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Chiropractic Science Delivers the Evidence with Convenience (and It’s Free)

ChiropracticScienceLogo1American chiropractors are very similar to chiropractors in other countries, as well as other health professionals in terms of their favorable attitudes towards evidence based practice (EBP) (1-2). The purpose of EBP is to promote effective chiropractic practice and enhance public health. Evidence based practice incorporates the best research evidence with individual clinical expertise and patient choice/values (3). There are however several limitations and barriers to implementing EBP that chiropractors express such as lack of research relevance, lack of time and insufficient skills for locating and appraising research (1). It is important to note that these same obstacles are also encountered by other professions including medicine and nursing.

In a recent survey, very few DCs indicated that computer, internet, or database access were barriers to their uptake of EBP (1). Since chiropractors are interested in implementing EBP, these findings underscore the importance of providing clinicians with training in EBP skills, particularly through online resources. It is likely that comprehensive and multi-faceted approaches that take into account all the relevant levels affecting EBP will likely be needed to integrate research into practice (1).

As a practitioner as well as a researcher, I realize the importance and barriers of translating research into practice. I have also begun to realize how I can give back to the profession. Some of you may recognize my On Target research summaries.  Others may be familiar with my chiropractic science podcast.  While there may be many ways to tackle the evidence-practice gap, one convenient educational method is a podcast. This is one of the ways that I have been utilizing to help get chiropractic research out to the masses. For those not familiar, a podcast describes audio and/or video files that can be downloaded and played on a personal computer or mobile device.

Podcast is the term commonly used to refer to a series of digital media files that are released periodically and can be subscribed to using an RSS (Really Simple Syndication) feed. This means of digital delivery is what makes podcasting different from other means of accessing media files over the internet.  Of course one can still download the audio and/or video files that makeup a podcast.  The automatically downloaded files can be stored locally on a computer or other device (such as your mobile phone) ready for offline use, providing simple and convenient access to regular releases.

Podcasting has been used successfully in teaching and learning in many different student groups (4-5). In theory podcasts provide educational content in a format that is convenient and available 24 hours a day and can be accessed whenever and wherever the learner chooses (4-5). Learners have the ability to replay a podcast as many times as they wish in order to improve understanding. In addition, podcasting offers the ability to embed additional content from researchers or clinicians to help make links between theoretical concepts and practice.

While many chiropractic podcasts exist, chiropractic science (CS) is the only podcast that exclusively interviews chiropractic researchers about the science of chiropractic. CS publicizes and disseminates chiropractic research. Hear about chiropractic research from the authors in plain English, not through the media, nor a middleman. Think about recent media coverage concerning the evidence of chiropractic in magazines or online.  While reports of chiropractic studies in the media may be very good (or very poor), some things get lost in translation.  By interviewing the chiropractic experts that are actually doing the research, you’ll get the information direct – the way the author intended it.

Making scientific findings available to the public is an important part of the research process.  Publicizing these interviews passes on the benefits of chiropractic research to other researchers, chiropractors in practice as well as practitioners from other disciplines and the wider community. In addition to publicizing the interviews, other goals of the podcast are to encourage collaboration of researchers to promote future high quality chiropractic research as well as to motivate and assist practitioners and students alike to pursue research careers in chiropractic science!

Why Chiropractic Science?

  • There is a lot of excellent chiropractic research published by top scientists in the field that deserve our attention
  • Incorporating the latest evidence into your practice of chiropractic is good for everyone
  • Reduce the evidence – practice gap and promote knowledge translation from the chiropractic research laboratory to the clinic
  • Engage clinicians in evidence based practice in a fun, easy to access manner
  • Learn from the experts and gain confidence in your knowledge and communications with others about chiropractic
  • A chiropractic resource for students, doctors and patients

Feedback about Chiropractic Science

  • “It has been such an inspiration to listen to all the greats in the world of chiropractic research”
  • “It has certainly made an impact on my practice and gives me a tremendous amount of certainty in what we do as chiropractors”
  • “I find the information profoundly motivating”
  • “It is difficult to read and interpret journal articles for a seasoned chiropractor. This saves time and hearing it explained from your colleagues themselves in language that I can communicate with my patients is invaluable”
  • “I am humbled by the sacrifice, hard work and accomplishments of all the researchers you have interviewed”
  • “Being in practice for many years, I am weary of ideologically biased forums when 21st Century chiropractic can have and bring it all; evidence and practice based science WITH a strong philosophical foundation. Highest accolades to Dr. Dean Smith for his untiring success at bringing the bar, raising colleagues and conversations together to articulate just how pertinent chiropractic is in contemporary health care”

In short, CS is starting to achieve what it set out to do, but this just the beginning. I am humbled by the feedback I have received from chiropractors about the podcast and am looking forward to interviewing as many chiropractic researchers as possible.  If you haven’t listened to the podcast, check them out.  If you like what you hear, please leave a great review on iTunes. This will help position CS as a leading health podcast – enlightening the masses about the evidence of chiropractic.  Listen to the podcast on iTunes or download the files directly to your device from chiropracticscience.com.  Enjoy and share with everyone.

References:

  1. Schneider MJ, Evans R, Haas M, Leach M, Hawk C, Long C, Cramer GD, Walters O, Vihstadt C, Terhorst L. US chiropractors’ attitudes, skills and use of evidence-based practice: A cross-sectional national survey. Chiropr Man Therap. 2015 May 4;23:16.
  2. Alcantara J, Leach MJ. Chiropractic Attitudes and Utilization of Evidence-Based Practice: The Use of the EBASE Questionnaire. Explore (NY). 2015 Sep-Oct;11(5):367-76.
  3. Lefebvre R, Peterson D, Haas M. Evidence-Based Practice and Chiropractic Care. J Evid Based Complementary Altern Med. 2012 Dec 28;18(1):75-79.
  4. Burke S, Cody W. Podcasting in undergraduate nursing programs. Nurse Educ. 2014 Sep-Oct;39(5):256-9.
  5. Strickland K, Gray C, Hill G. The use of podcasts to enhance research-teaching linkages in undergraduate nursing students. Nurse Educ Pract. 2012 Jul;12(4):210-4.


Dr. Dean Smith is founder of chiropractic science – dedicated to publicizing and disseminating chiropractic research through podcast interviews with the experts that are doing the research.  Listen to free chiropracticscience.com interviews on iTunes.  Dr. Smith is also a clinical professor at Miami University in Oxford, Ohio.  He has a practice of chiropractic in Eaton, Ohio.

Podcast

Dr. Scott Haldeman - Pioneering Chiropractic Research, Chiropractic Science

009- Scott Haldeman, DC, PhD, MD: Pioneering and Contemporary Chiropractic Science

Haldeman1In this episode, it is my great privilege to interview Scott Haldeman, DC, PhD, MD.  Dr. Haldeman is a pioneer of chiropractic science and a world leader in spine research. Dr. Haldeman holds the positions of Adjunct Professor, Department of Epidemiology, School of Public Health, University of California, Los Angeles, and Clinical Professor, Department of Neurology, University of California, Irvine.

He is Past President of the North American Spine Society, the American Back Society, the North American Academy of Manipulative Therapy, and the Orange County Neurological Society, and is currently Chairman Emeritus of the Research Council of the World Federation of Chiropractic. He is certified by the American Board of Neurology and Psychiatry and is a Fellow of the Royal College of Physicians of Canada and a Fellow of the American Academy of Neurology. He is a Diplomat of the American Board of Electrodiagnostic Medicine, the American Board of Electroencephalography and Neurophysiology and the American Board of Clinical Physiology. He also served on the US department of Health AHCPR Clinical Guidelines Committee on Acute Low Back Problems in Adults as well as four other Clinical Guidelines Committees. He presided over The Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders.

Scott Haldeman sits on the editorial boards of six journals, and has published over 200 articles or book chapters, over 70 scientific abstracts, and has authored or edited seven books. He was awarded an honorary Doctor of Humanities degree from the Southern California University of Health Sciences and an honorary Doctor of Science degree from the Western States Chiropractic College. He received the David Selby Award from the North American Spine Society. A resident of Santa Ana, California, he maintains an active clinical practice.

World Spine Care is a global charity on a mission to treat the disease with the greatest economic impact in the developing world: Spinal Disorders. To donate or volunteer to the project, please click below.

 

World Spine Care

 

For a list of Dr. Haldeman’s scientific publications please click here.

Here is a list of the publications we discuss during this interview:

1. The McAndrews Leadership Lecture: February 2015, by Dr Scott Haldeman. Challenges of the Past, Challenges of the Present.
Haldeman S, McAndrews GP, Goertz C, Sportelli L, Hamm AW, Johnson C.
J Chiropr Humanit. 2015 Nov 18;22(1):30-46. doi: 10.1016/j.echu.2015.09.001.
PMID: 26770177 [PubMed] Free PMC Article
Similar articles
2. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States.
Dagenais S, Brady O, Haldeman S, Manga P.
BMC Health Serv Res. 2015 Oct 19;15:474. doi: 10.1186/s12913-015-1140-5. Review.
PMID: 26482271 [PubMed – indexed for MEDLINE] Free PMC Article
Similar articles
3. Commentary: we can tell where it hurts, but can we tell where the pain is coming from or where we should manipulate?
Brady O, Haldeman S.
Chiropr Man Therap. 2013 Oct 21;21(1):35. doi: 10.1186/2045-709X-21-35.
PMID: 24499590 [PubMed] Free PMC Article
Similar articles
4. Advancements in the management of spine disorders.
Haldeman S, Kopansky-Giles D, Hurwitz EL, Hoy D, Mark Erwin W, Dagenais S, Kawchuk G, Strömqvist B, Walsh N.
Best Pract Res Clin Rheumatol. 2012 Apr;26(2):263-80. doi: 10.1016/j.berh.2012.03.006. Review.
PMID: 22794098 [PubMed – indexed for MEDLINE]
Similar articles
5. Is it time to discard the term “diagnosis” when examining a person with uncomplicated axial neck pain?
Haldeman S.
Spine J. 2011 Mar;11(3):177-9. doi: 10.1016/j.spinee.2011.01.032. No abstract available.
PMID: 21377599 [PubMed – indexed for MEDLINE]
Similar articles
Dr. Michael Schneider

008- Spine Care Research with Dr. Michael Schneider

Dr. Michael Schneider - Chiropractic Science Podcast
Learn about Dr. Michael Schneider’s chiropractic research on this episode of Chiropractic Science.  Dr. Schneider is a 1982 graduate of Palmer College of Chiropractic and obtained a PhD in Rehabilitation Science from the University of Pittsburgh in 2008. Dr. Schneider has published over 40 peer-reviewed articles on various musculoskeletal topics, and has received over $3 million in US research grant funding from the National Institutes of Health (NIH) and Patient Centered Outcomes Research Institute (PCORI). Dr. Schneider is currently implementing a large randomized clinical trial comparing various types of non-surgical treatment options, including chiropractic care, for patients with lumbar spinal stenosis. We will discuss the clinical significance of his past and present chiropractic research efforts.

Topics for this episode include:

  • A paper published in the journal Spine comparing spinal manipulation and usual medical care for acute and subacute low back pain: a randomized clinical trial
  • Evidence and the chiropractic identity
  • An article regarding US chiropractors’ attitudes, skills and use of evidence-based practice: A cross-sectional national survey
  • A paper in Chiropractic and Manual Therapies describing on ongoing study consisting of 180 older adults (>60 years) who have both an anatomic diagnosis of stenosis confirmed by diagnostic imaging, and signs/symptoms consistent with a clinical diagnosis of lumbar spinal stenosis confirmed by clinical examination. Treatment is randomized into 3 groups: 1) usual medical care; 2) individualized manual therapy and rehabilitative exercise; or 3) community-based group exercise.
  • Three consensus documents for the chiropractic profession including: 1) chiropractic care in health promotion, disease prevention, and wellness; 2) chiropractic care of older adults and; 3) chiropractic care for infants, children, and adolescents.
  • An observational intervention study dealing with a hospital-based standardized spine care pathway. The study looked at implementing a multidimensional spine care pathway (SCP) using the National Center for Quality Assurance (NCQA) Back Pain Recognition Program (BPRP) as its foundation. In the study, chiropractors were the main providers.

Here’s the link to the Foundations of Evidence Informed Practice modules that Dr. Schneider mentions in this podcast.  The course is hosted at the the University of Minnesota Center for Spirituality & Healing – Advancing the health and wellbeing of individuals, organizations and communities.

http://www.csh.umn.edu/research/foundations-evidence-informed-practice-modules

 

Dr. Heidi Haavik

006- Brain Adjustments with Dr. Heidi Haavik

HeidiHaavik
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Learn what happens in your brain when a chiropractor adjusts your spine.  Dr Heidi Haavik is a chiropractor and a neurophysiologist who has worked in the area of human neurophysiology for over 15 years. Heidi has a PhD in human neurophysiology from the University of Auckland. Her work has been instrumental in building the base of scientific evidence demonstrating the efficacy of chiropractic care in improving people’s health and wellbeing. As a researcher, she has investigated the effects of chiropractic adjustments of dysfunctional spinal segments (vertebral subluxations) on somatosensory processing, sensorimotor integration and motor cortical output.

Dr Haavik is the Director of Research at the New Zealand College of Chiropractic where she has established the Centre for Chiropractic Research. Dr Haavik is also an Adjunct Professor at the University of Ontario, Institute of Technology in Oshawa, Canada and is a member of the World Federation of Chiropractic’s Research Council. Dr Haavik has received numerous research awards and has published a number of papers in chiropractic and neurophysiology journals. She has presented her work to both chiropractic and neuroscience communities around Australasia, North America and Europe. She is on the Editorial Board of the Journal of Manipulative and Physiological Therapeutics and Journal of Chiropractic Education. She was named Chiropractor of the year in 2007 by both the New Zealand Chiropractic Association and the New Zealand College of Chiropractic Alumni Association.  She is also the author of a textbook – The Reality Check which describes in easy to understand language what happens in the brain when a chiropractor adjusts dysfunctional segments in your spine.

Read about Dr Haavik at her website, and get her book and posters at heidihaavik.com.  Subscribe to Dr Haavik’s research service at haavikresearch.com to get great evidence-informed marketing material for chiropractic practices including among other things, videos for your website that explain how chiropractic works.  Interested in donating toward her research efforts?  Contact her at haavikresearch.com.

HeidiDean2015

Dr. Haavik and Dr. Smith at the Ohio State Chiropractic Association Convention, 2015

reality check

Dr. Haavik’s book: The Reality Check

Dr. Bernadette Murphy

003- Chiropractic Neurophysiology with Dr. Bernadette Murphy

Dr. Bernadette Murphy
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Listen to this great interview with Dr. Bernadette Murphy. This is an interview that all chiropractors and students will want to listen to! We talk about many interesting concepts such as the current state of neurophysiology research within chiropractic, neural adaptation in humans and the role of chiropractic adjustments in aiding the re-establishment of appropriate neuromuscular connections, how a chiropractic adjustment works and much more.  She is at the forefront of research regarding the neurophysiology of chiropractic.  Dr. Murphy graduated from Queens University in 1985 and the Canadian Memorial Chiropractic College in 1989 before moving to New Zealand where she completed her MSc (1992) and PhD (1998) in Human Neurophysiology at the University of Auckland. She was a fulltime faculty member in the Department of Sport and Exercise Science from 1999-2007, where she established an MSc in Exercise Rehabilitation.  In January 2008, she returned to Canada and took on the role of Head of Kinesiology in the Faculty of Health Sciences at the University of Ontario Institute of Technology (UOIT).  She is the Director of the Human Neurophysiology and Rehabilitation Laboratory. The overall theme of her research is neural adaptation in humans and the role of physical interventions such as spinal manipulation and exercise in aiding the re-establishment of appropriate neuromuscular connections.  She has previously been awarded the World Federation of Chiropractic best scientific paper award (1995) and 3rd prize in 2007; the New Zealand Chiropractor of the year (2004) and the 2010 Ontario Chiropractic Association award for most significant contributions to research.  She has supervised numerous award winning Masters and PhD students and received significant research funding in New Zealand, Australia and Canada.

 

Dr. Smith and Dr. Murphy at University of Ontario Institute of Technology

 Dr. Murphy and Dr. Smith at University of Ontario Institute of Technology