Abstract
Objective: Health promotion and prevention services provided by the chiropractic profession
historically have been referred to as maintenance care (MC). The primary objective
of this investigation was to obtain information regarding multiple health issues of
patients age 65 years and over who have had a long-term regimen of chiropractic health
promotion and preventive care. The study also sought to explore the nature of the
interventions and methods that were most commonly used by chiropractors when administering
MC and to determine whether there were differences between patients who have had long-term
exposure to these preventive services versus those who have not. Design: This descriptive study was accomplished by selecting chiropractic patients (age 65
years and over) who had received health-promotion and prevention services for at least
5 years, with a minimum of 4 visits per year. To enhance the probability of securing
a more representative patient sample, selection was made through the participation
of chiropractors from 6 diverse geographic locations across the United States. Doctors
were asked to enroll the first 10 consenting patients who met the inclusion criteria.
A battery of diverse assessment instruments were completed by each patient to provide
a patient health profile. Information related to each patient included answers to
the SF-36D survey, patient health habits, expenditures of health services, frequency
of use of health providers, and perceived value of chiropractic prevention and health
promotion services. Results: A total of 73 chiropractors participated in this investigation from the 6 study sites.
In addition to an average 1.9 manual procedures used per patient, it was common to
recommend stretching exercises (68.2%), aerobic exercises (55.6%), dietary advice
(45.3%), and a host of other prevention strategies, including vitamins and relaxation.
The patients investigated in this study reported making only half the annual number
of visits to medical providers (4.76 visits per year) compared with the national average
(9 visits per year) for individuals age 65 years and over. Conclusions: On the basis of the response of participating chiropractors, this study describes
the therapeutic components of MC for the elderly patient. For these patients, MC does
not simply consist solely of periodic visits for joint manipulation, but it involves
an eclectic host of interventions (eg, exercise, nutrition, relaxation, physical therapy,
and manipulation) that are directed at both musculoskeletal and visceral conditions.
(J Manipulative Physiol Ther 2000;23:10–9)
Keywords
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Article info
Publication history
Received in revised form:
July 28,
1999
Received:
February 9,
1999
Footnotes
*Submit reprint requests to: Ronald L. Rupert, MS, DC, 721 I-35 E South, Suite 140, Denton, TX 76205.
**Supported by a grant from the National Chiropractic Mutual Insurance Company (NCMIC) and Cleveland Chiropractic College-KC and administered by the Foundation for Chiropractic Education and Research. The primary recipient of this grant was Abt Associates Inc.
Identification
Copyright
© 2000 JMPT. Published by Elsevier Inc. All rights reserved.
