Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial

• Published in: The journal of alternative and complementary medicine (New York, N.Y.) Vol. 26; no. 7; p. 592
• Main Authors: Vining, Robert, Long, Cynthia R, Minkalis, Amy, Gudavalli, M Ram, Xia, Ting, Walter, Joan, Coulter, Ian, Goertz, Christine M
• Format: Journal Article
• Language: English
• Published: United States 01.07.2020
• Subjects: Adolescent; Adult; Chiropractic - methods; Complementary Therapies - methods; Disabled Persons - psychology; Fear; Female; Humans; Low Back Pain - complications; Low Back Pain - psychology; Low Back Pain - therapy; Male; Manipulation, Chiropractic; Manipulation, Spinal; Military Deployment; Military Health; Military Personnel - psychology; Mind-Body Therapies; Muscle Strength; Pain Management; Patient Education as Topic; Physical Endurance; Postural Balance; Treatment Outcome; United States; Young Adult; United States; muscle strength; physical endurance; postural balance; spinal manipulation; low back pain; chiropractic
• ISSN: 1557-7708
• DOI: 10.1089/acm.2020.0107

To investigate whether chiropractic care influences strength, balance, and/or endurance in active-duty United States military personnel with low back pain (LBP). This study employed a prospective randomized controlled trial using a pragmatic treatment approach. Participants were randomly allocated to 4 weeks of chiropractic care or to a wait-list control. Chiropractic care consisted of spinal manipulation, education, advice, and reassurance. Naval Air Technical Training Center branch clinic at the Naval Hospital Pensacola Florida. One hundred ten active-duty military personnel 18-40 years of age with self-reported LBP. Isometric pulling strength from a semisquat position was the primary outcome. Secondary outcomes were single-leg balance with eyes open and eyes closed, and trunk muscle endurance using the Biering-Sorensen test. Patient-reported outcomes such as pain severity and disability were also measured. Outcomes were measured at baseline and 4 weeks. Linear mixed-effects regression models over baseline and 4 weeks were used for analysis. Participants had mean age of 30 years (18-40), 17% were female, 33% were non-white, and 86% reported chronic LBP. Mean maximum pulling strength in the chiropractic group increased by 5.08 kgs and decreased by 7.43 kgs in the wait-list group, with a statistically significant difference in mean change between groups (  = 0.003). Statistically significant differences in mean change between groups were also observed in trunk muscle endurance (13.9 sec,  = 0.002) and balance with eyes closed (0.47 sec,  = 0.01), but not in balance with eyes open (1.19 sec,  = 0.43). Differences in mean change between groups were statistically significant in favor of chiropractic for LBP-related disability, pain intensity and interference, and fear-avoidance behavior. Active-duty military personnel receiving chiropractic care exhibited improved strength and endurance, as well as reduced LBP intensity and disability, compared with a wait-list control.