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

Table 3.

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

Outcome	Mediator	Indirect effect (95% CI)	Direct effect (95% CI)	Total effect (95% CI)	Proportion
Fatigue 12 weeks	RMDQ	0.61 (−0.02 to 1.50)	0.71 (−1.62 to 3.24)	1.32 (−1.01 to 3.81)	0.46
	NPRS	0.50 (−0.05 to 1.40)	0.82 (−1.67 to 3.57)	1.32 (−1.15 to 3.98)	0.38
Fatigue 52 weeks	RMDQ	0.64 (−0.14 to 1.60)	0.81 (−2.20 to 4.10)	1.45 (−1.52 to 4.68)	0.44
	NPRS	0.65 (-0.02 to 1.79)	0.80 (−2.21 to 3.61)	1.45 (−1.50 to 4.35)	0.45
Sleep 12 weeks	RMDQ	0.58 (0.08 to 1.33)	2.36 (0.32 to 4.41)	2.94 (1.01 to 4.94)	0.20
	NPRS	0.48 (−0.005 to 1.17)	2.46 (0.58 to 4.41)	2.94 (1.02 to 4.95)	0.16
Sleep 52 weeks	RMDQ	0.82 (0.15 to 1.64)	4.07 (1.81 to 6.30)	4.89 (2.65 to 6.96)	0.17
	NPRS	0.64 (0.05 to 1.49)	4.25 (2.21 to 6.28)	4.89 (2.83 to 6.93)	0.13
Social 12 weeks	RMDQ	0.98 (0.21 to 2.00)	2.51 (0.09 to 5.03)	3.49 (1.21 to 5.92)	0.28
	NPRS	0.94 (0.13 to 1.84)	2.54 (0.05 to 4.86)	3.49 (1.00 to 5.99)	0.27
Social 52 weeks	RMDQ	0.75 (0.12 to 1.65)	1.54 (−0.77 to 3.89)	2.29 (0.16 to 4.45)	0.33
	NPRS	0.68 (−0.004 to 1.45)	1.61 (−0.45 to 4.00)	2.29 (0.31 to 4.49)	0.30

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