The Boot Camp Program is a structured, multimodal six-week course combining patient education, manual therapy, and daily home exercises. Its aim is to improve walking ability, reduce pain, and enhance patient self-management. The program has previously shown promising results in specialized clinics in Canada and the USA, but this pilot study is the first to examine its feasibility in a Danish chiropractic context.
The study was conducted in two Danish chiropractic clinics, involving 38 patients. Participants received 12 treatments over six weeks and were followed for up to one year. Most reported improvements in walking distance, pain, and function at follow-up points. The average walking distance measured on a treadmill increased from 415 meters to 1,295 meters at the 12-week follow-up - an improvement of over 212%.
Although patients generally adhered well to the program, the home exercise component proved more challenging, especially as the volume of exercises increased. However, many patients managed to complete one daily exercise session 5 - 7 days a week, suggesting that a modified and more flexible version of the program could improve adherence in practice.
The study also showed certain implementation barriers. Recruitment was slower than expected, and the target of 50 participants was not reached within the planned timeframe. Additionally, the use of paper-based self-reported data such as exercise diaries and pedometers was cumbersome and partly ineffective, unlike the electronically collected data. Researchers therefore recommend using digital tools to monitor treatment compliance and considering recruitment through general practice and hospital units in future studies.
The content of the Boot Camp Program aligns with recent international clinical guidelines recommending multimodal, conservative treatment for LSS, and the program also fits the structure of chiropractic care packages. It could potentially be used as a structured treatment offering in clinical practice.
The study documents that the program is feasible in everyday practice, but also that successful implementation requires attention to logistics, patient motivation, and resource use. The Boot Camp Program may therefore be a useful tool for Danish chiropractors.
Rikke Krüger Jensen, Lisbeth Hartvigsen, Berit Schiøttz‑Christensen, Henrik Wulff Christensen, Jan Hartvigsen. The Boot Camp treatment program for patients with lumbar spinal stenosis in Danish chiropractic care—a feasibility study. Pilot and Feasibility Studies 2025.
Read the research paper here