Greg Kawchuk

Greg Kawchuk
University of Alberta | UAlberta · Department of Physical Therapy

BSc, DC, MSc, PhD

About

167
Publications
50,315
Reads
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3,207
Citations
Introduction
Dr. Kawchuk’s research interests focus on defining the mechanisms that initiate and sustain spinal disorders so that clinically relevant strategies can be developed toward their prevention or resolution. A major component of his research involves developing new technologies to assess spinal structure and function, then using those technologies to evaluate various clinical interventions.
Additional affiliations
September 2004 - present
University of Alberta
Position
  • Professor
Education
September 1996 - June 2000
The University of Calgary
Field of study
  • Bioengineering
September 1993 - November 1995
The University of Calgary
Field of study
  • Biomechanics
September 1986 - April 1990

Publications

Publications (167)
Article
Full-text available
The Chiropractic Academy for Research Leadership (CARL) was formed in 2016 in response to a need for a global network of early career researchers and leaders in the chiropractic profession. Thirteen fellows were accepted competitively and have since worked together at residentials and virtually on many research and leadership projects. In 2020, the...
Article
Spinal manipulative therapy (SMT) is a common nonpharmacological treatment for low back pain (LBP). Although generally supported by systematic reviews and practice guidelines, clinical trials evaluating SMT have been characterized by small effect sizes. This study adopts a Multiphase Optimization Strategy framework to examine individual components...
Article
Magnetic resonance imaging findings often do not distinguish those with and without low back pain. However, there are still a large number of people who undergo magnetic resonance imaging to help determine the aetiology of their back pain. Texture analysis shows promise for classification of tissues that look similar, and machine learning can minim...
Article
Full-text available
Introduction: In individuals having low back pain, the application of spinal manipulative therapy (SMT) has been shown to reduce spinal stiffness in those who report improvements in post-SMT disability. The underlying mechanism for this rapid change in stiffness is not understood presently. As clinicians and patients may benefit from a better unde...
Article
Full-text available
Background: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made i...
Article
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Background: Internet analytics are increasingly being integrated into public health regulation. One specific application is to monitor compliance of website and social media activity with respect to jurisdictional regulations. These data may then identify breaches of compliance and inform disciplinary actions. Our study aimed to evaluate the novel...
Article
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Background: Social media has become an increasingly important tool in monitoring the onset and spread of infectious diseases globally as well monitoring the spread of information about those diseases. This includes the spread of misinformation, which has been documented within the context of the emerging COVID-19 crisis. Understanding the creation...
Article
Full-text available
Background Spinal manipulative therapy (SMT) is among the nonpharmacologic interventions that has been recommended in clinical guidelines for patients with low back pain, however, some patients appear to benefit substantially more from SMT than others. Several investigations have examined potential factors to modify patients’ responses prior to SMT...
Article
Full-text available
Background Device-based measurement of lumbar spinal stiffness has the potential to identify patients with low back pain who are more likely to improve with spinal manipulative therapy. This study evaluates how voluntary contraction of spine muscles may impact stiffness measures. Objective To determine how the contraction of different spinal muscl...
Article
Full-text available
Background: Approximately 50% of patients who receive spinal manipulative therapy (SMT) experience some kind of adverse event (AE), typically benign and transient in nature. Regardless of their severity, mitigating benign AEs is important to improve patient experience and quality of care. The aim of this study was to identify beliefs, perceptions...
Article
Full-text available
The mechanisms underlying pain relief following spinal manipulative therapy (SMT) are not understood fully although biomechanical and neurophysiological processes have been proposed. As such, we designed this randomized trial to elucidate the contributions of biomechanical and neurophysiological processes. A total of 132 participants with low back...
Article
Full-text available
Vaccine hesitancy–the reluctance to receive recommended vaccination because of concerns and doubts about vaccines–is recognized as a significant threat to the success of vaccination programs and has been associated with recent major outbreaks of vaccine-preventable diseases. Moreover, the association between complementary and alternative medicine (...
Article
Full-text available
PurposeArtificial intelligence algorithms can now identify hidden data patterns within the scientific literature. In 2019, these algorithms identified a thermoelectric material within the pre-2009 chemistry literature; years before its discovery in 2012. This approach inspired us to apply this algorithm to the back pain literature as the cause of b...
Preprint
Full-text available
Background Approximately 50% of patients who receive spinal manipulative therapy (SMT) experience some kind of adverse event (AE), typically benign and transient in nature. Regardless of their severity, mitigating benign AEs is important to improve patient experience and quality of care. The aim of this study was to identify beliefs, perceptions an...
Preprint
Full-text available
Background: Approximately 50% of patients who receive spinal manipulative therapy (SMT) experience some kind of adverse event (AE), typically benign and transient in nature. Regardless of their severity, mitigating benign AEs is important to improve patient experience and quality of care. The aim of this study was to identify beliefs, perceptions a...
Technical Report
Full-text available
This rapid review considers materials the WFC is aware have been cited in support of claims of effectiveness for spinal adjustment / manipulation in conferring or enhancing immunity.
Article
Introduction Building and implementing a robust evidence-base which is informed by high quality research is the challenge facing contemporary healthcare professions. In doing so, it can be valuable for healthcare professions to establish a strategic research agenda in order to enhance the professions public health priorities within healthcare and a...
Article
Objective: The purpose of this study was to conduct a systematic review of studies to determine whether sitting time measured objectively (by laboratory controlled time trial, direct observation, or wearable sensor) is associated with the immediate increase in low back pain (LBP) (determined by pain scale rating) in people >18 years of age. Metho...
Article
Objective: The objective of this review is to identify and map current literature describing the center of rotation locations and migration paths during lumbar spine movements. Introduction: The importance of lumbar spine kinematics has been described and altered kinematics has been associated with pain and injury. Intervertebral segments' cente...
Article
Full-text available
Synopsis: Individuals with back pain are often diagnosed with spine instability, even though it is unclear whether the spine is susceptible to unstable behavior. The spine is a complex system with many elements that cannot be directly observed, which makes the study of spine function and direct assessment of spine instability difficult. What is kn...
Article
Full-text available
Background: Few, if any, patient reported symptoms have been shown to be related to objective measures ofspine function. Recently, patient-reported measures of disability following spinal manipulative therapy have beenassociated with an immediate decrease in spinal stiffness obtained by instrumented L3 indentation. Given thisnovel relation, we anti...
Article
Objective: The purpose of this study was to quantify the threshold at which clinicians can detect a difference in spinal stiffness of the thoracic and lumbar spine via palpation and then determine if this detection threshold would affect a clinician's ability to identify changes in spinal stiffness as measured by an objective instrument. Methods:...
Article
Full-text available
Background The chiropractic profession has a long history of internal conflict. Today, the division is between the ‘evidence-friendly’ faction that focuses on musculoskeletal problems based on a contemporary and evidence-based paradigm, and the ‘traditional’ group that subscribes to concepts such as ‘subluxation’ and the spine as the centre of good...
Article
Full-text available
Objective Since the discovery of ionizing radiation, clinicians have evaluated X-ray images separately from the patient. The objective of this study was to investigate the accuracy and repeatability of a new technology which seeks to resolve this historic limitation by projecting anatomically correct X-ray images on to a person’s skin. Methods A t...
Article
Full-text available
Purpose Our prior study revealed that people with non-specific low back pain (LBP) who self-reported a > 30% improvement in disability after SMT demonstrated significant post-treatment improvements in spinal stiffness, dynamic muscle thickness and disc diffusion, while those not having self-reported improvement did not have these objective changes....
Article
Objectives: To: 1) develop/adapt and validate an instrument to measure patient safety attitudes and opinions of community-based spinal manipulative therapy (SMT) providers; 2) implement the instrument; and 3) compare results among healthcare professions. Methods: A review of the literature and content validation were used for the survey development...
Article
Full-text available
The tremendous cost, pain and disability associated with degenerative disc disease (DDD) makes the development of a biological agent that can mitigate the course of DDD, a critical unmet need. We have identified and reported that a single injection of a combination of recombinant human (rh) Transforming growth factor beta 1 (TGF-β1) and Connective...
Article
BACKGROUND CONTEXT Clinicians of all disciplines learn to visualize internal anatomy to enhance diagnostic accuracy and reduce iatrogenic injury. Unfortunately, the performance of this skill is poor. To address this issue, our team developed technology that superimposes diagnostic images on to a patient's skin while minimizing distortion caused by...
Article
BACKGROUND CONTEXT Degenerative disc disease (DDD) contributes significantly to the genesis of spinal pain. DDD-related spinal pain is an enormously expensive malady and a major cause of disability worldwide and no contemporary surgical treatments promote repair. Thus, there exists a need for the identification of effective, minimally invasive, reg...
Article
Full-text available
Ultrafast ultrasound imaging is used to capture driven spinal vibrations as a new method for non-invasive spinal testing in living subjects. Previously, it has been shown that accelerometer-based vibration testing in cadaveric models can reveal the presence, location and magnitude of spinal pathology. However, this process remains an invasive proce...
Article
Synopsis: Motor control exercise has been shown to be effective in the management of low back pain (LBP). However, the effect sizes for motor control exercise are modest, possibly because studies have used a one-size-fits-all approach, while the literature suggests that patients may differ in presence or type of motor control issues. In this comme...
Article
Synopsis: Compared to healthy individuals, patients with low back pain demonstrate differences in all aspects of trunk motor control that are most often studied as differences in muscle activity and kinematics. However, differences in these aspects of motor control are largely inconsistent. We propose that this may reflect the existence of 2 pheno...
Article
Full-text available
Background: Low back pain is a common and costly condition. Spinal manipulative therapy (SMT) is a treatment supported in some guidelines, although most clinical trials examining SMT report small effect sizes. Enhancing the effects of SMT requires an understanding of underlying mechanisms and a systematic approach to leverage understanding of mech...
Article
Objective: Spinal stiffness assessments are commonly used by manual therapists. Although devices have been developed to objectively measure spinal stiffness, individual characteristics (i.e., sex, age, weight, height) may affect the measurement results. Therefore, this study aimed to describe the correlations between individual characteristics and...
Article
Full-text available
Objective: To evaluate Australian and New Zealand chiropractic students' opinions regarding the identity, role setting, and future of chiropractic practice. Methods: An online, cross-sectional survey was administered to chiropractic students in all chiropractic programs in Australia and New Zealand. The survey explored student viewpoints about t...
Article
Full-text available
In an evidence-based health care environment, healthcare professions require a sustainable research culture to remain relevant. At present however, there is not a mature research culture across the chiropractic profession largely due to deficiencies in research capacity and leadership, which may be caused by a lack of chiropractic teaching programs...
Article
Background context: Previous studies found that the intervertebral disc (IVD) experiences the greatest loads during spinal manipulation therapy (SMT). Purpose: Based on that, this study aimed to determine if loads experienced by spinal tissues are significantly altered when the application site of SMT is changed. Study design: A biomechanical...
Article
Full-text available
Background The measurement of Posterior-Anterior (P-A) spinal stiffness is a common component of the physical examination of patients presenting with spinal disorders. The aim of this assessment is to provoke pain and/or to determine the degree of resistance or compliance of these structures and the associated soft-tissues to loading. This informat...
Article
Full-text available
We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movement to occur in a dynamically controlled fashion, the lumba...
Article
The McAndrews Leadership Lecture was developed by the American Chiropractic Association to honor the legacy of Jerome F. McAndrews, DC, and George P. McAndrews, JD, and their contributions to the chiropractic profession. This article is an edited and truncated version of the McAndrews Leadership Lecture given by Dr Greg Kawchuk on February 27, 2016...
Article
Full-text available
Background Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance. Methods We conduc...
Article
Objective: To better understand the research resources and environment within the Canadian chiropractic profession. Methods: All members of the Canadian Chiropractic Association (n=7200) were invited to access an electronic survey on research capacity, activity, and resources. Canadian chiropractic stakeholder organizations received an invitatio...
Article
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Our research group recently published a Delphi study that identified Canadian chiropractic profession research priority areas. At the same time, the Canadian Chiropractic Research Foundation (CCRF) was developing their own research priority areas. In this commentary, we discuss the results of the Delphi study, compare and contrast these results to...
Conference Paper
The internal anatomy of a patient can be difficult for clinicians and other patients to visualize and analyzed in context. The ability to project medical images (CT and MRI scans) directly onto a patient's body helps those viewing these images to recover missing anatomical context for more accurate interpretation. This paper proposes such a system....
Article
Full-text available
Does feeling back stiffness actually reflect having a stiff back? This research interrogates the long-held question of what informs our subjective experiences of bodily state. We propose a new hypothesis: feelings of back stiffness are a protective perceptual construct, rather than reflecting biomechanical properties of the back. This has far-reach...
Article
We present the movement control approach as part of the treatment-based classification system. This approach proposes a movement control schema that clarifies that movement control is a product of the interplay among multiple biopsychosocial components. The schema illustrates that for movement to occur in a dynamically controlled fashion, the lumba...
Article
Full-text available
Objective: In order to define the relation between spinal manipulative therapy (SMT) input parameters and the distribution of load within spinal tissues, the aim of this study was to determine the influence of force magnitude and application site when SMT is applied to cadaveric spines. Methods: In 10 porcine cadavers, a servo-controlled linear...
Article
Full-text available
Background Spinal manipulation (SM) is used commonly for treating low back pain (LBP). Spinal stiffness is routinely assessed by clinicians performing SM. Flexion-relaxation ratio (FRR) was shown to distinguish between LBP and healthy populations. The primary objective of this study was to examine the association of these two physiological variable...
Article
Objectives: This investigation compared indirect 3-dimensional angular kinematics (position, velocity, and acceleration) of the lumbar spine for 2 different high-velocity, low-amplitude (HVLA) spinal manipulation procedures (lumbar spinous pull or push), and altered initial patient lower limb posture. Methods: Twenty-four participants underwent...
Article
Study design: Comparative study using robotic replication of SMT vertebral kinematics together with serial dissection. Objective: To quantify loads created in cadaveric spinal tissues arising from three different forms of SMT application. Summary of background data: There exist many distinct methods by which to apply spinal manipulative therap...
Article
Abnormal spinal segmental motion/stiffness is purported to be a cause, or an effect of, low back pain. Therefore, the assessment of posteroanterior segmental spinal stiffness is a common practice in clinical and research settings. In clinical settings, manipulative practitioners routinely assess spinal stiffness manually to guide clinical decision-...
Article
Full-text available
Spinal manipulative therapy (SMT) creates health benefits for some while for others, no benefit or even adverse events. Understanding these differential responses is important to optimize patient care and safety. Toward this, characterizing how loads created by SMT relate to those created by typical motions is fundamental. Using robotic testing, it...
Article
Full-text available
O1 The functional properties of paraspinal muscles in adolescents with idiopathic scoliosis (AIS): A systematic review of the literature Eric Parent, Alan Richter O2 The importance of the lateral profile in the treatment of idiopathic scoliosis Angelo Gabriele Aulisa, Vincenzo Guzzanti, Paolo Pizzetti, Andrea Poscia, Lorenzo Aulisa O3 Radiological...