Weronika Grabowska, Wren Burton, Matthew Kowalski, Robert Vining, Cynthia Long, Anthony Lisi, Jeffrey Hausdorff, Brad Manor, Dennis Muñoz-Vergara, Peter Wayne
Research Category: Musculoskeletal/Orthopedics/Sports Medicine
Background: Falls in older adults are a growing public health concern. Multiple risk factors associated with falls may be addressed within the scope of chiropractic training and licensure. Few attempts have been made to summarize existing evidence on multimodal chiropractic care and fall risk mitigation.
Body: Systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Embase, Cochrane Library, PEDro, and Index of Chiropractic Literature. Eligible study designs included randomized controlled trials (RCT), prospective non-randomized controlled, observational, and cross-over studies in which multimodal chiropractic care was the primary intervention and changes in gait, balance and/or falls were outcomes. Risk of bias was also assessed. Original search yielded 889 articles; 21 met final eligibility. One study directly measured the frequency of falls (underpowered secondary outcome) while most studies assessed short-term measurements of gait and balance. Overall methodological quality and findings were mixed, limiting interpretation regarding the potential impact of chiropractic care on fall risk.
Conclusion: Little high-quality research has been published addressing how multimodal chiropractic care can positively influence fall prevention. We propose strategies for building an evidence base informing the role of multimodal chiropractic care in fall prevention and outline recommendations for future research to fill current evidence gaps.
Background: Falls in older adults are a growing public health concern. By nature, chiropractic care uses many treatments (multimodal) and has the potential to target multiple fall risk factors. This may provide advantages over single treatment approaches when managing fall risk older adults. Summarizing evidence on multimodal chiropractic care and fall prevention has not been completed to date.
Body: We searched for studies through June 2022 looking at multimodal chiropractic care and changes to gait, balance, and/or falls. We found 21 eligible trials including 976 participants. Participants varied widely in terms of age and condition being treated. Only one study directly measured the frequency of falls, and most studied short-term measurements of gait and balance. Reductions in risk of bias ratings were due to problems such as study design, small numbers of participants, or difference in how outcomes were measured. Interpreting the results from these studies was challenging.
Conclusion: We need more high-quality research trials to address the role of multimodal chiropractic care in fall prevention. We outline strategies for building an evidence base to inform these trials and provide suggestions for future research in this area.