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The Research Crisis in American Institutions of Complementary and Integrative Health

By |June 18, 2019|Chiropractic Research|

The Research Crisis in American Institutions of Complementary and Integrative Health:
One Proposed Solution for the Chiropractic Profession

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2019 (Jun 17); 27: 32

Ian D. Coulter and Patricia M. Herman

RAND Corporation,
1776 Main Street, P.O. Box 2138,
Santa Monica, CA 90407-2138, USA


A crisis confronts the Complementary and Integrative Health (CIH) teaching institutions in the US. Research infrastructure is needed to build and sustain productive research programs and retain their own research faculty. In most health professions, this infrastructure is largely built through research grants. In CIH, most educational institutions are funded through student tuition, which has historically also had to be the source for building their research programs. Only a limited number of these institutions have emerged as National Institute of Health (NIH) grant-funded programs. As a result, the American chiropractic institutions have seen a retrenchment in the number of active research programs. In addition, although research training programs e.g., NIH’s K awards are available for CIH researchers, these programs generally result in these researchers leaving their institutions and depriving future CIH practitioners of the benefit of being trained in a culture of research.

One proposed solution is to leverage the substantial research infrastructure and long history of collaboration available at the RAND Corporation (https://www.rand.org) This article presents the proposed five components of the RAND Center for Collaborative CIH Research and the steps required to bring it to being:

1)   the CIH Research Network –   an online resource and collaborative site for CIH researchers;

2)   the CIH Research Advisory Board –   the governing body for the Center selected by its members;

3)   the RAND CIH Interest Group –   a group of RAND researchers with an interest in and who could provide support to CIH research;

4)   CIH Researcher Training –   access to existing RAND research training as well as the potential for the Center to provide a research training home for those with training grants; and

5)   CIH RAND Partnership for Research –   a mentorship program to support successful CIH research.

By necessity the first step in the Center’s creation would be a meeting between the heads of interested CIH institutions to work out the details and to obtain buy-in.

The future success of CIH-directed research on CIH will require a pooling of talent and resources across institutions; something that the American chiropractic institutions have not yet been able to achieve. This article discusses one possible solution.

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Effect of Chiropractic Manipulative Therapy on Reaction Time in Special Operations Forces Military Personnel

By |January 6, 2019|Chiropractic Research, Veterans|

Effect of Chiropractic Manipulative Therapy on Reaction Time in Special Operations Forces Military Personnel: A Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Trials. 2019 (Jan 3); 20 (1): 5

James W. DeVocht, Robert Vining, Dean L. Smith, Cynthia R. Long, Thomas M. Jones and Christine M. Goertz

Palmer Center for Chiropractic Research,
741 Brady St,
Davenport, IA, 52803, USA.


BACKGROUND:   Chiropractic manipulative therapy (CMT) has been shown to improve reaction time in some clinical studies. Slight changes in reaction time can be critical for military personnel, such as special operation forces (SOF). This trial was conducted to test whether CMT could lead to improved reaction and response time in combat-ready SOF-qualified personnel reporting little or no pain.

METHODS:   This prospective, randomized controlled trial was conducted at Blanchfield Army Community Hospital, Fort Campbell, KY, USA. Active-duty US military participants over the age of 19 years carrying an SOF designation were eligible. Participants were randomly allocated to CMT or wait-list control. One group received four CMT treatments while the other received no treatment within the 2-week trial period. Assessment included simple hand/foot reaction time, choice reaction time, and Fitts’ Law and whole-body response time. On visits 1 and 5, the same five assessments were conducted immediately pre- and post-treatment for the CMT group and before and after a 10-min wait period for the wait-list group. Primary outcomes included between-group differences for the pre-CMT/wait-list period at visit 1 and visit 5 for each test. Secondary outcomes included between-group differences in immediate pre- and post-(within visit) changes. Analysis of covariance was used for all data analysis.

RESULTS:   One hundred and seventy-five SOF-qualified personnel were screened for eligibility; 120 participants were enrolled, with 60 randomly allocated to each group. Due to technical problems resulting in inconsistent data collection, data from 77 participants were analyzed for simple hand/foot reaction time. The mean ± standard deviation (SD) age was 33.0 ± 5.6 years and all participants were male. No between-group statistically significant differences were found for any of the five biomechanical tests, except immediate pre- and post-changes in favor of the CMT group in whole-body response time at both assessment visits. There were four adverse events, none related to trial participation.

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Evidence Based Chiropractic Care For Lower Back Pain

By |December 3, 2018|Chiropractic Research|

Evidence Based Chiropractic Care For Lower Back Pain

The Chiro.Org Blog


SOURCE:   Texas Chiropractic Association 2018


Our thanks to the TCA, Andrea Howard and Chris Dalrymple, D.C., F.I.C.C. for giving us permission to display their PowerPoint in an interactive fashion on Chiro.Org.

Just click on the screen to view all 24 slides.

Click on the underlined citations to see the studies.


You can even click for FULL SCREEN viewing!



Most of the citations are interactive, and link to the materials on our website,

We hope you will enjoy these slides as much as we do.

Special thanks to Michael Beattie, D.C. for rendering the PPT as a Google Doc that works!

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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