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Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel With Low Back Pain

By |July 20, 2016|Veterans|

Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel With Low Back Pain: Study Protocol for a Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Trials. 2016 (Feb 9);   17:   70

Christine M. Goertz, Cynthia R. Long, Robert D. Vining,
Katherine A. Pohlman, Bridget Kane, Lance Corber,
Joan Walter and Ian Coulter

Palmer College of Chiropractic,
Palmer Center for Chiropractic Research,
741 Brady Street, Davenport, IA, 52803, USA.
christine.goertz@palmer.edu


BACKGROUND:   Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of pain and function within a civilian population is spinal manipulative therapy provided by doctors of chiropractic. Chiropractic care, delivered within a multidisciplinary framework in military healthcare settings, has the potential to help improve clinical outcomes for military personnel with low back pain. However, its effectiveness in a military setting has not been well established. The primary objective of this study is to evaluate changes in pain and disability in active duty service members with low back pain who are allocated to receive usual medical care plus chiropractic care versus treatment with usual medical care alone.

METHODS/DESIGN:   This pragmatic comparative effectiveness trial will enroll 750 active duty service members with low back pain at three military treatment facilities within the United States (250 from each site) who will be allocated to receive usual medical care plus chiropractic care or usual medical care alone for 6 weeks. Primary outcomes will include the numerical rating scale for pain intensity and the Roland-Morris Disability Questionnaire at week 6. Patient reported outcomes of pain, disability, bothersomeness, and back pain function will be collected at 2, 4, 6, and 12 weeks from allocation.

DISCUSSION:   Because low back pain is one of the leading causes of disability among U.S. military personnel, it is important to find pragmatic and conservative treatments that will treat low back pain and preserve low back function so that military readiness is maintained. Thus, it is important to evaluate the effects of the addition of chiropractic care to usual medical care on low back pain and disability.

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Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

By |June 18, 2016|Veterans|

Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

The Chiro.Org Blog


SOURCE:   Evid Based Complement Alternat Med. 2013: 701280

Raheleh Khorsan, Angela B. Cohen, Anthony J. Lisi,
Monica M. Smith, Deborah Delevan, Courtney Armstrong,
and Brian S. Mittman

VA Center for Implementation Practice and Research Support,
VA Greater Los Angeles Healthcare System,
16111 Plummer Street,
Sepulveda, Los Angeles, CA 91343, USA


Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches-insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1) the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2) ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.


The Full-Text Article:

Introduction

There is growing consumer interest in complementary and alternative medicine (CAM) in the USA and internationally. [1-3] Healthcare systems have responded to this demand by offering a range of CAM services in outpatient and inpatient settings. [4, 5] Patients enrolled in the US Department of Veterans Affairs (VA) healthcare delivery system often use CAM services outside of VA but have a strong interest in receiving these services within the VA system. [6-11] In response, VA began providing selected in-house CAM services in about 2001. [12] VA’s most substantial undertaking in delivering any CAM-related service has been its introduction of chiropractic services.

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Q&A With the First VA Chiropractic Residents

By |June 29, 2015|News, Veterans|

Q&A With the First VA Chiropractic Residents

The Chiro.Org Blog


SOURCE:   Dynamic Chiropractic ~ July 1, 2015 ~ FULL TEXT

By Clinton Daniels, DC, MS, Amanda Dluzneiwski, DC, Derek Golley, DC,
Benjamin Liang, DC and Rachel Perrucci, DC


The Inaugural class of 2015 shares their residency experiences.


As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.1-2 This program is the result of years of dedication and strategic planning by the VA chiropractic leadership, and is congruent with the VA’s mission to train providers to serve the VA and the nation at large.

As the inaugural class, we are honored to have participated in the first phase of the three-year pilot program.

In March 2015, we had the opportunity to gather for a VA meeting held in advance of the Association of Chiropractic Colleges /Research Agenda Conference in Las Vegas. At this meeting, we worked with representatives from VA Central Office, the five residency program directors, and representatives from each program’s academic affiliates: Logan University, New York Chiropractic College, Southern California University of Health Sciences and the University of Bridgeport.

After this, many of us attended the ACC/RAC conference itself, where we participated in workshops and observed several cutting-edge research presentations. In our interaction with many of the ACC/RAC attendees, we noted a tremendous amount of interest in the VA Chiropractic Residency Program. We received questions ranging from inquiries about our future career plans to how perspective residents may apply. The following are some of the most frequent questions we fielded, as well as personal residency experiences.


How long is the residency program and is it a paid position?

(more…)

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

By |September 27, 2011|Outcome Assessment, Veterans|

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

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2011 (Oct); 34 (8): 533–538

Andrew S. Dunn, DC, MEd, MS, Bart N. Green, DC, MSEd, Lance R. Formolo, DC, MS, David R. Chicoine

Chiropractic Department, Medical Care Line, VA Western New York, Buffalo, NY, USA. andrew.dunn@va.gov


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. (more…)