Notice bibliographique
Résumé
This thesis investigates the clinical course and management of low back pain (LBP) in older adults receiving chiropractic care, aiming to provide a comprehensive understanding of treatment outcomes and healthcare utilization in this demographic. Through a prospective, multi-center, observational cohort study, the research addresses several critical clinical questions. Chapters 3 - 5 present the results of various analyses using this data, while additional insights are drawn from a related study on healthcare costs. Chapter 1: Introduction In Chapter 1, a brief overview of the studies included in this thesis is provided, along with the primary clinical questions addressed. The focus is on understanding the course of LBP in older adults and the effectiveness of chiropractic care. Chapter 2: Spinal Manipulative Therapy in Older Adults: An Individual Participant Data Analysis Chapter 2 discusses the efficacy of spinal manipulative therapy for older patients with chronic low back pain. It introduces various researchers and practitioners involved in the study, illustrating the need for tailored therapeutic approaches. The chapter underscores the potential benefits of chiropractic care while acknowledging the necessity of further research to optimize treatment outcomes. Chapter 3: Comparison of Disability Indexes Chapter 3 examines the validity, reliability, and responsiveness of three commonly used disability questionnaires (Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale) in older adults undergoing chiropractic care for LBP. Findings indicate that all three indexes have sufficient reliability and validity, though each has unique strengths and limitations. Chapter 4: Pain Trajectories in Older Adults In Chapter 4, latent class analysis is used to identify distinct pain trajectories in older adults with LBP. Three main trajectories are identified: improvement from severe pain, improvement from moderate pain, and stable moderate pain. The study highlights the variability in pain experiences among older adults and discusses the implications for tailored interventions. Chapter 5: Back Complaints in the Elders – Chiropractic (BACE-C): design of a cohort study in chiropractic care Chapter 5 outlines the design and methodology of the Back Complaints in Elders Chiropractic (BACE-C) study. This chapter details the inclusion criteria, data collection methods, and the significance of studying LBP in older adults across multiple countries, specifically the Netherlands, Sweden, and the UK. Chapter 6: The Clinical Course of LBP Chapter 6 evaluates the one-year clinical course of LBP in older adults receiving chiropractic care. Key findings include a gradual reduction in pain levels and consistent functional improvements throughout the year. The chapter also discusses healthcare utilization patterns, noting high use of medical specialist visits and diagnostic imaging, particularly in Sweden. Chapter 7: General Discussion The final chapter presents the principal findings of the thesis, discussing their implications for clinical practice and future research. The strengths and limitations of the study are reviewed, and recommendations for optimizing chiropractic care for older adults with LBP are provided. Overall, this thesis contributes valuable real-world evidence on the clinical course, treatment outcomes, and healthcare utilization associated with chiropractic care for older adults with LBP. It underscores the importance of personalized, multidisciplinary care strategies to enhance the quality of life for this growing population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».