Monthly Archives: November 2013

Chiropractic Improves Neck Pain in Seniors

253955_highNeck pain is a considerable healthcare problem for individuals of all ages. About 20% of individuals 70 years of age and older experience neck pain at least once a month. Neck pain is also associated with other health complaints and poorer self-rated health. A new study investigated the effectiveness of chiropractic care (consisting of manipulation, mobilization, light soft tissue massage, stretching) and supervised rehabilitative exercise, both in combination with and compared  to home exercise alone for neck pain in individuals aged 65 years or older. Chiropractic care with home exercise resulted in greater decreases in pain after 12 weeks of treatment compared to both the supervised plus home exercise and the home exercise alone groups. In addition, supervised exercise sessions appear to add little to home exercise alone.




Manual Therapy Improves Standing Balance

9332385_sDynamic standing balance is fundamental to perform daily activities. Balance impairment occurs in up to 75% of people aged 70 years and older and is common in people with neurological and musculoskeletal disorders such as stroke and arthritis. Given the high prevalence of balance impairments and their potential impact on function, interventions to improve balance are an important public health concern. There exist many methods to restore standing balance including stability exercises, functional retraining, and manual therapy. A recent study investigated the effects of manual therapy using a rearfoot distraction manipulation on dynamic standing balance. Twenty healthy participants completed this study. Dominant leg balance was quantified using the Y-balance test which measures lower extremity reach distances. Reach distances were normalized to leg length and measured in the anterior, posteromedial and posterolateral directions. Overall balance was calculated through the summing of all normalized directions. The study showed that dynamic standing balance improved after a rearfoot distraction manipulation in healthy participants.

Is Acetaminophen Really Safe During Pregnancy?

Counter-intuitively, over-the-counter medication is commonly taken by pregnant women. In this context, acetaminophen (APAP, e.g. Paracetamol, Tylenol) is generally recommended by physicians to treat fever and pain during pregnancy. Thus, acetaminophen ranks at the top of the list of medications taken prenatally. Insights on an increased risk for pregnancy complications such as miscarriage, stillbirth, preterm birth or fetal malformations upon acetaminophen exposure are rather ambiguous. However, emerging evidence arising from human trials clearly reveals a significant correlation between acetaminophen use during pregnancy and an increased risk for the development of asthma in children later in life. Acetaminophen ranks at the top of medication taken by pregnant women. The frequency of pregnant women taking APAP at least once during pregnancy is as high as 20–30%. Further, the use of APAP is often recommended by doctors during all stages of pregnancy in order to treat pain or fever. Therefore, acetaminophen is generally perceived as a ‘safe’ medication during pregnancy. Despite this, studies of potential adverse effects on neurodevelopmental outcomes in children prenatally exposed to acetaminophen are lacking. A recent study using a large sample size investigated prenatal acetaminophen exposure and child neurodevelopment using a sibling-controlled cohort study. Results showed that children exposed to prenatal acetaminophen (paracetamol) for more than 28 days had poorer gross motor development, adverse psychomotor, behavioural and temperamental outcomes at 3 years of age, after adjusting for familial and genetic confounding. Children exposed prenatally to shorter-term use of paracetamol (1–27 days) also had poorer gross motor outcomes but the effects were smaller than with 28 or more days use.

Psychological Interventions, Wellness and Brain

20522847_sPsychological interventions are a mainstay of modern pain management and many psychological treatments have been developed for common mental problems and disorders such as depression and anxiety. The efficacy and effectiveness of psychological interventions has been well established. It is important to note however that psychology interventions can be effective in the enhancement of subjective well-being and psychological well-being – in other words in prevention of disorders, not just in the treatment of disease. Psychotherapy can have the most profound influence on a person’s belief system, emotional state and behaviour, and it is perhaps therefore not surprising that it may also lead to significant structural and functional changes in the brain. The aim of a new article was to perform a systematic and critical review of longitudinal studies addressing the impact of psychotherapy on the brain published to date. The evidence reviewed indicates that: (i) depending on the disorder under investigation, psychotherapy results in either a normalisation of abnormal patterns of activity, the recruitment of additional areas which did not show altered activation prior to treatment, or a combination of the two; (ii) the effects of psychotherapy on brain function are comparable to those of medication for some but not all disorders; and (iii) there is preliminary evidence that neurobiological changes are associated with the progress and outcome of psychotherapy. It is hoped that a better understanding of the impact of psychotherapy on brain function will eventually inform the development of new biologically informed treatments and allow clinicians to make more effective treatment decisions.

Better diet quality at midlife related to better health when older

22423367_sThe way women eat in their 50s and early 60s may have some connection to how well they age later on, according to a new study. Most health conditions develop slowly over many years. So, midlife lifestyle practices are thought to be particularly important. According to a recent study in Annals of Internal Medicine, better mid-life diet is linked to healthy aging. The report included 10,670 women who were enrolled in the Nurses’ Health Study, a large, long-term study which began in 1976. Women included in the study were in their late 50s and early 60s and had no major chronic diseases in the mid-1980s. All participants filled out two diet questionnaires, one in 1984 and one in 1986. The researchers assigned women scores based on how closely their diets matched a general healthy eating index or a Mediterranean-style diet. Then, researchers followed the participants to see how well they aged through 2000, when women were in their 70s. The researchers defined “healthy aging” as having no major chronic diseases, physical impairment, mental health problems or trouble with thinking and memory. Results showed that greater adherence to healthy eating and/or Mediterranean diet was related to greater odds of healthy aging. The study concludes that better diet quality at midlife seems to be strongly linked to greater health and well-being in persons surviving to older ages.