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HEALTHBEAT SHOW NOTES .... Episode #24 - Recorded December 23, 2005In
this week’s news:
We’ll Look At -
For
HealthBeat, This is Dr. Todd Eglow. Welcome
to HealthBeat Podcast #24, our news
heavy Holiday Edition, recorded December 23, 2005.
HealthBeat is Chiropractic OnLine Today’s radio program, providing
current news and commentary about Chiropractic and Health.
From
all of us at Chiropractic OnLine Today’s HealthBeat family, a very Happy For the usual banter about our services and contact information, including creating personalized HealthBeat podcasts for your Office’s Web site, please surf to our Podcast Home Page at www.ChiropracticRadio.com And
Now for some news …. Dr. Cerf
Says Thank You In
an Email correspondence from Dr. John Cerf, he wished to send his thanks to
everyone who has attempted to see if they are a possible donor for his nephew
Aiden. As
you may recall from HealthBeat episode #23, Dr. John Cerf, a 1985 alumnus
and fellow colleague of the chiropractic profession, has requested help.
His three-year old nephew, Aiden, suffers from a rare blood disorder called hemophagocytic
lymphohistiocytosis (HLH). And, unfortunately, his condition has worsened and become life-threatening. In short, Aiden now needs a bone marrow transplantation to save his life. Please
surf to our Show Notes for detailed information about how to get tested to see
if you can help Aiden with his condition. We will replay Dr. Cerf’s Audio later
in this Podcast. If you would like to donate money to help support the cost of testing, again, please contact Anna. General information concerning bone marrow transplantation is provided at www.marrow.org. Further information may be obtained from Aiden's father, Tom Berges, a nurse practitioner, at (201) 996-5830. Those
who are not local to the area, or who need more information, can contact Anna,
the blood drive coordinator, at annaforaiden@optonline.net To
help Aiden, simply determine whether your leukocyte antigen (HLA) type
matches his. This is easily accomplished with an oral swab. People
local to the Northern New Jersey/Southern New York State area can locate testing
site information at Aiden's web site, http://www.caringbridge.org/visit/aidenberges New CPR
Guidelines
- American Heart Association Updates CPR Standards The
American Heart Association has drastically altered its guidelines for what is
now proper Cardio-Pulmonary Resuscitation, also known as CPR protocol. The new
protocol changes the ratio of compressions to each rescue breath. The
new guidelines should make learning and administering CPR much easier. In
addition, the new guidelines eliminate any differences between CPR
administration for infants, children, and adults. The thought process behind the
change is the noted increased importance of keeping blood circulating through
the body until advanced care arrives. Every fitness instructor should annually
participate in CPR and AED Training. For
more information, contact the American Heart Association - http://circ.ahajournals.org/cgi/reprint/112/24_suppl/IV-1 Summary
- http://www.americanheart.org/downloadable/heart/1132621842912Winter2005.pdf
ACA’s HHS
Lawsuit Continues to Reap Benefits for Chiropractic Profession According
to an recent press release from the American Chiropractic Association, also
known as the ACA, the U.S. Court of Appeals has reversed a lower court decision
allowing medical doctors and osteopaths to perform “manual manipulation of the
spine to correct a subluxation” on Medicare beneficiaries, paving the way for
chiropractors to pursue further hearings on the issue under a new administrative
review process enacted in 2003. The Dec. 13 decision represents a major step in
the American Chiropractic Association’s (ACA) landmark lawsuit against the
U.S. Department of Health and Human Services (HHS) and comes at a critical time
as millions of Medicare patients are choosing Medicare managed care plans as
part of their new prescription drug benefit. The
ACA is exploring ways it can assist individual doctors of chiropractic through
the administrative review process and provide them with the resources and
materials they need to establish their unique qualifications to an
administrative law judge, if necessary. For
a copy of the Dec. 13 decision, additional information on Medicare managed care
plans, and resources on the Medicare administrative review process, visit
ACA’s Web site at: www.acatoday.com/government/medicare Fitness and Career - According
to the http://www.FitnessBusiness-Pro.com
newsletter, Seventy five percent of executives surveyed by http://www.TheLadders.com
said good physical fitness is critical for success at the executive level and
being overweight is a serious career impediment. The majority of the respondents
stated that corporations should help their employees get fit. Seventy five
percent of the executives said companies should provide on-site fitness centers
or subsidize gym memberships, and 12 percent said companies should offer cash
incentives to regular exercisers. Exercise and Heart Disease - In
another http://www.FitnessBusiness-Pro.com
news item, Exercise capacity, as measured in terms of VO2max, is a powerful
predictor of death in patients with coronary artery disease, not just patients
with heart failure, according to research presented at the American Heart
Association's Scientific Sessions 2005 in In
this study, the significance of low VO2max levels was examined in patients with
coronary artery disease -- the top cause of death in the The
results confirm that poor functional capacity -- specifically a VO2max of less
than 18 ml/kg/min -- is a major predictor of long-term mortality, even in a
group of cardiac rehabilitation patients with good medical management, close
follow-up and excellent short-term prognosis. As
always, COT’s HealthBeat recommends discussing any Exercise recommendations
with a Qualified Healthcare Professional. Exercise and Diabetes - A
poor diet and lack of physical activity can lead to adult-onset diabetes, but
diabetics can reverse their illness through lifestyle changes, according to a
study by Brigham Young University (BYU). BYU exercise scientist Steve Aldana, a
professor of health and human performance, conducted a study to determine the
effect of fitness and nutrition on reversing diabetes. He designed a corporate
wellness program in which employees who were at risk of developing diabetes were
invited to participate. The year-long health program involved 16 weeks of
healthy lifestyle classes and 30-minute workouts each day. BYU
screened the participants' blood insulin levels and glucose intolerance in the
beginning of the program, at the six-month mark and a year after the program
started. The researchers found improvements at the six-month and one-year mark,
and by the end of the study, more than half of the participants were no longer
diabetic or at risk, according to BYU. If
you have Diabetes, COT’s HealthBeat recommends discussing these findings with
your Qualified Healthcare Professional. The
U.S. Department of Health and Human Services (HHS) will enter the bookstores and
libraries in time for the holidays with a consumer-friendly interpretation of
the Dietary Guidelines for Americans, the federal recommendations for healthy
living. A
Healthier You gives consumers simple steps for healthy living drawn from the
science-based nutrition and physical activity advice of the 2005 Dietary
Guidelines, the latest update of the report. To
make the advice easier to find, the new book will be offered in places where
people usually look for diet and exercise books, including retail bookstores and
the Internet. The book will be available on the Web and in bookstores in
November. http://www.health.gov/dietaryguidelines/dga2005/healthieryou/ Assessing Risks from Obesity - In
a November 2005 study, researchers suggest that the best way to check heart
attack risk in the obese isn’t body mass index (BMI); Rather, measuring a
person’s waist-to-hip ratio was far more effective, according to new, global
research. In
a study published in The Lancet medical journal, researchers assessed whether
other markers for obesity, especially waist-to-hip ratio, would be a stronger
predictor of heart attack than the conventional measure of BMI in different
ethnic populations. Previous research has shown that obesity increases the risk
of heart disease; however, most have been done in European and North American
populations. The
investigators looked at BMI, waist-to-hip ratio, waist measure, and hip measure
in more than 27,000 people from 52 countries. The
team found that BMI was only slightly higher in heart attack patients than in
controls, with no difference in the Middle East and The
authors' found that compared with BMI, waist-to-hip ratio is three times
stronger than BMI in predicting the risk of a heart attack. According
to Research Author Salim Yusuf, "Our findings suggest that substantial
reassessment is needed of the importance of obesity for cardiovascular disease
in most regions of the world”. The
waist-to-hip ratio is calculated by dividing the waist measure by the hip
measure. The cut off point for cardiovascular risk factors is less than 0.85 for
women and 0.90 for men. A higher number denotes more risk. COT’s
HealthBeat suggests discussing these new research findings with a Qualified
Healthcare Professional versed in Exercise Rehab and Physiology. http://fitnessbusiness-pro.com/news/syndicate/waist_to_hip_heart_attack_111005/ For
any of these stories, please surf to http://www.Fitnessbusiness-Pro.com
and we will post full links in our Show Notes. Foot
Levelers and Chiropractic Foot
Levelers, Inc. has committed to contributing $1 million over a five-year period
to the Foundation for Chiropractic Progress’ Campaign for Chiropractic. The
goal of the FCP is to increase both the public awareness of chiropractic and the
number of people who seek chiropractic treatment on a regular basis. According
to Foot Levelers President, Kent Greenwald, “Foot Levelers is contributing $1
million to the Foundation for Chiropractic because it is the right thing to do.
Foot Levelers wants to do all we can do to bring chiropractic to more
people”. For
more information or to make a donation to the Campaign for Chiropractic, contact
Gene Veno, president of F4CP through the Foundation’s Web site, www.foundation4cp.com Chiropractic
and Prepayment Plans The Manitoba Chiropractors Association
(MCA) has advised its members to discontinue accepting prepayment for
chiropractic services. Under current Canadian law, prepayment plans are not
legal, according to a legal opinion obtained by the MCA board of directors. The MCA retained an administrative law
lawyer, whose opinion reads, “ The MCA advised its members to
discontinue accepting all prepayments in a Nov. 9, 2005, memo. The memo said
that more details of the implications of this interpretation in practice will be
sent to members shortly. For
more information, surf to http://www.chiroeco.com http://www.chiroeco.com/news/2005/November/Manitoba.php Food
Allergy Labeling Law Your patients who have
food allergies will have an easier job of refraining from eating offending foods
on January 1, 2006. That’s when the Food Allergen Labeling and Consumer
Protection Act of 2004 goes into effect. At that time, all foods
and dietary supplements must be labeled if they contain milk, eggs, fish,
Crustacean shellfish, tree nuts, peanuts, wheat, and soybeans or an ingredient
that contains protein derived from these foods. According to the Food and
Drug Administration (FDA), approximately 2 percent of adults and about 5 percent
of infants and young children in the For
more information, surf to - www.cfsan.fda.gov http://www.chiroeco.com/news/2005/November/Allergy.php Judge
rules against The San Diego County Superior Court has denied the California Chiropractic Association’s standing to bring class allegations filed in 2001 against American Specialty Health Plans of California, Inc. (ASHP) and American Specialty Health Networks, Inc. (ASHN). But the association
reaffirms it will pursue its claims against the insurer. Judge William R. Nevitt's
Oct. 20 decision was premised upon a finding that the new standing requirements
of For
more information, surf to our Show Notes for a Link to this story - http://www.chiroeco.com/news/2005/November/Judge.php CCGPP's
Best Practices Guidelines The Council on
Chiropractic Guidelines and Practice Parameters (CCGPP) is pleased to announce
that in early February 2006 we will be releasing the initial draft of the Best
Practices Low Back document for review and comment by stakeholders, including
the public. This is the culmination of 10 years of process and two years of
diligent effort by nearly 100 chiropractic scientists, field practitioners,
vendors and friends. This highly anticipated document is the first chapter of
what will become the Best Practices Chiropractic Clinical Compass, providing a
chiropractic review of the current literature in an effort to enhance outcomes
for our individual patients. The Low Back document
will be available at www.ccgpp.org for
review and comment for 60 days from its initial release. Subsequent chapters
will then follow for your review. The CCGPP encourages any and all interested
parties to invest the time to comment on this work. The scientific validity
criteria (e.g. AGREE document) process guiding the CCGPP requires broad
stakeholder review before final release. In this case stakeholders include
Doctors of Chiropractic, patients, students and educators, third party payers,
governmental entities and all other interested parties. Back
pain in school children—Where to from here? A recent study looked at
Back Pain in Children. Back pain is
now recognized to occur early in childhood and is associated with high
prevalence rates when estimated by survey. This
Study considered the risk factors associated with back pain in children aged
11-14 years, and particularly those present in a school setting. The risk
factors most significantly associated with back pain are primarily
characteristics of the individual with less strong associations with factors
present in the school environment. The majority of
intervention studies undertaken in a school setting have focused on the effect
of school furniture on posture and comfort and were of short-term duration.
There is a need for further research in order to achieve a better understanding
of the risk factors present in a school environment and to address ways to
reduce the currently recognized perceived problem of back pain among school
children. A strategy for an
evidence-based longitudinal intervention study is proposed, with the content
outlined under the headings: policy, school equipment and furniture, individual
and family. For
more information - Applied Ergonomics. January 2006 Inter-examiner
reliability of passive assessment of intervertebral motion in the cervical and
lumbar spine: A systematic review A systematic review was
conducted to determine inter-examiner reliability of passive assessment of
segmental intervertebral motion in the cervical and lumbar spine. Passive
assessment of motion is used to decide on treatments for neck and low-back pain
patients. Inter-examiner reliability has been a matter of debate, resulting in
questions about professional credibility and accountability. A structured search for
relevant studies in MEDLINE and CINAHL was followed by extensive reference
tracing and hand searching. Studies presenting estimates of reliability for
individual motion segments were included. No language restrictions were imposed.
Study quality was assessed using criteria derived from the Standards for
Reporting of Diagnostic Accuracy (STARD) statement and a quality assessment tool
for studies of diagnostic accuracy included in systematic reviews (QUADAS).
Study selection, quality assessment, and data extraction were performed by two
reviewers independently. Qualitative analyses and additional subgroup analyses
were conducted. Nineteen studies were included. Two studies satisfied
criteria for external and internal validity, of which one found fair to moderate
reliability. Assessment of motion segments C1-C2 and C2-C3 almost consistently
reached at least fair reliability. Overall, inter-examiner reliability was poor
to fair. However, most studies were found to be of poor methodological quality.
We propose explicit recommendations for the conduct and reporting of future
research. For more information - Manual
Therapy. November 2005; Vol. 10 Chiropractic
and Stroke A just-released study
sponsored by NCMIC Chiropractic Solutions shows that a causative relationship
between chiropractic manipulation and stroke is highly unlikely. According to the study,
“There is an associative relationship between the two because people may go to
chiropractors for relief of stroke-related symptoms.” The report admonishes
chiropractors to be alert for signs of stroke, avoid neck manipulation on those
patients, and to get emergency intervention. It says, “The signs and symptoms
of a stroke may be subtle and may mimic other conditions, so it can be hard to
tell if a serious problem exists.” The monograph was
prepared for NCMIC by John J. Triano, DC, PhD, and Greg Kawchuck, The paper outlines a
number of key findings and advises how to proceed if a patient is suspected of
having stroke symptoms. For more information,
surf to - “Current Concepts: Spinal Manipulation and Cervical Artherial
Incidents 2005,” available at www.ncmic.com/cva http://www.chiroeco.com/news/2005/December/Stroke.php NYCC
and Acupuncture New York Chiropractic
College (NYCC) has been approved as a candidate for accreditation of its Master
of Science in Acupuncture (MSA) and Master of Science in Acupuncture and
Oriental Medicine (MSAOM) programs by the Accreditation Commission for
Acupuncture and Oriental Medicine (ACAOM). Candidacy status is
considered by ACAOM to be an endorsement of a program’s potential for
accreditation and indicates that the programs meet nationally accepted standards
for quality education and training. In addition, graduates of the AOM programs
are eligible to sit for the national licensing examination. NYCC now has three years
to apply for and attain full accreditation. To date, NYCC has enrolled 95 AOM
students and will graduate its first class in August 2006. Information about
NYCC’s acupuncture and Oriental medicine programs is available at 800-234-6922
or http://www.nycc.edu http://www.chiroeco.com/news/2005/December/NYCC.php Manual
Therapy and Exercise for TX of Low Back Pain The November/December
2005 issue of the Clinical Journal of Pain examined the effectiveness of manual
therapy with specific adjuvant exercise for treating chronic low back pain and
disability. A single blind,
randomized, controlled trial was employed. Patients were prescribed an exercise
program that was tailored to treat their musculoskeletal dysfunctions or given a
nonspecific program of general stretching and aerobic conditioning. In addition,
patients received manual therapy or sham manual therapy. Participants were seen
for 6 weekly sessions and were asked to perform their exercise program twice
daily. Manual therapy with
specific adjuvant exercise appears to be beneficial in treating chronic low back
pain. Despite changes in pain, perceived function did not improve. It is
possible that impacting chronic low back pain alone does not address
psychosocial or other factors that may contribute to disability. Further studies
are needed to examine the long-term effects of these interventions and to
address what adjuncts are beneficial in improving function in this population. This article was a focus
of a recent FCER eNewsletter, with
Commentary by Dr. Thomas Hyde who stated – This single blind,
randomized, controlled trial looked at the use of manual therapy with specific
adjuvant exercise and it’s role in the treatment of chronic low back pain.
Chronic was defined as pain for 3 or more months. The study looked at patients
between 18 and 65 years of age with single or primary complaints of
musculoskeletal, chronic low back pain
(CLBP) as determined by a physician or physical therapist. The mean duration of pain
in this group was 76.9 months. They were subjected to manual therapy treatment
twice a week for 8 weeks and were given specific exercises designed to treat
these musculoskeletal complaints. Participants were asked to record their
perceived levels of pain and disability on the McGill Pain Questionnaire, Visual
Analog Scale, Quebec Back Pain Disability Scale and the Interference Subscale of
the Multidimensional Pain Inventory questionnaires. At the end of treatment,
patients rated their overall satisfaction with the treatment based on a 7 point Likert
scale. The manual therapy
procedure utilized was muscle energy technique. All treatments were administered
by a PT. Patients received 1 of 2 exercise programs designed to help improve
specific musculoskeletal dysfunctions and were taken from Sahrman and Bookhout.
Some patients received non-specific exercises and all were asked to participate
in aerobic exercise for 20 minutes between 70% and 80% of their maximum heart
rate after being trained to determine this rate by the PT. The patients were
also asked to stretch and/or self-corrections twice daily. Six who completed the
treatment protocol were unable to reproduce 1 or more of their assigned
exercises. There were additional problems with overall compliance with exercise
at a rate of 75.2% overall. As a chiropractor, I
would have preferred to see a study utilizing either mobilization or
manipulation rather than muscle energy. I also feel there were too many
variables and not enough compliance with the exercise protocols. Would muscle
energy alone produced the same results as muscle energy with exercise? I think
this study would have yielded better results that would affect the every day
treatment of patients with CLBP with separation of criteria as stated. Another
problem with the study was that is was not a double blind study and the patients
were not examined for pain beliefs, mood and quality of life. It is not
surprising that the study did not support the use of manual therapy and exercise
alone as an effective means of treating CLBP. For more information, surf to our Show Notes for links to this Study http://www.clinicalpain.com/pt/re/clnjpain/abstract.00002508-200511000-00001.htm;jsessionid=Dg3IakuOUGdZg5HRiQOO7FKGXd34Pbmdqg8RDIMO1Ii8SmYt2T4F!-85436088!-949856145!9001!-1 Thank
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Finally,
I leave you with the following quote: "Get
your facts first, and then you can distort them as much as you please." For
Chiropractic OnLine Today’s HealthBeat, wishing everyone a Safe
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