Health-related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care plus Chiropractic Care plus Usual Care vs Usual Care Alone

Objective:   This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical pain rating 0-10 scale, 2) 24-item Roland-Morris Disability Questionnaire (RMDQ); and 3) global improvement (modified visual analog scale).

Design:   A pragmatic, prospective, multisite, parallel-group comparative effectiveness clinical trial comparing usual medical care (UMC) with UMC plus chiropractic care (UMC+CC).
Setting:   3 military treatment facilities.

Subjects:   750 active-duty military personnel with low back pain.

Methods:   Linear mixed effects regression models estimated the treatment group differences. Coefficient of repeatability to estimate significant individual change.

Results:   We found statistically significant mean group differences favoring UMC+CC for all PROMIS®-29 scales and the RMDQ score. Area under the curve estimates for global improvement for the PROMIS®-29 scales and the RMDQ, ranged from 0.79 to 0.83.

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LOW BACK PAIN Section and the:

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CHIROPRACTIC CARE FOR VETERANS Section

Conclusions:   Findings from this pre-planned secondary analysis demonstrate that chiropractic care impacts health-related quality of life beyond pain and pain-related disability. Further, comparable findings were found between the 24-item RMDQ and the PROMIS®-29 v1

Keywords:   PROMIS®; chiropractic care; clinical trial; health-related quality of life; low back pain; military; patient outcome assessment; usual medical care.

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