Chiropractic & Manual Therapies 2026 (Apr 16); 34: 12

Table 2.

Natural indirect, direct, and total effects and proportion mediated by fatigue, sleep disturbance, and social role of the effect difference between trial arms on 12- and 52-week outcomes of RMDQ and NPRS

Outcome	Mediator	Indirect effect (95% CI)	Direct effect (95% CI)	Total effect (95% CI)	Proportion
RMDQ 12 weeks	Fatigue	0.15 (−0.20 to 0.53)	1.81 (0.36 to 3.34)	1.96 (0.50 to 3.51)	0.08
	Sleep	0.13 (−0.22 to 0.54)	1.84 (0.42 to 3.38)	1.96 (0.53 to 3.55)	0.06
	Social	0.35 (−0.07 to 0.94)	1.61 (0.26 to 3.12)	1.96 (0.67 to 3.49)	0.18
RMDQ 52 weeks	Fatigue	0.23 (−0.39 to 0.74)	1.74 (0.11 to 3.47)	1.97 (0.19 to 3.71)	0.12
	Sleep	0.20 (−0.32 to 0.80)	1.77 (0.14 to 3.45)	1.97 (0.28 to 3.75)	0.10
	Social	0.38 (−0.06 to 0.94)	1.60 (−0.05 to 3.18)	1.97 (0.31 to 3.68)	0.19
NPRS 12 weeks	Fatigue	0.05 (−0.09 to 0.19)	0.56 (-0.01 to 1.10)	0.61 (0.04 to 1.17)	0.09
	Sleep	0.02 (−0.07 to 0.11)	0.59 (−0.01 to 1.18)	0.61 (0.002 to 1.19)	0.03
	Social	0.15 (−0.03 to 0.40)	0.46 (−0.04 to 0.98)	0.61 (0.06 to 1.21)	0.25
NPRS 52 weeks	Fatigue	0.06 (−0.09 to 0.22)	0.22 (−0.42 to 0.99)	0.28 (−0.40 to 1.03)	0.20
	Sleep	0.06 (−0.10 to 0.27)	0.22 (−0.45 to 0.95)	0.28 (−0.40 to 1.03)	0.22
	Social	0.13 (−0.03 to 0.34)	0.15 (−0.54 to 0.87)	0.28 (−0.42 to 1.00)	0.46

RMDQ = Roland-Morris disability questionnaire;
NPRS = numerical pain rating scale;
Sleep = sleep disturbance;
Social = satisfaction with participation in social role