Vertigo

Chiropractic Treatment of Older Adults with Neck Pain

By Frank M. Painter|January 31, 2020|Headache, Neck Pain, Vertigo|

Chiropractic Treatment of Older Adults with Neck Pain with or without Headache or Dizziness: Analysis of 288 Australian Chiropractors’ Self-reported Views

SOURCE: Chiropractic & Manual Therapies 2019 (Dec 18); 27: 65

Dein Vindigni, Laura Zark, Tobias Sundberg, Matthew Leach, Jon Adams, and Michael F. Azari

Chiropractic Discipline,
School of Health and Biomedical Sciences,
RMIT University,
Melbourne, Australia.

BACKGROUND: Neck pain is a leading cause of individual and societal burden worldwide, affecting an estimated 1 in 5 people aged 70 years and older. The nature and outcomes of chiropractic care for older adults with neck pain, particularly those with co-morbid headaches, remains poorly understood. Therefore, we sought to ascertain: What proportion of Australian chiropractors’ caseload comprises older adults with neck pain (with or without headache); How are these conditions treated; What are the reported outcomes?

METHODS: An online survey examining practitioner and practice characteristics, clinical patient presentations, chiropractic treatment methods and outcomes, and other health service use, was distributed to a random nationally representative sample of 800 Australian chiropractors. Quantitative methods were used to analyze the data.

RESULTS: Two hundred eighty-eight chiropractors (response rate = 36%) completed the survey between August and November 2017. Approximately one-third (M 28.5%, SD 14.2) of the chiropractors’ patients were older adults (i.e. aged ≥65 years), of which 45.5% (SD 20.6) presented with neck pain and 31.3% (SD 20.3) had co-morbid headache. Chiropractors reported to combine a range of physical and manual therapy treatments, exercises and self-management practices in their care of these patients particularly:

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Chiropractic Treatment Including Instrument-assisted Manipulation

By Frank M. Painter|May 21, 2018|Vertigo|

Chiropractic Treatment Including Instrument-assisted Manipulation for Non-specific Dizziness and Neck Pain in Community-dwelling Older People: A Feasibility Randomised Sham-controlled Trial

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2018 (May 10); 26: 14

Julie C. Kendall, Simon D. French, Jan Hartvigsen, and Michael F. Azari

School of Health and Biomedical Sciences,
RMIT University,
PO Box 71 Bundoora,
Melbourne, VIC 3083 Australia.

BACKGROUND: Dizziness in older people is a risk factor for falls. Neck pain is associated with dizziness and responds favourably to neck manipulation. However, it is unknown if chiropractic intervention including instrument-assisted manipulation of the neck in older people with neck pain can also improve dizziness.

METHODS: This parallel two-arm pilot trial was conducted in Melbourne, Australia over nine months (October 2015 to June 2016). Participants aged 65–85 years, with self-reported chronic neck pain and dizziness, were recruited from the general public through advertisements in local community newspapers and via Facebook. Participants were randomised using a permuted block method to one of two groups: 1) Activator II™-instrument-assisted cervical and thoracic spine manipulation plus a combination of: light massage; mobilisation; range of motion exercises; and home advice about the application of heat, or 2) Sham-Activator II™-instrument-assisted manipulation (set to zero impulse) plus gentle touch of cervical and thoracic spinal regions. Participants were blinded to group allocation. The interventions were delivered weekly for four weeks. Assessments were conducted one week pre- and post-intervention. Clinical outcomes were assessed blindly and included: dizziness (dizziness handicap inventory [DHI]); neck pain (neck disability index [NDI]); self-reported concerns of falling; mood; physical function; and treatment satisfaction. Feasibility outcomes included recruitment rates, compliance with intervention and outcome assessment, study location, success of blinding, costs and harms.

RESULTS: Out of 162 enquiries, 24 participants were screened as eligible and randomised to either the chiropractic (n = 13) or sham (n = 11) intervention group. Compliance was satisfactory with only two participants lost to follow up; thus, post-intervention data for 12 chiropractic intervention and 10 sham intervention participants were analysed. Blinding was similar between groups. Mild harms of increased spinal pain or headaches were reported by 6 participants. Costs amounted to AUD$2635 per participant. The data showed a trend favouring the chiropractic group in terms of clinically-significant improvements in both NDI and DHI scores. Sample sizes of n = 150 or n = 222 for dizziness or neck pain disability as the primary outcome measure, respectively, would be needed for a fully powered trial.

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Effectiveness of Chiropractic Care to Improve Sensorimotor Function

By Frank M. Painter|April 11, 2016|Vertigo|

Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2016 (Apr 2) [Epub]

Kelly R. Holt, BSc (Chiro), Heidi Haavik, BSc (Chiro), PhD,
Arier Chi Lun Lee, PhD, Bernadette Murphy, DC, PhD, C.
Raina Elley, MBChB, PhD

Research Fellow, Centre for Chiropractic Research,
New Zealand College of Chiropractic,
Mt. Wellington, Auckland, New Zealand

OBJECTIVE: This study assessed whether 12 weeks of chiropractic care was effective in improving sensorimotor function associated with fall risk, compared with no intervention, in community-dwelling older adults living in Auckland, New Zealand.

METHODS: Sixty community-dwelling adults older than 65 years were enrolled in the study. Outcome measures were assessed at baseline, 4 weeks, and 12 weeks and included proprioception (ankle joint position sense), postural stability (static posturography), sensorimotor function (choice stepping reaction time), multisensory integration (sound-induced flash illusion), and health-related quality of life (SF-36).

RESULTS: Over 12 weeks, the chiropractic group improved compared with the control group in choice stepping reaction time (119 milliseconds; 95% confidence interval [CI], 26-212 milliseconds; P = .01) and sound-induced flash illusion (13.5%; 95% CI, 2.9%-24.0%; P = .01). Ankle joint position sense improved across the 4- and 12-week assessments (0.20°; 95% CI, 0.01°-0.39°; P = .049). Improvements were also seen between weeks 4 and 12 in the SF-36 physical component of quality of life (2.4; 95% CI, 0.04-4.8; P = .04) compared with control.

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Chiropractic Management of Benign Paroxysmal Positional Vertigo

By Frank M. Painter|December 23, 2015|Vertigo|

Chiropractic Management of Benign Paroxysmal Positional Vertigo Using the Epley Maneuver: A Case Series

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2013 (Feb); 36 (2): 119–126 ~ FULL TEXT

Sandy S. Sajko, MSc, Kent Stuber, MSc, DC, Tim N. Welsh, PhD

Maple Grove Chiropractic Clinic,
ON, Canada.
sandysajko@gmail.com

OBJECTIVE: The purpose of this case series is to describe the management of benign paroxysmal positional vertigo in a chiropractic clinical setting.

CLINICAL FEATURES: Eight patients (4 women, 4 men) with symptoms of persistent benign paroxysmal positional vertigo presented for chiropractic care. The outcome measures included self-reported resolution of vertigo, a Short Form 12 Health Survey, Measure Yourself Medical Outcome Profile, and the Dix-Hallpike maneuver. Outcome measures were assessed at initial assessment, 6 days, 30 days, and 3 months postintervention.

INTERVENTION AND OUTCOME: The patients underwent one or more canalith repositioning procedures (Epley maneuver). Scores in each of the categories decreased from the initial to 6-day assessment and then again at the 30-day assessment. The effects of the treatment on the Short Form 12 scores showed changes between the initial assessment and 30 days posttreatment.

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Effects of Acupuncture, Cervical Manipulation and NSAID therapy on Dizziness

By Frank M. Painter|March 22, 2015|Spinal Manipulation, Vertigo|

Effects of Acupuncture, Cervical Manipulation and NSAID therapy on Dizziness and Impaired Head Repositioning of Suspected Cervical Origin: A Pilot Study

The Chiro.Org Blog

SOURCE: Man Ther 2000 (Aug); 5 (3): 151–157

Heikkila H, Johansson M, Wenngren BI

Department of Otorhinolaryngology,
Northern Sweden University Hospital,
Umea, Sweden.
hannu.heikkila@psychiat.umu.se

In a single-subject experiment undertaken on 14 consecutive patients, the effects of acupuncture, cervical manipulation, no therapy, and NSAID-percutan application on kinesthetic sensibility, dizziness/vertigo and pain were studied in patients with dizziness/vertigo of suspected cervical origin. The ability to perceive position of the head with respect to the trunk was studied. The effects of different forms of therapy-and none-on dizziness and neck pain were compared, using a 100 mm visual analogue scale (VAS). Active head relocation by subjects with dizziness was significantly less precise than in the control group. Manipulation was the only treatment to diminish the duration of dizziness/vertigo complaints during the past 7 days and increased the cervical range of motion.

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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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