Chiropractic management in a veteran population. Can outcomes be predicted?

BACKGROUND: The Department of Veterans Affairs (VA) began to implement chiropractic services in 2004. A previous retrospective review evaluated response to chiropractic management (CM) in the veteran patient population. This study suggested that certain demographic (distance traveled) and psychosocial factors (PTSD), may impact treatment outcome. We have further analyzed this data for other factors that may be predictive of response to CM. METHODS: A retrospective chart review of new patients who presented to the chiropractic clinic at a VA Medical Center, from March 1, 2007 through July 1, 2008 was conducted. This review collected descriptive information on all patients and treatment outcomes at 4, 6 and 8 week intervals. We performed a regression analysis to determine if there were any positive or negative factors associated with treatment outcome. RESULTS: There were 199 new consults. Subgroup analysis was performed and determined that there were several factors which influenced the overall response to treatment and could be predictive of a positive or negative response to CM. All findings were significant at p < 0.01. Patients with positive response to the initial treatment with no post manipulation soreness and those who underwent concurrent treatment with Physical Therapy responded positively to CM. Those with chronic low back pain responded positively, but those with concurrent CLBP and neck pain responded less favorably.

CONCLUSION: Positive and negative predictors for response to CM may further advance the knowledge and research agenda to further evaluate sub groups who may respond to CM.