Is There a Role for Neck Manipulation in Elderly Falls Prevention? – An Overview

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SOURCE:   J Can Chiropr Assoc. 2015 (Mar);   59 (1):   53–63 ~ FULL TEXT

Julie C. Kendall, BAppSc, MClinChiro [1]
Jan Hartvigsen, DC, PhD [2]
Simon D. French, BAppSc(Chiro), MPH, PhD [3]
Michael F. Azari, BAppSc(Chiro), BSc(Hons), PhD* [1,4]

1 Discipline of Chiropractic, School of Health Sciences,
RMIT University, Melbourne, Australia

2 Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark and Nordic Institute of
Chiropractic and Clinical Biomechanics, Odense, Denmark

3 School of Rehabilitation Therapy, Queens University,
Kingston, Canada

4 Health Innovations Research Institute, RMIT University,
Melbourne, Australia

Many risk factors exist for falls in the elderly. Dizziness is an important risk factor for such falls. Spinal pain has also been identified as a risk factor for these falls. In this overview of the literature, we examine studies, including trials, of neck manipulation for neck pain, unsteadiness and falls risk relevant to the elderly. We also examine two related, but not mutually exclusive, mechanisms through which a putative beneficial effect may be mediated. These are the effects of neck manipulation on neck pain and on non-specific dizziness. We focus on the available evidence primarily in terms of clinical data rather than laboratory-based measures of balance. We conclude that chiropractors may have a role in falls prevention strategies in the subpopulation of the elderly that suffer from mechanical neck pain or dysfunction and non-specific dizziness. However, this role remains to be rigorously studied and properly defined.

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Falls in the elderly can be due to many causes. Dizziness is an important risk factor for these falls. In this overview of the literature, we examine the relationship between non-specific dizziness, an important form of dizziness in the elderly [1], and neck pain and dysfunction. We further examine whether rigorous evaluation of neck manipulation is justified for the treatment of non-specific dizziness that is concomitant with chronic neck pain or dysfunction, with the aim of reducing the risk of falls in the elderly. This review does not focus on research data in relation to changes in laboratory-based measurements of balance such as postural sway and their changes with neck pain or neck manipulation. [2, 3] Instead, we focus primarily on clinical research data. A non-systematic method using Pubmed searches was used to source the available literature on the subject. No language restrictions were applied. Care was taken to guard against inclusion or exclusion bias.

Falls in the elderly and dizziness

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