physiotherapy

Pet Ownership And Cognitive Decline & PT Effectiveness

CF 312: Pet Ownership And Cognitive Decline & PT Effectiveness Today we’re going to talk about Pet Ownership And Cognitive Decline & PT Effectiveness 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 giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com 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 excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
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  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

 

On the personal end of things….. Alright, this was a crazy day. Where do we start? First, we had our new intern from Parker College start today. Welcome to the practice Donte. I’ll say he either picked the craziest day of days to start or he’s just bad luck.  Frist thing, it’s freezing outside and there are ice pellets coming out of the sky. It’s been pretty nice here in the Texas Panhandle until Donte’s first day with us. Now we’re just hoping no blizzard moves in with these 60 mph winds. 

Then, we one staffer out sick and then another got a call that her mother was having some health issues and she had to leave in a hurry so prayer for our work family. We’d appreciate your best wishes as well for her and her family.  Then we had a patient come in that was just a difficult one. It was our first from a PT so hey…..that’s cool as hell but this patient was a difficult one for sure.  There was more to the day that was challenging but I’m not going into the whole thing.

The point is, if Dontae was hoping to see an old guy navigate a day full of hurdles and land mines, he definitely got it.  It was a damn day and here’s hoping that the rest of the week is smooth sailing full of perfect patients and lots of learning for our new intern. 

Pro Tip, check out the C-sign. I was talking with one of my chiro buddies recently and he mentioned something about a patient with a low back and hip issue he had years ago. I asked if the patient had a C sign. My colleague wasn’t aware of the C-sign and I’ll admit that I wasn’t either until about 4 years ago when I went through the Ortho Diplomate. 

This is a Dr. Tim Bertlesman special for you. If they give you the C-sign, it’s the hip until you rule the hip out. That is an excellent rule of thumb and so easy to remember and bring back up because once you see and recognize the C-sign, you’ll be reminded immediately.  The C-sign is when a patient says, “It hurts right here.” And the have their thumb and index finger in a C shape and running the C along their iliac crest back and forth. Sometimes down into the inguinal area.  If you see that, assume it’s the hip until you rule it out with either orthos or imaging.  There’s your pro tip today.

Let’s get on with the episode. Since we’re going to have so many of the WHO and SMT and very low confidence episodes coming up, I’m going to split those up and just do them every other week to keep you invested and from getting bored with it.  You can thank Dr. Steven Brown from Gilber AZ for that. Lol. He said I seem obsessed with the topic.

He was joking of course but, while I’m not obsessed per se, I am definitely wondering; if we have as much research in our favor as we’ve covered for over 6 years now, how on Earth can the WHO have us at ‘very low confidence?’ Which is the same as ultrasound by the way.  I want to know. I’m figure a lot of you do as well. From our previous episodes on it, I see they’re using papers with low sample size and some that are definitely older studies to make that determination. But we’ll keep exploring. Just not this week. 

Item #1 Our first on ethis week is called, “How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis” by Dove, et. Al. and published in European Spine Journal on 29th of December 2022 and while it’s not piping hot, I haven’t gotten to use it in a bit so here ya go!! Remember citations to the papers can be found on our website at chiropracticforward.com and episode 312.  Dove, L., Jones, G., Kelsey, L. et al. How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. Eur Spine J 32, 517–533 (2023). https://doi.org/10.1007/s00586-022-07356-y

Why They Did It Physiotherapy interventions are prescribed as first-line treatment for people with sciatica; however, their effectiveness remains controversial.  The purpose of this systematic review was to establish the short-, medium- and long-term effectiveness of physiotherapy interventions compared to control interventions for people with clinically diagnosed sciatica

How They Did It It was a systematic review  Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Embase, PEDro, PubMed, Scopus and grey literature were searched from inception to January 2021.  Inclusion criteria were randomised controlled trials evaluating physiotherapy interventions compared to a control intervention in people with clinical or imaging diagnosis of sciatica.  Primary outcome measures were pain and disability.  Study selection and data extraction were performed by two independent reviewers with consensus reached by discussion or third-party arbitration if required.  Risk of bias was assessed independently by two reviewers  Three thousand nine hundred and fifty eight records were identified, of which 18 trials were included, with a total number of 2699 participants.  All trials had a high or unclear risk of bias. 

What They Found Meta-analysis of trials for the outcome of pain showed no difference in the short, medium or long term.  For disability there was no difference in the short, medium, or long term between physiotherapy and control interventions.  Subgroup analysis of studies comparing physiotherapy with minimal intervention favoured physiotherapy for pain at the long-term time points.  Large confidence intervals and high heterogeneity indicate substantial uncertainly surrounding these estimates.  Many trials evaluating physiotherapy intervention compared to substantial intervention did not use contemporary physiotherapy interventions.

Wrap It Up Based on currently available, mostly high risk of bias and highly heterogeneous data, there is inadequate evidence to make clinical recommendations on the effectiveness of physiotherapy interventions for people with clinically diagnosed sciatica.  Future studies should aim to reduce clinical heterogeneity and to use contemporary physiotherapy interventions.

Item #2 The last one today is called, “Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older” by Li et al and published in JAMA Network Open on December 26, 2023 and POW! That’s a hot one folks! Pet lovers listen up! Li Y, Wang W, Zhu L, et al. Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older. JAMA Netw Open. 2023;6(12):e2349241. doi:10.1001/jamanetworkopen.2023.49241

Why They Did It Is pet ownership associated with cognitive decline in older adults, and how does pet ownership mitigate the association between living alone and the rate of cognitive decline? They wanted to explore the association of pet ownership with cognitive decline, the interaction between pet ownership and living alone, and the extent to which pet ownership mitigates the association between living alone and cognitive decline in older adults.

How They Did It This cohort study used data from waves 5 (June 2010 to July 2011) to 9 (from June 2018 to July 2019) in the English Longitudinal Study of Ageing.  Participants included adults 50 years and older.  Pet ownership and living alone in wave 5. Verbal memory and verbal fluency were assessed, and composite verbal cognition was further calculated. Of the 7945 participants included, the mean (SD) age was 66.3 (8.8) years, and 56.0% of the subjects were women.

What They Found Pet ownership was associated with slower rates of decline in composite verbal cognition, verbal memory, and verbal fluency.  Three-way interaction tests showed that living alone was a significant modifier in all 3 associations.  Stratified analyses showed that pet ownership was associated with slower rates of decline in composite verbal cognition, verbal memory, and verbal fluency among individuals living alone, but not among those living with others.  Joint association analyses showed no significant difference in rates of decline in composite verbal cognition, verbal memory, or verbal fluency between pet owners living alone and pet owners living with others.

Wrap It Up In this cohort study, pet ownership was associated with slower rates of decline in verbal memory and verbal fluency among older adults living alone, but not among those living with others, and pet ownership offset the associations between living alone and declining rates in verbal memory and verbal fluency.  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 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.

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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