Chiropractic treatment including instrument-assisted manipulation for non-specific dizziness and neck pain in community-dwelling older people: a feasibility randomised sham-controlled trial

Autor: Julie C. Kendall, Simon D. French, Jan Hartvigsen, Michael F. Azari
Rok vydání: 2018
Předmět:
Male
Manipulation
Spinal
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system
Pilot Projects
Physical Therapy
Sports Therapy and Rehabilitation
Dizziness
law.invention
Disability Evaluation
03 medical and health sciences
Elderly
0302 clinical medicine
Randomized controlled trial
Neck pain
law
medicine
Humans
030212 general & internal medicine
Lost to follow-up
Postural Balance
Aged
Aged
80 and over
Randomised controlled trial
Massage
Manipulation
Chiropractic
business.industry
Research
Sham Intervention
lcsh:Chiropractic
Neck manipulation
Chiropractic
Clinical trial
Treatment Outcome
Complementary and alternative medicine
Patient Satisfaction
lcsh:RZ201-275
Physical therapy
Feasibility Studies
Accidental Falls
Female
Chiropractics
lcsh:RC925-935
medicine.symptom
business
030217 neurology & neurosurgery
Zdroj: Chiropractic & Manual Therapies, Vol 26, Iss 1, Pp 1-11 (2018)
Chiropractic & Manual Therapies
Kendall, J C, French, S D, Hartvigsen, J & Azari, M F 2018, ' Chiropractic treatment including instrument-assisted manipulation for non-specific dizziness and neck pain in community-dwelling older people : a feasibility randomised sham-controlled trial ', Chiropractic & Manual Therapies, vol. 26, 14 . https://doi.org/10.1186/s12998-018-0183-1
ISSN: 2045-709X
DOI: 10.1186/s12998-018-0183-1
Popis: Background: Dizziness in older people is a risk factor for falls. Neck pain is associated with dizziness and responds favourably to neck manipulation. However, it is unknown if chiropractic intervention including instrument-assisted manipulation of the neck in older people with neck pain can also improve dizziness.Methods: This parallel two-arm pilot trial was conducted in Melbourne, Australia over nine months (October 2015 to June 2016). Participants aged 65-85 years, with self-reported chronic neck pain and dizziness, were recruited from the general public through advertisements in local community newspapers and via Facebook. Participants were randomised using a permuted block method to one of two groups: 1) Activator II™-instrument-assisted cervical and thoracic spine manipulation plus a combination of: light massage; mobilisation; range of motion exercises; and home advice about the application of heat, or 2) Sham-Activator II™-instrument-assisted manipulation (set to zero impulse) plus gentle touch of cervical and thoracic spinal regions. Participants were blinded to group allocation. The interventions were delivered weekly for four weeks. Assessments were conducted one week pre- and post-intervention. Clinical outcomes were assessed blindly and included: dizziness (dizziness handicap inventory [DHI]); neck pain (neck disability index [NDI]); self-reported concerns of falling; mood; physical function; and treatment satisfaction. Feasibility outcomes included recruitment rates, compliance with intervention and outcome assessment, study location, success of blinding, costs and harms.Results: Out of 162 enquiries, 24 participants were screened as eligible and randomised to either the chiropractic (n = 13) or sham (n = 11) intervention group. Compliance was satisfactory with only two participants lost to follow up; thus, post-intervention data for 12 chiropractic intervention and 10 sham intervention participants were analysed. Blinding was similar between groups. Mild harms of increased spinal pain or headaches were reported by 6 participants. Costs amounted to AUD$2635 per participant. The data showed a trend favouring the chiropractic group in terms of clinically-significant improvements in both NDI and DHI scores. Sample sizes of n = 150 or n = 222 for dizziness or neck pain disability as the primary outcome measure, respectively, would be needed for a fully powered trial.Conclusions: Recruitment of participants in this setting was difficult and expensive. However, a larger trial may be feasible at a specialised dizziness clinic within a rehabilitation setting. Compliance was acceptable and the outcome measures used were well accepted and responsive.Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000653763. Registered 13 June 2013.Trial funding: Foundation for Chiropractic Research and Postgraduate Education (Denmark).
Databáze: OpenAIRE
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