Research Report

Fiscal Years 21-23 Research Report

Through fiscal years 2021-2023, we’ve focused our energy on meeting milestones of current projects, developing new projects, and strengthening strategic collaborations.

In addition, we continue to provide research experiences and training, publish in relevant scientific journals and communicate our research to varied audiences.

Take a look around our Research Report and see for yourself.

Research Mission: Advancing knowledge to inform chiropractic practice, education, and health policy.

Research Vision: Moving the field of chiropractic forward through high-quality scientific research that positively impacts patient care.

Honors & Awards

PCCR faculty and staff have been recognized for their outstanding research, mentoring, and service.

Stacie Salsbury – Guest Speaker, Palmer College of Chiropractic Graduation Luncheon, June 15, 2023
Anderson BR, Derby DC, Percuoco R. COVID-19 related curricular changes and their impact on National Board of Chiropractic Examiners Part 1 pass rates- Comparing classroom vs remote basic science education. (NBCE Best Scientific Paper Award, 2023).
Elissa Twist – Chairperson, Palmer College Institutional Review Board, 2022 – present
Stacie Salsbury – 2022 Outstanding Faculty of the Year, Main campus, Palmer College
Brian Anderson – NIH Loan Repayment Program Ambassador, 2022-present
Brian Anderson – Selected participant, U.S. Bone & Joint Young Investigator Initiative, 2022-2024
Anderson BR, McClellan SW. Quantifying the impact of COVID-19 on the utilization of musculoskeletal-related healthcare services: a comparison of insurance claims from 2019-2020. (NBCE Best Scientific Paper Award, 2022)
Roytman GR, Cheung KH, Bathulapalli H, Goertz CM, Long CR, Lisi AJ. Identifying predictors of virtual chiropractic care in the Veterans Health Administration during the COVID-19 pandemic. (NBCE Best Scientific Paper Award, 2022)
Vining R, Twist E, Onifer S, Ziegler A, Shannon K, Kedilaya S, Hoyt K, Corber L, Anderson B, Walden-Cobb A, Long C. Assessing thoracolumbar fascia mobility with musculoskeletal ultrasound (NBCE Best Scientific Paper Award, 2022)
Ziegler AM, Salsbury S, Maiers M. Discrepant perception on biopsychosocial and active care recommendations between doctors of chiropractic and older patients: A descriptive survey. (NBCE Best Research Paper Award, 2022)
Salsbury S. Doing our best for patient safety. (Independent Scientist Award, Parker Seminars, 2022)
Brian Anderson – Recipient, NIH/NCCIH Loan Repayment Program grant, 07/01/2022 – 07/31/2024.
Anderson BR, McClellan SW. Dosing of lumbar spinal manipulative therapy and its association with care escalation: an analysis of insurance claims. (Carloquium Early Career Research Award, 2022)
Stacie Salsbury – George B. McClelland Researcher of the Year, American Chiropractic Association, Arlington, VA, 2022
Robert Vining, Research Affiliate, Osher Center for Integrative Health, Harvard University, and Brigham and Women’s Hospital.
Cynthia Long, Research Affiliate, Osher Center for Integrative Health, Harvard University, and Brigham and Women’s Hospital.

28 articles in 17 peer-reviewed journals.

Articles	Authors
Thoracolumbar fascia mobility and chronic back pain: Phase 1 of a pilot and feasibility study assessing repeated measures and the influence of paraspinal muscle contraction. Read More	Vining R, Onifer SM, Twist E, Ziegler AM, Corber L, Long CR. Thoracolumbar fascia mobility and chronic back pain: Phase 1 of a pilot and feasibility study assessing repeated measures and the influence of paraspinal muscle contraction. J Bodyw Mov Ther 2023;34:19-27
Thoracolumber fascia mobility and chronic low back pain: phase 2 of a pilot and feasibility study including multimodal chiropractic care. Read More	Vining R, Onifer SM, Twist E, Ziegler AM, Corber L, Long CR. Thoracolumber fascia mobility and chronic low back pain: phase 2 of a pilot and feasibility study including multimodal chiropractic care. Chiropr Man Therap 2022;30:46.
Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a single-arm, pragmatic, pilot trial of multimodal chiropractic care for US veterans with chronic low back pain. Read More	Long CR, Salsbury SA, Vining RD, Lisi AJ, Corber L, Twist E, Abrams T, Wallace RB, Goertz CM. Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a single-arm, pragmatic, pilot trial of multimodal chiropractic care for US veterans with chronic low back pain. Pilot Feasibility Stud 2022;8(1):54.
Care Outcomes for Chiropractic Outpatient Veterans (COCOV): A qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care. Read More	Salsbury SA, Twist E, Wallace RB, Vining RD, Goertz CM, Long CR. Care Outcomes for Chiropractic Outpatient Veterans (COCOV): A qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care. Pilot Feasibility Study 2022;8(1):6.
Learning the neurobiology of pain: a scoping review of pain education from an instructional design perspective. Read More	Ziegler AM, Minkalis AL, Langdon ER, Vining R. Learning the neurobiology of pain: a scoping review of pain education from an instructional design perspective. Patient Educ Couns 2021;105(6):1379-1401.
Three Patterns of spinal manipulative therapy for back pain and their association with imaging studies, injection procedures and surgery: A Cohort Study of Insurance Claims. Read More	Anderson B, McClellan S. Three Patterns of spinal manipulative therapy for back pain and their association with imaging studies, injection procedures and surgery: A Cohort Study of Insurance Claims. J Manipulative Physiol Ther 2021;44(9):683-689.
Qualitative analysis of illness representations and coping perceptions among older adults with chronic spinal disability: “a thought in the back of my mind.“ Read More	Salsbury SA, Maiers M. Qualitative analysis of illness representations and coping perceptions among older adults with chronic spinal disability: “a thought in the back of my mind“. J Manipulative Physiol Ther 2021;44(8):652-662.
Characteristics of chiropractic patients in VHA during the COVID-19 pandemic: A cross-sectional analysis. Read More	Roytman GR, Cheung KH, Bathulapalli H, Goertz CM, Long CR, Lisi AJ. Characteristics of chiropractic patients in VHA during the COVID-19 pandemic: A cross-sectional analysis. J Manipulative Physiol Ther. 2023 Jun 9;S0161-4754(23)00012-X
Discrepant perceptions of biopsychosocial and active care recommendations between doctors of chiropractic and midlife and older adult patients: a descriptive study Read More	Ziegler AM, Salsbury SA, Maiers M. Discrepant perceptions of biopsychosocial and active care recommendations between doctors of chiropractic and midlife and older adult patients: a descriptive study. J Manipulative Physiol Ther. 2023 Jun 14;S0161-4754(23)00014-3

View All Publications

Active Grants and Projects

Development of a Web-based Diagnostic and Clinical Support Tool for Low Back Pain

Support: RAND Corporation Technology Incubator; Palmer Center for Chiropractic Seed Grant

Performance Period: 3/1/2023-3/1/2024

Principal Investigators: Robert Vining, D.C., DHSc; Robert Rudin, Ph.D. (Rand Corporation)

Co-Investigator: Patricia Herman, N.D., Ph.D. (Rand Corporation)

Collaborating Institution: RAND Corporation

Description: To systematically incorporate evidence-based examination, multidimensional working diagnosis, and evidence-based treatment into an electronic clinical decision support tool for clinicians caring for people with low back pain.

Measuring Chronic Pain Impact: Secondary Analysis

Performance Period: 12/05/2022-12/05/2023

Principal Investigator: Brian Anderson, D.C., M.P.H., M.S., Ph.D.

Mentors: Patricia Herman, N.D., Ph.D. (Rand Corporation); Ron Hays, Ph.D. (UCLA Department of Medicine)

Description: Secondary data analysis of a NIH-funded study to investigate the association between treatment exposures and patient-reported outcome measures among individuals with back pain.

Spinal Manipulative Therapy vs. Prescription Drug Therapy for Care of Aged Medicare Beneficiaries with Neck Pain

Funding Source: NIH/NCCIH

Award Amount: $68,834 (subaward)

Performance Period: 09/01/2022-07/31/2024

Principal Investigator: James Whedon, D.C., M.S. (Southern California University of Health Sciences)

PCCR Co-Investigator: Brian Anderson, D.C., M.P.H., M.S., Ph.D.

Research Honors Students: Alexis Hannah, Brandon Aki Jackson, Robin Ostermeier

Sites: Southern California University of Health Sciences (SCU); The Dartmouth Institute for Health Policy & Clinical Practice; Palmer Center for Chiropractic Research

Description: Students from SCU and research honors students from Palmer are taking part in this 2-year project, including participation in weekly Spine Care Research lectures by renowned experts in the field.

Combined Chiropractic Care and Tai Chi for Chronic Non-Specific Neck Pain

Funding Source: NIH/NCCIH

Performance Period: 09/12/2022 – 05/30/2025

Principal Investigator: Peter Wayne, Ph.D. (Osher Center for Integrative Health, Harvard & BWH)

PCCR Co-Investigators: Cynthia Long, Ph.D.; Robert Vining, D.C., DHSc

Sites: Osher Center for Integrative Health at Harvard and BWH; Chiropractic and Tai Chi centers in Boston, MA.

Description: A 3-armed mixed methods pilot randomized trial of 48 patients with chronic pain with care from community-based Tai Chi instructors and chiropractors (R34 clinical trial planning grant).

Quality Indicators of Chiropractic Care

Performance Period: 07/01/2022-06/29/2024

Principal Investigator: Robert Vining, D.C., DHSc

Co-Investigators: Jennifer Smith, MLIS; Brian Anderson, D.C., M.P.H., M.S., Ph.D.; Zachary Almquist, M.A.

Research Honors Student: Danveshka Wong

Implementation of the American College of Physician Guideline for Low Back Pain Using a Multidisciplinary Conservative Care Model at the Initial Point of Patient Contact: A Cluster Randomized Trial

Funding Source: NIH/NCCIH/NIAMS/NICHD

Award Amount: 173,440 (subaward)

Performance Period: 07/15/2021 – 06/30/2026

Principal Investigators: Christine Goertz, D.C., Ph.D (Duke University); Adam Goode, PT., Ph.D (Duke University); John Lurie, M.D., M.S. (Dartmouth)

PCCR Co-Investigators: Stacie Salsbury, Ph.D., R.N; Zacariah Shannon, D.C., M.S., Ph.D.

Sites: Duke University Clinics, University of Iowa Hospital and Clinics, Dartmouth – Hitchcock Clinics, Private Practices.

Description: Dr. Salsbury is the lead qualitative researcher on this project. She is assisting with study design, model development, and clinical trial planning. Initially a graduate research assistant on the trial, Dr. Shannon has transitioned into a co-investigator role, where he’s working on implementation science.

Safety Culture in Community-Based Clinics Offering Spinal Manipulative Therapy: A Qualitative Analysis 

Performance Period: 03/01/2022-03/31/2025 

Principal Investigator: Stacie Salsbury, Ph.D., R.N. 

SafetyNet Principal Investigators: Martha Funabashi, BSC, MSc, Ph.D. (Canadian Memorial Chiropractic College); Kathrine Pohlman, D.C., M.S., Ph.D. (Parker University)

Research Honors Students: Vanessa Woosley, Amanda Brown 

Read more about Chiropractic Safety Studies

The Impact of Prior Image Review and Clinical History Information in a Chiropractic Radiology Practice

Performance Period: 10/30/2021-07/14/2023

Principal Investigator: Robert Vining, D.C., DHSc

Co-Investigators: Ian McLean, D.C., DACBR; Kira Baca, M.S., D.C.; Emma Forlow, D.C.

Active Aging for Spine Health: Development of a Novel e-Health Intervention for Older Adults and Doctors of Chiropractic (AASH)

Funding Source: NCMIC Foundation

Award Amount: $38,101

Performance Period: 8/19/2020-08/18/2023

Principal Investigator: Stacie Salsbury, Ph.D., R.N.

Co-Investigator: Michele Maiers, D.C., M.P.H., Ph.D. (Northwestern Health Sciences University)

Collaborating Institution: Northwestern Health Sciences University

Read more about Active Aging for Spine Health

Thoracolumbar Fascia Mobility: A Pilot Study

Principal Investigator: Robert Vining, D.C., DHSc

Site: Palmer Center for Chiropractic Research

Status: Complete

Study Team: Lance Corber, M.S.I.T.M.; Katie Hoyt, M.O.L.; Sujatha Kedilaya, B.S.; Cynthia Long, Ph.D.; Anna-Marie Ziegler, M.M., D.C., M.S.; Elissa Twist, D.C., M.S., CCRP; James Fox (University of Vermont)

Publications:

Vining R, Onifer SM, Twist E, Ziegler AM, Corber L, Long CR. Thoracolumbar fascia and chronic low back pain: Phase 1 of a pilot and feasibility study assessing repeated measures and the influence of paraspinal muscle contraction. J Bodyw Mov 2023;34:19-27

Vining R, Onifer SM, Twist E, Ziegler AM, Corber L, Long CR. Thoracolumber fascia mobility and chronic low back pain: phase 2 of a pilot and feasibility study including multimodal chiropractic care. Chiropr Man Therap 2022;30:46.

Read more about Thoracolumbar Fascia Mobility

A Scoping Review of Pain Education from an Instructional Design Perspective

Performance Period: 03/01/2020-07/31/2021

Principal Investigator: Robert Vining, D.C., DHSc

Co-Investigators: Anna-Marie Ziegler, M.M., D.C., M.S.; Amy Minkalis, D.C., M.S.

Research Honors Student: Emma Langdon

Published:

Ziegler AM, Minkalis AL, Langdon ER, Vining R. Learning the neurobiology of pain: a scoping review of pain education from an instructional design perspective. Patient Educ Couns. 2021; 105 (6): 1379-1401.

Chiropractic Care for Veterans: A Pragmatic Randomized Trial Addressing Dose Effects for cLBP (VERDICT)

Funding Source: NIH/NCCIH UG3/UH3AT009761

Award Amount: $7,087,730 + Administrative Supplements for 4 DCs to participate in trial ($900K)

Performance Period: 09/20/2017 – 08/31/2024

Principal Investigators: Cynthia Long, Ph.D.; Christine Goertz, D.C., Ph.D. (Duke University)

Read more about Chiropractic Care for Veterans

Inter-Institutional Network for Chiropractic Research Projects:

Interinstitutional Network for Chiropractic Research (IINCR)

Funding Source: Palmer College Foundation

Performance Period: 07/01/2017 – 06/30/2025

Network Co-Directors: Cynthia Long, Ph.D.; Anthony Lisi, D.C. (Yale University); Peter Wayne, Ph.D. (Osher Center for Integrative Health, Harvard & BWH)

Network Steering Committee Members: Matt Kowalski, D.C. (Osher Center for Integrative Health, Harvard & BWH); Robert Vining, D.C., DHSc

Collaborating Institutions: Palmer Center for Chiropractic Research; Yale Center for Medical Informatics; Osher Center for Integrative Health at Harvard and BWH

Chiropractic Care for Episodic Migraine (IINCR Grant Application)

Funding Source: NIH/NCCIH

Proposed Performance Period: 12/11/2022-11/30/2025

Award Amount: 112,670 (subaward)

Status: Pending Notice of Grant Award

Principal Investigator: Peter Wayne, Ph.D. (Osher Center for Integrative Health, Harvard & BWH); Pamela Rist, Sc.D. (Osher Center for Integrative Health, Harvard & BWH); Jason Sico, M.D., M.H.S. (Yale University)

Co-investigators: Anthony Lisi, D.C. (Yale University); Cynthia Long, Ph.D.; Robert D Vining D.C., DHSc

Sites: Osher Clinical Center, Osher Center for Integrative Health at Harvard and BWH; West Haven, CT VA Hospital.

Description: A 2-site pilot randomized trial of 60 patients (men and women) diagnosed with episodic migraine (R01 multisite feasibility clinical trial).

Administrative Database of VA Chiropractic Use in Headache Patients (IINCR)

Principal Investigator: Anthony Lisi, D.C. (Yale University)

Co-Investigators: Jason Sico, M.D., M.H.S. (Yale University); Matt Kowalski, D.C. (Osher Center for Integrative Health, Harvard & BWH); Cynthia Long, Ph.D.; Robert Vining, D.C., DHSc; Peter Wayne, Ph.D. (Osher Center for Integrative Health, Harvard & BWH)

Sites: VA Headache Center of Excellence, VA CT; Yale Center for Medical Informatics

Description: Using administrative data in the Headache Centers to compare patients with headache who receive chiropractic care versus those who do not.

Chart Review of Characteristics of VA Chiropractic Care (IINCR)

Principal Investigator: Anthony Lisi, D.C. (Yale University)

Site: Yale Center for Medical Informatics

Description: Investigate elements of quality care, such as how visit dosage of exercise, adjustments, and patient education during care.

Presentations:

Muller R, Graham S, Sites A, Corcoran K, Lisi A. Assessing quality indicators and guideline-concordance in chiropractic low back pain visits in the Veterans Health Administration. ACC-RAC Conference, March 23-25, 2023, New Orleans, LA.
Sharma N, Graham S, Sites A, Coleman B, Lisi A. Describing congruence between ICD-10 coding and medical record text in Veterans Health Administration chiropractic notes. ACC-RAC Conference, March 23-25, 2023, New Orleans, LA.
Corcoran K, Coleman B, Zhao X, Bastian L, Brandt C, Lisi A. Assessing downstream healthcare utilization for low back pain among chiropractic users versus non-users in the Veterans Health Administration. ACC-RAC Conference, March 23-25, 2023, New Orleans, LA.
Graham S, Sites A, Zhao X, Lisi A. Assessing referral patterns to on-station chiropractic clinics within the Veterans Health Administration. ACC-RAC Conference, March 23-25, 2023, New Orleans, LA.

Chiropractic Care for Fall Prevention (IINCR)

Principal Investigator: Peter Wayne, Ph.D. (Osher Center for Integrative Health, Harvard & BWH)

Lead Authors: Wren Burton, D.C. (Osher Center for Integrative Health, Harvard & BWH); Weronika Gabowska, M.P.H. (Osher Center for Integrative Health, Harvard & BWH)

Site: Osher Center for Integrative Health at Harvard and BWH

PCCR co-authors: Cynthia Long, Ph.D.; Robert Vining, D.C., DHSc

Publication:

Grabowska W, Burton W, Kowalksi MH, Vining R, Long CR, Lisi A, Hausdorff JM, Manor B, Munoz-Vergara D, Wayne PM. A systematic review of chiropractic care for fall prevention: rationale, state of the evidence, and recommendations for future research. BMC Musculoskelet. Disord 2022;23:844.

Integrating Chiropractic Care & Mind-Body Training for the Treatment of Non-Specific Chronic Neck Pain  (IINCR)

Principal Investigator: Peter Wayne, Ph.D. (Osher Center for Integrative Health, Harvard & BWH)

Site: Osher Center for Integrative Health at Harvard and BWH

Study Team: Pamela Rist, ScD (Osher Center for Integrative Health, Harvard & BWH); Matt Kowalski, D.C. (Osher Center for Integrative Health, Harvard & BWH); Wren Burton, D.C. (Osher Center for Integrative Health, Harvard & BWH)

Description: Pilot study of nurses with chronic neck pain receiving chiropractic, Tai Chi and other mind-body therapies. 

Presentation:

Burton W, Kowalski M, Litrownik D, Wayne P. Integrating chiropractic care and Tai Chi training for the treatment of chronic nonspecific neck pain in nurses. ACC-RAC Conference, March 23-25, 2023, New Orleans, LA.

Longitudinal Cohort Assessing Healthcare Service Use for Spine-Related Disorders in VA (IINCR)

Principal Investigator: Anthony Lisi, D.C. (Yale University)

Site: Yale Center for Medical Informatics

Description: Evaluate differences in healthcare use and outcomes in administrative data among a large cohort of U.S. veterans receiving care in VHA facilities.

Publications:

Coleman BC, Lisi AJ, Abel EA, Runels T, Goulet JL. Association between early nonpharmacological management and follow-up for low back pain in the Veterans Health Administration. J Spine. Vol 14, June 2023, 100233.
Coleman BC, Finch D, Wang R, Luther SL, Heapy A, Brandt C, Lisi AJ. Extracting pain care quality indicators from US Veterans Health Administration chiropractic care using natural language processing. App Clin Inform. 2023 May (epub ahead of print)

UnitedHealthcare Project  (IINCR)

Principal Investigator: Anthony Lisi, D.C. (Yale University) 

Steering Committee Members: Scott Haldeman, D.C., M.D., Ph.D (UC Irvine).; Jason Sico, M.D., M.H.S. (Yale University); Peter Wayne, Ph.D.  (Osher Center for Integrative Health, Harvard & BWH)

Collaborators: Yale Center for Medical Informatics; UnitedHealthcare; UC Davis  

Description: To replicate the Optum low back pain study for chiropractic patients with neck pain. 

Presentation:

Romano P, Ray M, Fang SY, Elton D, Haldeman S, Wayne P, Fenton J, Padilla K, Lisi A. First-seen provider and pharmacotherapy patterns among patients with new-onset neck pain. Integrative Medicine & Health Symposium, February 28-March 2, 2023, Chicago, IL.

Our Team

Administration & Faculty

Cynthia Long, Ph.D., PStat® – Dean of Research & Professor

Robert Vining, D.C., D.H.Sc. – Associate Dean of Clinical Research & Professor

Joel Pickar, D.C., Ph.D. – Professor Emeritus

Stacie Salsbury, Ph.D., R.N. – Associate Professor

Brian Anderson, D.C., M.P.H., M.S., Ph.D. – Assistant Professor

Zacariah Shannon, D.C., M.S., Ph.D. – Assistant Professor

Professional & Administrative Staff

Leah Cafer – Administrative Assistant

Ann Hileman, B.Phil. – Assistant Director of Research

Katie Hoyt, M.O.L – Research Program Manager

Sujatha Kedilaya, B.S. – Data Analyst

Amy Minkalis, D.C., M.S., CCRP – Clinical Project Manager

Elissa Twist, D.C., M.S., CCRP – Clinical Research Specialist

Anna Walden-Steward, D.C., M.S., CCRC, ACRP-PM – Clinical Project Manager

Zachary D. Almquist, M.A. – Manager of Research Programs

Post-Doctoral Research Scholars & Fellows

Gregory Roytman, D.C. (Yale)

Anna-Marie Ziegler, M.M., D.C., M.S. (PCCR)

Kira Baca, D.C., M.S. (PCCR)

Budget Expenditures

Federally funded: $2.9M
Palmer funded: $3 M

Research budget graphic

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Fiscal Years 21-23 Research Report

Honors & Awards

28 articles in 17 peer-reviewed journals.

Development of a Web-based Diagnostic and Clinical Support Tool for Low Back Pain

Measuring Chronic Pain Impact: Secondary Analysis

Spinal Manipulative Therapy vs. Prescription Drug Therapy for Care of Aged Medicare Beneficiaries with Neck Pain

Combined Chiropractic Care and Tai Chi for Chronic Non-Specific Neck Pain

Quality Indicators of Chiropractic Care

Implementation of the American College of Physician Guideline for Low Back Pain Using a Multidisciplinary Conservative Care Model at the Initial Point of Patient Contact: A Cluster Randomized Trial

Safety Culture in Community-Based Clinics Offering Spinal Manipulative Therapy: A Qualitative Analysis

The Impact of Prior Image Review and Clinical History Information in a Chiropractic Radiology Practice

Active Aging for Spine Health: Development of a Novel e-Health Intervention for Older Adults and Doctors of Chiropractic (AASH)

Thoracolumbar Fascia Mobility: A Pilot Study

A Scoping Review of Pain Education from an Instructional Design Perspective

Chiropractic Care for Veterans: A Pragmatic Randomized Trial Addressing Dose Effects for cLBP (VERDICT)

Interinstitutional Network for Chiropractic Research (IINCR)

Chiropractic Care for Episodic Migraine (IINCR Grant Application)

Administrative Database of VA Chiropractic Use in Headache Patients (IINCR)

Chart Review of Characteristics of VA Chiropractic Care (IINCR)

Chiropractic Care for Fall Prevention (IINCR)

Integrating Chiropractic Care & Mind-Body Training for the Treatment of Non-Specific Chronic Neck Pain (IINCR)

Longitudinal Cohort Assessing Healthcare Service Use for Spine-Related Disorders in VA (IINCR)

UnitedHealthcare Project (IINCR)

Our Team

Budget Expenditures

Safety Culture in Community-Based Clinics Offering Spinal Manipulative Therapy: A Qualitative Analysis 

Integrating Chiropractic Care & Mind-Body Training for the Treatment of Non-Specific Chronic Neck Pain  (IINCR)

UnitedHealthcare Project  (IINCR)