A systematic review of chiropractic care for fall prevention: rationale, state of the evidence, and recommendations for future research

Weronika Grabowska, Wren Burton*, Matthew H. Kowalski, Robert Vining, Cynthia R. Long, Anthony Lisi, Jeffrey M. Hausdorff, Brad Manor, Dennis Muñoz-Vergara, Peter M. Wayne

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Falls in older adults are a significant and growing public health concern. There are multiple risk factors associated with falls that 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. Therefore, the broad purpose of this review was to summarize this research to date. 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 using the 8-item Cochrane Collaboration Tool. The original search yielded 889 articles; 21 met final eligibility including 10 RCTs. One study directly measured the frequency of falls (underpowered secondary outcome) while most studies assessed short-term measurements of gait and balance. The overall methodological quality of identified studies and findings were mixed, limiting interpretation regarding the potential impact of chiropractic care on fall risk to qualitative synthesis. Conclusion: Little high-quality research has been published to inform how multimodal chiropractic care can best address and positively influence fall prevention. We propose strategies for building an evidence base to inform the role of multimodal chiropractic care in fall prevention and outline recommendations for future research to fill current evidence gaps.

Original languageEnglish
Article number844
JournalBMC Musculoskeletal Disorders
Volume23
Issue number1
DOIs
StatePublished - Dec 2022
Externally publishedYes

Funding

FundersFunder number
National Chiropractic Mutual Insurance Company
National Institutes of HealthK24
National Center for Advancing Translational SciencesUL1TR001863
Office of Extramural Research, National Institutes of Health
National Center for Complementary and Integrative HealthK24AT009282
Office of Research Infrastructure Programs, National Institutes of Health

    Keywords

    • Balance
    • Chiropractic
    • Chiropractic care
    • Fall prevention
    • Falls
    • Gait

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