Methodology and demographics of a single blinded, randomized controlled trial of chiropractic compared to physical therapy for balance impairments in community dwelling geriatric patients with or without low back pain

Abstract

Background: Postural control problems effect between 28% and 35% of individuals over the age 65 and increases with age. Musculoskeletal pain in the elderly impacts 20% to 49% of people between the ages of 65 and 75, is a leading falls risk factor, and a robust predictor of morbidity. Polypharmacy in the management of chronic pain is common in the geriatric population. Conservative treatment options for balance and back pain are underrepresented in scientific literature.

Best Practices for Chiropractic Care for Older Adults: A Systematic Review and Consensus Update

“…The numbers of articles resulting from the literature search for effectiveness are summarized in Figure 2. We evaluated 6 articles for quality; 3 were RCTs, [23][24][25] 2 were cohort studies, 26,27 and 1 was a systematic review, 28 as outlined in Table 1.…”

“…A high-quality RCT found that, although spinal manipulation did not result in greater reduction in pain than sham, disability was slightly more improved at 12 weeks. 23 One low-quality 24 and 1 medium-quality RCT 25 found improvements in pain among older adults receiving manipulation. Two high-quality cohort studies found that, although Medicare users of chiropractic care had a slightly increased risk for declines in lower body function and self-rated health, chiropractic use was protective against 1-year decline in all outcomes, and users were satisfied with their care.…”

“…32,33 Furthermore, there is emerging evidence indicating older patients receiving chiropractic care (particularly mobilizations and manipulative procedures of the spine and peripheral joints) experience a variety of positive clinical outcomes and a high level of satisfaction with their care. 23,25,27 In the absence of conclusive evidence it is imperative that the clinician use a patient-centered approach that combines clinical experience and patient preference for a time-limited, outcome-based therapeutic trial of chiropractic care.…”