New scientific evidence on the effectiveness of manual therapies, passive physical modalities, and acupuncture was assessed in a recent systematic review. This update of the Neck Pain Task Force suggests that mobilization, manipulation, and clinical massage are effective interventions for neck pain. Conversely, they found that electroacupuncture, strain-counterstrain, relaxation massage, and other modalities such as heat, cold, diathermy, hydrotherapy, ultrasound are not effective.
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In this discussion, Dr. Michael Freeman talks about his research involving motor vehicle collisions, whiplash and forensic applications. Dr. Michael Freeman is a consultant in forensic medicine, and as such is a member of the Faculty of Forensic and Legal Medicine (FFLM) of the Royal College of Physicians in the United Kingdom. He has provided expert testimony more than 1,200 times in a wide variety of civil and criminal cases, including injury and death litigation, automotive and other product liability, toxic tort litigation, life expectancy, and medical negligence cases, as well as in homicide, assault, and other criminal matters.
Dr. Freeman has published around 220 scientific papers, books, and book chapters, primarily focusing on issues relating to forensic applications of epidemiology and general and specific causation. Research and publication topics include traffic crash-related injury and death, injury biomechanics and injury causation, genocide, cancer epidemiology, chronic pain mechanisms, and adult autologous stem cell therapy, among others. Dr. Freeman is the co-editor and co-author of the authoritative text on forensic applications of epidemiology; Forensic Epidemiology: Principles and Practice, published in 2016.
His published 3-step approach has been adopted by U.S. courts as a generally accepted injury causation methodology, as described in the 2016 10th circuit US DCA Etherton decision.
Dr. Freeman is a tenured associate professor of forensic medicine and epidemiology at Maastricht University Medical Center and a joint clinical professor of psychiatry and public health and preventative medicine at Oregon Health & Science University School of Medicine. He is a fellow of the American College of Epidemiology and the American Academy of Forensic Sciences. Dr. Freeman is a past Fulbright Fellow with the U.S. Department of State in the area of forensic medicine, and holds a diploma of legal medicine with the FFLM in the United Kingdom.
Dr. Freeman holds a doctor of medicine degree from Umeå University in Sweden, a Ph.D. and master’s in public health in epidemiology from Oregon State University, a master’s of forensic medical sciences with the Academy for Forensic Medical Sciences in the UK, a doctor of chiropractic from what is now the University of Western States, and a bachelor’s of science from University of Oregon. He has completed a 2-year fellowship in forensic pathology through Umeå University and the Allegheny County Office of the Medical Examiner.
Please see Dr. Michael Freeman’s research profile at researchgate profile.
Below are the articles Dr. Michael Freeman discusses in this episode:
| 1. | Estimating the number of traffic crash-related cervical spine injuries in the United States; An analysis and comparison of national crash and hospital data.Freeman MD, Leith WM.Accid Anal Prev. 2020 Jul;142:105571. doi: 10.1016/j.aap.2020.105571. Epub 2020 May 12.PMID: 32413544 |
| 2. | Diagnostic Accuracy of Videofluoroscopy for Symptomatic Cervical Spine Injury Following Whiplash Trauma.Freeman MD, Katz EA, Rosa SL, Gatterman BG, Strömmer EMF, Leith WM.Int J Environ Res Public Health. 2020 Mar 5;17(5):1693. doi: 10.3390/ijerph17051693.PMID: 32150926 Free PMC article. |
| 3. | Is Acceleration a Valid Proxy for Injury Risk in Minimal Damage Traffic Crashes? A Comparative Review of Volunteer, ADL and Real-World Studies. Nolet PS, Nordhoff L, Kristman VL, Croft AC, Zeegers MP, Freeman MD.Int J Environ Res Public Health. 2021 Mar 12;18(6):2901. doi: 10.3390/ijerph18062901. PMCID: PMC8001694. |
| 4. | A systematic approach to clinical determinations of causation in symptomatic spinal disk injury following motor vehicle crash trauma. Freeman MD, Centeno CJ, Kohles SS. PM R. 2009 Oct;1(10):951-6. doi: 10.1016/j.pmrj.2009.07.009. PMID: 19854423. |
Dr. Rubinstein and I discuss his latest paper that will appear soon in the British Medical Journal regarding his systematic review of spinal manipulative therapy and chronic low back pain. Sidney Rubinstein is an associate professor at the VU University, Amsterdam and adjunct research professor at Southern California University of Health Sciences (SCUHS). He is also a registered epidemiologist in the Netherlands. He has more than 60 publications in international peer-reviewed journals, including three systematic reviews in the Cochrane Library.
His research focuses on effectiveness and cost-effectiveness of interventions in musculoskeletal disorders. His broader goals are to lessen the burden of neck and low-back pain to society by providing high-quality scientific evidence. The projects that he currently supervises are strongly embedded in clinical practice, including the PTED trial, Warrior Trial, an IPD (individual patient data) meta-analysis on spinal manipulative therapy for chronic low-back pain and a large, international observational study in chiropractic care in the elderly (BACE-C cohort study).
One of his passions lies in systematic reviews and meta-analysis as these types of overviews represent a crucial link in the practice of evidence-based health care. He is actively involved in conducting and supervising these reviews, including a position on the Associate Editorial Board of the Cochrane Back and Neck Review Group. His reviews are quite diverse. One of the more recent Cochrane reviews focused on complications of trocar types for laparoscopic surgery, while another has examined the effectiveness of exercise for acute low back pain. An update of the Cochrane review on the effect of spinal manipulative therapy for chronic low-back has been accepted by the BMJ and should be published soon.
Dr. Rubinstein currently supervises 5 PhD students as well as MSc students, and teaches methodology of systematic reviews and meta-analyses at various levels, including BSc, MSc and PhD students. One chiropractor has received his PhD under Sidney’s supervision, while others are completing theirs.
Here is a link to Dr. Rubinstein’s research at researchgate.net.
Here is a link to Dr. Rubinstein’s page at Vrije Universiteit Amsterdam
The article we discuss in this episode is available now at https://www.bmj.com/content/364/bmj.l689
Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l689 (Published 13 March 2019) Cite this as: BMJ 2019;364:l689
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