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CMT in Geriatrics

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Geriatrics

  • Strength training and balance exercises improve function and reduces impairment
  • Strong evidence to support[1]
  • Counseling for physical activity and exercise[1]
  • Counseling for general health[1]
  • Counseling for fall prevention[1]
  • Screen for fall risks factors
  • Medication use (including polypharmacy)[1]
  • Blood pressure[1]
  • Balance and gait[1]
  • Heart health[1]
  • Home safety[1]
  • Tables included in the article
  • Outlines geriatric red flags for immediate referral and those requiring co-management or appropriate referral[1]
  • “Agency for Healthcare Research and Quality (AHRQ) recommendations for screening and counseling for adults aged 65 and older”[1]
  • Hawk et al. provides “a general framework for what constitutes an evidence-based and reasonable approach to the chiropractic management of older adults”[1]
  • Dougherty et al. article focuses on SMT, acupuncture, physical activity/exercise, nutritional counseling and fall prevention[2]
  • Observational studies and RCTs “have reported improvement of spinal pain (acute, sub-acute and chronic) among seniors using SMT, BioEnergetic Synchronization Technique and Cox Flexion-Distraction technique”[2]
  • 2010 UK Report of Manual therapies:
  • “SMT is effective in adults for: acute, subacute and chronic LBP; migraine and cervicogenic headache; cervicogenic dizziness”[2]
  • “Manipulation/mobilization is effective for several extremity joint conditions”[2]
  • “Thoracic manipulation/mobilization is effective for acute/subcute neck pain”[2]
  • Limited evidence for SMT for “COPD, constipation, depression (associated with back pain), Parkinson’s disease, MS, pneumonia, spinal stenosis, urinary incontinence, and OA pain and dysfunction, especially of the knee”[2]
  • Acupuncture and chronic MSK pain:
  • Insufficient experimental evidence showing it benefit over other modalities[2]
  • Limited evidence for supplement use impacting health outcomes
  • Most beneficial: Vitamin D and calcium as an “adjunct to pharmacologic regimen in treatment of osteoporosis and in the prevention of hip fractures and other non-vertebral fractures”[2]
  • Recommended 1,200 mg calcium; 1,000 IU of Vitamin D[2]
  • Other supplements have “inadequate evidence or evidence of significant side effects”[2]
  • Positive effects of aerobic exercise and strength training (strength, balance and physical functioning)[2]
  • Modest beneficial effect of resistive training on strength outcomes[2]
  • Strong evidence for improving gait speed and chair stands[2]
  • Decreased levels of arthritic knee pain with resistive training[2]
  • “DCs should collect falls history information, and provide treatment and exercises for musculoskeletal conditions”[2]

References