Heather Shearer

Canadian Memorial Chiropractic College | CMCC · Department of Graduate Education and Research Programs

Studies investigating long-term symptoms and disability after mild traumatic brain injury (mTBI) have yielded mixed results. This systematic review and meta-analysis aimed to determine the prevalence of self-reported post-concussion symptoms (PCS) and disability following mTBI. We systematically searched MEDLINE, Embase, CINAHL, CENTRAL, and PsycIn...

Aim: To describe the clinical course of pain intensity in individuals with cerebral palsy (CP) resulting from usual care or specific interventions. Method: We conducted an exploratory prognostic systematic review searching electronic databases from inception to 31st December 2021. Evidence from low and moderate risk-of-bias studies was synthesiz...

Aim: To identify 5-week pain intensity trajectories and their association with physical and psychological well-being in children/young people with cerebral palsy (CP). Method: A cohort study was conducted with 101 Canadian children/young people with CP, of whom 49 were female, with an overall mean age of 12 years 11 months (SD 3 years 1 month),...

Prevost et al. published a systematic review evaluating the use of manual therapy for clinical conditions in the pediatric population in 2019. However, several methodological flaws in the conduct of the review limit the internal validity of its conclusions. We caution readers about the validity of the recommendations and suggest that the review not...

An amendment to this paper has been published and can be accessed via the original article.

Sleep problems are common and may be associated with persistent pain. It is unclear whether non-pharmacological interventions improve sleep and pain in adults with comorbid sleep problems and musculoskeletal (MSK) pain. We conducted a systematic review on the effectiveness of non-pharmacological interventions on sleep characteristics among adults w...

Background Although chronic pain is common in children with cerebral palsy (CP), little is known about short-term pain fluctuations and their impact on children’s well-being. High-quality cohort studies are needed to understand the clinical course of pain in this population. We aimed to determine the feasibility of conducting a multicentre cohort s...

Purpose: The inter-rater reliability of the Quebec Task Force (QTF) classification system for Whiplash-Associated Disorders (WAD) remains unknown. Our objective was to determine the inter-rater reliability of the WAD classification between an experienced chiropractic clinician and two chiropractic residents. Methods: We conducted an inter-rater...

Objectives To develop an evidence‐based guideline for the non‐invasive management of soft tissue disorders of the shoulder (shoulder pain), excluding major pathology. Methods This guideline is based on high‐quality evidence from seven systematic reviews. Multidisciplinary experts considered the evidence of effectiveness, safety, cost‐effectiveness...

Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit...

We describe the implementation of brief action planning in conjunction with evidence‐based clinical practice guideline recommendations to improve self‐efficacy in a patient with psychosocial barriers and persistent nonspecific low back pain. We describe the implementation of brief action planning in conjunction with evidence‐based clinical practice...

Introduction Little is known about effective, efficient and acceptable management of back pain in children. A comprehensive and updated evidence synthesis can help to inform clinical practice. Objective To inform clinical practice, we aim to conduct a systematic review of the literature and synthesise the evidence regarding effective, cost–effecti...

Purpose: To update the findings of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) on prognostic factors for whiplash-associated disorder (WAD) outcomes. Materials and methods: We conducted a systematic review and best-evidence synthesis. We systematically searched MEDLINE, EMBASE, CIN...

Objective: To develop an evidence‐based clinical practice guideline for the non‐pharmacological management of shoulder soft tissue disorders (shoulder pain). Methods: This guideline is based on seven systematic reviews. A multidisciplinary expert panel formulated recommendations based on evidence of effectiveness, safety, cost-effectiveness, societ...

Introduction Surgical rates for low back pain (LBP) have been increasing in Europe, North America and Asia. Many patients treated surgically will require postsurgical rehabilitation. Little is known about the effectiveness of postsurgical rehabilitation interventions on health outcomes or about patients’ experiences with these interventions. Objec...

The purpose of this study is to determine the reliability and validity of clinical tests used to assess cervical function, muscle strength and endurance in adults with neck pain and its associated disorders (NAD). Systematic review and update of the Bone and Joint Decade 2000–2010 Task Force on NAD. We systematically searched five electronic databa...

Mental health conditions such as depression and anxiety represent a growing health concern among post-secondary students. Mental health and sleep problems tend to co-occur and circadian preference may have implications for mental health outcomes. We conducted a systematic review of the literature to synthesize the existing evidence on the associati...

Purpose To determine the reliability and validity of self-reported questionnaires to measure pain and disability in adults with grades I–IV neck pain and its associated disorders (NAD). Methods We updated the systematic review of the 2000–2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders and systematically searched da...

Objectives To develop an evidence‐based guideline for the non‐pharmacological management of persistent headaches associated with neck pain (i.e., tension‐type or cervicogenic). Methods This guideline is based on systematic reviews of high‐quality studies. A multidisciplinary expert panel considered the evidence of clinical benefits, cost‐effective...

Objective To evaluate the effectiveness of a government-regulated rehabilitation guideline compared with education and activation by general practitioners, and to a preferred-provider insurance-based rehabilitation programme on self-reported global recovery from acute whiplash-associated disorders (WAD) grade I–II. Design Pragmatic randomised clin...

Purpose: To determine the reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with grades I-IV neck pain and associated disorders (NAD). Methods: We systematically searched electronic databases to update the systematic review of the Bone and Joint Decade 2000–2010 Task Force on Neck Pai...

Purpose: The purpose of this review was to develop recommendations for non-invasive management of pain due to osteoporotic vertebral compression fractures (OVCF) that could be applied in medically underserved areas and low- and middle-income countries. Methods: We conducted a systematic review and best evidence synthesis of systematic reviews on...

Purpose: Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI)...

Purpose: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. Methods: The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evid...

Purpose: The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. Methods: World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiati...

Purpose: Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could b...

Purpose: To update findings of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) on the validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk adult patients with blunt trauma to the neck. Methods: We searched four databases fr...

The purpose of this review was to synthesize evidence on the associations of physical activity, sedentary time, and fitness with stress, depression, and anxiety in post-secondary students. We conducted a systematic review of the literature and searched four databases from 2000 to 2016. In total, 1942 articles were screened, 22 were critically appra...

Background: Neck pain and its associated disorders (NAD) are common in the general population. More than 80% of individuals experience NAD during their lifetime and 30-50% of the general adult population reports neck pain annually. An accurate diagnosis is necessary to guide patient management and inform prognosis. Clinicians require an approach th...

Purpose Our objective was to develop a clinical prediction model to identify workers with sustainable employment following an episode of work-related low back pain (LBP). Methods We used data from a cohort study of injured workers with incident LBP claims in the USA to predict employment patterns 1 and 6 months following a workers' compensation cla...

Objective: To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. Methods: We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literatu...

Background context Little is known about the effectiveness of multimodal care for individuals with whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD). Purpose To update findings of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of multimodal care...

We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Ser...

Purpose To update findings of the 2000–2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders and evaluate the effectiveness of non-invasive and non-pharmacological interventions for the management of patients with headaches associated with neck pain (i.e., tension-type, cervicogenic, or whiplash-related headaches). Methods...

Purpose: To develop an evidence-based guideline for the management of grades I-III neck pain and associated disorders (NAD). Methods: This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and...

Study Design Systematic review. Background Acupuncture is a commonly used treatment for musculoskeletal disorders (MSDs); however, little is known about the effectiveness of acupuncture therapies for the management of MSDs. Objective To summarize and evaluate the available research on the effectiveness and safety of acupuncture therapies for MSDs o...

Objective: To evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the elbow. Methods: We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane Central Register of Controlled Trials from 1990 to 2015. Studies meeting our selection criteria were eligible for critical appraisal. R...

Objective: The purpose of this narrative inquiry was to explore the experiences of persons who were injured in traffic collisions and seek their recommendations for the development of clinical practice guideline (CPG) for the management of minor traffic injuries. Methods: Patients receiving care for traffic injuries were recruited from 4 clinics...

Objective: The purpose of this systematic review was to evaluate the effectiveness of multimodal care for the management of soft tissue injuries of the shoulder. Methods: We conducted a systematic review and searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Two independent revie...

Objective: The purpose of this systematic review was to evaluate the effectiveness of multimodal care for the management of soft tissue injuries of the lower extremity. Methods: We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Random pairs of independent revie...

Objective: The purpose of this systematic review was to determine the effectiveness of exercise for the management of soft tissue injuries of the hip, thigh, and knee. Methods: We conducted a systematic review and searched MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, and CINAHL Plus with Full Text from January 1...

Background context: In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NA...

Purpose: To determine the effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities. Methods: We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from January 1, 1990 to March 14, 2015. Paired reviewers independently screened tit...

Background context: Whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD) are prevalent conditions that impact society and impose a significant economic burden on health-care systems. Health economic evidence on WAD and NAD interventions has been sparse: only three economic evaluations of interventions for NAD were ident...

Background: Musculoskeletal disorders (MSDs) of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpos...

Background: Soft-tissue therapy is commonly used to manage musculoskeletal injuries. Objective: To determine the effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities. Design: Systematic Review. Methods: We searched six databases from 1990 to 2015 and critically a...

The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children wi...

The purpose of this study was to critically appraise and synthesize evidence on the effectiveness of noninvasive interventions, excluding pharmacological treatments, for musculoskeletal thoracic pain. Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of noninvasive interventions were eligible...

The purpose of this systematic review was to evaluate the effectiveness of exercise compared to other interventions, placebo/sham intervention, or no intervention in improving self-rated recovery, functional recovery, clinical, and/or administrative outcomes in individuals with musculoskeletal disorders and injuries of the elbow, forearm, wrist, an...

To determine the effectiveness and cost-effectiveness of non-invasive interventions for temporomandibular disorders (TMD). We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central register from 1990 to 2014 for effectiveness studies and the Cochrane Health Technology Assessment Database, EconLit, NHS Economic Evaluation Da...

To evaluate the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for the management of neck pain and associated disorders (NAD), whiplash-associated disorders, and non-specific low back pain (LBP) with or without radiculopathy. We systematically searched six databases from 2000 to 2014. Random pairs of independent reviewers criticall...

Soft tissue injuries of the leg, ankle, or foot are common and often treated by exercise. The purpose of this study was to determine the effectiveness of exercise for the management of soft tissue injuries of the leg, ankle, or foot. A systematic review of the literature was conducted. We searched five databases from 1990 to 2015. Relevant articles...

Background Context: In 2008, the lack of published evidence prevented the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force [NPTF]) from commenting on the effectiveness of psychological interventions for the management of neck pain. Purpose: This study aimed to update findings of the NPTF and...

Background: Shoulder pain is a common musculoskeletal condition in the general population. Passive physical modalities are commonly used to treat shoulder pain. However, previous systematic reviews reported conflicting results. Purpose: The aim of this study was to evaluate the effectiveness of passive physical modalities for the management of s...

Sutton D, Côté P, Wong JJ, Varatharajan S, Randhawa K, Yu H, Southerst D, Shearer HM, van der Velde G, Nordin, Carroll LJ, Mior S, Taylor-Vaisey A, Stupar M.

Objective: To evaluate the methodological quality and synthesize recommendations of evidence-based guidelines for the management of common traffic injuries. Study design: We conducted a systematic review and best evidence synthesis of guidelines on musculoskeletal injuries, psychological disorders and mild traumatic brain injuries (MTBI) from 19...

In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders recommended patient education for the management of neck pain. However, the effectiveness of education interventions has recently been challenged. To update findings of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Diso...

In 2008, the Neck Pain Task Force (NPTF) recommended exercise for the management of neck pain and whiplash-associated disorders (WAD). However, no evidence was available on the effectiveness of exercise for grade III neck pain or WAD. Moreover, limited evidence was available to contrast the effectiveness of various types of exercises. To update the...

Purpose: We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. Methods: We searched electronic databases from 1990 to 2012. Random pairs of independent re...

Purpose: To determine the cost-effectiveness of education and activation, and a multidisciplinary rehabilitation program, compared to the province of Ontario’s legislated standard of care for acute whiplash injury. Method: We conducted an economic evaluation alongside the University Health Network Whiplash Intervention Trial. The trial compared t...

Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD). A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1) physician-based education and activation, 2) a re...

The objectives of this study were to determine the test-retest reliability of two self-perceived recovery questions in patients with recent whiplash-associated disorders (WAD), and to assess whether remembering previous answers influences reliability. The self-perceived general recovery and self-perceived change in neck pain questions were administ...

Whiplash injuries are an important public health problem that is associated with significant disability and high health care utilization. Recent cohort studies suggest that physician care may be the most effective treatment for patients with whiplash-associated disorders. However, these findings have not been tested in a randomized controlled trial...

Domestic violence is the most common cause of nonfatal injury to women in North America. In a review of 144 such injuries, the second most common manifestation of intimate partner violence was musculoskeletal injuries (28%). The American Academy of Orthopaedic Surgeons is explicit that orthopaedic surgeons should play a role in the screening and ap...

This study assessed chiropractors' attitudes, beliefs, knowledge, and experience about intimate partner violence (IPV) and identified if any differences exist between age groups, sex, and year of graduation of respondents. Five hundred five Ontario chiropractors were sampled from the Canadian Chiropractic Association membership using a randomizatio...

The purpose of the present study was to examine chiropractic utilization following a sport-related injury among National Team members and other high level Taekwondo athletes. Retrospective surveys were conducted among Canadian male and female Taekwondo athletes (Group A, n = 60) competing in a national tournament and National Taekwondo team athlete...

Synovial chondromatosis is a rare, generally benign condition which affects synovial membranes. It most commonly involves large joints such as the knee, hip, and elbow, but its presence in smaller joints has also been reported. The diagnosis of synovial chondromatosis is commonly made following a thorough history, physical examination, and radiogra...

The aim of this study is to assess chiropractors' attitudes, beliefs, knowledge, and experience about intimate partner violence (IPV). This cross-sectional survey was developed by members of the Violence Against Women Health Research Collaborative. The survey was disseminated to a voluntary, nonrandom convenience sample of chiropractors attending a...