The use of validated outcome measures in the chiropractic care of pregnant patients: A systematic review of the literature

Alcantara, Joel; Alcantara, Junjoe

doi:10.1016/j.ctcp.2015.01.003

Cited by 7 publications

(3 citation statements)

References 30 publications

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“…Their analysis of the existing measurement scales revealed important validity, reliability, and psychometric inadequacies making their use in comparative effectiveness research challenging. Specific to pregnancy care under chiropractic, Alcantara et al 38 published their findings on the systematic review of the literature on the use of validated outcome measures for the care of pregnant patients. The authors found in eight articles the use of the PGIC, the pain NRS, the Oswestry, Bournemouth, Fear Avoidance Belief and QDQ questionnaires, PROMIS-29, and the Measure Yourself Medical Outcome Profile.…”

Section: Discussionmentioning

confidence: 99%

“…The use of PROMIS-29 involved a limited sample size involving a case series of six patients. 39 Although the review found some measure of effectiveness in the chiropractic care of pregnant patients, Alcantara et al 38 concluded that given the heterogeneity and inconsistency of use of these outcome measures, cause and effect inferences for true measures of effectiveness in chiropractic pregnancy care were severely limited. Others have made similar conclusions on the use of validated outcome measures on chiropractic patients in general.…”

Section: Discussionmentioning

confidence: 99%

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The Use of the Patient Reported Outcomes Measurement Information System and the RAND VSQ9 to Measure the Quality of Life and Visit-Specific Satisfaction of Pregnant Patients Under Chiropractic Care Utilizing the Webster Technique

Alcantara¹,

Nazarenko

Ohm³

et al. 2018

The Journal of Alternative and Complementary Medicine

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Objective: To quantify the quality of life (QoL) and visit-specific satisfaction of pregnant women.Design: A prospective cohort within a practice-based research network (PBRN).Setting/Locations: Individual chiropractic offices.Subjects: Pregnant women (age ≥18 years) attending chiropractic care.Intervention(s): Chiropractic care (i.e., The Webster Technique, spinal adjustments, and adjunctive therapies).Main outcome measures: The RAND VSQ9 to measure visit-specific satisfaction and the Patient Reported Outcomes Measurement Information System (PROMIS®)-29 to measure QoL.Results: A convenience sample of 343 pregnant patients (average age = 30.96 years) comprised their study population. They were highly educated with 75% attaining a 2-year associate's degree or higher. The pregnant patients presented for chiropractic care with a mean week of gestation of 25.67 weeks (median = 28 weeks; range = 0–42 weeks) and parity (i.e., the number of live births) of 0.92 live births (median = 1; range = 0–6). From baseline (i.e., at study entrance with minimum first visit) and comparative (i.e., following a course of chiropractic care), the VSQ9 measurements revealed increasingly high satisfaction on the part of the subjects (i.e., the mean difference of baseline minus comparative measures = −0.7322; p < 0.005). The median number of visits (i.e., visits attended) at baseline and comparative measures was 1.00 (standard deviation [SD] = 22.69) and 3.30 (SD = 22.71), respectively. Across outcomes, QoL improved from baseline to comparative measurement after holding constant for visit number and time lapse, trimester of pregnancy, and care provider type. There was a reduction in mean T scores associated with fatigue (p < 0.05), pain interference (p < 0.05), sleep disturbance (p < 0.05), and an improvement in satisfaction with social roles (p < 0.05). A significant decrease was also found with pain interference (p < 0.05). No evidence was found that anxiety (p = 0.1404) or depression (p = 0.8785) changed.Conclusion: A PBRN study was successfully implemented among chiropractors to find pregnant patients highly satisfied and their QoL scores improving with care beyond chance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Use of the Patient Reported Outcomes Measurement Information System and the RAND VSQ9 to Measure the Quality of Life and Visit-Specific Satisfaction of Pregnant Patients Under Chiropractic Care Utilizing the Webster Technique

Alcantara¹,

Nazarenko

Ohm³

et al. 2018

The Journal of Alternative and Complementary Medicine

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“…There are more 100 published clinical trials in scientific journals to support this claim, as well as the public perception that doctors of chiropractic do, in fact, know more than a little about the spine and spinal health 72, 73, 91, 92, 93, 94, 95…”

Section: Introductionmentioning

confidence: 99%

Chiropractic Identity: A Neurological, Professional, and Political Assessment

Rosner¹

2016

Journal of Chiropractic Humanities

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ObjectiveThe purpose of this article is to propose a focused assessment of the identity of chiropractic and its profession, triangulating multiple viewpoints converging upon various aspects and definitions of neurology, manual medicine, and alternative or mainstream medicine.DiscussionOver 120 years since its inception, chiropractic has struggled to achieve an identity for which its foundations could provide optimal health care. Despite recognition of the benefits of spinal manipulation in various government guidelines, advances in US military and Veterans Administration, and persistently high levels of patient satisfaction, the chiropractic profession remains underrepresented in most discussions of health care delivery. Distinguishing characteristics of doctors of chiropractic include the following: (1) they embrace a model of holistic, preventive medicine (wellness); (2) they embrace a concept of neurological imbalance in which form follows function, disease follows disturbed biochemistry, and phenomenology follows physiology; (3) they diagnose, and their institutions of training are accredited by a body recognized by the US Department of Education; (4) they manage patients on a first-contact basis, often as primary care providers in geographical areas that are underserved; (5) the spine is their primary—but not exclusive—area of interaction; (6) they deliver high-velocity, low-amplitude adjustments with a superior safety record compared with other professions; and (7) they use a network of institutions worldwide that have shown increasing commitments to research.ConclusionThis article provides an overview of chiropractic identity from 6 points of view: (1) concepts of manual medicine; (2) areas of interest beyond the spine; (3) concepts of the chiropractic subluxation; (4) concepts of neurology; (5) concepts of mainstream or alternative health care; and (6) concepts of primary care, first-contact provider, or specialist.

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