Chiropractors can do: testing the feasibility of intervening to optimize chiropractic care for adults with neck pain disorders: a pilot cluster randomized controlled trial
Notice bibliographique
Résumé
Background: Neck pain in adults is common and a leading cause of physical disability. Recently, a guideline was developed for the management of non-specific neck pain (NSNP) with the aim of improving the quality of the delivery of chiropractic care. One key guideline recommendation is to undertake multimodal care for patients with NSNP. The aim of this pilot study was to determine the feasibility of implementing a multifaceted knowledge translation intervention by promoting the use of multimodal care by chiropractors managing patients with NSNP. Methods: The design was a cluster randomized controlled pilot and feasibility trial. Chiropractors in private practice in Canada were approached to participate in the study. Consenting chiropractors were randomized to receive either a theory-based educational intervention in the experimental group or simply a printed copy of the guideline in the control group. Each chiropractor was asked to recruit five neck pain patients. Primary feasibility outcomes for both chiropractors and patients included were rates of: 1) recruitment, 2) retention, and 3) adherence to the intervention. Secondary outcomes included were scores of behavioural constructs (level of knowledge and self-efficacy) for recommended multimodal care. Clinical outcomes were pain intensity and neck pain-specific disability. Results: Due to slow recruitment, a total of 400 chiropractors received a postal mailed invitation to participate. In total, 47 chiropractors were randomized to the intervention or the control group according to the random sequence allocation. Fifteen withdrew from the study, leaving a total of 32 participants. Eleven chiropractors in the intervention group completed the webinars and e-learning modules, two partially completed them and three did not register. Overall, nine chiropractors recruited a total of 29 patients (n=11, intervention group; n=18 control group). Sixty-three percent (n=7) of patients in the intervention group and 56% (n=10) in the control group completed all the outcome measures at baseline and at 3-month follow-up and attended follow-up visits and performed home exercises. Over half (54%, n=6) of chiropractors in the intervention group reported being familiar with the guideline and the BAP compared with 71.1% (n=5) in the control group. Confidence in implementing BAP was lower in the intervention group (27.3%, n=3). Of those who completed the trial, 17 patients completed all the 3-month follow-up outcome measures and the end of study questionnaires (n=7; intervention group and n=10; control group). Patients in the intervention group reported significant reduction in pain (P= 0.027) and reduction in disability scores severity (P= 0.033) from baseline to 3-month follow-up. Conclusion: In this pilot cluster randomized controlled trial, patient recruitment, retention and adherence of both chiropractors and patients were challenging. To overcome these challenges, a thorough evaluation of potential barriers, outcomes and possible solutions must be considered prior to embarking in a larger trial.
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 | 0,011 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,003 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,004 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,001 |
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 ».