CCRF Initiatives

Systemic inflammatory biomarkers and brain functional connectivity: Identifying a neuroinflammatory signature in patients with idiopathic chronic neck pain

Award: $25,000

Lead: Dr. Felipe Duarte, Canadian Memorial Chiropractic College

Impact: This study expands Dr. Duarte’s previously approved Functional magnetic resonance imaging (fMRI) project by adding a control group and blood inflammatory biomarker analysis which will evaluate the relationship between peripheral inflammatory biomarkers, brain functional connectivity, and clinical outcomes across all groups.

Developing the first evidence-based operationalization of pain-related suffering: A foundational step to targeting the reduction of suffering among people living with pain

Award: $25,000

Lead: Dr. Peter Stilwell, School of Physical & Occupational Therapy – The Royal Institution for the Advancement of Learning/McGill University

Impact: Building on previous work, Dr. Stilwell seeks to fill an important gap by determining the first evidence-based definition of pain-related suffering. His multi-disciplinary team will combine qualitative, quantitative and knowledge transfer methodologies to help clinicians better understand how patients are affected by this experience.

Measurement of spinal mobilization biomechanical parameters in the preschool pediatric population

Award: $13,000

Lead(s): Dr. Isabelle Pagé & Dr. Chantal Doucet, Université du Québec à Trois-Rivières

Impact: This ground-breaking study will measure the biomechanics of Spinal manipulation (SM) and mobilization (MOB) in children under 5 years of age using a pressure sensing glove system known as TekscanTM. The goal is to improve safety, explore the underlying mechanisms of MSK disorders and provide important clinical data to improve the training of chiropractic students.

Using ICF linking rules to catalogue characteristics of older adults with low back pain related disability

Award: $12,000

Lead: Aleisha Adeboyejo, University of Ontario Institute of Technology/Canadian Memorial Chiropractic College

Impact:    This is the first study to link epidemiological and qualitative research of older adults with low back pain to the WHO’s ICF framework, which measures health and disability. This will assist chiropractors in the evaluation and management of their patients, improve comparison of global data across health disciplines and communication between health care workers, researchers, and other stakeholders.

Practitioners’ Beliefs, Experiences, and Perceptions of Cultural Health Disparities in the Delivery of Chiropractic and Physiotherapy Services in Canada: A Qualitative Study

Award: $10,500

Lead(s): Dr. Nora Bakaa & Luciana Macedo, McMaster University

Impact: Equitable delivery of rehabilitation services and improved access to care will improve health outcomes for all Canadians. This project will examine the unique challenges faced by Canadian chiropractors and physiotherapists with respect to care delivery. Using data from a large-scale crosssectional survey that assessed diversity and cultural competency important and current social disparities within the Canadian health care system will be identified.

Identifying spine care needs, and perceived barriers to accessing evidence-based spine care in northern Manitoba: A Global Spine Care Initiative implementation project

Award: $45,000

Lead(s): André Bussières/Dr. Steven Passmore, Université du Québec à Trois- Rivières (UQTR)

Impact:  Pimicikamak, Manitoba (Cross Lake First Nation) has a largely indigenous population with underserved spine care needs. This project will determine the nature and impact of spinal disorders in the community and identify factors that may impact the community’s ability to adopt healthcare approaches intended to improve the health of its residents.

The development of a global tracer indicator to measure effective coverage for rehabilitation of low back pain

Award: $29,800

Lead: Dr. Jessica Wong/Dr. Pierre Côté, University of Ontario Institute of Technology (UOIT).

Impact:   In partnership with the WHO, this project will develop a much-needed metric for the rehabilitation of LBP from health care providers, including chiropractors. It will be used in high-impact global studies (like the Global Burden of Disease Study) to advance the goal for all people to receive high-quality services and rehabilitation for optimal health and function. This is the first research project of its kind led by university-based chiropractors in Canada.

Adaptation of chiropractic care in the aging population: exploration of the views and beliefs of chiropractors

Award: $15,200

Lead: Dr. Isabelle Pagé/Dr. Julie-Marthe Grenier, Université du Québec à Trois-Rivières (UQTR)

Impact: This project will explore chiropractors’ perspectives on the clinical management, safety and effectiveness of chiropractic care for our aging population. This will be followed by subsequent studies to evaluate whether their beliefs are supported by evidence and whether other aspects should be considered. The CCRF would like to acknowledge the dedication of our Research Committee and thank the Canadian Chiropractic Association, our Provincial Association partners, and individual donors for their generous financial support.

Does the use of Paramedical health services influence the care trajectory of patients with chronic spinal pain?

Award: $12,060

Lead: Dr. Marc-André Blanchette, Université du Québec à Trois-Rivières (UQTR)

Impact:    This project will provide valuable information for clinicians to improve care for chronic spinal pain patients; for professional colleges/associations to improve practice Guidelines; and for decision-makers who need evidence to help determine the optimal use of paramedical healthcare.

Lived Experiences with Symptomatic Degenerative Cervical Radiculopathy: The Patients’ Perspectives

Award: $5,000

Lead: Dr. Joshua Plener, Canadian Memorial Chiropractic College (CMCC)

Impact: DCR is expected to increase in prevalence as our population ages. Understanding its biopsychosocial impact will improve patient-centered care and develop effective non-operative interventions which can be used in interdisciplinary healthcare settings. It will also inform future studies and lead to the development of a high-quality, evidence-based intervention protocol.

Neuroimaging in Patients with Chronic Neck Pain

Award: $63,000

Lead: Dr. Felipe Duarte, Canadian Memorial Chiropractic College

Impact:  To track neuroplastic effects of a single cervical spinal manipulation – and SMT applied over time – on functional connectivity in the brains of patients with chronic neck pain. This is the first FMRI study of its kind on the cervical spine. It will provide important data needed to fill gaps in current knowledge. It’s also the first study that will measure both short and long-term effects of SMT on brain function and how these neuroplastic effects might change over time.

Understanding health care utilization for Musculoskeletal disorders and disability in Canada: A population-based perspective 

Award: $59,548

Lead: Dr. Pierre Côté, Faculty of Health Sciences, Ontario Tech University (OTU), and Centre for Disability Prevention and Rehabilitation at OTU and Canadian Memorial Chiropractic College

Impact:   This project will fill a knowledge gap and provide essential data to the national and provincial chiropractic associations to inform policy development.

Findings will also:

• Inform governments and payers about the health care needs of Canadians with musculoskeletal disorders and disabilities.
• Determine which health care providers Canadians consult to manage musculoskeletal pain.
• Describe the characteristics of Canadians who consult different types of health providers for musculoskeletal disorders and disability.

What is the effect of chiropractic or physiotherapy on medical health utilization and costs in adults with low back pain?
A population-based matched cohort study

Award: $47,000

Lead: Dr. Jessica Wong, Doctoral Candidate, Epidemiology Division, Dalla Lana School of Public Health, University of Toronto

Impact:  This is the first study to assess the effects of chiropractic and physiotherapy on medical care utilization costs in Canada. This research leverages novel data that captures all medical encounters and direct person-level costs over a 15-year period in a population-based sample of  Ontario adults with back pain.

The Association of Chiropractic Integration with Opioid Use for Chronic Non-Cancer Pain in an Ontario Health Care Centre: A Mixed Methods Study

Award: $44,000

Lead: Dr. Peter Emary, McMaster University, Departments of Health Research Methodology; Michael J. DeGroote Institute for Pain Research and Care

Impact: To examine the relationship between chiropractic integration and opioid use among vulnerable patients in a Community Health Clinic (CHC). This study directly addresses one of the country’s most pressing public health crises – opioid addiction. It’s the first study of its kind to track whether the receipt of chiropractic services can reduce opioid use reduction among patients already using prescription opioids. It also seeks to identify improvements in quality of life and other qualitative areas that may prove unique to chiropractic intervention and help validate outcomes seen in practice.

The role of sensitization and sensorimotor integration in understanding the biological basis of Chiropractic

Award: $26,600

Lead: Nicolas Antony, Ontario Tech University

Impact:  This study seeks to advance effective treatment strategies by evaluating neurophysiologic mechanisms of motor control during central sensitization states and chronic neck pain. This involves determining the neurophysiological effects of central sensitization (CS), on motor control/sensorimotor integration and identifying whether spinal manipulative therapy can play a role in normalizing sensorimotor integration in central sensitization states.

Tracking the impact of clinical care among patients with chronic lower back pain: the utility of performance-based measures of physical function and impairment

Award: $16,000

Lead: Sheila Hogg-Johnson, Canadian Memorial Chiropractic College

Impact: The goal of this study is to determine whether patient assessments can be improved by adding function tests to questionnaires and to see if changes perceived by patients are supported by functional changes. This will help chiropractors assess patients more effectively and improve patient satisfaction. This team includes high-level female investigators and is an international (Danish) collaboration.