Evidence map›Paper›PMID 39352877›Full record

Trial reportPloS one2024

Effect of chiropractic care on low back pain for active-duty military members: Mediation through biopsychosocial factors.

Zacariah K Shannon, Cynthia R Long, Elizabeth A Chrischilles, Christine M Goertz, Robert B Wallace, Carri Casteel, Ryan M Carnahan

Abstract readMulticenter StudyPragmatic Clinical Trial
In one paragraph

Trial report in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Zacariah K ShannonPalmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, United States of America.ORCID 0000-0003-3751-5465
Cynthia R LongPalmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, United States of America.
Elizabeth A ChrischillesDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States of America.
Christine M GoertzDepartment of Orthopaedic Surgery, Duke University, Durham, North Carolina, United States of America.
Robert B WallaceDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States of America.
Carri CasteelDepartment of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, United States of America.
Ryan M CarnahanDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States of America.ORCID 0000-0002-7478-4739

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study evaluates biopsychosocial factors as mediators of the effect of chiropractic care on low back pain (LBP) intensity and interference for active-duty military members. Data from a multi-site, pragmatic clinical trial comparing six weeks of chiropractic care plus usual medical care to usual medical care alone for 750 US active-duty military members with LBP were analyzed using natural-effect, multiple-mediator modeling. Mediation of the adjusted mean effect difference on 12-week outcomes of PROMIS-29 pain interference and intensity by 6-week mediators of other PROMIS-29 physical, mental, and social health subdomains was evaluated. The effect difference on pain interference occurring through PROMIS-29 biopsychosocial factors (natural indirect effect = -1.59, 95% CI = -2.28 to -0.88) was 56% (95% CI = 35 to 96) of the total effect (-2.82, 95% CI = -3.98 to -1.53). The difference in effect on pain intensity occurring through biopsychosocial factors was smaller (natural indirect effect = -0.32, 95% CI = -0.50 to -0.18), equaling 26% (95% CI = 15 to 42) of the total effect (-1.23, 95% CI = -1.52 to -0.88). When considered individually, all physical, mental, and social health factors appeared to mediate the effect difference on pain interference and pain intensity with mental health factors having smaller effect estimates. In contrast with effects on pain interference, much of the effect of adding chiropractic care to usual medical care for US military members on pain intensity did not appear to occur through the PROMIS-29 biopsychosocial factors. Physical and social factors appear to be important intermediate measures for patients receiving chiropractic care for low back pain in military settings. Further study is needed to determine if the effect of chiropractic care on pain intensity for active-duty military occurs through other unmeasured factors, such as patient beliefs, or if the effect occurs directly.

Indexed as

Low Back PainManipulation, ChiropracticMilitary PersonnelAdultFemaleHumansMalePain MeasurementTreatment OutcomeUnited StatesYoung Adult

Identifiers

PMID39352877
PMCPMC11444394

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.