GRANT AWARDED BY NCMIC/FCER, January 2007:

Principal Investigator: Jerrilyn Cambron, D.C., M.P.H.
Research Site: National University of Health Sciences
Title: “Chiropractic Dosage for Lumbar Stenosis”

Lumbar spinal stenosis (LSS), to date not studied from the perspective of clinical trials assessing chiropractic care in its treatment, is the subject matter of this pilot randomized clinical trial pilot. Within a 6-week period involving 45 volunteer subjects with LSS, this investigation will perform a randomization into three groups of flexion-distraction care: Group 1 receiving 8 treatments, Group 2 administered 12, and Group 3 having 18. A follow-up assessment is to be made at 12 weeks. The main outcome measures to be employed are the pain (VAS) scale, Oswestry Disability Index, the Stucki Condition Specific Questionnaire used for patients with LSS, and a measurement of ambulation time to the point of stenosis symptoms (Treadmill Test). Except for the latter, the outcomes are to be measured every two weeks from baseline to the end of treatment and then at the 12-week follow-up. The objectives of this investigation are to determine the feasibility of a larger study with respect to logistics, recruitment efforts, and sample size estimations; and to determine the change in perceived pain levels and general functional health status among the three experimental groups at the end of the treatment and follow-up times.

Principal Investigator: Michael Haneline, D.C., M.P.H.
Research Site: Palmer College of Chiropractic West
Title: “Chiropractic and Acute Neck Pain: A Practice-Based Study”

This prospective practice-based study of patients aged 18-71 with acute neck pain seeks to pool characteristics of the patients undergoing treatment with treatment parameters in the physicians' offices. The descriptive nature of this project defines it as a feasibility study, to gather information concerning prior patient history, mechanisms of injury, attributes of treatment and utilization, referral patterns, patient satisfaction, and several outcome measures. It will also determine whether the attending chiropractors used manipulation solely or in conjunction with such other interventions as exercise, physiotherapy, or nutritional advice. More specific data will include pain (VAS), disability (neck disability index), and patient satisfaction together with the specific spinal segments that were manipulated and the numbers of manipulations applied to each particular cervical segment. This prospective investigation with follow-up at 6 months is the proposed successor to a retrospective study of similar design already performed by the same authors.
 

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Principal Investigator: Cheryl Hawk, D.C., Ph.D.
Research Site: Cleveland Chiropractic College
Title: “Does Chiropractic Care Decrease Fall Risk in Older Adults?”

This investigation seeks to develop a line of investigation into the possible effects of chiropractic care in reducing the risk of falls in older adults with impaired balance. It is a an exploratory randomized pilot study in which one group of 10 will receive chiropractic care with spinal manipulation for 8 weeks; a second group of the same size receiving monthly follow-up visits for 10 months in addition to the aforementioned interventions, and a third cohort receiving no treatments but rather a booklet of home balance exercises. Berg Balance scores, interviews and fall inventories up to 12 months from baseline will be followed as this investigation seeks to establish a long-term surveillance of falls occurring in older adult chiropractic patients, building a recruitment pool within the local community in the process.

It is proposed that balance, the risk factor for falls, is adversely affected by both musculoskeletal function and low back and lower extremity pain—which have been found to be responsive in previous studies to chiropractic intervention. In this manner, the role of chiropractic care for the elderly could be justified and then documented should this pilot study and a more sophisticated follow-up study yield positive outcomes. A previous small cohort study did reveal significant improvements in balance in patients undergoing chiropractic care.
 

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GRANT AWARDED BY NBCE/FCER, MARCH 2007:

Principal Investigator: Martin Descarreaux, D.C., Ph.D.
Research Site: Universite du Quebec a Trois-Rivieres
Title: Preventive Care of Chronic Cervical Pain and Disabilities: Comparison of Spinal Manipulative Therapy and Individualized Home Exercise Programs

Although tertiary preventive (maintenance) care is commonly practiced by chiropractors with 95%1 of American chiropractors believing that such care will minimize the recurrence or exacerbation of pain and symptoms, there is at present very little research to directly support this assertion. This proposal seeks to address this problem by determining whether a preventive regime of spinal manipulation, or a home exercise program, a combination of approaches, or doing nothing following a period of intensive chiropractic care is the more efficient approach to reduce pain and increase functional capacity, quality of life, and the general health condition of patients initially complaining of chronic cervical pain.

This study will involve 105 patients who first receive 15 chiropractic adjustments using the diversified technique over a 5-week period. They are then passed into a second phase of the program which lasts 45 weeks by being randomly allocated into (i) a no-treatment group, (ii) a group receiving 15 additional chiropractic manipulations 3 weeks apart; and (iii) manipulation plus home exercise group of 10-15 minutes on a daily basis. Time spent with all 3 experimental groups will be equalized to eliminate attention bias as a possible confounding factor of results. Outcomes to be monitored will include pain (visual analog scale), disability (neck disability index), quality of life (SF-36), postural analysis, and various psychological measures (Beck Anxiety Inventory, Beck Depression Inventory, Yale-Brown Obsessive-compulsive scale, Trail Making Test, Stroop Test), in addition to maximal strength in extension, flexion and lateral flexion, active range of motion in 3 planes, and a kinematic analysis of head movement. All readings are to be conducted at baseline, second, and final evaluation. Exercises will include submaximal isometric and one dynamic contraction of the neck muscles with given rest periods between contractions.