Trial reportChiropractic & manual therapies2026
Mediators of the effect of chiropractic care on 12- and 52-week outcomes for U.S. active-duty military personnel with low back pain: secondary analysis of a clinical trial.
Trial report in Chiropractic & manual therapies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01692275 (Assessment of Chiropractic Treatment for Low Back Pain and Smoking Cessation in Military Active Duty Personnel), which is not on this map. Not yet cited in PubMed.
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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
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Assessment of Chiropractic Treatment for Low Back Pain and Smoking Cessation in Military Active Duty Personnel
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Authors and funding
6 authors.
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Abstract
backgroundThe aim of this secondary analysis is to examine pain and non-pain factors as mediators of the effect of chiropractic care on 12- and 52-week outcomes from a clinical trial subsample of U.S. active-duty military personnel.
methodsBeginning in November 2014, the final 154 participants enrolled in a clinical trial, were asked to provide outcome data for 52 weeks. Data collection concluded in February 2016. We used natural effect models to evaluate 6-week change in the Roland-Morris Disability Questionnaire (RMDQ) and Numerical Pain Rating Scale (NPRS) as mediators of the effect of chiropractic care on 12- and 52-week outcomes of fatigue, sleep disturbance, and social role. We also evaluated non-pain factors as mediators of the effect of chiropractic care on pain outcomes. Models were adjusted by trial allocation minimization variables and by baseline values of the mediators and outcomes and results are reported as between-group differences on the outcome scales with 95% confidence intervals.
resultsOne hundred forty-four participants were included in the analysis. Participants had an approximate mean age of 33 years, were 78% male, and 63% white race. Except for NPRS, which demonstrated negligible difference at 52 weeks, total effects favored the group receiving chiropractic care. At 52-weeks the indirect effects through RMDQ were fatigue: 0.64 (95%CI −0.14 to 1.60), sleep: 0.82 (0.15 to 1.64), and social: 0.75 (0.12 to 1.65), mediating 44%, 17%, and 33% of the total effects. Indirect effects through non-pain factors on 52-week RMDQ were fatigue: 0.23 (−0.39 to 0.74), sleep: 0.20 (−0.32 to 0.80), and social: 0.38 (−0.06 to 0.94), mediating 12%, 10%, and 19% of the total effects.
conclusionsImprovement in pain intensity and pain-related disability during chiropractic care were drivers of 12- and 52-week sleep disturbance and social role outcomes for U.S. active-duty military. Mediation by fatigue, sleep disturbance, and social role of longer-term pain outcomes was small to negligible. A larger sample size and study of differing patient populations is needed to better understand how to tailor chiropractic care to target specific intermediates and achieve better patient outcomes.
trial registrationThe trial was prospectively registered on clinicaltrials.gov (NCT01692275).
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