Chiropractic + Naturopathic Doctor • April 2018 • Roundup

A premium long viewed as a financial irritant in British Columbia paid by individuals and families for health care will be eliminated on Jan. 1, 2020.

The provincial government says once the premiums are eliminated, an individual will save up to $900 a year and families up to $1,800 annually.

To cover the loss of revenue, the government will introduce a new payroll tax on Jan. 1, 2019.

That means businesses with a payroll of more than $1.5 million will pay a tax of 1.95 per cent, those below $500,000 will be exempt, and employers whose payrolls fall in between will pay a lower rate.

The government says it collected $2.6 billion in premiums in the 2016-17 fiscal year, and the new payroll tax will provide $1.9 billion in revenue in 2019-20.

“B.C. is an outlier in Canada as the only province that levies unfair, regressive MSP premiums that penalize families and individuals,” Finance Minister Carole James said in her budget speech to the legislature.

The government says the premium cost a person earning $45,000 a year the same amount as someone making $250,000 annually, and the 1.95 per cent tax rate on payroll to help recover the loss of revenue is the lowest in Canada.

Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure – if it’s enough exercise, and if it’s begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources.

To reap the most benefit, the exercise regimen should begin by late middle age (before age 65), when the heart apparently retains some plasticity and ability to remodel itself, according to the findings by researchers at the Institute for Exercise and Environmental Medicine, a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas.

The exercise needs to be performed four to five times a week. Two to three times a week was not enough, the researchers found in an earlier study.

“Based on a series of studies performed by our team over the past five years, this ‘dose’ of exercise has become my prescription for life,” said senior author Dr. Benjamin Levine, director of the institute and professor of internal medicine at UT Southwestern. “I think people should be able to do this as part of their personal hygiene – just like brushing your teeth and taking a shower.”

The regimen included exercising four to five times a week, generally in 30-minute sessions, plus warmup and cool-down:

One of the weekly sessions included a high-intensity 30-minute workout, such as aerobic interval sessions in which heart rate tops 95 per cent of peak rate for four minutes, with three minutes of recovery, repeated four times.

Each interval session was followed by a recovery session performed at relatively low intensity.

One or two other sessions were performed each week at a moderate intensity, meaning the participant would break a sweat, be a little short of breath, but still be able to carry on a conversation – the “talk test.” In the study, exercise sessions were individually prescribed based on exercise tests and heart rate monitoring.

One or two weekly strength training sessions using weights or exercise machines were included on a separate day, or after an endurance session.

The more than 50 participants in the study were divided into two groups, one of which received two years of supervised exercise training and the other group, a control group, which participated in yoga and balance training.

At the end of the two-year study, those who had exercised showed an 18 per cent improvement in their maximum oxygen intake during exercise and a more than 25 per cent improvement in compliance, or elasticity, of the left ventricular muscle of the heart, Levine noted.

Sedentary aging can lead to a stiffening of the muscle in the heart’s left ventricle, the chamber that pumps oxygen-rich blood back out to the body, he explained.

“When the muscle stiffens, you get high pressure and the heart chamber doesn’t fill as well with blood. In its most severe form, blood can back up into the lungs. That’s when heart failure develops,” said Levine, who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research.

Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who don’t exercise and aren’t fit, leaving them with small, stiff chambers that can’t pump blood as well.

The researchers also found that the heart chamber in competitive masters-level athletes remains large and elastic, and that even four to five days of committed exercise over decades is enough for noncompetitive athletes to reap most of this benefit.

In the current study, researchers wanted to know if exercise can restore the heart’s elasticity in previously sedentary individuals – especially if begun in late middle age. The researchers recruited 53 participants, ages 45 to 64.

The new study appears in Circulation, a journal of the American Heart Association.

A new study from The Ohio State University Wexner Medical Center examines what may cause chronic back pain in runners and the exercises to help prevent it.

Published in the Journal of Biomechanics, the study suggests runners with weak deep core muscles are at higher risk of developing low back pain. Unfortunately, most people’s deep core muscles aren’t nearly as strong as they should be.

To examine the role of the superficial and deep core muscles, researchers used motion detection technology and force-measuring floor plates to estimate muscle movements during activity.

“We measured the dimensions of runners’ bodies and how they moved to create a computer model that’s specific to that person. That allows us to examine how every bone moves and how much pressure is put on each joint,” said Ajit Chaudhari, associate professor of physical therapy and biomedical engineering at The Ohio State University Wexner Medical Center, who led the study. “We can then use that simulation to virtually ‘turn off ’ certain muscles and observe how the rest of the body compensates.”

What they found is that weak deep core muscles force more superficial muscles like the abs to work harder and reach fatigue faster. When those superficial muscles are doing the work the deep core should be doing, there are often painful consequences.

“When your deep core is weak, your body is able to compensate in a way that allows you to essentially run the same way,” Chaudhari said. “But that increases the load on your spine in a way that may lead to low-back pain.”

Experts say it’s common for even well-conditioned athletes to neglect their deep core, and there is a lot of misinformation online and in fitness magazines about core strength. Traditional ab exercises with a large range of motion, such as sit-ups or back extensions, will not give you the strong core needed to be a better runner.

Instead, Chaudhari said exercises such as planks that focus on stabilizing the core, especially on unstable surfaces, are what’s really going to make you a better runner.

“Working on a six-pack and trying to become a better runner is definitely not the same thing. If you look at great runners, they don’t typically have a six-pack but their muscles are very fit,” Chaudhari said. “Static exercises that force you to fire your core and hold your body in place are what’s really going to make you a better runner.”

This research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH.

For the last 12 years, volunteer chiropractors have been providing on site chiropractic service for teams from around the world participating at the World Pond Hockey Championships, an annual fundraising event benefitting the people of Tobique River Valley in New Brunswick.

Six chiropractors participated this year, including Dr. Susan DeWolfe, a chiropractor from Toronto and who instigated the idea of bringing chiropractic to the event. DeWolfe’s father is from Plaster Rock, N.B., where the annual World Pond Hockey Championships are held.

“I realized there was an opportunity for a chiropractic clinic at this event,” said DeWolfe, who first started volunteering at this hockey tournament in 2007, and have been there every year since.

As an athlete and a sports chiropractor, DeWolfe has a keen interest in the management of sports injuries. Volunteering at the World Pond Hockey Championships is an opportunity to practice what she loves and give back to the Village, where some of her family members still live.

“This (event) originated because the old arena had been condemned and the Village knew that if they didn’t have a hockey rink, people would move away and they knew that would be the death of their village,” DeWolfe said. The Village now has a new indoor arena and continues to benefit from this yearly event – which now boasts 120 teams from around the world.

DeWolfe had been the lone chiropractor at the event until 2011, when she was finally joined by a fellow sports chiropractor, Dr. Matt Cochran from Fredericton. The number of volunteers gradually increased – through active promotion by the New Brunswick Chiropractors Association to its members – to six chiropractors volunteering at this year’s tournament held last February.

The chiropractic clinic also had a volunteer “office manager” this year, who took care of all paperwork, including informed consent forms that those coming into the chiropractic tent for treatment had to sign, De- Wolfe said.

DeWolfe is hopeful more chiropractors, especially those with special interest in sports injuries, would come and volunteer at the World Pond Hockey tournament.

“We were doing sports chiropractic, we showed the athletes (at World Pond Hockey) that chiropractic wasn’t what they had preconceived. We were treating ankle injuries, hip injuries. We were able to really show people what we could do as chiropractors, showcase chiropractors in a sporting event,” De Wolfe said.

Nearly every minute, a woman dies from heart disease in the United States – it is the number one killer of women, causing one in three deaths each year, according to the American Heart Association (AHA).

When it comes to heart disease, women experience unique causes, symptoms and outcomes compared to men. In addition, certain conditions appear to increase heart disease risk in women, including pre-eclampsia and eclampsia, gestational diabetes, migraine headaches with aura, early onset menopause and autoimmune diseases such as lupus and rheumatoid arthritis.

Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian/Weill Cornell Medical Center, and Dr. Jennifer Haythe, a cardiologist specializing in cardiac health during pregnancy at the Center for Advanced Cardiac Care at NewYork-Presbyterian/Columbia University Irving Medical Center, say more work needs to be done.

• Women are more likely to die from heart disease than men, according to the AHA.

• Despite outreach efforts, a Women’s Heart Alliance survey of more than 1,000 women between 25 and 60 years of age found that 45 per cent of women still don’t know that heart disease is the leading cause of death for women in the United States.

• Women are less inclined to call 911 when they believe they may be experiencing heart attack symptoms.

• Cardiovascular disease complicates up to four per cent of pregnancies, and that number has been increasing.

• Women’s heart attack symptoms are often different from men’s. They may experience shortness of breath, nausea, palpitations, jaw discomfort or overwhelming fatigue, according to the AHA.

• Women are less likely to be referred for cardiac rehab after a heart attack.

• Women’s heart disease is under- researched: only 35 per cent of participants in clinical trials of cardiovascular disease are women, and just 31 per cent of the studies report outcomes by gender.

• Pre-eclampsia is an independent predictor of developing cardiovascular disease later in life. Women who have had pre-eclampsia should be mindful of having their blood pressure, fasting glucose and cholesterol checked annually.

• Women are less likely to receive bystander CPR in public than men (45 per cent in men versus 39 per cent in women). Learning hands-only CPR can help save a life.

• Recent blood pressure guidelines from the American College of Cardiology recommend all people to have a blood pressure target of 120/80 or lower. Additionally, after the age of 65, hypertension (high blood pressure) is more common in women. Stay up-to-date on your annual physical and have your doctor check your blood pressure and other cardiovascular disease risk factors.