A practice-based research (PBR) project specifically focused on the upper cervical chiropractic practice was proposed at the 13th Annual Upper Cervical Spine conference in November 1996.
The primary measures of health status were the RAND (SF-36 ) health survey and a visual analog scale for global well-being (GWBS). The SF-36 is administered to patients at three specific times during the course of care while the GWBS is given at each visit. Demographic information as well as the chief complaint for patients was collected as part of the enrollment process. Additionally, the characteristics of the cervical misalignments for each patient as measured on radiographs have been tabulated.
Since the onset of the study 16 months ago, data have been collected on 153 patients. The preliminary results show that patients enter into upper cervical chiropractic care with a variety of mostly musculoskeletal complaints. At the outset of care, those patients have significantly lower health status, as measured by the SF-36, than the general population. There is a general trend for patients to experience an upward trend in their perception of health as measured by both the SF-36 and the GWBS. Analysis of x-ray listing factors suggests that upper cervical chiropractic adjustment improves misalignment of the occipito-atlanto-axial spine.
Although these results are encouraging, many of our original questions go unanswered because of a lack of follow-up data. In addition, the sample size is too small; additional upper cervical chiropractic offices are needed as collection sites. Better tracking of patient attrition is required to assess the length of chiropractic care needed to reach maximum improvement for specific conditions.
Author Keywords: chiropractic, subluxation, practice-based research, upper cervical, RAND Health Survey, global well-being scale.
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