In this upcoming episode, Dr. Meier will discuss how people move differently in the presence of (or in anticipation of) pain. Changes in motor control may play an important role in musculoskeletal pain. His lab uses a cross-disciplinary approach that combines neuroscience and movement biomechanics to provide new insights into the role of potential interactions between movement behavior, psychological factors and supraspinal mechanisms in the development and maintenance of persistent low back pain. We’ll touch also on fear avoidance and pain related movement avoidance.  Dr. Michael L. Meier is a senior pain researcher and group leader at the Department of Chiropractic Medicine at the University of Zurich. He received his master’s degree in neuropsychology and his doctorate in cognitive neuroscience from the University of Zurich, focusing on the processing of pain and nociception in the brain. In 2019, he received a grant from the Swiss National Science Foundation (SNF) to study the role of movement behavior and cortical processes in the development and persistence of low back pain. A hallmark of his work is linking research from different disciplines such as biomechanics, neuroscience, and psychology, shedding light on novel interacting pathomechanisms underlying persistent low back pain whose pathoanatomical cause is often unclear.

Happy Holidays!  As you are enjoying your holidays, listen to the top 5 downloaded episodes of the Chiropractic Science podcast of all time.

#1 Brain Adjustments with Dr. Heidi Haavik

#2 Scott Haldeman, DC, PhD, MD: Pioneering and Contemporary Chiropractic Science

#3 Chiropractic Neurophysiology with Dr. Bernadette Murphy

#4 Evidence Based Practice with Jan Hartvigsen, DC, PhD

#5 Assessing Spinal Structure, Function and Intervention with Dr. Greg Kawchuk

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Dr. Ken Weber is an Instructor in the Department of Anesthesia, Perioperative and Pain Medicine at Stanford University. He obtained his Doctor of Chiropractic from Palmer College of Chiropractic Florida in 2009 and then completed a PhD in neuroscience at Northwestern University in 2016, specializing in movement and rehabilitation science. Ken’s research intersects clinical pain research and advanced MRI techniques with an emphasis on brain, spinal cord, and musculoskeletal imaging. His research aims to better understand the neural and musculoskeletal changes underlying clinical pain conditions, the mechanisms of treatments, and predictors for recovery. Ken is currently supported by a K23 Mentored Patient-Oriented Research Career Development Award from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health. His previous funding has included the National Center for Complementary and Integrative Health, the National Institute on Drug Abuse, and the NCMIC Foundation, Inc.

Tue Secher Jensen graduated from the University of Southern Denmark in 2002 and has been working as a researcher since his student years. After graduation, he worked as a chiropractic intern and as a chiropractor for a couple of years alongside his work as a research assistant. In 2009, he defended his PhD thesis on the prevalence, development and clinical value of Modic changes in the general population. From 2013 to 2016, he was employed as a senior researcher and clinical associate professor at the Spine Centre of Southern Denmark and since 2013 he has also been employed as a senior researcher at the Nordic Institute of Chiropractic and Clinical Biomechanics (NIKKB). We plan on discussing topics such as: a) Getting the Bio back into Biopsychosocial; b) Distinguishing among asymptomatic vs symptomatic individuals with imaging (MRI); c) Disc herniations and sciatica – does size matter?; d) Modic changes (what are they and why do we care); e) MRI techniques and when to use imaging. 

Dr. Kevin Haussler

Dr. Haussler graduated from The Ohio State University, College of Veterinary Medicine in 1988 and completed a small animal internship in Sacramento, CA.  To further his training in the conservative management of spinal-related disorders, he pursued human training at Palmer College of Chiropractic-West and completed a veterinary chiropractic certification program in 1993.  He attended the University of California-Davis to attain a PhD focusing on spinal pathology and pelvic biomechanics in Thoroughbred racehorses.   Currently, he is an Associate Professor at the Orthopaedic Research Center at Colorado State University and is involved in teaching, clinical duties, and research into the objective assessment of musculoskeletal pain, spinal dysfunction and the application of physical therapy and rehabilitation. Please comment below if you have any questions for us during the interview. I might choose some of them for our conversation.

I am excited for the opportunity to discuss chiropractic research with Drs. Peterson and Humphreys in the near future. Cynthia Peterson, RN, DC, DACBR, M.Med.Ed. has worked as a chiropractic radiologist, researcher and educator in 4 countries.  She retired from her positions as Professor and researcher, Radiology Department, Orthopaedic University hospital Balgrist and Professor, Chiropractic Medicine Programme, University of Zürich in 2017.  She is currently a Visiting Professor for the Chiropractic Department in the Faculty of Health at the University of Johannesburg, South Africa and is the Quality Assurance Consultant for the European Council on Chiropractic Education.  Barry Kim Humphreys, BSc, DC, PhD, is Professor Emeritus, Faculty of Medicine, University of Zurich. He retired in July 2017, after 9 years as the first Professor for Chiropractic Medicine in Switzerland. During this time, Professor Humphreys was responsible for the development and accreditations of the chiropractic education program, research portfolio and teaching clinic within the university, medical faculty and teaching hospital. He has been active in research including chiropractic clinical outcome studies for back and neck pain, functional MRI studies of chronic pain patients and back pain in various gravitational environments (parabolic flight).  Please comment below if you have any questions for us during the interview. I might choose some of them for our conversation.

Chiropractic care can be complicated for patients because of its specialized terminology for assessment, treatment plans, symptom trajectories, and potential for benign adverse events.  One solution is for chiropractors to adopt functional health literacy, interactive health literacy, and critical health literacy into patient-centered chiropractic care. Health literacy empowers patients of all backgrounds to “read” and “listen” to their bodies, verbally communicate their thoughts and needs during the chiropractic visit, and access print and digital technologies to optimize their health outcomes. See here for our recent poster describing health literacy within the chiropractic profession (https://chiropracticscience.com/advancing-a-framework-for-chiropractic-health-literacy/). 

Based upon several U.S. and international consensus studies (2017), we advocate for chiropractors and D.C. students to use, implement, and practice health literacy competencies developed by Coleman et al. (2013 & 2017). We propose the adoption of a Health Literacy Curriculum (HLC) for chiropractors, because other health and medical professionals are adopting these competencies also.

The top consensus recommendation by the Coleman et al study (2017) was to use a “teach back” or “show me” technique with patients to check for understanding and correct misunderstandings, during the clinical visit and and during the informed consent process. In this regard, patients are asked to demonstrate their level of understanding by repeating back in their own words the information the professional has communicated to them.  To learn more about the other health literacy recommendations, please look at our poster or visit the link below to the Coleman study.

References:

Coleman, C., Hudson, S., & Pederson, B. (2017). Prioritized health literacy and clear communication practices for health care professionals. HLRP: Health Literacy Research and Practice, 1(3): e91-e99 https://doi.org/10.3928/24748307-20170503-01

Coleman, C. A., Hudson, S., & Maine, L.L. (2013). Health literacy practices and educational competencies for health professionals: a consensus study.Journal of Health communication,18 Suppl 1(Suppl 1), 82-102.

This video is an introduction to Chiropractic Science – the podcast and the website as well as some ideas for how to integrate chiropractic science into your practice to reduce the evidence-practice gap.  

Jeff Hebert, DC, PhD is a Professor and the CCRF/NBHRF Chair of Musculoskeletal Health Research at the University of New Brunswick, as well as an Adjunct Professor at Murdoch University in Australia. Jeff’s career to date includes 18 years of experience in faculty, clinical, and administrative positions in Canada, the United States, and Australia.  Most recently, he was the Associate Dean (Research) in Murdoch University’s School of Psychology and Exercise Science. Previous appointments include positions as a Senior Lecturer of Rehabilitation Science (Murdoch University) and Assistant Professor of Neurosurgery (University of Utah). He serves as an Associate Editor for the journal Chiropractic & Manual Therapies. Jeff worked as an outpatient and hospital-based clinician in multidisciplinary environments including as pain medicine, sports medicine, and spine surgery. Please comment below if you have any questions for us during the interview. I might choose some of them for our conversation.

Upcoming interview with Dr. Martha Funabashi. Martha Funabashi, PhD is currently working as a clinical research scientist at CMCC. She is also a CARL fellow and the co-lead study coordinator of SafetyNET – an international and multidisciplinary research team to support patient safety among spinal manipulative therapy (SMT) providers. Martha has a Bachelor’s Degree in Physiotherapy and a Master’s Degree in Neuroscience from the University of Sao Paulo – Brazil. She completed her PhD in Rehabilitation Sciences at the University of Alberta under the supervision of Dr. Greg Kawchuk and her post-doctoral fellowship also at the University of Alberta with Dr. Sunita Vohra. Martha’s research interests and passion are on the SMT’s biomechanics, underlying mechanisms, force-time characterization and its safety aspects. Martha has 26 peer-reviewed scientific journal publications, over 40 conference presentations and is on the editorial boards for peer review journals, such as Chiropractic and Manual Therapies. Martha has won research prizes, including the New Investigator Award at the World Federation of Chiropractic Conference 2017 and works in collaboration with emerging and well-known researchers around the world. Please comment below if you have any questions for us during the interview. I might choose some of them for our conversation.