title: Chiropractic treatment of hand and wrist pain in older people: systematic protocol development Part 2: cohort natural-history treatment trial.
abstract: 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.
authors.affiliation: Associate Professor, Basic Sciences Department, Northwestern Health Sciences University, Bloomington, MN 55431-1599.
authors.forename: James R
authors.initials: JR
authors.lastname: Hulbert
authors.forename: Paul
authors.initials: P
authors.lastname: Osterbauer
authors.forename: P Thomas
authors.initials: PT
authors.lastname: Davis
authors.forename: Richard
authors.initials: R
authors.lastname: Printon
authors.forename: Casey
authors.initials: C
authors.lastname: Goessl
authors.forename: Noah
authors.initials: N
authors.lastname: Strom
references.citation: Ann Intern Med. 2001 Sep 4;135(5):344-51
references.pmid: 11529698
references.citation: JAMA. 1989 Aug 18;262(7):925-30
references.pmid: 2754793
references.citation: Phys Ther. 1998 Feb;78(2):160-9
references.pmid: 9474108
references.citation: Cochrane Database Syst Rev. 2003;(1):CD003219
references.pmid: 12535461
references.citation: JAMA. 1999 Jul 14;282(2):153-8
references.pmid: 10411196
references.citation: J Chiropr Med. 2005 Autumn;4(3):144-51
references.pmid: 19674656
references.citation: N Engl J Med. 1993 Jan 28;328(4):246-52
references.pmid: 8418405
references.citation: JAMA. 1998 Nov 11;280(18):1569-75
references.pmid: 9820257
references.citation: Med Care. 1988 Jul;26(7):724-35
references.pmid: 3393032
references.citation: J Bone Joint Surg Am. 1993 Nov;75(11):1585-92
references.pmid: 8245050
references.citation: J Hand Surg Am. 1984 Mar;9(2):222-6
references.pmid: 6715829
references.citation: Ann Intern Med. 2001 Aug 21;135(4):262-8
references.pmid: 11511141
references.citation: J Hand Surg Am. 1994 Jul;19(4):531-8
references.pmid: 7963303
references.citation: Neurology. 1993 Nov;43(11):2404-5
references.pmid: 8110238
references.citation: Arch Phys Med Rehabil. 1985 Feb;66(2):69-74
references.pmid: 3970660
references.citation: Ann Emerg Med. 1990 Dec;19(12):1418-21
references.pmid: 2240755
references.citation: J Manipulative Physiol Ther. 1998 Jun;21(5):317-26
references.pmid: 9627862