Chiro.org - Chiropractic Resource Organization.     Support Chiropractic Research!

Veterans

Home/Veterans

Nonpharmacological Treatment of Army Service Members with Chronic Pain Is Associated with Fewer Adverse Outcomes After Transition to the Veterans Health Administration

By |November 12, 2019|Low Back Pain, Veterans|

Nonpharmacological Treatment of Army Service Members with Chronic Pain Is Associated with Fewer Adverse Outcomes After Transition to the Veterans Health Administration

The Chiro.Org Blog


SOURCE:   J Gen Intern Med. 2019 (Oct 28) [Epub]

Esther L. Meerwijk, PhD, MSN , Mary Jo Larson, PhD, MPA, Eric M. Schmidt, PhD, Rachel Sayko Adams, PhD, MPH, Mark R. Bauer, MD, Grant A. Ritter, PhD, Chester Buckenmaier III, MD, and Alex H. S. Harris, PhD, MS

VA Health Services Research & Development,
Center for Innovation to Implementation (Ci2i),
VA Palo Alto Health Care System,
Menlo Park, CA, USA.



BACKGROUND:   Potential protective effects of nonpharmacological treatments (NPT) against long-term pain-related adverse outcomes have not been examined.

OBJECTIVE:   To compare active duty U.S. Army service members with chronic pain who did/did not receive NPT in the Military Health System (MHS) and describe the association between receiving NPT and adverse outcomes after transitioning to the Veterans Health Administration (VHA).

DESIGN AND PARTICIPANTS:   A longitudinal cohort study of active duty Army service members whose MHS healthcare records indicated presence of chronic pain after an index deployment to Iraq or Afghanistan in the years 2008-2014 (N = 142,539). Propensity score-weighted multivariable Cox proportional hazard models tested for differences in adverse outcomes between the NPT group and No-NPT group.

EXPOSURES:   NPT received in the MHS included acupuncture/dry needling, biofeedback, chiropractic care, massage, exercise therapy, cold laser therapy, osteopathic spinal manipulation, transcutaneous electrical nerve stimulation and other electrical manipulation, ultrasonography, superficial heat treatment, traction, and lumbar supports.

MAIN MEASURES:   Primary outcomes were propensity score-weighted proportional hazards for the following adverse outcomes: (a) diagnoses of alcohol and/or drug disorders; (b) poisoning with opioids, related narcotics, barbiturates, or sedatives; (c) suicide ideation; and (d) self-inflicted injuries including suicide attempts. Outcomes were determined based on ICD-9 and ICD-10 diagnoses recorded in VHA healthcare records from the start of utilization until fiscal year 2018.

KEY RESULTS:   The propensity score-weighted proportional hazards for the NPT group compared to the No-NPT group were 0.92 (95% CI 0.90-0.94, P < 0.001) for alcohol and/or drug use disorders; 0.65 (95% CI 0.51-0.83, P < 0.001) for accidental poisoning with opioids, related narcotics, barbiturates, or sedatives; 0.88 (95% CI 0.84-0.91, P < 0.001) for suicide ideation; and 0.83 (95% CI 0.77-0.90, P < 0.001) for self-inflicted injuries including suicide attempts.

There are more articles like this @ our:

Low Back Pain Page

(more…)

Congress Introduces Bipartisan Legislation to Expand Chiropractic Access to Military Retirees, National Guard and Reserves

By |January 9, 2019|Veterans|

Congress Introduces Bipartisan Legislation to Expand Chiropractic Access to Military Retirees, National Guard and Reserves

The Chiro.Org Blog


SOURCE:   The American Chiropractic Association (ACA)

Arlington, VA – The American Chiropractic Association (ACA) is pleased to announce that Congress yesterday introduced bipartisan legislation that would expand access to chiropractic services to military retirees as well as members of the National Guard and Reserve through the Department of Defense TRICARE health program.

The legislation — S. 30, introduced by Sen. Tammy Baldwin (D-Wis.) and Sen. Jerry Moran (R-Kan.), and H.R. 344, introduced by Rep. Mike Rogers (R-Ala.) and David Loebsack (D-Iowa) — would ensure that those who retire from military service can continue to receive the quality chiropractic care they accessed previously through the Department of Defense (DoD) healthcare system. Since painful musculoskeletal conditions are a common complaint among those who have served in the military, the legislation adds an important non-drug option for pain management in TRICARE for those who wish to avoid or reduce their need for prescription opioid pain medications.

“In the wake of the opioid epidemic, we are grateful that Congress recognizes the need for increased access to non-drug options for pain management,” said ACA President N. Ray Tuck, Jr., DC. “Chiropractors have become valued members of the military healthcare team. We are honored to help keep our service members battle-ready without the use of drugs or surgery and to help those who retire to continue to manage their pain conservatively with safe and effective chiropractic services.”

There are more articles like this @ our:

CHIROPRACTIC CARE FOR VETERANS Page

(more…)

Effect of Chiropractic Manipulative Therapy on Reaction Time in Special Operations Forces Military Personnel

By |January 6, 2019|Chiropractic Research, Veterans|

Effect of Chiropractic Manipulative Therapy on Reaction Time in Special Operations Forces Military Personnel: A Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Trials. 2019 (Jan 3); 20 (1): 5

James W. DeVocht, Robert Vining, Dean L. Smith, Cynthia R. Long, Thomas M. Jones and Christine M. Goertz

Palmer Center for Chiropractic Research,
741 Brady St,
Davenport, IA, 52803, USA.


BACKGROUND:   Chiropractic manipulative therapy (CMT) has been shown to improve reaction time in some clinical studies. Slight changes in reaction time can be critical for military personnel, such as special operation forces (SOF). This trial was conducted to test whether CMT could lead to improved reaction and response time in combat-ready SOF-qualified personnel reporting little or no pain.

METHODS:   This prospective, randomized controlled trial was conducted at Blanchfield Army Community Hospital, Fort Campbell, KY, USA. Active-duty US military participants over the age of 19 years carrying an SOF designation were eligible. Participants were randomly allocated to CMT or wait-list control. One group received four CMT treatments while the other received no treatment within the 2-week trial period. Assessment included simple hand/foot reaction time, choice reaction time, and Fitts’ Law and whole-body response time. On visits 1 and 5, the same five assessments were conducted immediately pre- and post-treatment for the CMT group and before and after a 10-min wait period for the wait-list group. Primary outcomes included between-group differences for the pre-CMT/wait-list period at visit 1 and visit 5 for each test. Secondary outcomes included between-group differences in immediate pre- and post-(within visit) changes. Analysis of covariance was used for all data analysis.

RESULTS:   One hundred and seventy-five SOF-qualified personnel were screened for eligibility; 120 participants were enrolled, with 60 randomly allocated to each group. Due to technical problems resulting in inconsistent data collection, data from 77 participants were analyzed for simple hand/foot reaction time. The mean ± standard deviation (SD) age was 33.0 ± 5.6 years and all participants were male. No between-group statistically significant differences were found for any of the five biomechanical tests, except immediate pre- and post-changes in favor of the CMT group in whole-body response time at both assessment visits. There were four adverse events, none related to trial participation.

There are more articles like this @ our:

CHIROPRACTIC CARE FOR VETERANS Page

(more…)

Chiropractic Management for US Female Veterans With Low Back Pain

By |December 4, 2017|Veterans|

Chiropractic Management for US Female Veterans
With Low Back Pain: A Retrospective Study
of Clinical Outcomes

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2017 (Oct); 40 (8): 573–579

Kelsey L. Corcoran, DC, Andrew S. Dunn, DC, MEd, MS,
Lance R. Formolo, DC, MS, Gregory P. Beehler, PhD, MA

Chiropractic Department,
Medical Care Line,
VA Western New York,
Buffalo, New York


OBJECTIVE:   The purpose of this study was to determine if female US veterans had clinically significant improvement in low back pain after chiropractic management.

METHODS:   This is a retrospective chart review of 70 courses of care for female veterans with a chief complaint of low back pain who received chiropractic management through the VA Western New York Healthcare System in Buffalo, New York. A paired t test was used to compare baseline and discharge outcomes for the Back Bournemouth Questionnaire. The minimum clinically important difference was set as a 30% improvement in the outcome measure from baseline to discharge.

RESULTS:   The average patient was 44.8 years old, overweight (body mass index 29.1 kg/m2), and white (86%). The mean number of chiropractic treatments was 7.9. Statistical significance was found for the Back Bournemouth Questionnaire outcomes. The mean raw score improvement was 12.4 points (P < .001), representing a 27.3% change from baseline with 47% of courses of care meeting or exceeding the minimum clinically important difference.

There are more articles like this @ our:

Chiropractic Care For Veterans Page

(more…)

Military Report More Complementary and Alternative Medicine Use Than Civilians

By |November 1, 2017|Complementary and Alternative Medicine, Veterans|

Military Report More Complementary and Alternative Medicine Use Than Civilians

The Chiro.Org Blog


SOURCE:   J Altern Complement Med. 2013 (Jun); 19 (6): 509–517

Christine Goertz, DC, PhD, Bernadette P. Marriott, PhD,
Michael D. Finch, PhD, Robert M. Bray, PhD,
Thomas V. Williams, PhD, Laurel L. Hourani, PhD,
Louise S. Hadden, BA, Heather L. Colleran, PhD,
and Wayne B. Jonas, MD

Palmer College of Chiropractic,
Davenport, IA 52803, USA.


OBJECTIVES:   The study objective was to estimate complementary and alternative medicine (CAM) use among active duty military and compare data with civilian use.

DESIGN:   A global survey on CAM use in the 12 previous months was conducted. Final participants (16,146) were stratified by gender, service, region, and pay grade. Analysis included prevalence of CAM use, demographic and lifestyle characteristics.

RESULTS:   Approximately 45% of respondents reported using at least one type of CAM therapy. Most commonly used therapies were as follows: prayer for one’s own health (24.4%), massage therapy (14.1%), and relaxation techniques (10.8%). After exclusion of prayer for one’s own health, adjusting to the 2000 U.S. census, overall CAM use in the military (44.5%) was higher than that in comparable civilian surveys (36.0% and 38.3%).

There are more articles like this @ our:

Chiropractic Care For Veterans Page

(more…)

A Typical Week at the St. Louis VA Medical Center

By |September 21, 2017|Veterans|

A Typical Week at the St. Louis VA Medical Center

The Chiro.Org Blog


SOURCE:   ACA Blog ~ 9–19–2017

By Steven Huybrecht, DC

VA St. Louis Healthcare System


I’ve had more than a handful of family and friends ask me, “What’s it like working for the VA in St Louis?” and my response is always the same—“It’s great!” I usually then proceed to give them a rundown of what a typical week looks like as my activities vary from day to day and sometimes from month to month.

An average week is broken down into four different segments:

outpatient clinic,
interdisciplinary pain rehabilitation (IPR) program,
scholarly activities, and
clinical rotations.

The majority of my time is spent in clinic helping veterans manage their pain and develop healthy habits for self-care. However, the time spent outside the clinic has also been beneficial for personal development and education.

On Mondays, Wednesdays and Fridays, I provide chiropractic care in the pain clinic during our normal hours of 8 a.m.- 4 p.m. along with the program director Dr. Pamela Wakefield and attending chiropractor Dr. Glenn Bub. I usually see anywhere from six to eight veterans on an average day, some more clinically complex than others. We have a (relatively) small workspace, but are very busy and have a full schedule on almost every clinic day.

This time is the “bread and butter” of my week where I’m working with veterans who not only have pain issues, but also often have multiple comorbidities. I spent over two years in private practice before starting at the St. Louis VA Healthcare System and have already seen more complexity in my patient population in the first two months of my residency than I saw in those previous two years.

On Tuesdays, in addition to treating veterans I have some scholarly time. One of the recent projects I participated in with two other residents, Nicholas Evertz from Canandaigua, N.Y. and Rachel Mooers from Los Angeles, Calif., was to create a presentation of evidence-based spinal examination procedures. After scouring the literature and cultivating sources, the best tests for diagnosing spinal-related complaints were established. This taught us not only how to critically appraise research, but also how to work together from different sites across the United States.

There are more articles like this @ our:

Chiropractic Care For Veterans Page

(more…)