Chiropractic & Falls Prevention Presented by Dr. Neil Patrick - PowerPoint PPT Presentation

Chiropractic & Falls Prevention Presented by Dr. Neil Patrick

Today’s Agenda • Chiropractic: assessment, diagnosis and treatment • Treatments to increase strength, flexibility and stamina • Exercises to minimize risks • Collaboration and interprofessional care

What is Chiropractic? Chiropractic is a non-invasive, hands-on health care discipline that focuses on the musculoskeletal system. Chiropractors practice a manual approach, providing diagnosis, treatment and preventive care for disorders related to the spine, pelvis, nervous system and joints.

Scope of Practice: “The practice of chiropractic is the assessment of conditions related to the spine, nervous system and joints, and the diagnosis, prevention and treatment, primarily by adjustment, of: Dysfunctions or disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the nervous system; and, Dysfunctions or disorders arising from the structures or functions of the joints.” — The Chiropractic Act

Education & Training • 4 year / 4,200+hours from an accredited program • Completion of the national competency examinations • Apply for licensure & accepted by the provincial regulatory board

Collaborative Models Referral Private Networks with Multidisciplinary Publicly Funded Clinics Providers Co-Location with Interprofessional Publicly Funded Primary Care Providers Team Integration

Older Adults & MSK Disability risk among older adults increases as more areas of the body experience MSK pain.

Older Adults & Falls Prevention Among adults aged 65 and older, falls were responsible for over half of all injuries.

Complex Care Individuals with type 2 diabetes are approximately twice as likely Diabetes to suffer from MSK pain. 11 One in six Canadians (15 years and older) report having arthritis, Arthritis which amounts to 4.6 million individuals. 12 Nearly 36% of COPD patients experience back pain; 13% COPD experience neck pain. 13 MSK pain in two or more locations is associated with an increased Seniors risk of falls among community-living older adults. 14

Chiropractors’ Role Chiropractors can assess, diagnose and treat MSK conditions, prescribe exercise and educate patients on self- care and falls prevention.

Case Study: SC • 67 year old, female • Arthritis, reduced mobility in knees, hips, and lower back; worried about falling • Referred by nurse practitioner for assessment and support related arthritis

Chiropractic Assessment Asses Patient History: • Location • Onset • Duration • Frequency • Intensity • Character • Radiation • Aggravating Factors • Relieving Factors

History: SC • Bilateral knee & hip pain, periodic low back pain; insidious onset • Reduced mobility – difficulty with stairs, transitions • Meds: blood pressure and joint pain • Retired, worked for 35 yrs as a nurse at local hospital

Physical Examination • Observation / Gait • Ranges of motion • Neurological testing • Orthopedic / functional testing • Palpation

Physical Exam: SC • Decreased hip int rot, lower limb mm strength bilaterally • Pain, crepitus, reduced ROM knee flex/ext • Wide gait; difficulty standing from seated • Orthopedic testing indicative of OA

Additional testing • As appropriate • In collaboration with other health care providers

Consent • Informed consent • Treatment options discussed and modified based on individual basis • Benefits • Potential risks

Plan of Management Manual Self-care / Education therapy Exercise Referral / Modalities Collaboration

Treatment • Manual therapy • Modalities and/or orthotics • Fall prevention and nutritional counseling • Rehabilitation and referral to community programs

Treatment • Patient education: • Condition specific • Self-management strategies • Guided therapeutic exercise

Increase Strength, Flexibility & Stamina • Address MSK pain in order to allow people to become more active • Prescribe exercise with focus on range of motion and strength • Postural awareness and functional exercises (ex. Stairs)

Treatment: SC • Patient education & self-management strategies • Soft tissue therapy • Joint mobilization/adjusting • Therapeutic modalities for pain control

Chiropractors Responding to Falls In addition to assessing, diagnosing and treating patients, chiropractors collaborate and refer to community services.

OCA Public Education The Don’t Let a Fall Get You Down Toolkit and healthy aging materials can be found on OCA’s website.

MOHLTC Pilots Primary Care Low Back Pain Pilot program improves treatment of patients with low back pain.

MOHTLC Pilots The Inter-professional Spine Assessment and Education Clinics (ISAEC) offer rapid access, thorough consultations and personalized management plans.

Community Referrals Mechanical or non-specific LBP and MSK conditions Absence of red flags Conservative care in-line with patient values

Patient Benefits + Increased coordination of care + Improved function and pain management + Ability to engage in active care = Improved Patient Outcomes

Questions? For more information please contact: Dr. Neil Patrick Collingwood Chiropractic, Creemore Chiropractic Phone: (705) 466-3447 Web: www.creemorechiro.com Email: drpatrick@creemorechiro.com @ON_Chiropractic Ontario Chiropractic Association www.chiropractic.on.ca