CHIROPRACTIC CARE
TO RESET
Skeleto-muscular Impairments
Viral-induced HMR/D and Skeleto-muscular Impairments
Skeleto-muscular indications: Myalgia (muscle pain)/fatigue is the third most common symptom in COVID-19 and PASC. Elderly patients with preexisting metabolic syndromes (i.e. diabetes, obesity, cardiovascular disease) are highly prone to severe muscle injuries in later stages of viral-induced HMR/D. Weight loss is common trait that affects non-fat mass (especially in obese patients), which may inflict dystrophic damages to skeletal muscle in HMR/D. One in five hospital-admitted patients show severe weight loss and 73% experience high risk of sarcopenia. Rhabdomyolysis, an acute muscle injury with intense muscle soreness, fatigue, weakness, and lower limb pain/twitching, often observed in elderly patients, is a characteristic feature of HMR/D. Sarcopenia and rhabdomyolysis could lead to long-term disabilities in HMR/D patients.
Metabolic targets to reset skeleto-muscular impairments in viral-induced HMR/D
Skeletal muscle is the largest body tissue involved in glucose metabolism; therefore, a primary target for SARS-CoV-2 infection. Hyper-inflammatory response during viral-induced HMR/D may also exacerbate mitochondrial dysfunction (m-Dys) with subsequent myofibrillar breakdown, vertebral misalignment, and muscle degradation. Elevated synthesis of creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin (a heme-containing globular protein) in hyper-catabolic conditions trigger oxidative stress (OxS) and may lead to severe myocyte damage in viral-induced HMR/D. Decline in muscle mass (sarcopenia) is a whole-body process, which may also affect respiratory, masticatory, and swallowing functions, resulting in a negative impact on nutrient intake and increase the risk for malnutrition. Several COVID-19 survivors may have sequelae of muscle wasting and require progressive dietary plan for gradual recovery to pre-onset mobility function. Malnutrition has been attributed for muscular and immune dysfunction in viral-induced HMR/D.
Precision Chiropractic care to reset skeleto-muscular disorders in viral-induced HMR/D
Chiropractic spinal adjustments could provide an effective short-term increase in muscle strength for chronic stroke patients. A multi-center clinical study evaluated the effects of chiropractic spinal adjustments combined with physical therapy (Chiro+PT) on motor functions in chronic stroke patients (ClinicalTrials.gov NCT03849794). Outcomes were assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). Four weeks of Chiro+PT showed clinically significant improvements in motor function among individuals with subacute or chronic stroke. There was also a robust improvement from baseline to the 4- and 8-week assessments. Secondary outcomes included enhanced health-related quality of life and other measures of functional mobility and disability. This clinical study has significant scientific as well as practical relevance to the ongoing viral-induced HMR/D global project. Also, the high-velocity, low-amplitude (HVLA) spinal adjustments seem to help resolve central segmental motor control (CSMC) problems and improve neuro-muscular function in a variety of ways by increasing the muscle force and reducing fatigue. These changes in neuro-muscular function most likely occur due to changes in supraspinal excitability. Fibromyalgia syndrome is yet another commonly diagnosed non-articular soft tissue problem and skeleto-muscular impairment in viral-induced HMR/D. Chiropractic treatment combined with resistance training is shown to improve muscle functionality in fibromyalgia patients. Chiropractic interventions are known to improve treatments and management of musculoskeletal disorders and visceral diseases over the decades. In a clinical study, chiropractic treatment was shown beneficial in reducing muscle pain and more effective than either placebo or muscle relaxants based on the Global Impression of Severity (GIS) scale. Chiropractic spinal manipulation combined with soft tissue therapy is shown to increase joint mobility and decrease muscle hypertonicity. Thus, applying these interventions to the chest wall in COPD patients, the chest wall rigidity could be reduced; thereby, could improve breathing parameters. Incidentally, pulmonary condition is a prominent clinical manifestation in long-COVID patients with viral-induced HMR/D.
In chiropractic care (which also includes myofascial therapy, spinal and proximal radioulnar joint adjustments, neural mobilization, and using of a splint), the chronic radical nerve entrapment symptoms as well as muscle dysfunction could be relieved. Mobility-impaired individuals, either geriatric or young but suffering with systemic neuromuscular disorders or chronic fatigue, spend small amounts of time for daily physical activity, aggravating their poor mobility by resting muscle atrophy. Sooner or later their restricted mobility confines them to bed and to more frequent hospitalizations. The high prevalence of impairment in skeletal muscle strength and physical performance in hospitalized patients recovering from viral-induced HMR/D without previous locomotor disabilities suggests the need for rehabilitation programs, such as the Precision Chiropractic Care.