Chiropractic treatment of hand and wrist pain in older people: systematic protocol development Part 2: cohort natural-history treatment trial.
OBJECTIVE
This study examines (a) the feasibility of continued research with an older population; (b) the variety of hand-wrist conditions presented by older patients; (c) the accommodations to standard chiropractic treatment for older patients; and (d) the validity, reliability, responsiveness of measures, and preliminary estimates of outcome of treatment for general hand-wrist pain.


METHODS
A cohort of 55 volunteers, first evaluated over a 5-week natural-history baseline period, was offered 5-week chiropractic treatment and then interviewed at 6 months posttreatment. Descriptive and preliminary inferential analyses are reported. Start values for power analysis are offered.


RESULTS
The project recruited a sample of 55 and retained 47 (85%) participants over 8 months, indicating feasibility of a larger project. Participants provided strong self-reported, albeit preliminary, evidence of benefit. Mean values and SDs of pain and strength measures are provided for future power calculations.


CONCLUSIONS
Clinical research with older participants presenting with hand-wrist pain and dysfunction is feasible. Validity, reliability, and responsiveness of self-reports are demonstrated. The research presents preliminary evidence of the benefit of chiropractic treatment for older patients presenting with hand-wrist symptoms.
Hulbert
James R
JR
Associate Professor, Basic Sciences Department, Northwestern Health Sciences University, Bloomington, MN 55431-1599.
Osterbauer
Paul
P
Davis
P Thomas
PT
Printon
Richard
R
Goessl
Casey
C
Strom
Noah
N
Ann Intern Med. 2001 Sep 4;135(5):344-51
11529698
JAMA. 1989 Aug 18;262(7):925-30
2754793
Phys Ther. 1998 Feb;78(2):160-9
9474108
Cochrane Database Syst Rev. 2003;(1):CD003219
12535461
JAMA. 1999 Jul 14;282(2):153-8
10411196
J Chiropr Med. 2005 Autumn;4(3):144-51
19674656
N Engl J Med. 1993 Jan 28;328(4):246-52
8418405
JAMA. 1998 Nov 11;280(18):1569-75
9820257
Med Care. 1988 Jul;26(7):724-35
3393032
J Bone Joint Surg Am. 1993 Nov;75(11):1585-92
8245050
J Hand Surg Am. 1984 Mar;9(2):222-6
6715829
Ann Intern Med. 2001 Aug 21;135(4):262-8
11511141
J Hand Surg Am. 1994 Jul;19(4):531-8
7963303
Neurology. 1993 Nov;43(11):2404-5
8110238
Arch Phys Med Rehabil. 1985 Feb;66(2):69-74
3970660
Ann Emerg Med. 1990 Dec;19(12):1418-21
2240755
J Manipulative Physiol Ther. 1998 Jun;21(5):317-26
9627862