Clinical Course of Spinal Pain in Adolescents: a Feasibility Study in a Chiropractic Setting

Overview

Journal BMJ Open

Date 2025 Jan 31

PMID 39890151

Authors

Laura Rc Montgomery

Steven J Kamper

Anika Young

Amber Beynon

Katherine A Pohlman

Lise Hestbaek

Mark J Hancock

Simon D French

Christopher G Maher

Michael S Swain

Affiliations

Soon will be listed here.

Abstract

Design: Prospective feasibility study.

Objectives: To inform the design and conduct of a large-scale clinical cohort study investigating adolescents with moderate-to-severe spinal pain.

Setting: Chiropractic care in Sydney, Australia.

Participants: Adolescents aged 12-17 years with spinal pain (≥4/10 pain intensity score).

Methods: Adolescents and chiropractors completed baseline and week-12 follow-up questionnaires, with adolescents reporting pain intensity and recovery weekly via text messages during weeks 1-11. Questionnaire measures included spinal pain, pain coping, quality of life, physical activity, clinical assessment findings and care delivered. Chiropractors provided usual clinical care. We conducted a descriptive feasibility analysis.

Primary Outcomes: (1) Recruitment rate, (2) response rate to each data collection instrument and (3) retention rate.

Results: From May 2021 to February 2023, 20 chiropractors from 10 clinics were enrolled (invited n=85). 10 chiropractors recruited 45 adolescents (15.4±1.4 years, 43% female) over 13.5 months, excluding an 8-month pause due to COVID-19 disruptions. The average recruitment rate was 0.6 adolescents/recruiting chiropractor/month. We achieved a 100% response to chiropractor baseline and follow-up questionnaires, 98% to adolescent baseline, 94% average response to combined weekly text messages and 93% retention of adolescents at study completion.

Conclusions: Our high response and retention rates demonstrate feasible data collection methods in this population. Addressing low recruitment by expanding the number and type of clinicians is necessary for a successful larger study.

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