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Chiropractic Management for Veterans with Neck Pain: A Retrospective Study of Clinical Outcomes

Published:September 12, 2011DOI:https://doi.org/10.1016/j.jmpt.2011.08.009

      Abstract

      Objective

      The purpose of this study was to report demographic characteristics, chiropractic treatment methods and frequency, and clinical outcomes for chiropractic management of neck pain in a sample of veteran patients.

      Methods

      This is a retrospective case series of 54 veterans with a chief complaint of neck pain who received chiropractic care through a Veterans Health Administration medical center. Descriptive statistics and paired t tests were used with the numeric rating scale and Neck Bournemouth Questionnaire serving as the outcome measures. A minimum clinically important difference was set as 30% improvement from baseline for both outcomes.

      Results

      The mean number of chiropractic treatments was 8.7. For the numeric rating scale, the mean raw score improvement was 2.6 points, representing 43% change from baseline. For the Neck Bournemouth Questionnaire, the mean raw score improvement was 13.9 points, representing 33% change from baseline. For both measures, 36 (67%) patients met or exceeded the minimum clinically important difference.

      Conclusion

      Mean chiropractic clinical outcomes were both statistically significant and clinically meaningful for this sample of veterans presenting with neck pain.

      Key Indexing Terms

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      References

        • Haldeman S
        • Carroll L
        • Cassidy JD
        Findings from the bone and joint decade 2000 to 2010 task force on neck pain and its associated disorders.
        J Occup Environ Med. 2010; 52: 424-427
        • De Loose V
        • Van den Oord M
        • Burnotte F
        • Van Tiggelen D
        • Stevens V
        • Cagnie B
        • et al.
        Individual, work-, and flight-related issues in F-16 pilots reporting neck pain.
        Aviat Space Environ Med. 2008; 79: 779-783
        • Green BN
        • Dunn AS
        • Pearce SM
        • Johnson CD
        Conservative management of uncomplicated mechanical neck pain in a military aviator.
        J Can Chiropr Assoc. 2010; 54: 92-99
        • van den Oord MH
        • De Loose V
        • Meeuwsen T
        • Sluiter JK
        • Frings-Dresen MH
        Neck pain in military helicopter pilots: prevalence and associated factors.
        Mil Med. 2010; 175: 55-60
        • Drew WE
        Spinal symptoms in aviators and their relationship to G-exposure and aircraft seating angle.
        Aviat Space Environ Med. 2000; 71: 22-30
        • Cohen SP
        • Kapoor SG
        • Nguyen C
        • Anderson-Barnes VC
        • Brown C
        • Schiffer D
        • et al.
        Neck pain during combat operations: an epidemiological study analyzing clinical and prognostic factors.
        Spine. 2010; 35: 758-763
        • Konitzer LN
        • Fargo MV
        • Brininger TL
        • Lim Reed M
        Association between back, neck, and upper extremity musculoskeletal pain and the individual body armor.
        J Hand Ther. 2008; 21: 143-148
        • Knapik JJ
        • Ang P
        • Meiselman H
        • Johnson W
        • Kirk J
        • Bensel C
        • et al.
        Soldier performance and strenuous road marching: influence of load mass and load distribution.
        Mil Med. 1997; 162: 62-67
        • Mäkelä JP
        • Hietaniemi K
        Neck injury after repeated flexions due to parachuting.
        Aviat Space Environ Med. 1997; 68: 228-229
        • De Loose V
        • Burnotte F
        • Cagnie B
        • Stevens V
        • Van Tiggelen D
        Prevalence and risk factors of neck pain in military office workers.
        Mil Med. 2008; 173: 474
        • Dunn AS
        • Green BN
        • Gilford S
        An analysis of the integration of chiropractic services within the United States military and Veterans' health care systems.
        J Manipulative Physiol Ther. 2009; 32: 749-757
        • Lisi AJ
        • Goertz C
        • Lawrence DJ
        • Satyanarayana P
        Characteristics of Veterans Health Administration chiropractors and chiropractic clinics.
        J Rehabil Res Dev. 2009; 46: 997-1002
        • Dunn AS
        • Towle JJ
        • McBrearty P
        • Fleeson SM
        Chiropractic consultation requests in the Veterans Affairs Health Care System: demographic characteristics of the initial 100 patients at the Western New York medical center.
        J Manipulative Physiol Ther. 2006; 29: 448-454
        • Dunn AS
        • Passmore SR
        Consultation request patterns, patient characteristics, and utilization of services within a Veterans Affairs medical center chiropractic clinic.
        Mil Med. 2008; 173: 599-603
        • Christensen MG
        • Kollasch MW
        • Ward R
        • et al.
        Job Analysis of Chiropractic 2005: a project report, survey analysis, and summary of the practice of chiropractic within the United States. National Board of Chiropractic Examiners, Greeley (Colo)2005: 135
        • Passmore SR
        • Dunn AS
        Positive patient outcome after spinal manipulation in a case of cervical angina.
        Man Ther. 2009; 14: 702-705
        • Lisi AJ
        Management of Operation Iraqi Freedom and Operation Enduring Freedom veterans in a Veterans Health Administration chiropractic clinic: a case series.
        J Rehabil Res Dev. 2010; 47: 1-6
        • Dunn AS
        • Passmore SR
        • Burke JM
        • Chicoine DR
        A cross sectional analysis of clinical outcomes following chiropractic care in veterans with and without post-traumatic stress disorder.
        Mil Med. 2009; 174: 578-583
        • Triano J
        The mechanics of spinal manipulation.
        in: Herzog W Clinical biomechanics of spinal manipulation. Churchill Livingstone, Philadelphia2000: 92-190
        • Downie WW
        • Leatham PA
        • Rhind VM
        • Wright V
        • Branco JA
        • Anderson JA
        Studies with pain rating scales.
        Ann Rheum Dis. 1978; 37: 378-381
        • Bolton JE
        • Humphreys BK
        The Bournemouth Questionnaire: a short form comprehensive outcome measure. II. Psychometric properties in neck pain patients.
        J Manipulative Physiol Ther. 2002; 25: 141-148
        • Bolton JE
        Sensitivity and specificity of outcome measures in patients with neck pain: detecting clinically significant improvement.
        Spine. 2004; 29: 2410-2417
        • Hurst H
        • Bolton J
        Assessing the clinical significance of change scores recorded on subjective outcome measures.
        J Manipulative Physiol Ther. 2004; 27: 26-35
        • Ostelo RWJG
        • Deyo RA
        • Stratford P
        • Waddell G
        • Croft P
        • Von Korff M
        • et al.
        Interpreting change scores for pain and functional status in low back pain.
        Spine. 2008; 33: 90-94
        • Department of Veterans Affairs
        Federal benefits for Veterans, dependents & survivors.
        US Government Printing Office, Washington, DC2010
        • Vernon H
        • Mior S
        The neck disability index: a study of reliability and validity.
        J Manipulative Physiol Ther. 1991; 14: 409-415
        • Rogers WH
        • Kazis LE
        • Miller DR
        • et al.
        Comparing the health status of VA and non-VA ambulatory patients: the Veterans' health and medical outcomes studies.
        J Ambul Care Manage. 2004; 27: 249-262
        • Spiro A
        • Hankin CS
        • Mansell D
        • Kazis LE
        Post-traumatic stress disorder and health status: the Veterans health study.
        J Ambul Care Manage. 2006; 29: 71-86
        • Dunn AS
        • Passmore SR
        When demand exceeds supply: allocating chiropractic services at VA medical facilities.
        J Chiropr Humanit. 2007; 14: 22-27