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$14 Million Research Grant Puts SMT in the Spotlight

Chiro.Org Blog: 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. […]

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

Chiro.Org Blog: Overall, the 2 treatment groups were similar based on primary or secondary outcome measure scores for the full treatment period (4 weeks, with up to 7 treatments). However, there were statistically significant and clinically meaningful differences in both disability and pain scores at week 2 (midpoint) with 4 treatments, suggesting that the protocol of care had a more rapid effect than usual care. The results of this study offer guidance to musculoskeletal practitioners, who regularly use manual and manipulative therapy (MMT) for acute LBP, that an evidence-based, structured protocol of care may yield comparable results to usual care in a shorter period with less treatment. […]

Essential Literature for the Chiropractic Profession

Chiro.Org Blog: A systematic approach to surveying educators in all international chiropractic institutions was accomplished. The results of this survey provide a cursory list of essential literature for the chiropractic profession. An interesting follow-up or related study would be an examination of the scientific literature used in chiropractic program syllabi. We recommend establishment of a chiropractic faculty registry for ease of communication and collaboration. This could be done under a current established organization, such as the WFC, or alternatively as an international entity affiliated with the ACC. […]

Prevalence of Low Back Pain in Adolescents
with Idiopathic Scoliosis

Chiro.Org Blog: The results of this systematic review indicate that adolescents with idiopathic scoliosis frequently experience low back pain. However, there was insufficient evidence to confidently estimate low back pain prevalence in adolescents with idiopathic scoliosis and further studies are needed in this area. […]

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

Chiro.Org Blog:The current findings do not support the theory that HVLA-manipulation has a non-specific, reflex-mediated local or generalized analgesic effect on experimentally induced deep muscle pain. This in turn suggests, that any clinical analgesic effect of HVLA-manipulation is likely related to the amelioration of a pre-existing painful problem, such as reduction of biomechanical dysfunction. […]

Interprofessional Collaboration in Research, Education, and Clinical Practice

Chiro.Org Blog: When discussing collaboration, the key issues include putting the community or client first, the organization second, oneself last, and prejudices aside. Shortages in primary care providers and the challenges of managing chronic, complex diseases, such as musculoskeletal problems, are excellent opportunities for the health professions to bring unique skills to collaborative environments. Times are changing, silos are falling, national health burdens are being shared, and it is going to take much more than a single practitioner or paradigm to solve the serious health care issues confronting humanity today and in the future. Through collaboration, we can work together for a better future. […]

Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part 3

Chiro.Org Blog: Many commentators have recognised the limitations and inapplicability of the traditional quantitative pyramid hierarchy especially with respect to complementary and alternative (CAM) health care, observing the way Evidence-based Practice [EBP] is sometimes implemented is controversial, not only within the chiropractic profession, but in all other healthcare disciplines, including medicine itself. A phased approach to the development and evaluation of complex interventions can help researchers define the research process and complex interventions may require use of both qualitative and quantitative methods. The chiropractic profession has little to fear from evidence-based practice; in fact it should be used productively to improve patient care, clinical outcomes and the standing of the profession in the eyes of the public, other health professions and legislators. […]

Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part 2

Chiro.Org Blog: The plethora of quantitative evidence in chiropractic science stands in contrast to the relative dearth of qualitative studies. This phenomenon exists in spite of the intuitive impression that chiropractic is indeed suitable for investigation with a variety of qualitative methodologies. There is a long tradition of qualitative investigation in the social sciences, which focuses on gathering rich experiential data, recognising both that health research deals with ‘real’ people, and that people are not predictable or pre-determined. Qualitative chiropractic research can examine various aspects of a “package” of care and the participants “care journey” and the interplay between verbal and nonverbal, including tactile interactions, which may be diagnostic or therapeutic. Research in chiropractic ideally integrates experience, neurobiology and nonlinear dynamic thinking. Many chiropractic scientists are used to only working with linear models, consequently they may be reluctant to adopt the nonlinear framework of complexity theory and recognise that the analysis of lived experience including subjective phenomena can be an integral part of studies in the chiropractic space. […]

Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part I

Chiro.Org Blog: This paper discusses the role of sophisticated design in quantitative chiropractic research, presenting examples sequentially through the traditional quantitative hierarchy and concludes that optimal methodology depends on the research question. Research design must allow for the various dimensions of the (chiropractic) clinical encounter, and may be sophisticated at all levels, but must above all, be contextual. The ‘best available’ or most relevant evidence depends on what one needs for a specific purpose. A critical caution is the proviso that care must be exercised not to draw inappropriate conclusions such as causation from descriptive studies. […]

Chiropractic Research Review 2015

Chiro.Org Blog: Enjoy this fascinating review of Chiropractic Redsearch. […]

Evaluating the Relationship Among Cavitation, Zygapophyseal Joint Gapping, and Spinal Manipulation: An Exploratory Case Series

Chiro.Org Blog: This project determined the feasibility of conducting larger studies assessing the relationship between cavitation and zygapophyseal (Z) joint gapping following spinal manipulative therapy (SMT). […]

Chiropractors Included in New Danish Muscle and Joint Health Research Team

Chiro.Org Blog: A team of leading researchers, including chiropractors, have founded a new research institute that aims to become a top centre for musculoskeletal health. Research has previously shown that a Dane loses an average of seven years of good quality of life due to pain and functional problems related to the musculoskeletal system. Muscle and joint disorders now constitute the major cause of functional impairment of populations in Europe – larger than other common disorders like depression, dementia and heart disease. […]

Chiropractic Use of Somatosensory Evoked Potentials (SEPs) in Research

Chiro.Org Blog:Evoking and recording somatosensory evoked potentials (SEPs) is appearing in scientific literature that pertains to spinal manipulation (SM). There is evidence to support that SEPs are a neurophysiological technique capable of elucidating differences in cortical activity associated with an SM intervention. [1, 2] Haavik and Murphy [3] hypothesized that appropriate spinal movement normalizes afferent input and restores sensorimotor function and integration by filtering and processing appropriate somatosensory input. The purpose of this manuscript is to provide an overview of the origin, and application of somatosensory evoked potentials as a neurophysiological technique to investigate neuroplasticity. […]

Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Chiro.Org Blog: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients’ lives. Such cLBP is often termed non-specific, and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The NIH Pain Consortium therefore charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research participants (drawing heavily on the PROMIS methodology); reporting “responder analyses” in addition to mean outcome scores; and suggestions for future research and dissemination. […]

The First Research Agenda For theChiropractic Profession in Europe

Chiro.Org Blog: In total, 70 research priorities were identified, of which 19 reached consensus as priorities for future research. The following three items were thought to be most important: 1) cost-effectiveness/economic evaluations, 2) identification of subgroups likely to respond to treatment, and 3) initiation and promotion of collaborative research activities. […]