2. Nordic DCs' recommendations for maintenance care as a preventive strategy

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Authors: Linda Zange and DC
Date: July-August 2013
Publisher: American Chiropractic Association Inc.
Document Type: Brief article; Report
Length: 266 words
Lexile Measure: 880L

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Abstract :

Background: Low-back pain (LBP) is a prevalent condition and has been found to be recurrent and persistent in a majority of cases. Chiropractors have a preventive strategy, maintenance care (MC), aimed toward minimizing recurrence and progression of such conditions. The indications for recommending MC have been identified in the Nordic countries from hypothetical cases. This study aims to investigate whether these indications are indeed used in the clinical encounter. Methods: Data were collected in a multicenter observational study in which patients consulted a chiropractor for their nonspecific LBP. Patient baseline information was a) previous duration of the LBP, b) the presence of previous episodes of LBP, and c) early improvement with treatment. The chiropractors were asked if they deemed each individual patient an MC candidate. Logistic regression analyses (uni- and multi- level) were used to investigate the association of the patient variables with the chiropractor's decision. Results: The results showed that "previous episodes" with LBP were the strongest predictor for recommending MC and that the presence of all predictors strengthens the frequency of this recommendation. However, there was considerable heterogeneity among the participating chiropractors concerning the recommendation of MC. Conclusions: The study largely confirms the clinical use of the previously identified indications for recommending MC for recurrent and persistent LBP. Previous episodes of LBP were the strongest indicator.

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Gale Document Number: GALE|A353753377