Frank M. Painter

Mediterranean Diet and Telomere Length in Nurses’ Health Study

By Frank M. Painter|March 8, 2015|Nutrient Deficiency, Nutrition|

Mediterranean Diet and Telomere Length in Nurses’ Health Study: Population Based Cohort Study

SOURCE: British Medical Journal 2014 (Dec 2) ~ FULL TEXT

Marta Crous-Bou, Teresa T Fung, Jennifer Prescott,
Bettina Julin, Mengmeng Du, Qi Sun, Kathryn M Rexrode,
Frank B Hu, Immaculata De Vivo

Channing Division of Network Medicine,
Department of Medicine,
Brigham and Women’s Hospital
and Harvard Medical School,
Boston, MA 02115, USA

OBJECTIVE: To examine whether adherence to the Mediterranean diet was associated with longer telomere length, a biomarker of aging.

DESIGN: Population based cohort study.

SETTING: Nurses’ Health Study, an ongoing prospective cohort study of 121,700 nurses enrolled in 1976; in 1989-90 a subset of 32,825 women provided blood samples.

PARTICIPANTS: 4676 disease-free women from nested case-control studies within the Nurses’ Health Study with telomere length measured who also completed food frequency questionnaires.

MAIN OUTCOME MEASURE: Association between relative telomere lengths in peripheral blood leukocytes measured by quantitative real time polymerase chain reaction and Alternate Mediterranean Diet score calculated from self reported dietary data.

RESULTS: Greater adherence to the Mediterranean diet was associated with longer telomeres after adjustment for potential confounders. Least squares mean telomere length z scores were -0.038 (SE 0.035) for the lowest Mediterranean diet score groups and 0.072 (0.030) for the highest group (P for trend = 0.004).

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Beyond the Spine: A New Clinical Research Priority

By Frank M. Painter|March 7, 2015|Chiropractic Research|

Beyond the Spine: A New Clinical Research Priority

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2015 (Mar); 59 (1): 6–12

James Donovan, BSc, DC, J.
David Cassidy, DC, PhD, DrMedSc,
Carol Cancelliere, DC, MPH,
Erik Poulsen, DC, PhD,
Mette Jensen Stochkendahl, DC, PhD,
Jørgen Kilsgaard, DC, MPH,
Marc-André Blanchette, DC, MSc, and
Jan Hartvigsen, DC, PhD

Division of Health Care and Outcomes Research,
Toronto Western Research Institute,
University Health Network,
University of Toronto, Canada

Over the past two decades, clinical research within the chiropractic profession has focused on the spine and spinal conditions, specifically neck and low back pain. However, there is now a small group of chiropractors with clinical research training that are shifting their focus away from traditional research pursuits towards new and innovative areas. Specifically, these researchers are now delving into areas such as brain injury, work disability prevention, undifferentiated chest pain, hip osteoarthritis, and prevention of pain in children and adolescents to name a few. In this paper, we highlight recent research in these new areas and discuss how clinical research efforts in musculoskeletal areas beyond the spine can benefit patient care and the future of the chiropractic profession.

KEYWORDS: OA; brain injury; chest pain; chiropractic; research; work disability

From the FULL TEXT Article:

Introduction

Chiropractors with clinical research training have traditionally focused on the spine and its related disorders and especially neck and low back pain. Examples include the recent Decade of the Bone and Joint 2000–2010 Task Force on Neck Pain and Its Associated Disorders [1] as well as several excellent randomized trials of spinal manipulative therapy (SMT) for neck [2] and low back pain [3–5]. Despite these and many other research successes, from 1990 to 2010 disability from spine-related pain has significantly increased, with low back pain now the leading cause of global disability, affecting 10% of the population or more than 600 million people worldwide. [6] Over the same two decades, disability from other musculoskeletal disorders has also increased by 44.6% [7], and with an aging and increasingly sedentary society this trend is likely to continue and so too will the demand for improved care and prevention. Even patients seeking care for neck and low back pain rarely have pain isolated to just the spine and frequently report co-occurring non-spinal pain, not to mention other co-morbid diseases. [8] Chiropractors already commonly manage a variety of musculoskeletal disorders and at different anatomical sites, not just those related to the spine. Taken together, these facts provide a good basis to promote the growth of clinical research efforts in other non-spinal musculoskeletal areas.

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Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

By Frank M. Painter|March 6, 2015|Chiropractic Care, Chronic Pain, Neck Pain|

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

The Chiro.Org Blog

SOURCE: Spine J. 2014 (Sep 1); 14 (9): 1879–1889

Michele Maiers, DC, MPH, Gert Bronfort, DC, PhD,
Roni Evans, DC, MS, Jan Hartvigsen, DC, PhD,
Kenneth Svendsen, MS, Yiscah Bracha, MS,
Craig Schulz, DC, MS, Karen Schulz, DC,
Richard Grimm, MD, PhD

Northwestern Health Sciences University,
Wolfe-Harris Center for Clinical Studies,
2501 W. 84th St, Bloomington, MN 55431, USA
mmaiers@nwhealth.edu

BACKGROUND CONTEXT: Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy (SMT) and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors.

PURPOSE: To assess the relative effectiveness of SMT and supervised rehabilitative exercise, both in combination with and compared to home exercise (HE) alone for neck pain in individuals ages 65 years or older.

STUDY DESIGN/SETTING: Randomized clinical trial.

PATIENT SAMPLE: Individuals 65 years of age or older with a primary complaint of mechanical neck pain, rated =3 (0-10) for 12 weeks or longer in duration.

OUTCOME MEASURES: Patient self-report outcomes were collected at baseline and 4, 12, 26, and 52 weeks after randomization. The primary outcome was pain, measured by an 11-box numerical rating scale. Secondary outcomes included disability (Neck Disability Index), general health status (Medical Outcomes Study Short Form-36), satisfaction (7-point scale), improvement (9-point scale), and medication use (days per week).

METHODS: This study was funded by the US Department of Health and Human Services, Health Resources and Services Administration. Linear mixed model analyses were used for comparisons at individual time points and for short- and long-term analyses. Blinded evaluations of objective outcomes were performed at baseline and 12 weeks. Adverse event data were collected at each treatment visit.

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

By Frank M. Painter|March 3, 2015|Vertigo|

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

The Chiro.Org Blog

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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Introduction

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Identification of Internal Carotid Artery Dissection

By Frank M. Painter|February 27, 2015|Carotid Artery Dissection, Diagnosis|

Identification of Internal Carotid Artery Dissection in Chiropractic Practice

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2004 (Sep); 48 (3): 206-210 ~ FULL TEXT

Michael T Haneline, DC, MPH and Gary Lewkovich, DC

Palmer College of Chiropractic West,
Palmer Center for Chiropractic Research,
90 E. Tasman Drive,
San Jose, CA 95134
michael.haneline@palmer.edu

Internal carotid artery dissection (ICAD) is a condition involving separation of the artery’s intimal lining from its medial division, with subsequent extension of the dissection along varying distances of the artery, usually in the direction of blood flow. ICAD may produce cerebral ischemia due to occlusion of the involved artery. This occlusion may occur at or near the site of the dissection, or “downstream” as a result of embolization from a dislodged thrombus fragment. The problem any chiropractic physician faces in identifying ICAD patients is that the condition may present without any symptoms or the symptoms may appear benign (e.g., headache, neck pain or cervicogenic dizziness). Consequently, it may be impossible to identify some ICAD patients, especially in the early stages of the pathology. As the ICAD progresses and neural blood flow is compromised, the symptom picture typically manifests more completely. The chiropractic physician must be alert to characteristic findings of a progressing ICAD, since an immediate referral to a medical specialist may be required.

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Stroke and Chiropractic Page

From the FULL TEXT Article:

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The Etiology of Cervical Artery Dissection

By Frank M. Painter|February 26, 2015|Diagnosis, Vertebral Artery|

The Etiology of Cervical Artery Dissection

The Chiro.Org Blog

SOURCE: J Chiropr Med. 2007 (Summer); 6 (3): 110-120 ~ FULL TEXT

Michael T. Haneline [a], and Anthony L. Rosner [b]

a Professor,
Palmer College of Chiropractic West,
Department of Research, San Jose, CA 95134
michael.haneline@palmer.edu

b Professor,
Parker College of Chiropratic,
Brookline, MA 02446

The etiology of cervical artery dissection (CAD) is unclear, although a number of risk factors have been reported to be associated with the condition. On rare occasions, patients experience CAD after cervical spine manipulation, making knowledge about the cervical arteries, the predisposing factors, and the pathogenesis of the condition of interest to chiropractors. This commentary reports on the relevant anatomy of the cervical arteries, developmental features of CAD, epidemiology of the condition, and mechanisms of dissection. The analysis of CAD risk factors is confusing, however, because many people are exposed to mechanical events and known pathophysiological associations without ever experiencing dissection. No cause-and-effect relationship has been established between cervical spine manipulation and CAD, but it seems that cervical manipulation may be capable of triggering dissection in a susceptible patient or contributing to the evolution of an already existing CAD. Despite the many risk factors that have been proposed as possible causes of CAD, it is still unknown which of them actually predispose patients to CAD after cervical spine manipulation.

From the FULL TEXT Article:

Introduction

The etiology of cervical artery dissection (CAD) is, for the most part, unclear; and what has been proposed as an explanation for its pathogenesis is largely hypothetical. [1] Furthermore, when dealing with a particular case of CAD, the pathogenesis is especially speculative. [2] Nevertheless, a number of risk factors have been reported to be associated with the condition, including connective tissue abnormalities, hypertension, recent infection, migraine headache, the use of oral contraceptives, and others. Of special interest to chiropractors is the role cervical spine manipulation (CSM) plays, if any, in the pathogenesis of CAD. Indeed, patients do experience CAD on rare occasions after CSM, making knowledge about the cervical arteries, the predisposing factors, and the pathogenesis of the condition important for chiropractors.

Anatomy of the cervical arteries

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About Frank M. Painter

Mediterranean Diet and Telomere Length in Nurses’ Health Study

Mediterranean Diet and Telomere Length in Nurses’ Health Study: Population Based Cohort Study

Beyond the Spine: A New Clinical Research Priority

Beyond the Spine: A New Clinical Research Priority

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

Spinal Manipulative Therapy and Exercise For Seniors with Chronic Neck Pain

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

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

Identification of Internal Carotid Artery Dissection

Identification of Internal Carotid Artery Dissection in Chiropractic Practice

The Etiology of Cervical Artery Dissection

The Etiology of Cervical Artery Dissection