Changes in Physical State and Self-Perceptions in Domains of Health Related Quality of Life Among Public Safety Personnel Undergoing Chiropractic Care
Wesley McAllister, BA, DC., WR Boone, DC, Ph.D.
Journal of Vertebral Subluxation Research ~ August 6, 2007 ~ Pages 1-7
Objective: A pilot study was conducted at Sherman College of Straight Chiropractic, Spartanburg SC, with volunteers primarily from the North Spartanburg Fire and Emergency Services Department. The study was conducted to evaluate the impact of chiropractic care on the physical and self-perceived health related benefits of public safety personnel. Preliminary data regarding their care has been collected and analyzed. Over an average of 5.5 months volunteers received routine chiropractic care at the College Health Center. Each subject was assessed on a weekly basis and adjusted when necessary.
Methods: Physical assessments were conducted on 10 volunteers during the initial visit and at the re-assessment period. As well, a Health Related Quality of Life Survey (HRQL) was completed by each subject at the initial assessment and the following reassessment. Physical assessments included: (a) visual postural analyses (6 tests), (b) cervical range of motion (6 tests), (c) lumbar range of motion (6 tests) (d), spinal balance and leg length (5 tests), (e) orthopedics (19 tests), (f) motor strength (11 tests), (g) deep tendon reflexes (5 tests), (h) superficial reflexes,(3 tests) and (i) sensory testing (14 tests). Positive tests were assigned a numeric of +1 and negative findings a zero. Self-perceptions were also assessed by Cohen’s method of determining effect size (ES), or size of the clinical effect.
Results: As a group, the ten volunteers decreased from an average of 16.0 positive findings to 9.5 positive findings, a statistically significant reduction (p = 0.021). In addition, volunteers’ self-evaluations of HRQL domains included: physical well-being, mental/emotional state, stress management, life enjoyment, and overall quality of life, When tallied together over the average 5.5 months of care, these domains represented a significant change (p = 0.040). As well, a 6th domain, referred to as a “wellness index,” representing the sum of the 5 domains, was also significantly improved (p = 0.000). The ES for improvement in all HRQL domains was large, (0.81 + 0.44), ranging from 0.35 to 1.30.
Conclusion: The results of this preliminary study revealed that ten volunteers showed significant improvements in physical assessment findings and self perceptions in health related domains while undergoing an average of 5.5 months of chiropractic care. The changes also appeared to elicit a large clinical effect with regard to self-ratings. Further study, including individuals from various areas of public service, will be required to validate these findings.
Key Words: Chiropractic, public safety personnel, vertebral subluxation