Impact of the MAINTAIN instrument on clinical decision-making for new spinal pain patients: a cross-sectional study

J Can Chiropr Assoc. 2026 Apr;70(1):81-93. Epub 2026 Apr 30.

ABSTRACT

OBJECTIVE: This quantitative pilot study with a qualitative adjunct aimed to characterize patients at two U.S.-based chiropractic teaching clinics using the novel MAINTAIN instrument, and to assess clinicians' and interns' initial clinical impressions based on patients' MAINTAIN scores.

METHODS: Between February and September 2022, 597 spinal pain patients were screened. Eligible patients (n=91) completed demographic and health questionnaires, including the MAINTAIN instrument. Clinicians and interns completed surveys to assess treatment plans and expectations for recovery. A qualitative analysis assessed clinicians' and interns' initial impressions based on patients' MAINTAIN scores.

RESULTS: The mean MAINTAIN score was 15.06 (SD: 9.03, range -7 to 32), with 39.6% of participants identified as potential candidates for maintenance care. Qualitative analysis identified several themes and subthemes which describe how clinicians and interns used patients' MAINTAIN scores.

CONCLUSIONS: Despite limitations, these findings highlight the value of integrating the MAINTAIN instrument in chiropractic teaching clinics to enhance clinical decision-making and patient management.

PMID:42238488 | PMC:PMC13229142