The Quality of Life of Children Under Chiropractic Care Using PROMIS-25: Results from a Practice-Based Research Network

Objectives: To characterize pediatric chiropractic and assess pediatric quality of life (QoL). Design: A prospective cohort. Setting/Locations: Individual offices within a practice-based research network located throughout the United States. Subjects: A convenience sample of children (8-17 years) under chiropractic care and their parents. Exposure: Chiropractic spinal adjustments and adjunctive therapies. Outcome measures: Survey instrument measuring sociodemographic information and correlates from the clinical encounter along with the Patient Reported Outcomes Measurement Information System (PROMIS)-25 to measure QoL (i.e., depression, anxiety, and pain interference). Sociodemographic and clinical correlates were analyzed using descriptive statistics (i.e., frequencies/percentages, means, and standard deviations). The PROMIS-25 data were analyzed using scoring manuals, converting raw scores to T score metric (mean=50; SD=10). A generalized linear mixed model was utilized to examine covariates (i.e., sex, number of visits, and motivation for care) that may have played an important role on the PROMIS outcome. Results: The original data set consisted of 915 parent-child dyads. After data cleaning, a total of 881 parents (747 females, 134 males; mean age=42.03 years) and 881 children (467 females and 414 males; mean age=12.49 years) comprised this study population. The parents were highly educated and presented their child for mainly wellness care. The mean number of days and patient visits from baseline to comparative QoL measures was 38.12 days and 2.74 (SD=2.61), respectively. After controlling for the effects of motivation for care, patient visits, duration of complaint, sex, and pain rating, significant differences were observed in the probability of experiencing problems (vs. no reported problems) across all QoL domains (Wald=82.897, df=4, p<0.05). Post hoc comparisons demonstrated the children were less likely to report any symptoms of depression (Wald=6.1474, df=1, p<0.05), anxiety (Wald=20.603, df=1, p<0.05), fatigue (Wald=22.191, df=1, p<0.05), and pain interference (Wald=47.422, df=1, p<0.05) after a trial of chiropractic care. Conclusions: The QoL of children improved with chiropractic care as measured by PROMIS.