Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain, and dizziness in older adults.
OBJECTIVE
The purpose of this study was to collect preliminary information on the effect of a limited and extended course of chiropractic care on balance, chronic pain, and associated dizziness in a sample of older adults with impaired balance.


METHODS
The authors conducted a randomized pilot study targeting a sample size of 30, comparing 2 schedules of chiropractic care to a no-treatment group. Group 1 (limited schedule) was treated for 8 weeks, group 2 (extended schedule) was treated for 8 weeks and then once per month for 10 months, and group 3 received no treatment. Assessments were made at baseline and 1, 2, 6, and 12 months later. The primary outcome was changed in the Berg Balance Scale (BBS) from baseline to 1 year. Changes in the Pain Disability Index and Dizziness Handicap Index were also measured.


RESULTS
Thirty-four patients were enrolled, 13 in group 1, 15 in group 2, and 6 in group 3. Only 5 had baseline BBS scores less than 45, indicating increased risk for falls. There were no treatment-related adverse events. Nine patients dropped out by 1 year. No significant differences within or between groups in median BBS from baseline to 12 months were observed. Median Pain Disability Index scores improved more from baseline to 1 year in group 2 compared with groups 1 and 3 (P = .06, Kruskal-Wallis test). For the 9 patients with dizziness, a clinically significant improvement in Dizziness Handicap Index scores of groups 1 and 2 was observed at 1 month and remained lower than baseline thereafter; this was not true of group 3.


CONCLUSIONS
Further investigation of the possible benefit of chiropractic maintenance care (extended schedule) for balance and pain-related disability is feasible and warranted, as well as both limited and extended schedules for patients with idiopathic dizziness.
Hawk
Cheryl
C
Cleveland Chiropractic College, Kansas City, Mo, USA. cheryl.hawk@cleveland.edu
Cambron
Jerrilyn A
JA
Pfefer
Mark T
MT
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002684:Chiropractic / Q000379:methods*; D002908:Chronic Disease; D004244:Dizziness / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D010146:Pain / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D010147:Pain Measurement; D010353:Patient Education as Topic; D010865:Pilot Projects; D004856:Postural Balance; D040242:Risk Reduction Behavior; D012678:Sensation Disorders / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome