Table 5

Participant-reported secondary outcome measures

Treatment groupGroup differenceP value*
Chiropractic careIntegrated careChiropractic care minus integrated care
Low back disability (Roland Morris) [0 to 100; lower scores indicate less disability]
Mean at baseline (SD)40.9 (21.3)38.1 (19.2)
Mean at week 4 (95% CI)30.3 (27 to 33.6)27.0 (23.7 to 30.2)3.07 (− 0.95 to 7.08)0.14
Mean at week 12 (95% CI)19.9 (16.6 to 23.2)16.5 (13.3 to 19.7)3.66 (− 0.65 to 7.97)0.10
Short term response summary (area under the curve minus baseline through week 12)3.36 (− 0.65 to 7.38)0.10
Mean at week 26 (95% CI)24.6 (21.2 to 27.9)20.2 (16.9 to 23.4)4.05 (− 0.97 to 9.07)0.12
Mean at week 52 (95% CI)25.6 (22.1 to 29)19.0 (15.7 to 22.3)6.54 (1.18 to 11.90)0.02
Long term response summary (area under the curve minus baseline through week 52)4.62 (0.88 to 8.36)0.02
Improvement [1 to 9; 1 = 100% Improvement, 9 = 100% Worse]
Mean at week 4 (95% CI)3.9 (3.6 to 4.1)3.6 (3.3 to 3.8)0.31 (0.03, 0.60)0.03
Mean at week 12 (95% CI)3.1 (2.9 to 3.4)2.8 (2.6 to 3.1)0.29 (− 0.04, 0.63)0.09

Short term response summary

(Area under the curve through week 12)

0.31 (0.01 to 0.61)0.04
Mean at week 26 (95% CI)3.5 (3.2 to 3.8)3.1 (2.8 to 3.3)0.38 (0.08, 0.68)0.01
Mean at week 52 (95% CI)3.6 (3.3 to 3.9)3.1 (2.8 to 3.3)0.37 (0.08, 0.65)0.01
Long term response summary (area under the curve through week 52)0.41 (0.14 to 0.68) < 0.01
Medication use [days/week]
Mean at baseline (SD)2.8 (2.4)2.9 (2.4)
Mean at week 4 (95% CI)2.3 (1.9 to 2.7)2.6 (2.2 to 3)− 0.27 (− 0.77 to 0.24)
Mean at week 12 (95% CI)1.8 (1.4 to 2.2)1.8 (1.4 to 2.2)− 0.05 (− 0.63 to 0.52)
Short term response summary (area under the curve minus baseline through week 12)− 0.21 (− 0.71 to 0.30)
Mean at week 26 (95% CI)1.8 (1.4 to 2.2)2.2 (1.8 to 2.6)− 0.44 (− 1.06 to 0.19)
Mean at week 52 (95% CI)2.3 (1.9 to 2.8)1.9 (1.5 to 2.4)0.50 (− 0.17 to 1.17)
Long term response summary (area under the curve minus baseline through week 52)− 0.11 (− 0.58 to 0.36)0.65
Quality of life (EuroQol) [− 0.109 to 1; higher scores indicate better quality of life]
Mean at baseline (SD)0.76 (0.10)0.79 (0.06)
Mean at week 4 (95% CI)0.80 (0.78 to 0.82)0.81 (0.79 to 0.83)− 0.01 (− 0.04 to 0.02)
Mean at week 12 (95% CI)0.83 (0.81 to 0.85)0.85 (0.83 to 0.87)− 0.02 (− 0.05 to 0.01)
Short term response summary (area under the curve minus baseline through week 12)− 0.01 (− 0.04 to 0.01)
Mean at week 26 (95% CI)0.81 (0.79 to 0.83)0.82 (0.80 to 0.84)− 0.02 (− 0.04 to 0.01)
Mean at week 52 (95% CI)0.82 (0.79 to 0.84)0.84 (0.82 to 0.86)− 0.02 (− 0.05 to 0.004)
Long term response summary (area under the curve minus baseline through week 52)− 0.02 (− 0.04 to 0.003)0.09
Satisfaction with care [1 to 7; 1 = Completely Satisfied, 7 = Completely Dissatisfied]
Mean at week 4 (95% CI)2.1 (1.9 to 2.3)1.8 (1.6 to 2)0.34 (0.12, 0.57) < 0.01
Mean at week 12 (95% CI)2 (1.8 to 2.2)1.7 (1.5 to 1.9)0.33 (0.09, 0.56) < 0.01
Short term response summary (area under the curve minus baseline through week 12)0.34 (0.11 to 0.56) < 0.01
Mean at week 26 (95% CI)2.3 (2.1 to 2.5)1.9 (1.7 to 2.1)0.38 (0.08, 0.68)0.01
Mean at week 52 (95% CI)2.2 (2 to 2.4)1.8 (1.6 to 2)0.37 (0.08, 0.65)0.01
Long term response summary (area under the curve through week 52)0.38 (0.16 to 0.59) < 0.01
Low back symptom frequency [0 to 5; 0 = none of the time, 5 = all of the time]
Mean at baseline (SD)
Mean at week 4 (95% CI)3.11 (2.9 to 3.32)2.83 (2.62 to 3.04)0.28 (− 0.01 to 0.58)0.06
Mean at week 12 (95% CI)2.38 (2.17 to 2.59)2.02 (1.81 to 2.23)0.36 (0.06 to 0.66)0.02

Short term response summary

(Area under the curve minus baseline through week 12)

0.31 (0.07 to 0.56)0.01
Mean at week 26 (95% CI)2.68 (2.47 to 2.9)2.33 (2.12 to 2.54)0.35 (0.05 to 0.66)0.02
Mean at week 52 (95% CI)2.41 (2.19 to 2.64)1.95 (1.74 to 2.16)0.46 (0.16 to 0.77)0.003
Long term response summary (area under the curve through week 52)0.38 (0.15 to 0.60)0.001
Leg symptom frequency [0 to 5; 0 = none of the time, 5 = all of the time]
Mean at baseline (SD)
Mean at week 4 (95% CI)1.1 (0.92 to 1.28)1.03 (0.85 to 1.21)0.07 (− 0.19 to 0.32)
Mean at week 12 (95% CI)0.77 (0.58 to 0.95)0.66 (0.49 to 0.84)0.1 (− 0.15 to 0.36)

Short term response summary

(Area under the curve minus baseline through week 12)

0.08 (− 0.13 to 0.29)
Mean at week 26 (95% CI)0.94 (0.75 to 1.12)0.87 (0.69 to 1.05)0.07 (− 0.2 to 0.33)
Mean at week 52 (95% CI)1.04 (0.85 to 1.24)0.79 (0.6 to 0.97)0.26 (− 0.01 to 0.52)

Long term response summary

(Area under the curve through week 52)

0.12 (− 0.06 to 0.31)0.19
Any missed work days due to back problem in past month [%]
Percentage at baseline (n)36.3 (36)36.6 (37)
Percentage at week 4 (95% CI)23.5 (16.4 to 30.5)24.2 (17.4 to 31.0)− 0.7 (− 10.2 to 8.7)
Percentage at week 12 (95% CI)17.5 (11.0 to 24.1)13.0 (8.2 to 17.8)4.5 (− 3.1 to 12.1)
Percentage at week 26 (95% CI)15.2 (9.4 to 21.1)16.6 (10.6 to 22.6)− 1.3 (− 9.1 to 6.5)
Percentage at week 52 (95% CI)17.3 (10.5 to 24.1)16.1 (9.9 to 22.3)1.2 (− 7.6 to 10.0)
Number of missed work days due to back problem in past month [0–31 days]
Mean at baseline (SD)6.0 (4.9)6.6 (6.8)
Mean at week 4 (95% CI)6.09 (3.56 to 8.62)4.49 (3.13 to 5.85)1.60 (− 1.29 to 4.49)
Mean at week 12 (95% CI)2.18 (1.35 to 3.01)3.84 (1.55 to 6.12)− 1.65 (− 4.12 to 0.81)
Mean at week 26 (95% CI)6.23 (1.33 to 11.14)5.38 (0.54 to 10.21)0.86 (− 6.07 to 7.78)
Mean at week 52 (95% CI)3.16 (1.98 to 4.33)6.11 (0.20 to 12.02)− 2.96 (− 9.03 to 3.11)
Any reduced activity days due to back problem in past month [%]
Percentage at baseline (n)74.0 (74)72.2 (73)
Percentage at week 4 (95% CI)54.4 (45.7 to 63.1)64.8 (56.5 to 73.1)− 10.4 (− 22.4 to 1.6)
Percentage at week 12 (95% CI)41.3 (31.4 to 51.2)41.8 (32.9 to 50.8)− 0.6 (− 13.9 to 12.8)
Percentage at week 26 (95% CI)43.7 (34.7 to 52.7)37.1 (30.0 to 44.2)6.6 (− 4.4 to 17.6)
Percentage at week 52 (95% CI)41.5 (32.6 to 50.4)34.7 (26.9 to 42.5)6.8 (− 4.5 to 18.2)
Number of reduced activity days due to back problem in past month [0–31 days]
Mean at baseline (SD)9.0 (8.2)8.4 (8.0)
Mean at week 4 (95% CI)6.05 (5.02 to 7.08)5.07 (4.19 to 5.95)0.98 (− 0.26 to 3.01)
Mean at week 12 (95% CI)5.04 (3.10 to 6.99)4.22 (3.10 to 5.35)0.82 (− 1.37 to 3.01)
Mean at week 26 (95% CI)4.58 (3.56 to 5.60)4.53 (3.55 to 5.51)0.05 (− 1.24 to 1.33)
Mean at week 52 (95% CI)4.84 (3.36 to 6.33)4.53 (3.54 to 5.52)0.31 (− 1.34 to 1.96)
Fear avoidance beliefs—work subscale [0–42; higher scores indicate greater fear avoidance beliefs]
Mean at baseline (SD)9.13 (8.94)9.69 (8.47)
Mean at week 4 (95% CI)8.30 (7.15 to 9.45)7.53 (6.4 to 8.66)0.77 (− 0.84 to 2.38)
Mean at week 12 (95% CI)7.10 (5.94 to 8.26)5.94 (4.82 to 7.06)1.16 (− 0.45 to 2.77)
Short term response summary (area under the curve minus baseline through week 12)0.93 (− 0.46 to 2.31)
Mean at week 26 (95% CI)6.80 (5.62 to 7.98)5.65 (4.51 to 6.78)1.15 (− 0.48 to 2.79)
Mean at week 52 (95% CI)6.60 (5.39 to 7.81)6.49 (5.34 to 7.64)0.11 (− 1.56 to 1.78)
Long term response summary (area under the curve through week 52)0.84 (− 0.44 to 2.11)0.20
Fear avoidance beliefs—physical activity subscale [0 to 24; higher scores indicate greater fear avoidance beliefs]
Mean at baseline (SD)11.66 (5.42)11.63 (5.32)
Mean at week 4 (95% CI)9.03 (8.04 to 10.01)9.3 (8.33 to 10.27)− 0.28 (− 1.66 to 1.11)
Mean at week 12 (95% CI)7.54 (6.55 to 8.54)7.36 (6.39 to 8.33)0.18 (− 1.21 to 1.57)

Short term response summary

(Area under the curve minus baseline through week 12)

− 0.09 (− 1.31 to 1.12)
Mean at week 26 (95% CI)7.71 (6.7 to 8.72)6.52 (5.53 to 7.5)1.20 (− 0.21 to 2.6)
Mean at week 52 (95% CI)7.61 (6.57 to 8.64)7.22 (6.23 to 8.21)0.39 (− 1.04 to 1.82)
Long term response summary (area under the curve through week 52)0.59 (− 0.55 to 1.72)0.31
Self-efficacy [0 to 60; higher scores indicate greater self-efficacy]
Mean at baseline (SD)48.0 (10.0)49.2 (8.7)
Mean at week 4 (95% CI)52.2 (50.9 to 53.6)52 (50.7 to 53.4)0.18 (− 1.70 to 2.07)
Mean at week 12 (95% CI)54.4 (53 to 55.7)54.7 (53.4 to 56)− 0.33 (− 2.22 to 1.57)
Short term response summary (area under the curve minus baseline through week 12)− 0.02 (− 1.67 to 1.63)
Mean at week 26 (95% CI)52.5 (51.2 to 53.9)53.2 (51.8 to 54.5)− 0.63 (− 2.55 to 1.29)
Mean at week 52 (95% CI)51.8 (50.4 to 53.2)53.8 (52.5 to 55.2)− 1.99 (− 3.94 to − 0.04)
Long term response summary (area under the curve through week 52)− 0.82 (− 2.35 to 0.71)0.29
Active pain coping strategies (pain management inventory) [5 to 25; higher scores indicate more frequent use]
Mean at baseline (SD)17.3 (3.4)17.1 (3.6)
Mean at week 12 (95% CI)18.2 (17.6 to 18.9)19.0 (18.4 to 19.7)− 0.8 (− 1.7 to 0.1)0.07
Passive pain coping strategies (Pain Management Inventory) [6 to 30; higher scores indicate more frequent use]
Mean at baseline (SD)13.8 (4.5)13.9 (3.9)
Mean at week 12 (95% CI)12.6 (12.0 to 13.2)11.7 (11.1 to 12.3)0.9 (0.1 to 1.7)0.036
Kinesiophobia [17 to 68] (11 questions; 1 = Strongly Disagree—4 = Strongly Agree)
Mean at baseline (SD)35.2 (6.3)33.2 (5.8)
Mean at week 12 (95% CI)29.7 (28.6 to 30.8)28.7 (27.6 to 29.8)1.0 (2.6 to − 0.6)0.20

Mean values adjusted for baseline except for improvement and satisfaction

*Long term response summary serves as the omnibus test p-value. If p > .05, p-values for short term response and individual time points are not computed

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