Chiropractic services in the active duty military setting

a scoping review

Silvano Mior*, Deborah Sutton, Daphne To, Carolina Cancelliere, Simon French, Anne Taylor-Vaisey, Pierre Côté

*Corresponding author for this work

Research output: Contribution to journalReview article

1 Citation (Scopus)
3 Downloads (Pure)

Abstract

Background: Musculoskeletal injuries are one of the most prevalent battle and non-battle related injuries in the active duty military. In some countries, chiropractic services are accessed to manage such injuries within and outside military healthcare systems; however, there is no recent description of such access nor outcomes. This scoping review aimed to synthesize published literature exploring the nature, models, and outcomes of chiropractic services provided to active duty military globally. Method: We employed scoping review methodology. Systematic searches of relevant databases, including military collections and hand searches were conducted from inception to October 22, 2018. We included peer-reviewed English literature with qualitative and quantitative designs, describing chiropractic practice and services delivered to active duty military worldwide. Paired reviewers independently reviewed all citations and articles using a two-phase screening process. Data from relevant articles were extracted into evidence tables and sorted by study type. Results were descriptively analyzed. Results: We screened 497 articles and 20 met inclusion criteria. Chiropractic services were commonly provided on-base only in the US. Services were accessed by physician referral and commonly after initiation or non-response to other care. Use of scope of practice was determined by the system/facility, varying from intervention specific to comprehensive services. Back pain with and without radiculopathy accounted for most complaints. Treatment outcomes were reported primarily by case reports. However, two recent randomized trials reported improved pain, disability, and satisfaction when adding chiropractic care to usual medical care compared to usual medical care alone in management of low back pain. Specific reaction time measures in special operation forces military did not improve after chiropractic care compared to wait-list control. Conclusions: Our scoping review found the majority of published articles described chiropractic services in the active duty military in the US setting. Recent RCTs suggest a benefit of including chiropractic care to usual medical care in managing back pain in active duty military. Yet despite reported benefits in Australia, Canada, and the US, there is a need for further qualitative, descriptive, and clinical trial data worldwide to inform the role of chiropractic services in active duty military.

Original languageEnglish
Article number45
Pages (from-to)1-19
Number of pages19
JournalChiropractic and Manual Therapies
Volume27
Issue number1
DOIs
Publication statusPublished - 15 Jul 2019

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Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • military personnel
  • active duty
  • chiropractic
  • military medicine

Cite this

Mior, S., Sutton, D., To, D., Cancelliere, C., French, S., Taylor-Vaisey, A., & Côté, P. (2019). Chiropractic services in the active duty military setting: a scoping review. Chiropractic and Manual Therapies, 27(1), 1-19. [45]. https://doi.org/10.1186/s12998-019-0259-6