The American Chiropractic Association (ACA) Council on Neurology has been particularly busy since Sen. Michael Enzi (R-Wyo.) introduced the Elder Fall Prevention Act in June 2003.1 In response to the proposed legislation, the council has developed fall prevention testing protocols that underscore, as the bill does, the need to reduce falls in the elderly population.
As we go to press, the bill has passed the Senate and is proceeding through the House of Representatives. The text of the Elder Fall Prevention Act notes a number of sobering statistics regarding the consequences of falls, including the following: Falls are the leading cause of injury deaths among individuals older than age 65; twenty-five percent of elderly individuals who sustain a hip fracture die within one year; and nearly 65,000 individuals older than age 65 sustain a traumatic brain injury annually as the result of a fall. And in a recent study evaluating disability in the elderly population, the results of which were published in the Journal of the American Medical Association, "Hospital admissions for falls were most likely to lead to disability."2
At the American Association of Retired Persons (AARP) Las Vegas Convention in October 2004, the ACA Council on Neurology tested hundreds of attendees using a screening technology that, according to the council, allows a clinician to predict the probability of a fall with a .002% false positive.3 The testing, which takes only minutes, allowed the council to test hundreds of seniors and provide them with a statistical report that they can bring to their health care provider. At the meeting, the council also aired the PBS documentary, "Waking Up the Brain: Amazing Adjustments." The program documents the work of Frederick Carrick, DC, PhD, relative to chiropractic management of vertigo and stability. (Dr. Carrick, who is president of the council, also spoke about the importance of fall prevention testing for the chiropractic profession at the recent Parker Seminar in Las Vegas.)
According to the council, more than 50% of the seniors tested at the AARP meeting had significant risks of falling, despite showing no symptomatology.
The council is sponsoring a 125-hour certificate program in vestibular rehabilitation and fall prevention, offered by the American Chiropractic Neurology Board (ACNB). The certification is designed to bring doctors of chiropractic to the forefront of fall prevention testing and treatment protocols. Additionally, since the AARP meeting, the council has received countless requests for referrals to chiropractors trained in fall prevention. The council says it does not currently have adequate trained clinicians to meet the demand for referral, and is requesting that any chiropractor trained in fall prevention contact the council, so that the clinician can be listed in its referral databank.
For more information or to be listed, contact Julie Bjornson, DC, secretary of the ACA Council on Neurology, at 772-283-2417 or neurosecretary@compuserve.com.
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
