Chiropractic Adjustments & Fall Prevention: New Research on Older Adults | #477

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode, we are back with more brand new research and it's a great one. It is all about how a chiropractic adjustment may be able to reduce the risks of falls in older adults with spinal pain. We're going to break down the the research, the take home messages, clinical pearls and how you may be able to approach this in your community, in your practice, having conversations with your patients. Stay tuned for that. Now before we get started, I want to say a few words about neck care, the best objective assessment tool the cervical spine, reliable assessments and exercises for neuromuscular control, proprioception, range of motion and sensory motor integration. To learn more, have a conversation with their team, check it out@neckcare.com again that is neckcare.com and I will drop a link down in the show notes. But as I said at the top on today's episode, all about the research. And this was a study that came out just last year, 2024 and the title is Chiropractic Spinal Manipulation and Fall Risk in Older Adults with Spinal Pain. And observational findings from a matched retrospective cohort study. As you can imagine, that link will be down in the show notes that you can check out. And the purpose of this study was to investigate whether chiropractic adjustments reduced the fall risk in older adults struggling with spinal pain. There were researchers from institutions like Harvard Medical School, Cleveland Medical center and more. And if we dive into why this is so important, it's that falls are the leading cause of injury and fatality. Get that leading cause of injury and fatality in adults older than 65 years old. And I want to tie this to something that if you have some older adults in your family you've probably dealt with, which is somebody falls and then they have a hip replacement, the hip replacement goes well, but they never get up and moving again. And down the road that they pass away. That's why hip replacements, while relatively easy to perform from a surgical perspective in an older adult can be so challenging because if they don't get up and moving, it really starts a cascade that ultimately can result in death. So falls as the leading cause of injury and fatality in adults over 65 years old. This is an important part. If you take care of people older than 65. This is something you need to be tuned into. We also know spinal pain can increase fall risk due to impaired balance, gait and and altered sensory motor function. So when somebody's getting older and they have spinal pain, it's kind of like a double whammy that is really increasing their likelihood of having a fall. And if they fall now, we start to see again that negative cascade that can ultimately result in severe injury, surgical intervention and ultimately death in a solid portion of these individuals. So anything that we can do as chiropractors to help reduce that risk within the tool set of what we can do, how we approach healthcare is massively impactful, not only in the avoidance of injury, but potentially in literally extending somebody's life by avoiding that fall, all to begin with and with chiropractic adjustments. We know and have seen the literature that we've touched on. Each and every week on this podcast, we have the opportunity to enhance sensorimotor function range, reduce pain and improve balance. All of these factors independently can mitigate fall risk. When you combine all of those things again, improving sensory motor function, reducing pain, improving balance, we have a powerful application of who we are and what we do that can make really big impacts in a lot of people's lives in your community. Now, this study specifically looked at over 1600 patients in matched cohorts. They controlled for factors like age, sex, comorbidities, and they got this from real world data. So they leveraged over 116 million patient records to really whittle down the sample size and get very, very accurate data. So patients aged 65 and older receiving spinal adjustments showed a 3.8% rate over 13 months compared to 5.4 in the non adjustment group. So that is nearly a halving of the risk factor that is massively powerful. There is no difference in limb fracture rates between the groups, but the risk ratio showed a statistically significant reduction that is massively powerful. Let's highlight some quotes from from this study. Quote this study suggests that older adults receiving spinal manipulative therapy for spinal pain may have a reduced risk of falls. And that is a big, big impact point. The clinical implications for this go a variety of different directions. One, that chiropractic care, what you do each and every day, is an effective and non invasive option to reduce fall risk in adults with spinal pain. Two highlights the potential for multidisciplinary prevention strategies. There's a lot of people out there that quite frankly they'll go to their primary care doctor and they say they have spinal pain and well, guess what? The first option is, of course, drugs and medications, even though that shouldn't be in his guideline discordant. And then the second one is, well, let's get you in pt and if you go into any big box, you know, PT place right now, I guarantee you you're gonna see a good chunk of individuals age 65 and above that are there because they have fallen in the past or because they are weak and they're trying to regain that muscle tone. Well, you and I know, but many other doctors just haven't pieced this together. That strength is only a portion of the equation. Balance, sensorimotor, integration, all of those things we discussed at the beginning of this episode, but play just as much of an important role as strength in somebody's ability to stay upright and not fall down. So what we do is a really necessary component. It's not a nice to have, it's a need to have if somebody is really looking towards reducing their risk of falls. So from a multidisciplinary perspective, this ties into the core of what we do with MD connection at the evidence based chiropractor. But bridging those gaps with other healthcare providers and helping them understand it's not only about strength. Strength is an important component, but it's also about balance and sensory motor integration. That's an important conversation to be able to have with other healthcare providers in your community and it opens up a world of referral opportunities. Because probably right now I'm imagining, oh, I'll just ask you how many people have been referred into your practice over the last, I would say week, but I'll extend that month, year, 10 years, your career, because they were a potential fall risk. Probably not five or 10 per week. And there probably could be, depending upon the size of your community, based upon the fact that when people get old, if they're not under chiropractic care, and specifically if they have spinal pain, and definitely if they have previous falls or balance issues, they probably should at least be checked out to see if you can help them feel and function a bit better than they do today.

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Now, from a broad based perspective, this could result in cost savings. Reducing falls in older adults could lead to significant healthcare cost savings by lowering the Rate of fall related hospitalizations and long term care needs. Again, I'll kind of reiterate these points, but it's important to really dive into the details. It's not only only preventing the fall, but when you prevent that fall. Now, if that patient fell and went to the hospital, guess what's gonna happen? Well, depending upon how bad the fall is, they might end up with anything from surgical intervention to medication and pretty much anything in between those two things. Avoiding that is a massive, massive benefit for literally every single one of those individuals that can avoid this. That cascade of events and side benefit is that it also ends up lowering the cost because then you don't end up with multi, you know, five figure surgery costs, you know, medication costs that are just absolutely astronomical and all, you know, basically. Well, I won't get into how, how people bill and charge at the hospitals, but let's just say I don't believe it's the most ethical way in terms of how much they charge and how much they receive. All of those things can be avoided when somebody doesn't have that fall to begin with. And this study really supports spinal adjustments and what we do as chiropractors, our role in enhancing balance and proprioception, again, which are all critical for fall prevention. Not to mention people that are having fear, avoidance behaviors. Not to mention the fact you just think of, I think of just like somebody with spinal stenosis alone that's bent forward, weakening muscles, diminishing sensory motor integration. They're bent at 45 degrees because they have spinal stenosis and they're just, it's just a matter of time for many of these individuals of when they're going to fall. So being able to get in there, maybe this is fodder for you to have talks at local facilities. Maybe this is an opportunity for you to go down to different clubs and activities in your local community center and just start these conversations. Because even saving one individual from again, that cascade and reducing their likelihood of falling is one of the most important things you can do for that population. So this study really emphasized the significance of reducing falls in older adults and as a byproduct of improving quality of life and reducing healthcare costs. I think it's also really important for you to be the advocate in your community about the messaging with this. Almost every patient that goes in, even your patients that are not 65 plus, if they're younger, they probably have parents, aunts, uncles, grandparents, they know people that are in that age bracket. And what you are doing, whether you're using SFMA DNS, regardless of how you apply your craft, delivering a chiropractic adjustment and anything else that you do beyond that based upon that patient's presentation is a really meaningful improvement in their ability to reduce the likelihood of a fall. Which, again, I'll tie it back to where we started, is quite literally the number one cause of injury and fatality for people over 65 years old. Beyond those community centers, getting out there and starting these conversations with other healthcare providers in your community so they understand quite often the referrals haven't happened because these other providers, number one, you might not have a system and a process to generate those referrals. That's what MD Connection is all about. But there also is the component on the other side, which is part of that outreach process. Many other providers just don't know what happens in your practice. I could point you to 10 different chiropractors right now and you wouldn't know. Is one a sports chiropractor? Is one a personal injury chiropractor? Is one focused on this technique, the other on this technique? Nobody knows unless you get out there and tell that story. So even though you might be telling that story through email marketing, even though you might be telling that story across your social media channels, ensuring that that story gets appropriately connected with the other healthcare providers, whether it's an md, a do, a midwife, a doula, a nurse practitioner, physician's assistant, I don't care about their designation. Anybody who has patients that could be referred into your practice needs to know who you are, what, what you do, and how you can help their people. And that matters. The specificity around that messaging matters so clearly when I'm talking about specificity. Anybody that's taking care of older adults at scale is a great target, so to speak, for this information. It's not maybe as relevant for the pediatricians in town, but it's really relevant for those individuals taking care of older people and I think of older. All of the care facilities that are probably in your town, in your community, I think about all of those community centers, I think about all the relatives and colleagues of the patients that you already have. And falls are a big deal. Anything that we can do as chiropractors to help reduce that is important and impactful. And the beauty of this research is it continues to show the power of what you and I do and how we apply it each and every day, that we can make meaningful impacts not only in pain reduction, but also in quality of life risk factors, also in functional ability, also in just helping people live a longer, healthier and happier life. So I'm gonna drop this link down in the show notes to this study. I'd encourage you to check it out. It is a good one. And before we wrap up, I'll say a few words about turncloud. They have stripped away anything that's not essential in the EHR space and made everyday functions simpler. Turncloud.com check out their intuitive application where no one needs a user manual. Have a conversation with their team. See if it's a good fit for you and your practice. I will drop that link down in the show notes that is turncloud.com if you have not left a rating or review for this podcast, I would greatly appreciate if you took a moment and do so. You can swipe on down. If you're listening on your phone, tap how many stars, leave a line or two of text. I would greatly appreciate it. Thank you so much for tuning in. Thank you for being a chiropractor. I appreciate. I look forward to catching you next week. Have a fantastic week in practice and I will talk to you soon.

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