{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:30:19Z","timestamp":1790368219357,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T00:00:00Z","timestamp":1572307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["R18HP15127"],"award-info":[{"award-number":["R18HP15127"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01\u2010AT\u201000896"],"award-info":[{"award-number":["K01\u2010AT\u201000896"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Back and neck pain are associated with disability and loss of independence in older adults. Whether long\u2010term management using commonly recommended treatments is superior to shorter\u2010term treatment is unknown. This randomized clinical trial compared short\u2010term treatment (12 weeks) versus long\u2010term management (36 weeks) of back\u2010 and neck\u2010related disability in older adults using spinal manipulative therapy (<jats:styled-content style=\"fixed-case\">SMT<\/jats:styled-content>) combined with supervised rehabilitative exercises (<jats:styled-content style=\"fixed-case\">SRE<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eligible participants were ages \u226565 years with back and neck disability for \u226512 weeks. Coprimary outcomes were changes in Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores after 36 weeks. An intent\u2010to\u2010treat approach used linear mixed\u2010model analysis to detect between\u2010group differences. Secondary analyses included other self\u2010reported outcomes, adverse events, and objective functional measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 182 participants were randomized. The short\u2010term and long\u2010term groups demonstrated significant improvements in back disability (<jats:styled-content style=\"fixed-case\">ODI<\/jats:styled-content> score \u20133.9 [95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) \u20135.8, \u20132.0] versus <jats:styled-content style=\"fixed-case\">ODI<\/jats:styled-content> score \u20136.3 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u20138.2, \u20134.4]) and neck disability (<jats:styled-content style=\"fixed-case\">NDI<\/jats:styled-content> score \u20137.3 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u20139.1, \u20135.5] versus <jats:styled-content style=\"fixed-case\">NDI<\/jats:styled-content> score \u20139.0 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u201310.8, \u20137.2]) after 36 weeks, with no difference between groups (back <jats:styled-content style=\"fixed-case\">ODI<\/jats:styled-content> score 2.4 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u20130.3, 5.1]; neck <jats:styled-content style=\"fixed-case\">NDI<\/jats:styled-content> score 1.7 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.8, 4.2]). The long\u2010term management group experienced greater improvement in neck pain at week 36, in self\u2010efficacy at weeks 36 and 52, and in functional ability, and balance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For older adults with chronic back and neck disability, extending management with <jats:styled-content style=\"fixed-case\">SMT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SRE<\/jats:styled-content> from 12 to 36 weeks did not result in any additional important reduction in disability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23798","type":"journal-article","created":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T10:04:45Z","timestamp":1540375485000},"page":"1516-1524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Short\u2010 or Long\u2010Term Treatment of Spinal Disability in Older Adults With Manipulation and Exercise"],"prefix":"10.1002","volume":"71","author":[{"given":"Michele","family":"Maiers","sequence":"first","affiliation":[{"name":"Northwestern Health Sciences University  Bloomington Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hartvigsen","sequence":"additional","affiliation":[{"name":"University of Southern Denmark and Nordic Institute of Chiropractic and Clinical Biomechanics  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roni","family":"Evans","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Westrom","sequence":"additional","affiliation":[{"name":"Northwestern Health Sciences University  Bloomington Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Schulz","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Leininger","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Bronfort","sequence":"additional","affiliation":[{"name":"University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.04.017"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-003-0542-y"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-5-200109040-00007"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13089"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-13-168"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000099394.18994.2F"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31678-6"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12066"},{"key":"e_1_2_6_10_1","unstructured":"OrtmanJM VelkoffVA HoganH.An aging nation: the older population in the United States. 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