Chiropractic maintenance care - what’s new? A systematic review of the literature
Abstract Background Maintenance Care is a traditional chiropractic approach, whereby patients continue treatment after optimum benefit is reached. A review conducted in 1996 concluded that evidence behind this therapeutic strategy was lacking, and a second review from 2008 reached the same conclusio...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Chiropractic & Manual Therapies |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12998-019-0283-6 |
| _version_ | 1818401015445061632 |
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| author | Iben Axén Lise Hestbaek Charlotte Leboeuf-Yde |
| author_facet | Iben Axén Lise Hestbaek Charlotte Leboeuf-Yde |
| author_sort | Iben Axén |
| collection | DOAJ |
| description | Abstract Background Maintenance Care is a traditional chiropractic approach, whereby patients continue treatment after optimum benefit is reached. A review conducted in 1996 concluded that evidence behind this therapeutic strategy was lacking, and a second review from 2008 reached the same conclusion. Since then, a systematic research program in the Nordic countries was undertaken to uncover the definition, indications, prevalence of use and beliefs regarding Maintenance Care to make it possible to investigate its clinical usefulness and cost-effectiveness. As a result, an evidence-based clinical study could be performed. It was therefore timely to review the evidence. Method Using the search terms “chiropractic OR manual therapy” AND “Maintenance Care OR prevention”, PubMed and Web of Science were searched, and the titles and abstracts reviewed for eligibility, starting from 2007. In addition, a search for “The Nordic Maintenance Care Program” was conducted. Because of the diversity of topics and study designs, a systematic review with narrative reporting was undertaken. Results Fourteen original research articles were included in the review. Maintenance Care was defined as a secondary/tertiary preventive approach, recommended to patients with previous pain episodes, who respond well to chiropractic care. Maintenance Care is applied to approximately 30% of Scandinavian chiropractic patients. Both chiropractors and patients believe in the efficacy of Maintenance Care. Four studies investigating the effect of chiropractic Maintenance Care were identified, with disparate results on pain and disability of neck and back pain. However, only one of these studies utilized all the existing evidence when selecting study subjects and found that Maintenance Care patients experienced fewer days with low back pain compared to patients invited to contact their chiropractor ‘when needed’. No studies were found on the cost-effectiveness of Maintenance Care. Conclusion Knowledge of chiropractic Maintenance Care has advanced. There is reasonable consensus among chiropractors on what Maintenance Care is, how it should be used, and its indications. Presently, Maintenance Care can be considered an evidence-based method to perform secondary or tertiary prevention in patients with previous episodes of low back pain, who report a good outcome from the initial treatments. However, these results should not be interpreted as an indication for Maintenance Care on all patients, who receive chiropractic treatment. |
| first_indexed | 2024-12-14T07:45:45Z |
| format | Article |
| id | doaj.art-78c423e198a24067963e7958616dd4e1 |
| institution | Directory Open Access Journal |
| issn | 2045-709X |
| language | English |
| last_indexed | 2024-12-14T07:45:45Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Chiropractic & Manual Therapies |
| spelling | doaj.art-78c423e198a24067963e7958616dd4e12022-12-21T23:10:53ZengBMCChiropractic & Manual Therapies2045-709X2019-11-012711910.1186/s12998-019-0283-6Chiropractic maintenance care - what’s new? A systematic review of the literatureIben Axén0Lise Hestbaek1Charlotte Leboeuf-Yde2Karolinska Institutet, Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker HealthDeptartment of Sport Science and Clinical BiomechanicsInstitute for Regional Health Research, University of Southern DenmarkAbstract Background Maintenance Care is a traditional chiropractic approach, whereby patients continue treatment after optimum benefit is reached. A review conducted in 1996 concluded that evidence behind this therapeutic strategy was lacking, and a second review from 2008 reached the same conclusion. Since then, a systematic research program in the Nordic countries was undertaken to uncover the definition, indications, prevalence of use and beliefs regarding Maintenance Care to make it possible to investigate its clinical usefulness and cost-effectiveness. As a result, an evidence-based clinical study could be performed. It was therefore timely to review the evidence. Method Using the search terms “chiropractic OR manual therapy” AND “Maintenance Care OR prevention”, PubMed and Web of Science were searched, and the titles and abstracts reviewed for eligibility, starting from 2007. In addition, a search for “The Nordic Maintenance Care Program” was conducted. Because of the diversity of topics and study designs, a systematic review with narrative reporting was undertaken. Results Fourteen original research articles were included in the review. Maintenance Care was defined as a secondary/tertiary preventive approach, recommended to patients with previous pain episodes, who respond well to chiropractic care. Maintenance Care is applied to approximately 30% of Scandinavian chiropractic patients. Both chiropractors and patients believe in the efficacy of Maintenance Care. Four studies investigating the effect of chiropractic Maintenance Care were identified, with disparate results on pain and disability of neck and back pain. However, only one of these studies utilized all the existing evidence when selecting study subjects and found that Maintenance Care patients experienced fewer days with low back pain compared to patients invited to contact their chiropractor ‘when needed’. No studies were found on the cost-effectiveness of Maintenance Care. Conclusion Knowledge of chiropractic Maintenance Care has advanced. There is reasonable consensus among chiropractors on what Maintenance Care is, how it should be used, and its indications. Presently, Maintenance Care can be considered an evidence-based method to perform secondary or tertiary prevention in patients with previous episodes of low back pain, who report a good outcome from the initial treatments. However, these results should not be interpreted as an indication for Maintenance Care on all patients, who receive chiropractic treatment.http://link.springer.com/article/10.1186/s12998-019-0283-6Maintenance carePreventionChiropracticPainDisease managementSystematic review |
| spellingShingle | Iben Axén Lise Hestbaek Charlotte Leboeuf-Yde Chiropractic maintenance care - what’s new? A systematic review of the literature Chiropractic & Manual Therapies Maintenance care Prevention Chiropractic Pain Disease management Systematic review |
| title | Chiropractic maintenance care - what’s new? A systematic review of the literature |
| title_full | Chiropractic maintenance care - what’s new? A systematic review of the literature |
| title_fullStr | Chiropractic maintenance care - what’s new? A systematic review of the literature |
| title_full_unstemmed | Chiropractic maintenance care - what’s new? A systematic review of the literature |
| title_short | Chiropractic maintenance care - what’s new? A systematic review of the literature |
| title_sort | chiropractic maintenance care what s new a systematic review of the literature |
| topic | Maintenance care Prevention Chiropractic Pain Disease management Systematic review |
| url | http://link.springer.com/article/10.1186/s12998-019-0283-6 |
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