A Comparison of Manual VS. Mechanical Chiropractic Manipulation Methods

描述(由申请者提供)：NCCAM的使命和战略计划包括为那些将从事严格的CAM研究的合格的CAM专业人员提供一条独立的途径。候选人的长期目标是从私人脊椎疗法过渡到全职研究生涯，调查脊椎疗法和CAM治疗的临床效果。该奖项的K99博士后奖学金部分将为他提供一个机会，在极其合格的导师的指导下微调他的研究技能，并完成他的论文研究，这将为根据该奖项的Roo部分提议的随机临床试验产生重要的初步数据，并为他准备提交自己的R01拨款申请所需的技能。3年期Roo奖励独特的“可移植性”应该有助于候选人在申请从事CAM研究的机构的终身教职跟踪职位时获得更多的职业机会，因为他知道候选人随身携带着NIH的资金，以及提交R01申请未来资金的能力。候选人建议该奖项的Roo部分设计和实施一项随机临床试验，使用从他的论文研究中获得的初步数据，比较机械和手动手法治疗下腰痛的临床有效性。这项研究与公共健康相关的是，脊医提供了用于治疗下腰痛的绝大多数脊柱手法治疗，但关于脊医使用的不同类型脊柱手法的比较数据很少。脊椎按摩师治疗腰背最常用的两种脊椎手法是侧位手法、手动手法和产生机械冲动的器械。拟议的随机试验将比较这两种类型的操作，并得出关于治疗效果大小、报告的副作用发生率和剂量问题(治疗频率和持续时间)的差异的数据。这位候选人预计未来将有一个长期的研究生涯，致力于提高人们对各种脊椎疗法在不同条件下的临床有效性的了解，为公众提供更多数据，以便做出关于脊椎疗法的知情医疗决策。

DESCRIPTION (provided by applicant): The mission and strategic plan of the NCCAM includes providing mechanisms that facilitate a pathway to independence for qualified CAM professionals who will become engaged in careers of rigorous CAM research. The candidate's long term objective is to make a transition from the private practice of chiropractic to a full-time research career, investigating the clinical effectiveness of chiropractic and CAM treatments. The K99 post doctoral fellowship portion of this award will provide him with an opportunity to fine tuning his research skills under the guidance of extremely qualified mentors and finish his dissertation research, which will yield important preliminary data for the randomized clinical trial proposed under the ROO portion of this award and prepare him with the skills required to submit his own R01 grant application. The unique "portability" of the 3 year ROO award should facilitate the candidate's career opportunities when applying for tenure track positions at institutions engaged in CAM research, knowing that the candidate brings NIH funding with him, as well as the ability to submit R01 applications for future funding. The candidate proposes for the ROO portion of this award to design and implement a randomized clinical trial comparing the clinical effectiveness of mechanical versus manual manipulation methods for low back pain, using preliminary data obtained from his dissertation research. The relevance of this research to public health is that chiropractors provide the vast majority of spinal manipulation treatments used for the treatment of low back pain, yet there is a paucity of data on the comparison of the different types of spinal manipulation used by chiropractors. The two types of spinal manipulation most commonly used by chiropractors for the treatment of low back are side posture manual manipulation and instruments that deliver a mechanical impulse. The proposed randomized trial will compare these two types of manipulation, and derive data regarding the differences in treatment effect size, reported rates of side effects, and issues regarding dosage (treatment frequency and duration). The candidate anticipates a long career of future research that is dedicated to advancing knowledge about the clinical effectiveness of a wide variety of chiropractic methods for different conditions, giving the public more data on which to make informed health care decisions regarding chiropractic care.