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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.
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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 chiropractic clinics

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 at: www.research.va.gov/programs/rrd.cfm

Researchers in bold are graduates and/or faculty members of Palmer College. 

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