A practice-based research (PBR) project specifically focused on the upper cervical chiropractic practice was proposed at the 13th Annual Upper Cervical Spine conference in November 1996. The primary measures of health status were the RAND (SF-36) health survey and a visual analog scale for global well-being (GWBS). The SF-36 is administered to patients at the outset of care, after four weeks of care, and when the doctor determines that the patient has reached maximum improvement. The GWBS is given at each visit to gage the patient's assessment of their improvement on a more frequent basis. Demographic information, as well as the chief complaint for patients was collected as part of the enrollment process. Additionally, the characteristics of the cervical misalignments for each patient as measured on radiographs have been tabulated.
Since the onset of the study 16 months ago, data have been collected on 153 patients. The preliminary results show that patients enter into upper cervical chiropractic care with a variety of mostly musculoskeletal complaints. At the outset of care, those patients have significantly lower health status, as measured by the SF-36, than the general population. There is a general trend for patients to perceive an improvement in their health as measured by both the SF-36 and the GWBS. Analysis of x-ray listing factors suggests that upper cervical chiropractic adjustment improves alignment of the occipito-atlanto-axial spine.
Although these results are encouraging, many of our original questions go unanswered because of a lack of follow up data. In addition, the sample size is too small to make any general conclusions. To enlarge the scope of the study, we would like to incorporate data from a wider sample of chiropractors, including those who use full spine techniques aimed at the correction of subluxation.
Key words: chiropractic, subluxation, practice-based research, upper cervical, RAND Health Survey, global well-being scale.