The primary aims of the proposed proof-of-concept trial are centred around examining the feasibility of conducting a prospective, chiropractic intervention study on an obese population living in and around Athens, Georgia. This includes evaluating various implementation outcomes including recruitment, adherence, tolerability, retention, acceptability, and data fidelity. As a secondary aim, we will assess the potential effects of removing vertebral subluxations via chiropractic adjustments on psychological, neurological, and immunological functioning. The results of this trial will inform the design of a future randomised, controlled trial (RCT) that has an increased focus on effectiveness outcomes.

Grant Value: $10,000
Chief Investigator: Dr Tyson Perez & Dr Phillip Tomporowski – Life University and University of Georgia
Status: In Progress

Chiropractic care is frequently utilised by infants and children for wellbeing and various health concerns. Considering the utilisation and apparent benefits of chiropractic care for infants, but the significant lack of research exploring the mechanisms and neurophysiological effects of chiropractic adjustments on infants, it is necessary to explore these potential effects further. This research aims to investigate the feasibility of conducting a randomised controlled trial (RCT) utilising Electroencephalogram (EEG) and heart rate variability (HRV) to measure changes to the central and autonomic nervous system (ANS) following chiropractic care in preterm infants. Preterm infants are at a heightened risk of developing deficits in neuromotor development and cognitive and executive functions and thus are an important group to investigate potential benefits of chiropractic care.

Grant Value: $9,960
Chief Investigator: Dr Jenna Duehr – New Zealand College of Chiropractic
Status: In Progress

Neuroscientific studies provide valuable insights, but not all chiropractors and patients engage with thisresearch. Many prioritise real-life experiences of others who have improved their health through similarapproaches. Recognising the need for patient-centred approaches, this project explores patient perspectives and attitudes regarding the impact of chiropractic care on immune function, stress, adaptability and resilience. Utilising qualitative and mixed methods, this project aims to enhance the understanding of chiropractic practice from the patient’s viewpoint, contributing to rigorous research focused on vertebral and health outcomes. Ultimately, the goal is to make chiropractic care more accessible and relevant, strengthening its position in healthcare.

Grant Value: $18,093 (funding for first year)
Chief Investigator: Dr Tanja Glucina – New Zealand College of Chiropractic
Status: In Progress

This Research aims to investigate the impact of Vertebral Subluxation, or dysfunction, on stress levels. The study will utilise machine-learning models and time series analysis to predict stress based on subluxation severity and to analyse its evolution over time. Participants underwent chiropractic sessions, with stress levels gauged using Heart Rate Variation (HRV), sputum, and hair cortisol. Key outcomes will determine whether chiropractic care influences stress levels and elucidate the relationship between subluxation and stress. The integration of Artificial Intelligence into chiropractic research aims to provide personalised interventions and deepen the understanding of patient care.

Grant Value: $19,947.52 (funding for the first year)
Chief Investigator: Dr Imran Amjad & Dr Imran Khan Niazi  – New Zealand College of Chiropractic
Status: In Progress

2023 was our third year for the ‘ASRF Case Report Project’, using funds raised during Spinal Research Hero Month. By September 2024, we will have published 51 case reports through this project, five of which were case series covering 22 individual cases (ie: 68 cases in total). We have also published two standalone literature reviews and a commentary piece – all available in the Asia-Pacific Chiropractic Journal. We’re so proud of this project! See more here.

This study aims to investigate the effects of chiropractic adjustments on brain function, specifically the prefrontal cortex (PFC), using functional MRI and advanced computational methods e.g. multivariate pattern decoding. The PFC plays a central role in higher-level cognition and modulation of cognitive control. It is implicated in various complex behaviours, including stress response and emotion regulation in resilience. This is a first of its kind fMRI study that would allow identification and localisation of the changes at neural level that may underlie the positive effects of chiropractic care on emotion regulation behaviour.

Grant Value: $36,487
Chief Investigator: Dr Adrian Wenban – Barcelona College of Chiropractic.
Status: In Progress

Researcher Update:

• March 2024
  

  The project team has created a clear project design and formulated clear study objectives. The software required for the study has been developed and undergone preliminary testing to ensure functionality and reliability.

  The researchers are now planning and resourcing a research laboratory with appropriate electronic and physical security measures, as required by Spanish data protection laws.  The plan is to then recruit participants during the third quarter of 2024 and commence data collection in 2025,  with the aim of data analysis taking place mid 2025, and manuscript preparation late 2025.

  The team are all dedicated to see the project progress and be able to see how fMRI can demonstrate the effect chiropractic therapy has on the human brain.

In the literature, chiropractic care has been shown to impact the central nervous system (CNS), autonomic nervous system (ANS), and immune system function. There is a lack of robust research investigating the long-term benefits of chiropractic care on stress and immune function. This research will investigate the effects of 6 weeks of chiropractic care on stress and immune function.

Grant Value: $39,946
Chief Investigator: Dr Imran Khan Niazi – New Zealand College of Chiropractic.
Status: In Progress

Researcher updates:

• July 2023
  Ethics has been approved and data collection is now underway.

This pilot randomised control trial involves the allocation of 20 adults with subclinical spinal-related pain to either six weeks of ‘chiropractic care’ or six weeks of ‘sham chiropractic care’. Multiple objective biomarkers of autonomic function will be used as outcome measures, including heart rate variability, galvanic skin response, pupil response to light, pre-frontal cortex function using functional near infrared spectroscopy, and assessing participants quality of life with the PROMIS-29 health questionnaire. This is the first step in a series of larger studies that will investigate the impact of adjusting vertebral subluxations on autonomic functions.

Grant Value: $9,924
Chief Investigator: Ms Marie Brunsart – New Zealand College of Chiropractic.
Status: In Progress

Researcher updates:

• July 2023
  Data collection has been completed and we are now moving onto data processing and analysis.

In the literature, chiropractic care has been shown to impact older adults’ sensory and motor systems, which may impact neuromuscular risk factors for falling. Therefore, looking at the change in the balance of older adults (Age>65) before and after chiropractic adjustments can provide valuable insight to chiropractors. Currently, chiropractors do not have a tool to give information about balance measures during the session. Therefore, in this study, we will look at the feasibility of using a novel mobile-based balance assessment tool, gait and balance app (G&B), to monitor the balance in older people (Age > 65) every week during chiropractic care.

Grant Value: $9,687
Chief Investigator: Dr Usman Ghani – New Zealand College of Chiropractic.
Status: In Progress

Researcher updates:

• July 2023
  Data collection has commenced and should be gathered by the end of 2023.

This research will investigate the convergent validity of physiological and psychological stress symptoms measured by the novel Stress and Sensorimotor Integration Questionnaire (SDSSMIQ) against the established Depression, Anxiety and Stress scale. The SDSSMIQ is a new tool that has been developed to measure the degree to which an individual’s vertebral subluxation affects how they process sensory information and function and how vertebral subluxations correlate with symptoms of stress. This study will be the first of a series of research studies to assess the psychometric properties of the SDSSMIQ.

Grant Value: $9,736
Chief Investigator: Dr Jenna Duehr – New Zealand College of Chiropractic.
Status: In Progress

Researcher updates:

• July 2023
  Data collection has been completed, and we are now moving onto data processing and analysis.

In 2022, we again raised funds through our Spinal Research Hero Month, for some very important research – the ‘ASRF Case Report Project’. This exciting project has been designed to gather front-line evidence in the form of case study information, from Chiropractors around the globe. This project has resulted in a collection of published and indexed reports being published in the Asia-Pacific Chiropractic Journal. See more here.

Basic science evidence suggests that chiropractic adjustments modulate immune mediators in healthy individuals in the short term and cortisol levels in symptomatic and asymptomatic individuals. However, clinically relevant research has not yet been done. The purpose of this study is to determine whether there is an association between regular chiropractic care and immune status. Two groups, one that has received regular chiropractic care over the past 12 months and one that has not, will complete self-reporting questionnaires and blood analyses relevant to assessing their immune status. The results of this observational case-control study will help inform the design of future experimental trials.

Grant Value: $39,898
Chief Investigator: Dr Heidi Haavik – New Zealand College of Chiropractic
Status: In Progress

Researcher Updates:

• July 2023
  Ethics has been approved and data collection is now underway.

The pupil diameter, controlled by sympathetic and parasympathetic innervation, is a direct reflection of autonomic nervous system (ANS) activity. This study aims to investigate the clinical feasibility of using pupillary activity measured with a cost-effective eye tracker as a measure of ANS function in people under chiropractic care. Computerised pupillometry is a low cost, non-invasive objective measure that could potentially be a useful outcome measure for chiropractors in practice to assess nervous system function in their patients.

Grant Value: $9,976
Chief Investigator: Dr Imran Amjad – New Zealand College of Chiropractic
Status: In Progress

Researcher updates:

• July 2023
  Data collection has commenced and should be gathered by the end of 2023.

Chiropractic adjustments have a positive impact on various aspects of central and autonomic nervous system function, in particular, a single session of chiropractic adjustments has been shown to alter pre-frontal cortex (PFC). However, how chiropractic adjustments impact PFC activity under stress has not been explored. This proposed pilot study aims to evaluate the feasibility of conducting a randomised controlled trial using mobile functional near-infrared spectroscopy to understand the effects of chiropractic adjustments on PFC activity during a stressful activity. This study will help us to refine the study protocol and understand how chiropractic adjustments influences acute stress and PFC activity.

Grant Value: $9,931
Chief Investigator: Dr Nitika Kumari – New Zealand College of Chiropractic
Status: In Progress

Researcher update:

• July 2023
  Data collection has commenced and should be completed by the end of the year.

In 2021, we raised funds through our Spinal Research Hero Month, for some very important research – the inaugural ‘ASRF Case Report Project’. This exciting project has been designed to gather front-line evidence in the form of case study information, from Chiropractors around the globe.

This project has resulted in over 30 published and indexed reports being published in the Asia-Pacific Chiropractic Journal. See more here.

Multiple sclerosis (MS) is an inflammatory autoimmune disease associated with an imbalance between pro- and anti-inflammatory cytokines resulting in a demyelinating and neurodegenerative disease. There is moderate quality evidence that spinal manipulation (SM) is better than control in influencing cytokine activity in asymptomatic individuals, but few studies have been completed in individuals with chronic inflammatory conditions. The objective of this project is to examine the immediate (1 SM treatment) and summative impact (8 SM treatments/4wks) on pro-inflammatory (IL-1β, IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) plasma cytokines 20 minutes and 2 hours post-SM in individuals diagnosed with neuroinflammatory relapsing-remitting MS (MS-RR).

Grant Value: $39,980
Chief Investigator: William R. Reed DC, PhD
Status: In Progress

Researcher Update:

• November 2024
  Project still in progress. Some delays have resulted from COVID and other challenges. Expected completion in December 2024.

This study will expand previous suggestive work in the literature [1-6] to explicitly determine whether immune function can be improved after a series of spinal manipulative therapy (SMT) sessions. The primary aim is to investigate and measure the impact of reducing vertebral subluxation on immune cell function. Before and after 12 weeks of prescribed chiropractic SMT treatments in participants diagnosed with vertebral subluxation, immune biomarkers will be measured with state-of-the-art lab-based immune cell phenotyping. This research will be the first to comprehensively characterise the impact of SMT to reduce vertebral subluxation on immune function in humans.

Grant Value: $37,763 (Co-Funded with the UCA)
Chief Investigator: Dr Jonathan Little – University of British Columbia
Status: In Progress

Researcher Update:

• March 2023
  The project has experienced some delays, however data collection is taking place, and researchers are proceeding towards analyses and completion of the project.

The overall goal of this PhD project is to develop the understanding of chiropractic practice through mixed methods research, and 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 project aims to create a platform to strengthen chiropractic, both intra-professionally and within the healthcare arena locally and internationally.

Grant Value: $10,000
Chief Investigator: Dr Tanja Glucina – New Zealand College of Chiropractic
Status: In Progress

Researcher Updates:

• December 2023
  PhD submitted.  Final report coming in March 2024.

Publications:

• Complementary Therapies in CLinical Practice, Volume 39, May 2020
  Glucina, T. T., Krägeloh, C. U., Farvid, P., & Holt, K. (2020). Moving towards a contemporary chiropractic professional identity. https://doi.org/10.1016/j.ctcp.2020.101105

Presentations:

• Concordia – Adelaide College of Chiropractic March 2022 Adelaide, Australia
  Changing the Conversation around the Professional Identity of Chiropractic
• New Zealand Chiropractors Asssociation AGM June 2021. New Plymouth, New Zealand
  The importance of Chiropractic Professional Identity

Posters:

• Chiropractic Academy for Research Leadership Congress (CARLoquium) March 2022, Virbela. Poster D32
  Glucina, T.T., Krageloh, C., Spencer, K., Holt, K. (2021). Defining Chiropractic Professional Identity
• Chiropractic Academy for Research Leadership Congress (CARLoquium) March 2021, Virbela.Poster E28
  Glucina, T.T., Krageloh, C., Farvid, P., Holt, K. (2021). Moving towards a contemporary chiropractic professional identity
• Proceedings of the 16th World Federation of Chiropractic Biennial Congress Convention September 2021, Virtual
  Glucina, T.T., Krageloh, C., Spencer, K., Holt, K. (2021). Defining Chiropractic Professional Identity. 

Correcting vertebral subluxations lies at the heart of chiropractic practice. Most chiropractic techniques emphasise the importance of a thorough spinal examination in order to locate and analyse vertebral subluxations and determine the most appropriate approach to facilitate their correction. Yet, no research exists that clearly shows that specific spinal adjustments are of more benefit to nervous system and human function than gross, non-specific, spinal manipulation. This study is the first in a programme of research that will investigate the importance of the artful, masterful application of chiropractic care for improved patient outcomes.

Grant Value: $19,535
Chief Investigator: Dr Heidi Haavik – New Zealand College of Chiropractic
Status: In Progress

Researcher updates:

• March 2022
  I am pleased to report we have some exciting results from this!!! Sorry about the excessive use of exclamation marks, but I cannot contain how excited I am about our results!!! 😊 We managed to get the data collection complete and have since analysed this. Preliminary results show that specificity (i.e. directing our thrust towards a subluxation) does indeed matter when it comes to neurophysiological outcomes! The group that received a specific adjustment directed at a vertebral subluxation demonstrated significant neurophysiological changes in sensorimotor integration compared to the group that received a thrust directed at a non-subluxated segment.
• October 2023
  The project is now in the review process, and hopefully publications will be submitted this month.  Watch this space!

Newsletters:

• Article in ASRF newsletter. December 2021
  Does Specificity matter?

This preliminary clinical trial will examine the effects of vagal nerve activation via cervical chiropractic adjustments on clinical outcomes in patients with colon cancer. Specifically, we hypothesize that participants randomly assigned to receive cervical chiropractic adjustments will have higher heart rate variability (HRV), better health-related quality of life (QOL) and lower levels of both pain and a colon cancer tumour marker, than controls. We aim to recruit 80 participants with advanced colon cancer (stage III-IV) who will be measured at baseline for QOL, pain, HRV and a colon cancer marker. Thereafter, they will be randomized to receive the intervention or sham for 10 weeks. Follow up will be at specific intervals across 6months.

Grant Value: $39,850 (Co-Funded with the UCA)
Chief Investigator: Adrian Wenban & Yori Gidron Barcelona College of Chiropractic
Status: In Progress

Researcher update:

• October 2021
  Unfortunately Covid has caused delays with the gathering of data.  We are hoping to have new updates to share very soon.
  

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.

Grant Value: $80,000 (a joint venture project with ASRF and The Hamblin Trust)
Chief Investigator: Dr Imran Khan Niazi – New Zealand College of Chiropractic
Status: In Progress

Researcher Updates:

• March 2022
  Covid has caused numerous and significant delays. We did secure funding from another funding body to investigate the neurophysiological aspects of subluxated and non-subluxated individuals using High-density EMG. So, the data we have already collected will provide us with greater clarity about the neurophysiological aspects of vertebral subluxations. Also, we added the question of investigating the effects of a single session of chiropractic care on the biomechanics and neurophysiological aspects of subluxation.
• October 2023
  We have finished data collection, and we have been analysing the data. Hopefully, we will finish the data collection by the end of the year, and then be ready to report outputs towards the end of 2024.

Publications:

• Article in ASRF newsletter, June 2022
  Understanding the Biomechanics of a Vertebral Subluxation

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.

Grant Value: $19,708
Chief Investigator: Dr Kelly Holt – New Zealand College of Chiropractic
Status: In Progress

Researcher Updates:

• Ocotober 2023
  COVID-related uncertainties, and team members were stuck overseas, resulting in a shortage of on-ground staff. Has delayed the progress of this project.  However data is being collected right now and the analysis will take place during 2024.

Determining where to adjust is fundamental to the practice of chiropractic. Many of the methods commonly utilised in chiropractic practice have low reliability or conflicting results. There is no universally agreed upon ‘gold standard’ test for detecting subluxation, meaning that a validity study is not possible. However, the agreement between different chiropractors testing the same person can be measured statistically. The objective synchronous test is the primary procedure used by chiropractors trained in Advanced BioStructural Correction™ to determine where to adjust. This study aims to evaluate both the inter-rater and intra-rater reliability of this test. This research is important because the reliable detection of subluxation is fundamental to the clinical practice of chiropractic.

Grant Value: $2,500
Chief Investigator: Dr Beau Woods & Dr Melinda Stanners – Torrens University Australia, Dr Kelly Holt – New Zealand College of Chiropractic.
Status: Complete

Publications:

• Journal of Contemporary Chiropractic, Volume 6, Issue 1, January 2023, Page 1 – 7
  Woods, B., Thomas, N., Stanners, M., & Holt, K. (2023). Reliability of the objective Synchronous  test as used in Advanced Biostructural Correction™ to assess for L5 dysfunction (Roosta-L5). Journal of Contemporary Chiropractic, 6(1) 

Clinical Applications of this research:

This project helps chiropractors to understand the reliability of the Objective Synchronous Test, as used in Advanced BioStructural Correction. This methodology is at least as good, if not better, than commonly used chiropractic procedures such as motion palpation and static palpation.

Tests of sacral function are an integral component of many chiropractic techniques, however, individual tests that include sacroiliac joint motion have generally been found to have limited reliability and validity. The sacral leg check is routinely used in chiropractic practice but it’s clinical utility has not yet been adequately assessed. This project will evaluate the psychometric properties of the sacral leg check. This will include an assessment of the reliability, validity, and sensitivity to change of the test.  This should be of interest to chiropractors and educators who routinely use and teach the use of this test as a means of analysing subluxations in the sacroiliac region.

Grant Value:$19,911
Chief Investigator: Dr Kelly Holt – New Zealand College of Chiropractic
Status: In Progress

Researcher Progress:

• November 2018
  Training is progressing well. We are still modifying the protocol as we go but are happy with the progress we are making with our reliability findings. We have secured the use of a motion capture lab to perform the reliability and validity data collection which will really benefit this part of the project.
• Ocotober 2023
  COVID-related uncertainties, and team members were stuck overseas, resulting in a shortage of on-ground staff. Has delayed the progress of this project.  However data is being collected right now and the analysis will take place during 2024.

Do you have days when you reach for an object and miss, or seem to make a lot more typos than usual? A vertebral subluxation is an area in the spine of altered biomechanical and neurological function, which is treated by chiropractors. Vertebral subluxations alter the sensory feedback from the spine to the brain, and can affect your brain’s ability to blend information coming from other senses, affecting co-ordination and the ability to learn new movements. This project is measuring whether chiropractic care can improve eye-hand coordination, brain function and the learning and performance of complex new movements.

This grant represents an outstanding opportunity to use the equipment recently obtained through a Canada Foundation for Innovation grant to investigate the impact of vertebral subluxations on brain function. In order to understand the source(s) in the brain where the changes occur, the “whole head” 64-channel eego mylab system will be used. The advanced AsaPro software that is part of this system is essential to map the source (areas of the brain) responsible for changes in individual SEP peaks.  Without this research, our assertions that chiropractic adjustments have changed the strength of the contribution from different brain areas important for learning new movement patterns, would not be readily accepted by the scientific community. It is also critical to understand if altered sensory input due to the presence of vertebral subluxations is altering cerebellar plasticity, as it is much harder to reverse maladaptive neuroplasticity in the cerebellum than in the cortex. The Eye Link II is the only system with the sensitivity to investigate the role of altered sensory input on multisensory integration and motor performance.  If we can show that SCNP individuals have altered cerebellar function, which affects oculomotor integration and motor skill acquisition and retention, it has the potential to provide sensitive biomarkers of people at risk of injury or accident.  In our modern world, everyone wants to be smarter, faster and better at performing and learning new skills. If chiropractic can be shown to help achieve this, it will greatly expand the range and number of individuals who would benefit from care, ranging from athletes wanting to improve performance to employers wanting to decrease performance errors to individuals wanting to improve function and well-being at work, home and leisure. This study has a strong focus on the cerebellum because it is so important in learning skilled movement, and has connections to nearly every other part of the brain. If we can provide evidence of the mechanisms by which chiropractic adjustments are improving function it provides a scientific rationale for both maintenance and preventive care.

Grant Value: $80,000
Chief Investigator: Professor Bernadette Murphy – University of Ontario Institute of Technology
Status: Complete

Publications:

• Experimental Brain Research, Volume 240, Issue 7-8, August 2022, P.1911-1919
  Sanmugananthan, P.*, Burkitt, J.J.*, Campbell, D*. Cheema, N., Murphy, B.A., Yielder, P.  (2022). “The Impact of Subclinical Neck Pain on Goal-Directed Upper Limb Movement in the Horizontal Plane.” Experimental Brain Research (in press).  
• Cureus, Volume 13, Issue 10, October 2022
  Sanmugananthan P, Nguyen N, Murphy B, Hosseini, A. (2021) Design and Development of a Rotating Chair to Measure the Cervico-Ocular Reflex. Cureus 13(10): e19099. DOI 10.7759/cureus.19099 

Posters:

• Neural Control of Movement, July 2022. Dublin, Ireland
  Ushani Ambalavanar, Nicholas La Delfa, Heather McCracken, Mahboobeh Zabihhosseinian, Bernadette Murphy. Differential Changes in Somatosensory Evoked Potentials and Motor Performance: Pursuit Movement Task versus Force matching Tracking Task. 

Presentations:

• Biannual International Society of Electrophysiology & Kinesiology (ISEK XIV) July 2022. Quebec, Canada
  Devonte Campbell, Bernadette Murphy, James Burkitt, Nicholas La Delfa, Praveen Sanmugananthan, Paul Yielder. Accepted  “The effects of subclinical neck pain on cerebellar processing as measured by the cervico-ocular and vestibulo-ocular reflexes” 
• Biannual International Society of Electrophysiology & Kinesiology (ISEK XIV) July 2022. Quebec, Canada
  Ushani Ambalavanar, Paul Yielder, Heather McCracken, Hailey Tabbert, Bernadette Murphy  “Subclinical neck pain leads to Differential Changes in Early and Middle-latency Somatosensory Evoked Potentials and Motor Performance in response to a novel force matching tracking task”
• Southern Ontario Motor Behaviour Symposium in partnership with the Centre for Motor Control April 2022. Wilfred Laurier University, Waterloo, Canada
  Devonte Campbell, Bernadette Murphy, James Burkitt, Nicholas La Delfa, Praveen Sanmugananthan, Paul Yielder. The effects of spinal manipulation on cerebellar processing as measured by the cervico-ocular & vestibulo-ocular reflexes in a subclinical neck pain population (2022).
• Southern Ontario Motor Behaviour Symposium 2023. Virtual hosted by University of Toronto Centre for Motor Control
  Praveen Sanmugananthan*, Bernadette A. Murphy ,James Burkitt*, Paul Yielder. (2020) The impact of subclinical neck pain on upper limb vertical goal-directed movements in the dominant and non-dominant arms.
• University of Toronto Centre for Motor Control 2023. Virtual hosted by University of Toronto
  Rufeyda Cosgun*, Devonte Campbell*, James J. Burkitt*, Paul Yielder. Bernadette A. Murphy (2020) Vestibulo-ocular reflex padaptation appears to be increased in people with sub-clinical neck pain.
• Exercise Neuroscience Group Biannual meeting June 2019. McMaster University, Hamilton, Canada
  Cosgun, Rufeyda*,Murphy, Bernadette. Development of a protocol to investigate the vestibulo-ocular reflex in sub-clinical neck pain (2019).  

Newsletters:

• Article in ASRF newsletter. September 2022
  Recurrent neck pain alters brain function and eye-hand coordination and chiropractic care can help reverse the changes.

Clinical Applications of this research:

The work confirms that individuals with SCNP individuals have altered cerebellar function, which affects oculomotor integration and motor skill acquisition and retention. In the future this work has the potential to provide sensitive biomarkers of people at risk of injury or accident.  In our modern world, everyone wants to be smarter, faster and better at performing and learning new skills. If chiropractic can be shown to help achieve this, it will greatly expand the range and number of individuals who would benefit from care, ranging from athletes wanting to improve performance to employers wanting to decrease performance errors to individuals wanting to improve function and well-being at work, home and leisure. This study has a strong focus on the cerebellum because it is so important in learning skilled movement, and has connections to nearly every other part of the brain. If we can provide evidence of the mechanisms by which chiropractic adjustments are improving function it provides a scientific rationale for both maintenance and preventive care. 

The therapeutic mechanism of spinal adjustment (SA) for low back pain patients remains elusive. One promising mechanism is the potential for SA to influence the different biomechanics and neuromuscular control of spine movement in low back pain patients. Our goal is to investigate the effect of SA on neuromuscular control of coordination patterns between the pelvis and thorax in low back pain patients. These data would provide clinicians and researchers with evidence for the mechanistic foundation of SA, and may also provide an objective outcome for clinical prediction rules to identify patients who are likely to improve with SA.

Grant Value: $20,000
Chief Investigator: Dr Samuel Howarth – Canadian Memorial Chiropractic College & Dr Bernadette Murphy – University of Ontario Institute of Technology
Status: Completed

Researcher Update:

• Final Update October 2023
  The final analysis has been completed. Thoracopelvic coordination was operationalised using continuous relative phase. Two measures were extracted that related to the overall coordination pattern (mean absolute relative phase) and the variability of the coordination pattern from one gait cycle to the next (deviation phase).We were unable to replicate the previous finding of differences in thoracopelvic coordination between people with and without low back pain. Furthermore, neither the coordination nor the variability of coordination were different following SMT.There are many potential explanations for these findings. Two of these are the large amount of between-subject variability for coordination patterns and the high-functioning status of our participants with low back pain.

The elderly suffer from reduced health-related quality of life and increased mortality from all causes in association with reduced grip strength. In addition, a recent study, wherin chiropractic neck adjustments increased judo athletes’ grip strength, recommended further similar studies, to evaluate performance enhancing effects of chiropractic adjustments, amongst other populations. The present preliminary study aims to determine whether chiropractic adjustments improve neck movement and grip strength in elderly patients. This investigation is important because the results will contribute to the knowledge base regarding the effects of chiropractic adjustments and may open new pathways to explore the scientific basis of chiropractic theory.

Grant Value: $9,283
Chief Investigator: Dr Adrian Wenban – Barcelona College of Chiropractic
Status: Complete

Posters:

• Journal Chiropractic Education, Volume 34, Issue 1, March 2020, Page 103 
  Wenban AB, Perez de la Oslo P. THe effect of cervical spine adjustment on elderly patient’s grip strength. [Abstract] Journal of Chiropractic Education. 2020;34(1):103. 

Newsletters:

• Article in ASRF newsletter. March 2022
  The Effect of Cervical Spine Adjustment on Elderly Patient’s Grip-strength

Subluxation of the upper cervical vertebrae is regarded among chiropractors as an important cause of disease and disability. However, currently there is no animal model of the upper cervical subluxation, and so it is difficult for researchers to study the underlying mechanisms and the clinical consequences of this lesion. This research will develop a model of the upper cervical subluxation, and test whether this model compromises spinal cord function and the function of visceral organs, as many chiropractors postulate. This model will permit researchers to address important questions about the consequences and treatments of upper cervical subluxation.

Grant Value:$23,068
Chief Investigator: Dr Brian Budgell – Canadian Memorial Chiropractic College
Status: Complete

Researcher Updates:

• Final Report
  We had previously reported that experiments from the earlier phases of the study were consistent with the hypothesis that relatively moderate (non-destructive) short-term compression of the upper cervical spinal cord causes a reversible impairment of spinal cord function and this is reflected in changes in cardiovascular function.  This supports, but of course in itself does not prove, the concept of the upper cervical subluxation producing effects beyond purely bio mechanical changes. 
• June 2018
  The experiments completed to date indicate that, in an animal model, relatively moderate (non-destructive) short-term compression of the upper cervical spinal cord causes a reversible impairment of spinal cord function and this is reflected in changes in cardiovascular function. This is consistent with, but of course in itself does not prove, the concept of the upper cervical subluxation producing effects beyond purely biomechanical changes. To the extent that biological rationale is one component of clinical decision making, this may provide some guidance to clinicians confronting the case of upper cervical subluxation with, for example, cardiovascular changes. 
  Stakeholders should be encouraged to know that all experiments planned in the grant application have been completed with sufficient reliable data to produce a credible manuscript for a peer-reviewed journal. New knowledge obtained through these experiments will be used to design subsequent studies with further clinical implications. 
• October 2016
  Progress report including detailed photos and explanations of the research carried out.

Spinal manipulative treatment (SMT) is the primary clinical approach in chiropractic care. The cellular and molecular mechanisms responsible for SMT remain elusive. It is well know that SMT influences neurophysiological activities. However, a question remains: How can very short transient changes of cellular electricity impact patients’ long-term health? We propose to address this issue by examining whether manipulate forces impact neurons at cellular and molecular levels, particular in epigenetic regulation of neuronal differentiation – a potential mechanism in neuroplasticity. This research project should yield important insights in understanding the long-term benefits of chiropractic care.

Grant Value:$40,000
Chief Investigator: Liang Zhang – Palmer College of Chiropractic
Status: Complete

Researcher update:

• Final report, April 2019
  The long-term effects of brief stimulated LVVA loads on neurogenesis in cultured PC-12 cells

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is associated with significant alterations in brain development and function.(1) One of these alterations in brain function involves a breakdown in the control of eye movement which can be responsible for the reading impairments that are often seen in children with ADHD.(2) It is possible that chiropractic care may enhance control of eye movements in children with ADHD. To study this potential relationship we will perform a crossover design pilot study that will investigate the effects of chiropractic care on the control of eye movement in 15 children with ADHD.

Grant Value:$19,600
Chief Investigator: Dr Alice Cade – New Zealand College of Chiropractic
Status: Complete

Publications:

• Auckland University of Technology – Masters postgraduate qualification
  Cade, A., Jones, K., Haavik, H., Holt, K. (2017) Chiropractic Intervention and the control of eye movement in children with Attention Deficit Disorder: A pilot study. Auckland University of Technology, Auckland Submitted April 2017 as part of Masters postgraduate qualification.  
• Brain Sciences 2021, Vol.11, Page 1047
  Cade, A., Jones, K., Holt, K., Penkar, A.M., & Haavik, H. (2021). The Effects of Spinal Manipulation on Oculomotor Control in Children with Attention Deficit Hyperactivity Disorder: A Pilot and Feasibility Study. Brain Sciences 2021, Vol. 11, Page 1047, 11(8), 1047.

Presentations:

• Platform presentation ACC-RAC 2018. Dallas, Texas
  Cade, A., Taylor, D., Holt, K. (2017) The effects of chiropractic care on oculomotor control in children with attention deficit hyperactivity disorder: A pilot study. ACC-RAC 2018. Dallas, Texas  

Newsletters:

• Article in ASRF newsletter. December 2022
  The Eyes Have It – Objective Markers of Concussion in Clinical Practice

Research has shown that chiropractic adjustments can improve reaction time, improve the timing of when postural muscles switch on, and improve the ability to perform tasks requiring co-ordination. The part of the brain which could be involved with these effects is the cerebellum, receiving information from the joints and muscles and communicating with all the other regions of the brain. This means that if there is a problem with the neck, it may not only cause neck pain, but it could actually affect the timing and co-ordination of movement and performing skills, as a result of the neck joints and muscles sending distorted feedback to the cerebellum. Thus, the cerebellum cannot perform optimally in its role in blending information from the brain and body. This project will further investigate how the cerebellum functions and how chiropractic adjustments affect the way that the cerebellum processes input from the joints and muscles from the hand and forearm. This project also plans to compare changes in the function of the cerebellum to the way that people perform tasks with their upper limbs following chiropractic adjustments. Tasks such as throwing, learning of new skills that challenge timing and use the hand muscles, and repositioning a subject`s upper limb in space.

This research has the potential to be making a fundamental contribution to our understanding of the role and mechanism behind spinal  adjustments. This will also help scientists to understand more about the way that the cerebellum functions when incoming sensory input is altered by spinal dysfunction. This work could have very important implications, perhaps suggesting that chiropractic care may be able to play a role  beyond treating pain, and in fact possibly benefiting everyone.

Grant Value: $80,000
Chief Investigator: Professor Bernadette Murphy – University of Ontario Institute of Technology
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 1, January 2016, Pages 23 – 30 Baarbe J, Holmes MWR, Murphy HE, Haavik H, Murphy BA. Influence Subclinical Neck Pain on the Ability to Perform a Mental Rotation Task: A Four Week Longitudinal Study with a Healthy Control Group Comparison.

Posters:

• Sensorimotor Control Meeting, February 2015, Brisbane, Australia, Page 26
  Baarbé, J., Holmes, M., Murphy, H., Haavik, H., Murphy, B. Low Grade Neck Pain Interferes with the Ability to Perform a Mental Rotation Task.
• 13th World Federation of Chiropractic Biennial Congress May 2015, Athens, Greece, Page 99
  Baarbé, J., Yielder, P., Haavik, H., Holmes, M., Debison-Larabie, C., Murphy, B. Enhanced cerebellar disinhibition when cervical manipulation precedes motor learning in individuals with subclinical neck pain. Poster Abstract 

Presentations:

• Satellite Symposium of the Canadian Association of Neuroscience 10th Annual Meeting May 2016, Toronto, Canada
  Baarbé, J.*, Murphy, B., Haavik, H., Holmes, M. Subclinical Neck Pain Alters Upper Limb Kinematics during Dart Throwing. “Action & Perception: Cognition, Coding and Clinical Populations”; Canadian Action and Perception Network (CAPnet)-Canadian Physiological Society (CPS) 
• Satellite Symposium of the Canadian Association of Neuroscience 10th Annual Meeting May 2016, Toronto, Canada
  Baarbé, J.*, Yielder, P., Haavik, H., Holmes, M., Murphy, B. Subclinical neck pain impairs the cerebellar response to motor training which is normalized following treatment with spinal manipulation. “Action & Perception: Cognition, Coding and Clinical Populations”; Canadian Action and Perception Network (CAPnet)-Canadian Physiological Society (CPS)
• 13th World Federation of Chiropractic Biennial Congress May 2015, Athens, Greece
  Baarbé, J., Murphy, B. Haavik, H., Holmes, M. Upper Limb Kinematics Differ between subclinical neck pain and healthy participants during a dart throwing task.
• 13th World Federation of Chiropractic Biennial Congress May 2015, Athens, Greece
  Baarbé, J., Holmes, M., Murphy, H., Haavik, H., Murphy, B. Neck pain participants show impaired ability to perform a mental rotation task in a four week longitudinal study as compared to healthy controls

Awards:

• 13th World Federation of Chiropractic Biennial Congress May 2015, Athens, Greece
  Scott Haldeman Award for paper on ‘Neck pain participants show impaired ability to perform a mental rotation task in a four week longitudinal study as compared to healthy controls’.

Neck pain has been estimated to occur in as many as 4 out of 5 individuals. For many, symptoms do not resolve. Healthcare and societal costs (work absenteeism, reduced productivity) associated with chronic neck pain are high and predicted to rise. Despite the common and successful use of chiropractic in patients with neck pain and some evidence for its effectiveness, the biological mechanisms by which chiropractic care reduces pain are less well understood.

Preliminary evidence indicates that the brain appears and functions differently when pain is present. In this project, we will investigate the effects of chronic neck pain on individuals, and the effects of chiropractic care and management on abnormal spinal function associated with chronic neck pain. We will determine whether we can identify clinical circumstances (from brain imaging and three-dimensional movement analysis) that distinguish patients with chronic neck pain from healthy individuals. This will identify specific physical signs (biomarkers) that clinicians can use to guide their care of patients with neck pain. We will also test whether a specific chiropractic procedure is effective in reducing chronic neck pain, and whether it changes the identified biomarkers, thus possibly providing evidence for their use in clinical practice to evaluate the effectiveness of care.

The results of this project could provide preliminary biological evidence for the potentially painreducing effects of a chiropractic procedure. This will provide clinicians with knowledge to improve the effectiveness of their care, impacting on the economic costs of spine problems, which are second only to heart disease and stroke in terms of healthcare expenditure.

Grant Value: $20,000
Chief Investigator: Dr Suzanne Snodgrass – University of Newcastle
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 43, Issue 5, June 2020
  ‘The effect of chronic neck pain on movement strategies during functional tasks in individuals with chronic neck pain: a 3D motion analysis study’ 

Presentations:

• International Federation of Orthopaedic Manual Physical Therapists Congress July 2016. Glasgow, Scotland
  Snodgrass SJ, de Zoete RMJ, Rivett DA, Stanwell P. Assessment of cerebral biochemistry in individuals with chronic idiopathic neck pain and health individuals: Evidence for central changes in the presence of chronic neck pain.
• Australian Physiotherapy Association Biennial Conference October 2017. Sydney, Australia
  Blyton SJ, Edwards S, Moghaddas D, de Zoete RMJ, Palazzi, K, Oldmeadow C, Bolton P, Rivett DA, Snodgrass SJ. Associations between neck kinematics and pain individuals with chronic idiopathic neck pain. Presented by Honours graduate Sarah Blyton, she won Best Oral Presentation by a clinician, awarded by Musculoskeletal Physiotherapy Australia. 

Posters:

• Australian Physiotherapy Association Biennial Conference October 2017. Sydney, Australia
  Snodgrass SJ, Stanwell P, Edwards S, Moghaddas D, Blyton SJ, Cooper RA, de Zoete RMJ, Oldmeadow C, Rivett DA. Relationships between brain biochemistry and neck kinematics in individuals with chronic neck pain. 
• International Federation of Orthopaedic Manual Physical Therapists Congress July 2016. Glasgow, Scotland
  Snodgrass SJ, Cooper RA, Edwards S, Moghaddas D, Bayton SJ, de Zoete RMJ, Rivett DA. Altered movement strategies during functional tasks in individuals with chronic idiopathic neck pain.

Clinical applications for this research:

Neck kinematics and pain: Greater neck pain was associated with lower maximum and total rotation during functional tasks requiring cervical rotation, support clinical observations of altered movement strategies in individuals with chronic idiopathic neck pain.

Neck kinematics and brain biochemistry: Preliminary analyses suggest that neck kinematics are associated with brain biochemistry in individuals with idiopathic neck pain, providing evidence for a central mechanism influencing the cervical movement patterns clinicians observe.

Over the past decade there has been growing evidence to suggest that chiropractic care influences brain function. The researchers that have done this work have used sophisticated brain research methods such as measuring brain waves using electroencephalography (EEG). These studies have shown that adjusting subluxations in the spine alters function in various brain structures. However, the evidence for the involvement of these brain structures is indirect. Although EEG measures brain activity very accurately time-wise, it has poor spatial resolution, which means it’s hard to tell exactly where in the brain the activity occurs.

Recently efforts have been made to improve the spatial resolution of EEG using a new EEG technique, known as multichannel matching pursuit technique. With this technique it is possible to determine with greater clarity where in the brain activity occurs. A group of chiropractic researchers in New Zealand and Canada are pairing up with a group from Denmark and intend to use this new technique to explore which structures in the brain are talking to each other prior to, and after, chiropractic adjustments.

The researchers believe that they will be able to identify differences in the way the brains of a group of 15 subluxated individuals, who are developing spinal symptoms, function compared with a group of 15 healthy people with no history of symptoms. They also believe that a single session of chiropractic care in the subluxated group will change the way parts of the brain are talking to each other. The researchers aim to reveal the brain areas involved in subclinical pain processing, then study the communication between these brain areas and how the communication changes following a single session of spinal adjustments.

By completing this study the researchers hope to gain a much better understanding about how vertebral subluxations and adjustments affect nervous system function.

Grant Value:$73,841
Chief Investigator: Imran Khan Niazi – New Zealand College of Chiropractic
Status: Complete

Publications:

• Neural Plasticity, 2016
  Lelic D, Niazi IK, Holt K, Jochumsen M, Dremstrup K, Yielder P, et al. Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study. Neural plasticity. 2016;2016:3704964. 

Presentations:

• ACCRAC March 2016, Orlando, Florida, USA
  Lelic D, Niazi IK, Holt K, Jochumsen M, Dremstrup, Yielder P, Murphy B, Drewes AM, Haavik H. Chiropractic adjustments alter sensorimotor integration in the pre-frontal cortex – A brain source localisation study.
• The Parker Experience January 2016, Las Vegas, Nevada, USA
  Lelic D, Niazi IK, Holt K, Jochumsen M, Dremstrup, Yielder P, Murphy B, Drewes AM, Haavik H. Chiropractic adjustments alter sensorimotor integration in the pre-frontal cortex – A brain source localisation study. 
• CAA Scientific Symposium, October 2015, Melbourne, Victoria, Australia
  Lelic D, Niazi IK, Holt K, Jochumsen M, Dremstrup, Yielder P, Murphy B, Drewes AM, Haavik H. (2015) Manipulation of dysfunctional spinal joints affects sensorimotor integration in the pre-fontal cortex: A brain source localization study.

Awards:

• Chiropractors Association of Australia Scientific Symposium, October 2015, Melbourne, Victoria, Australia
  Winner of Conference Delegates Prize

This project investigates the impact of the subluxation on joint position sense and movement. Chiropractors and their patients often report improvements in balance and coordination after having chiropractic care. In physiological terms, this may be defined as a decrease in the ability to accurately perceive where the limb is in space and how it is moving. This project plans to examine the plausibility that such improvements may be attributable to removal of the chiropractic subluxation. DD Palmer, the founder of chiropractic, defined the chiropractic subluxation as “too little or
too much nerve energy”. We have translated this definition into physiological terms – subluxation is a mechanical derangement with a resultant disruption of appropriate / accurate sensory signals that are transmitted into the central nervous system. One consequence of this disruption that may be experienced by patients is clumsiness – a decrease in the ability to accurately perceive where the limb is in space and how it is moving.

We have developed a physiological model of subluxation that exploits the property of muscle thixotropy. This phenomenon is usually applied to fluids that become stiff and viscous at rest but more fluid when stirred. Muscle also exhibits thixotropic behaviour. When the muscle is at rest, the muscle becomes stiff; when the muscle moves, stiffness is reduced. By exploiting muscle thixotropy, we are able to alter neck muscle stiffness and therefore the output from the muscle spindles (the length detectors) of the neck in a predictable way, either increasing or decreasing the quantity of the sensory signals. By changing the quantity of sensory signals from the neck we can measure the effect of ‘too much or too little nerve energy’ on the accuracy of a person’s perception of where body segments are in space and in relation to each other. This project may provide evidence to support the proposal that chiropractic subluxation contributes to clumsiness.

Grant Value: $36,192
Chief Investigator: Dr Barbara Polus – RMIT
Status: Complete

Publications:

• Frontiers in Pain Research, October 2021, Volume 2
  Harman, S. C., Zheng, Z., Kendall, J. C., Vindigni, D., & Polus, B. I. (2021). Does my neck make me clumsy? A systematic review of clinical and neurophysiological studies in human https://doi.org/10.3389/fpain.2021.756771

Presentations:

• COCA Researchers’ Day, Sydney , Australia
  Harman, S., Wong, M,. Polus BI. “The role of neck muscles in understanding where our body lies in space” peoples’ choice poster award 
• Chiropractor’s Association of Australia Annual Conference  ,Cairns, QLD, Australia
  Harman, S., Zheng, Z., Azari, MF. and Polus BI 2016 “Is the pain in my neck making me clumsy? A systematic review of clinical and neurophysiological studies in humans.” Poster presentation finalist 
• Engineering and Health HDR Student Conference ‘From Inception to Excellence’ 2012, RMIT University, VIC, Australia
  Harman, S., Azari, MF. And Polus BI. 2012 “Role of neck proprioceptive afferents in producing symptoms of clumsiness in patients with neck pain and injury“ poster presentation
• Australian Neuroscience Society Sensorimotor Satellite Meeting  February 2014, Adelaide, Australia
  Harman, S., Zheng, Z., Azari, MF. and Polus BI  2014 ‘The Association Between Neck Pain and Injury and Errors In Limb Position Sense and Movement: Systematic Literature Review’

Chiropractic patients frequently report feeling great after an adjustment and experience results such as getting more out of their body, and coping more effectively with the stresses of daily life. Yet the ‘why’ behind these results has remained a subject of debate. Groundbreaking results of a recent research study suggest these positive outcomes are due to changes in brain function.

Research conducted in partnership by Dr Heidi Haavik, a leading chiropractor and neurophysiology researcher at the New Zealand College of Chiropractic, and world-renowned neurophysiologist, Professor Kemal Türker, found that subjects’ ability to flex their lower limb muscles increased by over 70% following just one full spine chiropractic adjustment session.

The results also indicated that the adjustment session allowed for greater drive from the brain to the muscle and prevented the muscles becoming fatigued. This research, suggests that chiropractic care changes the way the brain sends messages down the spinal cord and out to muscles. It also suggests that the nervous system is able to produce greater muscle contractions following an adjustment, which may mean muscles become stronger.

Perhaps the most interesting finding was that the results recorded from the research subjects occurred after just one session of chiropractic care, yet were similar to what has been shown to occur in the body after three weeks of strength training.

This research was conducted at the New Zealand College of Chiropractic thanks to a recent grant partnership between the Australian Spinal Research Foundation, The New Zealand Hamblin Trust and the New Zealand College of Chiropractic. Importantly, it will contribute to building the base of scientific evidence for what has long been understood from anecdotal reports; that chiropractic adjustments can result in greater energy, strength, better brain control, and less fatigue. This research demonstrates the ongoing benefits that flow directly from the Chiropractic Research Partnership, an initiative of Australian Spinal Research Foundation.

Grant Value:$34,750
Chief Investigator: Dr Heidi Haavik & Professor Kemal Türker – New Zealand College of Chiropractic
Status: Complete

Publications:

• Experimental Brain Research, Volume 233, Issue 4, January 2015, Pages 1165-1173
  Niazi IK, Turker KS, Flavel S, Kinget M, Duehr J, Haavik H. Changes in H-reflex and V-waves following spinal manipulation. https://doi.org/10.1007/s00221-014-4193-5
• Journal of Electromyography & Kinesiology, Volume 42, October 2018, Pages 24-35
  Haavik H, Niazi IK, Duehr J,Jochumsen M, Ugincius P,Sebik O,Yilmaz G,Navid MS, Özyurt G, Turker KS, Chiropractic alters TMS induced I-wave excitability and shortens the cortical silent period. https://doi.org/10.1016/j.jelekin.2018.06.010

Posters:

• International MotoNeuron Society Meeting, June 2016. Istanbul, Turkey. Page 72
  Haavik H, Niazi IK, Duehr J, Kinget M, Ugincius P, Sebik O, Yılmaz G & Türker.  Chiropractic alters TMS induced I-wave excitability and cortical silent period duration.
• International MotoNeuron Society Meeting, June 2016. Istanbul, Turkey. Page 66
  Niazi IK, Turker KS, Flavel SC, Kingett M, Duehr J, Haavik Taylor H. Changes in H-reflex and V-waves following spinal manipulation.

Presentations:

• World Federation of Chiropractic’s 12th Biennial Congress, April 2013. Durban, South Africa
  Niazi IK, Turker KS, Flavel SC, Kingett M, Duehr J, Haavik Taylor H. Increased cortical drive and altered net excitability of low-threshold motor unit levels to the lower limb following spinal manipulation. Platform presentation Proceedings p.155-156
• 2nd International Conference on NeuroRehabilitation, June 2014. Aalborg, Denmark.
  Haavik H, Niazi IK, Duehr J, Kinget M, Ugincius P, Sebik O, Yılmaz G & Türker KS (2014). Chiropractic alters TMS induced motor neuronal excitability: Preliminary findings. Pages 35-37. https://doi.org/10.1007/978-3-319-08072-7_8
• World Federation of Chiropractic Conference, May 2015. Athens, Greece.
  Haavik H, Niazi IK, Kingett M, Duehr J, Holt K. The effects of a single session of chiropractic care on lower limb muscle strength.
• ACCRAC, March 2015. Las Vegas, USA.
  Haavik H, Niazi IK, Kingett M, Duehr J, Holt K. The effects of a single session of chiropractic care on lower limb muscle strength.

Dizziness is a common problem that can lead to disability and impact on quality of life. In some cases of dizziness the cause can be attributed to pathology or dysfunction of upper cervical vertebral segments. This form of cervicogenic dizziness is characterized by symptoms of imbalance or spinning associated with neck pain, stiffness or headache.

One of the factors resulting in cervicogenic dizziness may be the mechanical compression of the vertebral artery. Reduced blood flow in one or both of the vertebral arteries may result from mechanical compression, tension, dissection or stenosis. This mechanical compromise of one or both of the vertebral arteries may be caused by poor head and neck posture and mal-alignment of the upper cervical spine, thus leading to cervicogenic dizziness. As such, adjusting the cervical spine to correct the mal-alignment could potentially improve vertebral artery blood flow and
affect dizziness.

The primary aim of this study is to investigate the potential role of reduced vertebral artery blood flow in the pathophysiology of cervicogenic dizziness. This study will also secondarily explore the potential influence of a course of upper cervical spine chiropractic adjustments on vertebral artery blood flow volume.

To date no studies have investigated the possible role of vertebral artery blood flow characteristics in the pathophysiology of cervicogenic dizziness or the potential beneficial effects of chiropractic upper cervical spine adjustment on the vertebral artery blood flow in patients with cervicogenic dizziness. Presently, there is some evidence to advocate the use of spinal adjustment or other manual therapy techniques for cervicogenic dizziness.
However, the effect of upper cervical spine chiropractic adjustment on the vertebral artery blood flow is still largely unknown.

This will be the first study to investigate a possible link between the changes in vertebral artery blood flow volume and severity of cervicogenic dizziness and the potential for upper cervical adjustment to provide a beneficial effect on vertebral artery blood flow volume in people with  cervicogenic dizziness. This project will expand the current knowledge of the pathophysiology and mechanisms underlying cervicogenic dizziness and improve our understanding on the effect of upper cervical chiropractic adjustment on the vertebral artery blood flow.

With dizziness being such a common clinical problem, this study has the potential to greatly affect clinical success and clinical outcomes from chiropractic care.

Grant Value: $20,000
Chief Investigator: Dr Gary Shum – University of Plymouth
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapies, Volume 40, Issue 4, May 2017, Page 255-262 
  Shum GL, Cinnamond S, Hough AD, Craven R, Whittingham W. Test-retest reliability of measuring the vertebral arterial blood flow velocity in people with cervicogenic dizziness. DOI: https://doi.org/10.1016/j.jmpt.2017.02.005
• Journal of Spine, Volume 5, Issue 3, May 2016, Page 255-262
  Shum G, Whittingham W, Cinnamond S, Choy S and Hough A. Cervical Radiograph of a Patient with Cervicogenic Dizziness. DOI: 10.4172/2165-7939.1000i102

Presentations:

• AGM of Royal College of Chiropractors, 2015. London, England
  Shum G, Keynote Speaker, Effect of toggle recoil adjustment on the vertebral artery velocity in people with cervicogenic dizziness. 
  
• University of Roehampton, Department of Life Sciences Lecture Series, 2013. London, England
  Shum G, Invited Speaker, Application of duplex ultrasonography in musculoskeletal research
• European Chiropractic Union Convention, August 2013. Sitges, Spain
  Gary Shum, Sally Cinnamond, Alan Hough and Wayne Whittingham. Evaluation of a course of cervical adjustments in treating cervicogenic dizziness. 
  

Chronic inflammation has vast consequences, possibly leading to life-threatening conditions, such as atherosclerosis and diabetes. This research investigates the relationship of the subluxation, neuropathy and IVF inflammation as well as the possibility that inflammation and its potential fatal consequences could be forestalled or even prevented by adjustments.

Lumbar intervertebral foramen inflammation plays a critical role in the pathogenesis of low back pain. This process can produce injury or disease to the structures and tissues within and / or adjacent to the IVF. These researchers will measure markers of inflammation and neuropathic pain, before and after adjusting.

This research will investigate a model that may demonstrate the possible fatal, long-term consequences of spinal subluxations as well as the effects of spinal adjustments on such conditions. Such findings have the potential to significantly advance the relevance and understanding of chiropractic care.

Grant Value:$40,000
Chief Investigator: Professor Xue-Jun Song, Ronald L.Rupert, Zhijiang Huang, Yankai Zhang – Parker University Research Institute
Status: Complete

Posters:

• Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 1, January 2016, Pages 42-53 
  Xue-Jun Song, Zhi-Jiang Huang, William B. Song, Xue-Song Song, Arlan F. Fuhr, Anthony L. Rosner, Harrison Ndtan, Ronald L. Rupert. Attenuation Effect of Spinal Manipulation on Neuropathic and Postoperative Pain Through Activating Endogenous Anti-Inflammatory Cytokine Interleukin 10 in Rat Spinal Cord. https://doi.org/10.1016/j.jmpt.2015.12.004
• Journal of the International Association for the Study of Pain, Volume 156, Issue 12, December 2015, Pages 2572-2584
  Su Liu, Yue-Peng Liu, Zhi-Jiang Huang, Yan-Kai Zhang, Angela A. Song, Ping-Chuan Ma, Xue-Jun Song. Wnt/Ryk signaling contributes to neuropathic pain by regulating sensory neuron excitability and spinal synaptic plasticity in rats. DOI: 10.1097/j.pain.0000000000000366
  

Awards:

• World Federation of Chiropractic Congress, June 2015. Athens, Greece
  NCMIC Louis Sportelli Original Research Award – 3rd place. 

The overall objective of the proposed project is to investigate the role of the cerebellum in sensorimotor integration (SMI) following spinal adjustments in human participants who have pre-existing spinal dysfunction in the form of vertebral subluxations. The general hypothesis is that the cerebellum is the central integrator of proprioceptive input and that when the balance of afferent input is normalized by spinal adjustments, it helps to normalize sensorimotor integration and motor control via the cerebellar interactions with the basal ganglia, cortex and periphery.

Understanding the mechanisms of the changes in SMI will help clinicians understand who is most likely to benefit from chiropractic care, help identify patients with disordered SMI who may need adjustments to be combined with other approaches or who may need a longer course of care, potentially providing a rationale for treating people with recurrent neck and back pain as a way of normalizing sensorimotor integration to break the cycle of recurrence. This research has the potential to shift away from the “pain treatment” model into a “normalization of SMI” model to
prevent the development of chronic pain, to enhance function, to decrease the risk of injury in occupational, domestic and recreational settings.

Grant Value: $79,926
Chief Investigators: Professor Bernadette Murphy – University of Ontario Institute of Technology & Dr Heidi Haavik – New Zealand College of Chiropractic
Status: Complete

Posters:

• Journal of Manipulative and Physiological Therapeutics, Volume 36, Issue 8, October 2013, Pages 527-537
  Daligadu, J., Haavik, H. Yielder, P. Baarbe. J,  Murphy, B. (2013) Alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation DOI:https://doi.org/10.1016/j.jmpt.2013.08.003
• Experimental Brain Research, Volume 231, Issue 4, December 2013, Pages 397-403
  Haavik, H., Murphy, B. (2013) Selective changes in cerebellar-cortical processing following motor training. https://doi.org/10.1007/s00221-013-3704-0
• Journal of Neurophysiology, Volume 111, Issue 4, February 2014, Pages 715-721
  Baarbé, J., Yielder, P., Daligadu, J., Behbahani, H., Haavik, H., Murphy, B.  A Novel Protocol to Investigate Motor Training-Induced Plasticity and Sensorimotor Integration in the Motor Cortex and Cerebellum https://doi.org/10.1152/jn.00661.2013

Presentations:

• Society for Neuroscience November 2013, San Diego, LA, USA
  Baarbé, J.,  Debison-Larabie, C., Haavik, H, Yielder, P. Murphy, B. Differences in effects of cerebellar inhibition following motor learning in Subclinical neck pain patients.  Abstract Control Number: 16473  
• Progress in Motor Control IX Biennial Conference of the International Society for Motor Control July 2013, Montreal, Canada
  Baarbé, J., Daligadu, J., Behbahani, H., Haavik, H., Yielder, P., Murphy, B.  The effects of motor learning on the cerebellum and motor cortex. Abstract #169.  
• Proceedings of the 12th World Federation of Chiropractic Biennial Congress April 2013, Durban, South Africa
  Bossé, Passmore, S., Yielder, P., Haavik, H., Murphy, B. The effect of spinal manipulation on sensorimotor integration and cortical effects of motor training in a cohort of participants with subclinical neck pain, p. 170.  
• Proceedings of the 12th World Federation of Chiropractic Biennial Congress April 2013, Durban, South Africa
  Daligadu, J., Yielder, P., Baarbé, J., Haavik, H., Murphy, B. Alterations in Cortical and Cerebellar Motor Processing in Neck Pain Patients Following Chiropractic Manipulation.  p. 96 

Posters:

• International Society of Electromyography and Kinesiology (ISEK) Biannual Meeting July 2012, Brisbane, QLD, Australia
  Daligadu, J., Yielder, P., Behbahani, H. Holland, L., Murphy, B. “The feasibility of using cerebellar stimulus response curves to investigate changes in excitability of cerebellar projections to primary motor cortex” (poster)  

For almost 120 years chiropractic has been based on the idea that chiropractic adjustments help people live healthier, happier more active lives by removing interference to the nervous system. Chiropractors have also placed a lot of emphasis on specificity – the idea that the line of drive of the adjustment and the amount of preload applied in setting up for the adjustment are incredibly important aspects of the art of the adjustment. This study aims to add to the understanding of these two ideas by measuring the effect of chiropractic adjustments to adjustments using different preload, force and line of drive.

Most recent theories on the mechanism of chiropractic adjustments emphasise the central role of the thalamus. Its function includes relaying sensation, spatial sense, and motor signals to the cerebral cortex, along with the regulation of consciousness, sleep, and alertness. Since the thalamus serves as an integration and relay site for neural messages sent from the rest of the body, it becomes an excellent location to study the sensory effects of the spinal adjustment.

This study will use electrophysiological recording techniques to record the response from neurons in the thalamus before and after a spinal adjustment has been given to a rat vertebra in the lower back.

Grant Value: $19,465
Chief Investigator: Dr William Reed – Palmer College of Chiropractic
Status: Complete

Publications:

• Experimental Brain Research, Volume 235, Issue 9, September 2017, Pages 2883-2892
  Reed, W.R., Cranston, J.T., Onifer, S.M. et al. Decreased spontaneous activity and altered evoked nociceptive response of rat thalamic submedius neurons to lumbar vertebra thrust. https://doi.org/10.1007/s00221-017-5013-5
• Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5, June 2014, Pages 277-286
  Reed WR, Pickar JG, Sozio RS, Long, CR. Effect of spinal manipulation thrust magnitude on trunk mechanical thresholds of lateral thalamic neurons. DOI:https://doi.org/10.1016/j.jmpt.2014.04.001
• Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 8, October 2014, Pages 552-560
  Reed WR, Sozio, R, Pickar JG, Onifer SM. Effect of spinal manipulation thrust duration on trunk mechanical activation thresholds of nociceptive-specific lateral thalamic neurons. DOI:https://doi.org/10.1016/j.jmpt.2014.08.006 

Posters:

• Society for Neuroscience October 2012, New Orleans, LA, USA
  Effect of spinal manipulation on thalamic neuron somatic activation thresholds
• NIH 9th Pain Consortium, May 2014. Maryland, USA
  Reed WR, Pickar JG, Peripheral Proprioceptive and Central Nociceptive Responses to Spinal Manipulation Dosage Parameters

Presentations:

• Society for Neuroscience October 2015, Chicago, IL, USA
  Reed WR, Cranston JT, Onifer SM, Sozio RS. Effect of spinal manipulation on spontaneous and evoked activity of thalamic submedius neurons (603.05).  
• International Research Congress on Integrative Health & Medicine  May 2014, Miami, Florida, USA
  Reed WR, Sozio R, Pickar J, Onifer SM. Effect of spinal manipulation thrust duration on trunk mechanical activation thresholds of nociceptive specific lateral thalamic neurons.
• Association of Chiropractic Colleges-Research Agenda Conference March 2014, Orlando, Florida, USA
  Reed WR, Sozio RS, Pickar JG, Long CR. Spinal manipulation can increase trunk mechanical thresholds of lateral thalamic neurons.(Platform) 

One of the biggest predictors of a loss of quality of life in older people is a fall. A fall in an older person is associated with large increases in their risk of morbidity and mortality. In people over the age of 65 80% of injury related hospital admissions are caused by falls and they are the leading cause of injury related death.

The research literature shows that falls often happen in association with a decline in nervous system function with ageing. What sort of difference could chiropractic make here? Could we deliver on our promise to “add years to your life and life to your years?” Some of the statistics relating to falls are:

• In New Zealand and Australia 30% of older Australians have a fall each year. This is even greater in other parts of the world where rates are as high as 40%.
• Every second fall causes an injury.
• Serious injuries occur in around 30% of falls.
• 5-10% of falls cause a fracture.
• Costs of falls in the US estimated to be $32 billion by 2020.
• The proportion of the population over 65 is expected to double in the next 50 years.

There is also a huge social cost of falls in terms of loss of independence, depression and overall quality of life.Many clinical studies are criticised by field practitioners for having too short a period of care to expect to see much physiological change. This study utilises 16 weeks of chiropractic care. It is also based on assessment and correction of vertebral subluxation. The outcome measures for this study are objective markers of sensorimotor function. In other words, they are established measures of how well the brain and nervous system process information.

Some of the outcome measures are:

• Choice stepping reaction time. A testing approach that uses special platform that tests the ability to control foot placement. It has been previously shown to predict fallers vs non-fallers.
• Joint Position sense of the ankle.
• Postural stability using computerised posturography.
• SF 36

Grant Value: $36,200
Chief Investigators: Dr Kelly Holt, Dr Heidi Haavik, Associate Professor Bernadette Murphy, Dr C Raina Elley – New Zealand College of Chiropractic
Status: Complete

Posters:

• Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4, May 2016, Page 267-278 
  Holt KR, Haavik H, Lee AC, Murphy B, Elley CR. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial. DOI:https://doi.org/10.1016/j.jmpt.2016.02.003

Presentations:

• Association of Chiropractic Colleges Research Agenda Conference, March 2014. Orlando, Florida, USA.
  Holt K, Haavik H, Lee ACL, Murphy B & Raina Elley R. (2014) Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial. 
• General Practice and Primary Healthcare, University of Auckland, 2014. Auckland, New Zealand
  Holt KR. Effectiveness of Chiropractic Care in Improving Sensorimotor Function Associated with Falls Risk in Older People.

Many chiropractors notice that women under their care seem to have easier labours with less complications, fewer issues with incontinence and better core stability.

Pelvic floor muscle function is incredibly important for many reasons. Having coordinated, synchronous muscle function is important in labour (particularly in the pushing stage) in maintaining continence and in maintaining core stability along with activation of the abdominal muscles.

This study will investigate whether adjusting lumbopelvic vertebral subluxations changes pelvic muscle function. The study is designed in three stages. Study 1, which this grant relates to, aims to develop and test a new multi-sensor intravaginal surface electrode probe and test the validity and reliability of the probe. If the device is shown to be valid and reliable Study 2 will test the synchronicity of the pelvic muscle contractions of 90 women. Women who show asynchronous activity will be recruited for Study 3 where the investigators will test immediate pre and post adjustment measurements of pelvic muscle activity.

Grant Value:$65,600
Chief Investigators: Dr Heidi Haavik, Dr Stanley Flavel – New Zealand College of Chiropractic
Status: Complete

Publications:

• Journal Chiropractic Education, Volume 31, Issue 1, March 2017, Page 75
  Salmons, J., Niazi, I.K., Nedergaard, R.W., Holt, K., Haavik, H. (2017) Chiropractic spinal manipulation improves the onset of contractions of female pelvic floor muscle.  ACC-RAC Platform and poster presentation abstracts. 

Posters:

• 39th World Congress of Chiropractic Students Annual General Meeting at Life West Chiropractic College, August 2017, San Francisco, USA
  Jenna Duehr. 3rd equal research poster award. The effects of Chiropractic Care on the onset of contractions of the female pelvic floor muscles. 

• World Federation of Chiropractic’s Congress in conjunction with the Association of Chiropractic Colleges and the American Chiropractic Association March 2017, Washington, USA
  Duehr, J. New Investigator Research Poster Award

Chiropractic theories advocate that physiologic effects of chiropractic adjustments have an effect upon the sympathetic nervous system (SNS). These theories are used to explain the mechanisms to justify the clinical benefits observed in patients with Type O disorders receiving chiropractic care.

Because a validated research model of vertebral subluxation has yet to be defined, The objective of this study is to examine the effects of chiropractic adjustments on somato-sympathetic responses in an ovine model of cervical disc degeneration.

Not only is cervical disc degeneration a common spinal condition affecting human kind, it also provides a unique opportunity to study a subgroup of vertebral subluxation, characterized by altered mechanical loading with biochemical consequences.

Grant Value: $40,000
Chief Investigators: Christopher Colloca – Research Scientist Department of Kinesiology Arizona State University, Robert J. Moore Head – Adelaide Centre for Spinal Research, Robert Gunzburg – Eeuwfeestkliniek Hospital, Antwerp, Belgium
Status: Complete

Posters:

• World Federation of Chiropractic’s 12th Biennial Congress, April 2013, Durban, South Africa
  Colloca CJ, Gunzburg R, Afifi Hegazy M, Moore RJ. Biomechanical and somatosympathetic responses to spinal manipulation in an in Vivo model of cervical intervertebral disc degeneration

Presentations:

• Association of Chiropractic Colleges Educational Conference and Research Agenda Conference March 2016, Orlando, Florida, USA
  Colloca CJ, Kuliwaba JS, Freeman BJ, Gunzburg R, Afifi Hegazy M, Hinrichs RN. Biomechanical evaluation of a cervical intervertebral disc degeneration model: part 1 – histological analysis (Oral Presentation). J Chiropr Educ 2016; 30(1):54-5 
• Association of Chiropractic Colleges Educational Conference and Research Agenda Conference March 2016, Orlando, Florida, USA
  Colloca CJ, Gunzburg R, Freeman BJ, Harrison DE, Afifi Hegazy M, Hinrichs RN. Biomechanical evaluation of a cervical intervertebral disc degeneration model: part 2 – in vivo biomechanical testing (Oral Presentation). J Chiropr Educ 2016; 30(1):55. 
• Association of Chiropractic Colleges Educational Conference and Research Agenda Conference March 2016, Orlando, Florida, USA
  Colloca CJ, Gunzburg R, Freeman BJ, Harrison DE, Afifi Hegazy M, Hinrichs RN. Biomechanical evaluation of a cervical intervertebral disc degeneration model: part 3 – spinal manipulative therapy (Oral Presentation). J Chiropr Educ 2016; 30(1):55. 
• Annual Scientific Meeting of the Spine Society of Australia April 2016, Melbourne, Victoria, Australia
  Colloca CJ, Kuliwaba JS, Gunzburg R, Hegazy MA, Freeman BJC. Multi-level histological analysis of an ovine cervical spine intervertebral disc degeneration model (Oral Presentation). 
• Spine week – The North American Spine Society May 2016, Singapore
  Colloca CJ, Kuliwaba JS, Freeman BJC, Gunzburg R, Hegazy Afifi M, Hinrichs R. Does an interbody fusion cage with nanoscale porous titanium coating increase spinal segmental stiffness? An In Vivo Biomechanical Analysis in an ovine model (Oral Presentation). P21

Previous work demonstrates that spinal manipulation leads to neural plastic changes in subjects with spinal dysfunction and subclinical neck pain (SCNP). The definition of SCNP is recurring neck dysfunction such as stiffness and pain for which the patients have not yet sought treatment. A limitation of previous studies is that they applied simple repetitive movement sequences, measuring the effects of repetitive motor movements rather than motor skill acquisition. If the presence of SCNP affects the way the central nervous system (CNS) responds when learning upper limb motor tasks it could have important implications for the relationship between SCNP and the development of overuse injuries. This study sought to investigate the immediate effects of spinal manipulation on CNS processing in a group with SCNP following a motor skill acquisition task.

Methods: Peripheral (N9), spinal (N13), brainstem (P14, N18) and cortical (N20 and N30) somatosensory evoked potentials (SEP) were recorded following median nerve stimulation before and after passive head movement (PHM), or cervical spinal manipulation (SM). The study was a between-group experimental design, where SEPS were collected before SM or PHM, following SM or PHM, and following a complex motor task. Twenty one individuals participated in the study, eleven (mean age 22.2) in the PHM group and twelve (mean age 22.4) in the SM group. All participants consented to treatment by a licensed chiropractor and the study received approval by the ethical committee at the University of Ontario, Institute of Technology. Data was analyzed in SPSS as a mixed design split-plot repeated measures ANOVA with 3 levels; pre-intervention, post-intervention and post-motor training, and 2 groups; PHM and SM. Post hoc comparisons were done with paired 2 samples t tests were also performed as needed. Results: There was a significant main effect of the repeated measures ANOVA [F2,38 = 12.87, P b .001] as well as an interaction between group and repeated measure [F2,38 = 4.38, P = .02] for the N30 SEP peak. Post hoc analysis revealed a significant 12.1% increase (P = .05) in the N30 SEP peak amplitude post SM and an 18.01% increase (P = .02) for the same peak following the subsequent motor training. There was a 47.63% increase in the N30 peak following motor training in the PHM group (P = .04). There were no other significant findings for any of the other SEP peaks.

Conclusion: These preliminary results have shown an increase in cortical SEP amplitudes following a cervical spine manipulation intervention in subclinical neck pain participants. The changes occurred for a SEP peak known to be involved in early sensorimotor integration. The results also suggest that a complex motor training task induces changes in neural processing, supporting previous work. That the N30 SEP peak amplitude increase was attenuated following motor learning when preceded by spinal manipulation (compared to what occurred after PHM) provides evidence that SM has the potential to normalise the afferent processing that takes place during early motor learning in a SCNP population.

Grant Value: $45,550
Chief Investigator: Dr Heidi Haavik – New Zealand College of Chiropractic
Status: Completed

Posters:

• Proceedings of the 12th World Federation of Chiropractic Biennial Congress April 2013, Durban, South Africa
  Jessica Bosse, Steven Passmore, Paul Yielder, Heidi Haavik, Bernadette Murphy The effect of spinal manipulation on sensorimotor integration and cortical effects of motor training in a cohort of participants with subclinical neck pain, page 111
• Jessica Bosse, Steven Passmore, Paul Yielder, Heidi Haavik, Bernadette Murphy The effect of spinal manipulation on sensorimotor integration and cortical effects of motor training in a cohort of participants with subclinical neck pain

 Presentations:

• Swedish Chiropractic Association’s Annual General Meeting October 2012. Stockholm, Sweden
  Haavik H. The Science of Adjusting Subluxations. Keynote speaker
• New Zealand College of Chiropractic Lyceum September 2012. Auckland, New Zealand
  Haavik H. Communicating the Science of Chiropractic. Invited speaker
• Chiropractic Association of Australia August 2012. South Australia, Australia
  Haavik H. The science of adjusting subluxations. Keynote speaker
• World Congress of Chiropractic Students inaugural United States regional congress May 2012. San Francisco, USA
  Haavik H. The neurophysiology of chiropractic. Invited speaker
• ‘Spring for Life’ Life West Chiropractic College May 2012. San Francisco, USA
  Haavik H. Zap into life with real Chiropractic science. Invited speaker
• Scottish Chiropractic Association April 2012. Edinburgh, Scotland
  Haavik H. The Science of Adjusting Subluxations. Keynote speaker
• Norwegian Chiropractors Association April 2012. Oslo, Norway
  Haavik H. Forsknings oppdatering fra New Zealand (Research update from New Zealand). Invited speaker
• Chiropractic Association of Australia’s National Development Forum October 2011. Hobart, Australia
  Haavik H. How to effectively include science in your chiropractic toolbox (four 1 ½ hour sessions). The keynote speaker
• Chiropractic Association of Australia’s National Development Forum October 2011. Hobart, Australia
  Haavik H. Research update from NZ!
• LifeSource Octagon Conference Event April 2011. Atlanta, Georgia, USA
  Haavik H. Understanding research efforts and Subluxation. Invited speaker Contemporary Scientific Paradigms; A new model for Subluxation.
• Chiropractic Association of Australia Victoria April 2011. Melbourne, Australia
  Haavik H. Inspiring Change. Keynote speaker Inspiring Change Conference.
• World Congress of Chiropractic Students Conference April 2011. Rio de Janeiro, Brazil
  Haavik H. The science of chiropractic.
• Chiropractic Association of Australia’s National Development Forum October 2010. Cairns, Australia
  Haavik, H. Exploring the Neuromodulatory Effects of the Vertebral Subluxation and Chiropractic Care. Keynote speaker
• Chiropractic Association of Australia’s National Development Forum October 2010. Cairns, Australia
  Haavik, H. Effects of manipulation on cortical function. Invited Research Presentation
• Macquarie University Chiropractic Alumni annual research seminar August 2010. Sydney, Australia
  Haavik Taylor, H. Current & Future Directions for Chiropractic Research in Australasia. Invited speaker.
• Chiropractic Association of Australia – South Australia Annual General Meeting August 2010. Adelaide, Australia
  Haavik, H. Believe it or not…….Chiropractic changes brain function. Keynote Speaker

Falls are a major health concern for older adults. They are a significant cause of death, injury and loss of quality of life. In people over the age of 65 falls account for over 80% of injury related hospital admissions and they are the leading cause of unintentional injury related death in older adults. Currently falls prevention is receiving considerable attention worldwide. Public health research provides compelling evidence to support investment in programmes aimed at identifying and assessing members of the community at risk of falling and to promote falls prevention programmes. Falls are caused by a number of factors including poor sensorimotor integration. The objectives of this study were:
1. To assess the effect of six months of chiropractic care on objective markers of sensorimotor integration in the elderly. These markers were joint position sense (of elbow, knee and ankle), postural stability (as measured by computerised posturography) and two transcranial magnetic stimulation measures (short interval intracortical inhibition and facilitation).

2. To evaluate the relationship between the overall integrative balance measure (computerised posturography) with the other markers of sensorimotor integration.

3. To assess the effect of six months of chiropractic care on falls incidence, quality of life and other falls related measures in the elderly.  Participants over the age of sixty-five were selected to take part in this study. Participants were randomised into two groups. The experimental group received six months of chiropractic care and the control group received no chiropractic care. The objective neurophysiological markers of sensorimotor integration outlined above, quality of life and other falls related measures were be assessed twice at baseline then at 6 weeks, 12 weeks, 6 months, and follow-up at 9 month. Participants were also monitored on a monthly basis for the occurrence of any falls.

Grant Value: $39,315
Chief Investigator:Dr Kelly Holt – New Zealand College of Chiropractic
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4. May 2016, Page 267 – 278
  Holt, K., Haavik, H., Lee, A.C.L., Murphy, B., & Raina Elley, R. (2016) Effectiveness of chiropractic care to improve sensorimotor function associated with falls risk in older people: A randomized controlled trial. doi: 10.1016/j.jmpt.2016.02.003.
• Auckland: General Practice and Primary Healthcare, University of Auckland 2014
  Holt K.R.  (2014) Effectiveness of Chiropractic Care in Improving Sensorimotor Function Associated with Falls Risk in Older People. 

Presentations:

• Association of Chiropractic Colleges Research Agenda Conference, March 2014. Orlando, Florida, USA.
  Holt, K., Haavik, H., Lee, A.C.L., Murphy, B., & Raina Elley, R. (2014). Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated with Falls Risk in Older People: A Randomized Controlled Trial. 

Purpose:
Muscle spindles play an important role in perception of head- neck position. The sensitivity of muscle spindles to stretch depends on how they have been conditioned beforehand. When a muscle is passively shortened, spindles are unable to take up the new shortened length and fall slack. This leaves them in a desensitised state. Our hypothesis is that neck muscles conditioned so that intramuscular receptors are in a desensitised state result in increased errors in head-neck position sense.

Methods:
Two experiments on human subjects (n=7 and n=10) were conducted. Subjects were blindfolded, and their head-neck moved actively five times into flexion/extension. The head-neck was then moved passively to a pre-determined target head position. This process was repeated three times so that the subject familiarised themselves with the target position. The dorsal neck muscles were then conditioned to leave neck intramuscular receptors either tight (hold short conditioning) or slack (hold long conditioning). The end point of the conditioning procedure returned the head to a neutral position. From here the head-neck of the subject was passively moved toward the target head position and subjects were asked to identify when they reached that position.

Results:
There was a statistically significant difference between the hold long (12.5 +/- 1.8 deg) and hold short (10.5 +/- 0.8 deg) estimates of target position at 10 degrees. Similar results were obtained for other target positions. Conclusion: Neck muscle conditioning alters perception of head neck position in a predictable way. It is suggested that hold long conditioning decreases neck intramuscular afferent input to the CNS which disturbs head-neck kinaesthetic sensibility.

Grant Value: $20,186
Chief Investigator: Dr Barbara Polus – RMIT
Status: Completed

Researcher Updates:

This project was combined with a 2012 Grant, Muscle thixotrophy, subluxation and clumsiness. 

Presentation:

• Proceedings of the 28th Annual Meeting of the Australian Neuroscience Society January 2008. Hobart, Australia
  Repka A Polus BI Neck muscle conditioning alters perception of head and neck position. Page 97 
• AGM Presentation
  A Physiological Model of Subluxation in Humans – A proposal

Chiropractic care is used successfully by many women for low back pain in pregnancy, but no one has investigated whether chiropractic care might help the delivery process itself by improving the function of the pelvic floor muscles. Pelvic floor muscles are fundamental in the birth process, mainly during the pushing stage of labour. A difficult vaginal delivery can lead to pelvic floor damage, resulting in incontinence and pelvic organ prolapse. Therefore if spinal adjustments are able to improve pelvic floor function, it could have important benefits for both delivery and pelvic floor health. Spinal adjustments improve the timing and ability to contract of the deep abdominal muscles. Since the pelvic floor muscles work together with the abdominal muscles, it is highly likely that adjustments will also be able to improve the function of the pelvic floor.
Ultrasound was used to measure the movement of the pelvic floor when women push down and pull up using their pelvic floor muscles, as well as the size of the opening in the pelvic floor. Pelvic floor function was assessed with ultrasound before and after adjustments to the lower back and pelvis. If the adjustments improved pelvic floor function, then it suggests that chiropractic care might be able to make the second stage of labour easier. This could lead to a bigger study investing the effect of chiropractic care on labour and post-delivery pelvic floor function, with the potential to reduce the costs to society of difficult deliveries and associated pelvic floor damage.

Grant Value: $35,208
Chief Investigator: Dr Heidi Haavik & Dr Bernadette Murphy – New Zealand College of Chiropractic, Dr Jenny Kruger – University of Auckland
Status: Complete

Presentations:

• Swedish Chiropractic Association’s Annual General Meeting, October 2012. Stockholm, Sweden
  Haavik H. The Science of Adjusting Subluxations. Keynote speaker 
• World Federation of Chiropractic Education Conference, September 2012. Perth, Australia
  Haavik H. The Subluxation: The evidence and how do we instruct students about this entity? Invited speaker 
• New Zealand College of Chiropractic Lyceum, September 2012. Auckland, New Zealand
  Haavik H. Communicating the Science of Chiropractic. Invited speaker 

Objective:
To investigate whether joint position sense (JPS) accuracy differs between subjects with a history of subclinical neck pain syndrome (SCNPS) and those with no neck complaints, and to see whether adjusting dysfunctional cervical segments in the SCNPS group improves their JPS accuracy.

Methods:
Twenty-five SCNPS subjects and 18 control subjects participated in this study. Elbow JPS was measured utilising an electrogoniometer. Subjects reproduced a previously presented angle of the elbow joint with their neck in four positions: neutral, flexion, rotation, and combined flexion/rotation. The experimental intervention was high velocity, low-amplitude cervical adjustments and the control intervention was a 5-minute rest period. Group JPS data were compared and assessed pre- and post interventions using three parameters: absolute, constant, and variable error.

Results:
At baseline the control group was significantly better at reproducing the elbow target angle. The SCNPS group’s absolute error significantly improved following the cervical adjustments when the subjects’ heads were in the neutral and left rotation positions. They displayed a significant overall decrease in variable error following the cervical adjustments. The control group subjects’ JPS accuracy was worse after the control intervention with a significant overall effect in absolute and variable error. No other significant effects were detected.

Conclusion:
These results suggest that asymptomatic people with a history of SCNPS have reduced elbow JPS accuracy compared with those with no history of any neck complaints. Furthermore, the results suggest that adjusting dysfunctional cervical segments in people with SCNPS can improve their upper limb JPS accuracy.

Grant Value: $20,000
Chief Investigator: Dr Heidi Haavik – New Zealand College of Chiropractic
Status: Completed

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 34, Issue 2, February 2011, Pages 88-97
  Haavik Taylor H and Murphy B. (2011). Association of Chiropractic Colleges Research Agenda Conference 2010 Award Winning Paper: Subclinical neck pain and the effects of cervical manipulation on elbow joint position sense. DOI:https://doi.org/10.1016/j.jmpt.2010.12.009
• Chiropractic Journal of Australia, Volume 40, Issue , August 2010, Pages 37-44
  Haavik Taylor H, Holt KR, Murphy B. (2010). Chiropractors’ Association of Australia Scientific Symposium 2009 first prize award winning paper: Exploring the neuromodulatory effects of the vertebral subluxation and chiropractic care.

Posters:

• Association of Chiropractic Colleges Research Agenda Conference March 2010. Las Vegas, USA
  H Haavik Taylor, B Murphy (2010). Cervical adjustments improve elbow joint position sense. Abstract published in The Journal of Chiropractic Education, 2010; 24 (1): p.114.

Presentations:

• Swedish Chiropractic Association’s Annual General Meeting October 2012. Stockholm, Sweden
  Haavik H. The Science of Adjusting Subluxations. Keynote speaker
• World Federation of Chiropractic Education Conference, September 2012. Perth, Australia
  Haavik H. The Subluxation: The evidence and how do we instruct students about this entity? Invited speaker 
• New Zealand College of Chiropractic Lyceum September 2012. Auckland, New Zealand
  Haavik H. Communicating the Science of Chiropractic. Invited speaker
• Chiropractic Association of Australia August 2012. South Australia, Australia
  Haavik H. The science of adjusting subluxations. Keynote speaker
• World Congress of Chiropractic Students inaugural United States regional congress May 2012. San Francisco, USA
  Haavik H. The neurophysiology of chiropractic. Invited speaker
• ‘Spring for Life’ Life West Chiropractic College May 2012. San Francisco, USA
  Haavik H. Zap into life with real Chiropractic science. Invited speaker
• Scottish Chiropractic Association April 2012. Edinburgh, Scotland
  Haavik H. The Science of Adjusting Subluxations. Keynote speaker
• Norwegian Chiropractors Association April 2012. Oslo, Norway
  Haavik H. Forsknings oppdatering fra New Zealand (Research update from New Zealand). Invited speaker
• Chiropractic Association of Australia’s National Development Forum October 2011. Hobart, Australia
  Haavik H. How to effectively include science in your chiropractic toolbox (four 1 ½ hour sessions). The keynote speaker
• Chiropractic Association of Australia’s National Development Forum October 2011. Hobart, Australia
  Haavik H. Research update from NZ!
• LifeSource Octagon Conference Event April 2011. Atlanta, Georgia, USA
  Haavik H. Understanding research efforts and Subluxation. Invited speaker Contemporary Scientific Paradigms; A new model for Subluxation.
• Chiropractic Association of Australia Victoria April 2011. Melbourne, Australia
  Haavik H. Inspiring Change. Keynote speaker Inspiring Change Conference.
• World Congress of Chiropractic Students Conference April 2011. Rio de Janeiro, Brazil
  Haavik H. The science of chiropractic.
• Chiropractic Association of Australia’s National Development Forum October 2010. Cairns, Australia
  Haavik, H. Exploring the Neuromodulatory Effects of the Vertebral Subluxation and Chiropractic Care. Keynote speaker
• Chiropractic Association of Australia’s National Development Forum October 2010. Cairns, Australia
  Haavik, H. Effects of manipulation on cortical function. Invited Research Presentation
• Macquarie University Chiropractic Alumni Annual Research Seminar August 2010. Sydney, Australia
  Haavik Taylor, H. Current & Future Directions for Chiropractic Research in Australasia. Invited speaker.
• Chiropractic Association of Australia – South Australia Annual General Meeting August 2010. Adelaide, Australia
  Haavik, H. Believe it or not…….Chiropractic changes brain function. Keynote Speaker
• Chiropractic Student Association RMIT University May 2012. Melbourne, Australia
  Haavik H. The importance of becoming a competent critical consumer of chiropractic relevant research!
• Academic Research Series Macquarie University May 2012. Sydney, Australia
  Haavik H. The importance of becoming a competent critical consumer of chiropractic relevant research!
• New Zealand Chiropractic Association Annual General Meeting and Conference May 2012. Auckland, New Zealand
  Haavik H. Chiropractic Care with Confidence, Clarity and Charisma
• ASRF Dynamic Growth Congress February 2012. Brisbane, Australia
  Haavik H. How science can provide clarity, confidence and certainty!
• ASRF Dynamic Growth Congress February 2011. Brisbane, Australia
  Haavik H. Success through science
• Norwegian Chiropractors’ Association International Conference & Research Symposium October 2010. Bergen, Norway
  Haavik, H. Chiropractic care alters CNS function in various ways – how does it affect the autonomic nervous system? – A report on human research work in New Zealand. 
• Jumpstart Dynamic Growth Experience August 2010. Sydney, Australia
  Haavik, H. The power of Science
• The XVIII Congress of the International Society of Electrophysiology and Kinesiology June 2010. Aalborg, Denmark.
  Haavik Taylor H, Murphy B. Joint dysfunction as a form of altered afferent input: part I: Sensory processing changes following spinal manipulation.
• Dynamic Growth Experience New Zealand May 2010. Tauranga, New Zealand
  Haavik Taylor H, Make the Connection
• Chiropractic Association of Australia Scientific Symposium November 2009. Melbourne Australia
  Haavik Taylor H, Holt KR, Murphy B. Exploring the neuromodulatory effects of the vertebral subluxation and chiropractic care. 
• ASRF Annual General Meeting November 2009. Sydney, Australia
  Haavik Taylor, H. Current & Future Directions for Chiropractic Research in Australasia.
  
• New Zealand Chiropractic Association Annual General Meeting May 2009. Auckland, New Zealand
  Haavik Taylor, H. Research; Why should be bother? What sort of research should we do?
  
• Dynamic Growth Congress February 2009. Brisbane, Australia
  Haavik Taylor, H. Research for Practice on Monday “An introduction to the research we do”
• World Congress of Chiropractic Students January 2009.  Auckland, New Zealand
  Haavik Taylor, H. The misalignment of heads, hearts and guts.
  

Purpose:
The aim of this study was to test whether applying transient (range 10-60 min) compression to the upper cervical spinal cord modulates somatic evoked reflex activity in the adrenal nerve.

Methods:
Experiments were performed on spontaneously breathing adult Wistar rats (n=5; 380-430g) initially anaesthetized with urethane (1.3g/kg i.p.) and supplemented (i.v.) to maintain absence of withdrawal and palpebral reflexes. Venous and arterial canulas provided fluids and a record of arterial blood pressure. Averaged adrenal nerve activity was recorded in response to electrical stimulation (1Hz, 5 X 0.5ms square wave pulses) of the ipsilateral sciatic nerve at ≥ 1.5X threshold (T) for muscle twitch, while static compression was applied using a probe (2.3 X 2.8 mm) placed on the dorsal surface of the exposed, dura intact, upper cervical spinal cord.

Results:
High intensity (≥ 15T) stimuli evoked a reflex response (onset latency range 50-100ms; duration ~120ms) in each rat’s stimulus- triggered averaged (n=500) adrenal nerve recordings. Applied pressure ranging (1.13-3.92g) from that sufficient to compress the dura so it just contacted the dorsal surface of the cord to that necessary to occlude the vessels on the dorsal surface of the cord, induced a reduction (range 12-35%) in the amplitude of the somatic evoked adrenal nerve response. When tested up to 60 min after removing the probe, the somatic evoked responses were present but remained reduced in amplitude

Conclusion:
In the anaesthetized rat, static transient (< 60 min) compression of the upper cervical spinal cord can reduce somatic afferent induced activity in the adrenal nerve and it remains reduced for more than an hour after compression has been removed.

Grant Value: $26,752
Chief Investigator: Dr Philip Bolton – University of Newcastle
Status: Completed

Publications:

• The Spine Journal Volume 15, Issue 6, June 2015
  Bigland, Mark J. et al. The influence of cervical spinal cord compression and vertebral displacement on somatosympathetic reflexes in the rat 1310 – 1317

Posters:

• Australian Neuroscience Society January 2010. Sydney, Australia
  Budgell BS, Bolton PS Somato-adrenal reflex and upper cervical spinal cord compression-a pilot study. P-083, Page 150

Presentations:

• Department of Chiropractic, Faculty of Science Macquarie University 2013.  Sydney, Australia
  Bolton. PS., What do lab-based neurophysiological studies tell us about the chiropractor’s vertebral subluxation hypothesis?
• Research Symposium Annual National Conference, Chiropractors Association of Australia 2011 Melbourne, Australia
  Bolton PS Investigation of the chiropractic vertebral subluxation hypothesis – An update on the physiological impacts of spinal cord compression in an animal model

Falls are a major health concern for older adults. They are a significant cause of death, injury and loss of quality of life and they result in considerable healthcare costs. There are a number of risk factors for falling including medication use, environmental hazards, poor vision, lower extremity impairments and balance and gait impairments. Of particular interest to the chiropractic profession is the relationship between dysfunction of the spine and risk of falling. 

Chiropractors are concerned with a functional impairment in the spine called vertebral subluxation. It is thought that vertebral subluxation may affect the nervous system in a way that leads to improper function and coordination in vital areas and systems of the brain and brainstem that are involved in maintaining balance. Dysfunction within these areas or systems can potentially lead to an increased risk of falling. If chiropractic care can lead to an improvement in the function of the spine then it may also reduce the risk of an individual falling. There is currently little to no published data of falls history, falls risk, or balance profiles of elderly chiropractic patients 

It is not known if elderly chiropractic patients are representative of the wider community in these areas or if they are at an even greater risk of falling. By better understanding the nature of problems associated with patients that present to their offices it is hoped that this study will help to empower chiropractors to have a primary role in detection of falls risk and engage in falls prevention. 

This study was an observational study that aimed to provide and compare the falls risk profiles of community dwelling older adults who either: 

• Do not attend a chiropractor 
• Are new chiropractic patients 

The participants were assessed on a single occasion. Relevant health and falls history information were then recorded and the participants were asked to complete questionnaires to establish their balance confidence, quality of life, and disability related to neck pain. They were then assessed using a functional test that is an established falls risk predictor. The final assessment was conducted using a portable balance platform. This computerised system assesses an individual’s postural stability which is a good way of identifying people at risk of falling. 

This data showed the falls risk profile of elderly people in Australasia who present to chiropractors differs from non-chiropractic patients. This valuable data will also help plan for future studies that will investigate the effect of chiropractic care on falls risk. By including the balance platform, we will be able to tell how well it matches other established scales that are used to predict future falls. 

Grant Value: $33,529.26
Chief Investigator: Dr Kelly Holt – New Zealand College of Chiropractic
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 42, Issue 2, February 2011, Page 78-87
  Holt KR, Noone PL, Short K, Elley CR, Haavik H. (2011) Fall risk profile and quality-of-life status of older chiropractic patients. DOI:https://doi.org/10.1016/j.jmpt.2010.12.010
• Auckland: General Practice and Primary Healthcare, University of Auckland 2014
  Holt K.R.  (2014) Effectiveness of Chiropractic Care in Improving Sensorimotor Function Associated with Falls Risk in Older People. 

Posters:

• Association of Chiropractic Colleges Research Agenda Conference March 2010. Las Vegas, USA
  K Holt, P Noone, K Short, H Haavik Taylor Falls risk profile of elderly chiropractic patients. Abstract published in The Journal of Chiropractic Education, 2010; 24 (1): p.97 

Presentations:

• Chiropractors’ Association of Australia Scientific Symposium November 2009. Melbourne, Australia
  Holt KR, Noone P, Short K, Haavik Taylor H. (2009). Falls risk profile of elderly chiropractic patients.
• LifeSource Octagon Conference Event April 2011. Atlanta, Georgia, USA
  Haavik H. Understanding research efforts and Subluxation. Invited speaker Contemporary Scientific Paradigms; A new model for Subluxation.
• Chiropractic Association of Australia’s National Development Forum October 2011. Hobart, Australia
  Haavik H. How to effectively include science in your chiropractic toolbox (four 1 ½ hour sessions). The keynote speaker
• Chiropractic Association of Australia Victoria April 2011. Melbourne, Australia
  Haavik H. Inspiring Change. Keynote speaker Inspiring Change Conference.
• World Congress of Chiropractic Students Conference April 2011. Rio de Janeiro, Brazil
  Haavik H. The science of chiropractic.
• New Zealand Chiropractic Association Annual General Meeting May 2009. Auckland, New Zealand
  Holt K. Falls Risk Profile of Elderly Chiropractic Patients.
• New Zealand Chiropractic Association Annual General Meeting May 2007. Christchurch, New Zealand
  Holt K. Research at the NZCC 

Both the community and chiropractors regard chiropractic as a wellness profession. However wellness is difficult to define. The first phase of this study seeks to determine how chiropractors and their patients define wellness and how wellness outcomes resulting from chiropractic care should be measured. It also explores the mechanisms whereby the chiropractic adjustment and other aspects of chiropractic care are perceived to contribute to wellness outcomes. 

The second phase of the study seeks to obtain consensus about how the chiropractic profession believes well ness should be practised in the future. 

Grant Value: $8,624
Chief Investigator: Dr Jennifer Jamison – Murdoch University
Status: Complete

Publications:

• Chiropractic Journal of Australia, Volume 37, Issue 1, March 2007, pages 11-14
  Jamison JR.Wellness: from the perspective of Australian chiropractic patients
• Chiropractic Journal of Australia, Volume 37, Issue 1, March 2007, pages 2-6
  Jamison JR. Wellness: defining the way ahead for chiropractic in Australia?
• Chiropractic Journal of Australia, Volume 37, Issue 1, March 2007, pages 7-10
  Jamison JR.Wellness: the perspectives and practices of Australian chiropractors

BACKGROUND:
67% of people will suffer neck pain at some point in their lives. Abnormal muscle recruitment patterns may lead to a cycle of impaired movement patterns, which result in neck pain becomig chronic. Spinal manipu- lation combined with exercise has been shown to decrease pain and disability in patients with chronic low back pain and this improvement can be partially attributed to improved neuromuscular activation patterns. The purpose of this pilot study was to apply this model from the back to the neck and also to determine whether similar changes in neuromuscular activation occurred in chronic neck pain patients.
DESIGN:
This pilot study was a randomized controlled trial comparing chiropractic care combined with exercise versus exercise only for participants with chronic neck pain. Group 1 received 4 weeks of chiropractic care, and Group 2 waited 4 weeks before both groups participated in an 8-week exercise intervention. The following outcome measures were assessed in week 1 (baseline), week 4 and at week 12: Neck Disability Index (NDI); Visual Analogue Scale; Neck flexion-relaxation (FR) response and feed forward activation times.
OBJECTIVES:
1) To determine whether a 4-week period of chiropractic care improves the ability of patients to respond to an 8-week period of exercise rehabilitation on indices of disability, and neuromuscular function.

2) To determine effect sizes for any changes in neuromuscular activation patterns.
RESULTS:
There was a significant reduction observed in functional disability and pain levels in both groups. There were medium effect size changes in feed forward activation for both groups and for the FR response in the exercise group.
CONCLUSIONS:
Chiropractic care combined with exercise and exercise alone are both effective at reducing functional disability and pain in chronic non-specific neck pain patients, which may be related to improved neuromuscular measures.

Grant Value: $36,030.82
Chief Investigator: Dr Bernadette Murphy – University of Auckland
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 33, Issue 3, March 2010, Pages 168 – 177
  Murphy, B.A., Haavik Taylor, H., Marshall, P.W., (2010) The effect of spinal manipulation on the efficacy of a rehabilitation protocol for patients with chronic neck pain: a pilot study.
• Spine, Volume 35, Issue 24, November 2010
  Murphy, Bernadette A. DC, PhD*; Marshall, Paul W. PhD†; Taylor, Heidi Haavik BSc (Chiro), PhD‡. The Cervical Flexion-Relaxation Ratio: Reproducibility and Comparison Between Chronic Neck Pain Patients and Controls. Spine 35(24):p 2103-2108, November 15, 2010. | DOI: 10.1097/BRS.0b013e3181cbc7d8

Posters:

• Proceedings of the 12th World Federation of Chiropractic Biennial Congress April 2013, Durban, South Africa Page 107
  Barker, I., Yielder, P., Haavik, H, Murphy, B. The Effect of 12 Weeks of Manipulative Care on the Cervical Flexion Relaxation Response: A Pilot Study.

Presentation:

• International Society of Electromyography and Kinesiology (ISEK) Biannual Meeting July 2012. Brisbane, QLD, Australia. Page 244
  Barker, I., Yielder, P., Murphy, B. “The effects of neck muscle fatigue on the cervical flexion relaxation response and on cervical joint position sense”.
• Proceedings of the 9th World Federation of Chiropractic Biennial Congress May 2007. Vilamoura, Portugal.
  Murphy B, Marshall P, Haavik Taylor H, Govorko D, Palmer S (2007). The cervical flexion-relaxation ratio: Reproducibility and Comparison between Chronic neck pain patients and controls. World Federation of Chiropractic’s 9th Biennial Congress in Vilamoura, Portugal May 17-19,
• ACC Research Agenda Conference March 2009. Las Vegas, USA
  Murphy B.A., Marshall, P.W. and Haavik Taylor H. The effect of spinal manipulation on exercise rehabilitation neuromuscular outcome measures for patients with chronic neck pain: a pilot study. JCA 23(1):p83

While spinal manipulation is widely seen as a reasonable treatment option for biomechanical disorders of the spine, such as neck pain and low back pain, the use of spinal manipulation to treat non-musculoskeletal complaints remains controversial. This controversy is due in part to the perception that there is no robust neurobiological rationale to justify using a biomechanical treatment of the spine to address a disorder of visceral function. This paper therefore looks at the physiological evidence that spinal manipulation can impact visceral function. A structured search was conducted, using PubMed and the Index to Chiropractic Literature, to construct of corpus of primary data studies in healthy human subjects of the effects of spinal manipulation on visceral function. The corpus of literature is not large, and the greatest number of papers concerns cardiovascular function. Authors often attribute visceral effects of spinal manipulation to somato-autonomic reflexes. While this is not unreasonable, little attention is paid to alternative mechanisms such as somato-humoural pathways. Thus, while the literature confirms that mechanical stimulation of the spine modulates some organ functions in some cohorts, a comprehensive neurobiological rationale for this general phenomenon has yet to appear.

Grant Value: $30,268
Chief Investigator: Dr Philip Bolton – University of Newcastle
Status: Complete

Publications:

• Journal of Electromyography and Kinesiology, Volume 22, Issue 5, October 2012, Page 777-784
  Budgell B & Bolton PS (2012) Visceral responses to spinal manipulation. https://doi.org/10.1016/j.jelekin.2012.02.016
• Journal of Manipulative  and Physiological  Therapeutics, Volume 33, Issue 5, June 2010, Page 355-361
  Budgell BS & Bolton PS (2010) Cerebrospinal fluid pressure response to upper cervical vertebral motion and displacement in the anaesthetized rat.
• Journal of Manipulative  and Physiological  Therapeutics, Volume 30, Issue 5, June 2007, Page 351-356|
  Budgell B & Bolton PS (2007) Cerebrospinal fluid pressure in the anaesthetized rat. DOI:https://doi.org/10.1016/j.jmpt.2007.04.002

Posters:

• Australian Neuroscience Society Conference, 2010. Sydney, Australia
  Budgell BS & Bolton PS (2010) Somato-Adrenal Reflex and Upper Cervical Spinal Cord Compression – A Pilot study

Presentations:

• New Zealand College of Chiropractic Research Conference, 2009. Auckland, New Zealand.
  Bolton PS (2009) Does vertebral motion influence cerebrospinal fluid pressure? New Zealand College of Chiropractic Research Conference, Auckland NZ

Background:
Hypothyroidism is a common endocrine condition. There is evidence to suggest that, for a proportion of sufferers, the standard medical treatment does not completely reverse the constitutional and neuropsychiatric symptoms brought about by this condition. The management of hypothyroidism follows a biomedical model with little consideration given to alternative management approaches. There exists anecdotal evidence and case reports supporting the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET) for this population. The aim of this study was to explore the potential short-medium term clinical efficacy and safety of NET for individuals with primary hypothyroidism.
Design – Placebo-controlled, blinded, parallel groups, randomized trial.
Methods:
Ninety adults with a diagnosis of primary hypothyroidism were recruited from Sydney, Australia. Blinded participants were randomized to either the NET or placebo group and received ten intervention sessions over a six week period. The primary outcome involved the measurement of states of depression using the DASS-42 questionnaire. Secondary outcomes included thyroid function, thyroid autoimmunity testing, SF-36v2 questionnaire, resting heart rate and temperature measurement. Outcomes were obtained at baseline, seven weeks and six months. Questionnaires were completed at the private clinics, and serum measures were obtained and analysed at commercial pathology company locations. Heart rate and temperature were also measured daily by participants. Linear mixed-effects models were used to analyse the continuous outcomes. Unadjusted odds ratios with 95% confidence intervals were calculated for the binary outcomes.
Results:
Participants were randomly allocated to the NET (n=44) and placebo (n=46) groups. A proportion of the sample displayed neuropsychiatric disturbances and alterations in quality of life measures at baseline. There were no statistically significant or clinically relevant changes in the primary or secondary outcomes between the NET and placebo groups at time seven weeks or six months. There were a few short-lived minor adverse events reported in both the NET and placebo groups that coincided with the application of the intervention.
Conclusions:
The application of the NET intervention appears to be safe, but did not confer any clinical benefit to the participants in this study and is unlikely to be of therapeutic use in a hypothyroid population.

Grant Value: $28,000
Chief Investigator: Dr Ben Brown – Macquarie University
Status: Complete

Publications:

• Trials, Volume 11, Article number 106, November 2010
  Brown, B.T., Bonello, R., Pollard, H. et al. The influence of a biopsychosocial-based treatment approach to primary overt hypothyroidism: a protocol for a pilot study. Trials 11, 106 (2010). https://doi.org/10.1186/1745-6215-11-106\
• Cases in Differential Diagnosis for the Physical and Manipulative Therapies, 2010, R. Bergman.
  Case Study 23:4 Page 169-171
• Chiropractic Journal of Australia, Volume 39, Number 1, March 2009
  Brown, BT, Bonello R, Pollard H. Response to a letter to the editor Re:”The use of Traditional Chinese Medical Principles in Chiropractic Technique”
• Chiropractic and Osteopathy, Volume 13, Issue 5, April 2005
  Brown BT, Bonello R, Pollard H. The biopsychosocial model and hypothyroidism. doi: 10.1186/1746-1340-13-5. PMID: 15967049; PMCID: PMC1151653.

Posters:

• Third International Congress of Complementary Medicine Research, March 2008. Sydney, Australia
  Brown BT. “A Biopsychosocial Approach to Hypothyroidism” The Journal of Alternative and Complementary Medicine 2008 14:1, Article 43, S-12

A study to describe the prevalence and wellness outcomes of chiropractic care of nonmusculoskeletal complaints amongst paediatric patients is proposed. Particular attention will be paid to describing the diagnostic criteria, management protocols and outcomes of chiropractic care of patients with irritable baby syndrome and enuresis.
In addition to providing insight into the potential scope for chiropractic care of non-musculoskeletal conditions in infancy and childhood, it is anticipated the study will provide the chiropractic profession with a benchmark for the care of irritable babies whose symptoms are unrelated to organic dysfunction or pathology and of children with enuresis.

Grant Value: $12,856
Chief Investigator: Dr Jennifer Jamison – Murdoch University
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 29, Issue 6 July 2006
  Jamison JR, Davies NJ Chiropractic Management Of Cow’s Milk Protein Intolerance  In Infants With Sleep Dysfunction Syndrome: A Therapeutic Trial  – J Manipulative Physiol Ther 2006; 29:469-74
• Chiropractic Journal of Australia, Volume 37, Issue 1, March 2007, pages 25-29
  Davies N, Jamison J Chiropractic management of irritable baby syndrome.

The aim of this project is to provide simple but accurate home tests for individuals or health professionals such as chiropractors to monitor the correct functioning of important bodily systems that are important for health and well-being. A number of key biochemical substances exist in urine that can be used as markers of health and of disease. If impairment of basic bodily systems can be identified early by self testing for these key markers, and hence potential disease states recognised, appropriate steps can be taken to reverse these and to maintain the health of the population. It is desirable that disease be prevented rather than cured. However, at present there are few biochemical tests that can be applied with the desired accuracy to achieve this goal and hence few tests that serve to demonstrate unequivocally the beneficial effect of spinal manipulation. 

Stress is endemic in our early 21st century society. This proposal is to develop a non-invasive, simple, but laboratory-accurate device for home use, based on our previous experience, which can determine the levels of a principle metabolite of cortisol (the stress hormone), in urine. Such capability will enable the early recognition of stress and enable early intervention with associate savings in both human and financial costs. The project will provide a new research tool that will enable data on cortisol levels and their relationship to stress and other conditions to be collected on a large scale since every individual with the tests is in effect a research technician. The accuracy of this home test will be compared with standard laboratory procedures and then it will be used in a new study to establish normal levels and user protocols.

The tests will be used by volunteers to measure their cortisol levels throughout the day and it will be possible for individuals to determine rapidly whether they are in a state of elevated cortisol excretion (and hence under stress) by the simple urine tests. 

It has been shown also in recent research by chiropractors, particularly at Macquarie University, that the hormone cortisol (the stress hormone) responds in parallel with manipulation for diseases such as asthma but no simple tests exist which allow the profession to establish their findings in the general population. The two new non-invasive test systems that will be developed in this project are suitable for measurement of a urinary form of cortisol in home or clinic settings. The aim is that the results obtained from these simple home or clinic tests will be as accurate as most laboratory methods for the same biomarkers and hence can be used in research in clinics. 

Grant Value: $79,500
Chief Investigator: Dr Len Maxwell
Status: Complete

Final Report:

Maxwell L., Self testing of cortisol for well-being – May 2008

Chiropractors have long held that a left to right difference in the skin temperature along the spine may indicate a level of spinal lesion or subluxation. This is due to an understanding that the nervous system controls the amount of blood flow in the small vessels in the skin and muscles around the spine, and the amount of blood flow alters the skin temperature. Blood is warm and when more blood flows to the tissues the temperature of those tissues will be increased. Conversely, when less blood flows, the temperature will be cooler.

Chiropractors use a variety of sensitive instruments to measure the difference between the temperatures on either side of the spine at each segmental level. It is considered that any level which demonstrates a difference in temperature should be investigated further to determine whether the spinal column is functioning correctly at that level, or whether it is not functioning correctly, perhaps due to subluxation, and therefore whether there is a problem in the spine which should be corrected by the chiropractor to restore normal function.

The stability of paraspinal temperature over time is not known in the scientific manner, hence the clinical value of measuring a temperature differential is not known. This study is designed to explore important questions about the thermal patterns alongside the spine and will determine whether or not such patterns are present for an amount of time which is clinically meaningful, or whether they are a short term and variable finding.

The benefits to the public include the possible identification of the clinical usefulness of measuring the differences in the temperature of the skin and muscles which are a part of the human spine. If chiropractors can find this evidence they will then be able to develop better investigative protocols which will result in more effective treatment methods and improved outcomes for patients with spine-related pain and discomfort as well as generally poor health.

Grant Value: $5860
Chief Investigator: Dr Phillip Ebrall – RMIT
Status: Complete

Publications:

• Chiropractic Journal of Australia, Volume 24, Number 4, December 1994, Page139-146
  Ebrall PS., Iggo A., Hobson P., Farrant G., The Thermal Characteristics of Spinal Levels Identified as Having Differential Temperature by Contact Thermocouple Measurement (Nervo Scope)

Background:
Analysis of rhythmic patterns embedded within beat-to-beat variations in heart rate (heart rate variability) is a tool used to assess the balance of cardiac autonomic nervous activity and may be predictive for prognosis of some medical conditions, such as myocardial infarction. It has also been used to evaluate the impact of manipulative therapeutics and body position on autonomic regulation of the cardiovascular system. However, few have compared cardiac autonomic activity in supine and prone positions, postures commonly assumed by patients in manual therapy. We intend to redress this deficiency.

Methods:
Heart rate, heart rate variability, and beat-to-beat blood pressure were measured in young, healthy non-smokers, during prone, supine, and sitting postures and with breathing paced at 0.25 Hz. Data were recorded for 5 minutes in each posture: Day 1 – prone and supine; Day 2 – prone and sitting. Paired t-tests or Wilcoxon signed-rank tests were used to evaluate posture-related differences in blood pressure, heart rate, and heart rate variability.

Results:
Prone versus supine: blood pressure and heart rate were significantly higher in the prone posture (p < 0.001). Prone versus sitting: blood pressure was higher and heart rate was lower in the prone posture (p < 0.05) and significant differences were found in some components of heart rate variability.

Conclusion:
Cardiac autonomic activity was not measurably different in prone and supine postures, but heart rate and blood pressure were. Although heart rate variability parameters indicated sympathetic dominance during sitting (supporting work of others), blood pressure was higher in the prone posture.
These differences should be considered when autonomic regulation of cardiovascular function is studied in different postures.

Grant Value: $60,000
Chief Investigator: Dr Barbara Polus – RMIT
Status: Complete

Publications:

• Chiropractic Journal of Australia Volume 37, Issue 2, June 2007 Page 42
  Watanabe N and Polus BI. (2007) A single mechanical impulse to the neck; Does it influence autonomic regulation of cardiovascular function?
• Chiropractic and Osteopathy Volume Number 1 November 2007 Page 19
  Watanabe, N, Reece, J & Polus, BI 2007, Effects of body position on autonomic regulation of cardiovascular function in young, healthy adults.

Posters:

• Proceedings of The 28th annual meeting of the Australian Neuroscience Society, January 2008. Hobart, Australia.
  Watanabe N, Potocnik S, Polus BI. The contribution of neck afferents to cardiovascular function in sitting humans. Page 83
• Proceedings of The 26th annual meeting of the Australian Neuroscience Society, February 2006. Sydney, Australia.
  Watanabe N, Polus BI. Mechanical perturbation of the neck: Does it influence cardiovascular function?
  
• Proceedings of The 4th ISAN (International Society for Autonomic Neuroscience) congress, July 2005. Marseille, France
  Watanabe N and Polus BI (2005) The effects of different body positions on autonomic regulation of cardiovascular function. p. 138
  

Presentations:

• Proceedings of The 5th ISAN (International Society for Autonomic Neuroscience) congress, October 2007. Kyoto, Japan
  Watanabe N, Potocnik S, Polus BI. The contribution of neck sensory inputs to cardiovascular regulation during moderate head-up tilt in humans.
• Proceedings of The 7th IBRO World Congress of Neuroscience, July 2007. Melbourne, Australia
  Watanabe N, Reece J and Polus BI The effects of mechanical impulse to the neck on cardiac autonomic and cardiovascular functions in young healthy adults; is it an artefact or a genuine response?
• Proceedings of The 7th IBRO World Congress of Neuroscience, July 2007. Melbourne, Australia
  
  Watanabe N, Potocnik S and Polus BI. The role of proprioceptive inputs from the dorsal neck to cardiovascular regulation during orthostasis in humans.
• The 3rd Research Conference School of Health Sciences, RMIT University, July 2007. Melbourne, Australia
  Watanabe N, Potocnik S and Polus BI The role of proprioceptive inputs from the dorsal neck to cardiovascular regulation during orthostasis in humans.
• Proceedings of The World Federation of Chiropractic 8th Biennial Congress June 2005. Sydney, Australia p.254
  Watanabe N and Polus BI (2005) The effects of body posture on autonomic regulation of cardiovascular function.

Awards

• First Prize – The 3rd Research Conference School of Health Sciences, RMIT University, July 2007. Melbourne, Australia
  Watanabe N, Potocnik S and Polus BI The role of proprioceptive inputs from the dorsal neck to cardiovascular regulation during orthostasis in humans.

Since the inception of chiropractic, patients have reported improvements in areas of nervous system function following chiropractic adjustments of their spine. A spinal adjustment is a very quick thrust, delivered to an area of the spine in order to restore spinal and nervous system function. In the past ten years researchers have objectively demonstrated that spinal adjustments can change aspects of nervous system function including muscle reflexes, reaction time and the speed at which the brain processes information. 

A very exciting new area of chiropractic research is being conducted by a group of researchers at the University of Auckland in New Zealand. The project is lead by Dr. Bernadette Murphy, who is both a chiropractor and a human neurophysiologist. She is collaborating with colleagues in the Human Motor Control Laboratory, led by Dr. Winston Byblow. These researchers think that some of the changes in nervous system function reported by patients receiving chiropractic adjustments may be partly explainable by a process called neural plasticity. Scientists now understand that when the nervous system is subjected to unaccustomed inputs, changes can occur in the way the system processes all subsequent inputs. This ability of the nervous system to change the way it responds has been termed “neural plasticity”. These researchers have been able to show that neural plasticity partially explains how people can recover function after damage to the nervous system such as stroke. They are now applying their combined research expertise to investigate whether neural plasticity might occur when areas in the spine are not functioning properly, and whether spinal adjustments might, in fact, be able to reverse these changes. 

In the past ten years, two techniques have been developed to a level enabling the study of neural plasticity in human subjects. One of these techniques, somatosensory evoked potentials (SEPs), involves the measurement of spinal cord and brainwave peaks occurring in response to sensory inputs. By measuring how these brain waves are altered before and after spinal adjustments, it may be possible to understand whether neural plasticity occurs as a result of joint dysfunction. The second technique is called transcranial magnetic stimulation (TMS). TMS is a safe, non-invasive way of stimulating the motor area of the brain that controls movement. A magnetic coil causes a small excitation of the nervous system cells that control output to specific muscles. TMS allows us to measure changes in motor processing that may result from altered input from dysfunctional joints, and how that motor processing is changed following adjustments to the spine. 

Previously, the Auckland researchers have been able to show that adjustments to the cervical spine can change both the sensory processing of input from nerves in the hand and the output of the brain to muscles in the hand. Other researchers have previously demonstrated that plastic changes in neural processing occur in the brain in patients with carpal tunnel syndrome. The Auckland group has also shown that if input from a nerve in the arm is temporarily blocked with local anaesthetic, the output to muscles supplied from a different nerve is changed is changed, even though this nerve has not been blocked. These findings suggest that when the balance of inputs from the nervous system is altered, it changes the way the spinal cord and brain process all subsequent sensory input. These findings may be fundamental to understanding why the vertebral subluxation complex leads to nervous system disturbances that appear to be reversible. When a joint is not functioning properly, it alters the input from sensory receptors in the joint capsule and the muscles that move that joint. 

This altered input may lead to similar alterations in neural processing as observed in the patients with carpal tunnel syndrome or during nerve block with local anaesthetic. If neural plasticity is occurring as a result of “vertebral subluxations”, then spinal adjustments, by restoring normal inputs to the nervous system, will allow the spinal cord and brain to process incoming information in a more coherent way. This would then explain in whole, or in part, some of the improvements in nervous system functioning that have been previously documented following spinal adjustments. 

In order to study the way in which spinal adjustments were able to alter the output from the brain to the forearm muscles, the Auckland group are now making use of a new technique called “paired pulse magnetic stimulation”. By using two magnetic pulses a fraction of a second apart, the degree to which the output to a given muscle is “switched off’ or “switched on” can be measured. This technique provides a sensitive way of measuring markers of sensorimotor integration where sensory inputs to the central nervous system are modified (e.g. spinal adjustments). Changes to the levels of these markers are expected to reflect changes in the way the brain integrates the input from the muscles and joints in the neck and subsequently changes its motor output. By studying how altering the input from the neck to the brain can alter the output of the brain to the arm muscles, the researchers hope to better understand how chiropractic works. Ultimately this type of basic science research may help us understand how chiropractic is able to help improve strength, co-ordination, posture and balance.

Grant Value: $30,000
Chief Investigator: Dr Bernadette Murphy – University of Auckland
Status: Complete

Awards 

• ACC Research Agenda Conference, March 2008 . Washington DC, USA. First Prize.
  Altered Central Integration of Dual Somatosensory Input Following Cervical Spine Manipulation.  – First Prize Abstract published in the Journal of Chiropractic Education, 22 (1): p.79
• World Federation of Chiropractic’s 9th Biennial Congress May 2007. Vilamoura, Portugal. Third Prize
  Haavik Taylor H and Murphy B. (2008) World Federation of Chiropractic’s 9th Biennial Congress Award Winning Paper (3rd Prize): Altered sensorimotor integration with cervical spine manipulation. 
  
• ACC Research Agenda Conference March 2009. Las Vegas, USA. First Prize Basic Science
  Spinal Manipulation alters central integration of dual somatosensory input observed following motor training First Prize Basic Science, Abstract published in The Journal of Chiropractic Education, 23 (1):p.97

Publications 

• Journal of Manipulative and Physiological Therapeutics Volume 33, Issue 4, May 2010, Pages 271-262. 
  Haavik Taylor, H. Murphy, B.A., (2010) The effects of spinal manipulation on central integration of dual somatosensory input observed following motor training: A crossover study. 
• Journal of Manipulative and Physiological Therapeutics Volume 33, Issue 3, March 2010, Pages 178-188.
  Haavik Taylor H and Murphy B. (2010) Altered Central Integration of Dual Somatosensory input Following Cervical Spine Manipulation.
• Chiropractic Journal of Australia, Volume 37, 2007, Page 106-116.
  Haavik Taylor H and Murphy B. Transient modulation of intracortical inhibition following spinal manipulation. 
• Clinical Neurophysiology, Volume 118, Issue 2, February 2007, Pages 391-402.
  Haavik-Taylor, H. & Murphy, B.A. Cervical spine manipulation alters sensorimotor integration: A somatosensory evoked potential study.
• Experimental Brain Research, Volume 178, Issue 4, April 2007, Pages 488-498.
  Haavik Taylor H, Murphy B. Altered cortical integration of dual somatosensory input following the cessation of a 20 minute period of repetitive muscle activity. 
• Journal of Manipulative and Physiological Therapeutics, Volume 31, Issue 2, February 2008, Pages 115-126.
  Haavik Taylor H and Murphy B. (2008) World Federation of Chiropractic’s 9th Biennial Congress Award Winning Paper (3rd Prize): Altered sensorimotor integration with cervical spine manipulation. 

Presentations 

• The XVIII Congress of the International Society of Electrophysiology and Kinesiology June 2010. Aalborg, Denmark. Page 518
  Murphy B.A., Haavik Taylor H, Joint dysfunction as a form of altered afferent input: part II: changes in motor control following spinal manipulation and exercise. 
• Chiropractors’ Association of Australia Scientific Symposium November 2009. Melbourne, Australia
  Haavik Taylor H, Holt, K., Murphy B.A., Exploring the neuromodulatory effects of the vertebral subluxation and chiropractic care. (1st prize paper) 

Posters:

• Australian Neuroscience Society 29th Annual Meeting January 2009.  Canberra, Australia.
  Haavik Taylor, H. and Murphy B. Selective changes in cerebellar-cortical processing following motor training. POS 81

Chiropractors and their patients have long believed that regular chiropractic care provides substantial health benefits. This case study seeks to describe the how chiropractic maintenance care may influence the sleep behaviour of patients with insomnia. 

Research – A tripartite pilot study to evaluate the effect of chiropractic care on insonmia was conducted. The expectations of the chiropractic community were canvassed, a retrospective study to recall changes in sleep patterns was undertaken and a prospective pilot study to monitor sleep patterns following chiropractic care was carried out. Convenience sampling was used. 

Results – The 221 patients and 15 chiropractors who completed the expectation study tended to believe that patients with sleeping difficulties benefited from chiropractic care. The chiropractors were more guarded in their expectations than participating patients. One third of the 154 patients who completed the semi-structured interview reported their sleep pattern was changed immediately following their chiropractic adjustment. All but 1 of these 52 patients reported improvement. Twenty patients with insomnia participated in the prospective study. Although, compared to the report in their screening questionnaire, improvement was noted in certain sleep parameters in the 6 days following their adjustment, no temporal trends emerged in the days and/or weeks following the chiropractic consultation. The majority of patients reported experiencing less or no discomfort during the duration of the study. 

Discussion – Despite optimistic expectations and positive patient perceptions this study produced little objective evidence to suggest that routine chiropractic care improves disordered sleep behaviour. Although a number of patients do perceive chiropractic care offers temporary respite from their insomnia problem, when changes were more objectively monitored, improvements were erratic and no consistent temporal trends were detectable. 

Conclusion – Convincing evidence has yet to be produced before routine chiropractic care can be considered adequate intervention for patients with sleeping difficulties. More definitive answers may result from future research being undertaken in sleep laboratories. 

Grant Value: $10,653
Chief Investigator: Professor Jennifer Jamison
Status: Complete

Publications:

• Chiropractic Journal of Australia, Volume 34, Issue 2, June 2004, Pages 63-67
  Jamison JR. Expectations; a potent trigger to non-specific intervention in chiropractic practice.
• Chiropractic Journal of Australia, Volume 35, Issue 1, March 2005, Pages 4-8
  Jamison JR. The chiropractic adjustment: The Patients’ Perception.
• Journal of Manipulative and Physiological Therapeutics, Volume 28, Issue 3, March 2005, Pages 179-186
  Jamison JR. Insomnia: Does Chiropractic Help?

A fundamental premise on which the clinical practice of chiropractic is based is that misalignment of bones (vertebra) and/or dysfunction in the movement of the bones in the vertebral column or spine produces dysfunction in the nervous system, which leads to ill health and disease. These vertebral misalignments are referred to by chiropractors as vertebral subluxation and may be present in humans or animals.  

Recent work in our laboratory suggests that vertebral displacement/misalignment in the neck can influence the nervous system. However, it remains to be determined if these effects are normal responses as might occur in daily activities of living or are in fact likely to cause dysfunction that is consistent with ill health or disease. 

The general aim of this study is to determine if a vertebral subluxation in the neck, as proposed by the chiropractic vertebral subluxation hypothesis, alters the characteristics of postural reflexes that are normally elicited by some neck movements. 

The study will be performed in adult rats that are first anaesthetised. Recordings will be made from muscles or nerves in the forelimbs while simultaneously moving the upper part of the neck. The effects of moving the neck should normally induce activity in specific muscles and nerves. The characteristics of this response are well defined. We will examine if the existence of a vertebral subluxation in the upper neck changes the characteristics of this neck-evoked reflex response in a manner that suggests dysfunction in the control of posture. We will then reduce the misalignment or subluxation and examine if the characteristics return to the pre-subluxation state 

This study will determine if vertebral subluxation in the upper neck influence neck evoked postural reflexes in a manner consistent with dysfunction and or ill health. Furthermore, it will determine the relative amount of misalignment necessary to cause changes in the characteristics of the reflex. Importantly, it will identify if the reduction of the vertebral subluxation produces normal characteristics in the reflex. 

Grant Value: $60,494
Chief Investigator: Dr Philip Bolton – University of Newcastle
Status: Complete

Publications:

• Journal of Electromyography and Kinesiology Volume 22, Issue 5, October 2012, Pages  785-794
  Pickar JG, Bolton PS., Spinal manipulative therapy and somatosensory activation.
• The Anatomical Record Volume 290, Issue 7, July 2007, Pages 893-899
  Flynn JR & Bolton PS (2007) Measurement of the vertebral canal dimensions of the neck of the rat with a comparison to the human. 
• Journal of Manipulative and Physiological Therapeutics, Volume 23, Issue 2, February 2000, Pages  101-103.
  Bolton PS “Reflex effects of vertebral subluxation: the peripheral nervous system. An update” 
• Activator Vision Volume 16, Issue 1, 2001. Pages 6 – 10
  Bolton PS (2001) Neck mechanoreceptors influence on lower limb posture cervical isolation tests.

Presentations:

• Australian Neuroscience Society, January 2005. Perth Australia.
  Bolton PS, Holland CT (2005) Response characteristics of deep paravertebral muscle spindle afferents to vestibular movements in the neck of the cat. P127, Perth, Australia 
• 7th International Congress of the Musculoskeletal Physiotherapy Association of Australia. November 2003. Sydney, Australia.
  Bolton PS (2003) Laboratory studies of neck afferent information and their clinical implications.

In both the elderly and rehabilitation populations, the maintenance and I or restoration of balance (and mobility) is essential. A decline in the ability to maintain balance has been identified as a significant risk factor for falls. Maintenance of balance is determined by many factors such as visual cues, inner ear mechanisms and mobility. There is growing evidence that an important relationship exists between the function of the spine – in particular the cervical region – and the complex neurology involving the senses of vision, balance and coordination. The presence of dysfunction in the neck may lead to changes in postural control mechanisms that can cause a decrease in the ability to maintain balance. 

Age -related changes in the neural, sensory and musculoskeletal systems can lead to impairments in postural control systems and balance resulting in increased risk of falls and reduced ability to move around safely in the elderly. Injuries resulting from falls particularly in the aged can result in a loss of independence, psychological stress, a general decrease in quality oflife and spiraling costs in the health care system. This study examines the relationship between the presence of clinical findings of cervical spine dysfunction and clinical measures of balance and risk of falling. Approximately 50 young healthy adults aged 20-35 years and 50 healthy older adults aged 60+ years will be evaluated for the presence of positive clinical findings associated with cervical spine dysfunction using standard procedures. Each subject will then be assessed for balance using functional clinical tests. 

The study will assist in identifying the role cervical spine dysfunction, as indicated by the presence of positive clinical findings, plays on balance and risk of falling in the aged as assessed by standard clinical outcome measures. This in turn could add to information on the possible role of chiropractic therapy in improving balance and reducing the risk of falling in the elderly with the potential to improve quality of life and reduce health care costs. 

Grant Value: $1,500
Chief Investigator: Dr Maxwell Walsh – RMIT
Status: Complete

Publications 

• Chiropractic Journal of Australia, Volume 34, Issue 1, March 2004, Pages 19 – 22
  Walsh MJ, Polus BI, Webb MN. The role of the cervical spine in balance and risk of falling in the elderly. 

Presentations

• The World Federation of Chiropractic 7th Biennial Congress, May 2003. Orlando, USA
  Walsh MJ (2003). A pilot study of the association between frequency of positive clinical findings in the cervical spine and clinical measures used to predict risk of falling in the aged. p.371 

Myofascial pain syndromes are prevalent in the commnnity with Chiropractors often managing these conditions in their practices. Myofascial trigger points are the hallmark clinical sign of myofascial pain syndromes and often develop as a secondary condition to other musculoskeletal injuries. Myofascial trigger points can be associated with vertebral subluxation, both of which can contribute to somatic dysfunction.

This study is designed to investigate the effect of latent myofascial trigger points (LTP’s) on the temporal sequence of muscle recruitment in the shoulder girdle during elevation of the arm in the scapular plane. Latent trigger points are asymptomatic, except when being palpated directly, although they can reduce the range of motion of the muscle in which they are located. It has been shown that glenohumeral joint pain is associated with increased variability in the temporal sequence of muscle recruitment of the scapular rotator muscles during elevation of the arm in the scapular plane. However, it is not known whether such altered muscle recruitment patterns cause, or are the result of joint dysfunction.

The aims of this study are as follows:

1. To use electromyography to establish the temporal sequence of muscle recruitment of key shoulder girdle muscles during elevation of the arm in the scapular plane, in normal subjects.

2. To establish the prevalence ofLTP’s in the scapular rotator muscles in asymptomatic subjects.

3. To use electromyography to compare the shoulder girdle muscle recruitment pattern of normal subjects to that of asymptomatic subjects with LTP’s in the scapular rotator muscles, during elevation of the arm in the scapular plane.

4. To investigate what effect removing the LTP’s from the scapular rotator muscles has on the muscle recruitment pattern of key shoulder girdle muscles during elevation of the arm in the scapular plane.

This project has direct clinical relevance as it contributes to an understanding of the anatomical and biomechanical mechanisms underlying chiropractic care. Any differences found in the sequence of muscle recruitment between groups will be present in an asymptomatic environment and so will not be affected by the presence of pain. IfLTP’s in the scapular rotator muscles increases the variability of the muscle recruitment pattern employed to elevate the arm in the plane of the scapula, it may be appropriate for Chiropractors to focus on the removal of LTP’s around the scapula in order to decrease the incidence of recurrent shoulder pain.

Grant Value: $18,184
Chief Investigator: Dr Karen Lucas – RMIT
Status: Complete

Posters:

• The International Society of Biomechanics XVIIIth Congress, July 2001. Zurich, Switzerland
  Lucas, Karen & Polus, Barbara & Rich, Peter. (2001). The effects of latent myofascial trigger points in the scapular rotator muscles on the temporal sequence of muscle recruitment during loaded scapular plane elevation.

Although the chiropractic profession has yet to agree upon its scope of practice, it appears that chiropractic is emerging as an independent limited health profession in modem society. In reality, chiropractors usually function at the community: health care system interface, a level of health care at which health professionals are expected to actively engage in promoting patient self-care. This study seeks to clarify chiropractic’s scope of practice with respect to self-care and explore how brochures, tailored to the perceived needs of chiropractors and their patients, can enhance the cost-effectiveness of providing self-care in chiropractic clinics. It describes the actual scope of practice of chiropractors with respect to the promotion of patient self-care and explores the nature of self-care assistance chiropractic patients would like their chiropractors to provide. This study then proposes to develop, based upon the information expectations of patients and comments of their chiropractors, health information brochures that may help chiropractic practitioners meet this commitment and provide cost-effective self-care guidance to their patients.

The study passes through two phases. The first is a situational analysis of the self care needs of chiropractic patients. A survey of chiropractors will be triangulated with a case study of chiropractic practices. The survey will involve requesting a random sample of members of the Australian Chiropractic Association to complete a questionnaire. Questionnaires will be analysed using descriptive statistics. Chi squared tests will be performed where appropriate. The case study will be undertaken using purposive sampling of chiropractic practices in order to include diverse practice models. As the objective is to describe the broadest level of self-care available in chiropractic clinics, the patient sample will be restricted to maintenance patients. Data will be collected by means of practice observation, patient questionnaire and interview of both patients and practitioners. Interviews and practice observation will be subject to thematic analysis. Results from the survey and case study will be triangulated and used as the basis for developing health information brochures. In phase 2, the self-care brochures will be tested in selected chiropractic clinics.

Grant Value: $24,646
Chief Investigator: Dr Jennifer Jamison – RMIT
Status: Complete

Publications:

Chiropractic Journal of Australia Volume 31, Issue 3, September 2001, Page 92
Jamison JR “Chiropractic Patient-Centred Care:Suggestions from and International Case Study” 

Journal of Manipulative and Physiological Therapeutics Volume 24, Issue 6, July / August 2001, Page 378 – 384
Jamison JR “Reducing the personal risk of perceived disease: The chiropractic patients self-care endeavour.”

Journal of Manipulative and Physiological Therapeutics Volume 24, Issue 5, June 2001, Page 331 – 334
Jamison JR “The Health Information Brochure: A Useful Tool for Chiropractic Practice” 

Journal of the Canadian Chiropractic Association Volume 45, Issue 2, June 2001, Pages 100 – 105
Jamison JR, Rupert R. Maintenance care: towards a global description

Chiropractic Journal of Australia Volume 31, Issue 2, June 2001, Page 47
Jamison JR (2001) “Maintenance Care: An Australian Case Study”

Chiropractic Journal of Australia Volume 31, Issue 1, September 2001, Page 133 – 138
Jamison JR (2001) ” Expectations: A case Study Describing the Outcome Expectations of Chiropractors and their patients” 

Topics in Clinical Chiropractic
Jamison JE. A case study to evaluate the acceptability of health information brochures to chiropractic patients

The expression of the c-fos immediate early gene (c-fos mRNA and c-fos protein) has been extensively used to trace stimulated neurones in the central nervous system. Previous nerve tracing technique studies from our lab have suggested that sensory nerves from the upper thoracic facet joints in the rat relay nociceptive information to projection neurones like the spinothalamic tract in the superficial dorsal horn of the spinal cord. The pattern of c-fos expression has been shown to correlate well with these neuronal tracer studies.

This study uses in-situ hybridisation of c-fos mRNA and irnmunohistochemical detection of c-fos protein to further trace pain pathways from upper thoracic facet joints (TI to T4). In addition the level of c-fos mRNA and protein expression with increasing level of noxious pain stimulation (formalin challenge test) will be presented. Further, the time course of c-fos mRNA and protein expression before and after different levels of noxious stimulation will be analysed. Correlation of this data will add to our understanding of c-fos involvement in the pain circuitry associated with spinal facet joints.

Experiments are currently performed on naive acclimatised adult rats (300-400g). The animal s are surgically dissected to expose the joint space which is then infused with either SµL of I.5% formalin in saline for up to a period of two hours. The joint is then washed with saline, animal overdosed with anaesthetic and perfused first with saline followed by paraformaldehyde. The fixed spinal cord is then removed and 40µm transverse sections cut for in situ hybridisation and c-fos immunohistochemistry.

In order to determine the c-fos dose response to differing levels of stimuli and determine the time course ofc-fos expression, facet joints will be stimulated for I minute but with II range of formalin concentrations and c-fos expression monitored after stimulus removal for a further 4 hrs. Control experiments will receive all of the steps outlined above including anaesthetic and surgery, however, only a saline injection is delivered into the facet joint.

Grant Value: $42,093
Chief Investigator: Dr Sinan Ali – Macquarie University
Status: Complete

Publications:

• Final Report 2001
  Hayek R. BSc(Hons) MChiropract. PhD., Ali S. BSc MSc PhD., Holland R J. BSc., Sidaway G BSc. & Bassett JR. PhD. C-fos Expression in the Rat Spinal Cord in Response to Facet Joint Stimulation with Formalin. 

Posters:

• Proceedings of the 2000 International Conference on Spinal Manipulation, September 2000. Minnesota, USA
  Hayek R. Ali S, Bassett JR (2000). The level and Extent of Pain Expression from Thoracic Facet Joints: A c-fos “time-Series Analysis.  P.88. 

Presentations:

• World Federation of Chiropractic’s 6th Biennial Congress, May 2001. Paris, France
  Buht.”l H, Hayek RAli S,Holland R (2001). Visualization of the Convergence Pattern. of the Sensory· Afferents from T1-T4 Facet Joint and the Pericardium in the Rat. Using Confocal Microscopy and the Neuronal Tracers Dll And DlO. 
  
• World Federation of Chiropractic’s 6th Biennial Congress, May 2001. Paris, France
  Hayek R. Ali S, Holland R, Sidaway G {2001). C-Fos Expression in the Rat Spinal Cord in Response to Facet Joint Stimulation with Formalin. 
• International Conference on Spinal Manipulation, September 2000. Minnesota, USA.
  Ali S Heyek R and Bassett JR (2000) “The level and extent of pain expression from Thoracic Facet Joints: A c-fos time-series analysis” 

Aims

To determine the intra- and interexaminer reliability of chiropractic methods used to detect manipulable lesions in patients with chronic low back pain.

Methods

This study is an intra- and interexaminer reliability study.  Four chiropractors will examine twenty patients suffering from chronic mechanical low back pain.  The examination will consist of common methods that are employed by chiropractors in the state of Victoria to detect manipulable lesions. Each chiropractor will examine each patient on two different occasions to determine where they would direct a manipulative procedure if they were then to go on and treat the patient. Each chiropractor will carry out the procedure blind to the final purpose of the study, and also blind to the results of the other chiropractors. The analysis of the results will be carried out by determining agreement beyond chance for each of the spinal joints of the lumbar spine, and the sacroiliac joints.

Potential Significance

The use of a diagnostic routine that is reliable in classifying patients is an essential part of any health care intervention.  The evaluation of common methods used to detect manipulative lesions will be able to indicate if these procedures, in combination, have good intra- and interexaminer reliability. As chiropractors strive to validate their procedures, this research study will be a unique and significant project in determining if commonly used methods by chiropractors in Victoria do in fact achieve high levels of intra- and interexaminer reliability.

Grant Value: $1320
Chief Investigator: Dr Simon French – Monash University
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 23, Issue 4, May 2000, Pages 231-238
  Simon D. French, Sally Green, Andrew Forbes, Reliability of chiropractic methods commonly used to detect manipulable lesions in patients with chronic low-back pain,

Final Report:

• French S., Green S., Forbes A., July 1999 Reliability of Chiropractic diagnosis – July 1999

Fibromyalgia syndrome is a multifaceted disorder characterised by chronic widespread pain, tenderness to pressure, stiffness, sleep disturbances and emotional distress. It is 1O to 20 times more common in females than males. Typically, the patient feels “sore all over”. It is considered to be the most common cause of chronic widespread musculoskeletal pain and is commonly seen in chiropractic practice.

The main objective of this study is to compare the efficacy of chiropractic treatment with ultrasound therapy, on the symptoms of fibromyalgia syndrome, and with the natural history of the syndrome.

A group of people suffering with fibromyalgia syndrome will be recruited and randomly assigned to a treatment group, a control treatment group and a control group that will receive no treatment. The treatment group will receive chiropractic treatment that patients would be to likely receive in clinical practice. The control treatment group will receive ultrasound therapy to the muscles around the spine. The purpose of the untreated control group is to monitor the natural history of the syndrome. Informed consent regarding the trial will be obtained. To assess the presence and severity of fibromyalgia syndrome, instruments will be used that have been validated in the peer-reviewed literature. A chiropractic examination will be performed to determine whether chiropractic treatment is indicated and if so, whether it is safe and appropriate to treat the subject with chiropractic.

An X-ray examination will be performed when clinically indicated to determine if there are any disease processes that would contra-indicate chiropractic treatment and for biomechanical assessment.

The treatment and control treatment will be provided for a period of ten weeks by an experienced, registered, fully qualified chiropractor in private practice.

The subjects’ condition will be measured at O weeks, 5 weeks, 1O weeks and followed up at six months.

Currently the mainstream approach to treatment of fibromyalgia syndrome is a multidisciplinary approach utilising psychotherapy, patient education, low-doses of tricyclic antidepressants, exercise and manual therapies. Current treatments have been shown to have limited effectiveness with limited response to therapy in many cases and side-effects can be a problem with tricyclic antidepressant medication.

If chiropractic is demonstrated to be an effective treatment approach it has been shown to be safe and cost effective and has existing benefits of being available to a wide spectrum of the population in urban and country areas. It would also strengthen the claim that chiropractic has a role to play in the management of chronic pain.

Grant Value: $15,000
Chief Investigator: Dr Paul Wise – RMIT
Status: Complete

Publications:

• European Journal Chiropractor, Volume 49, Number 1, 2002. Pages 198-199
  Wise P, Walsh M, Littlejohn G. Efficacy of chiropractic treatment on fibromyalgia syndrome: a randomised controlled trial. 

The chiropractic vertebral subluxation hypothesis proposes that a vertebral subluxation results in alterations in nerve activity in respect of that occurring during typical physiological movements or displacements of the vertebral column. We propose to examine the role of the vertebral displacement component of the vertebral subluxation by investigating the influence that displacement of an individual vertebra (C2) has on nerve activity and contrast this with the effects of regional (upper cervical) movement on the same nerves.           •

Experiments will be performed in anaesthetised or decerebrate adult rats.

Electrical recordings will be made from the splanchnic and/or adrenal nerves while simultaneously moving the intact upper cervical region of the vertebral column. These data will be compared with data recorded from the splanchnic and/or adrenal nerves while simultaneously moving or displacing the intact C2 vertebra. During this study we will investigate the relative role of the skin, muscles and intervertebral joints in modulating splachnic and/or adrenal nerve activity during the upper cervical or C2 vertebral movement/displacements. The role of muscle spindle afferents and the effects of the presence of noxious stimuli in the skin, muscles or joints of the upper cervical region will also be examined.

This study will provide original data concerning the role of upper cervical vertebral movement and displacement in the nervous system regulation of visceral organs. Importantly, it will examine if the vertebral displacement component of the chiropractic vertebral subluxation modulates activity in nerves innervating the intestine and adrenal gland. This study may also provide clues as to why some patients presenting to chiropractors with dysfunctions associated with the regulation of visceral organs are occasionally reported to respond well to particular chiropractic strategies used to resolve vertebral subluxations in the neck but not to others.

Grant Value: $8,800
Chief Investigator: Dr Philip Bolton – University of Newcastle
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapies, Volume 23, Number 2, February 2000
  Bolton PS., Reflex Effects of Vertebral Subluxations:The Peripheral Nervous System. An Update

Previous nerve tracing technique studies (HRP-WGA) from our lab have suggested that sensory nerves innervating the T2/3 facet joint in the rat may relay information to projection neurones like the spinothalamic tract in the superficial dorsal horn of the spinal cord. This study aims to use the immunohistochemical detection ofa protein product (fas) of the c-fos immediate early gene. The c­ fos can be used as a transynaptic marker for neuronal activity following noxious stimulation. The pattern of c-fos expression has been shown to correlate well with other anatomical studies, like HRP-WGA. To date no spinal data has been sourced which correlates spinal joint sensory nerves and their role as a source of pain in back pain sufferers. This proposed study has the potential to aid our clinical understanding of the nature of back pain, particularly that of joint origin.

Experiments will be performed on adult rats (400-S00g), anaesthetised, placed in a stereotaxic frame and surgical dissection performed to expose the facet joints. There are 4 joints from T1 to T4 and performing the same experiment 6 times per joint, this requires a total of 24 animals for this group. The joint space will be injected with SµL ofl.5% formalin in saline. The animal’s respiratory rate, hindplimb withdrawal reflex, mucous membrane and rectal temperature will be monitored at 15 minute intervals for the subsequent 2 hours under anaesthesia

The joint will then be washed with saline, the animal and perfused with saline followed by a fixative (paraformaldehyde) and the spinal cord removed. Sections will be cut at 40µm transversely.

The same procedure as outlined above will be performed except that the nerve to the joint will be cut at its most distal attachment (Tl to T4, at 6 animals per nerve leads to a total of24 animals). The nerve will be positioned vertically in a wax well (low melting point dental wax) to avoid surrounding tissue contamination, then bathed in SµL of 1.5% formalin in saline for 2 hour.

Control experiments will receive all of the steps outlined above including anaesthetic and surgery, however, no formalin injections will be delivered into the facet joint (N=4) or the nerve (N=4).

Using brightfield microscopy for cytoarchitectural boundaries and the location of c-fos reaction product, all central observations will be traced onto a spinal cord outline using the drawing tube.

Grant Value: $23,783
Chief Investigator: Dr Ray Hayek – Macquarie University
Status: Complete

Posters:

• Proceedings of the 2000 International Conference on Spinal Manipulation, September 2000. Minnesota, USA
  Hayek R. Ali S, Bassett JR (2000). The level and Extent of Pain Expression from Thoracic Facet Joints: A c-fos “time-Series Analysis.  P.88. 

We investigated whether vibratory stimulation of the dorsal neck muscles activates fusimotor neurons of lower limb muscles in relaxed human subjects.

Methods: The triceps surae (TS) muscles of seated subjects (n = 15) were conditioned to leave their muscle spindles in either an insensitive (hold-long) or sensitive (hold-short) state. A vibrator (80 HZ) was applied to the dorsal neck muscles for 10 seconds. The tendon jerk was evoked from the right TS immediately before (during) or 5 seconds after (interposed) the offset of vibration.

Results: The size of the reflex after hold-long muscle conditioning and after neck vibration was significantly smaller than the control hold-short reflex (P < 0.001). However, after hold-short conditioning, neck vibration significantly increased tendon jerk amplitude, both during (P = 0.001) and interposed (P = 0.026).

Conclusion: Dorsal neck vibration increases spinal reflex excitability of the TS in relaxed and seated subjects, but not through fusimotor excitation. Muscle Nerve, 2012

Grant Value: $14,970
Chief Investigator: Dr Barbara Polus
Status: Complete

Publications:

• Muscle and Nerve, Volume 45, Issue 3, March 2012, Pages 376 – 384.
  Sasaki H and Polus BI (2012) Can neck muscle spindle afferents activate the fusimotor neurons of the limb in the relaxed and seated human?
• Chiropractic journal of Australia, Volume 37, Issue 1, March 2007, Pages 30-37.
  K, Kumar, DK and Polus BI (2007) The reliability and validity of lumbar paraspinal SEMG during unsupported sitting.
  
• Chiropractic Journal of Australia, Volume 34, Issue 1, March 2004, Pages 19-22
  Walsh MJ, Polus BI, Webb MN. (2004) The role of the cervical spine in balance and risk of falling in the elderly.
  
• Journal of Neuromusculoskeletal System, Volume 9, Issue 3, September 2001, Pages 82-87
  Polus BI and Walsh MJ (2001) “The effect of longitudinal whole body rotation against a steady head on changes in lower motoneuron excitability – a study in humans”

Presentations:

• 5th Interdisciplinary World Congress on Low Back and Pelvic Pain. November 2004. Melbourne, Australia
  Kamei K, Kumar DD and Polus BI (2004) The reliability and validity of surface electromyography (SEMG) to study activity patterns of lumbar paraspinal muscles during the execution of simple static postures.
• World Federation of Chiropractic’s Biennial Congress,  May 2003. Orlando, Florida, USA
  Walsh MJ, Polus BI, Webb MN (2003) A pilot study of the association between frequency of positive clinical findings in the cervical spine and clinical measures used to predict the risk of falling in the aged
• World Federation of Chiropractic’s Biennial Congress,  May 2003. Orlando, Florida, USA
  Polus BI, Fernandes K and Walsh MJ (2003) The role of neck proprioceptors in modifying the tonic activation of limb muscles in awake humans
• Proceedings of the Australian Physiological and Pharmacological Society, November 2000. Melbourne, Victoria, Australia
  Polus BI and Walsh MJ (2000) “The impact of changes in proprioceptive input from the neck on lower limb motoneuron excitability” ” vol 31(2); 109P

Posters:

• Proceedings of the first world congress on Chinese Medicine, November 2003. Beijing, China.
  Polus BI Evans BS and Budgell BS (2003) The effect of paraspinal stimulation of the neck on the autonomic regulation of cardiovascular function. p.121
• Proceedings of the Eighth Australian and New Zealand Intelligent Information Systems Conference, December 2003. Sydney, Australia
  Ragupathy SC, Kumar DK, Kamei K, Polus BI (2003) Multiple regression and statistical analysis on SEMG of lumbar muscles. PPS 35-40
• Proceedings of the eighth Australian and New Zealand Intelligent Information Systems Conference, December 2003. Sydney, Australia
  Djuwari D, Kumar, DK, Ragupathy SC, Polus BI (2003) Multistep independent component analysis for removing ECG artefacts from back SEMG signals.pps 439-444

ABSTRACT:

This study describes the disability and outcome perceptions of acute and chronic workcare and non-workcare patients.

RESEARCH METHOD:

Eight chiropractors were requested to recruit patients, taking care to include workers compensation cases. Patients were requested to complete up to 3 questionnaires. The first questionnaire to be completed on admission, the second 3 weeks later or on discharge, whichever occurred first. A third questionnaire was to be completed by patients still receiving care at 3 months. Questions focused on outcome expectations and pain and disability perceptions. Practitioners were asked to document the patient’s level of disability and comment on their outcome expectations.

RESULTS:

One hundred and sixteen patients entered the study, 57% were acute on admission and 53% of all patients recruited had been injured at work. Few discrepancies emerged between workcare and non workcare patients. The outcome expectations of both patients and chiropractors were more positive for acute cases although the outcome expectations of chronic patients was less negative after chiropractic care than on admission.

CONCLUSION:

Although the size of the sample precludes generalisation, this study does emphasise the importance of judging each case on its merits and not permitting preconceived notions to cloud the outcome expectations of individual workcare cases.

Grant Value: $12,625.07
Chief Investigator: Dr Jennifer Jamison
Status: Complete

Publications:

• Chiropractic Journal of Australia, Volume 30, Number 3. September 2000, Pages 96-101
  Jamison JR(2000) “Health Promotion: exploring the behaviour of chiropractic patients”
  
• Journal of Manipulative and Physiological Therapeutics, Volume 23, Number 1. January 2000 Pages 32-33
  Jamison JF (2000) ” Stress Management: An Exploratory Study of Chiropractic Patients”
  
• Chiropractic Journal of Australia, Volume 30, Number 2. June 2000, Pages 45-47
  Jamison JF (2000) “Self-care: a comparative case study of chiropractic patients’ Health Information Interests”

To describe the clinical management with spinal manipulation of a male patient with risk factors for lumbar disk herniation initially suffering from what appeared to be mechanical low back pain that evolved into radiculopathy; also to review issues pertinent to chiropractic/manipulative management of disk herniation.

Grant Value: $269
Chief Investigator: Dr Colin Crawford
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 22, Issue 4, May 1999, Pages 235 – 244
  Colin M. Crawford, Robert F. Hannan, Management of acute lumbar disk herniation initially presenting as mechanical low back pain, Journal of Manipulative and Physiological Therapeutics,

A systematic literature review of population prevalence studies of low back pain between 1966 and 1998 was conducted to investigate data homogeneity and appropriateness for pooling. Fifty-six studies were analysed using methodologic criteria that examined sample representativeness, data quality, and pain definition. Acceptable studies were assessed for homogeneity and appropriateness for pooling. Thirty were methodologically acceptable. Of these there were significant differences in study design, patient age, mode of data collection, potential temporal effects, and prevalence results. Point prevalence ranged from 12% to 33%, 1-year prevalence ranged from 22% to 65%, and lifetime prevalence ranged from 11% to 84%. A limited number of studies were left for analysis, making the pooling of data difficult. A model using uniform best-practice methods is proposed.

Grant Value: $800
Chief Investigator: Dr Bruce Walker – James Cook University
Status: Complete

Publications:

• Journal of Spinal Disorders, Volume 13, Issue 3, June 2000, Pages 205-217
  Walker B (2000) The Prevalence of Low Back Pain:A Systematic Review of the Literature from 1966 to 1998

Objective: This study examines the effect of chiropractic spinal manipulative therapy on salivary cortisol levels.

Design: Prospective case series over six weeks duration. The trial consisted of establishment of each individual’s baseline cortisol level, a two week treatment period (4 treatments), and a two week post treatment period.

Setting: Macquarie University Chiropractic Research Centre.

Participants: Nine subjects (six male, three female), employed in a large corporation, volunteered to the trial of spinal manipulative therapy.

Main outcome measures: Saliva samples were analysed using an Amerlex Radioimmunoassay Kit to determine the cortisol concentrations present.

Results: Statistical interpretation, after exclusion of an apparent outlying subject, revealed results of statistical significance (p<0.001) for reduction of salivary cortisol over the complete five week study. In addition, there was no apparent alteration in salivary cortisol levels immediately preceding and 15 minutes after spinal manipulative therapy.

Conclusion: The initial evidence is inconclusive, however, the potential relationship demands further investigation. Additional research is necessary in measuring the physiological effects of Chiropractic spinal manipulative therapy. This method is currently being used in a larger randomised controlled trial.

Grant Value: $19,644
Chief Investigator: Dr Peter Tuchin – Macquarie University
Status: Complete

Publications:

• Australasian Chiropractic and Osteopathy Volume 7, Issue 2, July 1998, Pages 86-92
  Tuchin PJ(1998) The Effect of Chiropractic Spinal Manipulative Therapy on Salivary Cortisol Levels.

The aim of this review is to identify the main characteristics of classic migraine, with specific regard to diagnostic criteria for manual therapy practitioners, including chiropractors and physiotherapists. Ten case studies on migraine were reviewed for symptoms and clinical features. Many cases reviewed as classic migraines were in reality not correct diagnoses in accordance with International Headache Society classification system. Some cases had classic signs which may have been misinterpreted, whilst other cases had possible inconsistent symptoms, making diagnosis difficult. The various classification systems are presented with guidelines for diagnosis to assist practitioners making the accurate diagnosis.

Grant Value: $39,855
Chief Investigator: Dr Peter Tuchin – Macquarie University
Status: Complete

Publications:

• Australasian Chiropractic and Osteopathy Volume 6, Issue 2, July 1997. Pages 41-47
  Tuchin PJ. The Efficacy Of Chiropractic Spinal Manipulative Therapy (SMT) In The Treatment Of Migraine- A Pilot Study.
  
• Physical Therapy reviews, Volume 3, Issue 3, 1998, Pages 149-162
  Tuchin PJ, Pollard H. Does Classic Migraine Respond To Manual Therapy- A Case Series. 
  
• Australasian Chiropractic and Osteopathy Volume 8, Issue 2, July 1999. Pages 61-65
  Tuchin PJ. A twelve month clinical trial of Chiropractic spinal manipulative therapy for migraine.

Chiropractors are called upon to manage patients complaining of pain. Although in chiropractic practice the emphasis is the patient rather than the condition, formal chiropractic assessment focuses largely upon bio-mechanical evaluation. As there is increasing evidence that psychological stress has physical repercussions, and chronic pain cannot be adequately understood using objective measures, it is possible that routine psychological screening may enhance the efficiency and effectiveness of chiropractic care. This study explores the usefulness of a screening questionnaire as an aide to assessing patient distress, enhancing patient awareness of the impact of psychosocial stressors on their wellbeing, and as a guide to referral for counselling.

Grant Value: $15,827
Chief Investigator: Dr Jennifer Jamison – RMIT
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 22, Issue 7, September 1999, Page 454 – 457.
  Jamison JR (1999) “A Psychological Profile of Fibromyalgia Patients: A Chiropractic Case Study” 
  

This study aims to increase awareness of Chiropractic management and the degree to which it can be beneficial to patients who suffer from asthma. Patients who present to the chiropractic clinic and are diagnosed or established to have this breathing disorder will be approached to participate in this study. A total of 50 patients suitable for this study will be recruited from the Macquarie University’s two outpatient clinics to participate.  The study involves mobilising the ribs and hypomobile segments in the spine (release hypertonic respiratory muscles i.e. intercostal, diaphragm accessory respiratory muscles) (1), adjusting the subluxated segments (2,3).

Research plan: Patients diagnosed with asthma who are under medical management and who voluntarily attend chiropractic care, are asked to breath into a spirometer (disposable mouth piece) before and after chiropractic management. Results from the test will be culminated and statistically analysed. From this project it is anticipated to show the therapeutic value of chiropractic treatment for asthma.

Grant Value: $2000
Chief Investigator: Dr Ray Hayek
Status: Complete

Presentation:

• International Conference on Spinal Manipulation, September 2000. Bloomington, USA
  Hayek, R., Ali, S., Curson, P., Beirman, R., & McKelvey, S-E. (2000). A multisite trial: chiropractic and asthma with physiological markers. 9-9. Abstract

The purpose of this study was to test the validity of Doppler ultrasound (US) velocimeter examination of vertebral arteries during contralateral (to the opposite side) cervical rotation. Vertebral arteries from 20 subjects were insonated using a bidirectional Doppler velocimeter at the suboccipital portal (standard technique) and C2 transverse process level (new technique) during contralateral cervical rotation. The results, regarding persistence or major reduction in Doppler signals, were then compared with those from a colour-flow duplex US scanner using the same procedure. There was complete agreement between the combined suboccipital and C2 velocimeter results and those from the duplex scanner (k = 1.00 at p = 0.01): both sensitivity (n = 5) and specificity (n = 34) were 100%. This study provides evidence to support the validity of bidirectional Doppler velocimeter examination, by an experienced examiner, for the purpose of assessing the effects of contralateral rotation on vertebral artery blood flow.

Grant Value: $51,303
Chief Investigator: Dr Michael Haynes
Status: Complete

Publications:

• Ultrasound in Medicine and Biology, Volume 26, Issue 1, January Page 57-62
  Haynes MJ (2000) “Vertebral arteries and neck rotation: Doppler velocimeter and duplex results compared” Ultrasound in Med. & Bio; 26,1:57-62
  

Skeletal muscle contractions emit a low frequency sound (<100Hz) that can be detected by vibromyography (VMG) or mechanomyography (MMG). The aim of this study was to determine the future application of the VMG signal as a clinical tool in reflecting the physiological state or function of muscle during rehabilifation and diagnosis. In order to achieve this aim, the following was investigated. A) The technical characteristics: Three different transducers (the capacitance and piezoelectric accelerometers and the contact sensor) and the transducer/ amplifier system. B) The repeatability of the VMG signal at different force levels. C) Physiological characteristics of the VMG signal comparing ‘normal’ and ‘abnormal’ muscle function. Past studies on VMG have revealed that these three areas have received little attention.
The VMG signal was taken from the biceps brachii muscle at different contraction levels 10%, 50% and 80% maximum voluntary contraction (MVC) for within day (n=3) and between day (n=17) recordings. The signal from asymptomatic (n=29) and symptomatic (n=23) low back pain subjects was then compared. Recordings were taken from the erector spinae muscle at an incremental increase in voluntary contraction (10%-100%MVC). These recordings were repeated on the next day.
Results from this study have revealed the following: A) Technical characteristics : the lower cut-off frequency is important and insufficient attention in past studies has been given to the transducer-amplifier system. Additionally, the capacitance accelerometer was the favoured transducer due to its greater sensitivity to low frequencies, simplicity of use and ease of stabilising and coupling techniques to the skin. B) Repeatability of the VMG signal: For successive recordings, compared with precision (%C.O.V and L.O.A) and reliability (I.C.C), correlation (r value) of the VMG signal appears a much stronger and a more consistent statistic in the time and frequency domains. C) Physiological Characteristics: Although having a high individual variation, the erector spinae demonstrated a strong curvilinear relationship with increasing submaximal voluntary contraction (%MVC) reflecting the recruitment and rate coding strategies for this muscle. The VMG RMS for symptomatic low back pain subjects was considerably less than asymptomatic subjects suggesting a deficiency in muscle function. In contrast, the PSD was less favourable in distinguishing between the two subject groups. Reasons for these findings are discussed.
In future, the clinical application of the VMG RMS values may quantitatively assess paraspinal muscle force reflecting physiological changes in recruitment and rate coding strategies in ‘normal’ and ‘abnormal’ muscle function during rehabilitative care.

Grant Value: $1975
Chief Investigator: Dr Sharyn Eaton
Status: Complete

Publications:

• University of Southampton, School of Engineering Sciences, 1999, Doctoral Thesis, 280pp
  Eaton, Sharyn. The technical and physiological characteristics of the vibromyographic signal

Two case studies to describe and compare the practise and explanatory models used in chiropractic care within culturally diverse societies are proposed. This qualitative study seeks to describe how practitioners and patients interact to construct clinical reality and explore how this reality influences patient compliance and informed consent.  It also seeks to understand how chiropractors cope with diagnostic and therapeutic uncertainty in the clinical encounter.  In order to discriminate between socio-cultural determinants and behaviours characteristic of chiropractic practice, two culturally diverse case studies will be undertaken and compared.

Purposeful sampling, using a maximum variation strategy, will be undertaken and data will be collected by audiotaping consultations , in depth practitioner interviews and patient questionnaires or semi-structured interviews. Content and thematic analysis will be undertaken.

Grant Value: $12,357
Chief Investigator: Dr Jennifer Jamison – RMIT
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 21, Issue 5, June 1998, Pages 348-355
  Jamison JR. Informed Consent: an Australian Case study
• Chiropractic Journal of Australia, Volume 27, Issue 4, December 1997, Pages 147-152
  Jamison JR. Clinical Uncertainty: An Australian Case Study
• Chiropractic Journal of Australia, Volume 27, Issue 3, September 1997, Pages 111-116
  Jamison JR. Compliance or empowerment: An Australian Case Study
• Chiropractic Technique, Volume 10, Issue 4, November 1998, Pages 143-149
  Jamison JR. The chiropractic adjustment: A case study of chiropractor explanations and patient understanding

Objective: It has been proposed that Doppler velocimetry, which is noninvasive, quick, and relatively inexpensive, should be used when the screening vertebral arteries before manipulation to reduce the risk of cervical manipulation-related injury to these vessels. The objective of this analysis of the literature is to study the evidence of the suitability of Doppler velocimetry for this purpose.

Data Selection: Studies were examined that dealt with the incidence of stroke after manipulation, the proposed mechanisms for this clinical entity, the validity of the provocational tests that have been used in screening before manipulation, the validity and reliability of Doppler velocimetry of vertebral arteries, and the biomechanics of vertebral arteries.

Results: There is a suspicion of increased risk for vertebrobasilar stroke for vertebral arteries that have markedly reduced patency in the neutral position and/or stenosis during cervical rotation. There is evidence that provocational tests lack validity and that Doppler velocimetry is valid in assessing the patency of vertebral arteries in the neutral position and during cervical rotation. Interexaminer reliability of the Doppler technique has been shown to be high. Doppler ultrasound screening also seems to be able to provide an indirect assessment of the mechanical stresses to the artery during cervical movements.

Conclusion: There is strong evidence to suggest that Doppler velocimetry should be included in the screening of vertebral arteries before manipulation.

Grant Value: $5,950
Chief Investigator: Dr Michael Haynes – High Wycombe Chiropractic Clinic
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 25, Issue 9, November 2002. Pages 556 – 567
  Michael J. Haynes, Vertebral arteries and cervical movement: Doppler ultrasound velocimetry for screening before manipulation,

Presentations:

• Chiropractic Association of Australia Seminar, September 1996. Western Australia, Australia

• University of Western Australia Department of Anatomy and Human Biology Postgraduate Student Expo, June 1996. Western Australia, Australia

Objectives: To determine if there is a relationship between the side of head rotation and the side of joint crack during “diversified” rotatory manipulation of the cervical spine.

Design: Randomised experimental study.

Setting: Macquarie University, Centre for Chiropractic, Summer Hill, New South Wales.

Subjects: Fifty asymptomatic subjects were recruited from the students and staff of the above college.

Intervention: Single, unilateral “diversified,” high velocity, low amplitude, rotatory thrust technique.

Main outcome measures: Joint crack sound wave analysis of digital audio tape (DAT) recordings, taken from two skin mounted microphones positioned on either side of the cervical spine.

Results:All 50 subjects exhibited at least one audible joint crack sound during manipulation. Forty-seven subjects (94%) exhibited cracking on the ipsilateral side to head rotation (95% confidence interval, 83.5% to 98.7%). One subject exhibited joint cracking on the contralateral side only, while two subjects exhibited bilateral joint crack sounds. There was a statistically significant lower rate of exclusively ipsilateral joint cracking in subjects with a history of neck trauma (80% vs. 100%, p = .023).

Conclusions: This research suggests that during the “diversified” rotatory manipulation of the cervical spine utilized in this study, there is a higher occurrence of the joint crack on the ipsilateral side to head rotation.

Grant Value: $11,343
Chief Investigator: Dr John Reggars – Monash University
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 18, Issue 2, February 1995, Pages 65-71.
  Reggars JW, Pollard HP. Analysis of zygapophyseal joint cracking during chiropractic manipulation. 
• Australasian Chiropractic and Osteopathy, Volume 5, Issue 2. July 1996. Pages 39-44
  Reggars JW. The manipulative crack. Frequency analysis.

Research Update:

• Final Report, January 1994
  Reggars J, Pollard H, Analysis of Zygapophyseal Joint Cracking During Chiropractic Manipulation

Objective: To identify the main characteristics of classic migraine, with specific regard to diagnostic criteria for manual therapy practitioners, including chiropractors and osteopaths.

Grant Value: $1500
Chief Investigator: Dr Peter Tuchin – Macquaire University
Status: Complete

Publications:

• Australasian Chiropractic and Osteopathy Volume 5, Issue 3, November 1996. Pages 66-74
  Tuchin PJ, Bonello R. Classic migraine or not classic migraine. That is the question. 
• Australasian Chiropractic and Osteopathy Volume 5, Issue 2, July 1996. Pages 47-52
  Tuchin PJ, Brookes MJ, Swaffer T. A case study of chronic headaches. 
  

The objective of this study was to evaluate the cost-effectiveness of a spinal care lecture in reducing the number of spinal injury and associated costs in the workplace. A lecture was designed following a workplace inspection to assess the most likely risk factors for injury, to increase employees’ awareness of back injury and how it might be avoided. Volunteer subjects, all from the same company, were randomly assigned to a study group (n = 34) and a central group (n = 27). The remaining employees (n = 60) formed a non-intervention (baseline) comparison group. The number and severity of injuries for both groups were monitored over a six-month period prior to and following the lecture. In addition, Oswestry pain and disability questionnaires were collected prior to the lecture and at the six-month follow-up period. The cost of reported back injuries decreased by 57% in the first three months for the educated group when compared to pre-intervention levels. At the six-month follow up, the cost of back injuries remained 40% lower than previous levels.

Grant Value: $1500
Chief Investigator: Dr Peter Tuchin – Macquaire University
Status: Complete

Publications:

• Journal of Occupational Health and Safety – Australia and New Zealand, Volume 14, Issue 1 February 1998. Pages 43-51
  Tuchin, P., & Pollard, H. (1998). The cost-effectiveness of spinal care education as a preventive strategy for spinal injury. 
• Journal of the Chiropractic and Osteopathic college of Australasia, Volume 7, Issue 1, March 1998. Pages 8-14
  Tuchin PJ. Spinal care education as a preventative strategy for occupational health and safety: A New Role for Chiropractors. 
  

Objective:This study proposes an interactionist model of chiropractic care, uses practice observation to ascertain whether this framework is compatible with clinical reality and explores a novel explanation of how chiropractic clinical communication may contribute to healing.

Design:A constructivist inquiry paradigm based upon purposive sampling, grounded theory, inductive analysis and contextual interpretation was used. The compatibility of chiropractic clinical reality with an evolving interactionist model was ascertained through reflection on contemporary literature and practice observation of 208 consultations undertaken by 34 chiropractors working in geographically dispersed areas of Australia. Sample selection used a maximum variation strategy. Triangulation of data collected was undertaken by mailing the clinical communication scenario constructed by the investigator to participating chiropractors for comment and by having 144 patients complete a questionnaire.

Results:Interaction observed in chiropractic practice is bidirectional, is both task- and relationship-oriented, and seems to be verbal and nonverbal in nature. Touch, whether diagnostic or therapeutic, emerged as a fundamental feature of chiropractic care.

Conclusion: Verbal and nonverbal communication in chiropractic practice, when analysed within a interactionist framework, can be construed to create an environment conducive to healing by establishing a shared clinical reality. The ability of the consultation to change perceptions and reduce anxiety is presented as a substantial factor contributing to the potency of the chiropractic care. The interactionist model proposed for chiropractic care was found to provide a useful framework for reconceptualizing chiropractic clinical practice. By providing an additional perspective of chiropractic practice, this model enhances discourse on the variables contributing to the success of chiropractic care.

Grant Value: $9,000
Chief Investigator: Dr Jennifer Jamison – RMIT
Status: Complete

• Chiropractic Journal of Australia, Volume 26, Issue 3, September 1996 Pages 94 – 99
  Jamison JR, The Chiropractic Consultation: establishing a therapeutic alliance.
• Chiropractic Journal of Australia, Volume 26, Issue 4, December 1996, Pages 118 – 124
  Jamison JR, Tools for Refining patient centred care:a consideration of LOC and SOC in the chiropractic consultation.
• Journal of Manipulative and Physiological Therapeutics, Volume 20, Issue 6, July 1997, Pages 382 – 388
  Jamison JR, An interactive model of chiropractic practice: reconstructing clinical reality.
• Journal of Manipulative and Physiological Therapeutics, Volume 20, Issue 6, July 1997, Pages 382 – 388
  Jamison JR, The Chiropractic Consultation: a stressful experience?
• Chiropractic Technique, Volume 9, Issue 3, August 1997, Pages 115 – 119
  Jamison JR, The Chiropractic practice model: an observational study

The Purpose of this Study was to investigate whether a manipulation to the L3/4 motion segment of healthy individuals would affect the strength of the quadriceps muscle tested postmanipulation. Fifteen consenting experimental subjects received a lumbar roll manipulation and 15 nonexperimental subjects underwent a simulated manipulation in the lumbar roll position. After these procedures, all subjects were required to perform a unilateral isometric maximal contraction of the quadriceps femoris after 60 sec. This was achieved using a force transducer to provide a digital measurement of the force of contraction of the quadriceps femoris.

The study found that in an asymptomatic student population receiving a manipulation to the L3/4 motion segment, an overall statistically significant short-term increase in quadriceps femoris muscle strength was observed. This establishes a relationship between the short-term effects of a manipulation and the modulation of muscle strength, and supports anecdotal claims. Discussion is undertaken to describe further studies that can be performed to provide information on the way in which this relationship could possibly benefit sporting populations and rehabilitation therapists.

Grant Value: $1,240
Chief Investigator: Dr Henry Pollard – Macquarie University
Status: Complete

Publications

• Journal of the Neuromuscular Skeletal System, Volume 4, Issue 4, December 1996, Pages 137-144
  Pollard, H., & Ward, G. (1996). Strength change of quadriceps femoris following a single manipulation of the L3/4 vertebral motion segment: A preliminary investigation.

Objective: To examine the relationship between bed hardness and muscle activity during sleep.

Design: All subjects sleep on mattresses of varying hardness. Mattress hardness is determined by the Australian Spinal Research Foundation rating protocol on a one to five scale. The beds used are designated as soft, medium and firm. Each subject will sleep three nights on each of the three beds. Following an acclimatisation period, electromyographic readings will be taken throughout sleep.

Setting: A sleep laboratory developed by the authors at Macquarie University.

Subjects: Young healthy subjects, age 18 to 45 will be used in this study.

Main Outcome Measures: Electrical activity will be measured by a Medelec Sapphire Premiere EMG computerised system. Total electrical activity will be compared between subjects. Additionally, an index of  rest-fullness be reported on showing the frequency of movement occurring during sleep.

Grant Value: $15,000
Chief Investigator: Dr Henry Pollard – Macquarie University
Status: Complete

Researcher updates:

Final project summary September 1996
Summary of aims

• To establish a methodology for the assessment of motor activity of neck and back muscles during sleep on beds of various hardness levels.
• To examine the relationship between bed hardness and muscle activity during rest on beds of different hardness.
• To identify key factors for clinicians to better advise patients on their bedding

Findings / Outcomes

The initial pilot data collection indicated a high likelihood that significant differences in motor activity could be elicited and measured.

Three mattresses were employed; rated I (very soft), 3 (medium hardness), and 5(very hard). Real time surface EMG traces derived from cervical, upper and lower thoracic, and lumbar paravertebral muscles showed clearly visible differences between mattress types.

Integrating the function of the rectified traces gave area under the curve calculations for level of action potentials generated in each of the muscle groups on the three different mattresses. Statistically significant differences were found at the p < 0.05 level between the mattresses rated I and 5, and between the mattresses rated 3 and 5.

This study shows clearly that motor activity in sleeping subjects is significantly greater on harder mattresses. This relates directly to the level of work performed by these muscle groups, and may also be related to fatiguability.

Implications may be –

• Patients with muscle tension disorders such as tension headache or spasticity may be better suited to soft mattresses.
• Osteoporosis sufferers may benefit from higher levels of muscle tension during sleep as a strategy to maintain electrical stimulus to muscles and physical tension on ligaments and bones, potentially helping to prevent progressive bone loss during sleep
• Those patients undergoing certain motor strength rehabilitation programs may be best advised to sleep on harder mattresses.

Researcher update – January 1996
Pilot findings

1. Significant levels of muscle activity do exist in sleep. Iu this contextthe word significant is qual For different individuals the level of significance will vary.
2. Beds of different hardness cause different levels of motor activity in the same Importantly, initial findings do show a relationship between mattress hardness and motor activity. The implications of this finding will be discussed below.
3. Beds of different hardness probably have significantly different effects on different in different subjects. Sec below
4. The rate of tossing and turning may be related to mattress hardness. By this is meant that our findings show initial evidence of the different mattress hardnesses having an effect on the degree of tossing and turning when all other factors are controlled. This represents, probably, the first evidence of one bed type being genuinely more ‘restful’ than another.

Implications of findings
 A number of important implications can already be drawn from the findings. Some of these implications have promotional and commercial potential.                                                                                    •

1. For a number of people the choice of bed type may be an important health consideration.
2. The hardness of a bed may be a vital factor in the rehabilitation of patients or the management of certain health problems. Arthritis and osteoporosis are two very commonly occurring conditions for which careful selection of mattress hardness may be an important.
3. Mattress hardness considerations may be important in terms of preventative health care strategies. Additionally, mattress choice in child bedding may take on a new significance never before realised.
4. Individuals with special needs, such as those who suffer chronic fatigue syndrome, or for others who may have a greater need than the average for a more restful sleep may also benefit from judicious advice on bedding factors.
5. Specialist markets , such as nursing home and hospital settings should also be interested in the findings.

Conclusion
Some very encouraging and surprising results have already come to light in this project.

The frustrations normally associated with new areas of research have once again been encountered and now surmounted.

Very useful data has already arisen and begins to show sign of consistency so that statistically significant quantities are being defined.

It is arguable that very important findings have arisen which may bring new importance to bedding choice decisions for a great many people.

Purpose: To determine the most commonly used diagnostic methods for detecting the spinal entity that chiropractors adjust/manipulate and the preferred term for describing this entity.

Design: Postal survey (self-completed questionnaire).

Setting: Victoria, Australia.

Participants: All 554 chiropractors registered May 30, 1994, with the Chiropractors and Osteopaths Registration Board of Victoria.

Main outcome measures: Frequency of use and opinion with respect to reliability of 16 specific methods, measured on a 7-point, Likert-type scale [never used (1) to always used (7) and very unreliable (1) to very reliable (7), respectively]; the respondent’s preferred term for describing the spinal entity that chiropractors adjust/manipulate.

Results: The response rate was 85%. The most commonly used method was static palpation (mean score 6.6 +/- 1.1). Seven other methods, including pain description of the patient, orthopedic tests, motion palpation, visual posture analysis, leg length discrepancy, neurological tests and plain static X-rays had mean scores greater than 4.0. All of these methods, as well as functional X-ray views and kinesiological muscle testing, were considered reliable, with mean reliability scores greater than 4.0. Motion palpation was regarded as the most reliable method (mean reliability score 5.9 +/- 1.2). Seventy-five different terms for describing the spinal entity were named by 440 respondents. “Subluxation” was included in the preferred term of 294 respondents (67%), 46 included “dysfunction” (11%), 35 included “fixation” (8%) and 20 included “manipulable” (4.5%).

Conclusion: Chiropractors commonly use a variety of methods to identify the spinal entity that they manipulate. There is no consensus as to the preferred term for describing this entity.

Grant Value: $ 4,345
Chief Investigator: Dr Bruce Walker – Monash University
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 20, Issue 9, November 1997, Page 583 – 589
  Walker BF, Buchbinder R. Most commonly used methods of detecting spinal subluxation and the preferred term for its description: a survey of chiropractors in Victoria, Australia.
  

Researcher Final Report:

• Research report June 1995
  Walker B, Methods of detecting chiropractic subluxation: the opinion of Victorian Chiropractors. 

The history of chiropractic in Australia is traced from the first grateful patient who also attended a course of instruction at the Palmer School and Infirmary of Chiropractic under D.D. Palmer and B.J. Palmer and brought chiropractic to Australia. The influence of Henry Otterholt–a U.S.-born Palmer graduate who was recruited by an untrained manipulator to take over his practice in order to study chiropractic at Palmer–on the early development of chiropractic in Australia and New Zealand is noted. He actively recruited students to the Palmer school, who upon graduation not only spread chiropractic in New Zealand, but also in the various states of Australia. The first twenty years saw the establishment of chiropractic practices in the capital cities of most states, but it would take more years before chiropractic was established in the capital cities. By this time country circuits had been established to serve patients in provincial centers. The advent of World War II brought further development to a standstill. This early period saw the emergence of the first group of what is considered today as the second stream in chiropractic in Australia, practitioners who would later be registered as chiropractors in the various Australian jurisdictions under grandfather clauses.

Grant Value: $1,200
Chief Investigator: Dr Rolf Peters
Status: Complete

Publications:

• Chiropractic History, Volume 16, Issue 1, June 1996. Pages 29-38
  Peters RE, Chance MA. Chiropractic in Australia: the first forty years (1905-1945).
• Chiropractic : an illustrated history / Dennis Peterson, Glenda Wiese. 1995 St. Louis : Mosby.  Chapter 16
  Chiropractic Around the World Herbert J. Vear, Pierre Louis Gaucher-Peslherbe, Rolf Peters, Mary-Ann Chance and Glenda Wiese, 

Objectives: To (i) measure lumbar intervertebral motion patterns produced during low force, high frequency posteroanterior (PA) thrusts applied to adjacent thoracolumbar spinal segments; (ii) determine the dependence of PA stiffness and impedance characteristics of the thoracolumbar spine on loading frequency; and (iii) ascertain the feasibility of using PA stiffness or impedance to characterize the in vivo mechanical response of the spine during spinal manipulation.

Setting: Hospital in Gothenburg, Sweden.

Subjects: Three subjects–one normal (male), one patient diagnosed with L4-5 degenerative disk disease (female), and one patient diagnosed with L5 retrospondylolisthesis (male).

Interventions: Intervertebral motion device (IMD) attached to pins inserted into the L3-4 or L4-5 spinous processes. Four repeated PA impulses were delivered to each of the spinous processes (T11-L3) using an Activator Adjusting Instrument with a force-acceleration measurement system.

Outcome measures: Peak-to-peak intervertebral axial displacement, PA shear displacement and flexion-extension (FE) rotation were obtained using the IMD. Thoracolumbar PA impedance (force/velocity) vs. frequency histories and peak PA dynamic stiffness (impedance x frequency) were determined from the force-acceleration measurements. Averages and standard deviations of these measures were calculated from the repeated interventions performed at each level.

Main results: For the normal subject, the AAI PA impulses applied to the L2 spinous process (72 +/- 9 N) produced a 1.62 +/- 1.06 mm peak-to-peak intervertebral axial displacement, 0.48 +/- 0.1 mm PA shear displacement, and 0.89 +/- 0.49 degrees FE rotation at the L3-4 spinal segment. The amplitude of the lumbar intervertebral motion in the normal subject’s spine decreased approximately sixfold when the AAI impulses were delivered further from the IMD measurement site. In both patients the axial, PA shear and FE lumbar intervertebral motions were of the same magnitude, but showed less variability than the normal subject as the AAI impulses were delivered closer to the IMD measurement site. The normal thoracolumbar spine exhibited a maximum dynamic PA impedance at a frequency of approximately 100-150 Hz, resulting in a peak PA stiffness ranging from 62 KN/m (L2 segment) to 124 KN/m (T11 segment). Thoracolumbar PA stiffness values tended to be higher for the patient with a severely degenerated disk (85-362 KN/m), whereas the patient with retrospondylolisthesis had a lower PA stiffness (32-96 KN/m).

Conclusions: In vivo kinematic measurements of the normal and pathologic human lumbar spine indicate that low force, PA impulses produce measurable segmental motions and reinforce the notion that mechanical processes play an important role in spinal manipulation and mobilisation. Calculations of the peak dynamic stiffness derived from impedance vs. frequency measurements indicate that the dynamic stiffness of the thoracolumbar spine is considerably greater than previously reported stiffness values obtained using static and quasistatic manipulation and mobilization procedures. Computations of spinal input impedance are relatively simple to perform, can provide a noninvasive measure of the dynamic mechanical behavior of the spine, appear to have potential to discriminate pathologic changes to the spine, and warrant further study on a larger sample of normals and patients. Ultimately, chiropractic clinicians may be able to use low force, impact type spinal manipulation, together with dynamic impedance analysis procedures, to quantify the mechanical response of the normal and abnormal spine, to perform spinal diagnosis and subsequently to prescribe therapeutic treatment to patients.

Grant Value: $1,200
Chief Investigator: Dr Tony Scott Keller – University of Vermont
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 17, Issue 7, September 1994. Pages 431 – 441
  Nathan M, Keller TS. Measurement and analysis of the in vivo posteroanterior impulse response of the human thoracolumbar spine: a feasibility study.

Presentations:

• International conference on Spinal Manipulation, June 1994. Palm Springs, USA
  Nathan M, Keller TS., Lehneman JB., The dynamic response of the human spine to low amplitude high velocity posteroanterior thrusts.

Objective: To determine the prevalence of indigestion and mid-back pain in persons seeking chiropractic care.

Design: A cross-sectional survey using a self-report questionnaire.

Setting: Three primary care private chiropractic practices in metropolitan Perth, Australia.

Subjects: Persons seeking chiropractic care during a 1-month period.

Intervention: None.

Outcome measures: Six-month prevalence of indigestion and mid-back pain, rate of association between indigestion and mid-back pain, and distribution of thoracic dysfunction and manipulation. Proportion who report relief from manipulation.

Observations: Of 1567 persons who consulted 8 chiropractors on 2974 occasions during November 1994, 1494 responses were obtained. There were 119 first-time consultations. The mean age of respondents was 41 yr (range 10-94); 57% were women. Fifty-seven percent reported indigestion infrequently or more and 71% reported mid-back pain during the previous 6 months. Forty-six percent experienced both symptoms during this time. Of these, 36% reported the symptoms together at some time. Twenty-two percent of those with indigestion reported some relief after chiropractic care. Compared with those reporting no relief, mid-back pain was more common among those reporting indigestion. The level at which the manipulation was given was unrelated to relief. No major differences were noted between the three clinics in patient demographics or the main outcome measures.

Conclusions: Indigestion and mid-back pain are commonly experienced in this population. A person with indigestion is more likely to report mid-back pain. Relief of indigestion by manipulation is more common among those who report mid-back pain. Further research is needed to understand differences between subgroups and differences compared with other studies.

Grant Value: $908
Chief Investigator: Dr Peter Bryner – RMIT
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 19, Issue 5, June 1996, Pages 317-23.
  Bryner P, Staerker PG. Indigestion and heartburn: a descriptive study of prevalence in persons seeking care from chiropractors. 

Awards:

• Chiropractic Centennial Foundation Research Committee, Second Prize, 1995
  Bryner P, Indigestion and Heartburn
  

Objective: As part of a randomised clinical trial to determine the efficacy of chiropractic therapy on premenstrual syndrome (PMS), subjects were evaluated for initial underlying spinal dysfunction.

Subjects: Fifty-four subjects with diagnosed PMS (using a Moos PMS questionnaire plus daily symptom monitoring) and 30 subjects with no diagnosable PMS were recruited by newspaper advertising and referrals.

Design: All subjects underwent a full history and physical and chiropractic examination carried out by 1 of 2 fully qualified and registered chiropractors, each with a minimum of 10 years experience. The results of the assessment for the PMS group were compared with those of the non-PMS group.

Setting: RMIT teaching clinics.

Data Analysis: The data collected were entered into a spread sheet and contigency tables were created. The data were analysed by use of chi-squared tests, with the statistical significance being set at P < .05.

Results: The PMS group had a higher percentage of positive responses for each of 12 measured spinal dysfunction indexes except for range of motion of the low back. The indexes where the increase was statistically significant (P < .05) were cervical, thoracic, and low back tenderness, low back orthopedic testing, low back muscle weakness, and the neck disability index. An average of 5.4 of the 12 indexes were positive for the PMS group compared with 3.0 for the non-PMS group. Conclusions: A relatively high incidence of spinal dysfunction exists in PMS sufferers compared with a comparable group of non-PMS sufferers. This is suggestive that spinal dysfunction could be a causative factor in PMS and that chiropractic manipulative therapy may offer an alternative therapeutic approach for PMS sufferers.

Grant Value: $32,566
Chief Investigator: Dr Max Walsh – RMIT
Status: Complete

Publications:

• Journal of Manipulative and Physiological Therapeutics, Volume 22, Issue 4, May 1999, pages 216 – 220
  Walsh MJ, Polus BI(1999) The incidence of spinal dysfunction in a sample of premenstrual syndrome sufferers. 
• Journal of Manipulative and Physiological Therapeutics, Volume 22, Issue 9, November 1999, pages 582 – 585
  Walsh MJ, Polus BI (1999) A randomised placebo controlled clinical trial on the efficacy of chiropractic therapy on premenstrual syndrome. 
• Chiropractic Journal of Australia, Volume 24, 4, December 1994, Pages 122-126
  Walsh MJ, Chandrara JS, Polus BI, The efficacy of chiropractic theory on premenstrual syndrome: A case study
• Chiropractic Journal of Australia, Volume 23, 2, June 1993, Pages 48-53
  Walsh MJ, Premenstrual Syndrome: A clinical update for the chiropractor

Posters:

• Chiropractors Association of Australia National Conference, September 1998. Melbourne, Australia
  Walsh MJ (1998) A randomised placebo controlled cross-over clinical trial on the efficacy of chiropractic manipulative therapy on premenstrual syndrome.
  
• International Conference on Spinal Manipulation, July 1998. Vancouver, Canada.
  Walsh MJ, Polus BI. (1998) A randomised placebo controlled cross-over clinical trial on the efficacy of chiropractic manipulative therapy on premenstrual syndrome.
• International Conference on Spinal Manipulation, October 1996. Bournemouth, United Kingdom.
  Walsh MJ. (1996) The incidence of spinal dysfunction in a sample of premenstrual syndrome sufferers.
  

Presentations:

• Californian Chiropractic Foundation’s 7th Annual Conference on Research and Education, June 1992. Palm Springs, California, USA.
  Walsh MJ. The efficacy of chiropractic treatment on premenstrual syndrome.

Summary of aim(s):

To demonstrate the terminal afferents from the thoracic spine, particularly from TI to T4 intra articular tissues.

To demonstrate the types of different afferent projections, from a typical thoracic spinal joint.

To demonstrate the distribution of those afferents within the Rexed laminae.

Findings / Outcomes:
A study was undertaken to investigate the distribution of those somatic afferent fibres directly associated with a spinal zygapophyseal joint (Thoracic joints Tl to T4). It elucidated the location of the central projections within the central nervous system of those neurons that are likely to produce direct input from mechanosensitive and noxious nerves innervating the vertebral column. By comparing this information with an understanding of the Rexed laminae to provide some insight into the anatomical distribution of the synaptic terminals in the spine, it was found that terminal labelings were observed within laminae I, II and III of the dorsal horn. This preliminary data suggests that the joint proper (left T2/3 zygapohyseal joints) has led to terminal labelings in lamina I, II and III of the dorsal horn. The potential benefits was to describe the anatomical wirings that may exist between spinal joints and spinal cord.

Grant Value: $18,346
Chief Investigator: Dr Ray Hayek
Status: Complete

Presentations:

• Chiropractors Association of Australia, National Annual Conference, September 1995, Melbourne, Australia
  Hayek, R ‘Central Projections of Afferents Innervating Thoracic Joints’

Publications:

• Journal of Neuroscience, 1996
  Hayek, R ‘Central Projections of Afferents Innervating Thoracic Joints’