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October 2004 Table of Contents
CBP® Research Update • Conventional Wisdom • Don's Opinion • CBP® and Geriatrics: A Case Report • Enough of Chiropractic is for This Pain or That Pain • Chiropractic Passion • The Purpose Driven Practice • Three New and Important Whiplash Articles • You Hired Me To Do A Job • ACA Lawsuit Dismissed • CBP® Online Cyber Update • Harrisons' and Caillet • ICA Files 'Amicus' Brief • A Response to Dr Fuhr • Life University Achieves Financial Goal • Structural Rehab Tool • CBP®'s Chiropractor of the Year • CBP®'s Annual Awards
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CBP® and Geriatrics:
A Case Report
by Jason W. Haas, DC
 Dr. Jason Haas graduated from Life Chiropractic College West. He participated as a CBP student club officer and instructor throughout his chiropractic education. He successfully passed the CBP® Club Certification in June of 1997 and passed the CBP® Technique Certification, making him a Distinguished Fellow of Clinical Biomechanics of Posture®. He is originally from Colorado where he attended undergraduate school at the University of Colorado at Boulder. His association with CBP® began at Life University in Georgia where he was Student Club President and Vice President. He has co-authored the Cervical Rehabilitation text with Drs. Don and Deed Harrison and has been a contributing author to research papers on the Thoracic Spine Normal Model, reliability studies, and a clinical control trial showing the efficacy of CBP® protocols. He is currently the International Chiropractic Association representative by proxy for the state of Wyoming. Dr. Haas is currently working with CBP® researchers in Wyoming and Nevada to further the knowledge of the human spine and advance chiropractic principles.
The Baby Boomer generation is the largest segment of the US population. This population group is a large consumer of alternative and complimentary medicine. This group in its entirety will be over the age of 60 next year. Many of theses individuals and the generation older than them suffer from chronic, debilitating, and painful spinal conditions. This population group is becoming more and more skeptical of traditional drugs and surgery and is spending more on alternative and complimentary therapies. Chiropractic is one of the major choices baby boomers use for healthcare. CBP® is aware of this group and has very specific protocols of care that can greatly benefit this group as they age into the largest elderly population this country has ever experienced.
Many in the realm of chiropractic believe that CBP® protocols are strenuous and difficult, not only for the practitioner to learn, but also for the patient to experience. I have been told by students and DC’s alike, “You could never do that CBP® traction with someone 65 or 75 or 90 years old.” So, I wrote this article to clear some things up about the protocols of CBP® and to give practitioners some tips on caring for elderly patients with these protocols.
First, we all must realize that there are some special considerations that must be made when one attempts to remodel the spine of an elderly person. These considerations include, but are not limited to, organic pathologies, musculoskeletal degeneration, and other underlying disease states. Pathologies and other known or suspected disease states can properly be co-managed by, high-quality, well educated, medical doctors. Practitioners should also realize that many of the elderly have been abused by previous healthcare practitioners and may be on an astonishing amount of pharmaceuticals. If you suspect that your patient may be over-medicated, as an astute clinician you should highly recommend a consultation with a medical doctor in your area that you have established rapport and trust. Medication alteration may be in order.
That being said, your job as spinal correction specialist now takes on greater significance. For, as we know, the structure of the nervous system, spine, and posture have control mechanisms that can alter the physiologic function of all systems of the body and this may in turn alter pharmaceutical function to say the least. Furthermore, many elderly individuals have very poor dietary habits. Clinicians who wish to improve all of the outcomes of their elderly patients may wish to nutritionally consult with the patient or to refer to a trusted practitioner who does. For those clinicians who were wise enough to attend the recent CBP® Annual in Las, Vegas, implementation of those recommendations by Dr. Dan Murphy should be in order.
Now, when it comes to correction of the spine in elderly individuals, degeneration and scar tissue from previous micro or macro-trauma will usually slow the progress that would be seen in younger individuals. This should be implicitly stated to the patient and they should understand that many of the problems they are suffering from have arisen not suddenly, but over the course of many years from poor postural habits, and as a result of previous trauma. For example, they may need to have an explanation of how a vehicle collision, when they were in their teens, can be affecting their health today.
CBP® protocols are quite extensive. Clinicians should update themselves often to assure that the techniques they apply in their offices are the best, most current services available to patients. CBP® Seminars and research are constantly evolving. The addition of the new PosturePrint® postural analysis and future radiograph digitization will only continue to build the arsenal of CBP® research available. The following case report is an example of a typical case in our office. We, at the CBP® Spine Center in Windsor, CO, see just over 200 patient visits per week and 75% of those patients are over the age of 65. We apply all of the CBP® Protocols for full spine traction to the vast majority of our patients.
Case Report
This is a case report of a 78 year old female. She originally stated she had been suffering from intense low back pain and neck pain for several years. She stated that she had been unable to walk without assistance for the last two years. She carried a cane and had very poor posture upon presentation. Her primary postural abnormalities were severe anterior translation of her thorax (+TZT) and significant anterior translation of her head upon her thorax (+TZH) coupled with cervical flexion (+RXH). She had several positive orthopedic tests, including cervical compression and straight and well leg raising tests. She had a significant decrease in range of motion in both her cervical and lumbar spine in all directions. She also reported significant pain after prolonged walking, standing, sitting, reaching, bending, and lifting. Her daughter stated that she had spent a majority of the time over the past two years in a sedentary position and was unable to do most activities of daily living beyond personal hygiene.
Radiographic Findings
Anterior-Posterior sectional films and Lateral full-spine plain film radiographs were obtained in our office. The films demonstrated several significant findings. Segmental degeneration of both the bone and soft tissue was apparent at nearly all spinal levels. The amount of degeneration varied from moderate to severe. The degeneration of the cervical and lumbar spine was most severe. The cervical and lumbar spine were kyphotic and the thoracic spine was hypokyphotic.
X-ray Mensuration
Treatment
Treatment of the cervical and lumbar was performed using CBP® Protocols. These Protocols have been shown to be both valid and reliable with current research. A three-times per week care schedule was arranged. Moist heat was applied to the cervical and lumbar spine, light trigger point therapy was followed by Mirror Image® Instrument Adjusting. Passive cervical and lumbar spine musculature stretching was utilized. Mirror Image® Traction Protocols including the use of the Target Force® and the Posture Pump® simultaneously for up to 20 minutes was applied each visit, and cryotherapy was applied following traction. The patient was very compliant and signed a consent form. Additionally, daily NRS, and the SF-36(c) outcomes were measured.
PRE POST
 
Results
On post-x-ray examination, the patient had a change in her kyphotic cervical spine (+9 degrees) to a lordosis of -20 degrees at C2-C7. She had an increase in her hypo-kyphotic thoracic kyphosis and a return to a lumbar lordosis of -25 degrees at L1-L5 from an initial lumbar kyphosis of +19 degrees (see table above). She improved from an initial pain scale of NRS = 8.5 to post-treatment NRS = 4.5. After treatment, she was able to walk unassisted without a cane, and her SF-36 score (health status questionnaire) improved from initial at her post-examination. (see graphs above)
Conclusion
The elderly are the fastest growing population segment in our country. They have special needs, and require a compassionate, gently understanding of the aging human body in order to care for them. They often have extremely severe and chronic problems that are painful and debilitating. They require an attention to detail, and a gentle touch. This segment of the population can be an extremely rewarding group of people to care for utilizing CBP® Protocols. Generally, they are very compliant, respectful and willing to work to achieve results.
This case is an example of the incredible spinal corrections seen by CBP® Practitioners on a repeatable, reliable basis. This type of care is available only through CBP® Seminars. So, if you would like to see corrections like this in the most important people in your life, your patients, attend CBP® Seminars and become a Certified Distinguished Fellow of CBP®. This incredible life changing, extremely well documented, spinal correction system is available all across the world, and is providing this profession the respect it deserves. Your continued support of CBP® enables research into common daily practices of spinal structural rehabilitation practitioners. The case report format can often be used to draw conclusions, however, CBP® is involved in many forms of research including case series, controlled trials, anatomical studies, biomechanical modeling, and neurophysiological implications of CBP®.
CBP® References can be found in the Research Corner section of this journal or online at www.idealspine.com. For more information concerning US population statistics, please visit www.census.gov.
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