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Casey Rogers
Madeleine Hackney
Lisa Zubkoff
Katharina Echt


Patient Goals, Chronic Low Back Pain, Geriatrics, Veterans Health


Objective: There is no literature addressing the impact chiropractic services have on older adults achieving individualized specific goals throughout a course of care for chronic low back pain. This study will explore the effect of setting a self-determined, “what matters most” activity/goal of rehabilitation care with relevant activities as part of standard chiropractic care on the self-rated pain and disability of older Veterans.

Methods: Participants will be randomized into 2 groups. The first is an experimental group where participants will identify a goal and receive standard chiropractic care. The second will be a control group that receives standard chiropractic care only. Participants will receive 6 sessions of care.

Results: Outcome assessment tools, including an individualized goal setting measurement tool will be utilized at pre, post, and 6-week follow-up for both groups as primary measures. Relationships between clinical and demographic patient characteristics such as age, sex, and comorbid conditions will be explored with correlation regression as secondary measures.

Conclusion: The results of this pilot may aid in recognizing the value of employing patient-priorities/“what matters most” goal-setting as a means of amplifying the effect of chiropractic services on return to self-identified goals or activities that impact the quality of life among older Veterans.


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1. Rubin Dl. Epidemiology and risk factors for spine pain. Neurol Clin 2007;25(2):353-371

2. Wertli MM, Rasmussen-Barr E, Weiser S, Bachmann LM, Brunner F. The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review. Spine J 2014;14:816-836

3. Camacho-Soto A, Sowa GA, Perera S, Weiner DK. Fear avoidance beliefs predict disability in older adults with chronic low back pain. Phys Med Rhabili 2012;4:493-497

4. Kumar A, Delbaere K, Zijlstra GA, Carpenter H, Iliffe S, Masud T, Skelton D, Morris R, Kendrick D. Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age Ageing 2016;45:345-352

5. Cadore EL, Rodríguez-Mañas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res 2013;16:1-5-114

6. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2017;166:514-530

7. 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;53:194-204

8. Tegner H, Frederiksen P, Esbensen BA, Juhl C. Neurophysiological pain education for patients with chronic low back pain: a systematic review and meta-analysis. Clin J Pain 2018;34:778-786

9. Ammendolia, C., Côté, P., Rampersaud, Y.R. et al. The boot camp program for lumbar spinal stenosis: a protocol for a randomized controlled trial. Chiropr Man Therap 2016;24:25

10. Aslan Telci E, Yagci N, Can T, Cavlak U. The impact of chronic low back pain on physical performance, fear avoidance beliefs, and depressive symptoms: A comparative study on Turkish elderly population. Pak J Med Sci 2013;29:560-564

11. Zis P, Daskalaki A, Bountouni I, Sykioti P, Varrassi G, Paladini A. Depression and chronic pain in the elderly: links and management challenges. Clin Interv Aging 2017;12:709-720

12. De Biasi A,Wolfe M, Carmody J, Fulmer T, Auerbach J. Creating an age-friendly public health system. Innov Aging 2020;4:igz044

13. Dougherty PE, Karuza J, Dunn AS, Savino D, Katz P. Spinal manipulative therapy for chronic lower back pain in older veterans: a prospective, randomized, placebo-controlled trial. Geriatr Orthop Surg Rehabil 2014;5:154-164

14. Gardner T, Refshauge K, McAuley J, Goodall S, Hübscher M, Smith L. Patient led goal setting in chronic low back pain-What goals are important to the patient and are they aligned to what we measure? Patient Educ Couns 2015;98:1035-1038

15. Rogers CJ, Hackney ME, Zubkoff L, Echt KV. The use of patient-led goal setting in the intervention of chronic low back pain in adults: a narrative review. Pain Manag 2022;12:653-664