Veterans

Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data

By Frank M. Painter|May 6, 2023|Chiropractic Care, Chiropractic Management, Veterans|

Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data

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SOURCE: J Chiropractic Medicine 2022 (Jun); 21 (2): 77–82

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Brian A. Davis DC, Andrew S. Dunn DC, MS, MEd, Derek J. Golley DC, MS, Dave R. Chicoine DC, MS

Chiropractic Department,
VA Western New York Healthcare System,
Buffalo, New York

FROM: Military.com 2019

Objective: The purpose of this study was to determine whether a sample of older adult male U.S. veterans demonstrated clinically and statistically significant improvement in chronic lower back pain on validated outcome measures after a short course of chiropractic care.

Methods: We performed a retrospective review of a quality-assurance data set of outcome metrics for male veterans, aged 65 to 89 years, who had chronic low back pain, defined as pain in the lower back region present for at least 3 months before evaluation. We included those who received chiropractic management from January 1, 2010, to December 31, 2018. Paired t tests were used to compare outcomes after 4 treatments on both a numeric rating scale (NRS) and the Back Bournemouth Questionnaire (BBQ). The minimum clinically important difference (MCID) was set at 30% change from baseline.

Results: There were 217 individuals who met the inclusion criteria. The mean NRS score change from baseline was 2.2 points, representing a 34.1% reduction (t = 13.5, P < .001). The mean score change for BBQ was 14.7 points, representing a 35.9% reduction (t = 16.7, P < .001). The percentage of participants reaching the MCID for the NRS was 57% (n = 124) and for the BBQ was 59% (n = 126), with 41% (n = 90) of the sample reaching the MCID for both the NRS and BBQ.

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Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data

By Frank M. Painter|December 14, 2022|Nonpharmacologic Therapies, Veterans|

Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2022 (Jun); 21 (2): 77–82

OPEN ACCESS

Brian A. Davis, DC, Andrew S.Dunn, DC, MS, MEd, Derek J. Golley, DC, MS, Dave R. Chicoine, DC, MS

Chiropractic Department,
VA Western New York Healthcare System,
Buffalo, New York.

FROM: Nahin ~ Pain 2017

Objective: The purpose of this study was to determine whether a sample of older adult male U.S. veterans demonstrated clinically and statistically significant improvement in chronic lower back pain on validated outcome measures after a short course of chiropractic care.

Methods: We performed a retrospective review of a quality-assurance data set of outcome metrics for male veterans, aged 65 to 89 years, who had chronic low back pain, defined as pain in the lower back region present for at least 3 months before evaluation. We included those who received chiropractic management from January 1, 2010, to December 31, 2018. Paired t tests were used to compare outcomes after 4 treatments on both a numeric rating scale (NRS) and the Back Bournemouth Questionnaire (BBQ). The minimum clinically important difference (MCID) was set at 30% change from baseline.

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We Built It, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

By Frank M. Painter|December 8, 2022|Veterans|

We Built It, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

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SOURCE: J Gen Intern Med 2022 (Nov 30); 1-8
Stephanie L. Taylor, PhD, Hannah M. Gelman, PhD, Rian DeFaccio, MS, Jamie Douglas, MA, Matthew J. Hawrilenko, PhD, Nathan K. McGinty, BA, Adam Resnick, PhD,et al.

Center for the Study of Healthcare Innovation,
Implementation and Policy, Health Services Research & Development,
Greater Los Angeles VA Healthcare System, MC 151,
11301 Wilshire, Bldg. 206, 2nd Floor,
Los Angeles, CA, 90073, USA.

FROM: Nahin ~ Pain 2017

Background: Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in national guidelines. To offer nonpharmacological health management options and meet patient demand, the nation’s largest integrated healthcare system, the Veterans Health Administration (VA), greatly expanded their provision of CIH approaches recently.

Objective: This paper addressed the questions of how many VA patients might use CIH approaches and chiropractic care if they were available at modest to no fee, and would patients with some health conditions or characteristics be more likely than others to use these therapies.

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Nonpharmacological Treatment of Army Service Members

By Frank M. Painter|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

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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.

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Congress Introduces Bipartisan Legislation to Expand Chiropractic

By Frank M. Painter|January 9, 2019|Veterans|

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

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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.”

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Effect of Chiropractic Manipulative Therapy on Reaction Time

By Frank M. Painter|January 6, 2019|Chiropractic Research, Veterans|

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

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.

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