A preliminary path analysis of expectancy and patient-provider encounter in an open-label randomized controlled trial of spinal manipulation for cervicogenic headache.

Journal of Manipulative and Physiological Therapeutics
Mitchell HaasDarcy Vavrek

Abstract

The purpose of this article was to present a preliminary model to identify the effects of expectancy of treatment success and the patient-provider encounter (PPE) on outcomes in an open-label randomized trial. Eighty participants with chronic cervicogenic headache (CGH) were randomized to 4 groups: 2 levels of treatment dose (8 or 16) and 2 levels of therapy from a chiropractor (spinal manipulation or light massage). Providers were instructed to have equal enthusiasm for all care. Structural equation modeling with standardized path coefficients (beta) was used in a path analysis to identify the effects of patient expectancy and the PPE on CGH pain. The model included monthly pain from baseline to 12 weeks. Expectancy and PPE were evaluated on Likert scales. The patient-provider encounter was measured as patient perception of chiropractor enthusiasm, confidence, and comfort with care. Baseline patient expectancy was balanced across groups. The PPE measures were balanced across groups and consistent over the 8-week treatment period. Treatment and baseline pain had the strongest effects on pain outcomes (|beta| = .46-.59). Expectations had little effect on pain (abs value(beta) < .15). The patient-provider encounter had a weak eff...Continue Reading

Associated Clinical Trials

References

Feb 1, 1996·Controlled Clinical Trials·A R JadadH J McQuay
Jun 11, 1999·Spine·M R UnderwoodM R Vickers
Jul 29, 1999·The American Psychologist·I Kirsch, S J Lynn
Dec 11, 2007·Journal of General Internal Medicine·Samuel S MyersDavid M Eisenberg
May 13, 2009·Archives of Internal Medicine·Daniel C CherkinRichard A Deyo

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Citations

Apr 6, 2011·Current Pain and Headache Reports·Maurice B Vincent
Jun 7, 2011·Journal of Manipulative and Physiological Therapeutics·Roland BryansEleanor White
Jun 7, 2011·Journal of Manipulative and Physiological Therapeutics·Femke M de GrootArianne P Verhagen
Oct 22, 2013·The Spine Journal : Official Journal of the North American Spine Society·Mitchell HaasMoni B Neradilek
May 8, 2003·BMC Complementary and Alternative Medicine·Wadie I NajmArnold F Goodman
May 3, 2016·Manual Therapy·Marco Testa, Giacomo Rossettini
May 30, 2019·Chiropractic & Manual Therapies·Mégane PasquierMartin Descarreaux

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