ACT: Assessment of Chiropractic Treatment
Principal Investigators: Ian Coulter, PhD, Christine Goertz, DC, PhD and Joan Walter, JD
The RAND corporation, Samueli Institute and the Palmer College of Chiropractic have been awarded a grant from the Congressionally Directed Medical Research Program. This is the largest single award to a chiropractic research project in the history of the chiropractic profession. The four-year grant has 3 separate research studies occurring at 6 different military locations. The main study will assess chiropractic treatment for low back pain in military active duty personnel, as well as whether chiropractic intervention can help service members to stop smoking.
Cervical Distraction Sham Development: Translating from Basic to Clinical Studies
Principal Investigators: M. Ram Gudavalli, Ph.D., and Avinash G. Patwardhan, Ph.D.
This developmental study is a collaboration between the investigators at PCCR and investigators at Loyola University Stritch School of Medicine (LUSSM) and Edward Jr. Hines Veterans Affairs (VA) Hospital. Cadaveric studies performed at LUSSM/VA will quantify descriptive parameters for the manual cervical distraction (MCD) manipulation. This data will then be integrated with ‘sham perception’ information collected in clinical studies conducted at PCCR with asymptomatic study participants. A sham MCD procedure based on the application of measured and controlled distraction forces will then be produced. A pilot study will be designed to test the feasibility of using this sham in future clinical trials of SM for neck pain. This is a project under the Developmental Center for Clinical and Translational Research in Chiropractic (DCRC I) Grant funded by the National Institutes of Health.
CHiP: Chiropractic for Hypertension in Patients
Principal Investigator: Christine Goertz, DC, PhD
The CHiP study is being conducted to assess the feasibility of performing a Phase II research study on the efficacy of a specific chiropractic treatment in lowering blood pressure in patients with hypertension or high blood pressure. Participants receive either toggle recoil upper cervical adjustments or a sham treatment over the course of 6 weeks, while having their blood pressure monitored for any changes CHiP is funded by the Palmer College of Chiropractic.
COCOA: Collaborative Care for Older Adults with Low Back Pain.
Principal Investigator: Christine Goertz, DC, PhD
Low back pain is a common, costly, and often chronic health condition among older adults that accounts for frequent visits to medical doctors (MD) and complementary or alternative medicine (CAM) providers, including doctors of chiropractic (DC). While patients often seek care for back pain from both MDs and DCs, care coordination between these two provider groups is an infrequent occurrence. The long-term goal of the Collaborative Care for Older Adults (COCOA) study is to develop and test a model of patient-centered care for older adults who have their low back pain co-managed by a team of MDs and DCs. COCOA is a Chiropractic Demonstration Project funded by the Health Resources and Services Administration (HRSA) and represents a collaboration between the Palmer Center for Chiropractic Research and Genesis Family Medical Center in Davenport, IA, The University of Iowa in Iowa City, IA, and Thomas Jefferson University in Philadelphia, PA.
Conservative Treatment of Patients with Temporomandibular Disorders (TMD) – A Pilot Study
Principal Investigators: James DeVocht, D.C., Ph.D., and Clark Stanford, D.D.S., Ph.D.
The TMD study is a collaboration between the Palmer Center for Chiropractic Research and the Dow Institute of Dental Research at the University of Iowa in Iowa City, Iowa to compare four interventions for the treatment of patients with chronic TMD. The Activator Methods protocol of chiropractic treatment will be compared to three reference groups: dental treatment (reversible interocclusal splint therapy), self-care only, and placebo care. Eighty participants will receive treatment for 2 months with outcome measures assessed at 2, 3, and 6 months. This study is a project under the Developmental Center for Clinical and Translational Research in Chiropractic (DCRC I) Grant funded by the National Institutes of Health.
Effects of Spinal Manipulation on Sensorimotor Functions in Back Pain Patients
Principal Investigators: Christine Goertz, D.C., Ph.D., and David Wilder, Ph.D.
This study is a collaboration between the Palmer Center for Chiropractic Research and the University of Iowa to collect information about potential changes in spinal function after a chiropractic treatment occurs, to determine if these changes are short or long-term, and to see if any changes are more pronounced in participants who show the best improvement in their back pain. Participants will receive one of three chiropractic treatments over the course of 6 weeks. This is a project under the Developmental Center for Research on Complementary and Alternative Medicine (DCRC II) Grant funded by the National Institute of Health, National Center for Complementary and Alternative Medicine.
Neural & Biomechanical Responses to Mechanical Features of Spinal Manipulation
Principal Investigators: Joel Pickar, D.C., Ph.D., and Gregory Kawchuk, D.C., Ph.D.
Spinal manipulation is a form of body-based therapy that patients often seek for treatment of musculoskeletal complaints. While numerous techniques are used clinically, each shares the common denominator of applying force to the spine. The most form of spinal manipulation includes a short lever, High Velocity, Low Amplitude (HVLA) thrust. Investigation of HVLA spinal manipulation is the focus of this application. By its very nature spinal manipulation is a mechanical intervention that lasts a fraction of a second (typically <200ms) yet produces effects that outlast the intervention itself. How? This question provides the basis for our study and motivates our long term goal: to understand and improve the effective use of spinal manipulation. We will take advantage of an animal model and approaches developed by the two co-leaders in order to understand the relationship between spatial and temporal characteristics of a spinal manipulation and their effects on neural and biomechanical responses from paraspinal tissues. We will determine whether either the responsiveness of primary afferent signaling from paraspinal muscle spindle and/or the passive biomechanical properties of the manipulated region outlast the manipulation itself. Specifically, we will determine if muscle spindle responsiveness increases and spinal stiffness decreases as a function of 1) the spinal manipulation’s duration; 2) the presence, magnitude or shape of a preload preceding the manipulation; 3) the anatomical contact point used for the spinal manipulation; and 4) the direction with which the manipulation is applied. These studies will provide insight into potential mechanisms underlying the effects of SM as well as identify dosing features of the manipulation to which the body is most responsive. The information from these complementary studies will help provide information useful for identifying dosing features of the manipulation to which the nervous system and biomechanical properties of paraspinal tissues may be most responsive and in determining strategies for optimizing the delivery of SM.
Osteoclast Signaling and Bone Health
Principal Investigator: Liang Zhang, M.D., Ph.D.
This NIH-funded project focuses on molecular biology research on osteoclast signaling. Osteoclast is a type of specialized cells responsible for bone resorption, and its up-regulation is a key in the development of various aging associated human bone loss such as in osteoporosis and arthritis. It is unknown if chiropractic care or interventions affect osteoclasts. We will address this interesting question in the future. Successful completion of this project will provide a track record for obtaining future NIH funds.
R25: Expanding Evidence Based Clinical Practice and Research across the Palmer College of Chiropractic
Principal Investigator: Cynthia R. Long, Ph.D.
The Palmer College of Chiropractic seeks to increase the quality and quantity of the research and evidence based clinical practice (EBCP) content that Doctor of Chiropractic (DC) students receive in the curriculum. We have partnered with collaborators at the University of Iowa and Thomas Jefferson University to develop and implement a program to train our faculty in EBCP principles and to provide assistance and resources to incorporate EBCP principles into courses and clinical educational activities. We are also training selected faculty in clinical research through our graduate program and are significantly expanding our Research Honors program to provide DC students with the opportunity for a mentored-research experience. The long term goal of our program is to train chiropractors to have the knowledge, skills and attitudes to implement an evidence-based model of clinical chiropractic practice that will ultimately affect provider behaviors and enhance patient outcomes. This grant is funded by the National Institutes of Health.
Vertebral Displacements and Ligament Strains during Simulated Spinal Manipulations
Principal Investigators: M. Ram Gudavalli, Ph.D., Yi-Xian Qin, Ph.D.
This study is a collaboration between PCCR, State University of New York-Stony Brook, and University of Toledo. Our long-term goal is to contribute to a broad understanding of SM mechanisms by characterizing the responses of intervertebral connective tissues to range of manipulative forces. The objective of this study is to understand the biomechanical effects of different spinal manipulations. This developmental study is being carried out with experimental simulations on human cadaveric spine specimens at PCCR to measure directly the vertebral motions and the biomechanical strains of facet joint capsular ligaments. Co-leaders at Stony Brook and co-investigators at University of Toledo developing finite element model to validate experimental data estimate the strains of internal ligaments and deep intervertebral muscles that cannot be measured. This is a project under the Developmental Center for for Study of Mechanisms and Effects of Spinal Manipulation (DCRC II) Grant funded by the National Institutes of Health.