Supporting Clinical Chiropractic Research
On behalf of our members, we support multiple clinical chiropractic and related research studies to elevate patient care and advance understanding of the chiropractic profession.
We invest directly and indirectly in important chiropractic clinical research studies, as well as provide support through subscriptions, promotion and collaboration with leading chiropractic research entities:
- The OCA Board of Directors Research Committee
- Canadian Chiropractic Research Foundation (CCRF)
- Knowledge Translation Organizations
- RRS Education
- Canadian Chiropractic Guideline Initiative (CCGI)
- Canadian Memorial Chiropractic College (CMCC) Research
- Relevant third-party initiatives
In the Human Performance Lab at the Canadian Memorial Chiropractic College (CMCC), Dr. Samuel (Sam) Howarth works with a patient. (Photo: CMCC)
OCA Board of Directors Research Committee
Our OCA Board Research Committee reviews and funds chiropractic-related studies involving researchers that advance understanding clinical practice and patient care. The committee accepts and reviews submissions, then awards research funding to select studies that will evolve patient care and advance understanding of the chiropractic profession.
We review and provide direct funding to support chiropractic clinical studies that the committee selects.
Current Clinical Chiropractic Research Projects:
The role of central sensitization and neurogenic inflammation in the pathophysiology of chronic myofascial pain
Lead: Dr. John Srbely, DC, PhD, Associate Professor, University of Guelph
His research program adopts a broad and integrative approach to the study of chronic musculoskeletal pain, incorporating both basic and clinical sciences. A major arm to his research program is investigating the underlying pathophysiologic mechanisms using both animal and human models. His research also aims to advance reliable diagnostic criteria (imaging, biomarkers) and physical assessment techniques (quantitative sensory testing, electromyography) that enable effective and reliable treatment and management strategies. By emphasizing transdisciplinary and multi-institutional collaborations, his research program will continue to inform future clinical and experimental initiatives in the field of chronic musculoskeletal pain.
“Dr. Srbely knows what’s important to chiropractors in the field because he knows what chiropractors observe in practice. His research is looking at a problem that chiropractors see a lot of with their patients – trigger points. I think his research is really worth the profession getting behind. I think he’s going to answer some of the big questions.”
Background: Dr. Srbely’s research focuses on the study of the neurophysiologic phenomenon called ‘central sensitization,’ which is a neuradaptive state associated with chronic pain. He has a specific interest in the study of chronic pain and joint function associated with aging and chronic musculoskeletal (spine, muscle and joint) diseases, such as osteoarthritis, myofascial pain and fibromyalgia.
Through his research, Dr. Srbely aims to develop novel and/or enhance existing treatment approaches in clinical pain management (diagnosis and treatment), as well as musculoskeletal (spine, muscle and joint) biomechanics/pathomechanics associated with chronic disease and aging.
Study III Good life with osteoarthritis in Denmark: prevalence and outcomes of patients with co-occurring degenerative lumbar spinal stenosis, and hip and knee osteoarthritis
Lead: Dr. James J. Young, DC, MSc, PhD Research Fellow, University of Southern Denmark (USD) and Clinical Sciences Resident and Adjunct Professor, Canadian Memorial Chiropractic College (CMCC)
Background: Dr. Young is currently conducting research at SDU before his return to Ontario. He published Skou ST, Koes BW, Grønne DT, Young JJ, Roos EM.
Thesis Advisor: Dr. Carlo Ammendolia, DC, PhD, Assistant Professor, Institute of Health Policy, Management and Evaluation, Department of Surgery and the Institute of Medical Sciences, University of Toronto
Background: As Director of the Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases, at Mount Sinai Hospital, Dr. Ammendolia combines research, clinical practice and teaching. His specialty clinic treats about 70 to 100 patients every week and is a training facility for chiropractic and medical residents.
Dr. Ammendolia is actively engaged in clinical research studies of non-operative treatments for degenerative lumbar spinal stenosis, including this study, as well as ankylosing spondylitis and mechanical neck and back pain.
Executive Director: Robert Harris, CCRF
Chair: Dr. Chris Martin, DC
“Creating new knowledge is critical to improving patient care. The OCA is proud to support the CCRF as it works to discover the best, evidence–based care for patients living with spinal dysfunction and disease.”
The CCRF funds chiropractic research to discover the best evidence-based treatments for patients living with pain and disability, which is caused by spinal dysfunction and disease. Its national research priorities include:
On behalf of members, we invest in funding CCRF to support its Canadian-based research projects, which have a local, national and global impact.
Current Clinical Chiropractic Research Projects:
Our members’ investment currently supports the following evidence-based research projects (in descending order of the award amount). These projects are expected to advance the profession’s knowledge base and contribute to improved care for patients living with muscular, skeletal and nervous system pain.
Reducing wait times, opioid prescriptions and imaging rates for acute and chronic spine pain patients: A university-hospital based chiropractic clinic implementation project
Lead: Dr. Steven Passmore, University of Manitoba
Purpose: To understand potential barriers to managing spine pain patients without opioid medication and spine imaging prescription and the main factors related to referring these patients to hospital-based chiropractic care; and evaluate the impact of knowledge translation (KT) interventions combined with chiropractic care on reducing ED and SAC opioid medication and diagnostic imaging prescriptions, ED wait-time, and patient health outcomes.
National Research Priority: Health Systems & Population Health
- Determine potential barriers to managing spine pain patients without opioid medication and diagnostic imaging prescriptions
- Determine the factors related to referring these patients to hospital-based chiropractic care
- Evaluate the impact of knowledge translation interventions combined with guideline-informed chiropractic care on reducing hospital emergency department (ED) and opioid medication, as well as diagnostic imaging prescriptions, ED wait-times, and patient outcomes
Understanding health care utilization for musculoskeletal disorders and disability in Canada: A population-based perspective
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
Purpose: 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 disability.
National Research Priority: Population Health
- Determine which health care providers Canadians consult to manage MSK pain.
- Describe the characteristics of Canadians who consult different types of health providers for MSK disorders and disability
Advancing Patient Safety for Special Populations: Active Surveillance Reporting to Identify Adverse Events Following Chiropractic Care in Older Adults
Leads: Dr. Martha Funabashi, Clinical Research Scientist and Assistant Professor CMCC and Dr. Katharine Pohlman, Director of Research, Parker University
Purpose: Inadequate prospective data on the safety of chiropractic care exists for chiropractic patients aged over 65 and the frequency of potential associated adverse events remains unknown.
National Research Priority: Clinical Science & Population Health
- Calculate the frequency of reported adverse events following chiropractic care
- Explore patient and provider factors associated with reported changes in symptoms
Operationalizing ‘whole person’ pain care and the development of clinical resources
Lead: Dr. Peter Stilwell, Dalhousie University
Purpose: Whole person care shifts the focus from pain as a symptom to pain as a complex experience – promoting treatment of a patient as a full human being and aligns with current evidence indicating that most back pain does not have a single identifiable cause. However, literature on whole person care related to musculoskeletal (MSK) or spine, muscle and joint pain is fragmented; common language and clinical guidance is lacking.
National Research Priority: Clinical Science, Population health
- Identify central features of whole person care as they relate to people experiencing MSK pain
- Develop practical evidence-based resources, including a collection of whole patient care principles, themes, and strategies clinicians can use when interacting with patients experiencing MSK pain
Knowledge Translation Organizations: Integrating Evidence into Clinical Practice
These organizations include: RRS Education (Research Review Service Inc.) and The Canadian Chiropractic Guideline Initiative (CCGI). Each organization provides unique resources to help chiropractors integrate or apply scientific evidence from research studies into their clinical practice.
Through subscriptions and promotion, we support RRS Education and CCGI’s important work.
Founder and CEO: Dr. Shawn Thistle, B. Kin. (Hons.), D.C., Medical Acupuncture, ART®, C.S.C.S
This online, subscription-based service strives to facilitate knowledge transfer from bench-to-bedside. Through research reviews, informative seminars and e-learning courses, RRS Education helps clinicians integrate current scientific evidence from chiropractic, physiotherapy and exercise sciences research into evidence-informed clinical practice and patient care.
The RRS database contains more than 900 reviews and serves clinicians around the world. An annual subscription to RRS can be submitted as 20 unstructured credit hours for continuing-education (CE) requirements.
Dr. Sean Thistle, Founder and CEO, RRS Education, OCA 2019 Chiropractor of the Year tribute video.
Project Lead: Carol Cancelliere DC, MPH, PhD, University of Ontario Institute of Technology (Ontario Tech University)
CCGI’s mandate is to develop evidence-based clinical practice guidelines and best practice recommendations. Then, it facilitates their dissemination and implementation within the chiropractic profession.
- Transforming the culture of the chiropractic profession to one that is guided by evidence-informed practice
- Producing, adapting or adopting recommendations relevant to chiropractic practice to enhance patient care, based on the best available evidence
- Creating and applying innovative knowledge translation strategies to influence chiropractic practice
- Engaging stakeholders to assist in disseminating best practice to their members
CCGI creates varied content for chiropractors, with the goal of advancing excellence in chiropractic care. Its content is available in various digital categories, such as:
Relevant Health Care Initiatives
We collaborate with medical, academic and other partners to support relevant research initiatives that advance the understanding of care for Ontarians. Our members’ expertise complements these initiatives and often aligns directly with the needs of patients.
Through promotion, member engagement and collaboration, we support select third-party research initiatives.
Select health care initiatives we support include:
Study on Low Back Pain in Primary Care: “Back ON”
We partnered with a team of investigators from Queen’s University to help recruit chiropractors to participate in this Back ON study, which is funded by the Canadian Institutes of Health Research.
This cohort study (i.e. with no interventions) is investigating the natural course and treatment of patients with low back pain in primary care in Ontario.
Together with family doctors and physiotherapists, chiropractors are part of the 175 primary care practices involved in the study. During the study period, the Back ON team will follow the practitioners’ regular practice patterns. Patient characteristics and their use of our health system will also be determined.
Heart & Stroke Foundation of Canada: “Activate”
We partnered with Heart & Stroke to support Activate – a community-based wellness program designed to prevent the onset of high blood pressure, by moving individuals to a healthier lifestyle.
As Heart & Stroke was seeking health care professionals to help screen and enroll patients in this beneficial program, we promoted this opportunity to our members. Since many chiropractors regularly take and monitor their patients’ blood pressure as part of their care plan, the program was a natural fit and many of our members participated.
Canadian Memorial Chiropractic College (CMCC)
CMCC has one of the most innovative clinical chiropractic research programs in North America.
Focused on five major areas of research, senior research scientists and clinical faculty members seek to answer vital questions about the changes that chiropractic adjustments make on a micro and macro level, including:
- How to increase its efficacy and how best to apply it
- How to integrate it within the health and performance spectrum
We showcase and promote CMCC’s independent clinical research to advance understanding of the chiropractic profession.
Dr. Sam Howarth with patient in the Human Performance Lab at CMCC. (Photo: CMCC)
CMCC’s major areas of research include:
Biological Basis of Musculoskeletal Injury and Manual Therapies
To conduct clinically oriented and mechanistic studies assessing the development of musculoskeletal injuries and the biological basis of manual therapies. Primary areas of study include cellular and molecular biology, immunology, biomechanics, ergonomics, mechanobiology, morphology, neurophysiology and ultrasonography.
Clinical and Health Sciences Research
To improve patient centered care for musculoskeletal conditions through studies focusing on clinical assessment and interventions. Primary areas of study include clinical guideline development, systematic reviews, studies of assessment and diagnosis, clinical and cost-effectiveness trials, prognosis, disability, rehabilitation and health services. Multimodal non-surgical intervention for individuals with knee osteoarthritis — a retrospective case series protocol.
Education in Health Care
To enhance the development of curriculum, explore novel methods for content delivery and assessment, improve collaborative learning and the utilization of innovative technologies, techniques and learning strategies within the context of healthcare education. Primary areas of study include simulation education, interprofessional education, competency-based education, elearning, blended learning, clinical education, active learning strategies, professional development and problem-based learning. A pilot study entails evaluating the baseline abilities of second year chiropractic students to identify cardiac and lung sounds at the CMCC using high fidelity manikin simulators.
Health and Wellness
To produce evidence that further promotes healthy living of patients and the public. Primary areas of study include physical activity, mental health, dietetics and nutrition. The influence an Exercise is Medicine workshop has on recording exercise minutes per week as a vital sign in CMCC clinics.
Knowledge Translation and Health Policy
To improve the uptake, delivery and continuity of health care, based on research evidence, patient-oriented outcomes and informed decision making. Primary areas of study include knowledge translation, health policy, health economics, health services organization and management, as well as implementation science. A pre-implementation qualitative case study includes development of an evidence-informed self-management toolkit for low back pain, adapted for the Tobique First Nation, Canada.
The Ontario Tech – CMCC Centre for Disability Prevention and Rehabilitation (CDPR)
This centre is dedicated to understanding and improving return to work rates to improve lives and reduce costs to Canadian businesses. It is an internationally recognized centre of excellence focused on collaborative, transdisciplinary work with key stakeholders and knowledge users, which crosses research areas
With offices at Ontario Tech in Oshawa and at CMCC in Toronto, CDPR is able to leverage the academic excellence resident at both institutions. A core team of researchers (including five chiropractors), two international post-doctoral fellows, two PhD students, six Master’s students, three chiropractic residents and 25 national and international collaborators from 23 universities fulfills the centre’s mandate.