Katherine A Pohlman

Parker University · Parker Research Institute

This prospective, community-based, active surveillance study aimed to report the incidence of moderate, severe, and serious adverse events (AEs) after chiropractic (n = 100) / physiotherapist (n = 50) visit in offices throughout North America between October-2015 and December-2017. Three content-validated questionnaires were used to collect AE info...

Objectives Patients’ interactions with health care providers influence back pain–related outcomes. The Health Care Providers’ Pain and Impairment Relationship Scale (HC‐PAIRS) is an instrument that assesses providers’ attitudes and beliefs about patients with persistent back pain, with lower scores implying that persistent pain does not indicate di...

Background The Global Patient Safety Action Plan, an initiative of the World Health Organization (WHO), draws attention to patient safety as being an issue of utmost importance in healthcare. In response, the World Federation of Chiropractic (WFC) has established a Global Patient Safety Task Force to advance a patient safety culture across all face...

Background Manual therapies are commonly used by healthcare professionals when caring for children. However, few prospective studies have evaluated their adverse events (AEs). This study aims to assess the feasibility of a pragmatic prospective study aiming to report the immediate and delayed (48-hours post-treatment) AEs associated with manual the...

Background While the use of chiropractic care for persistent low back pain (PLBP) is prevalent, chiropractors’ attitudes and beliefs related to PLBP patients are not fully understood. The purpose of this study was to assess the attitudes, beliefs and activity/work recommendations of students and faculty at a chiropractic college regarding PLBP pati...

Background: Manual therapies are commonly used by healthcare professionals when caring for children. However, few prospective studies have evaluated their adverse events (AEs). This study aims to assess the feasibility of a pragmatic prospective study aiming to report the immediate and delayed (48-hours post-treatment) AEs associated with manual th...

Background Chiropractors commonly treat pediatric patients within their private practices. The objectives of this study were (1) to identify the treatment techniques and health advice used by Quebec chiropractors with pediatric patients; (2) to explore the research priorities of Quebec chiropractors for the pediatric population; and (3) to identify...

Objective: The purpose of this study was to describe patient demographics and pain changes for women over the course of care in a chiropractic program. Methods: We performed a retrospective cross-sectional analysis of a prospective quality assurance database from the Mount Carmel Clinic (MCC) in Winnipeg, Manitoba, Canada. Pain scores were repor...

Background Healthcare providers’ attitudes and beliefs about pain conditions influence those of patients and may impact outcomes. While the use of chiropractic care for persistent low back pain (PLBP) is prevalent, chiropractors’ attitudes and beliefs related to PLBP patients are not fully understood. The purpose of this study was to assess the att...

Background Worldwide, many patients, including minors, seek chiropractic care. The purpose of this study was to investigate the practice characteristics of chiropractors who treat pediatric patients in Quebec, Canada. Methods We conducted a web-based cross-sectional survey of all licensed chiropractors working in Quebec (Canada). Data were collect...

Introduction Spinal and peripheral joint manipulation and mobilization are interventions used by many healthcare providers to manage musculoskeletal conditions. Although there are many reports of adverse events (or undesirable outcomes) following such interventions, there is no common definition for an adverse event or clarity on any severity class...

Background The unprecedented impact of COVID-19 on healthcare professionals has implications for healthcare delivery, including the public health guidance provided to patients. This study aims to assess the response and impact of COVID-19 on chiropractors internationally, and examines the public health response of chiropractors to the COVID-19 pand...

Objective Evaluate chiropractic care including flexion distraction spinal manipulation for improving function, symptoms and performance-based mobility in patients with lumbar spinal stenosis (LSS) using a pretest-posttest design. Methods Data were collected at baseline, midpoint and final visits prior to care on each visit. Objective data included...

Objective This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical pain rating 0–10 scale, 2) 24-item Roland-Morris Disability Questionnaire (RMDQ); and 3) global...

Correspondence from Yu et al. identify methodological issues with the systematic review of manual therapy for pediatric manuscript. Like any research study, limitations are important for readers to keep in consideration when reviewing study findings. The primary authors maintain full confidence in the use of the review to provide practicing clinici...

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

Background Patient-reported outcome measurements (PROM) are instruments that seek a patient’s health or functional status. Inclusion of standardized PROMs in research studies and clinical practice provides a more comprehensive understanding of an intervention from the patient’s viewpoint. This secondary analysis identified PROM usage and appropriat...

Introduction Spinal and peripheral joint manipulation (SMT) and mobilisation (MOB) are widely used and recommended in the best practice guidelines for managing musculoskeletal conditions. Although adverse events (AEs) have been reported following these interventions, a clear definition and classification system for AEs remains unsettled. With many...

Objective The purpose of this project was to develop a best-practices document on chiropractic care for pregnant and postpartum patients with low back pain (LBP), pelvic girdle pain (PGP), or a combination. Methods A modified Delphi consensus process was conducted. A multidisciplinary steering committee of 11 health care professionals developed 71...

Background Patient safety research is expanding from hospitals to community-based healthcare settings. Knowledge gaps persist among manual therapy professions that may impede patient safety initiatives within musculoskeletal care settings. Objectives To describe perceptions of patient safety among chiropractors and physiotherapists who provide spi...

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...

Background Previous research demonstrated that manipulation of the extremities was associated with changes in multisegmental postural sway as well as improvement in a lower extremity balancing task. We were interested if these effects would extend to an upper extremity task. Our aim in this study was to investigate whether extremity manipulation co...

Objective: To pilot a pretest-posttest study of spinal manipulation on improving function and symptomatology in patients with lumbar spinal stenosis (LSS). Methods: Participants received spinal manipulation at the chiropractor’s discretion. Data were collected at baseline, midpoint and final visits. Objective data included timed-up-and-go, sit-to-s...

Objectives This pragmatic, cluster, stratified randomised controlled trial (RCT) compared the quantity and quality of adverse event (AE) reports after chiropractic manual therapy in children less than 14 years of age, using active versus passive surveillance reporting systems. Method Data were collected between November 2014 and July 2017 from 60...

Background: Patient safety research has lagged within academic settings, including chiropractic teaching institutions. To develop a robust patient safety culture, the Institute of Medicine emphasized the need for employee's attitudes to be understanding and positive. To initiate the assessment of the current culture and future needs, this study ev...

Background: Previous research demonstrated that manipulation of the extremities was associated with changes in multisegmental postural sway as well as improvement in a lower extremity balancing task. We were interested if these effects would extend to an upper extremity task. Our aim in this study was to investigate whether extremity manipulation c...

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...

Objective: The purpose of this study was to conduct a systematic review (SR) of the literature to assess the effectiveness of chiropractic care options commonly used for pregnancy-related low back pain (LBP), pelvic girdle pain (PGP), or combination pain for both experienced practitioners and students of chiropractic. Methods: We included proced...

Objective Evaluate multisegmental postural sway after upper- vs lower-extremity manipulation. Methods Participants were healthy volunteers (aged 21-40 years). Upper- or lower-extremity manipulations were delivered in a randomized crossover design. Postural assessments were made pre-post manipulation, in floor and rocker board conditions. Analysis...

Objective This study aimed to assess the feasibility of implementing an active-surveillance reporting system within a chiropractic teaching clinic and subsequently determining the frequency of adverse events (AEs) after treatment administered by chiropractic interns. Methods Interns were invited to collect data from patients using 3 questionnaires...

Objective The purpose of this study was to conduct a systematic review (SR) of the literature to assess the effectiveness of specific chiropractic care options commonly used for postpartum low back pain (LBP), pelvic girdle pain (PGP), or combination (LBP and PGP) pain. Methods A search strategy was developed. Interventions were those manual or ot...

Objective To describe the clinical use of patient-reported outcome measures (PROMs) and screening tools (STs) for low back pain (LBP) in clinics of chiropractic teaching institutions in the United States. Methods A descriptive analysis was completed with data collection achieved between June 2018 and March 2019. PROMs/STs were classified as disabi...

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...

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...

Background Approximately 60% of people with low back pain also have associated leg pain symptoms. Guidelines for low back pain recommend non-pharmacological approaches, including spinal manipulation - a therapy provided by chiropractors. However, limited empirical data has examined the characteristics of chiropractors managing patients with low bac...

Background: Patient-centred care is internationally recognized as a foundation of quality patient care. Attitudes of students towards patient-centred care have been assessed in various health professions. However, little is known how chiropractic students' attitudes towards patient-centred care compare to those of other health professions or wheth...

Objective To assess the self-perceived importance, skills, and utilization of evidence-based practice (EBP) among faculty and students at a chiropractic institution without a structured EBP program. The survey also evaluated EBP satisfaction among students and EBP implementation barriers/facilitators among the faculty. Methods In this cross-sectio...

Background Low back pain (LBP) is a global public health challenge, which causes high health‐care costs and the highest burden on society in terms of years lived with disability. While patient expectations for improvement may have effects on LBP treatment outcomes, it remains unclear if psychological profiles modify this relationship. Therefore, th...

Objective: To evaluate student perceptions of chiropractic cultural authority, role in healthcare and use of terms at two chiropractic institutions, the Canadian Memorial Chiropractic College (CMCC) and Parker University (Parker). Methods: A unique survey was developed and administered electronically to Year 2-3 students (n=387) at CMCC and as a...

Background This systematic review evaluates the use of manual therapy for clinical conditions in the pediatric population, assesses the methodological quality of the studies found, and synthesizes findings based on health condition. We also assessed the reporting of adverse events within the included studies and compared our conclusions to those of...

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 developm...

Importance It is critically important to evaluate the effect of nonpharmacological treatments on low back pain and associated disability. Objective To determine whether the addition of chiropractic care to usual medical care results in better pain relief and pain-related function when compared with usual medical care alone. Design, Setting, and P...

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...

Background Patient safety performance can be assessed with several systems, including passive and active surveillance. Passive surveillance systems provide opportunity for health care personnel to confidentially and voluntarily report incidents, including adverse events, occurring in their work environment. Active surveillance systems systematicall...

Objective: The purpose of this cross-sectional survey was to evaluate attitudes and opinions of doctors of chiropractic (DCs) specializing in pediatric care toward patient safety. Methods: The Medical Office Survey on Patient Safety Culture of the Agency for Healthcare Research and Quality was adapted for providers who use spinal manipulation th...

Objective: The purpose of this pilot sham-controlled clinical trial was to estimate the treatment effect and safety of toggle recoil spinal manipulation for blood pressure management. Methods: Fifty-one participants with prehypertension or stage 1 hypertension (systolic blood pressure ranging from 135 to 159 mm Hg or diastolic blood pressure ran...

A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the...

An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to th...

Background Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of...

Low back pain (LBP) is a major health problem in industrialized societies. Spinal manipulation (SM) is often used for treating LBP, though the therapeutic mechanisms remain elusive. Research suggests that sensorimotor changes may be involved in LBP. It is hypothesized that SM may generate its beneficial effects by affecting sensorimotor functions....

Background: Systematic procedures addressing the limitations of eligibility determination are needed to improve the quality of participant recruitment and enrollment in randomized clinical trials. This paper describes an eligibility determination process developed by and in use at a chiropractic research center engaged in community recruitment for...

Background Low back pain (LBP) is a major health issue due to its high prevalence rate and socioeconomic cost. While spinal manipulation (SM) is recommended for LBP treatment by recently published clinical guidelines, the underlying therapeutic mechanisms remain unclear. Spinal stiffness is routinely examined and used in clinical decisions for SM d...

Aim of the study/Introduction. Spinal manipulation therapy (SMT) is used throughout the world by chiropractors, osteopaths, physiotherapists and other manual therapists, yet there are no systematic data collection mechanisms in place to monitor and evaluate adverse events (AE) that occur after SMT. We established a reporting and learning system (“S...

Introduction A team of interdisciplinary research leaders have taken a novel approach to support a patient safety culture for spinal manipulation therapy (SMT) providers. The aim was to devise a team-based approach to identify modifiable and non-modifiable patient and provider risk factors. Methods SafetyNET has four main areas of inquiry, led by...

Purpose: Bakris et al. reported dramatic blood pressure (BP) lowering effects resulting from an upper cervical manipulation technique (NUCCA) in narrowly selected patients with Stage 1 hypertension. Our study compared BP changes between a similar but more commonly used upper cervical technique, Toggle Recoil (TR), and a sham intervention (SI) in a...

A chiropractic pediatric specialist often encounters novel clinical findings not reported currently in the literature. This project matched board certified chiropractic pediatric specialists with a mentor experienced in scientific writing to co-author a research paper to add to the literature base available on chiropractic pediatric practice. Clini...

Otitis media (OM) is one of the common conditions for doctor visits in the pediatric population. Spinal manipulation therapy (SMT) may be a potential conservative treatment of OM. The purpose of this study is to review the literature for OM in children, outlining the diagnosis of OM, SMT description, and adverse event notation. Databases (PubMed, C...

Purpose Fifty to 80% of pregnant women suffer from low back pain (LBP), a condition commonly treated by doctors of chiropractic (DC). Holzer Clinic, an Appalachian inte-grative health facility with 140 multispecialty physicians, utilizes both conventional prenatal and chiropractic care for their pregnant patients. This study assessed the feasibilit...

Purpose To describe a consensus-based case review development process that applies eligibility and diagnostic criteria for diverse clinical trials of chiropractic care for chronic pain conditions. Methods A multidisciplinary team of investigators and clinical research staff provide iterative feedback to develop case review processes for applicatio...

Purpose Successful scientific investigations at CAM institutions are often hampered by limited research infrastructure. Enhancing the clinical trial capabilities of our chiropractic research center was one goal of 2 NIH/NCCAM developmental center grants. Methods Web applications were enhanced and customized based on individual project needs and tr...

Low back pain (LBP) is a well-recognized public health problem with no clear gold standard medical approach to treatment. Thus, those with LBP frequently turn to treatments such as spinal manipulation (SM). Many clinical trials have been conducted to evaluate the efficacy or effectiveness of SM for LBP. The primary objective of this paper was to de...