Dementia

Intermittent Fasting & Dementia And Your Level Of Activity

CF 212: Intermittent Fasting & Dementia And Your Level Of Activity

Today we’re going to talk about Intermittent Fasting & Dementia And Your Level Of Activity But first, here’s that sweet sweet bumper music    

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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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.   If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and your patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • The last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #212 Now if you missed last week’s episode, we talked about Chiropractic And Colicky Babies & Breathing With Thoracic Outlet Syndrome. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Things slow down in January for most of us. That’s a time to set some goals, a time to get your taxes prepped for your CPA, and a time to reflect on the year we just wrapped up and where we can leverage our experience to springboard beyond next year.  You never can tell with some offices. But for me, January through the end of February is traditionally slower than the rest of the year. We usually see a slow down again around back-to-school time in late August. Other than those times of the year, it’s typically nonstop busy busy.  So, while it’s slow, we use that to our advantage. Have you lined up your marketing plan for the next year? Have you started gathering your tax info for your accountant? It’s probably a decent time to do a recall effort. Have your staff contact patients you haven’t seen in forever and ask them how their holidays went and make sure they’re doing good. Just a check-in type of thing.  You’d be amazed at how many people just like to know they weren’t forgotten and how a checkin from our office can spur them to go ahead and come on back in because their back has been nagging lately or those headaches have started creeping back in later.  Employees. If you’ve followed along, we just recently replaced the front desk staffer. Now, just this morning we got a 2-week notice for one of our best back-office staff members. Ugh, right?? So, now it’s off I go to find a replacement there. You always hate losing one of your best. The job she’s going to pays $1.50 more per hour and offers a 401k. Well, she was due next month for a yearly raise and we’ve offered 401ks in the past but no employees ever took us up on the offer. But, she never asked and I’m never going to beg someone to stay. That’s not in my DNA. But if employees would talk to us before jumping ship, there may be something we can do to hold on to the best of them.  But it is what it is. Now, we have a staffer trying to take vacation days she doesn’t have and it’s just blah around here so here we go. I’m just going to get into this episode and forget all my woes.  Item #1 The first one today is called “Intermittent Fasting and Obesity-Related Health Outcomes An Umbrella Review of Meta-analyses of Randomized Clinical Trials” by Patikorn et. al. (Patikorn C 2021) and published in JAMA Network Open on December 17, 2021, Hot tamale! Why They Did It The authors wanted to answer the questions, “What is the association of intermittent fasting with health outcomes and what is the strength of evidence of studies on intermittent fasting?” How They Did It
  • This was a meta-analysis of Randomized Controlled Trials
  • They went through databases that included Embase, PubMed, and Cochrane
  • The search was done from April 2021
  • They found 11 meta-analyses comprising 130 RCTs, 38 participants
What They Found
  • There were 28 statistically significant associations (27%) that demonstrated the beneficial outcomes for body mass index, body weight, fat mass, low-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting plasma glucose, fasting insulin, homeostatic model assessment of insulin resistance, and blood pressure. 
  • IF was found to be associated with reduced fat-free mass. 
  • One significant association (1%) supported by high-quality evidence was modified alternate-day fasting for 1 to 2 months, which was associated with a moderate reduction in body mass index in healthy adults and adults with overweight, obesity, or nonalcoholic fatty liver disease compared with regular diet. 
  • Six associations (6%) were supported by moderate-quality evidence. 
Wrap It Up In this umbrella review, we found beneficial associations of IF with anthropometric and cardiometabolic outcomes supported by moderate to the high quality of evidence, which supports the role of IF, especially modified alternate-day fasting, as a weight loss approach for adults with overweight or obesity. Item #2 Our last one today is called “Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea” by Yoon et. al. (Yoon M 2021) and published in JAMA Network Open on December 16th of 2021. Hot hot hot. A lot hot.  Why They Did It The authors wanted to answer the question, “Is physical activity, especially light-intensity physical activity, independently associated with new-onset dementia?” How They Did It
  • It was a nationwide retrospective cohort study, 
  • They analyzed 62,286 participants aged 65 years or older without preexisting dementia who had available health checkup data from the Korean National Health Insurance Service database from January 2009 to December 2012. 
  • Participants were followed up until December 31, 2013, and 
  • data analysis was performed from July 2020 to January 2021.
  • Physical activity level was assessed using a standardized, self-reported questionnaire at baseline. 
  • Physical activity-related energy expenditure was calculated by summing the product of frequency, intensity, and duration.
What They Found I’m not going to tell you. Because we try to keep it simple light and fun around here and getting into the specifics here will make you wonder what happens when you turn on your headlights if you’re car were to be moving the speed of light. Like….why are there braille dots on a drive-up ATM? What’s up with that? Anyway, we’re skipping right to the conclusions.  Wrap It Up In older adults, an increased physical activity level, including a low amount of light-intensity physical activity, was associated with a reduced risk of dementia. Promotion of light-intensity physical activity might reduce the risk of dementia in older adults. This is a bit different from previous findings. They recommended medium intensity or higher to reduce dementia risk. They also have now shown that total sedentary behavior is associated with unfavorable health outcomes. Which is really no surprise, is it??  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 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 preventatively 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. Website
Home
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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography Patikorn C, R. K., Veettil SK, (2021). “Intermittent Fasting and Obesity-Related Health Outcomes: An Umbrella Review of Meta-analyses of Randomized Clinical Trials.” JAMA Netw Open 4(12).   Yoon M, Y. P., Jin M (2021). “Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea.” JAMA Netw Open 4(12).  

Dry Needling, Types of Exercise Count, Motor Skills For Chronic Back, and Blood Pressure & Dementi

CF 166: Dry Needling, Types of Exercise Count, Motor Skills For Chronic Back, and Blood Pressure & Dementia

Today we’re going to talk about Dry Needling, how the types of exercising count in the long run, we talk about Motor Skills For Chronic Back Pain, and we wrap it up with a paper on Blood Pressure & Dementia

But first, here’s that sweet sweet bumper music

 

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. The AC/DC, Motley Crew, Metallica kind of research. 

Not the stuffy, high-brow, Beethoven and Mozart 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.  

If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. 

You have found yourself smack dab in the middle of Episode #166 

Now if you missed last week’s episode, we talked about chiropractors working on kids. A controversial topic in some areas of the land and some professions don’t like chiropractors doing so. We talk about it. Check it out. You might learn something

Keep up with the class.  

On the personal end of things…..

Alright, if you listen regularly, you know I just lost my office manager of over 11 years to a little higher paying job. 

You know that my main computer that contains my whole life decided to take a dirt nap. It’s dead now. 

You know I have been up on the ropes a little here lately with slower numbers and all so let’s get into the nitty gritty here and see if we can make lemonade our of a crappy bunch of lemons, shall we?

Let’s start with the manager taking an exit. We can make these things positive or negative. I choose to make it a positive. Think about it; after 11 years, this person was by far my most highly paid employee. Probably overpaid honestly because I was trying to keep her happy. 

She had some difficulties financially at one point a couple of years ago so my wife and I created a marketing position for her so that we could justify paying her quite a bit more money per month while getting some marketing benefit out of it as well. 

So, not only was she highly paid for the office work, in addition, she made a good amount with the marketing side too. So, her leaving is an impact for sure. Not to mention the fact that she’s my buddy. She’s basically family. So it was an impact professionally but a bit personally. 

Here’s the thing though; do we let that paralyze us or do we make it positive? I make things positive when I can. Where are the positives here? 

Well, first thing is….I’m going to save a TON of money. Even when I get her replacement hired, I’m still getting about $1800 raise every month. Who the hell doesn’t want that kind of raise in their lives? Yes please, may I have another?

Also, with her having been out a bunch marketing, the other girls know how to do everything around the office that she used to do. That’s a big benefit. 

So, do we sit on that money or do we invest it? I invest. Remember, my ultimate goal is growth to the point I can remove myself and we do that be integrating and replacing me while making sure there are enough of alternatives to provide a comfortable retirement. 

Investing that money means it’s time to get off my tookus and integrate my practice. I’ve talked about it for years but never pulled the trigger. It’s time now and that’s what I’m doing. 

There is also the option of owning a Rural Health Clinic. That is on the table as well and I’ve got a call set up on Thursday to explore that option as well. 

Let’s say the RHC isn’t viable in Texas. OK, integration with the nurse prac is the path. I have an attorney in place and waiting on my to set it all up and I have a consulting company set up to help me get there. 

Here’s what I love about how life has created me. The best way to make sure I do something is to tell me that I can’t. The best way to see what I can do is to underestimate me or put me on the ropes and throw a few jabs. That’s when I tend to come out firing. 

I think we have to approach life like that every day but most definitely when life takes its jabs at our rib cage or our nethers. 

Instead of taking it, absorbing it, and letting it work us, come out firing on all cylinders. Prove yourself worthy of the things you really really desire 

Now, that doesn’t mean be stupid and financially dangerous. I take measured risks. I never jump off of cliffs. But, I have a pile of PPP money to pay employees and I just got an unexpected raise so now is the time to pounce. I may not have a chance quite like this again so let’s make it happen. And I will. 

The new computer will be here tomorrow. I’ve been without it for a couple of weeks now but, overall it hasn’t been too miserable. Macs have this cool thing called iCloud and a lot of my info including browser book marks and anything I had moved over just to my desktop screen….they’re all in iCloud so I started bringing my MacBook laptop to work and signed in and BAM….it was all there. I’m missing some important stuff but overall, I’ve been able to do the things I need to do. Including keeping up with this podcast. 

The big thing I’m behind on right now is keeping stats because it’s all in my computer memory. I’m working on a solution for that. For me and for you so keep your eyes and ears on the lookout for that in the coming months. You’ll see what I mean when I get it ready for you. That’s another good reason to be in our private Facebook group. I’ll be announcing it and the need for some beta testers and I’ll only make that available in the private group so make sure you’re in there for that special opportunity. 

In other big news, I got a call from Dr. James Lehman and he shared with me the existence of a Diplomate program called Forensics. I have to admit I’d never heard of it. He told me it’s a subspecialty of the Neuromusculoskeletal Diplomate. Which I already have. And he said that since I already have it, then to get the Forensics Diplomate, all I’d need to do is get 100 additional hours. It would break down into 60 hours online through ChiroCredit, 20 hours taking the AMA’s Impairment Rating course, and 20 hours in a conference in Chicago. 

Once completed, I would have the Diplomate in Forensics as well as the Neuromusculoskeletal Diplomate and I’d be able to command some hefty prices serving as a court expert and consultant. 

Well, that fit into the retirement plan doesn’t it? It’s not exactly retiring but it is getting our of the day to day, in-person tasks of daily patient treatment. Which is the goal eventually. And it fits that path. 

So, as you guessed, I’m signed up and have already knocked out about 2 hours of the 60. If you’ve been a listener since the start, you know that I gave you updates on the Neuromusculoskeletal Diplomate as I went through it. I told you all about it and what I was working on and learning. 

I plan on doing some of the same here for you on the Forensics thing. That way you’ll be able to learn more about it and might consider it for yourself. Plus, I’ll have Dr. Lehman come on in a future podcast and share more about it. 

The goal for the profession is to eventually get more and more chiropractors exploring the Diplomates and specializing. Raising the game of this profession one chiropractor at a time. 

CHIROUP 

Item #1

This first one is called “Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis” by Fernandez-de-las-Penas et. al. (1) and published in Pain Medicine on December 18, 2020 and that’s a lot hot in the pot!

Why They Did It

To evaluate the effects of muscle dry needling alone or combined with other interventions on post-stroke spasticity (muscle tone), related pain, motor function, and pressure sensitivity.

How They Did It

  • Electronic databases were searched for randomized controlled trials including post-stroke patients where at least one group received dry needling and outcomes were collected on spasticity and related pain
  • Secondary outcomes included motor function and pressure pain sensitivity
  • Data were extracted by two reviewers
  • 7 studies were included

What They Found

  • The meta-analysis found significantly large effect sizes of dry needling for reducing spasticity, post-stroke pain, and pressure pain sensitivity as compared with a comparative group at short-term follow-up
  • The effect on spasticity was found mainly in the lower extremity
  • No effect on spasticity was seen at 4 weeks
  • No significant effect on motor function
  • The risk of bias was generally low, but the imprecision of the results downgraded the level of evidence.

Wrap It Up

The authors ended it by saying, “Moderate evidence suggests a positive effect of dry needling on spasticity (muscle tone) in the lower extremity in post-stroke patients. The effects on related pain and motor function are inconclusive.”

Item #2

Our second on today is called “Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain: A Randomized Clinical Trial” by Van Dillen, et. Al (2) and published in JAMA Neurology on December 28, 2020 and it’s a lot hot in the pot as well. 

Why They Did It

For people with chronic, nonspecific low back pain, does person-specific motor skill training in functional activities result in better short-term and long-term outcomes than strength and flexibility exercise? You all know I love me some chronic pain research! I gobble it up like meat lover’s pizza. 

How They Did It

  • Single-blind, randomized clinical trial of people with chronic, nonspecific LBP
  • 149 participants
  • 12-month follow-up
  • Recruitment spanned December 2013 to August 2016
  • Testing and treatment were performed at an academic medical center
  • Participants received 6 weekly 1-hour sessions of motor skill training in functional activity performance or strength and flexibility exercise of the trunk and lower limbs
  • Half of the participants in each group received up to 3 booster treatments 6 months following treatment.
  • The primary outcome was the modified Oswestry Disability Questionnaire (MODQ) score (0%-100%) evaluated immediately, 6 months, and 12 months following treatment.

Wrap It Up

“People with chronic low back pain who received motor skill training had greater short-term and long-term improvements in function than those who received strength and flexibility exercise. 

Person-specific motor skill training in functional activities limited owing to low back pain should be considered in the treatment of people with chronic low back pain”

Item #3

Item 3 is called “Association of Physical Activity Intensity With Mortality A National Cohort Study of 403 681 US Adults” by Wang et. al. (3) and published in JAMA Internal Medicine on November 23, of 2020. It’s a skootch steamy, Sir!

Why They Did It

They asked the question, “Is vigorous physical activity associated with additional mortality risk reduction compared with moderate physical activity?” Great question. I’ve been working out but wouldn’t it be nice if moderate was just as effective as rigorous? I say it would be. So let’s see how it plays out. 

How They Did It

  • Cohort study
  • 403,681 adults from the National Health Interview Survey 1997-2013. Hello big, large sample size!
  • provided data on self-reported physical activity and were linked to the National Death Index records through December 31, 2015.
  • Statistical analysis was performed from May 15, 2018, to August 15, 2020.

Wrap It Up

“This study suggests that, for the same volume of moderate physical activity, a higher proportion of vigorous physical activity to total physical activity was associated with lower all-cause mortality. Clinicians and public health interventions should recommend 150 minutes or more per week of moderate physical activity but also advise on the potential benefits associated with vigorous physical activity to maximize population health.”

Dammit, looks like it’s as I feared. Vigorous is superior. Which honestly is pretty obvious but I was hoping for the keys to the kingdom with as little work as possible. 

Item #4

The last one is called “Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment A Systematic Review and Meta-analysis” by Hughes, et. al. (4) and published in JAMA on May 19, of 2020 and I say it’s hot enough, fools. Stand back!

Why They Did It

The authors asked the question, “Is there an association between blood pressure lowering with antihypertensive therapy and the incidence of dementia or cognitive impairment?” 

We are answering so many good questions today, people!!

How They Did It

  • Meta-analysis 
  • Search of PubMed, EMBASE, and CENTRAL for randomized clinical trials published from database inception through December 31, 2019, that evaluated the association of blood pressure lowering on cognitive outcomes
  • The control groups consisted of either placebo, alternative antihypertensive agents, or higher blood pressure targets.
  • Data were screened and extracted independently by 2 authors
  • The primary outcome was dementia or cognitive impairment. 
  • The secondary outcomes were cognitive decline and changes in cognitive test scores.

Wrap It Up

“In this meta-analysis of randomized clinical trials, blood pressure lowering with antihypertensive agents compared with control was significantly associated with a lower risk of incident dementia or cognitive impairment.”

So, besides stroke and other similar dangers, add dementia and cognitive abilities to the list of reasons to keep blood pressure in check. 

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 preventatively 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.

Website 

Home

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

 

Bibliography

  1. César Fernández-de-las-Peñas, PT, PhD, Albert Pérez-Bellmunt, PT, PhD, Luis Llurda-Almuzara, PhD, Gustavo Plaza-Manzano, PT, PhD, Ana I De-la-Llave-Rincón, PT, PhD, Marcos J Navarro-Santana, PT, MSc, Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis, Pain Medicine, Volume 22, Issue 1, January 2021, Pages 131–141, https://doi.org/10.1093/pm/pnaa392
  2. van Dillen LR, Lanier VM, Steger-May K, et al. Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Neurol. Published online December 28, 2020. doi:10.1001/jamaneurol.2020.4821
  3. Wang Y, Nie J, Ferrari G, Rey-Lopez JP, Rezende LFM. Association of Physical Activity Intensity With Mortality: A National Cohort Study of 403 681 US Adults. JAMA Intern Med. 2021;181(2):203–211. doi:10.1001/jamainternmed.2020.6331
  4. Hughes D, Judge C, Murphy R, et al. Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment: A Systematic Review and Meta-analysis. JAMA. 2020;323(19):1934–1944. doi:10.1001/jama.2020.4249

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

Subscribe button 

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.  

If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

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 [email protected] 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

Lifestyle Effect On Dementia & Feeling A Stiff Back May Not Mean A Stiff Back

CF 112: Lifestyle Effect on Dementia & Feeling A Stiff Back May Not Mean A Stiff Back

Today we’re going to talk about Lifestyle and Dementia and Does the feeling of a stiff back really mean your back is actually stiff?

But first, here’s that sweet sweet  bumper music

Chiropractic evidence-based products
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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.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #112

Now if you missed last week’s episode , we talked about how the American Family Physicians my be warming up to chiropractic and what supplements actually have some evidence behind them. 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 to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

You remember how I mentioned that my life has been a bit of a soup sandwich lately? Yeah, well, I had my front door glass broken out yet again. That’s twice in about 3 weeks. We’ve not had any issue whatsoever with our building or break-ins in over 10 years in the same locations. All of the sudden, bam…. here we are about $500 lighter in deductible fees and about to be a lot lighter in the bank account because now I have to invest in some security cameras. 

Because I’m done folks. Luckily, they caught the little a-holes and they’re sitting in the Randall County Jail. I’m hoping that’ll be their new home for a while. Hopefully long enough for them to learn their lessons. 

Other than than, life is motoring a long. Wrapped up January in fine fashion. My goals are always 10% better. If you can do better than that, then heck yeah. But for me, 10% better is a minimum for me each year. In each category. Are you keeping stats? I mean accurate, robust stats. 

I keep them for just about everything I can think of. And you should too. I hit my numbers big time in 2019. Now, I’m getting with my main marketing girl and trying to see how we’re going to improve 10% over what was already a big big year for us. 

That’s another question I have; without getting into politics, I’m going to tell you that all was well up through 2014 or so. But then 2015 and 2016 came along. We dropped off. Not dangerous numbers but I’d classify it as a significant dropoff for sure. 

Then came 2017 through 2019 and we saw tremendous growth and numbers. So, my question, if we look at what was happening in the USA around that time, we had the winding down of the Obama Presidency and the election of a different President. 

Now, anyone can say anything they want about the White House’s current occupant but I don’t think anyone can deny that the economy has been hitting on all cylinders. 

So back to the question at hand; does it matter at all which President is in office? Which party holds the office at The White House? Does it matter?

I may get some blow back here but I’m trying to look at it in a non-partisan, non-political way and say, that in my expereince, it has mattered and my business has done much better since the 2016 election than the years prior to. 

Now let’s be fair, a lot of research has emerged in that time. The American College of Physicians recommended spinal manipulation, the White House recommended spinal manipulation, The Lancet Papers came out, Dr. Goertz kicked the VA doors down with her research…..basically, I don’t think it’s one thing like which party is in the Presidency. 

But, can we deny that when the economy is killing it like right now, that patients seem more willing and more confident to spend money? My uneducated but experienced guess is that yes, the economy has an effect on our businesses and the party in power affects the economy. 

Alright, those of you that disagree, go fire up my email inbox. I’m always all ears and willing to learn so feel free to tell me all about it. 

I want to talk about some much much cooler stuff than that right now though. I want to discuss some papers on lifestyle and genetics in regard to dementia as well as if feeling back stiffness actually means you have a stiff back. Pretty interesting stuff there. 

Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that. 

If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.

Regular listeners know I’ve used ChiroUp since for well over a year now. I’m going to tell you want it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, activities of daily living, & for their exercises. 

This save you so much time – no more explaining & re-explaining your patient’s care, because they have access to it right there at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports and exercises are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you by people that are deep into the research. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice.

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL and, to sweeten the deal, you can use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super saver code is Williams99.

Item #1

Let’s start out with this one in JAMA called “Association of Lifestyle and Genetic Risk With Incidence of Dementia” by Lourida, et. al. and published on July 14, 2019(Lourida I 2019)….it’s not sizzlin but it’s steamy folks. 

Why They Did It

The authors objective was to investigate whether a healthy lifestyle is associated with lower risk of dementia regardless of genetic risk. 

How They Did It

  • The study included 196,383 subjects
  • They were followed up for 1,545,433 person-years
  • This paper was a retrospective cohort study i
  • It included adults of European ancestry aged at least 60 years 
  • The subjects had no cognitive impairment or dementia at baseline. 
  • They joined the UK Biobank study from 2006-2010 and were followed until 2016 or 2017
  • They scored for dementia
  • and paid close attention to lifestyle factors such as smoking, physical activity, diet, and moderate alcohol consumption

Wrap Up

The authors concluded the following, “Among older adults without cognitive impairment or dementia, both an unfavorable lifestyle and high genetic risk were significantly associated with higher dementia risk. A favorable lifestyle was associated with lower dementia risk among participants with high genetic risk.”

So, just to keep you all smart, in summary, no matter where you fall on the genetic risk continuum, don’t smoke, eat healthily, drink in moderation, and get some exercise. And tell your patients to do the same. 

OK, Item #2 

This one is called “Feeling stiffness in the back: a protective perceptual inference in chronic back pain” by Stanton, et. al. and was published in Scientific Reports in August of 2017(Stanton TR 2017). Not smoking hot but only a couple years or so old. 

Why They Did It

The authors were looking to test the idea or notion that have a back that FEELS stiff actually means you have a stiff back. They wanted to propose a new hypothesis and that is that feelings of back stiffness are a protective perceptual construct, rather than reflecting biomechanical properties of the back. This new theory, if proven, would have far-reaching implications for the treatment of pain and stiffness going forward. 

How They Did It

They used three different experiments to challenge the view by demonstrating that feeling stiff doesn’t actually relate to the objective measure of actually being stiff. In addition, objective back stiffness doesn’t differ any between those who report FEELING stiff vs those who do not. 

What They Found

Those reporting a feeling of stiffness actually are showing self-protective responses and they significantly overestimate force applied to their spine. 

Wrap It Up

Here we show that conscious experience of feeling stiff does not reflect true biomechanical back stiffness, but may rather represent a protective perceptual inference that may serve to reduce movement and re-injury. By showing that feelings of stiffness do not relate to biomechanical stiffness measures and that biomechanical measures of stiffness do not differ between those with and without feelings of stiffness, this suggests that information other than actual joint stiffness is influencing this perceptual inference

Correct me if I’m wrong but, to an extent that sounds similar to what we commonly hear called ‘fear-avoidance’. What would you say is a common way to deal with fear-avoidance? I would be bold enough to suggest that an effective means is a concept of ‘hurt vs harm.’ 

Fear-avoidance can keep patients in chronic pain syndrome but if they start moving and start exercising, they start trusting their bodies more and more. We are clear to them that some movements may hurt a little bit and that’s OK. It’s part of the process. But, if the movements feel ‘harmful’, they should stop and let’s take a closer look at what’s going on. 

We all know that most exercises for most people are not actually harmful. Once they get moving and making progress, they get excited, don’t they? Fear-avoidance goes down, activity level goes up, and health gets a boost. 

The patient is a winner and the doctor is a winner. Hell, the patient’s family is a winner. Have you ever had to be around a chronically painful or ill patient? It’s misery for all involved. Plus, what if the person in chronic pain typically cooks for the family? Obviously, everyone here is the winner because I like some biscuits. 

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 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 preventatively 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. 

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 & VloggerBibliography

Lourida I, H. E., Littlejohns TJ, (2019). “Association of Lifestyle and Genetic Risk With Incidence of Dementia.” JAMA 322(5): 430-437.

Stanton TR, M. G., Wong AYL, Kawchuk G, (2017). “Feeling stiffness in the back: a protective perceptual inference in chronic back pain.” Sci Rep 7(9681).