Annual Report 2019 – 2020

It’s been a year of refining, adapting and collaborating.

Together, we are making a difference!

Research Highlights

The 2019 funding round saw the introduction of the three new funding categories: Targeted Research Grants (TRG), Seeding Research Grants (SRG), and Postgraduate Research Grants (PRG). In 2020, the PRG has been renamed the David Russell Memorial Scholarship Grant (DRMSG) in honour of our dear friend and colleague Dr Dave Russell.

ASRF Board approved funding for the following three projects in the 2019 round – two under the TRG and the other under the PRG programs.

Effects of cervical chiropractic adjustments on heart rate variability, quality of life and tumor marker in colon cancer patients.

Dr Adrian Wenban and Dr Yori Gidron PhD, Barcelona College of Chiropractic, Spain; Life university, France. (a joint venture project with ASRF and UCA)

Cancer remains a leading cause of morbidity and mortality worldwide. Among the leading fatal and common cancers is colon cancer. Despite important progress in cancer therapies, many treatments have significant adverse side effects (e.g., inflammation, hair loss, cognitive impairments, fatigue). Thus, while certain treatments increase duration of life, they can reduce quality of life. Furthermore, some treatments are not effective for most patients such as immunotherapy. Advances in cancer treatment could occur if a resilience factor, which inhibits multiple oncogenic factors and improve patients’ well-being, could be found.

Gidron et al. (2005) proposed the vagal nerve hypothesis in cancer prognosis. The vagal nerve is the 10th cranial nerve which helps people to adapt in multiple systems following stress (Weber et al., 2010). The vagus nerve inhibits oxidative stress, inflammation and sympathetic activity (e.g., Rosas-Ballina et al., 2011), all which otherwise contribute to carcinogenesis (e.g., Eschleden et al., 2004; Mantovani et al., 2008). High vagal activity, indexed by heart rate variability (HRV), independently predicts longer cancer survival (Zhou, Adrian B. Wenban 3 et al., 2016). HRV is also positively correlated with quality of life (Lu et al., 2016) and vagal activation reduces depression and pain (Silberstein et al., 2016), relevant to cancer.

While HRV biofeedback increases vagal activity, this intervention depends greatly on patients’ adherence. While transcutaneous vagal nerve stimulation can be effective, it also has some side effects (e.g., pain). In contrast, chiropractic could be a novel alternative for activating the vagus nerve and for improving cancer patients’ well-being and possibly even prognosis, with minimal side effects. Win, et al. (2015) and other studies have found that chiropractic adjustment at C1-2 can increase HRV, the vagal nerve index. Furthermore, chiropractic has also been shown to reduce some patients pain scores (Walker et al., 2010), improve Health-related Quality of Life (HrQoL) (Montgomery, 2011) and studies which have examined the use of Complementary and Alternative Medical therapies by cancer patients consistently show the popularity of chiropractic compared to various practitioner-based CAM therapies (Saxe et al., 2008; Sierpina et al., 2007; McEachrane-Gross et al., 2006; Habermann TM et al., 2009).

Thus, chiropractic may potentially improve cancer patients’ HrQoL and reduce their suffering. However, the effects of such chiropractic adjustments on cancer patients’ wellbeing and tumor progression have not been systematically tested. We hypothesize that patients randomly assigned to receive chiropractic adjustments to the upper cervical spine will have higher HRV, better HrQoL and lower levels of the colon cancer tumor marker CEA, than controls.

Does specificity matter when chiropractors adjust vertebral subluxations?

Dr Heidi Haavik PhD, New Zealand College of Chiropractic

Chiropractic is based on the premise that correcting vertebral subluxations will improve central neural function, that in turn will result in improved human performance, function and adaptability. Vertebral subluxations have been defined as a diminished state of being, comprising of a state of reduced coherence, altered biomechanical function, altered neurological function and altered adaptability. It has been suggested that vertebral subluxations impact central neural function due to a breakdown in central segmental motor control that results in altered afferent feedback from muscle spindles in the paraspinal muscles at subluxated levels of the spine. This in turn is thought to result in maladaptive neural plastic changes in the central nervous system that alter sensorimotor control. Therefore, it would be logical to assume that if adjusting vertebral subluxations improves spinal function, this will lead to adaptive central neural plastic changes, and ultimately improve performance, function and adaptability. Research supports these premises because several studies have shown changes and improvement in somatosensory processing and sensorimotor integration and motor control following as little as a single session of chiropractic care.

Despite a growing body of evidence that shows we can now reliably detect subluxations, and that when we correct subluxations it has a positive effect on nervous system function,  there are still leaders in our profession who say that either vertebral subluxations don’t exist, or they are a vitalistic construct, unsupported by evidence, that should be viewed purely as an historical construct. When researchers from our group present at chiropractic research conferences it is often asserted that the nervous system changes we are reporting, following the correction of vertebral subluxations, are merely “contextual effects that would occur if we hit our participants with a golden shovel.” One way to show that vertebral subluxations are in fact a real entity, would be to demonstrate that providing an adjustive thrust to a subluxated segment results in different neurophysiological outcomes to providing a similar thrust to a vertebra that is not subluxated.

To date little is known about whether specificity matters when adjusting vertebral subluxations. Previous studies using animal models have examined how specificity of spinal adjustments, i.e. whether the adjustment is applied to a fixated vertebra (target) vs. a non-fixated (non-target) vertebra, impacts the neural response from muscle spindles in the paraspinal muscles. These studies suggested that applying the adjustive thrust to a specific vertebra might not be as important as previously expected, since 60-80% of the afferent response can still be obtained when a thrust is applied to a non-target vertebra two segments away from the target vertebra. However, this research was done on animals, using a fixation model that may not accurately represent a vertebral subluxation, and it did not examine cortical sensorimotor integration. Therefore, the aim of the present study is to examine how an adjustive thrust to a subluxated vertebra, compared to a similar thrust to a non-subluxated vertebra, impacts cortical sensorimotor integration in healthy participants.

Contemporary Chiropractic: Shifting practice and outcomes.

Dr Tanja Glucina, New Zealand College of Chiropractic

As the 2016 recipient of the New Zealand Chiropractors Association McKay scholarship for Dr Glucina’s Honours dissertation study (also recently presented at the 2019 World Federation of Chiropractic Congress, and is accepted for publication with the Journal of Manipulative and Physiological Therapeutics), this pioneering study builds on previous knowledge. The overall goal of this PhD thesis is to develop the understanding of chiropractic practice through mixed methods research, to inform systematic controlled studies in the field of chiropractic, specifically pertaining to vertebral subluxation-based research.

This proposal seeks to assist the profession in its understanding of individual philosophies and how this relates to how chiropractors’ practice and communicate chiropractic. This research will also investigate the public’s perception of the chiropractic profession including vertebral subluxation. Using Patient Reported Outcome Measures (PROMs), the study may also be able to show the impact of vertebral subluxation-based care on client outcomes. This research aims to create a platform to strengthen chiropractic, both intra-professionally and within the healthcare arena locally and internationally.

Key Achievements

Launched our online learning platform, to provide Members with complimentary resources and continuing education material.
The Board Directors continued to liaise and engage with our major stakeholders to expand our global reach and to grow our Member, Supporter, Commercial Supporter and Donor bases.
Continued to look for opportunities to collaborate with other organisations to assist our funding and facilitation of research projects that are driven by our Research Agenda; this year the ASRF co-funded a major project with the United Chiropractic Association (UCA).
This year the Board of Directors initiated the inaugural David Russell Postgraduate Scholarship Grant in memory of the late Dr. David Russell who served tirelessly over most of his career as both a Board Director and a valued supporter of the Foundation.
Entered into a commercial and symbiotic relationship with the Australian Chiropractic College.

Research Report: Collaboration and Innovation 

Joint Venture Research

We are again proud to announce co-funding of Dr Adrian Wenban’s project “Effects of cervical chiropractic adjustments on heart rate variability, quality of life and tumor marker in colon cancer patients” with United Chiropractic Association (UCA) based in the UK.  This is testament to our shared vision to gain a further understanding of chiropractic through facilitating funding for vertebral subluxation research to support the principles of vitalistic chiropractic.

Research Output

The Foundations unique two panel assessment of research grants by the Research Committee (RC) and the Clinical Advisory Panel (CAP) ensures facilitated research not only stands up to scientific rigour but is also clinically relevant. The ultimate aim of researchers is to gain a better understanding of chiropractic and to articulate that to their colleagues and the wider community through internationally recognised and reputable publications.  This year we highlight a publication of a clinically relevant paper on neck pain in the Journal of Manipulative and Physiological Therapeutics (JMPT) led by Newcastle University based Dr Susan Snodgrass.  Dr Snodgrass received ASRF funding for this project in 2013.

A Pilot Longitudinal Study of 3-Dimensional Head and Neck Kinematics During Functional Tasks in Individuals With Chronic Idiopathic Neck Pain Either Wait-Listed for or Receiving Chiropractic Spinal Manipulative Therapy With Exercise

Sarah J. Blyton, PT, a Suzi Edwards, PhD, b Diana Moghaddas, PT, b Rutger M.J. de Zoete, PhD, a Kerrin Palazzi, MPH, c Chris Oldmeadow, PhD, c Philip Bolton, PhD, d Darren A. Rivett, PhD, a andSuzanne J. Snodgrass, PhD a

ABSTRACT

Objective: The purpose of this study was to determine if there is a relationship between pain and movement kinematics during functional tasks, evaluated over time, in individuals with chronic idiopathic neck pain.

Methods: Ten participants with chronic idiopathic neck pain performed 2 functional tasks (overhead reach to the right and putting on a seatbelt) while evaluated using 8 Oqus 300+ cameras. Kinematic variables included joint angles and range of motion (ROM) (°), head segment relative to neck segment (head-neck [HN]); and head/neck segment relative to upper thoracic segment (head/neck-trunk), velocity (m/s), and time (% of movement phase). Pain was quantified using a 100-mm visual analog scale. Linear mixed effects regression models were used to analyze associations between pain and kinematic variables adjusting for treatment group.

Results: For overhead reach, higher pain was associated with less HN peak rotation at baseline (b = _0.33; 95% CI _0.52 to _0.14, P = .003) and less HN total rotation ROM at 6 months (b = _0.19; 95% CI _0.38 to _0.003, P = .048). For the seatbelt task, higher pain was associated with less HN peak rotation (b = _0.52; 95% CI _0.74 to _0.30 to _0.74, P < .001) and less HN total rotation ROM at baseline (b = _0.32; 95% CI _0.53 to _0.10, P = .006). No other movement variables demonstrated meaningful relationships with pain for the reach or seatbelt tasks.

Conclusion: Higher pain is associated with less HN peak and total rotation during functional reaching tasks requiring head rotation. Recognizing altered functional kinematics in individuals with chronic neck pain may assist patient management. (J Manipulative Physiol Ther 2020;00;1-16)

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 2019 applications and their ongoing commitment to the Foundation’s research process. We would also like to thank our 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 subluxation.

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.

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Our Mission: to facilitate research that furthers the understanding of chiropractic care.

President’s Report: Resilience Through Challenging Times

I’m so proud of the actions of the previous and current Boards. Their decisions, actions, focus, combined knowledge and abilities have really shaped and evolved the Australian Spinal Research Foundation into what it is today. I have served on the Board of Spinal Research since 2011 and have been President for the past 5 years. I follow in some big footsteps, of those that have walked before me.  I am thankful for the opportunity to have learnt from you all, and the dedication of these individuals over the years has been truly inspiring.

2020 has been memorable for many reasons (good and bad). Leading up to the events of this year the Foundation had:

  • Reduced our overheads significantly by selling the head office and changing the daily operations to an ‘online’ Foundation.
  • Increased the diversity of our revenue to include book sales of our first book: The Case For Chiropractic. This included setting up of printing and sales in North America and around the world.
  • Launched our online CPD platform, to be able to provide further value for our Members, through online content.
  • Entered into a commercial and symbiotic relationship with the Australian Chiropractic College, loaning them crucial funds for their launch and to support the future security of their course.
  • Updating (and over hauling) the Constitution, to enable the use of technology to increase the contributions made by our non-Australian Members.

The past few years the Board have been busy streamlining the Foundation, so when the COVID-19 pandemic hit earlier this year, we found ourselves in a position where we were able to continue to focus on increasing value for Members, and keep the research grant rounds operating as normal. After all, pandemic or not, the research needs to get done.

I’m very proud to say that the Foundation has been able to return to generating a profit, and at the same time increase our research output to 18% of this year’s revenue. Of course this figure will not reflect the active role we’ve had in facilitating projects, like the UCA’s involvement with the Niazi, Holt and Haavik study, showing significant brain functional connectivity changes following chiropractic care for chronic stroke survivors.

Earlier this year we suffered the huge loss of our past Board member and advocate, Dr. David Russell. Dave has left behind a big void that we are still adapting to, and our thoughts go out to his family and friends closest to him. The Foundation has decided to honour Dave and his massive contribution to research, with the launch of the David Russell Postgraduate Scholarship Grant.

I’d like to thank everyone associated with the Foundation… the dedicated Board members, the fantastic staff (past and present) and our loyal Members for their ongoing support. The past 9 years on the Board has certainly been a privilege and a challenge, but I’m proud to say we are in a far stronger position than we were. This report marks my final as President, as after 9 years it is now time for me to step aside and let the incoming Board continue to guide the Foundation to greater strengths and wins.

I’d lastly like to thank my wife Cath for her continued support.  She has graciously enabled me to fulfil my role as both Board member and President over many years.  Our kids have also endured weekends without me at home and now that they are all teenagers, it’s a great time for me to dedicate to them. It’s been a true highlight of my career to be on the Board of Spinal Research and lead the Foundation and I sincerely thank you for the ongoing support and friendships.

Dr Craig Foote, Foundation President

Treasurer’s Report: Diversifying and Value-Adding for Sustainability

Dominating this past financial year has been the onset of the global COVID-19 Pandemic that has affected not only the state of health worldwide, but has and will continue to dramatically impact the global economy.

The Foundation, like many others, was not immune to the financial implications and the effect on memberships and donations, as a result of various restrictions imposed by State Governments and Health Departments. We understand that many of our Members have been affected by the Global Pandemic, which is why the Board of Directors and Foundation staff continue to explore and create ways to provide greater value for your support.

At the Foundation, we have continued to diligently make improvements in our work efficiency and to cut costs where it’s possible. But at the same time, continue to fund and facilitate research to investigate the impact of chiropractic care on the quality of life of an individual and on their community.

Despite the combination of the pandemic, a slight fall in membership numbers and reduced investment income due to sustained low interest rates on the financial markets, this last financial year has seen the Foundation pay its highest percentage of revenue towards research, and provide more funding to projects whilst still making a profit, in several years.

Over the past few years the Foundation has identified the necessity to continually look at profitable ways to diversify its revenue streams. This year we saw the launch of the Chiropractic Research Coffee Table book. The first round of printing sold out and our second round of printing has included large sales in the UK and distribution in the US and Canada. We have also built a solid and growing portfolio of Commercial Supporters. All of these strategies have greatly improved the Foundations overall sustainability.

Thank you to all our Members, Supporters and Donors – the Foundation greatly values you all, and your loyalty to our Vision and Research Agenda. Much appreciation and thanks to the Spinal Research team – your tireless work and efforts are always appreciated.

Dr Billy Chow, Treasurer

Commercial Supporters

We acknowledge and sincerely thank our Commercial Supporters for their contribution to chiropractic research. The companies below are our Commercial Supporters from 2019-20 Financial Year. To see current Commercial Supporters and more information about the companies, see here.

Event Sponsors

Thank you to those companies who sponsored our Spinal Research Hero Month 2020. We truly appreciate it.

Foundation Board

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. Board members and roles listed below are from 2019-20 Financial Year. To see current Board Directors, click here.