Sunday, August 23, 2009

Changes in General Health Status during Upper Cervical Chiropractic Care: A Practice-Based Research Project Update

Kathryn T. Hoiriis, BS, DC
Deana Burd, BA
Research Department
Life University, School of Chiropractic
Marietta, GA
Edward F. Owens, Jr., MS, DC
Director of Research
Sherman College of Straight Chiropractic
Spartanburg, SC


Introduction: An upper cervical practice-based research (PBR) project, proposed at the 13th Annual Upper Cervical Conference in November 1996, is being used to study the effectiveness of upper cervical care related to the general health status of patients. This project uses the RAND (SF-36) Health Survey and a global well-being scale (GWBS) as primary outcome measures. Also, we are looking at concomitant changes in misalignment of the occipito-atlanto-axial joints as determined by pre- and post-adjustment radiographs.

Methods: Field doctors were recruited to contribute sequential information from their new patients between 18 and 59 years of age. The patients were followed through the course of care until maximum improvement for the presenting complaint was noted. The SF-36 was given to patients at the initial visit, after four weeks and at the end of the care plan (the level of maximal chiropractic improvement, MCI). The GWBS was completed at each visit. Radiographic analysis of upper cervical subluxation was recorded. Data are continually being collected from field practitioners and entered into a computerized database. This update summarizes the results from the first two years of the study.

Results: The patients (N=311) sought care for a variety of mostly musculoskeletal complaints: back pain (33.9%), neck pain (40.9%) and headache (9.8%). Forty % (N=34) of the 85 completed patients had acute complaints, while 60% (N=51) complained of chronic problems.

The average pre-adjustment C1 misalignment was 2.2 degrees of laterality. The average measured radiographic change was 51-75% with the average post-adjustment C1 misalignment reduced to 0.89 degrees.

The SF-36 data reduces to health scores ranging from 0 to 100 in eight discreet dimensions or subscales: physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (V), social function (SF), role emotional (RE) and mental health (MH). The mean SF-36 results for 4 week data (n=161) and MCI (n=85) show statistically significance changes from initial values (n=311) at both 4 weeks and MCI. All subscales showed improvement with the greatest average gain seen for role physical (39 points

Conclusions: In our chiropractic population, the improvement in average SF-36 scores might be attributed to changes in health due to the spinal correction, but there is no data available from a control population to support that conclusion.

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