Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study

Abstract Background Many chiropractors use spinal manipulative techniques (SMT) to treat spinal pain. A recent Delphi study posited 18 items across five domains as predictors of patients experiencing non-specific low back pain most likely to experience a strong and immediate positive response to SMT...

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Main Authors: Stanley Innes, Reece Granger, Jean Théroux
Format: Article
Language:English
Published: BMC 2023-09-01
Series:Chiropractic & Manual Therapies
Subjects:
Online Access:https://doi.org/10.1186/s12998-023-00510-3
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author Stanley Innes
Reece Granger
Jean Théroux
author_facet Stanley Innes
Reece Granger
Jean Théroux
author_sort Stanley Innes
collection DOAJ
description Abstract Background Many chiropractors use spinal manipulative techniques (SMT) to treat spinal pain. A recent Delphi study posited 18 items across five domains as predictors of patients experiencing non-specific low back pain most likely to experience a strong and immediate positive response to SMT. We sought to create a ‘pen and paper’ questionnaire that would measure these items and then pilot its use in a clinical setting to determine its ‘usability’ for a larger study. Knowing this information would inform a more efficacious use of SMT. Method Of the 18 items identified in the Delphi study, 13 were deemed historical in nature and readily provided by the chiropractor and patient. A literature search revealed reliable and valid measures for two more items. The remaining three items were generated by creating descriptive questions matched to an appropriate Likert scale. A panel of six chiropractors who had used SMT for at least 7 years when treating non-specific low back pain was formed to evaluate the items for clarity and relevance. Ten Western Australian chiropractors were then recruited to pilot the questionnaire on ten consecutive patients with non-specific low back pain where SMT was used from March to June 2020. Ethics approval was obtained from Murdoch University. Results COVID-19 restrictions impacted on practitioner recruitment and delayed the data collection. Of the intended 100 participants, only 63 could be recruited over a 3-month period from seven chiropractors. Time constraints forced the closure of the data collection. The measures of all predictor items demonstrated ceiling effects. Feedback from open-ended practitioner questions was minimal, suggesting an ease of use. Conclusion The length of time and level of participation required to collect the calculated sample size was inadequate and suggested that incentivization may be required for a larger investigation. Significant ceiling effects were found and suggested that participants did so because of a positive bias toward chiropractic care and the use of SMT. The questionnaires in this pilot study require alternative measures and further validation before use in a larger study.
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spelling doaj.art-93038d39940549f1b029b6d5914c75592023-11-26T13:50:29ZengBMCChiropractic & Manual Therapies2045-709X2023-09-013111910.1186/s12998-023-00510-3Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot studyStanley Innes0Reece Granger1Jean Théroux2School of Allied Health, Murdoch UniversitySchool of Allied Health, Murdoch UniversitySchool of Allied Health, Murdoch UniversityAbstract Background Many chiropractors use spinal manipulative techniques (SMT) to treat spinal pain. A recent Delphi study posited 18 items across five domains as predictors of patients experiencing non-specific low back pain most likely to experience a strong and immediate positive response to SMT. We sought to create a ‘pen and paper’ questionnaire that would measure these items and then pilot its use in a clinical setting to determine its ‘usability’ for a larger study. Knowing this information would inform a more efficacious use of SMT. Method Of the 18 items identified in the Delphi study, 13 were deemed historical in nature and readily provided by the chiropractor and patient. A literature search revealed reliable and valid measures for two more items. The remaining three items were generated by creating descriptive questions matched to an appropriate Likert scale. A panel of six chiropractors who had used SMT for at least 7 years when treating non-specific low back pain was formed to evaluate the items for clarity and relevance. Ten Western Australian chiropractors were then recruited to pilot the questionnaire on ten consecutive patients with non-specific low back pain where SMT was used from March to June 2020. Ethics approval was obtained from Murdoch University. Results COVID-19 restrictions impacted on practitioner recruitment and delayed the data collection. Of the intended 100 participants, only 63 could be recruited over a 3-month period from seven chiropractors. Time constraints forced the closure of the data collection. The measures of all predictor items demonstrated ceiling effects. Feedback from open-ended practitioner questions was minimal, suggesting an ease of use. Conclusion The length of time and level of participation required to collect the calculated sample size was inadequate and suggested that incentivization may be required for a larger investigation. Significant ceiling effects were found and suggested that participants did so because of a positive bias toward chiropractic care and the use of SMT. The questionnaires in this pilot study require alternative measures and further validation before use in a larger study.https://doi.org/10.1186/s12998-023-00510-3ChiropracticTherapeutic alliancePatient expectationsSpinal manipulation
spellingShingle Stanley Innes
Reece Granger
Jean Théroux
Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study
Chiropractic & Manual Therapies
Chiropractic
Therapeutic alliance
Patient expectations
Spinal manipulation
title Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study
title_full Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study
title_fullStr Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study
title_full_unstemmed Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study
title_short Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study
title_sort creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non specific low back pain a pilot study
topic Chiropractic
Therapeutic alliance
Patient expectations
Spinal manipulation
url https://doi.org/10.1186/s12998-023-00510-3
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