• Mior S
• Sutton D
• To D
• Cancelliere C
• French S
• Taylor-Vaisey A
• Côté P

• Affiliation / Canadian Memorial Chiropractic College (CMCC). Division of Research and Innovation
• Affiliation / Centre for Disability Prevention and Rehabilitation (CDPR), Ontario Tech University and Canadian Memorial Chiropractic College (CMCC)
• Affiliation / Macquarie University. Faculty of Science and Engineering. Department of Chiropractic
• Affiliation / Ontario Tech University. Faculty of Health Sciences
• Affiliation(G) / Australia / New South Wales / North Ryde
• Affiliation(G) / Canada / Ontario / Oshawa
• Affiliation(G) / Canada / Ontario / Toronto
• Military Chiropractic
• Military Medicine
• Military Personnel
• Open Access Document
• Review Literature as Topic

Background: Musculoskeletal injuries are one of the most prevalent battle and non-battle related injuries in the active duty military. In some countries, chiropractic services are accessed to manage such injuries within and outside military healthcare systems; however, there is no recent description of such access nor outcomes. This scoping review aimed to synthesize published literature exploring the nature, models, and outcomes of chiropractic services provided to active duty military globally.

Method: We employed scoping review methodology. Systematic searches of relevant databases, including military collections and hand searches were conducted from inception to October 22, 2018. We included peer-reviewed English literature with qualitative and quantitative designs, describing chiropractic practice and services delivered to active duty military worldwide. Paired reviewers independently reviewed all citations and articles using a two-phase screening process. Data from relevant articles were extracted into evidence tables and sorted by study type. Results were descriptively analyzed.

Results: We screened 497 articles and 20 met inclusion criteria. Chiropractic services were commonly provided on-base only in the US. Services were accessed by physician referral and commonly after initiation or non-response to other care. Use of scope of practice was determined by the system/facility, varying from intervention specific to comprehensive services. Back pain with and without radiculopathy accounted for most complaints. Treatment outcomes were reported primarily by case reports. However, two recent randomized trials reported improved pain, disability, and satisfaction when adding chiropractic care to usual medical care compared to usual medical care alone in management of low back pain. Specific reaction time measures in special operation forces military did not improve after chiropractic care compared to wait-list control.

Conclusions: Our scoping review found the majority of published articles described chiropractic services in the active duty military in the US setting. Recent RCTs suggest a benefit of including chiropractic care to usual medical care in managing back pain in active duty military. Yet despite reported benefits in Australia, Canada, and the US, there is a need for further qualitative, descriptive, and clinical trial data worldwide to inform the role of chiropractic services in active duty military.

Author keywords: Military personnel — Active duty — Chiropractic — Military medicine

Author affiliations: SM, DS, DT, CC, AT-V, PC: UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Ontario, Canada; SM: Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada; CC, PC: Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada; SF: Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, North Ryde, New South Wales, Australia

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record