Fiscal Years 19-21 Research Report

Through fiscal years 2019-2021, we've focused our energy on meeting milestones of current projects, developing new projects, and strengthening strategic collaborations. In addition, we continue to provide research experiences and training, publish in relevant scientific journals and communicate our research to varied audiences. Take a look around our Research Report and see for yourself.

strategy

We worked to develop this strategy with our Mission and Vision at the forefront.
mission
research mission

The Palmer Center for Chiropractic Research is dedicated to advancing health care for patients by developing knowledge and translating knowledge that improves the practice of chiropractic.

vision
research vision

The Palmer Center for Chiropractic Research impacts health care practice and policy through our universally recognized, robust and sustainable collaborative research, attracting accomplished scientists, high-level staff and dedicated trainees.

research project highlights

palmer center for chiropractic research collage
Chiropractic Care for Veterans: A Pragmatic Randomized Trial Addressing Dose Effects for cLBP (VERDICT)
  • Transitioned UG3 planning phase to UH3 clinical trial
  • Trial protocol published in Pain Medicine
  • Trial launched at all four sites
  • Four D.C. post-doctoral scholars/fellows funded for mentored experiences in projects
Active Aging for Spine Health Study
  • Funded August 2020 by NCMIC Foundation
  • Actively recruiting 10 doctors of chiropractic and 20 patients age 50+
  • Conducting interviews on the role of technology in spine health self-management and chiropractic care
Inter-Institutional Network for Chiropractic Research
  • Implemented and completed Thoracolumbar Fascia Mobility pilot study
  • Integrative Migraine Pain Alleviation through Chiropractic Therapy: The IMPACT Study completed; produced five publications
  • Three-year research fellowship for a doctor of chiropractic at the Osher Center, funded by NCMIC Foundation

active grants and projects

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:

  1. 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.
  2. 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.
  3. 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

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

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.

Principal Investigator: Anthony Lisi, D.C.
Site: Yale Center for Medical Informatics
Status: In progress

Principal Investigator: Peter Wayne, Ph.D.
Site: Osher Center for Integrative Medicine
Status: Trial launching soon

publications

25 publications in 13 peer-reviewed journals
The relationship between healthcare provider availability and conservative versus non-conservative treatment for back pain among older americans.

Anderson BR, Yakusheva O, Liu H, Bynum JPW, Davis MA. The relationship between healthcare provider availability and conservative versus non-conservative treatment for back pain among older americans. J Gen Inten Med 2021 (epub ahead of print)
Read More

Veteran response to dosage in chiropractic therapy (VERDICT): study protocol of a pragmatic randomized trial for chronic low back pain.

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;21(S2):S37-S44.
Read More

Like peanut butter and jelly: a qualitative study of chiropractic care and home exercise among older adults with spinal disability.

Maiers M, Salsbury SA. "Like peanut butter and jelly": a qualitative study of chiropractic care and home exercise among older adults with spinal disability. Arthritis Care Res 2021 (epub ahead of print)
Read More

Multimodal chiropractic care for migraine: a pilot randomized controlled trial.

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. Cephalagia 2021;41(3):318-328.
Read More

Effects of chiropractic care on strength, balance, and endurance in active-duty US military personnel with low back pain: a randomized controlled trial.

Vining R, Long C, Minkalis A, Gudavalli MR, Xia T, Walter J, Coulter I, Goertz C. Effects of chiropractic care on strength, balance, and endurance in active-duty US military personnel with low back pain: a randomized controlled trial. J Altern Complement Med 2020;26(7):592-601.
Read More

Improper communication makes for squat: a qualitative study of the health-care processes experienced by older adults in a clinical trial for back pain.

Wells BM, Salsbury SA, Nightingale LM, Derby DC, Lawrence DJ, Goertz CM. Improper communication makes for squat: a qualitative study of the health-care processes experienced by older adults in a clinical trial for back pain. J Patient Exp 2020;7(4):507-515.
Read More

Series
Current evidence for diagnosis of common conditions causing low back pain: systematic review and standardized terminology recommendations.

Development of an evidence-based practical diagnostic checklist and corresponding clinical exam for low back pain.

Development of a clinical decision aid for chiropractic management of common conditions causing low back pain in Veterans: results of a consensus process.

Vining R, Shannon Z, Minkalis A, Twist E. Current evidence for diagnosis of common conditions causing low back pain: systematic review and standardized terminology recommendations. J Manipulative Physiol Ther 2019;42(9):651-664.
Read More | Video Abstract

Vining R, Minkalis A, Shannon Z, Twist E. Development of an evidence-based practical diagnostic checklist and corresponding clinical exam for low back pain. J Manipulative Physiol Ther 2019;42(9):665-676.
Read More | Video Abstract

Vining R, Shannon Z, Salsbury S, Corber L, Minkalis A, Goertz C. 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;42(9):677-693.
Read More | Video Abstract

See all Publications >

budget

pie graph: $40,000 - Private support; $3,350,000 - Federal support; $4,000,000 - Palmer support

our team

Administration & Faculty

Cynthia Long, Ph.D., PStat ® - Dean of Research & Professor

Robert Vining, D.C., D.H.Sc. - Associate Dean of Clinical Research & Professor

Robert Cooperstein, M.A., D.C. - Director of Research, Palmer West & Professor

Joel Pickar, D.C., Ph.D. - Professor Emeritus

Stephen Onifer, Ph.D. - Associate Professor

Stacie Salsbury, Ph.D., R.N. - Associate Professor

Brian Anderson, D.C., Ph.D., M.S., M.P.H. - Assistant Professor

Professional, Technical & Administrative Staff

Charlie Arends, BS, ALAT - Laboratory Animal Technician

Leah Cafer - Administrative Assistant

Lance Corber, M.S.I.T.M. - Data Architect

Ann Hileman, B.Phil. - Assistant Director of Research

Katie Hoyt, M.O.L. - Research Program Manager

Sujatha Kedilaya, B.S. - Data Analyst

Amy Minkalis, D.C., M.S., CCRP - Clinical Project Manager II

Kara Shannon, D.C. - Research Clinician

Randall Sozio, B.S., LATG - Animal Care Manager

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

Anna Walden, D.C., M.S., CCRC - Clinical Project Manager

Post-Doctoral Research Scholars

Stephanie Halloran, D.C., M.S. (Yale)

Vivian Ly, D.C. (Yale)

Gregory Roytman, D.C. (Yale)

Zacariah Shannon, D.C., M.S.

Anna-Marie Ziegler, D.C., M.M.