Abstract
Objective
At this time, the scientific evidence base supporting the effectiveness of chiropractic
care for musculoskeletal conditions has not yet definitively addressed its appropriateness
for older adults. Expert consensus, as a form of evidence, must be considered when
higher levels of evidence are lacking. The purpose of this project was to develop
a document with evidence-based recommendations on the best practices for chiropractic
care of older adults.
Methods
A set of 50 seed statements was developed, based on the clinical experience of the
multidisciplinary steering committee and the results of an extensive literature review.
A formal Delphi process was conducted, following the rigorous RAND-UCLA (University
of California, Los Angeles) methodology. The statements were circulated electronically
to the Delphi panel until consensus was reached. Consensus was defined as agreement
by at least 80% of the panelists. There were 28 panelists from 17 US states and Canada,
including 24 doctors of chiropractic, 1 physical therapist, 1 nurse, 1 psychologist,
and 1 acupuncturist.
Results
The Delphi process was conducted in January-February 2010; all 28 panelists completed
the process. Consensus was reached on all statements in 2 rounds. The resulting best
practice document defined the parameters of an appropriate approach to chiropractic
care for older adults, and is presented in this article.
Conclusion
A multidisciplinary panel of experienced chiropractors was able to reach a high level
(80%) of consensus on evidence-informed best practices for the chiropractic approach
to evaluation, management, and manual treatment for older adult patients.
Key Indexing Terms
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Article info
Publication history
Accepted:
June 8,
2010
Received in revised form:
May 20,
2010
Received:
April 19,
2010
Identification
Copyright
© 2010 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
