doorknob. The patronizing doctor. Or, as one young woman experienced, the doctor who is callous and judgmental.

Some patients say they have to rely on each other's experience to know which doctors to seek out and which to avoid. The Council on Size and Weight Discrimination, a nonprofit organization, publishes lists of fat-friendly doctors on its Web site.

One of the common benefits and kudos that Chiropractors commonly receive, is the time and tactile approach to healthcare that the profession and many other Alternative professions adhere to.

For more information, surf to the NY Times - http://www.nytimes.com/2005/11/30/health/30patient.html?hp&ex=1133413200&en=c8ddc0bd96c48d60&ei=5094&partner=homepage

Cochrane Review of Electrotherapy

The Journal Spine recently published a study to assess whether electrotherapy relieves pain or improves function/disability in adults with mechanical neck disorders, referred to by the acronym MND.  A background search revealed that the effectiveness of electrotherapy as a physiotherapy option has remained unclear.

The authors concluded that in pain as well as other outcomes, the evidence for treatment of acute or chronic MND by different forms of electrotherapy is either lacking, limited, or conflicting.

From an editorial published by the FCER, Commentary from Anthony L. Rosner, PhD stated the following –

Given that electrotherapy is a commonly used means to treat mechanical neck disorders with a direct bearing upon the direct costs of medical care, it is essential that studies of the nature provided by the recent systematic Cochrane review by Kroeling, Gross et al be undertaken and reported.

This paper performs the additional admirable task of clearly classifying and describing four different types of elective currents applied in treatment: [i] galvanic current for pain control; [ii] electrical nerve stimulation [ENS]/transcutaneous electrical nerve stimulation [TENS] for pain control; [iii] electrical muscle stimulation [ EMS ]; and [iv] pulsed electromagnetic fields [PEMF] and permanent magnets.

In selecting randomized and quasi-randomized controlled trials for adults with acute, subacute, or chronic neck disorders, the authors searched a commendably comprehensive list of computerized bibliographic databases from their beginning to March 2003 and reported 14 studies together with an assessment of their quality. The conclusion was that in pain as well as other outcomes, the evidence for treatment by different forms of electrotherapy was either lacking, limited, or conflicting.

One must keep in mind that the methodologic quality of studies cited in this review was assessed by using a validated set of criteria reported by Jadad;1 however, it has been clearly shown elsewhere that virtually diametrically opposing results in meta-analysis can be obtained by using alternative validated criteria.2 Hence one is advised to interpret any findings based upon one set of quality criteria with a degree of caution.

Secondly, one must not confuse evidence for or against a procedure by itself as opposed to its possible synergistic role within the multimodal framework of treatment commonly employed in practice. Thus, the two trials of TENS which are shown to deliver conflicting results within the multimodal framework demand closer attention to experimental details and interactions rather than be simply dismissed for lack of evidence.

The most telling statement by the authors which might support this assertion is that, overall, specifics on treatment characteristics in the papers cited were poorly described or missing, unfortunately all too common in the literature used to describe spinal manipulation as well as electrotherapy. As the authors so correctly point out, more precise standardizations as well as fuller descriptions of the treatment characteristics are sorely needed.

REFERENCES:

1.    Jadad Ar, Moore RA, Correll D, et al. Assessing the quality of reports of randomized controlled trials: Is blinding necessary? Journal of Clinical and Pharmacological Research 1996; 17: 1-12.

2.    Juni P, Witschi A, Bloch R, Egger M. The hazards of scoring the quality of clinical trials for meta-analysis. Journal of the American Medical Association 1999; 282(11): 1054-1060.

For more information, surf to the November 1^st 2005 issue of Spine.  

Chiropractic and Neck Pain

More than 70% of people in the developed world will experience neck pain at some point in their lifetimes. The socioeconomic cost is considerable, as is the human cost to the individuals and their families; however, as yet, there is no agreed treatment protocol.  In the December 2005 issue of Clinical Chiropractic, a study was published to explore whether chronicity affects patient response to chiropractic treatment of neck pain, and how this may impact chiropractic patient management.

The results demonstrate a positive effect for chiropractic on symptoms of neck pain. The more chronic the presentation, the more treatments were required to achieve asymptomatic status. More acute presentations were perceived as more severe, giving, on average, a higher pre-intervention score. However, the post-intervention scores were, on average, lower.

Although the lack of a control group and small sample size limit the generalizations that can be drawn from the results, the overall conclusions may provide important lines of enquiry for future possible study and inform aspects of chiropractic management.

For more information, surf to our Show Notes for a link to the Clinical Chiropractic web site - http://www.sciencedirect.com/science?_ob=JournalURL&_cdi=12922&_auth=y&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=cb0ef7ed82266c9f6ed2015fc3a9ca0f

Mouth and Heart Connection

There's mounting evidence that brushing, flossing and regular dental checkups may be at the heart of good cardiovascular health.

According to the American Heart Association, People who have chronic infections -- and gum disease is one of the major chronic infections -- are at increased risk later in life for atherosclerosis [hardening of the arteries] and coronary heart disease.

The reason: Chronic periodontal disease -- which is caused by a number of oral bacteria -- appears to set off an inflammatory process that exacerbates and contributes to the build-up of cholesterol-rich plaque on artery walls.

In fact, one study published earlier this year in the journal Circulation found that patients with high levels of gum disease bacteria were also at high risk for atherosclerosis.

But there's lots you can do to keep bacteria from setting up house in your gums. Some tips include:

• Get checked. A thorough oral exam will allow a dentist to detect and diagnosis gum disease.

• Brush and floss regularly. The more frequently food is kept away from teeth, the better, since regular cleaning robs oral bacteria of the nutrients they crave.

• Don't snack. Every snack delivers a fresh meal to germs that are hard at work destroying teeth and gums. If snacking is unavoidable, it is recommended to consume less-sticky foods that won't adhere to tooth structure.

For more information, see our Show Notes for a link to the DrKoop.com web site - http://www.drkoop.com/PrinterFriendly/93/528840.html

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

In this edition of HealthBeat’s Chiropractic Corner, we interview Dr. Douglas Menzies.

Welcome to Chiropractic OnLine Today’s Healthbeat Podcasts.  This is Dr. Todd Eglow.  HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.  HealthBeat Podcasts can be accessed via iTunes or other portable interfaces.  For Subscription information, surf to our web site at www.ChiropracticRadio.com

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"We make a living by what we get; we make a life by what we give." 
- Sir Winston Churchill

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

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