Cognitive Decline

Manipulation For Concussion, Sleep And Cognitive Decline, & Dementia Predictors And Prevention

CF 148: Manipulation For Concussion, Sleep And Cognitive Decline, & Dementia Predictors And Prevention

Today we’re going to talk about manipulation and concussion, sleep and cognitive decline, dementia predictors and prevention. 

But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

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Do it do it do it. 

Chiropractic’s Effect On Strength and More, Status of Muscle Relaxers, And The Best Recovery Posture

 

You have found yourself smack dab in the middle of Episode #148

Now if you missed last week’s episode , we were joined by Dr. Katie Pohlman, head of research at Parker University and the ACA Researcher of the Year for 2020. That right there is enough for you to just go and listen I think. What a great person and professional to have on our team. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function

On the personal end of things…..

On the personal side of things, it’s still looking up. I’m back to about 140-145/week. We started this Monday off with 7 new patients and 4 re-exams. As of right now, I’m writing this on a Monday. We already have 143 scheduled this week and that without today’s patients being all set up for Wednesday and Wednesday’s patients be re-booked on Friday so I’m looking to definitely have an up-week this week. 

If you listen regularly, I was at about 185-220 per week prior to COVID so, maybe we can make some strides this week toward getting back to some of the big numbers again. Maybe maybe. Fingers crossed. 

How are your numbers? I asked in our private group and will try to remember to share with you in next week’s episode. With me still being at about 80% or so, I’m curious if my experience is normal or not. If you want to jump into the private Chiropractic Forward group and comment on the thread, that’d be great or send me an email at dr.williams@chiropracticforward.com Either works just fine. 

Here’s a preview of something I’m working on. Many don’t know this but there was a big blow up at the World Federation of Chiropractic starting with the conference last year in Berlin. Now, just a month or so ago, several of the biggest baddest researchers we have in our profession left the WFC research committee and from an outsider looking in, it appears to be due to pressure from the ICA and the WFC sponsors. Sponsors that we evidence-based chiropractors use and sponsors that our money and business has given some teeth to. On the surface, it seems we have given them teeth to embolden the ICA and bully our top researchers. 

So, my goal is to compile as much information as I can in order to present what happened and why. I want to present it in a fair and well-balanced way looking only for the truth on the matter. I want to know which makes me suspect that you want to know as well. 

Everyone in the know has remained very hush hush on the matter and, if this is the vitalist side organizing sponsors that we use as well to bully the research community, then I want to know who I need to be doing business with and which businesses I may choose to find an alternative to. 

Be looking for that coming down the pike. I’m not trying to shake up the chiro world. I just want to know what happened and I may reconsider doing business with the businesses that made it happen. Because, again, on the surface, it seems our points of view on how the profession should proceed into the future are not in alignment. No pun intended. 

Outside of that, still so far so good around here. Just being smart and trying to stay healthy. Hell, I’m healthier now than I think I’ve ever been. I went back on Weight Watchers. It’s a program I was on about 8 years ago. I lost about 45-50 pounds without really much effort. I swore to the almighty I’d never put that weight back on again. Well…..I did. Lol. 

So, I’m back on the struggle bus but honestly, it’s not that bad. The program always made so much sense to me. It just teaches you how to eat what you’re surrounded by every day. Including fast food even. If you’re not familiar, based on height and weight, you’re assigned a point value. You’re allowed a certain number of points per day and overage points per week should you exceed those points. 

At the same time, foods are assigned point values and, once you are familiar with how much foods count against your daily points, you are able to make educated choices as to what is OK to eat and what just isn’t really worth eating. 

It’s a simple concept and I have to say, it works like crazy. I’ve lost over 15 pounds in about 3 weeks or so. 

Here’s to the next 45!!! Dammit. 

Alright, let’s get on with it this week. 

Item #1

This first one is called “Effectiveness of Osteopathic Manipulative Medicine vs Concussion Education in Treating Student Athletes With Acute Concussion Symptoms” by Yao et. al(Yao S 2020)., published in Journal of the American Osteopathic Association on August 7, 2020. Hot hot hot, it’s a lot hot! 

Why They Did It

The authors say that “current treatment options are limited and difficult to individualize. Osteopathic manipulative medicine (OMM) can aid musculoskeletal restrictions that can potentially improve concussion symptoms. Get that, they didn’t even say that they want to determine if it helps. They just straight up say osteopaths can help. Dammit. Chiropractors have to be more diplomatic in their research abstracts. 

As far as their objectives, more specifically, they said, “To assess concussion symptom number and severity in participants with concussion who received either OMM or an educational intervention.”

How They Did It

  • It was a randomized controlled trial 
  • Conducted at the New York Institute of Technology
  • Patients had concussion-like symptoms due to recent head injury within the previous 7 days
  • They were split randomly into two groups
  • One got manipulative therapy
  • The other group got concussion education intervention
  • They were assessed before and after with the Symptom Concussion Assessment Tool fifth edition

What They Found

  • 30 paticipants
  • The manipulation  group had significant decrease in symptom number and symptom severity compared with the concussion group

Wrap It Up

When used in the acute setting, OMM significantly decreased concussion symptom number and severity  compared with concussion education. This study demonstrates that integration of OMM using a physical examination-guided, individualized approach is safe and effective in the management of new-onset symptoms of uncomplicated concussions.

So let me just say this. Why in the H E double Hockey sticks does Osteopathic manipulation somehow trump chiropractic manipulation? Here’s your answer. It doesn’t if you see research validating osteo manipulation, then you just saw research validating chiropractic manipulation. Just because they got their outliers in line in a way that chiropractic has never even tried to do itself, doesn’t make their manipulation superior. At all. 

Adjusting Disc Herniations and Bulges

 

Item #2

This one is called “Association Between Sleep Duration and Cognitive Decline” by Ma, et. al(Ma Y 2020). and published in JAMA on September 21, 2020. My glasses just steamed up when I read that….because it’s that hot. 

Why They Did It

They wanted to answer the question, “What is the association between sleep duration and cognitive decline in the general aging population?”

How They Did It

  • This was a pooled cohort study 
  • Participants were 2 randomly enrolled cohorts comprising 28,756 individuals living in England and China
  • 50 years or older for the English
  • 45 years or older for the Chinese
  • Self-reported sleep duration per night according tro face-to-face interviews
  • Global cognitive z scores were calculatied 

Wrap It Up

They concluded that “an inverted U-shaped association between sleep duration and global cognitive decline was found, indicating that cognitive function should be monitored in individuals with insufficient (≤4 hours per night) or excessive (≥10 hours per night) sleep duration.” 

Item #3

This one is short, it’s an article in JAMA called “Nearly Half of Dementia Cases Could Be Prevented or Delayed” by Bridget Kuehn, published in JAMA on September 15, 2020. Fresh, sizzlin suckatash. 

Why They Did It

Basically, on this article, they’re covering the fact that there was a report in The Lancet back in 2017 identifying 9 preventable risk factors for dementia. They were….and still are:

  • Having little or no education
  • Hypertension
  • Untreated hearing impairment
  • Smoking
  • Obesity
  • Depression
  • Physical inactivity
  • Diabetes
  • Low social contact

This article is basically an update saying the emerging evidence suggests there are 3 more preventable dementia risk factors. They are:

  1. Head injuries
  2. Excessive alcohol consumption in midlife
  3. Air pollution exposure later in life. 

Some of the recommended steps to prevent dementia are as follows:

  • countries should provide primary and elementary education for all children,
  • take steps to prevent obesity and diabetes,
  • reduce air pollution 
  • reduce secondhand smoke exposure. 
  • programs to prevent people starting smoking, 
  • Prevent or treat hearing loss, and 
  • prevent head injuries,
  • encourage hearing aid use and smoking cessation. 
  • maintaining systolic blood pressure of 130 mm Hg or lower in midlife, 
  • limiting alcohol to fewer than 21 servings per week, and 
  • maintaining an active lifestyle.

Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it.

Let’s get to the message. Same as it is every week. 

 

 

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com. 

 

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.

And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerBibliography

Ma Y, L. L., Zheng F, (2020). “Association Between Sleep Duration and Cognitive Decline.” JAMA Open 3(9).

Yao S, Z. H., Angelo N, Leder A, Mancini J, (2020). “Effectiveness of Osteopathic Manipulative Medicine vs Concussion Education in Treating Student Athletes With Acute Concussion Symptoms.” J Am Osteopth Assoc

Inflammation and Cognitive Decline

Today we’re going to talk about brain inflammation, cognitive decline, your brain and your patients’ brains and we’ll talk about my brain. Scary stuff here. Plus we’ll talk about ALS and concussion. What’s the research saying?

But first, here’s that “hell yeah”  bumper music

Chiropractic evidence-based products
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OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have stuttered into Episode #66

Introduction

We’re here to advocate for chiropractic while we also make your life easier.  

Store

Part of that is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link

DACO

Let’s talk a bit about the DACO program which is the Dipolomate of the Academy of Chiropractic Orthopedists. Still trucking along and hauling a big load of knowledge nuggets in my big 18-wheeter trailer. I don’t know where that came from. 

Recent classes for me have been Managing preganncy-related SI pain, diagnosing thoracic facet joint pain, managing Scheuermann’s disease, and diagnosing merlagia paraesthetica. 

I have told you before that I’m no guru. I learn all the time because I clearly don’t know it all. I have no problem admitting that I’m not, nor have never been, particularly knowledgable on meralgia paraesthetica. I am crapping you negative, folks, when I tell you that the very day after I had the drill on it, it shows up in my office. I swear, unbelievable. 

I’m not above admitting that I’ve been missing it for all these years. It hurts me a bit to admit but facts are facts and if I’m not honest with you, well then, what’s the point in all of this anyway?

If I can get you pointed in the right direction to get started with the DACO, shoot me an email at dr.williams@chiropracticforward.com. I’m happy to help. I get nothing out of it. No discounts on hours, no special considerations, nothing. I just think it’s that important. 

Personal Happenings

Front desk hunt….still a go. Still no rock star. Still not settling. There’s your update. 

Item #1

On with it. This one is called “Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study.” It was authored by KA Walker, RF Gottesman, DS Knopman, and a slew of rascally cohorts(Walker KA 2019). It was published in Nuerology in February of 2019. Hot stuff….comin’ through. Brand new people. 

Why They Did It

They wanted to examine the associaiton between systemic inflammation measured during midlife and 20-year cognitive decline. 

You know speaking of cognitive decline……..what the hell was I saying? Why did I even come into this room? : )

Anyway, here’s how they did it

This is REALLY dumbing it down a bit for the purpose of brevity but, within the atherosclerosis risk in communities cohort study, inflammatory biomarkers were measured during middle adulthood. they worked some math magic using the biomarkers, creactive protein, and cognition periodically over 20 years. 

12,336 participants

What They Found

Participants with a midlife inflammation composite score in the top quartile had a 7.8% steeper cognitive decline, compared to participants in the lowest quartile; CRP in the top quartile was associated with an 11.6% steeper cognitive decline. In cognitive domain-specific analyses, elevated midlife inflammatory markers were most consistently associated with declines in memory.

Wrapping It Up

The authors concluded, “Our findings highlight what may be an early pathogenic role for systemic inflammation as a driver of cognitive decline in the decades leading up to older adulthood.”

The weirdest thing. As soon as I went over this article, I went home that night and opened up the lates version of Chiropractic Economics magazine. It’s issue 3: February 22, 2019. 

Anyway, there’s an article in there on this exact very thing because my mind is creepy like that. Seriously, you might do this too but, I can think of a patient I haven’t seen in a little while and Bazinga….that week or the next they show up in my office staring me in the face in live real life and it freaks me out every time to know I have gravitational mind powers like that. Lol. 

Evidently my gravitational mind powers work in the information world as well because that’s the way it happened my friends. 

Now, there was all kinds of research citations present in this article but I did not look them up. I don’t know the quality of them. I just don’t have the time but, in short, if we want to decrease the kind of inflammation we see for cognitive decline, the kind in the paper we just talked about, then we need to look at making sure we have good levels of Curcumin/turmeric as well as good serum levels of vitamin D. 

They say the curcumin plays a role in regenerating neurons, creating new brain cells (lord knows I need that), and refreshing cells that may have once been considered irretrievable. So, all the damage I did in young adulthood….maybe there’s some hope after all. 

And are you realizing all of the information that has come out about Vitamin D in the last several years? There is also data refuting the use of ANY supplement but, knowing there’s no harm in a Vitamin D supplement, why WOULDN’T you consider taking it regularly? Worst case scenario, you lost a very minimal amount on a supplement that did nothing. 

Best case, you’re near superhero level. 

Item #2

Continuing with our brain stuff this week, here is item #2 titled, “Contact Sports as a Risk Factor for Amyotrophic Lateral Sclerosis: A Systematic Review” authored by R Blecher, MA Elliott, E Yilmaz and a plethora of associates(Blecher RA 2019). It waspublished in Global Spine Journal in February 2019 because the new stuff makes the folks tickle. And why not? I love information but there’s just something warm and fuzzy about  NEW informaiton isn’t there?

Why They Did It

They say that environmental factors for ALS have remained largely unknown and recent evidence suggests that participation in certain types of sporting activities are….not may be….but ARE associated with increased risk for ALS. They wanted to test the hypothesis that competitive sports at the highest level that involve repetitive concussive head and cervical spinal trauma result in an increased risk of ALS.

How They Did It

They searched electronic databases adn reference lists of key articles from inception to November 22, 2017.

They used 16 studies fitting the criteria for inclusion. 

The sports they looked at were of course, American football, basketball, cycling, triathlon, and skating. I’m wondering where hockey or rugby is in the mix. 

What They Found

I hate to say it but here’s what they found, “Our review suggests that increased susceptibility to ALS is significantly and independently associated with 2 factors: professional sports and sports prone to repetitive concussive head and cervical spinal trauma. Their combination resulted in an additive effect, further increasing this association to ALS.”

While we love our sports and we hate seeing the sissy-fication of the world in general, we also don’t want people to knowingly and purposefully put themselves in danger like this. 

Certainly not our children. We have to pay attention to this stuff. 

I played from 3rd grade up into college and only had my bell rung one time but I’m thinking I’m the exception, not the rule. I was always taller and bigger than most of the others on teh field so that may be why I escaped. Or at least I think I escaped. I’m 46. I still have time to lose my mind I suppose. 

Anyway, food for thought. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Blecher RA, E. M., Yilmaz E, (2019). “Contact Sports as a Risk Factor for Amyotrophic Lateral Sclerosis: A Systematic Review.” Global Spine J 1: 104-118.
  • Walker KA, G. R., Knopman DS, (2019). “Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study.” Neurology.

CF 060: Medical Marketing & Integration Care Expectations