SynthesisChiropractic & manual therapies2022
Mixed methods systematic review of the literature base exploring working alliance in the chiropractic profession.
Synthesis in Chiropractic & manual therapies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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.
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.
Who cites it
9 citing papers in PubMed.
- Supported biopsychosocial self-management for back-related leg pain: a randomized feasibility study integrating a whole person perspective.Chiropractic & manual therapies · 2025Trial
- Between a rock and a hard place: balancing roles of clinician and co-researcher in a primary health care setting - A qualitative study.Chiropractic & manual therapies · 2026Article
- Traditional, Complementary, and Alternative Medicine for Self-Care in Chronic Neck and Shoulder Pain: A Scoping Review.Nursing reports (Pavia, Italy) · 2026Review
- An explanatory mixed methods study assessing Canadian chiropractors' attitudes and orientation toward patient-centred care.Chiropractic & manual therapies · 2025Article
- Integrated manual therapies: IASP taskforce viewpoint.Pain reports · 2024Article
- A new role for spinal manual therapy and for chiropractic? Part II: strengths and opportunities.Chiropractic & manual therapies · 2024Article
- The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic.Chiropractic & manual therapies · 2024Article
- A descriptive analysis of the contents of Care Response, an international data set of patient-reported outcomes for chiropractic patients.Chiropractic & manual therapies · 2023Article
- A new paradigm for musculoskeletal pain care: moving beyond structural impairments. Conclusion of a chiropractic and manual therapies thematic series.Chiropractic & manual therapies · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe construct of working alliance has been used to operationalise the patient-clinician relationship. Research evidence from the rehabilitation literature has established an association between the construct and several patient outcomes. The aim of this systematic literature review was to study working alliance in the chiropractic discipline.
methodThis review followed a mixed method systematic review methodology: EBSCO (The Allied and Complementary Medicine Database), EBSCO (MEDLINE), EBSCO PsycINFO, Web of Science Core Collection, Chiro index, and grey literature were searched for quantitative, qualitative, and mixed methods studies on 17th March 2021. Qualitative appraisal was conducted using the Mixed Methods Appraisal Tool, version 2018. The qualitative component was synthesised via thematic synthesis and explored patients' and chiropractors' perceptions of the nature and role of working alliance. The quantitative component was synthesised via narrative synthesis to examine how the construct has been measured in research and what its effect on clinical outcomes and patient satisfaction is. The findings were integrated in the discussion section.
resultsThirty studies were included. The qualitative component found that both patients and chiropractors consider working alliance as a key factor in the treatment journey. The findings illustrated that the construct includes the bond between a patient and a chiropractor which is underpinned by trust and attentiveness to patients' needs, values and preferences. Qualitative data also suggested that strong working alliance has the potential to improve patients' adherence to treatment and that it is characterised by ongoing negotiation of expectations about the goals of care and the tasks involved in the treatment plan. The quantitative component highlighted that even though working alliance is relevant to the chiropractic discipline, very few studies have quantitatively measured the construct and its effect.
conclusionThe findings of this review emphasise the subjective importance of working alliance in the chiropractic clinical encounter. However, there were not enough homogenous studies measuring the effect of working alliance on clinical outcomes and patient satisfaction to conduct a meta-analysis. Future research should focus on evaluating potential direct and mediated effects on patient outcomes.
Indexed as
Identifiers
What Socratic holds
Registered trials
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 Socratic graph.