The effect of chiropractic treatment on the reaction and response times of special operation forces military personnel: study protocol for a randomized controlled trial

James W DeVocht, Dean L Smith, Cynthia R Long, Lance Corber, Bridget Kane, Thomas M Jones, Christine M Goertz, James W DeVocht, Dean L Smith, Cynthia R Long, Lance Corber, Bridget Kane, Thomas M Jones, Christine M Goertz

Abstract

Background: Chiropractic care is commonly used to treat musculoskeletal conditions and has been endorsed by clinical practice guidelines as being evidence-based and cost-effective for the treatment of patients with low back pain. Gaps in the literature exist regarding the physiological outcomes of chiropractic treatment. Previous pilot work has indicated the possibility of improvements in response time following the application of chiropractic treatment. However, it is unknown whether or not chiropractic treatment is able to improve reaction and response times in specific populations of interest. One such population is the U.S. military special operation forces' (SOF) personnel.

Methods: This study is a randomized controlled trial of 120 asymptomatic volunteer SOF personnel. All participants are examined by a study doctor of chiropractic (DC) for eligibility prior to randomization. The participants are randomly allocated to either a treatment group receiving four treatments of chiropractic manipulative therapy (CMT) over 2 weeks or to a wait-list control group. The wait-list group does not receive any treatment but has assessments at the same time interval as the treatment group. The outcome measures are simple reaction times for dominant hand and dominant foot, choice reaction time with prompts calling for either hand or either foot, response time using Fitts' law tasks for small movements involving eye-hand coordination, and brief whole body movements using the t-wall, a commercially available product. At the first visit, all five tests are completed so that participants can familiarize themselves with the equipment and protocol. Assessments at the second and the final visits are used for data analysis.

Discussion: SOF personnel are highly motivated and extremely physically fit individuals whose occupation requires reaction times that are as quick as possible during the course of their assigned duties. A goal of CMT is to maximize the functionality and integration of the neuromusculoskeletal systems. Therefore, chiropractic treatment may be able to optimize the capacity of the numerous components of those systems, resulting in improved reaction time. The objective of this study is to test the hypothesis that CMT improves reaction and response times in asymptomatic SOF personnel.

Trial registration: ClinicalTrials.gov, NCT02168153 . Registered on 12 June 2014.

Keywords: Biomechanical assessments; Chiropractic manipulative therapy; Reaction times; Response times; Special forces.

Figures

Fig. 1
Fig. 1
Assessment of Chiropractic Treatment, part 2 (ACT 2) study flow chart and timeline
Fig. 2
Fig. 2
Computer screen used with the Fitts’ law test. The participant moves the cursor from one circle to the other and back. The process is repeated for 32 pairs of circles of different size and orientation
Fig. 3
Fig. 3
The t-wall. The participant goes through a random sequence of striking 100 lighted buttons, one immediately after the other

References

    1. Murphy DR, Justice BD, Paskowski IC, Perle SM, Schneider MJ. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States. Chiropr Man Therap. 2011;19(1):17. doi: 10.1186/2045-709X-19-17.
    1. Lin CW, Haas M, Maher CG, Machado LA, van Tulder MW. Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review. Eur Spine J. 2011;20(7):1024–38. doi: 10.1007/s00586-010-1676-3.
    1. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Jr, Shekelle P, Owens DK. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–91. doi: 10.7326/0003-4819-147-7-200710020-00006.
    1. Koes BW, van Tulder MW, Ostelo R, Kim BA, Waddell G. Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine (Phila Pa 1976) 2001;26(22):2504–13. doi: 10.1097/00007632-200111150-00022.
    1. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4(3):335–56. doi: 10.1016/j.spinee.2003.06.002.
    1. Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for acute low back pain: an update of the Cochrane review. Spine (Phila Pa 1976) 2013;38(3):E158–77. doi: 10.1097/BRS.0b013e31827dd89d.
    1. Goertz CM, Pohlman KA, Vining RD, Brantingham JW, Long CR. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. J Electromyogr Kinesiol. 2012;22(5):670–91. doi: 10.1016/j.jelekin.2012.03.006.
    1. Bishop PB, Quon JA, Fisher CG, Dvorak MF. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. Spine J. 2010;10(12):1055–64. doi: 10.1016/j.spinee.2010.08.019.
    1. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Rep. 2008;12:1–23.
    1. National Board of Chiropractic Examiners. Practice analysis of chiropractic 2015, Chapter 1. 2015. . Accessed 5 Apr 16.
    1. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States. Adv Data. 2002;2004(343):1–19.
    1. Weeks WB, Goertz CM, Meeker WC, Marchiori DM. Public perceptions of doctors of chiropractic: results of a National Survey and Examination of Variation according to respondents’ likelihood to use chiropractic, experience with chiropractic, and chiropractic supply in local health care markets. J Manipulative Physiol Ther. 2015;38(8):533–44. doi: 10.1016/j.jmpt.2015.08.001.
    1. Carey TS, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker DR. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med. 1995;333(14):913–7. doi: 10.1056/NEJM199510053331406.
    1. Cherkin DC, MacCornack FA. Patient evaluations of low back pain care from family physicians and chiropractors. West J Med. 1989;150(3):351–5.
    1. Weigel PA, Hockenberry JM, Wolinsky FD. Chiropractic use in the Medicare population: prevalence, patterns, and associations with 1-year changes in health and satisfaction with care. J Manipulative Physiol Ther. 2014;37(8):542–51. doi: 10.1016/j.jmpt.2014.08.003.
    1. Leininger BD, Evans R, Bronfort G. Exploring patient satisfaction: a secondary analysis of a randomized clinical trial of spinal manipulation, home exercise, and medication for acute and subacute neck pain. J Manipulative Physiol Ther. 2014;37(8):593–601. doi: 10.1016/j.jmpt.2014.08.005.
    1. Lisi AJ, Goertz C, Lawrence DJ, Satyanarayana P. Characteristics of Veterans Health Administration chiropractors and chiropractic clinics. J Rehabil Res Dev. 2009;46(8):997–1002. doi: 10.1682/JRRD.2009.01.0002.
    1. Green BN, Johnson CD, Lisi AJ, Tucker J. Chiropractic practice in military and veterans health care: The state of the literature. J Can Chiropr Assoc. 2009;53(3):194–204.
    1. Tricare. Find a military hospital or clinic. . Accessed 5 Apr 16.
    1. Stump JL, Redwood D. The use and role of sport chiropractors in the national football league: a short report. J Manipulative Physiol Ther. 2002;25(3):E2. doi: 10.1067/mmt.2002.122326.
    1. Konczak CR. Chiropractic utilization in BMX athletes at the UCI World Championships: a retrospective study. J Can Chiropr Assoc. 2010;54(4):250–6.
    1. Kelly DD, Murphy BA, Backhouse DP. Use of a mental rotation reaction-time paradigm to measure the effects of upper cervical adjustments on cortical processing: a pilot study. J Manipulative Physiol Ther. 2000;23(4):246–51. doi: 10.1067/mmt.2000.106099.
    1. Smith DL, Dainoff MJ, Smith JP. The effect of chiropractic adjustments on movement time: a pilot study using Fitts Law. J Manipulative Physiol Ther. 2006;29(4):257–66. doi: 10.1016/j.jmpt.2006.03.009.
    1. Passmore SR, Burke JR, Good C, Lyons JL, Dunn AS. Spinal manipulation impacts cervical spine movement and Fitts’ task performance: a single-blind randomized before-after trial. J Manipulative Physiol Ther. 2010;33(3):189–92. doi: 10.1016/j.jmpt.2010.01.007.
    1. Daligadu J, Haavik H, Yielder PC, Baarbe J, Murphy B. Alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation. J Manipulative Physiol Ther. 2013;36(8):527–37. doi: 10.1016/j.jmpt.2013.08.003.
    1. Whelan R. Effective analysis of reaction time data. Psychol Rec. 2008;58(3):475–82.
    1. Cagnie B, Vinck E, Beernaert A, Cambier D. How common are side effects of spinal manipulation and can these side effects be predicted? Man Ther. 2004;9(3):151–6. doi: 10.1016/j.math.2004.03.001.
    1. Hebert JJ, Stomski NJ, French SD, Rubinstein SM. Serious adverse events and spinal manipulative therapy of the low back region: a systematic review of cases. J Manipulative Physiol Ther. 2013;38(9):677-91.
    1. Vernon H, MacAdam K, Marshall V, Pion M, Sadowska M. Validation of a sham manipulative procedure for the cervical spine for use in clinical trials. J Manipulative Physiol Ther. 2005;28(9):662–6. doi: 10.1016/j.jmpt.2005.07.020.

Source: PubMed

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