THE ORIGIN OF THESES Dr. Jerome Fryer obtained his doctorate degree in chiropractic, graduating with honours, from Western States Chiroprac- tic College in Portland, Oregon, in 1999. In 1998, while observing a sea of sitting students in a biomechanics class, the germ that was to develop into the focus of his research came into being. Fryer understood that several people experience low back pain while sitting and/or as a result of sedentary habits, and hypothesized that this was in large part due to compressive effects on the inter- vertebral discs. His area of interest, and, thus, his practice focus, became disk in- tegrity. To help alleviate pain from sitting, Fryer developed a simple seated unload- ing exercise that is meant to shift the per- son’s weight while sitting and minimize the amount of time dependent pressure on the lumbar discs. Fryer put his theo- ries and exercises into clinical use with his patients, beginning with his earliest days in private practice – he still contin- ues to do so – and saw consistent posi- tive results. He found himself wanting to bring his fi ndings to a wider audience and, so, the drive to actually publish the simple seated exercise, and the ideas sur- rounding it, began. THE EARLY STAGES “I hired an artist to draw the seated un- loading strategy, coined ‘chair-care’,” says Fryer, thinking back to his fi rst steps in making his research goal a reality. “As well, I made a $1,000 purchase of the most accurate stadiometre in the world, (accurate to 0.01centimeters), in an at- tempt to provide the most precise height measurements for the scientific commu- nity.” “Then,” he continues, “I decided to run the study right at the clinic I was working at.” Following his work with the artist and the purchase of a stadiometer, Fryer sought a collaboration with a statistician from the University of Northern British Columbia. “After measuring standing height changes before and after the exercise, and finding signifi cant height increases in 89 subjects,” he notes, “I knew I had some- thing!” Considerations for the Private Research Initiative Although he would like independent chiropractors to know that achieving research goals is not impossible, Fryer would also like to point out that there are some checkpoints which DCs need to investigate when embarking on this initiative. 1. Funding: Different provinces, jurisdictions and associations have vary- ing policies on funding and DCs should check with their own associations for local policies and guidelines. 2. Use of human subjects: Independent chiropractors wanting to embark on research projects where human subjects are involved should contact their local jurisdictions for guidelines. Case studies do not require institutional review board approval, as they only require a patient’s full consent. 3. Networking with the appropriate professionals: Just as other practi- tioners and researchers are not qualifi ed in chiropractic, you may not be qualifi ed to handle all aspects of your project. Linking up with appropriate university-affi liated researchers – doctors, statisticians, artists, etc. – may garner you the partnership your project needs to gain depth and credibility. 4. Choosing a journal to target: Choose two or three scientific journals that you would like to see your work published in as early in the process as you can. Inform yourself regarding the submission guidelines, etc., of these publications so that you can tailor your work to their requirements. Send your paper to only one journal at a time. 5. Anticipate rejection: Be prepared for a few psychological bruises, and to persevere if one, two or three cranial contusions should occur. www.canadianchiropractor.ca MOVING THE IDEA BEYOND THE CLINIC DOORS Fryer was now faced with the challenge of taking his data outside of his clinic. At a research conference in Vancouver in 2006, Fryer met up with Dr. Mark Erwin, assistant professor, Department of Sur- gery at the University of Toronto Faculty of Medicine, and Canadian Chiropractic Research Foundation scientist in disc biology. Fryer presented his findings to Erwin who suggested that the data be corroborated with upright magnetic reso- nance imaging (MRI) of the spine. Fryer agreed that this was a logical next step, but felt that the potential financial re- quirements for this type of venture might prove inhibitive. “But also,” says Fryer, “I knew I had to do my scientific duty.” Fryer proceeded by contacting the FONAR corporation, the group that in- vented MRI and the upright-MRI. In early 2007, while the company’s representa- tives were in Vancouver to present their upright-MRI to B.C. medical profession- als, Fryer was invited – with 24 hours notice – to meet with them. His secretary was asked to reschedule his patients for the following day and, with limited time and sleep, Fryer worked at constructing a presentation that he knew would deter- mine the progress of his journey. “I began collating my preliminary fi ndings, and all the supporting evidence I could gather, into a Powerpoint pre- sentation,” he recalls. “I even built a new video on the ferry from Nanaimo to Van- couver.” “I hadn’t realized whom I was to pres- ent to,” Fryer continues, “It was Dr. Fran- cis Smith, the first doctor in the world to scan MRI in 1980!” Dr. Smith’s list of achievements in- cludes his current directorship of the posi- tional MRI Centre in Aberdeen, Scotland, and over 250 scientific publications. After Fryer had discussed his findings with the FONAR committee, Dr. Smith offered his positional MRI equipment and access to fi ve subjects, in order to gather some initial data on the seating exercises. Smith expressed the opinion that some solid data could be gathered, and collated with Fryer’s own fi ndings, to produce a preliminary paper for possible publica- tion. Dr. Fryer knew that he had just suc- cessfully gained the link that would lend CANADIAN CHIROPRACTOR | SEPTEMBER 2008 • 9
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