ADHD and Chiropractic Care?

Attention-deficit/hyperactivity disorder (ADHD) is a controversial diagnosis, as there are no clear objective clinical tests that can establish whether or not a patient has the condition. ADHD belongs to a spectrum of neurological disorders with no physiological basis (no clear lab tests exist) and often include other conditions such as learning disabilities, obsessive-compulsive disorder (OCD), or Tourette’s syndrome. Early-onset mania or bipolar mixed state can be difficult to differentiate from ADHD or they may co-exist with ADHD.

To complicate matters with regard to diagnosing ADHD, some kids may simply be at the high-end of the normal range of activity or have difficult temperaments. Poor attention may be caused by altered vision or hearing, seizures, head trauma, acute or chronic illness, poor nutrition, insufficient sleep, anxiety disorders, depression, and/or the result of abuse or neglect. Various drugs (such as phenobarbital) may interfere with attention ADHDas well.

Since the 1990s, the number of prescriptions to treat ADHD has skyrocketed 700%, possibly due to the increased awareness of the symptoms associated with ADHD and/or an increase in the diagnoses for ADHD, often demanded by frustrated teachers and/or parents. The classic medical model has embraced the use of Ritalin (methylphenidate) to treat ADHD. For parents who would like to explore other avenues of treatment, what can Chiropractic offer?

In a recent study involving 28 children aged 5-15 years with a primary diagnosis of ADHD, investigators randomly assigned 14 participants to a spinal manipulation (SM) group with conventional care and the other 14 to a control group (conventional care only). The researchers found the patients in the SM group experienced better outcomes based on several assessments and that a larger scale study would be necessary to verify their findings.

Nutrition may also have a role to play in the management of ADHD. In a 2015 study, researchers provided Lactobacillus rhamnosus GG (a probiotic) to infants at six months of age and then followed them for the next 13 years. At age 13, six of the children in a placebo group had been diagnosed with either ADHD or Asperger syndrome while none of the kids in the probiotic group had been affected by either condition. The researchers concluded that probiotic use early in life may reduce the risk of neuropsychiatric disorder development later in childhood.

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A 7 – Year Study of People Who Chose a Chiropractor as Their Primary Doctor

  • 60% Less Hospital Admissions
  • 59% Less Days in the Hospital
  • 62% Less Outpatient Surgeries
  • 85% Less in Pharmaceutical Cost

A 7-year study studying people who chose a chiropractor as their primary doctor

– JMPT 2007

Manipulation vs. Other Treatments?

Mechanical neck pain affects an estimated 70% of people at some point in life. Because many different treatment approaches are available for neck pain, it can be very difficult for those suffering from neck pain to know which treatment approach(es) to choose. Research on this topic has revealed some very interesting information that places chiropractic and spinal manipulation in a VERY STRONG POSITION—in fact, at the TOP OF THE HEAP!

neck

One such study looked at benefits of spinal manipulative therapy (SMT) in patients with acute and subacute neck pain. This study compared three study groups:

  1.  SMT only
  2.  medication only
  3.  home exercise and advice (HEA)

This study randomized 272 neck pain patients suffering from neck pain for 2 to 12 weeks into a twelve-week treatment period using 1 of the 3 treatment approaches tracking the results with the participant-rated pain as the primary treatment outcome measure. Secondary outcome data was obtained from other approaches. The results showed that the group treated with SMT, “…had a statistically significant advantage over medication after 8, 12, 26 and 52 weeks. HEA also had a statistical advantage over medication. Lastly, similar benefits were calculated between the SMT and exercise group. The conclusions support SMT and exercise/advise to be the choice over medication for acute and subacute neck pain patients. Regarding exercise, a similar study showed that “high-dosed supervised strengthening exercise” with and without SMT, was superior to a “low dose home mobilization exercise and advice group at 4, 12, 26, and 52 weeks.”

Regarding chronic neck pain patients (that means pain that has been present for greater than 3 months), another study evaluated the changes that occurred in 191 patients. These patients were randomly assigned to 1 of 3 treatment groups for eleven weeks and evaluated 3, 6, 12, & 24 months after treatment. The 3 treatment options included: 1. Spinal manipulative therapy (SMT) only; 2. SMT with low-tech neck exercises; or 3. a form of exercise using a MedX rehab machine. The results show the highest level of patient satisfaction was found in the 2nd group (SMT with low-tech exercise), suggesting that when individuals present for treatment, spinal manipulation with low-tech exercises results in the most satisfied patient. These findings are important as this study evaluated the LONG-TERM benefits among patients who have had neck pain for a long time (i.e., “chronic”), where as most studies only look at the short-term benefits.

Similar conclusions were reported from perhaps the largest scale study on neck pain based on research from 1980 to 2006 on the use, effectiveness, and safety of non-invasive treatment approaches for neck pain and associated disorders. This review that looked at over 350 published articles found manual therapy (manipulation and mobilization) and supervised exercise to again, SHINE when compared with other treatment options.

What is important is that ALL these studies support what chiropractors do: manipulate the neck and give supervised exercises! So, what are you waiting for? SPREAD THE WORD to everyone that you know who has neck pain—CHIROPRACTIC MAY BE THE BEST CHOICE!!!

Chiropractic Education

Many people seem surprised to find out that the chiropractic education process is so extensive.

We usually reply, “…whether you’re planning to become a chiropractor, medical doctor, or dentist, it takes four years of college followed by and additional 4-5 years of additional education (med school, dental school, chiropractic college) simply because there is that much to learn about the body to become a competent healthcare provider.”

Hence, depending on the area of interest a person has in the healthcare industry, it takes a similar amount of time to complete the educational program.

degrees-diploma_600x315

DID YOU KNOW…

The initial step is completing a typical “pre-med” undergraduate or college degree.

Courses including biology, inorganic and organic chemistry, physics, psychology, various science labs, as well as all the liberal art requirements needed to graduate are included in the undergraduate education process.

Many states require four years of college in addition to four to five academic years of chiropractic education to practice in their particular state. (The requirements are similar in other countries in which chiropractic is a licensed profession.)

The format for chiropractic universities is similar to that of most healthcare disciplines.

The basic sciences are covered in the first half of the educational process after which time successful completion of the National Boards Part I examination is required to move into the second half: the clinical sciences.

From there, internships, residency programs, preceptorship programs become available to the chiropractic student.

Once graduated, residence programs including (but not limited to) orthopedics, neurology, pediatrics, radiology, sports medicine, rehabilitation, internal medicine, and others are also available, as are various masters and doctorate-level programs in specialty areas.

The following chart shows the similarities between three healthcare delivery approaches, DC, MD, and DPT (doctor of physiotherapy).

Curriculum Requirements for the Doctor of Chiropractic degree (DC) in comparison to the Doctor of Medicine degree (MD) and the Doctor of Physical Therapy degree (DPT):chiropractic education

*Does not include hours attributed to post-graduation residency programs.

AS YOU CAN SEE, THE ACTUAL NUMBER OF AVERAGE CLASSROOM AND CLINICAL STUDY HOURS PRIOR TO GRADUATION IS EVEN HIGHER FOR CHIROPRACTIC COMPARED TO THE MD AND DPT CURRICULUM.

It should be noted that this does not include additional educational training associated with residency programs, which are available in the three disciplines compared here.

At one of the chiropractic colleges, the academic core program or Clinical Practice Curriculum consists of 308 credit hours of course study and includes 4,620 contact hours of lecture, laboratory, and clinical education.

There are 10 trimesters of education arranged in a prerequisite sequence.

The degree of Doctor of Chiropractic (D.C.) is awarded upon successful completion of the required course of study.

The academic program may be completed in three and one-third calendar years of continuous residency. Graduation, however, is contingent upon completion of the program in accordance with the standards of the college, which meet or exceed those of its accrediting agencies.

In addition to courses included in the core curriculum, a variety of procedure electives are available to the students. These electives are designed to complement the study of adjustive procedures included and facilitate investigation of specialized techniques.

Doctors of chiropractic are committed to providing the highest quality care available to their patients. They coordinate care with other doctors, when appropriate, in an effort to help their patients in the most efficient, economic, and evidence-based approach possible.

Chiropractic & The Gallup Poll

What Does the New Gallup Poll Tell Us About the Public Perception and Utilization of Chiropractic Today?

In 2015 Palmer College of Chiropractic in Davenport, Iowa commissioned Gallup Inc. to undertake a study called American’s Perceptions of Chiropractic. This was important because the last studies done about chiropractic were in the 1970’s and 1980’s and were very out of date. Those studies also occurred before Federal Antitrust Laws finally broke up the AMA’s nearly 100-year plan to contain and eliminate chiropractic in a verdict handed down in 1987.

gallup-chiropractic-use-on-the-riseHere are just a few observations made by this landmark poll of the American public by Gallup concerning utilization:

One half of all Americans have been to a chiropractor (much higher than previously thought)
14% of all those polled had been to their chiropractic in the past year (a number that is twice as high as projected in previous studies)

Here are just a few observations made by this landmark poll of the American public by Gallup concerning health conditions:

• Two-thirds (61 percent) of adult Americans believe chiropractors are effective at treating neck and back pain.
• The majority (57 percent) of adults are likely to see a chiropractor for neck or back pain.
• More than 1/2 of all U.S. adults have visited a chiropractor, and more than 1/4 of Americans would choose chiropractic first for back or neck pain.

It’s great that so many Americans see their chiropractor as someone they would see for the neck and back pain. But chiropractors certainly have an upward battle to educate the public about the importance of the nervous system and how it relates to all body functions, not just neck and back pain. One encouraging statistic from the study was that of those who are seeing a chiropractor 31% of them want to see their chiropractor regularly even if they have no pain (sounds like there are a lot of chiropractors educating their patients about the true benefits of chiropractic. Hopefully this number will continue to rise exponentially.

Here are couple of statistics that are great for chiropractors. Among those who have seen their chiropractor in the past five years:

74% of all people saw their chiropractor as trustworthy. (As opposed to 58% of MDs, NEJM)
82% of all people felt that their chiropractor has their best interest in mind when it comes to health care.

Source: 2015 Gallup-Palmer Inaugural Report: Americans’ Perceptions of Chiropractic

Research Supports Chiropractic

What Are The Top Research Studies of the Past 10 Years?

1. Decreased Costs and Utilization of
Medical Services with Chiropractic.

Spectacular decreases in the utilization of medical services and their attendant costs were observed when Doctors of Chiropractic were used as first contact providers. In an Independent Practice Association (IPA) which permitted patients to sclockelect a doctor of chiropractic as their primary care physician, clinical and cost utilization based on 70,274 member-months over a seven-year period demonstrated decreases of 60.2 percent in hospital admissions, 59 percent hospital days, 62 percent outpatient surgeries and procedures, and 85 percent pharmaceutical costs when compared with conventional medicine. These were across the board savings, not merely back and neck cases.

Sarnat RL, Winterstein J, Cambron JA: Clinical utilization and cost outcomes from an integrative medicine independent physician association: an additional 3-year update. J Manipulative Physiol Ther. 2007 May;30 (4):263-9.

2. Blood Pressure Regulation and
Upper Cervical Chiropractic
Adjustment.

The scope of chiropractic is as broad as the scope of influence of the human nervous system. This landmark study was a randomized, controlled trial of hypertensive patients. Those in the intervention group received a form of upper cervical chiropractic care (NUCCA). The authors wrote, “We conclude that restoration of Atlas alignment (C1 vertebra) is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.” This study received extensive positive exposure in the media.

Bakris G, Dickholtz M Sr, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, Bell B: Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J Hum Hypertens. 2007 May;21(5):347-52.

3. Benefits of a Wellness Program
Implemented by Chiropractors.

A retrospective study of a standardized, 18 week wellness protocol was shown to improve weight, heart rate, blood pressure, strength, body-mass index, and forced vital capacity. The wellness protocol (Creating Wellness) focused on diet, exercise, nutritional supplementation, and one-on-one coaching. The author also reported, “All of the participating clinics practice a form of chiropractic that involves management of vertebral subluxation. This application of chiropractic is not solely directed at pain syndromes. It is based on the contention that misalignments and/or abnormal motion of vertebral motion units may compromise neural integrity and may influence organ system function and general health and well-being.”

McCoy M: Evaluation of a standardized wellness protocol to improve anthropometric and physiologic function and to reduce health risk factors: a retrospective analysis of outcome. J Altern Complement Med. 2011 Jan;17(1):39-44.

4. Surgery Less Likely if a Doctor of
Chiropractic is Seen First

A study looking at 1885 workers, 174 of which had lumbar spine surgery in the last three years, sought to identify early predictors of having lumbar spine surgery. The authors reported “Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. The area under the receiver operating characteristic curve of the multivariate model was 0.93 (95% confidence interval, 0.92-0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery.”

http://www.ncbi.nlm.nih.gov/pubmed/23238486

5. Chiropractic Care Associated with
Satisfaction, Functional and Self-
Rated Health of Medicare Patients.

This study used a model to determine “the effect of chiropractic relative to medical care on decline in 5 functional measures and 2 measures of self-rated health among 12,170 person-year observations.” The authors concluded from the study that “chiropractic is significantly protective against 1-year decline in activities of daily living, lifting, stooping, walking, self-rated health, and worsening health after 1 year. Persons using chiropractic are more satisfied with their follow-up care and with the information provided to them.”

Weigel PA, Hockenberry JM, Wolinsky FD: Chiropractic use in the Medicare population: prevalence, patterns, and associations with 1-year changes in health and satisfaction with care. J Manipulative Physiol Ther. 2014 Oct;37 (8):542-51. .

Main_Chiropractic6. Asymptomatic Persons Benefit
from Chiropractic Care

A review of literature was conducted using the terms “asymptomatic” “normal” “pain-free” “healthy” or “free from physical injury.” The author concluded, “The data reviewed lend support to the contention that chiropractic adjustments for the purpose of correcting vertebral subluxation, confer measurable health benefits to people regardless of the presence or absence of symptoms. A significant amount of preliminary evidence supports that people without symptoms can benefit from chiropractic care. Improved function can be objectively measured in asymptomatic individuals following chiropractic care in a number of body systems often by relatively non-invasive means. It is plausible that chiropractic care may be of benefit to every function of the body and have the potential for long-term, overall health benefit to those receiving chiropractic care.”

Hannon SM: Objective physiologic changes and associated health benefits of chiropractic adjustments in asymptomatic subjects: A review of the literature. Journal of Vertebral Subluxation Research, April 26, 2004, Pages 1-9.

New Herb Study Says “Buyer Beware”

What Does This New Study Tell Us About The Quality of Herbal Supplements?

In February 2015 the Attorney General of the State of New York accused four national retailers on Monday of selling dietary supplements that were fraudulent and in many cases contaminated with unlisted ingredients. He sent cease and desist orders to retailers Walmart, Walgreens, Target and GNC to stop selling their own herbal products when research showed that roughly four out of five of the products contained none of the herbs listed on their labels. In many cases, the authorities said, the supplements contained little more than cheap fillers like rice and house plants, or substances that could be hazardous to people with food allergies.

shutterstock_220512667The herbs tested by scientists were Gingko Biloba, St. John’s Wort, Garlic, Echinacea, Saw Palmetto and Valerian Root. They used DNA testing which only determines if the herb is present, but not about quality of the herb. For quality, scientists use chromatography to determine if the right part of the herb was used and whether it was prepared or extracted property and contained the therapeutic constituents. What the research showed then was simply whether the herb on the label was in the product. 4 out of 6 GNC herbal products were found to contain none of the herb. 3 out of 6 Target brand products contained none of the labeled herb. 5 out of 6 Walgreens herb products were found to contain none of the herbs listed. Finally, 4 out of the 6 WalMart herbal products contained none of the herbs. These products not only contained no herbs but contained other products such as powdered rice, beans, peas, wild carrots, asparagus and spruce tree.

This testing found that many herbal supplements don’t contain what the label says; just fillers, not herbs.

MediHerb, a company thEchinacea-Purple-Emperor_JDWat provides quality herbal products for health care professionals did a survey of Echinacea products available in the U.S in 1994 using chromatography and mass spectrometry. The active constituents of Echinacea are to be alkylamides. The research revealed that most of the Echinacea products available in the U.S. were nearly devoid of alkylamides. What that means that the products were nearly useless and had no therapeutic value. When you purchase herbal products for yourself and family, please consult your healthcare professional. If you don’t you could spend your hard earned money on something that is worthless.