Musculoskeletal Pain
Conditions
Keywords
Chiropractic, Musculoskeletal health, Musculoskeletal pain, Health care quality
Brief summary
The Swiss chiropractic patient cohort (Swiss ChiCo) study is a nationwide research project which aims to describe the characteristics of patients presenting to Swiss chiropractors, assess the clinical course of patients with musculoskeletal pain, and examine the feasibility for performing a larger subsequent cohort study.
Detailed description
The chiropractic scope of practice within Switzerland includes the diagnosis and management of musculoskeletal (MSK) pain conditions through manual medicine, prescription medication, and diagnostic imaging (radiography, ultrasound, CT, MRI). Common patient complaints presenting to Swiss chiropractic offices mirror this scope of practice, with low back pain and pelvic related pain being the most prevalent. This combination of clinical expertise and access to a MSK pain patient population allows chiropractic health care centres to become useful real-world primary care settings to further understand the current management and clinical course of MSK pain conditions in Switzerland, and to identify practice gaps and opportunities for Swiss MSK primary health care quality improvement. This study aims to describe the characteristics of patients with new conservative healthcare seeking for MSK pain presenting to Swiss chiropractors, assess the clinical course of these patients over 12 weeks, and examine the feasibility for performing a larger subsequent prospective electronic cohort study using the newly established Swiss ChiCo practice-based research network (PBRN) and clinical cohort methodological framework. Participating chiropractors will recruit consecutive patients from community-based chiropractic practices into a 12-week observational prospective electronic cohort study. Patient participants will be asked to complete 5 electronic surveys over 12-weeks. The first survey will be provided to patient participants prior to their initial chiropractic assessment. Subsequent questionnaires will be provided 1-hour, 2-weeks, 6-weeks, and 12-weeks after the initial visit. This patient cohort study represents a collaborative effort of international researchers, Swiss chiropractic clinicians, and the chiropractic patient and clinical associations in Switzerland (Pro Chiropractic Switzerland and ChiroSuisse). The survey design and study implementation procedures have been conceptualized through stakeholder consultation.
Interventions
OTHERUsual chiropractic care
Usual chiropractic care in Switzerland can include spinal manual therapy, soft-tissue therapy, use of electric therapeutic modalities (low level laser therapy, therapeutic ultrasound, interferential current), acupuncture, prescription medication, exercise, education and reassurance.
Sponsors
University of Zurich
University of Southern Denmark, Department of Sports Science and Clinical Biomechanics
Swiss Chiropractic Association (ChiroSuisse)
Swiss Chiropractic Patient Association (Pro Chiropractic Switzerland)
Balgrist University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥18 years of age * Seeking new conservative health care for a musculoskeletal pain condition at a Swiss chiropractic clinic (ie, not having received participant-reported chiropractic care, physiotherapy, osteopathy, or massage therapy for the musculoskeletal complaint in the past 1 month and not a follow-up visit) * Consent to chiropractic treatment * Proficient in German, French, Italian, or English * Active email account * Willing to complete electronic study questionnaires
Exclusion criteria
* Presenting with red-flag symptoms (i.e., saddle anesthesia, loss of bowel and/or bladder control, history of major trauma, fracture, fever, severe or rapidly progressive neurologic deficit, sudden unexpected weight loss) * Presenting with non-musculoskeletal pain condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in musculoskeletal pain impact | Baseline; 1-hour after initial visit; 2-, 6-, 12-weeks | Assessment via Pain, Enjoyment, and General Activity scale (PEG scale, 0-10). A higher score reflects worse outcome (worse pain intensity and interference) |
| Change in musculoskeletal health status | Baseline; 1-hour after initial visit; 2-, 6-, 12-weeks | Assessment via musculoskeletal health questionnaire (MSK-HQ, 0-56). A higher score reflects better musculoskeletal health status |
| Invited patient participation proportion | Baseline | Proportion of invited patients who agree to participate (feasibility outcome) |
| Change in participant follow-up and retention | Baseline; 1-hour after initial visit; 2-, 6-, 12-weeks | Proportion of enrolled participants who complete follow-up surveys (feasibility outcome) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reasons for non-participation | Baseline | Reasons for invited participant non-participation (no email address, unfamiliar with electronic or internet tools, lack of time, lack of interest in the study, data privacy concerns, other) |
| Factors associated with non-response | Baseline and 12-weeks | A multivariable logistic regression analysis will be performed to assess the association between the participant factors (listed below) and non-response (versus response) at 12-weeks follow-up. Participant factors that will be assessed are: age (reported in years), sex (reported as male and female), medication use for MSK pain (reported as prescription medication, non-prescription medication, and no medication use), current MSK pain condition episode duration (dichotomised as acute \[\< 3 months duration\] and chronic \[≥ 3 months duration\]), MSK pain impact (PEG scale, 0-10), and MSK health status (MSK-HQ, 0-56) collected at baseline. |
Countries
Switzerland
Outcome results
None listed