Research on improved strength in stroke patients

6 Mar

A patient at our Chiropractic clinic brought me this research that she thought I would find interesting. I definitely do and think that you will too! I was actually waiting to read this published research after I heard Dr. Heidi Haavik mention it at a conference in California in 2017. The research published in 2019 is on the impact that Chiropractic care had on the strength of a specific muscle in chronic stroke patients. The study found an increase in strength of 64.2% on average following a chiropractic care session.

The effects of a single session of chiropractic care on strength, cortical drive, and spinal excitability in stroke patients

Here are some of my favourite excerpts from the research article:

” The key findings in this study were that in a group of chronic stroke patients, with lower limb muscle weakness, plantarflexion muscle strength increased on average by 64.2% following a chiropractic care session and the change in muscle strength appears to be modulated by cortical factors as opposed to modulation at the spinal level. “

-Plantarflexion muscle strength is the calf muscles, specifically in this study was the soleus muscle
-Cortical factors are a the brain level versus the spinal (cord) level.

Chiropractic care involves an holistic approach to health with a particular focus on the relationship between the spine and nervous system 11. Traditionally, the main focus of chiropractic care has been the location, analysis and correction of vertebral subluxations 11. Vertebral subluxations are recognized as a biomechanical lesion of the spine by the World Health Organization (ICD-10-CM code M99.1)12. They have been defined as a self- perpetuating, central segmental motor control problem that involves a joint, such as a vertebral motion segment, that is not moving appropriately, resulting in ongoing maladaptive neural plastic changes that interfere with the central nervous system’s ability to self-regulate, self-organize, adapt, repair and heal13. Chiropractors identify vertebral subluxations using a combination of pathophysiologic indicators of spinal dysfunction14 and then correct them using a variety of manual techniques15, the most common being specific high-velocity, low amplitude adjustments that are delivered by hand to the subluxated spinal segment16. “

-I enjoyed Dr. Heidi Haavik’s description of Chiropractic and what Chiropractors do when I was at the conference. She is a scientist so it was hard to write all the notes down while she was talking at the conference, as you can see by the great description above.
-There are many Chiropractic techniques to adjust vertebral subluxations. At our Chiropractic center in Mississauga we use a manual diversified adjusting technique as well as the Activator Chiropractic Technique.

“If chiropractic care results in improvements in spinal function that have a central neural plastic effect, this may be important for a variety of clinical populations. Recently, Niazi, Turker18 reported an increase in plantar flexor muscle strength of 16% in reasonably healthy participants following a single session of chiropractic care. “

-The Chiropractic patient at our office is a masters student and she thought the above research was surprisingly high and that it was could that Chiropractic adjustments could increase strength to the legs. We do see this in our offices regularly through our testing. Specifically, when examining a patient, the power of the legs or arms is used to determine where and when to adjust. If one leg won’t lift well, adjusting the subluxated pelvis/sacrum/or lumbar spine can increase the power of the body to lift the leg immediately. I describe this physiological experience to the patient as an increase in “power” to the leg. The scientist may describe it differently, but it is one of the experiences in Chiropractic that helps patients understand how an adjustment along the spine can improve their health, movement, and strength.

Where was the Chiropractor Adjusting the stroke patients in this research study?

“The entire spine and both sacroiliac joints were assessed for vertebral subluxations, and chiropractic adjustments were given where deemed necessary, by a New Zealand registered chiropractor.”

” All participants received at least 1 chiropractic adjustment in their cervical, thoracic and lumbopelvic spinal regions. A combination of chiropractic technique approaches were used on most participants; including high velocity low amplitude adjustments and instrument assisted adjustments. If vertebral subluxation indicators did not change at a specific level following an adjustive thrust a second thrust or alternate technique was used when deemed appropriate. “

What are the possible mechanisms for adjusting the spine to improve leg strength in stroke patients?

“Central neural plastic changes have been observed following chiropractic care which may be due to improvements in spinal function associated with the correction of vertebral subluxations 20. It is therefore possible that the improvements in muscle strength following chiropractic care observed in this study were due to changes in maladaptive neural plasticity that resulted in increased descending drive to the leg muscles.”

“..the change in muscle strength appears to be modulated by cortical factors as opposed to modulation at the spinal level.”

-By correcting or addressing the improper segment along the spine and spinal cord it allowed the brain to properly send signals to the muscle in the leg along the spinal cord. The proper signal allowed better strength for the muscle.

I hope that this study was exciting for you and made you think of more questions that I would be happy to discuss and brainstorm with you.

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