The Congressionally Directed Medical Research Program has awarded the Palmer Center for Chiropractic Research, the RAND Corporation and the Samueli Institute $7.4 million to conduct a four-year research project featuring members of the U.S. military as study subjects. The primary area of study: the impact of chiropractic treatment on the military readiness of active-duty personnel. Dr. Christine Goertz, Palmer College of Chiropractic's vice president for research and health policy, who serves as co-principal investigator of the project, summed up the importance of the award: "The three clinical trials to be conducted at six sites across the country under this grant represent the largest coordinated research effort to date within the chiropractic profession. In one of the trials, we will randomize 850 active-duty military personnel at four of the six sites. This represents the largest clinical trial effort to date evaluating chiropractic care."
When interviewed by DC following the award announcement, Dr. Goertz shared more key details regarding this historic research project, including the primary study parameters and the potential impact positive results could have on the expansion of chiropractic in the military.
How / why did the Palmer Center for Chiropractic Research collaborate with the RAND Corporation and the Samueli Institute in proposing this research project? We wanted a team that had the expertise and experience necessary to conduct this set of complex clinical trials and each of us brings something unique to the partnership. The PCCR has experience in the conduct of clinical trials in chiropractic, including a small pilot we finished at Ft. Bliss last year. RAND has deep experience in qualitative research and the management of DoD studies and the Samueli Institute is knowledgeable about DoD procedures and how to navigate effectively through the system when conducting research.
Please elaborate on the key study parameters, outcome measures, etc. (number of participants, recruitment measures, how each of the above organizations will participate). The primary objectives of the main study are to 1) assess the effectiveness of chiropractic manipulative therapy (CMT) for pain management and improved function in active-duty service members with orthopedic injuries or disorders of the low back that do not require surgery; and 2) to assess the impact of a chiropractic intervention on smoking cessation. Two additional studies will assess the impact of CMT on strength, balance and likelihood of re-injury in Armed Forces with combat specialties and assess CMT's effects on reflexes and reaction times in Special Operations Forces (SOF).
Palmer is responsible for the design and implementation of all three studies to be conducted. RAND is responsible for fiscal oversight of the entire grant, quality control, some qualitative analysis and statistical analysis. The Samueli Institute will work with RAND on quality control and qualitative analysis, as assisting in obtaining IRB and other military approvals.
As you mention, the impact of chiropractic care on smoking cessation is one of the areas of study - what was the rationale for including it in this particular project, and how will you evaluate its value / outcome? The Military Program Announcement specifically called for a study on smoking cessation, so that was the rationale for including it in this particular project. We are working with Dr. Mitch Haas at Western States on this aspect of the study and will use a model for dissemination and evaluation that he and Dr. Judith Gordon have used in the past with chiropractic clinicians.
Do you believe these research findings will help propel widespread expansion of chiropractic services in the military (currently available at only 42 or so military facilities worldwide)? I think that will depend on the results. What I do know is that the desired outcome of this research is to provide information to the DoD that allows them to make evidence-based decisions regarding the appropriate role for chiropractic care for our service members in the Armed Forces; and that the results from this collection of clinical trials will provide critical information regarding the health and mission-support benefits of chiropractic health care delivery for active-duty service members in the military.
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