CARL Research Fellows
CARL Research Fellows
Developing research capacity and leadership in chiropractic


CARL fellows are currently working on a number of  exciting multidisciplinary projects. If you would like more information about the project, please contact the study lead. To read published findings from our completed projects see our outputs page


Immediate effects of spinal manipulative therapy on clinical and biomechanical outcomes in participants with chronic thoracic pain.

[Update] The objective of this study is twofold. Data from four separate cross-sectional studies were analyzed together in order to compare participant characteristics, such as anthropometrics, age and gender with spinal stiffness. A secondary objective explores differences in outcome measures obtained with different spinal stiffness testing devices and protocols. Lead: Isabelle Pagé 

centre of rotation study

A scoping review looking at biomechanical testing investigating the center of rotation location on the lumbar spine is currently being conducted. From the results of this scoping review, a biomechanical testing study will be designed to investigate the influence of center of rotation location on the forces experienced by spinal tissues. Lead: Martha Funabashi


Challenges and lessons for recruitment within chiropractic studies

An analysis of recruitment and retention data from three studies, a narrative discussion on challenges of recruitment and potential suggestions for future studies. Lead: Michelle Holmes


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Common mechanical themes among persons referred for Objective Spine Motion Imaging Assessment

A retrospective analysis of existing spinal kinematic data from AECC University College’s Quantitative Fluoroscopy database will be used to determine common mechanical themes among persons referred for Objective Spine Motion Imaging Assessment (OSMIA). Data collection is well under way with motion data from 52 participants collated. Lead: Alex Breen

Does lower limb joint pain increase the risk of low back pain in older women?

This study will use the Australian longitudinal study on women’s health data to explore whether the presence of lower limb joint pain is associated with a higher prevalence and severity of low back pain. Introduction has been drafted and we are currently conducting data analysis. Lead: Arnold Wong


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Does psychological profile, pain intensity and self-rated health modify the association between expectations and the short-term subjective improvement in patients with low back pain? A longitudinal multicenter trial

The objectives of the study are to investigate if patient expectations predict short-term subjective improvement of recurrent and persistent low back pain and to explore whether psychological profile, pain intensity and self-rated health modify the relationship between expectations and outcome. Data analysis was completed this past fall and the manuscript is under review. Lead: Andreas Eklund

Multi-site joint pain in older Australian women

Up to 80% of adults have experienced at least one joint pain site in the last 12 months. Interestingly, people with low back pain usually experience concomitant pain at other spinal levels and people with extremity pain have pain in adjacent joints. Multiple factors predict multi-site joint pain syndromes, however no studies have been performed that report the prevalence and compare the impact of multi-site joint pain in the vulnerable population of older women. This program of study will firstly provide a descriptive analysis of older women with multisite joint pain, and secondly explore clusters of joint pain and their impact on health-related quality of life.Statistical analyses have been completed, with generalized ordinal logistic regression used to describe the association between multi-site joint pain and pain, health, and sociodemographic variables, in older Australian women. Manuscript under review. Lead: Katie De Luca



Princess and the pea palpation study: Do physiological limits of human touch prevent clinicians from appreciating relevant biomechanical changes in low back pain patients?

The purpose of this study it to quantify the threshold at which clinicians can detect a change in stiffness via palpation and to determine if these detection thresholds influence a clinician’s ability to identify clinically significant changes in stiffness. This manuscript is currently under review. Lead: Greg Kawchuk

SafetyNET Investigations – Advancing patient safety research for SMT providers

This work involves a series of projects, with current focus on the development of the data collection instruments. The population has been done within a chiropractic teaching institute. Plans are to reach out to practicing doctors on an international platform. The projects include: 1) Determine the incidence of mild, moderate, and serious adverse events following SMT administered by chiropractic interns using the SafetyNET active surveillance reporting paper-based system. 2) Determine the incidence of mild, moderate, and serious adverse events following SMT administered by chiropractic interns using the SafetyNET active surveillance reporting electronic system. 3) Qualitative evaluation of open-ended questions on SafetyNET’s Survey to Support Quality Improvement, which was conducted at teaching institutions and among practicing SMT providers. Lead: Katie Pohlman



Systematic Review and Meta-Analysis investigating the relationship between objectively measured sitting time and low back pain in adults

Current evidence suggests that self-reported sitting time substantially underestimates actual sitting time when measured objectively (activity monitor, other sensor or direct observation).  This project will involve a systematic review of literature, and if possible a meta-analysis of pooled data, to answer the following question: in adults, are longer periods of objectively measured sitting time associated with back pain (perceived ratings of pain, health care visits, lost days of work) compared to shorter periods of sitting time? The protocol for this project has been registered with PROSPERO. The initial search and paper selection was completed with the assistance of a health sciences librarian, data extraction and quality assessment with two independent researchers has been completed . Lead: Diana De Carvalho


The profile of chiropractors managing older patients: Analyses of chiropractors from the ACORN practice-based research network

The aim of the current project is to determine practitioner and practice-related factors associated with the frequent treatment of older people by Australian chiropractors, using a large nationally representative sample of Australian chiropractors. Lead: Craig Moore

The profile of chiropractors managing patients with low back-related leg pain: Analyses of 1907 chiropractors from the ACORN practice-based research network

This study is a secondary analysis of a cross-sectional survey of Australian chiropractors who are members of the Australian Chiropractic Research Network (ACORN) - a national practice-based research network. The aim of this paper is to investigate the prevalence and profile of chiropractors who have a high caseload of low back pain with related leg symptoms, and is considered representative of the wider Australian chiropractic profession. The study objectives are to investigate: 1) the proportion of Australian chiropractors who regularly treat patients who present with lumbar pain and associated referred or radicular symptoms; and 2) the practitioner characteristics, clinical practice characteristics, clinical management characteristics, and patient management factors associated with those chiropractors who frequently manage patients who present with lumbar pain and associated referred or radicular symptoms. Manuscript currently under review. Lead: Matt Fernandez



What’s behind the development of Transient Sitting-Induced Back Pain in Healthy Participants?

Using data from a laboratory controlled study; this study will explore the qualitative factors that may explain why some individuals, with no history of low back pain, develop transient back pain during prolonged sitting. Statistical analysis and results figures have been completed, manuscript to move forward in the fall. Lead: Diana De Carvalho

Physical activity endorsement by Australian chiropractors: analyses of 1,924 from the ACORN practice-based research network

Apart from the management of spinal pain, chiropractors are also recognised as advocates for active lifestyle promotion, with at least 90% prescribing or advising on physical activity throughout their consultations. Indeed, the chiropractic profession is ideally positioned to promote the health benefits of physical activity, yet the knowledge about the role these providers play regarding the management of this lifestyle-related risk factor is limited, particularly regarding their clinical characteristics. The aim of this current study is to therefore understand the role Australian chiropractors play within this public health field, by investigating their practitioner, practice and patient management features with respect to physical activity recommendations. Manuscript currently under review. Lead: Matt Fernandez



Chiropractic student identity: a global secondary data analysis

A secondary data analysis of surveys surrounding identity of European, North American, Australian and New Zealand chiropractic students. Lead: Michelle Holmes

Apportionment of lumbar intervertebral motion in a standardized flexion and return protocol using fluoroscopy: basic data to improve current spine models

Recent studies using standardized image acquisition protocols have indicated that the sharing of motion between lumbar levels during bending may be a mechanical marker in low back pain. To support future comparative studies, this project aims to outline a standardized protocol and to identify the how continuous intervertebral motion for L2-S1 during weight-bearing flexion and return in 78 asymptomatic individuals is taken up by each functional spinal unit. The use of quantitative fluoroscopy allows for continuous accurate in-vivo intervertebral lumbar spine motion measurement, the outputs of which are critical to inform dynamic multi-segmental spinal models and for comparisons in patients with low back pain which is suspected to have a mechanical origin. Lead: Alex Breen

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Attitudes and Beliefs of Chronic Low Back Pain of Faculty and Students at a Chiropractic Institution: a cross-sectional survey

To assess the attitudes and beliefs of students and faculty of a chiropractic teaching institution using the Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) and evaluate their recommendations for work and activity in patients with chronic low back pain. Data has been collected and manuscript in preparation. Lead: Katie Pohlman

Evidence-Based Practice Competencies: Evaluation of Progress

To present the results of a survey evaluating the self-perceived skills, importance, and utilization of evidence-based practice (EBP) among faculty and students at chiropractic institutions without a structured EBP program at baseline and after 2 years The survey also evaluated students EBP satisfaction and barriers/facilitators to implement EBP among the faculty. Data has been collected. Baseline manuscript in preparation. Follow-up data are being analyzed. Lead: Katie Pohlman

Job analysis of chiropractors with a pediatric specialty

Follow-up survey to assess change of practice patterns of chiropractors who have a diplomate in pediatrics. Data will be collected throughout Summer 2018. Lead: Katie Pohlman

Adverse events following chiropractic treatment in the pediatric population: an active surveillance study

Secondary data analysis of an active surveillance study to assess factors that may be associated with adverse events that follow chiropractic visits with the pediatric population (<14 years of age). Data is a collected with analysis being prepared. Lead: Katie Pohlman

Kinetinsense Research – Validation of Low Back Pain Measurements

To develop a database of Kinetisense measurements for low back pain individuals. In addition, this study will explore difference in Kinetisense measurements for low back pain individuals and those without low back pain and factors associated with difference in Kinetisense measurements within low back pain individuals. Data collection protocol under development. Lead: Katie Pohlman