Roni Evans

• PhD
• Professor (Associate) at University of Minnesota

Low back pain (LBP) is common in adolescence but there is a paucity of high quality research to inform care. We conducted a multicenter randomized trial comparing 12 weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) to ET alone.Participants were 185 adolescents aged 12-18 years with chronic LBP.The primary outcome was L...

Background context: The optimal number of visits for the care of cervicogenic headache (CGH) with spinal manipulative therapy (SMT) is unknown. Purpose: To identify the dose-response relationship between visits for SMT and chronic CGH outcomes; to evaluate the efficacy of SMT by comparison with a light massage control. Study design/setting: Tw...

Expressive writing has been shown to improve physical, mental, and social health outcomes for patients struggling with difficult diagnoses. In many online health communities, writing comprises a substantial portion of the user experience, yet little work has explored how writing itself affects user engagement. This paper explores user engagement on...

Study Design Cross-sectional. Background Although low back pain (LBP) occurs commonly in adolescence, little is known about the relationship between objectively measured physical activity and chronic LBP. Objectives To assess the relationship between an objective physical activity measure (accelerometer) and standard clinical measures (pain inten...

At July 2017, this protocol has been withdrawn. It was part of a series of three reviews (intended to update and replace the original review (Bronfort 2014)), but the series of reviews did not meet the expectations of PaPaS or Cochrane.

At July 2017, this protocol has been withdrawn. It was part of a series of three reviews (intended to update and replace the original review (Bronfort 2014)), but the series of reviews did not meet the expectations of PaPaS or Cochrane.

At July 2017, this protocol has been withdrawn. It was part of a series of three reviews (intended to update and replace the original review (Bronfort 2014)), but the series of reviews did not meet the expectations of PaPaS or Cochrane.

Background Cervicogenic headache is a prevalent and costly pain condition commonly treated by chiropractors. There is evidence to support the effectiveness for spinal manipulation, but the dose of treatment required to achieve maximal relief remains unknown. The purpose of this paper is to describe the methodology for a randomized controlled trial...

Objectives: To examine the prevalence of complementary and alternative medicine (CAM) use by race/ethnicity and to identify sociodemographic and health-related factors associated with CAM use among US adults with moderate mental distress (MMD). Methods: We analyzed data from the 2012 National Health Interview Survey (NHIS). We used data for 6016...

Background: Patient perceptions may influence the effectiveness and utilization of healthcare interventions, particularly for complex health conditions such as sciatica or back-related leg pain (BRLP). Objectives: To explore BRLP patients' perceptions of spinal manipulative therapy (SMT) and home exercise with advice (HEA). Design: Qualitative...

Background: Online education programs are becoming a popular means to disseminate knowledge about evidence-based practice (EBP) among healthcare practitioners. This mode of delivery also offers a viable and potentially sustainable solution for teaching consistent EBP content to learners over time and across multiple geographical locations. We cond...

Background: The public health impact of psychological trauma exacts a large toll on those who experience trauma, the people in those individuals’ lives, and society as a whole. Stemming from events or circumstances experienced as physically or emotionally harmful or life threatening, trauma can result in significantly diminished mental, physical, s...

Background context: Chronic neck pain is a prevalent and disabling condition among older adults. Despite the large burden of neck pain, little is known regarding the cost-effectiveness of commonly used treatments. Purpose: This study aimed to estimate the cost-effectiveness of home exercise and advice (HEA), spinal manipulative therapy (SMT) plu...

This is the protocol for a review and there is no abstract. The objectives are as follows: To quantify and compare the short- and long-term effects of manual treatment and spinal rehabilitative exercise for cervicogenic headache, classified according to the International Headache Society's (IHS) diagnostic criteria, with an active or placebo/sham c...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the short- and long-term effects of manual treatment and spinal rehabilitative exercise for the prevention of tension-type headache in adults.

Objective: Most health professions recognize the value of evidence-based practice (EBP), yet the uptake of EBP across most health disciplines has been suboptimal. To improve EBP uptake, it is important to first understand the many dimensions that affect EBP use. The Evidence-Based practice Attitude and utilization SurvEy (EBASE) was designed to me...

Background: Many people suffering from low back pain (LBP) have found conventional medical treatments to be ineffective for managing their LBP and are increasingly turning to complementary and alternative medicine (CAM) to find pain relief. A comprehensive picture of CAM use in the LBP population, including all of the most commonly used modalities...

Objectives: To identify Canadian chiropractors' attitudes, skills and use of evidence based practice (EBP), as well as their level of awareness of previously published chiropractic clinical practice guidelines (CPGs). Methods: 7,200 members of the Canadian Chiropractic Association were invited by e-mail to complete an online version of the Evide...

ABSTRACT Background: Online educational interventions to teach evidence-based practice (EBP) are a promising mechanism for overcoming some of the barriers to incorporating research into practice. However, attention must be paid to aligning strategies with adult learning theories to achieve optimal outcomes. Methods: We describe the development of...

This is the protocol for a review and there is no abstract. The objectives are as follows: The objectives of the review are to quantify and compare the short- and long-term effects of manual treatment and spinal rehabilitative exercise for episodic and chronic migraine classified according to the International Headache Societies (IHS) diagnostic cr...

Evidence based practice (EBP) is being increasingly utilized by health care professionals as a means of improving the quality of health care. The introduction of EBP principles into the chiropractic profession is a relatively recent phenomenon. There is currently a lack of information about the EBP literacy level of US chiropractors and the barrier...

Introduction: The world's population is aging quickly, leading to increased challenges of how to care for individuals who can no longer independently care for themselves. With global social and economic pressures leading to declines in family support, increased reliance is being placed on community- and government-based facilities to provide long-t...

Objective The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction. Methods This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered...

Objective: To explore perceptions of spinal manipulative therapy and exercise among adults aged 65 years and older with chronic neck pain. Design: Mixed methods study embedded within a randomized clinical trial. Subjects/patients: Interviews were conducted with 222 of 241 randomized clinical trial participants. They had a mean age of 72.2 year...

Background: Back-related leg pain (BRLP) is often disabling and costly, and there is a paucity of research to guide its management. Objective: To determine whether spinal manipulative therapy (SMT) plus home exercise and advice (HEA) compared with HEA alone reduces leg pain in the short and long term in adults with BRLP. Design: Controlled pra...

Purpose To identify and evaluate the effectiveness of conservative treatment approaches used in children and adolescents to manage and prevent low back pain (LBP). Methods Five electronic databases and the reference lists of systematic reviews were searched for relevant studies. Randomised controlled trials (RCTs) were considered eligible for in...

Back and neck disability are frequent in older adults resulting in loss of function and independence. Exercise therapy and manual therapy, like spinal manipulative therapy (SMT), have evidence of short and intermediate term effectiveness for spinal disability in the general population and growing evidence in older adults. For older populations expe...

Objectives: To present the varied approaches of 9 complementary and alternative medicine (CAM) institutions (all grantees of the National Center for Complementary and Alternative Medicine) used to develop faculty expertise in research literacy and evidence-based practice (EBP) in order to integrate these concepts into CAM curricula. Design: A su...

Background Low back pain is among the most common and costly chronic health care conditions. Recent research has highlighted the common occurrence of non-specific low back pain in adolescents, with prevalence estimates similar to adults. While multiple clinical trials have examined the effectiveness of commonly used therapies for the management of...

Purpose: The objective of this study was to determine the changes in perceptions on Integrative Medicine (IM) before and after taking IM related courses at University of California, Ir-vine. We hypothesized that student's familiarity, confidence in assessing treatments, and willingness to take more college courses would increase after taking these...

Global Perceived Effect (GPE) is a commonly used outcome measure for musculoskeletal conditions like neck pain; however, little is known regarding the factors patients take into account when determining their GPE. The overall objective of this work was to describe the thematic variables, which comprise the GPE from the patient's perspective. This w...

Background Back and neck disability are frequent in older adults resulting in loss of function and independence. Exercise therapy and manual therapy, like spinal manipulative therapy (SMT), have evidence of short and intermediate term effectiveness for spinal disability in the general population and growing evidence in older adults. For older popul...

Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors. To assess the relative effectiveness of spinal...

Purpose: The purpose of this study was to gain insight into how low back pain (LBP) patients conceptualize the construct of expectations regarding treatment. Methods: This study was nested within a mixed-method randomized clinical trial comparing three primary care interventions for LBP. A total of 77 participants with LBP lasting longer than 6...

Background: Adverse events (AEs) associated with spinal manipulative therapy and exercise are common, but generally mild in intensity and duration. Their occurrence in an elderly population is less well understood. Methods: AEs were collected as part of an IRB-approved randomized clinical trial of chronic neck pain in seniors > 65 years old. Part...

Purpose Elderly residents in long term care (LTC) settings experience a myriad of health complaints that may be amenable to complementary and alternative medicine (CAM) therapies. However, specialized training addressing the unique features of geriatric health care, particularly in LTC settings , will be required if CAM professionals are to play a...

Purpose There is insufficient information published on the topic of complementary and alternative medicine (CAM) clinical services within geriatric settings. The purpose of this presentation is to describe results of a CAM demonstration project carried out within two geriatric facilities. Acupuncture and Oriental medicine (AOM), chiropractic, and m...

Purpose To determine the relative effectiveness of multidisciplinary integrative care compared to chiropractic care for chronic LBP in patients over 18 years of age using pain as the primary outcome measure. Secondary outcomes were patient self-reported disability, global perceived effect, general health status, satisfaction, self-efficacy, fear av...

The NCCAM-funded R25 project has provided the impetus for meaningful culture change at Northwestern Health Sciences University (NWHSU) which, over the long term, can affect the professional culture of our CAM constituents. Benefiting from a unique collaboration with the University of Minnesota Center for Spirituality and Healing, we are making subs...

Mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives. Little research exists to guide the choice of therapy for acute and subacute neck pain. To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck...

Randomized controlled trial using mixed methods. To evaluate the relative effectiveness of high-dose supervised exercise with and without spinal manipulation and low-dose home exercise for chronic neck pain. Neck pain is a common global health care complaint with considerable social and economic impact. Systematic reviews have found exercise therap...

Several conservative therapies have been shown to be beneficial in the treatment of chronic low back pain (CLBP), including different forms of exercise and spinal manipulative therapy (SMT). The efficacy of less time-consuming and less costly self-care interventions, for example, home exercise, remains inconclusive in CLBP populations. The purpose...

Back-related leg pain (BRLP) is a common variation of low back pain (LBP), with lifetime prevalence estimates as high as 40%. Often disabling, BRLP accounts for greater work loss, recurrences, and higher costs than uncomplicated LBP and more often leads to surgery with a lifetime incidence of 10% for those with severe BRLP, compared to 1-2% for tho...

In this systematic review, we present a comprehensive and up-to-date systematic review of the literature as it relates to the efficacy and effectiveness of spinal manipulation or mobilization in the management of cervical, thoracic, and lumbar-related extremity pain. There is moderate quality evidence that spinal manipulation is effective for the t...

Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complement...

The literature search strategy.

Includes the criteria used for evaluating risk of bias from randomized controlled trials not included within systematic reviews, evidence based guidelines, or health technology assessments.

The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely ac...

Background Several initiatives at Northwestern Health Sciences University (NWHSU) reflect a strong commitment to integrative patient care. An assessment of current projects was conducted to inform future growth in NWHSU's clinical services, education and research programs. Methods On-going institutional initiatives, considered integrative in...

There is a growing need for students and practitioners of Traditional Chinese Medicine to gain experience with standardized data collection, patient outcomes measurement, and practice-based research. The purpose of this paper is to describe the development of a process for standardized data collection that could eventually be adopted for clinical,...

The purpose of this study was to describe patients who seek treatment at an acupuncture and Oriental medicine teaching clinic in the United States, and to systematically measure and describe patients' responses after treatment using a prospective study design. This is a prospective survey of clinic patients at intake and one month following the ini...

Content on integrative healthcare and complementary and alternative medicine is being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice....

The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goa...

Low back pain (LBP) and neck pain (NP) are common conditions in old age, leading to impaired functional ability and decreased independence. Manual and exercise therapies are common and effective therapies for the general LBP and NP populations. However, these treatments have not been adequately researched in older LBP and NP sufferers. The primary...

Objective: The purpose of this white paper is to help inform the chiropractic clinical research agenda with a focus on the United States. Methods and discussion: The recommendations and action items from 2 previous articles published in 1997 are discussed within the context of 3 broad topics: research culture, research infrastructure, and clinic...

In the April 2006 issue of the Journal of Royal Society of Medicine, Ernst and Canter authored a review of the most recent systematic reviews on the effectiveness of spinal manipulation for any condition. The authors concluded that, except for back pain, spinal manipulation is not an effective intervention for any condition and, because of potentia...

The purpose of this study is to review the literature concerning distraction manipulation of the lumbar spine, particularly regarding physiological effects, clinical efficacy, and safety. A search of the English language literature was conducted using the MEDLINE, Embase, CINAHL, Chiropractic Research Archives Collection, and Manual, Alternative, a...

To assess the feasibility of recruiting sciatica patients and to evaluate their compliance in preparation for a full-scale randomized clinical trial. We also aimed to determine the responsiveness of key outcome measures. Thirty-two subjects were randomly assigned to spinal manipulation (n=11), epidural steroid injections (n=11), or self-care educat...

To investigate the accrual rates and recruitment processes among 3 Midwestern sites during a pilot study on manual therapy for chronic pelvic pain. Multisite pilot study for a randomized, placebo-controlled clinical trial. Three chiropractic institutions in or near major metropolitan cities in the Midwestern United States. Thirty-nine women aged 18...

Despite the many published randomized clinical trials (RCTs), a substantial number of reviews and several national clinical guidelines, much controversy still remains regarding the evidence for or against efficacy of spinal manipulation for low back pain and neck pain. To reassess the efficacy of spinal manipulative therapy (SMT) and mobilization (...

Non-invasive physical treatments are often used to treat common types of chronic/recurrent headache. To quantify and compare the magnitude of short- and long-term effects of non-invasive physical treatments for chronic/recurrent headaches. We searched the following databases from their inception to November 2002: MEDLINE, EMBASE, BIOSIS, CINAHL, Sc...

Little is known about the issues low back pain patients take into account when deciding their satisfaction with care, the importance placed on such satisfaction, or the factors they consider when assessing their overall improvement. The purpose of this study was to explore these issues and to assess the feasibility of implementing qualitative resea...

To conduct a pilot study in preparation for a full-scale randomized clinical trial assessing conservative treatments for acute and subacute neck pain. Study design Prospective, randomized pilot study. Primary contact chiropractic and medical clinics. Ages 21 to 65 with current episode of neck pain less than 12 weeks in duration. Outcome measures Pa...

To better understand the experiences and problems encountered by research assistants (RAs) involved in clinical trials to improve the process of RA training for future studies. A 1-time focus group of research assistants was conducted. A chiropractic college in the United States during a national chiropractic research agenda conference. Eight resea...

Randomized clinical trial. To compare the effects of spinal manipulation combined with low-tech rehabilitative exercise, MedX rehabilitative exercise, or spinal manipulation alone in patient self-reported outcomes over a two-year follow-up period. There have been few randomized clinical trials of spinal manipulation and rehabilitative exercise for...

There are fundamental differences between the administration of medications and the application of manual procedures, such as those used by chiropractors. The objective of this study was to gather preliminary information on how to address these differences in the design of a multisite, randomized placebo-controlled trial of chiropractic care for wo...

The first objective was to determine if chiropractic spinal manipulative therapy (SMT) in addition to optimal medical management resulted in clinically important changes in asthma-related outcomes in children. The second objective was to assess the feasibility of conducting a full-scale, randomized clinical trial in terms of recruitment, evaluation...

Chronic headache is a prevalent condition with substantial socioeconomic impact. Complementary or alternative therapies are increasingly being used by patients to treat headache pain, and spinal manipulative therapy (SMT) is among the most common of these. To assess the efficacy/effectiveness of SMT for chronic headache through a systematic review...

A randomized, parallel-group, single-blinded clinical trial was performed. After a 1-week baseline period, patients were randomized to 11 weeks of therapy, with posttreatment follow-up assessment 3, 6, and 12 months later. To compare the relative efficacy of rehabilitative neck exercise and spinal manipulation for the management of patients with ch...

To assess the feasibility of patient recruitment, the ability of patients and clinicians to comply with study protocols, and the use of data collection instruments to collect cost-effectiveness data, and to obtain variability estimates for sample-size calculations for a full-scale trial. Prospective, observer-blinded, pilot randomized clinical tria...

Pediatric otitis media with effusion is a common and costly condition. Although chiropractors have anecdotally claimed success in treating otitis media, there is little research to support their claims. A pilot study was undertaken for the purpose of assessing the feasibility of conducting a full-scale randomized clinical trial investigating the ef...

Migraine headache affects approximately 11 million adults in the United States. Spinal manipulation is a common alternative therapy for headaches, but its efficacy compared with standard medical therapies is unknown. To measure the relative efficacy of amitriptyline, spinal manipulation and the combination of both therapies for the prophylaxis of m...