This Foundation is seeking grant applications to further research into the usefulness and limitations of Mechanical Diagnosis and Therapy (MDT). Consideration will be given to proposals examining basic and clinical sciences with the ultimate aim of improving the quality of care for musculoskeletal patients. New or experienced investigators are encouraged to apply. Preference will be given to proposals that include functional outcomes assessments. Proposals will be subjected to a peer-review process and only the highest quality projects will receive funding.
A maximum of $50,000 can be requested. Funds are for work to be performed, not for works in progress or already completed. All correspondence is with the principal investigator (PI). Grants are awarded for 2 years.
Musculoskeletal problems are extremely common in the adult population, with back and neck pain affecting the majority of adults at some point in their lives. These problems account for considerable reduction in functional ability and work loss. The personal and societal cost is immense. The natural history of these problems is often not benign with many people having persistent symptoms for many months and recurrences being extremely common.
The optimum treatment for musculoskeletal problems has not been determined, and consequently there is no standardised assessment and treatment of patients. Guidelines, where available, often give bland and non-specific advice as if all patients were the same. These problems are treated by a number of healthcare professions, each of whom have their own training and different methods for determining treatment. Furthermore it is not often possible to make specific diagnoses; back and neck pain are referred to as non-specific, and the problems of the reliability and validity of specific tests for extremity musculoskeletal problems has recently been highlighted. All of this suggests a need for standardisation of both assessment and treatment.
As a result, world-wide clinical practice guidelines have been developed in an attempt to standardize treatment recommendations for patients suffering from spinal musculoskeletal dysfunction and pain. In this system, the majority of patients with neck and back pain are classified into one large homogenous group labelled as non-specific spinal pain. This classification leads to the recommendation by present guidelines of a “one-size fits all” treatment for this large group. However, a disconnect exists between the clinical practice guidelines and everyday clinical practice. Specifically, practitioners have noted relatively poor patient outcomes using a one treatment approach for the non-specific spinal pain categorization. Instead, better treatment outcomes have been reported when the large group is subcategorized and treatment is tailored to that sub-grouping.
While sub-grouping is acknowledged by the clinician as important, there is no agreement on how best to identify and manage these subgroups. MDT is an assessment and classification system for musculoskeletal problems that governs treatment recommendations. In MDT, patient self-care and empowerment are essential to the management interventions used. Through the use of specific exercises and postural concepts, the patient learns how to manage their musculoskeletal pain both on this occasion and for future episodes. Since epidemiological studies demonstrate high prevalence and recurrence rates for musculoskeletal symptoms, self-management emerges as a critical tool for the patient. Of key importance is the phenomenon of centralization, which describes the lasting abolition of distal symptoms in response to repeated movements and sustained postures. Medical interest in centralization has increased because of its reliability and strong discriminative and prognostic ability.
Although the concepts and ideas that underpin MDT are supported by the scientific literature, there are clear gaps. Well-designed studies are needed to further explore issues of reliability of evaluation and classification systems, prognostic validity of diagnostic categories, treatment effectiveness and efficacy, longitudinal outcome studies, and comparisons of treatment paradigms. Other project proposals could include the integration of basic sciences with clinical observations.
Individuals are encouraged to network with other clinicians and researchers to develop and complete projects at single or multi-clinic sites. Individuals are allowed to submit more than one application as long as each application is distinct.
All applicants receiving an award for a research grant are required to submit annual reports to the Board of IMDTRF. A format for this report will be provided by the Board. Reports are due to the Vice-Chair of the Board of Directors of IMDTRF by February 1st at the completion of each grant year.
It is expected that the PI will prepare and submit a manuscript for publication in a peer-reviewed journal within 4 months following project completion. It is also expected that:
- a poster or platform presentation will be submitted for consideration at an appropriate national or international conference
- the proposal abstract will be published on our website.
If a grant is awarded the funding source should be cited in all publications and presentations resulting from the award.
If the PI fails to submit an annual report or fails to implement the proposed project, the PI will be requested to return all funds distributed to them within 30 days. This policy goes into effect six months past the due date of any delinquent report or the expected starting date of the project.
Letter of Intent : A Letter of Intent must be submitted by midnight of April 1st in order to be considered for a full proposal submission. This letter will include an abstract that contains the following components:
- Specific aims and hypothesis
- Background and clinical significance
- Research design and methods
Specific aims: Describe concisely and realistically what the research is intended to accomplish. List the specific research hypotheses. Give hypotheses when possible.
Background and significance: Critically evaluate the existing literature and identify existing shortcomings. Only consider the most important literature. Do NOT simply give a list of all literature on the topic. Discuss the clinical importance and relevance to the strengths and weaknesses of MDT.
Research design and methods: Describe the research design and the methods to accomplish the listed specific aims. The methods should, at least, include the following topics:
· subjects – include description of the population sample, inclusion/exclusion criteria, recruitment method, power analysis to support sample size
· data collection – identification of independent and dependent variables, outcome measures including reliability and validity, description of raters and rating instruments where applicable
· data analysis – identify appropriate statistical analyses
Maximum length is two pages. Notification of eligibility to submit full proposals will be sent by April 30th.
Application: After receiving approval of the Letter of Intent by the Board of IMDTRF, please complete the required application forms found on the Grant Application Forms page and submit all required materials through this website. Only electronic submissions will be accepted.
- To be considered for review, submissions must be received by 17.00 Greenwich Mean Time on July 1st. Late submissions will be returned without review.
- The PI will receive electronic notification by July 15th for proposals that have adhered to the submission guidelines and have been referred on to the peer-review process.
- All PIs will receive feedback from the peer review by December 31st.
- The Board of Directors will determine funding during their annual fall meeting.
- Applicants receiving funding must notify the Vice-Chair of acceptance of funds within 14 days.
- All awarded applicants must provide evidence of project approval by an Ethical Review Board before funds are dispersed.
- The expectation of the Board is that the project will be completed within 2 years from the starting date. Funds are granted only once at the beginning of the project.
The initial screening is performed by the Secretary of the Board. This initial screen determines if the applicant has fulfilled all requirements detailed in the research program announcement and submission guidelines. Reasons for rejection without further consideration:
- Incomplete or late submissions
- Submissions that do not adhere to the GRANT APPLICATION INSTRUCTIONS
- requests for funds for more than $50,000
- projects that are not related to the mission statement of the Foundation
The Peer Review Committee will review and rank all grant proposals based on the following criteria:
- Significance – the extent to which the research project makes an original and important contribution to the body of evidence related to the usefulness and/or limitations of MDT
- Research design – the extent to which the conceptual framework, design, methods, and analyses are properly developed, well integrated, and appropriate to the specific aims of the project
- Feasibility – the likelihood that the proposed research project can be completed by the PI given his/her experience, expertise, and resources. The institution or clinic sponsoring the project must submit in writing tangible evidence that may ensure the completion of the project. Any consultants must submit letters of agreement.
Board of IMDTRF review
The Board of Directors of IMDTRF has the final review of the proposals and their budgets. The Board will award funding based on the recommendations of the peer review process.
PIs submitting applications do so with the understanding that they will abide by the conditions, deadline policies, and decisions of the Board of IMDTRF. The Board reserves the right to change the amount of any award at its sole discretion. The Board of the IMDTRF makes no guarantee that requested grants will be awarded or that if your proposal is accepted you will receive the total amount of funds requested.
Questions regarding the application process can be directed to the secretary of IMDTRF via firstname.lastname@example.org.