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Research Priorities of the Canadian Chiropractic Profession

By |December 14, 2017|Chiropractic Research|

Research Priorities of the Canadian Chiropractic Profession: A Consensus Study Using a Modified Delphi Technique

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2017 (Dec 12); 25: 38

Simon D. French, Peter J. H. Beliveau, Paul Bruno, Steven R. Passmore, Jill A. Hayden, John Srbely and Greg N. Kawchuk

School of Rehabilitation Therapy,
Queen’s University


Background   Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance.

Methods   We conducted a modified Delphi consensus study between August 2015 and May 2017 to determine the views of Canadian chiropractic organisations (e.g. Canadian Chiropractic Association; provincial associations) and stakeholder groups (e.g. chiropractic educational institutions; researchers). Participants completed three online Delphi survey rounds. In Round 1, participants suggested research areas within four broad research themes:

1)   Basic science;
2)   Clinical;
3)   Health services; and
4)   Population health.

In Round 2, researchers created sub-themes by categorising the areas suggested in Round 1, and participants judged the importance of the research sub-themes. We defined consensus as at least 70% of participants agreeing that a research area was “essential” or “very important”. In Round 3, results from Round 2 were presented to the participants to re-evaluate the importance of sub-themes. Finally, participants completed an online pairwise ranking activity to determine the rank order of the list of important research sub-themes.

Results   Fifty-seven participants, of 85 people invited, completed Round 1 (response rate 67%). Fifty-six participants completed Round 2, 55 completed Round 3, and 53 completed the ranking activity. After three Delphi rounds and the pairwise ranking activity was completed, the ranked list of research sub-themes considered important were:

1)   Integration of chiropractic care into multidisciplinary settings;
2)   Costs and cost-effectiveness of chiropractic care;
3)   Effect of chiropractic care on reducing medical services;
4)   Effects of chiropractic care;
5)   Safety/side effects of chiropractic care;
6)   Chiropractic care for older adults;
7)   Neurophysiological mechanisms and
       effects of spinal manipulative therapy;
8)   General mechanisms and effects of spinal manipulative therapy.

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Chiropractic Research Agenda Page

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$14 Million Research Grant Puts SMT in the Spotlight

By |December 9, 2017|Chiropractic Research|

$14 Million Research Grant Puts SMT in the Spotlight

The Chiro.Org Blog


SOURCE:   Dynamic Chiropractic 2017 (Nov); 35 (11)


  Landmark study could solidify DCs as the
  first line of care for acute LBP.  

The National Institutes of Health has awarded a $14 million grant to the University of Minnesota and University of Washington to study the benefits of spinal manipulation for back pain vs. standard medical care (including prescription medication).

Touted as one of the largest back pain studies ever funded by the NIH’s National Center for Complementary and Integrative Health, the national, multi-site clinical trial will feature a multidisciplinary research team from the chiropractic, medical, osteopathic, physical therapy and psychology fields, representing a half-dozen universities.

Participating researchers hail from the University of Minnesota (whose
Earl E. Bakken Center for Spirituality & Healing received the bulk of the NIH award for the clinical trial, which will be conducted at the University of Minnesota and the University of Pittsburgh – two of the leading research-based universities in the U.S.), the University of Washington (which received the remaining funds for data management / statistical support), Oregon Health and Sciences University, Duke University, and the University of North Texas.

The “Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain Trial” will compare spinal manipulative therapy and supported self-management vs. usual medical care (including prescription medications). Supported self-care includes behavioral and copies strategies, mind-body approaches, lifestyle advice, and pain education – all designed to address the biopsychosocial aspects of back pain. Nearly 1,200 patients will be enrolled in the study beginning next spring.

Gert Brontfort, DC, PhD, a professor in the Bakken Center’s Integrative Health and Wellbeing Research Program, will serve as lead investigator on the study. Other doctors of chiropractic involved in the study include the University of Pittsburgh’s Michael Schneider, DC, PhD (co-principal investigator for the Clinical Coordinating Center, which will conduct the clinical trial) and Joel Stevens, DC, PhD; Roni Evans, DC, PhD (who directs the Integrative Health and Wellbeing Research Program at the University of Minnesota Bakken Center), and Brent Leininger, DC, MS, also from the U. of Minnesota.

The Earl E. Bakken Center for Spirituality & Healing is partially funded by the NCMIC Foundation. According to Mary Jo Kreitzer, PhD, RN, FAAN, a professor in the School of Nursing at the U. of Minnesota and director of the Bakken Center, “The support of NCMIC Foundation has been pivotal to helping the Center establish a world-class research program in chiropractic and integrative health from the influential platform of a prestigious land-grant university. It has also helped us to advance future research affiliations.”


The Chiropractic Perspective:
Q&A With Drs. Brontfort and Evans

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A Structured Protocol of Evidence-based Conservative Care Compared with Usual Care for Acute Nonspecific Low Back Pain

By |September 16, 2017|Chiropractic Research, Randomized Controlled Trial|

A Structured Protocol of Evidence-based Conservative Care Compared with Usual Care for Acute Nonspecific Low Back Pain: A Randomized Clinical Trial

The Chiro.Org Blog


SOURCE:   Arch Phys Med Rehabil. 2012 (Jan); 93 (1): 11–20

Gregory F. Parkin-Smith, MTech(Chiro), MSc, DrHC,
Ian J. Norman, BSc, MSc, PhD,
Emma Briggs, BSc, PhD, RN,
Elizabeth Angier, BSc, MSc(Chiro),
Timothy G. Wood, BSc, MTech(Chiro),
James W. Brantingham, DC, PhD

School of Chiropractic & Sports Science,
Murdoch University,
Perth, Australia.


OBJECTIVE:   To compare a protocol of evidence-based conservative care with usual care for acute nonspecific low back pain (LBP) of less than 6 weeks’ duration.

DESIGN:   Parallel-group randomized trial.

SETTING:   Three practices in the United Kingdom.

PARTICIPANTS:   Convenience sample of 149 eligible patients were invited to participate in the study, with 118 volunteers being consented and randomly allocated to a treatment group.

INTERVENTIONS:   The experimental group received evidence-based treatments for acute nonspecific LBP as prescribed in a structured protocol of care developed for this study. The control group received usual conservative care. Participants in both groups could receive up to 7 treatments over a 4-week period.

MAIN OUTCOME MEASURES:   Oswestry Low Back Disability Index (ODI), visual analog scale (VAS), and Patient Satisfaction Questionnaire, alongside estimation of clinically meaningful outcomes.

RESULTS:   Total dropout rate was 14% (n=16), with 13% of data missing. Missing data were replaced using a multiple imputation method. Participants in both groups received an average of 6 treatments. There was no statistically significant difference in disability (ODI) scores at the end of week 4 (P=.33), but there was for pain (VAS) scores (P< .001). Interestingly, there were statistically significant differences between the 2 groups for both disability and pain measures at the midpoint of the treatment period (P<.001). Patient satisfaction with care was equally high (85%) in both groups. Minimally clinically important differences in scores and number needed to treat scores (NNT<6) indicated that the experimental treatment (protocol of care) offered a clinically meaningful benefit over the control treatment (usual care), particularly at the midpoint of the treatment period.

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Low Back Pain and Chiropractic Page

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Essential Literature for the Chiropractic Profession

By |August 7, 2017|Chiropractic Research|

Essential Literature for the Chiropractic Profession: Results and Implementation Challenges from a Survey of International Chiropractic Faculty

The Chiro.Org Blog


SOURCE:   Journal of Chiropractic Education 2017 (Aug 2) [Epub]

Barbara A. Mansholt, DC, MS,
Stacie A. Salsbury, PhD, RN,
Lance G. Corber, MSITM,
and John S. Stites, DC

Palmer College of Chiropractic
1000 Brady Street,
Davenport, IA 52803


OBJECTIVE:   Scientific literature applicable to chiropractic practice proliferates in quantity, quality, and source. Chiropractic is a worldwide profession and varies in scope between states or provinces and from country to country. It is logical to consider that the focus and emphasis of chiropractic education varies between programs as well. This original research study endeavored to determine “essential literature” recommended by chiropractic faculty. The purpose of this article is (1) to share our results and (2) to promote discussion and explore means for future collaboration of chiropractic faculty through a worldwide platform.

METHODS:   A 2-phase recruitment occurred initially at the institutional level and subsequently at the faculty level. A Web-based survey used qualitative data collection methods to gather bibliographic citations. Descriptive statistics were calculated for demographics, and citation responses were ranked per number of recommendations, grouped into categories, and tabulated per journal source and publication date.

RESULTS:   Forty-one chiropractic programs were contacted, resulting in 30 participating chiropractic programs (16 US and 14 international). Forty-five faculty members completed the entire survey, submitting 126 peer-reviewed publications and 25 additional citations. Readings emphasized clinical management of spine pain, the science of spinal manipulation, effectiveness of manual therapies, teaching of chiropractic techniques, outcomes assessments, and professional issues.

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About Chiropractic Page


Make sure to review Table 2   which reports on the top 126 peer-reviewed submissions..

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Prevalence of Low Back Pain in Adolescents
with Idiopathic Scoliosis

By |April 24, 2017|Chiropractic Research, Scoliosis|

Prevalence of Low Back Pain in Adolescents with Idiopathic Scoliosis: A Systematic Review

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2017 (Apr 20); 25: 10

Jean Théroux, Norman Stomski, Christopher J. Hodgetts,
Ariane Ballard, Christelle Khadra, Sylvie Le May and
Hubert Labelle

Research Center,
Sainte-Justine University Hospital Center
School of Health Profession,
Murdoch University


Background   Adolescent idiopathic scoliosis is the most common spinal deformity occurring in adolescents and its established prevalence varies from 2 to 3%. Adolescent idiopathic scoliosis has been identified as a potential risk factor for the development of low back pain in adolescents. The purpose of this study was to systematically review studies of the prevalence of low back pain in adolescents with idiopathic scoliosis in order to establish the quality of the evidence and determine whether the prevalence estimates could be statistically pooled.

Methods   Systematic electronic searches were undertaken in PubMed, CINAHL, and CENTRAL without any restrictions. Studies were eligible for inclusion if they reported the prevalence of low back pain in adolescents with idiopathic scoliosis. Studies were excluded if they detailed the prevalence of pain in post-surgical subjects or were published in languages other than English or French. Data were reported qualitatively, since there was insufficient evidence for statistical pooling.

Results   The electronic search strategies yielded 1811 unique studies. Only two studies fulfilled the eligibility criteria. The prevalence of low back pain in adolescents with idiopathic scoliosis ranged from 34.7 to 42.0%. However, these prevalence estimates should be viewed cautiously as the included studies were at high risk of bias.

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Scoliosis and Chiropractic Page

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The Effect of Spinal Manipulation on Deep Experimental Muscle Pain in Healthy Volunteers

By |February 23, 2017|Chiropractic Research, Pain Relief|

The Effect of Spinal Manipulation on Deep Experimental Muscle Pain in Healthy Volunteers

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2015 (Sep 7);   23:   25

Søren O’Neill, Øystein Ødegaard-Olsen and Beate Søvde

Institute of Regional Health Research,
University of Southern Denmark,
Campusvej 55, Odense, 5230 DK Denmark ;

Spine Centre of Southern Denmark,
Lillebælt Hospital, Østre Hougvej 55,
Middelfart, 5500 DK Denmark


BACKGROUND:   High-velocity low-amplitude (HVLA) spinal manipulation is commonly used in the treatment of spinal pain syndromes. The mechanisms by which HVLA-manipulation might reduce spinal pain are not well understood, but often assumed to relate to the reduction of biomechanical dysfunction. It is also possible however, that HVLA-manipulation involves a segmental or generalized inhibitory effect on nociception, irrespective of biomechanical function. In the current study it was investigated whether a local analgesic effect of HVLA-manipulation on deep muscle pain could be detected, in healthy individuals.

METHODS AND MATERIALS:   Local, para-spinal muscle pain was induced by injection of 0.5 ml sterile, hyper-tonic saline on two separate occasions 1 week apart. Immediately following the injection, treatment was administered as either a) HVLA-manipulation or b) placebo treatment, in a randomized cross-over design. Both interventions were conducted by an experienced chiropractor with minimum 6 years of clinical experience. Participants and the researcher collecting data were blinded to the treatment allocation. Pain scores following saline injection were measured by computerized visual analogue pain scale (VAS) (0-100 VAS, 1 Hz) and summarized as a) Pain duration, b) Maximum VAS, c) Time to maximum VAS and d) Summarized VAS (area under the curve). Data analysis was performed as two-way analysis of variance with treatment allocation and session number as explanatory variables.

RESULTS:   Twenty-nine healthy adults (mean age 24.5 years) participated, 13 women and 16 men. Complete data was available for 28 participants. Analysis of variance revealed no statistically significant difference between active and placebo manipulation on any of the four pain measures.

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Chiropractic and Spinal Pain Page and the:

Subluxation Neurology Section

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