When we hear the term “quality of life” it is usually used to describe someone who is aging, frail or in the grip of illness that affects their ability to engage with life in a healthy and vital way. Rarely do we think about quality of life outside of that construct. But perhaps we should, when the tools used to measure quality of life within a research context are actually measuring things like physical and mental wellbeing, social connectedness, daily activities, personal development or personal fulfillment and more. Thus, when some notable chiropractic research names decided to do a little investigating into the impact of chiropractic on quality of life in children, it becomes quite a compelling question.
Those names were chiropractors Joel and Junjoe Alcantara, Andrew Whetten and the late, great Jeannie Ohm, and the resulting paper was carried in the journal of Complementary Therapies in Clinical Practice. It follows work that Alcantara and colleagues published back in 2010, in which it was estimated that “86 million pediatric visits were made annually to chiropractors in the United States” alone .
Thus, Alcantara et al set about measuring whether chiropractic care improved Quality of Life in these kids but undertaking a survey-based research project within a practice-based research network.
The survey they used was not an uncommon one. It is called the “Patient-Reported Outcomes Measurement Information System” or PROMIS and is a measurement tool that pops up in numerous research projects across disciplines. This means, essentially, that it is tried and tested. Chiropractors who were eligible to participate invited parents of children between the ages of 8-17 who were under chiropractic care to respond.
- 1% of respondents brought their child in for a combination of wellness care and for relief of symptoms.
- 4% brought their child in for wellness care alone
- 5% brought their child in solely for symptom relief.
- 69% indicated that their child presented with a symptom or physical complaint
- 6% of these indicated that it was chronic
- 80% of responders were also under chiropractic care at the same time as their child.
From here, the statistical breakdown gets interesting, as it begins to delve into traditional medical care in comparison to chiropractic care. Nearly half of parents (44.5%) said their medical doctor knew about their child’s chiropractic care while more than 54% chose not to tell them. In just 1% of cases, the doctor actually made the referral. Attitudes regarding the effectiveness of medical care took up a significant part of the findings. However, it is the quality-of-life aspect which presented significant findings.
The researchers remarked that “All PROMISE QoL [quality of life] measures changed from T1 [baseline] to T2 [comparison point] in a statistically significant manner. More importantly, the changes were associated with improvements in QoL. ”
The paper specifically looked at anxiety, depression, fatigue, pain and physical function, which presents interesting considerations given the improvements noted across the board in terms of the PROMIS questionnaire results.
Another interesting note is this: we know that parent-proxy questionnaires give some room for error in terms of estimations. However, Alcantara et al cite other research that indicated that parents tend to over-estimate their child’s Quality of Life. Therefore, the difference could be even greater than we currently think.
There is, of course, more work to be done. When you are looking at a “child” age group spanning age 8 to 17, there are clearly many different developmental stages and core concerns within that group. This particular study was also looking at a large number of factors, which meant there was a lot of numbers to be crunched concerning different ages, symptoms and quality of life factors. All of this presents opportunity for further research. But for now, what we know is this:
“Following a course of chiropractic care, the QoL [Quality of Life] of children improved beyond chance as assessed by their parents. We encourage further research in this area of pediatric chiropractic .”
To be frank, we couldn’t agree more.
Alcantara, J., Whetten, A., Ohm, J., and Alcantara, J., (2020). The Quality of life in children under chiropractic care as measured by the PROMIS parent-proxy short forms. Complementary Therapies in Clinical Practice. 39(2020), DOI: https://doi.org/10/1016/j.ctcp.2020.101134