Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".