Funding Source: NIH/NCCIH UG3/UH3AT009761

Award Amount: $7,087,730

Performance Period: 09/20/2017 – 08/31/2023

Principal Investigators: Cynthia Long, Ph.D; Christine Goertz, D.C., Ph.D

Co-Investigators: Thad Abrams, M.D., M.S., Richard Branson, D.C., Kei-Hoi Cheung, Ph.D., Sally Haskell, M.D., Erin Krebs, M.D., M.P.H., Anthony Lisi, D.C., Jon Lurie, M.D., M.S., Stacie Salsbury, Ph.D, Paul Shekelle, M.D., Ph.D, Robert Vining, D.C., D.H.Sc., Robert Wallace, M.D., M.Sc.

Clinical Research Specialist: Elissa Twist, D.C., M.S., CCRP

Study Coordinators: Anna Walden-Cobb, D.C., M.S., CCRC at Iowa City VA, Courtney Karnopp, BS at Minneapolis VA, Rebecca Rudquist at Minneapolis VA, Kena McDermott, D.C., M.S. at VA Connecticut and Melvin Valle, B.S. at VA Greater LA Healthcare System

Collaborating Institutions: VA Connecticut Healthcare System, Minneapolis VA Health Care System, Iowa City VA Health Care System, VA Greater LA Healthcare System, University of Iowa College of Public Health, Yale University Center for Medical Informatics, The Dartmouth Institute for Health Policy & Clinical Practice, Duke Clinical Research Institute

Description: Two linked RCTs in four VA sites in veterans with chronic LBP; Phase 1: low dose (1-5 visits) vs. high dose (8-12 visits) over 10 weeks; Phase 2: scheduled monthly chiropractic visits vs. no chiropractic visits over 42 weeks.

Publications:

Long CR, Lisi AJ, Vining RD, Wallace RB, Salsbury SA, Shannon ZK, Halloran S, Minkalis AL, Corber L, Shekelle PG, Krebs EE, Abrams TE, Lurie JD, Goertz CM. Veteran Response to Dosage in Chiropractic Therapy (VERDICT): Study Protocol of a Pragmatic Randomized Trial for Chronic Low Back Pain. Pain Med. 2020 Dec 12;21(Suppl 2):S37-S44. doi: 10.1093/pm/pnaa289. PMID: 33313732; PMCID: PMC7734654.

Bastian LA, Cohen SP, Katsovich L, Becker WC, Brummett BR, Burgess DJ, Crunkhorn AE, Denneson LM, Frank JW, Goertz C, Ilfeld B, Kanzler KE, Krishnaswamy A, LaChappelle K, Martino S, Mattocks K, McGeary CA, Reznik TE, Rhon DI, Salsbury SA, Seal KH, Semiatin AM, Shin MH, Simon CB, Teyhen DS, Zamora K, Kerns RD; NIH-DOD-VA Pain Management Collaboratory. Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes. Pain Med. 2020 Dec 12;21(Suppl 2):S13-S20. doi: 10.1093/pm/pnaa333. PMID: 33313726; PMCID: PMC7824996.

Vining RD, Shannon ZK, Salsbury SA, Corber L, Minkalis AL, Goertz CM. Development of a Clinical Decision Aid for Chiropractic Management of Common Conditions Causing Low Back Pain in Veterans: Results of a Consensus Process. J Manipulative Physiol Ther. 2019 Nov;42(9):677-693. doi: 10.1016/j.jmpt.2019.03.009. Epub 2019 Dec 19. PMID: 31864769; PMCID: PMC7183425.

Administrative Supplements

Administrative supplement funding provides one to two years of in-depth research experiences for doctors of chiropractic: Stephanie Halloran, D.C., M.S.; Zacariah Shannon, D.C., M.S.; Gregory Roytman, D.C.; and Anna-Marie Ziegler, M.M., D.C. They are being mentored by investigators at the Palmer Center for Chiropractic Research and the Yale Center for Medical Informatics. In these roles, they actively participated in the planning phase and now implementation of VERDICT, the large, pragmatic clinical trial studying optimal dose of chiropractic care.

Funding source: NCMIC Foundation

Award Amount: $38,101

Performance Period: 08/19/2020-08/18/2021

Principal Investigator: Stacie A Salsbury, R.N., Ph.D.

Co-Investigator: Michele Maiers, D.C., M.P.H., Ph.D.

Collaborating Institution: Northwestern Health Sciences University

Description: To validate a model of spine care for chiropractic patients who are age 50 and older. The study will also explore how chiropractors use self-management and on-line health interventions to support the care of midlife and older persons.

Funding Source: Department of Defense; Award Amount: $7,500,000 ($5,100,000 subaward to Palmer)

Funding Period: 02/01/2011 – 02/14/2020

Principal Investigator: Ian D. Coulter, Ph.D., RAND Corporation

Co-Principal Investigators: Christine Goertz, D.C., Ph.D., Joan Walter, J.D., PA, Samueli Institute Co-investigator/Director of Clinical Trial Coordinating Center: Cynthia Long, Ph.D.; Co-Investigator: Robert Vining, D.C., D.H.Sc.

Lead Project Manager: Amy Minkalis, D.C., M.S., CCRP; Site Project Manager: Crystal Franklin, M.P.H., CCRP

Publication:

Vining R, Long CR, Minkalis A, Gudavalli MR, Xia T, Walter J, Coulter I, Goertz CM. Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med. 2020 Jul;26(7):592-601. doi: 10.1089/acm.2020.0107. Epub 2020 Jun 12. PMID: 32543211.

Funding Source: NIH/NCCIH R15AT009612

Award Amount: $451,522

Performance Period: 07/05/2017 – 09/30/2020

Principal Investigator: Stephen Onifer, Ph.D.; Co-Principal Investigator: Bradley K. Taylor, Ph.D.

Co-Investigator: Cynthia Long, Ph.D.; Laboratory Support: Randall Sozio, B.S., LATG, Charlie Arends, B.S.

Description: A collaboration between the PCCR and the University of Pittsburgh to learn more about the underlying factors of pain relief following spinal manipulative therapy, with a student research training component, the first of its kind at a chiropractic college. Forty-seven students participated in research projects, with five earning Research Honors at graduation.

Publication:

Onifer SM, Sozio RS, Long CR. Role for Endocannabinoids in Spinal Manipulative Therapy Analgesia? Evid Based Complement Alternat Med. 2019 Jul 15;2019:2878352. doi: 10.1155/2019/2878352. PMID: 31379956; PMCID: PMC6662436.

Performance Period: 03/01/2020 – 07/31/2021

Principal Investigator: Robert Vining, D.C., D.H.Sc.

Co-Investigator: Anna Ziegler, D.C., M.M.; Emma Rae Langdon, B.A.; Amy Minkalis, D.C., M.S.

Description: Learning modern pain biology concepts can improve important clinical outcomes for people with chronic pain. However, clinicians, who are best positioned to teach these concepts, are typically not trained educators. And, few evidence-based, pain education program materials are available. Specific information about how effective pain education is structured to promote learning is needed to inform future pain education in clinical trials and clinical settings. The primary purpose of the review is to report characteristics of chronic musculoskeletal pain education programs from an instructional design perspective.

The Network is a collaborative effort between the Palmer Center for Chiropractic Research (PCCR), Yale University Center for Medical Informatics, and the Osher Center for Integrative Medicine (jointly based at Harvard Medical School and Brigham and Women’s Hospital).

Co-Directors: Cynthia Long, Ph.D.; Anthony Lisi, D.C.; Peter Wayne, Ph.D.

Steering Committee Members: Matt Kowalski, D.C.; Robert Vining, D.C., D.H.Sc.

Program Manager: Katie Hoyt, MOL

Thoracolumbar Fascia Mobility: A Pilot Study

Principal Investigator: Robert Vining, D.C., D.H.Sc; Co-Principal Investigator: Stephen Onifer, Ph.D.

Site: PCCR Research Clinic

Status:

• Study launched September 2019; study completed in April 2021
• 40 participants enrolled in Phase 1; 31 participants enrolled in Phase 2
• Data analysis in progress

Integrative Migraine Pain Alleviation through Chiropractic Therapy: The IMPACT Study

Principal Investigator: Peter Wayne, Ph.D. & Carolyn Bernstein, M.D.

Site: Osher Center for Integrative Medicine

Status: Complete

Publications:

1. Rist PM, Bernstein C, Kowalski M, Osypiuk K, Connor JP, Vining R, Long CR, Macklin EA, Wayne PM. Multimodal chiropractic care for migraine: A pilot randomized controlled trial. Cephalalgia. 2021 Mar;41(3):318-328. doi: 10.1177/0333102420963844. Epub 2020 Oct 13. PMID: 33050719.
2. Connor JP, Bernstein C, Kilgore K, Rist PM, Osypiuk K, Kowalski M, Wayne PM. Perceptions of Chiropractic Care Among Women With Migraine: A Qualitative Substudy Using a Grounded-Theory Framework. J Manipulative Physiol Ther. 2021 Feb;44(2):154-163. doi: 10.1016/j.jmpt.2020.07.001. Epub 2021 Jan 9. PMID: 33431279.
3. Wayne PM, Bernstein C, Kowalski M, Connor JP, Osypiuk K, Long CR, Vining R, Macklin E, Rist PM. The Integrative Migraine Pain Alleviation through Chiropractic Therapy (IMPACT) trial: Study rationale, design and intervention validation. Contemp Clin Trials Commun. 2020 Jan 22;17:100531. doi: 10.1016/j.conctc.2020.100531. PMID: 32043014; PMCID: PMC6997836.
4. Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache. 2019 Apr;59(4):532-542. doi: 10.1111/head.13501. Epub 2019 Mar 14. PMID: 30973196; PMCID: PMC6461372.
5. Bernstein C, Wayne PM, Rist PM, Osypiuk K, Hernandez A, Kowalski M. Integrating Chiropractic Care Into the Treatment of Migraine Headaches in a Tertiary Care Hospital: A Case Series. Glob Adv Health Med. 2019 Mar 28;8:2164956119835778. doi: 10.1177/2164956119835778. PMID: 30944771; PMCID: PMC6440032.

Longitudinal Cohort Assessing Healthcare Service Use for Spine-Related Disorders in VA

Principal Investigator: Anthony Lisi, D.C.

Site: Yale Center for Medical Informatics

Status: In progress

Integrating Chiropractic Care & Mind-Body Training for the Treatment of Non-specific Chronic Neck Pain

Principal Investigator: Peter Wayne, Ph.D.

Site: Osher Center for Integrative Medicine

Status: Trial launching soon