Annual Report 2018 – 2019
It’s been a year full of streamlining, relationship building and innovative research goals!
Together, we are making a difference.
The Biomechanical Assessment of Vertebral Subluxations
Using 3D Motion Capture Analysis
Dr Imran Khan Niazi PhD, New Zealand College of Chiropractic
(a joint venture project with ASRF and The Hamblin Trust)
The Australian Spinal Research Foundation has defined vertebral subluxation as “a diminished state of being, comprising of a state of reduced coherence, altered biomechanical function, altered neurological function and altered adaptability”. Many chiropractic techniques include an assessment of biomechanical function as the basis for the identification of subluxations.
However, little is known about the biomechanical characteristics of vertebral subluxations. Therefore, implementing research methods that can objectively measure the biomechanical characteristics of vertebral subluxation can provide research evidence that will help the chiropractic profession to better understand the clinical entity that lies at the heart of each chiropractic patient encounter. Currently, there is no established method that clearly differentiates the biomechanical profile of a subluxated spinal segment from a segment that is functioning well.
This project seeks to investigate the second ASRF Research Agenda point, which is “Can subluxations be identified validly, reliably and reproducibly?”. To do this, we are proposing to measure the kinematics of spinal motion with a three-dimensional motion capture system and characterise changes in movement associated with spinal segmental levels that have been identified as being subluxated. This study is a collaborative study between the New Zealand College of Chiropractic and Aalborg University in Denmark. This study will be carried out in the state-of-the-art 3D motion capture laboratories located at Aalborg University.
The Clinical Utility of
Leg Length Inequality Assessment
Dr Kelly Holt PhD, New Zealand College of Chiropractic
Vertebral subluxation assessment generally involves evaluating what have been described as the “pathophysiological consequences of manipulatable lesions”. These have been loosely aggregated into overlapping categories that are often referred to as a PARTS evaluation. The categories include; Pain, Asymmetry, changes in relative Range of motion, changes in Tissue temperature/texture/tone, and other findings that can be identified using Special tests. Some methods of vertebral subluxation assessment, such as pain provocation at segmental levels, have been described as being reliable and valid. However, many of the methods commonly used by chiropractors to functionally assess the spine have previously been found to have limited inter-examiner reliability.
One vertebral subluxation analytical technique that has shown some promise with respect to reliability, is prone visual leg length analysis. There are numerous methods for assessing leg length inequality (LLI). The three most commonly used analytical methods are radiographic examination, orthopaedic devices (including basic tape measurement) and the ‘quick’ visual leg check. The choice of method to use depends on what type of LLI the practitioner is assessing for.
Tests of leg length inequality are an integral component of many chiropractic analytical techniques. However, little is known about the clinical utility of leg length testing. This project will evaluate the psychometric properties of leg length inequality testing. This will include an assessment of the reliability and validity of the test, sensitivity to change of the test, and an assessment of whether the cephalad pressure placed on the patient’s feet during compressive leg testing influences the results of the test. This study should be of interest to chiropractors and educators who routinely use and teach the use of this test as a means of analysing for vertebral subluxations.
Research Report: Clinically Relevant Joint Venture Research
Our Vision has been, and remains to be, to piece together through research, a more fundamental understanding of chiropractic through a clear understanding of the vertebral subluxation. Our vision is also shared and articulated by many other international chiropractic education and research institutions. The Foundation’s fundamental function is to facilitate research funding to investigate the impact of chiropractic care, and translate research outcomes that are clinically relevant in improving the quality of life of an individual. Our shared vision with other institutions led to co-funding an exciting research proposal with the Hamblin Trust, investigating the biomechanical assessment of vertebral subluxations using 3D motion capture analysis. Vertebral subluxation-based research and research-informed, evidence-based clinical practice is strong, and will continue to thrive through future collaboration and joint venture funding.
Beginning in 2017, the Foundation lead an initiative on a worldwide consultation process with clinicians and researchers alike, and launched a new and exciting research agenda. Our Research Agenda is the driving force behind encouraging researchers to investigate aims in order to gain a better understanding of the vertebral subluxation and the impact of chiropractic care.
The current elements of the Research Agenda are:
- What is the definition of subluxation? (complete)
- Can subluxations be identified validly, reliably and reproducibly?
- What are the impacts of a subluxation and an adjustment?
- What is the epidemiology of the subluxation?
- What are the impacts of the subluxation and the adjustment on the community?
This first element – to formulate and adopt a conceptual definition of vertebral subluxation – is now complete, with a number of citations of the definition appearing in internationally ranked journals. The Australian Spinal Research Foundation currently defines that “a vertebral subluxation is a diminished state of being, comprising of a state of reduced coherence, altered biomechanical function, altered neurological function and altered adaptability”. This definition is supported by, and articulated by, many clinicians and researchers across the globe. In 2019 we called for research projects to investigate the remaining elements of our research agenda.
The Foundation made a decision to change the 2 categories of research support for 2019, from ‘Large Research Grants’ and ‘Small Research Grants’, to 3 categories of research support. We feel the change will allow the Foundation to support a greater number and variety of projects focused towards our research agenda. The change in our research funding scheme will also provide much-needed support for early career researchers, postgraduate students and researchers with innovative ideas and projects. We look forward to the possibility of introducing new schemes in support of post-graduate research and training in the future.
The research funding schemes introduced for the 2019 funding round are:
Targeted Research Grants (TRG): intended to provide support for quality research projects relevant to the clinical practice and scientific basis of chiropractic and relevant to the research agenda categories that are currently being investigated.
Postgraduate Research Grants (PRG): intended for researchers who are currently undertaking a research higher degree and are yet to be recipients of competitive project funding. Funds for PRGs will be awarded for quality research projects relevant to the clinical practice and scientific basis of chiropractic and relevant to the research agenda categories that are currently being investigated.
Seeding Research Grants (SRG): intended to support novel research ideas, pilot studies or preliminary research develop into viable competitive research proposals for submission for funding to ASRF or other external granting bodies. It is intended that the recipients of SRG apply for full funding under the TRG scheme within 12 months or a similar external scheme. SRGs are open to any researcher, however preference will be given to an Early Career Researcher (ECR – defined as researchers who are currently within 5 years of having completed postgraduate studies and who have not as yet been recipients of competitive project funding. Funds for SRGs are to support quality research projects relevant to the clinical practice and scientific basis of chiropractic and relevant to the research agenda categories that are currently being investigated.
We also invited additional clinicians, chiropractors, and non-chiropractor researchers to participate in the Clinical Advisory Panel and Research Committee review of grants in 2019. This ensures the Foundation maintains best practice by having expert reviewers from a wide range of backgrounds, providing new and unique perspectives on the review process.
Our 2018 research grant program called for applications from researchers looking to explore one or both of the following items:
- Investigate reliability, validity and reproducibility of vertebral subluxation measures of identification
- Investigate the impact of a vertebral subluxation and an adjustment
Expressions of Interest from around the globe were received and reviewed by both our Clinical Advisory Panel and Research Committee as they progressed through our two-step process, leading to the submission of full grant proposals. This resulted in the Foundation awarding the two grants detailed in this report.
The Board would like to thank all the existing members of the Clinical Advisory Panel and the Research Committee for their time in reviewing the 2018 and 2019 applications. We would also like to thank our Foundation Members for endorsing our industry best-practice research application review process, as well as our researchers, for submitting exciting and relevant proposals aimed at a better understanding of vertebral subluxations.
As always, we endeavour to communicate research outcomes and their clinical relevance with our Members, through various channels, while our researchers communicate research outcomes globally through refereed international journals. We look forward to an inspiring and exciting future with increased joint venture support for postgraduate education and research.
Dr Sinan Ali, Research Agenda Working Committee Chair
Our Vision: A Clear Understanding of Vertebral Subluxation
President’s Report: Moving Forward, Through Challenging Times
There’s not too many chiropractic research organisations that can continue to fulfil their financial obligations to researchers when times are tough. That is what Spinal Research has been able to achieve, in a time where chiropractors are being attacked from all sides.
At the same time, it has taken a lot of re-organisation and adaptation to do so. The streamlining of the Foundation meant we no longer required an office, and on expert recommendation we sought to sell the building. A slow property market in Brisbane saw this taking longer than what we had hoped, and there were costs associated with that. In addition, we saw a small decline in membership numbers, as Australian Members chose to support the new private college in Adelaide.
Furthermore, we found ourselves being unable to cater to the unique needs of our international Members, with the major issue being our 43-year-old Constitution being very restrictive. So, we have brought it up to the times, while protecting the core values of the Foundation and its unique 2 panel research review process, thereby ensuring that the Foundation can continue to focus on achieving its research agenda. At the time of writing, we have a growing number of Members coming in from recent stage presentations in the USA, with more support and opportunities being offered up.
Spinal Research is unique in the world and is needed now, more than ever.
Dr Craig Foote, Foundation President
Treasurer’s Report: Streamlining for Success
The last year has seen some successes and challenges in the Foundation’s financial accounts.
Even though membership levels are slightly down, the membership and donation revenue is up in the last financial year. With the restructure of membership levels and with increasing opportunities to promote Spinal Research in overseas locations, there is further scope to increase our membership base and donations in this important revenue source in 2020.
Last financial period I reported that the Spinal Research office building had become vacant.
This building was the former office of the Foundation until we decided to downsize the administrative team and move to a smaller office. The building had been a good rental income for the Foundation over recent years. While it was a good source of rental income, when it suddenly became vacant in a slow real estate market, it remained vacant for an extended period of time. All efforts were placed on either acquiring a new tenant or sell the building. Unfortunately, it took over a year to sell the building, which was a lot longer than expected. Over this time the associated costs of the building remained, and this affected the Foundations cashflow. The good news is that the building has now been sold in 2019, which is noted in the Financial Statement.
The move to a virtual office this year, and further streamlining of the administrative team, has created further expense reductions for the Foundation.
For various reasons, we were recommended by our share advisors to transfer out of the share market and convert to cash for the short-to-medium term.
Over the last year, the Foundation has continued to explore alternate sources of revenue to support our research agenda. Work is continuing in implementing the fundraising initiatives that were suggested as part of the professional fundraising consultant process from the previous year.
I acknowledge the ongoing support, loyalty and diligence of the Spinal Research team, who are working tirelessly to move the Foundation forward.
Dr Malcolm Rudd, Treasurer
Our Strategy is Based on Three Goals:
We thank and acknowledge our Commerical Supporters for their contribution to chiropractic research.
The Foundation’s Board ensures that we fulfil the purpose for which we were established. They do this through maintaining strategic direction, culture, ethics and policy. In addition to funding approval for all research studies, the Board are responsible and accountable for the Foundation’s financial management, human resources, operational duties and compliance with all legal, financial and ethical obligations. All members of the Board are volunteers who freely donate their time, energy and professional expertise.