title: Assessment of chiropractic treatment for active duty, U.S. military personnel with low back pain: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of pain and function within a civilian population is spinal manipulative therapy provided by doctors of chiropractic. Chiropractic care, delivered within a multidisciplinary framework in military healthcare settings, has the potential to help improve clinical outcomes for military personnel with low back pain. However, its effectiveness in a military setting has not been well established. The primary objective of this study is to evaluate changes in pain and disability in active duty service members with low back pain who are allocated to receive usual medical care plus chiropractic care versus treatment with usual medical care alone.
  
  
  METHODS
  This pragmatic comparative effectiveness trial will enroll 750 active duty service members with low back pain at three military treatment facilities within the United States (250 from each site) who will be allocated to receive usual medical care plus chiropractic care or usual medical care alone for 6 weeks. Primary outcomes will include the numerical rating scale for pain intensity and the Roland-Morris Disability Questionnaire at week 6. Patient reported outcomes of pain, disability, bothersomeness, and back pain function will be collected at 2, 4, 6, and 12 weeks from allocation.
  
  
  CONCLUSIONS
  Because low back pain is one of the leading causes of disability among U.S. military personnel, it is important to find pragmatic and conservative treatments that will treat low back pain and preserve low back function so that military readiness is maintained. Thus, it is important to evaluate the effects of the addition of chiropractic care to usual medical care on low back pain and disability.
  
  
  BACKGROUND
  The trial discussed in this article was registered in ClinicalTrials.gov with the NCT01692275 Date of registration: 6 September 2012.
authors: Palmer College of Chiropractic, Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA, 52803, USA. christine.goertz@palmer.edu.
authors: Christine M
authors: CM
authors: Goertz
authors: Palmer College of Chiropractic, Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA, 52803, USA. long_c@palmer.edu.
authors: Cynthia R
authors: CR
authors: Long
authors: Palmer College of Chiropractic, Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA, 52803, USA. robert.vining@palmer.edu.
authors: Robert D
authors: RD
authors: Vining
authors: Research Institute, Parker University, 2540 Walnut Hill Lane, Dallas, TX, 75229, USA. kpohlman@parker.edu.
authors: Katherine A
authors: KA
authors: Pohlman
authors: Palmer College of Chiropractic, Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA, 52803, USA. bridget.kane.actstudies@gmail.com.
authors: Bridget
authors: B
authors: Kane
authors: Palmer College of Chiropractic, Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA, 52803, USA. corber_l@palmer.edu.
authors: Lance
authors: L
authors: Corber
authors: Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA, 22314, USA. jwalter@SIIB.org.
authors: Joan
authors: J
authors: Walter
authors: RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA. coulter@rand.org.
authors: Ian
authors: I
authors: Coulter
mesh_terms: D000293:Adolescent; D000328:Adult; D002985:Clinical Protocols; D003625:Data Collection; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D026882:Manipulation, Chiropractic; D008875:Middle Aged; D008889:Military Personnel; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011785:Quality Assurance, Health Care; D013223:Statistics as Topic