Top

Published in:

01-12-2020 | Care | Study protocol

BAck complaints in the elders - chiropractic (BACE-C): protocol of an international cohort study of older adults with low back pain seeking chiropractic care

Authors: Alan D. Jenks, Trynke Hoekstra, Iben Axén, Katie de Luca, Jonathan Field, Dave Newell, Jan Hartvigsen, Simon D. French, Bart Koes, Maurits W. van Tulder, Sidney M. Rubinstein

Published in: Chiropractic & Manual Therapies | Issue 1/2020

Abstract

Background

Low back pain is a common condition among older adults that significantly influences physical function and participation. Compared to their younger counterparts, there is limited information available about the clinical course of low back pain in older people, in particularly those presenting for chiropractic care. Improving our understanding of this patient population and the course of their low back pain may provide input for studies researching safer and more effective care than is currently provided.

Objectives

The primary objectives are to examine the clinical course over one year of pain intensity, healthcare costs and pain, functional status and recovery rates of low back pain in people 55 years and older who visit a chiropractor for a new episode of low back pain.

Methods

An international prospective, multi-center cohort study with one-year follow-up. Chiropractic practices are to be recruited in the Netherlands, Sweden, United Kingdom and Australia. Treatment will be left to the discretion of the chiropractor. Inclusion/Exclusion criteria: Patients aged 55 and older who consult a chiropractor for a new episode of low back pain, meaning low back pain for the first time or those patients who have not been to a chiropractor in the previous six months. This is independent of whether they have seen another type of health care provider for the current episode. Patients who are unable to complete the web-based questionnaires because of language restrictions or those with computer literacy restrictions will be excluded as well as those with cognitive disorders. In addition, those with a suspected tumor, fracture, infection or any other potential red flag or condition considered to be a contraindication for chiropractic care will be excluded. Data will be collected using online questionnaires at baseline, and at 2 and 6 weeks and at 3, 6, 9 and 12 months.

Discussion

This study, to our knowledge, is the first large-scale, prospective, multicenter, international cohort study to be conducted in a chiropractic setting to focus on older adults with low back pain consulting a chiropractor. By understanding the clinical course, satisfaction and safety of chiropractic treatment of this common debilitating condition in the aged population, this study will provide input for informing future clinical trials.

Trial registration

Nederlandse Trial Registrar NL7507.

Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(6):968–74.CrossRef

Buchbinder R, van Tulder M, Öberg B, Costa LM, Woolf A, Schoene M, et al. Low back pain: a call for action. The Lancet. 2018;391.

Cedraschi C, Luthy C, Allaz A-F, Herrmann F, Ludwig C. The impact of low back pain on health-related quality of life in seniors living in the community. Eur spine journal Conf Annu Congr EUROSPINE 2017 Irel [Internet]. 2017;26(2 Supplement 1):S305. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/767/CN-01421767/frame.html.

Hartvigsen J, Frederiksen H, Christensen K. Back and neck pain in seniors - prevalence and impact. Eur Spine J. 2006;15(6):802–6.CrossRef

Manogharan S, Kongsted A, Ferreira ML, Hancock MJ. Do older adults with chronic low back pain differ from younger adults in regards to baseline characteristics and prognosis? Eur J Pain (United Kingdom). 2017;21(5):866–73.

Walker BF, Muller R, Grant WD. Low back pain in Australian adults. Health provider utilization and care seeking. J Manip Physiol Ther. 2004;27(5):327–35.CrossRef

Williams JS, Ng N, Peltzer K, Yawson A, Biritwum R, Maximova T, et al. Risk factors and disability associated with low back pain in older adults in low- and middle-income countries. Results from the WHO study on global AGEing and adult health (SAGE). PLoS One. 2015;10(6):1–21.CrossRef

Rudy TE, Weiner DK, Lieber SJ, Slaboda J, Boston JR. The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain. 2007;131(3):293–301.CrossRef

Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67.CrossRef

10.

Beliveau PJH, Wong JJ, Sutton DA, Ben SN, Bussières AE, Mior SA, et al. the chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Ther. 2017;25(1):1–17.CrossRef

11.

de Luca KE, Fang SH, Ong J, Shin KS, Woods S, Tuchin PJ. The effectiveness and safety of manual therapy on pain and disability in older persons with chronic low Back pain: a systematic review. J manipulative Physiol Ther [internet]. 2017;40(7):527–34. Available from. https://doi.org/10.1016/j.jmpt.2017.06.008.

12.

Moore C, Swain M, Luca K De, Hartvigsen J, Wong AYL. Characteristics of chiropractors who manage people aged 65 and older : A nationally representative sample of 1903 chiropractors. Australas J Ageing. 2019;38:249–257. https://doi.org/10.1111/ajag.12652.

13.

Weigel P, Hockenberry JM, Bentler SE, Obrizan M, Kaskie B, Jones MP, et al. A longitudinal study of chiropractic use among older adults in the United States. Chiropr Osteopat [Internet]. 2010;18(1):34. Available from: http://chiromt.biomedcentral.com/articles/10.1186/1746-1340-18-34.

14.

Weigel PAM, Hockenberry JM, Wolinsky FD. Chiropractic use in the medicare population: prevalence, patterns, and associations with 1-year changes in health and satisfaction with care. J Manip Physiol Ther. 2014;37(8):542–51.CrossRef

15.

Goertz CM, Salsbury SA, Vining RD, Long CR, Andresen AA, Jones ME, et al. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial. Trials [Internet]. 2013;14(1):1–18 Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-84872196848&partnerID=40&md5=cd0b06c1cf5da88d346f6c99fa6cbf30.CrossRef

16.

Scheele J, Luijsterburg PA, Ferreira ML, Maher CG, Pereira L, Peul WC, et al. Back complaints in the elders (BACE); design of cohort studies in primary care: an international consortium. BMC Musculoskelet Disord [internet]. 2011;12:193. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21854620.

17.

Carvalho FA, Morelhão PK, Franco MR, Maher CG, Smeets RJEM, Oliveira CB, et al. Reliability and validity of two multidimensional self-reported physical activity questionnaires in people with chronic low back pain. Musculoskelet Sci Pract. 2017;27:65–70.CrossRef

18.

Weitkunat R, Coggins CRE, Sponsiello-Wang Z, Kallischnigg G, Dempsey R. Assessment of cigarette smoking in epidemiologic studies. Beitrage zur Tab Int Contrib to Tob Res. 2013;25(7):638–48.

19.

Frank D, DeBenedetti AF, Volk RJ, Williams EC, Kivlahan DR, Bradley KA. Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups. J Gen Intern Med. 2008;23(6):781–7.CrossRef

20.

Buysse DJ, Charles F, Reynolds III, Monk T, Berman S, Kupfer D. The Pittsburgh Sleep Quality Index: A new Instrument for Psychiatric Practic and Research. Psychiatry Res [Internet]. 1988;(28):193–213. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3023245/%0Ahttp://dx.doi.org/10.1016/S0735-1097(01)01746-6%0Ahttp://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed%7B&%7Did=2748771%7B&%7Dretmode=ref%7B&%7Dcmd=prlinks%0Ahttp://dx.doi.org/10.1016.

21.

Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The self-administered comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003;49(2):156–63.CrossRef

22.

Jasper D. Bier, Raymond W.J.G. Ostelo, Miranda L. van Hooff, Bart W. Koes APV. Validity and Reproducibility of the STarT Back Tool (Dutch Version) in Patients With Low Back Pain in Primary Care Settings. 2017;97(5):561–570. https://doi.org/10.1093/ptj/pzx023.

23.

Greenspan SL, Bouxsein ML, Melton ME, Kolodny AH, Clair JH, Delucca PT, et al. precision and discriminatory ability of calcaneal bone assessment technologies. J bone miner res [internet]. 1997;12(8):1303–1313. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9258762.

24.

Mangen MJJ, Bolkenbaas M, Huijts SM, van Werkhoven CH, Bonten MJM, de Wit GA. Quality of life in community-dwelling Dutch elderly measured by EQ-5D-3L. Health Qual Life Outcomes [Internet] 2017;15(1):1–6. Available from: https://doi.org/10.1186/s12955-016-0577-5.

25.

Whynes DK, McCahon RA, Ravenscroft A, Hodgkinson V, Evley R, Hardman JG. Responsiveness of the EQ-5D health-related quality-of-life instrument in assessing low back pain. Value Heal [Internet]. 2013;16(1):124–132. Available from: https://doi.org/10.1016/j.jval.2012.09.003.

26.

Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc [Internet]. 1991;39(2):142–8 Available from: http://doi.wiley.com/10.1111/j.1532-5415.1991.tb01616.x.CrossRef

27.

Dobson F. Timed Up and Go test in musculoskeletal conditions. J Physiother [Internet]. 2015;61(1):47. Available from: https://doi.org/10.1016/j.jphys.2014.11.003.

28.

Von Korff M, Jensen MP, Karoly P. Assessing global pain severity by self-report in clinical and health services research. Spine (Phila Pa 1976). 2000;25(24):3140–51.CrossRef

29.

Chiarotto A, Boers M, Deyo RA, Buchbinder R, Corbin TP, Costa LOP, et al. Core outcome measurement instruments for clinical trials in nonspecific low back pain. Pain [Internet]. 2018;159(3):1. Available from: http://insights.ovid.com/crossref?an=00006396-900000000-99091.

30.

Luijsterburg PA, Verhagen AP, Ostelo RW, van den Hoogen HJ, Peul WC, Avezaat CJ, et al. Conservative treatment in patients with an acute lumbosacral radicular syndrome: design of a randomised clinical trial [ISRCTN68857256]. BMC Musculoskelet Disord [Internet]. 2004;5(1):39. Available from: http://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-5-39.

31.

Bouwmans C, Krol M, Severens H, Koopmanschap M, Brouwer W, Roijen LH Van. The iMTA productivity cost questionnaire: a standardized instrument for measuring and valuing health-related productivity losses. Value Heal [Internet] 2015;18(6):753–758. Available from: https://doi.org/10.1016/j.jval.2015.05.009.

32.

Kanters TA, Bouwmans CAM, Van Der Linden N, Tan SS, Hakkaart-van RL. Update of the Dutch manual for costing studies in health care. PLoS One. 2017;12(11):1–11.CrossRef

33.

Twisk JWR. Applied mixed model analysis [internet]. Cambridge University Press; 2019. Available from: https://www.cambridge.org/core/product/identifier/9781108635660/type/book.

Title: BAck complaints in the elders - chiropractic (BACE-C): protocol of an international cohort study of older adults with low back pain seeking chiropractic care
Authors: Alan D. Jenks
Trynke Hoekstra
Iben Axén
Katie de Luca
Jonathan Field
Dave Newell
Jan Hartvigsen
Simon D. French
Bart Koes
Maurits W. van Tulder
Sidney M. Rubinstein
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Care
Back Pain
Back Pain
Back Pain
Published in: Chiropractic & Manual Therapies / Issue 1/2020
Electronic ISSN: 2045-709X
DOI: https://doi.org/10.1186/s12998-020-00302-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

BAck complaints in the elders - chiropractic (BACE-C): protocol of an international cohort study of older adults with low back pain seeking chiropractic care

Abstract

Background

Objectives

Methods

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objectives

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2020

Words matter: the prevalence of chiropractic-specific terminology on Australian chiropractors’ websites

More published full-time researchers, early career researchers, clinician-researchers and graduate students unite to call for actions against the pseudoscientific claim that chiropractic care boosts immunity

Determinants of health, health behaviours and demographic profile of patients attending an Australian university student-led osteopathy clinic

Controlled manual loading of body tissues: towards the next generation of pressure algometer

The bench-top accuracy of the VerteTrack spinal stiffness assessment device

The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary