Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain, and dizziness in older adults

J Manipulative Physiol Ther. Jul-Aug 2009;32(6):438-47. doi: 10.1016/j.jmpt.2009.06.008.

Abstract

Objective: The purpose of this study was to collect preliminary information on the effect of a limited and extended course of chiropractic care on balance, chronic pain, and associated dizziness in a sample of older adults with impaired balance.

Methods: The authors conducted a randomized pilot study targeting a sample size of 30, comparing 2 schedules of chiropractic care to a no-treatment group. Group 1 (limited schedule) was treated for 8 weeks, group 2 (extended schedule) was treated for 8 weeks and then once per month for 10 months, and group 3 received no treatment. Assessments were made at baseline and 1, 2, 6, and 12 months later. The primary outcome was changed in the Berg Balance Scale (BBS) from baseline to 1 year. Changes in the Pain Disability Index and Dizziness Handicap Index were also measured.

Results: Thirty-four patients were enrolled, 13 in group 1, 15 in group 2, and 6 in group 3. Only 5 had baseline BBS scores less than 45, indicating increased risk for falls. There were no treatment-related adverse events. Nine patients dropped out by 1 year. No significant differences within or between groups in median BBS from baseline to 12 months were observed. Median Pain Disability Index scores improved more from baseline to 1 year in group 2 compared with groups 1 and 3 (P = .06, Kruskal-Wallis test). For the 9 patients with dizziness, a clinically significant improvement in Dizziness Handicap Index scores of groups 1 and 2 was observed at 1 month and remained lower than baseline thereafter; this was not true of group 3.

Conclusion: Further investigation of the possible benefit of chiropractic maintenance care (extended schedule) for balance and pain-related disability is feasible and warranted, as well as both limited and extended schedules for patients with idiopathic dizziness.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control
  • Accidental Falls / statistics & numerical data
  • Aged
  • Aged, 80 and over
  • Chiropractic / methods*
  • Chronic Disease
  • Dizziness / complications
  • Dizziness / diagnosis
  • Dizziness / prevention & control*
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Pain / complications
  • Pain / diagnosis
  • Pain / prevention & control*
  • Pain Measurement
  • Patient Education as Topic
  • Pilot Projects
  • Postural Balance*
  • Risk Reduction Behavior
  • Sensation Disorders / complications
  • Sensation Disorders / diagnosis
  • Sensation Disorders / prevention & control*
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome