Funding Source: Department of Defense
Grant Number: W81XWH-10-DHP-CCTA
Award Amount: $7,500,000 ($5,100,000 to Palmer)
Funding Period: 02/01/2011 – 02/14/2019
Principal Investigator: Ian D. Coulter, Ph.D., RAND Corporation
Co-Principal Investigators: Christine Goertz, D.C., Ph.D., Joan Walter, J.D., P.A., Samueli Institute
Co-Investigators: Cynthia Long, Ph.D. Robert Vining, D.C.
Lead Project Manager: Amy Minkalis, D.C.
Site Locations: Walter Reed National Military Medical Center (WRNMMC), Bethesda, Maryland, Naval Medical Center San Diego (NMCSD), San Diego, California, Naval Hospital Pensacola (NHP), Pensacola, Florida
ACT comprises three separate randomized controlled trials, a collaborative effort between Palmer and the Department of Defense. The overarching goal is to assess the effectiveness of chiropractic manipulative therapy for pain management and improved function in active-duty service members with low-back pain. This study looks at the role of chiropractic care within the military health care system and has applications for a diverse population in a real-world setting.
ACT I: Assessment of Chiropractic Treatment for Low Back Pain and Smoking Cessation in Military and Active Duty Personnel – Completed
ACT I
ACT I Project Description
Funding Source: Department of Defense
Grant Number: W81XWH-10-DHP-CCTA
Award Amount: $7,500,000 ($5,100,000 to Palmer)
Funding Period: 02/01/2011 – 02/14/2019
Principal Investigator: Ian D. Coulter, Ph.D., RAND Corporation
Co-Principal Investigators: Christine Goertz, D.C., Ph.D., Joan Walter, J.D., P.A., Samueli Institute
Co-Investigators: Cynthia Long, Ph.D. Robert Vining, D.C.
Lead Project Manager: Amy Minkalis, D.C.
ACT comprises three separate randomized controlled trials, a collaborative effort between Palmer and the Department of Defense. The overarching goal is to assess the effectiveness of chiropractic manipulative therapy for pain management and improved function in active duty service members with low back pain. This study looks at the role of chiropractic care within the military health care system and has applications for a diverse population in a real-world setting.
The total targeted enrollment for all three studies is 980 participants. Recruitment concluded in November 2015 for ACT I, after 750 participants were enrolled and allocated to either the usual medical care or the usual medical care plus chiropractic care group. As of October 2017, the primary study results paper has been submitted for publication.
ACT I Publications
Goertz CM, Long CR, Vining RD, Pohlman KA, Walter J, Coulter I. Effect of usual medical care plus chiropractic care vs usual medical care alone on pain and disability among US service members with low back pain: a comparative effectiveness clinical trial. JAMA Network. Open 2018;1(1):e180105
Goertz CM, Long CR, Vining RD, Pohlman KA, Kane B, Corber L, Walter J, Coulter I. Assessment of chiropractic treatment for active duty, US military personnel with low back pain: study protocol for a randomized controlled trial. Trials 2016;17(70).
Ziegler AML*, Shannon ZK*, Long CR, Vining RD, Walter JA, Coulter ID, Goertz CM. Chiropractic services and diagnosis for low back Pain in 3 US Department of Defense Military treatment facilities: a secondary analysis of a pragmatic clinical trial. J Manipulative Physiol Ther. 2022 J Manipulative Physiol Ther. 2021;44(9):690-698. IF: 1.437
Hays RD, Shannon ZK, Long CR, Spritzer KL, Vining RD, Coulter ID, Pohlman KA, Walter JA, Goertz CM. Health-Related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care Plus Chiropractic Care vs Usual Care Alone: Secondary Outcomes of a Pragmatic Clinical Trial. Pain Me. 2022 Aug 31;23(9): 1440-1449. DOI: 10.1093/pm/pnac009.
ACT I Presentations
Shannon Z, Long C, Vining R, Goertz C. Secondary Analysis of Pain Occurrence Data Collected via SMS Text Message During a Pragmatic, Clinical Trial Comparing Usual Medical Care Plus Chiropractic Care to Usual Medical Care Alone for Low Back Pain. ACC-RAC Conference, March 19-21, 2020, San Diego, CA. (Platform)
Shannon Z, Long CR, Vining RD, Goertz CM. Pain Occurrence Collected via Weekly Text Message over 1 Year Pragmatic Trial Evaluating Chiropractic Care for Low Back Pain in Military Members. International Congress on Integrative Medicine and Health, April 28-May 1st, 2020, Cleveland, OH (Poster) [Event was cancelled due to COVID-19]
Goertz C, Shannon Z, Long C, Vining R, Hays R, Spritzer K, Coulter I. PROMIS®-29 Outcomes of US Military Personnel with Low Back Pain Adaptively Allocated to Usual Medical Care Alone Versus Usual Medical Care Plus Chiropractic Care. ACC-RAC Conference, March 14-16, 2019, Baltimore, MD. (Platform)
Goertz C, Long C, Shannon Z, Vining R, Hays RD, Spritzer K, Coulter I. PROMIS-29 Outcomes of Active-Duty Military Personnel with Low Back Pain in a Pragmatic Clinical Trial Comparing Usual Medical Care Plus Chiropractic Care to Usual Medical Care Alone. WFC-ECU Congress, March 20-23, 2019, Berlin, Germany. (Platform)
Goertz C, Long C, Vining R, Pohlman K, Walter J, Coulter I. Controlled Trial Evaluating the Addition of Chiropractic Care to Medical Care for Patients with Low Back Pain. International Congress on Integrative Medicine and Health, May 8-11, 2018, Baltimore MD. (Platform)
Goertz C, Long C, Vining R, Pohlman K, Walter J, Coulter I. Pragmatic Comparative Effectiveness Controlled Trial Assessing Chiropractic Treatment for Active Duty US Military Personnel with Low Back Pain (ACT I). Military Health System Research Symposium, August 27-30, 2017, Kissimmee FL. (Platform)
Goertz C, Long C, Vining R, Pohlman K, Walter J, Coulter I. Assessment of Chiropractic Treatment for Active Duty, US Military Personnel with Low Back Pain: A Randomized Controlled Trial. DC 2017, March 16-18, 2017, Washington, DC. (Platform)
Goertz C, Salsbury S, Hawk C, Vining R, Branson R, Burgo L, Smith V, Wallace R, Long C, Lisi A. Integrative Clinical Pathway for Veterans with Spine Pain and Mental Health Co-Morbidities: Results of a Delphi Process Study. DC 2017, March 16-18, 2017, Washington, DC. (Platform)
ACT II: Assessment of Chiropractic Treatment Using Reaction and Response Times in Members of the Special Operation Forces – Completed
ACT II
ACT II Project Description
Funding Source: Department of Defense
Grant Number: W81XWH-10-DHP-CCTA
Award Amount: $7,500,000 ($5,100,000 to Palmer)
Funding Period: 02/01/2011 – 02/14/2019
Principal Investigator: Ian D. Coulter, Ph.D., RAND Corporation
Co-Principal Investigators: Christine Goertz, D.C., Ph.D., Joan Walter, J.D., P.A., Samueli Institute
Co-Investigators: Cynthia Long, Ph.D. Robert Vining, D.C.
Lead Project Manager: Amy Minkalis, D.C.
Site Locations: Blanchfield Army Community Hospital, Chiropractic Clinic, Fort Campbell, Kentucky
ACT comprises three separate randomized controlled trials, a collaborative effort between Palmer and the Department of Defense. The overarching goal is to assess the effectiveness of chiropractic manipulative therapy for pain management and improved function in active duty service members with low back pain. This study looks at the role of chiropractic care within the military health care system and has applications for a diverse population in a real-world setting.
Recruitment of 120 participants for ACT II concluded in May 2016 and the primary results paper is currently in progress.
ACT II Publications
DeVocht JW, Smith DL, Long CR, Corber L, Kane B, Jones TM, Goertz CM. The effect of chiropractic treatment on the reaction and response times of special operation forces military personnel: study protocol for a randomized controlled trial. Trials 2016;17(457).
DeVocht JW, Vining R, Smith DL, Long C, Jones T, Goertz C. Effect of chiropractic manipulative therapy on reaction time in special operations forces military personnel: a randomized controlled trial. Trials 2019;205
ACT III: Assessment of Chiropractic Treatment: Strength and Balance
ACT III
ACT III Project Description
Funding Source: Department of Defense
Grant Number: W81XWH-10-DHP-CCTA
Award Amount: $7,500,000 ($5,100,000 to Palmer)
Funding Period: 02/01/2011 – 02/14/2019
Principal Investigator: Ian D. Coulter, Ph.D., RAND Corporation
Co-Principal Investigators: Christine Goertz, D.C., Ph.D., Joan Walter, J.D., P.A., Samueli Institute
Co-Investigators: Cynthia Long, Ph.D. Robert Vining, D.C.
Lead Project Manager: Amy Minkalis, D.C.
Site Locations: Madigan Army Medical Center, Fort Lewis, Washington
ACT comprises three separate randomized controlled trials, a collaborative effort between Palmer and the Department of Defense. The overarching goal is to assess the effectiveness of chiropractic manipulative therapy for pain management and improved function in active duty service members with low back pain. This study looks at the role of chiropractic care within the military health care system and has applications for a diverse population in a real-world setting.
ACT III is in the recruitment phase with 27 of 110 participants enrolled as of October 2017.
ACT III Publications
Vining R, Long C, Minkalis A, Gudavalli MR, Xia T, Walter J, Coulter I, Goertz C. Effects of chiropractic care on strength, balance, and endurance in active-duty US military personnel with low back pain: a randomized controlled trial. J Altern Complement Med 2020;26(7):592-601.
Vining R, Minkalis A, Long CR, Corber L, Franklin C, Gudavalli MR, Xia T, Goertz CM. Assessment of chiropractic care on strength, balance, and endurance in active-duty US military personnel with low back pain: a protocol for randomized controlled trial. Trials 2018;19671
ACT III Presentations
Long CR, Vining R, Minkalis A, Corber L, Franklin C, Goertz C. Improved Strength, Balance, and Endurance in US Military Personnel with Low Back Pain Receiving Chiropractic Care. APHA Annual Meeting, November 2-6, 2019, Philadelphia, PA. (Platform)
Vining R, Minkalis M, Gudavalli MR, Xia T, Cober L, Franklin C, Goertz C. Changes in Strength, Balance, and Endurance in Active Duty US Military Personnel with Low Back Pain Following Chiropractic Care. ACC-RAC Conference, March 19-21, 2020, San Diego, CA. (Platform)