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Joel Alcantara, DC, PhD, Andrew Whetten, PhD, Dennis Richards, DC, PhD
Annals of Vertebral Subluxation Research ~ September 21, 2026 ~ Volume 2026 ~ Pages 26-42
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Abstract
Objective: To evaluate changes in sense of coherence (SOC) and quality of life (QoL) among adult patients following a course of chiropractic care and to identify sociodemographic characteristics, clinical covariates, and QoL domains predictive of changes in SOC.
Methods: A prospective practice-based research network study assessed SOC and QoL in adult chiropractic patients at baseline and following a course of care using the SOC-29 and PROMIS-29 V2.0. Changes were evaluated using bootstrap paired t-tests. Linear mixed models and variable-selection methods, including backward selection and LASSO regression, were used to identify clinical and QoL predictors of change in SOC.
Results: Among 1,419 respondents (mean age, 41 years), SOC significantly increased following chiropractic care (mean increase, 1.99; 95% CI, 1.30–2.76; p = .00532), with significant improvements across SOC subdomains and PROMIS-29 QoL measures. Changes in depression, anxiety, sleep disturbance, social participation, and fatigue were important predictors of SOC change, with motivation for care also retained in the final model.
Conclusion: Among adults participating in a chiropractic practice-based research network, SOC and multiple QoL domains improved significantly over a course of chiropractic care. Changes in mental, physical, and social QoL, particularly depression, anxiety, sleep disturbance, social participation, and fatigue, were associated with changes in SOC. These findings support further investigation of the relationship between chiropractic care, QoL, and salutogenic outcomes and of the clinical and patient characteristics that may contribute to improvements in SOC
Keywords: chiropractic, sense of coherence, salutogenesis, quality of life, PROMIS-29, practice-based research network, patient-reported outcomes
