title: Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain, and dizziness in older adults.
abstract: 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.
authors.affiliation: Cleveland Chiropractic College, Kansas City, Mo, USA. cheryl.hawk@cleveland.edu
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hawk
authors.forename: Jerrilyn A
authors.initials: JA
authors.lastname: Cambron
authors.forename: Mark T
authors.initials: MT
authors.lastname: Pfefer
mesh_terms: 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