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| Name | Class |
|---|---|
| University of Zurich | OTHER |
| University of Southern Denmark | OTHER |
| Swiss Chiropractic Association (ChiroSuisse) | UNKNOWN |
| Swiss Chiropractic Patient Association (Pro Chiropractic Switzerland) |
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The Swiss chiropractic patient cohort (Swiss ChiCo) study is a nationwide research project which aims to describe the characteristics of patients presenting to Swiss chiropractors, assess the clinical course of patients with musculoskeletal pain, and examine the feasibility for performing a larger subsequent cohort study.
The chiropractic scope of practice within Switzerland includes the diagnosis and management of musculoskeletal (MSK) pain conditions through manual medicine, prescription medication, and diagnostic imaging (radiography, ultrasound, CT, MRI). Common patient complaints presenting to Swiss chiropractic offices mirror this scope of practice, with low back pain and pelvic related pain being the most prevalent. This combination of clinical expertise and access to a MSK pain patient population allows chiropractic health care centres to become useful "real-world" primary care settings to further understand the current management and clinical course of MSK pain conditions in Switzerland, and to identify practice gaps and opportunities for Swiss MSK primary health care quality improvement.
This study aims to describe the characteristics of patients with new conservative healthcare seeking for MSK pain presenting to Swiss chiropractors, assess the clinical course of these patients over 12 weeks, and examine the feasibility for performing a larger subsequent prospective electronic cohort study using the newly established Swiss ChiCo practice-based research network (PBRN) and clinical cohort methodological framework.
Participating chiropractors will recruit consecutive patients from community-based chiropractic practices into a 12-week observational prospective electronic cohort study. Patient participants will be asked to complete 5 electronic surveys over 12-weeks. The first survey will be provided to patient participants prior to their initial chiropractic assessment. Subsequent questionnaires will be provided 1-hour, 2-weeks, 6-weeks, and 12-weeks after the initial visit. This patient cohort study represents a collaborative effort of international researchers, Swiss chiropractic clinicians, and the chiropractic patient and clinical associations in Switzerland (Pro Chiropractic Switzerland and ChiroSuisse). The survey design and study implementation procedures have been conceptualized through stakeholder consultation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Chiropractic patient participants | Usual chiropractic care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Usual chiropractic care | Other | Usual chiropractic care in Switzerland can include spinal manual therapy, soft-tissue therapy, use of electric therapeutic modalities (low level laser therapy, therapeutic ultrasound, interferential current), acupuncture, prescription medication, exercise, education and reassurance. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in musculoskeletal pain impact | Assessment via Pain, Enjoyment, and General Activity scale (PEG scale, 0-10). A higher score reflects worse outcome (worse pain intensity and interference) | Baseline; 1-hour after initial visit; 2-, 6-, 12-weeks |
| Change in musculoskeletal health status | Assessment via musculoskeletal health questionnaire (MSK-HQ, 0-56). A higher score reflects better musculoskeletal health status | Baseline; 1-hour after initial visit; 2-, 6-, 12-weeks |
| Invited patient participation proportion | Proportion of invited patients who agree to participate (feasibility outcome) | Baseline |
| Change in participant follow-up and retention | Proportion of enrolled participants who complete follow-up surveys (feasibility outcome) | Baseline; 1-hour after initial visit; 2-, 6-, 12-weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Reasons for non-participation | Reasons for invited participant non-participation (no email address, unfamiliar with electronic or internet tools, lack of time, lack of interest in the study, data privacy concerns, other) | Baseline |
| Factors associated with non-response |
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Inclusion Criteria:
Exclusion Criteria:
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Persons presenting to chiropractic clinic seeking new conservative health care for a musculoskeletal pain condition in Switzerland
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| Name | Affiliation | Role |
|---|---|---|
| Cesar A Hincapié, DC PhD | Balgrist University Hospital and University of Zurich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Balgrist University Hospital | Zurich | 8008 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35831057 | Background | Lalji R, Hofstetter L, Kongsted A, von Wyl V, Puhan MA, Hincapie CA. Swiss chiropractic practice-based research network and musculoskeletal pain cohort pilot study: protocol of a nationwide resource to advance musculoskeletal health services research. BMJ Open. 2022 Jul 13;12(7):e059380. doi: 10.1136/bmjopen-2021-059380. | |
| 37024506 |
| Label | URL |
|---|---|
| Musculoskeletal Epidemiology Research Group, Balgrist University Hospital, Project webpage | View source |
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Data may be made available for research purposes. Requests, including a synopsis of the study plan, can be addressed to the central contact person.
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| ID | Term |
|---|---|
| D059352 | Musculoskeletal Pain |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
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| UNKNOWN |
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A multivariable logistic regression analysis will be performed to assess the association between the participant factors (listed below) and non-response (versus response) at 12-weeks follow-up. Participant factors that will be assessed are: age (reported in years), sex (reported as male and female), medication use for MSK pain (reported as prescription medication, non-prescription medication, and no medication use), current MSK pain condition episode duration (dichotomised as acute [< 3 months duration] and chronic [≥ 3 months duration]), MSK pain impact (PEG scale, 0-10), and MSK health status (MSK-HQ, 0-56) collected at baseline. |
| Baseline and 12-weeks |
| Lalji R, Hofstetter L, Kongsted A, von Wyl V, Puhan MA, Hincapie CA. The Swiss chiropractic practice-based research network: a population-based cross-sectional study to inform future musculoskeletal research. Sci Rep. 2023 Apr 6;13(1):5655. doi: 10.1038/s41598-023-32437-3. |
| 38480624 | Derived | Lalji R, Hofstetter L, Kongsted A, von Wyl V, Braun J, Puhan MA, Hincapie CA; Swiss ChiCo Clinicians Group. Swiss chiropractic cohort (Swiss ChiCo) pilot study: feasibility for a musculoskeletal cohort study conducted within a nationwide practice-based research network. Eur Spine J. 2024 May;33(5):2068-2078. doi: 10.1007/s00586-024-08175-z. Epub 2024 Mar 13. |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |