A randomized controlled trial
comparing two types of spinal
manipulation and minimal
conservative medical care for
adults 55 years and older with
subacute or chronic low back pain
AUTHORS: Maria A. Hondras, D.C., M.P.H., Cynthia R.
Long, Ph.D., Ying Cao, M.S., Robert M. Rowell, D.C.,
M.S., and William C. Meeker, D.C., West ’82, M.P.H.
The Palmer Center for Chiropractic Research
conducts studies at facilities on each of Palmer’s
three campuses, including the William and Jo
Harris Building, right, on the Davenport Campus.
Chiropractic care is used by many older patients for low back
pain (LBP), but there are no published results of randomized
trials examining spinal manipulation (SM) for older adults.
The purpose of this study was to compare the effects of two
biomechanically distinct forms of SM and minimal conservative
medical care (MCMC) for participants at least 55 years old with
subacute or chronic nonradicular LBP. The primary outcome
variable of this randomized controlled trial was low back-related
disability assessed with the 24-item Roland Morris Disability
questionnaire at 3, 6, 12, and 24 weeks. Participants were
randomly allocated to six weeks of care including 12 visits of
either high-velocity, low-amplitude (HVLA)-SM, low-velocity,
variable-amplitude (LVVA)-SM, or three visits of MCMC.
The results of this study can be found in the Journal of
Manipulative and Physiological Therapeutics article: J Manipulative
Physiol Ther 2009;32:330-343. Read it at: www.jmptonline.org
Characteristics of Veterans Health
Administration chiropractors and
AUTHORS: Anthony J. Lisi, D.C., West ’96, Christine
Goertz, D.C., Ph.D.; Dana J. Lawrence, D.C., M.Med.Ed.;
Preeti Satyanarayana, M.D., M.P.H.
Chiropractic services have been delivered on-station at select
Veterans Health Administration (VHA) medical facilities since
late 2004. No published data describing the characteristics of
VHA chiropractic physicians (chiropractors) and chiropractic
clinics exist at a national level. This study was designed to
examine elements of the structures of chiropractic services
in VHA settings. Web-based survey methods were used to
question all chiropractors in VHA facilities (N = 36). Data were
obtained from 33 providers, yielding a 91.6 percent response
rate. Most respondents were full-time VHA employees, while
others were part-time employees or contractors. Differences
were found in prior training, integrated practice, and academic
or research experience.
Of the respondents, 88 percent ranked low back pain as the
most common patient complaint seen in practice and 79
percent ranked cervical pain the second most common complaint.
Of the new patient consultations, 67.6 percent originated
from primary care, 9.4 percent from pain management, and
6.2 percent from physiatry. Most respondents were similar in
their reported use of diagnostic and therapeutic procedures, but
their reported rates of participation in various facility activities
were different. Further work is needed for researchers and
policy makers to more fully understand the integration and
delivery of chiropractic services in VHA settings.
The full article can be found in Journal of Rehabilitation Research
and Development: Rehab Res Dev 2009;46(8):997-1002. Read it
Researchers in bold are graduates and/or faculty members of