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Effects of Chiropractic on Chronic Cancer-related Fatigue

Not Applicable
Not yet recruiting
Conditions
Cancer
Fatigue
Interventions
Procedure: Chiropractic care
Registration Number
NCT06235671
Lead Sponsor
Life University
Brief Summary

The primary aims of the proposed trial are centered around examining the feasibility of conducting a prospective, chiropractic intervention study on a population of cancer survivors living in and around Atlanta, Georgia. This includes evaluating various implementation outcomes including recruitment, adherence, tolerability, retention, acceptability, and data fidelity. The results of this trial will inform the design of a future randomized controlled trial (RCT) that has an increased focus on the efficacy/effectiveness of chiropractic care on chronic cancer-related fatigue (CCRF) and other cancer-related sequelae in cancer survivors.

Detailed Description

Cancer remission is often marked by the cessation of curative-intent treatments (e.g., surgery, chemotherapy, radiotherapy, immunotherapy), however, troublesome signs and symptoms (e.g., fatigue, depression, cognitive impairment, dysautonomia) related to the cancer and its treatments commonly persist for prolonged periods (i.e., months to years). Of these, chronic cancer-related fatigue (CCRF) is one of the most frequently reported and debilitating symptoms. CCRF may be characterized as tiredness or exhaustion persisting for 3 or more months following the completion of the primary curative-intent cancer therapies which is independent on one's quantity or quality of rest and causes impairments in daily functioning and quality of life. Notably, although the mechanisms underlying CCRF are still unclear, there is some evidence that it may be related to autonomic dysregulation.

Irrespective of the cause(s), lack of identification of and treatment for CCRF and other chronic cancer-related sequelae is commonplace. Further, empirical data supporting the efficacy of interventions to remediate these issues are relatively sparse and urgently needed as the global population of cancer survivors continues to increase. Of note, although there is no universally accepted definition of 'cancer survivor', the investigators define it here as someone who has completed their primary curative-intent therapies and is cancer-free (i.e., has no evidence of active disease). This definition is in line with that of the European Organisation of Research \& Treatment of Cancer (EORTC) Survivorship Task Force and the EORTC Quality of Life Group.

Interestingly, a recent study suggested that a single chiropractic adjustment may mitigate lower extremity muscular fatigue during isometric exercise in young, healthy males. However, to the investigators' knowledge, the impact of chiropractic care on CCRF and other health-related challenges that burden cancer survivors has yet to be investigated.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Able to understand and provide written informed consent in English
  • 18-65 years of age
  • Informed by primary health care provider that there is no evidence of active disease (this is sometimes referred to as "complete remission" or "cured")
  • Minimum of 3 months since completion of primary curative-intent cancer therapies including surgery, chemotherapy, radiotherapy, and/or immunotherapy (long-term hormonal therapy permitted)
  • Onset of fatigue occurred at some point during illness and/or treatment
  • FACIT-Fatigue scale score in the moderate-to-severe range (i.e., at or above the 60th percentile)
  • If on any prescription medication (including hormonal therapy), on a stable dose for a minimum of 12 weeks with no plans to change medications or doses during the study
Exclusion Criteria
  • Taking any short-acting benzodiazepine including midazolam & triazolam
  • Known disorder resulting in syncope/fainting during postural changes (e.g., postural orthostatic tachycardia syndrome, orthostatic hypotension)
  • Pacemaker or known heart condition that influences the electrical or mechanical function of the heart (e.g., severe heart valve disease)
  • Diagnosed with an externalizing (e.g., substance use, antisocial disorder) or thought (e.g., schizophrenia, paranoid personality, bipolar) disorder that is uncontrolled or untreated
  • Diagnosed with rheumatoid arthritis, osteoporosis, or cervical spine instability
  • Currently pregnant
  • Current litigation related to a physical, health-related injury
  • Chronic pain rated at least 3/10 on a visual analog scale (VAS)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Chiropractic interventionChiropractic careUpper cervical chiropractic care
Primary Outcome Measures
NameTimeMethod
Participant tolerability6-month data collection period

Proportion of participants unable/unwilling to complete a given assessment

Participant retention6-month data collection period

Proportion of participants completing the trial

Assessment acceptability6-month data collection period

Most common patient-related acceptability score for each assessment process/procedure

Data fidelity6-month data collection period

Proportion of acquisitions from a given assessment that are unsuitable for analysis

Participant compliance6-month data collection period

Proportion of participants violating 1 or more pre-assessment lifestyle restrictions \& unable/unwilling to be rescheduled

Participant adherence6-month data collection period

Proportion of participants not attending at least 80% of their chiropractic sessions

Participant recruitment6-month data collection period

Average number of participants recruited/enrolled per month

Participant scheduling6-month data collection period

Average time lag between first lab assessment \& first chiropractic visit

Implementation acceptability6-month data collection period

Most common clinician-rated acceptability score for each trial process/procedure

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Dr. Sid E. Williams Center for Chiropractic Research

🇺🇸

Atlanta, Georgia, United States

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