Flex Grant Pilot Awards Request for Applications: Force-Based Manipulations of the Spine

What is SPINEWORK? 

SPINEWORK is a network community that exists to connect interdisciplinary force-based manipulation (FBM) researchers and/or clinicians of diverse backgrounds to improve the scientific basis for understanding and improving force-based treatment of spine pain.  

Force-based manipulation involves the application of forces to the body with or without a therapeutic intent. FBM approaches include manipulation and mobilization and/or touch-based techniques such as massage.  Examples of force-based manipulations include but are not limited to spinal manipulation, chiropractic, massage, etc. SPINEWORK focuses on the relationship between FBMs and pain mechanisms, as well as exploring the potential role of FBMs in alleviating spine pain. The network’s overall mission is to lay the intellectual groundwork for improved treatment of low-back and neck pain via FBMs; this mission is to be accomplished by creating and fostering a multidisciplinary, scientifically, and culturally diverse network of researchers from across the spectrum of approaches to understand FBMs and spine pain.

SPINEWORK provides its members an opportunity to identify new collaborators, to learn about other disciplines, to share and disseminate ideas and information to colleagues and the larger clinical and research communities, and to foster better interdisciplinary communication as the Research Network addresses several high-priority target areas: (1) Terminology and Measurement of FBMs; (2) Mechanistic, (3) Multiscale Research into Mechanisms of FBMs; (4) Biomarker Development of FBMs. 

SPINEWORK is funded by the National Center for Complementary and Integrative Health (NCCIH) and the National Institute of Neurological Disorders and Stroke (NINDS) (U24 AT011978). Principal Investigators are Beth A. Winkelstein, PhD, Eduardo D. Glandt President’s Distinguished Professor of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania and Victor Barocas, PhD, College of Science and Engineering Distinguished Professor, Biomedical Engineering, University of Minnesota. 

Funding Opportunity Title: SPINEWORK Flex Grant Pilot Awards 

The SPINEWORK network invites interdisciplinary applications for 1 year Flex Grant pilot awards (up to $75,000 total costs) to provide project support for new or established investigators interested in FBM research. Flex grant applications must propose to support small-scale pilot projects to develop data, theoretical frameworks, or empirical methods, or to support the development of novel approaches requiring interdisciplinary collaboration. SPINEWORK pilot projects may involve primary data collection, but preference will be given to projects involving secondary data analysis on existing datasets related to FBM mechanistic research.

Human subject studies involving high-risk populations or high-risk interventions are prohibited for SPINEWORK Flex grants. 

SPINEWORK High Priority Areas

  • Terminology and Measurement of FBMs – to define and/or quantify the relevant measurements in either the application or manipulation of forces associated with FBM application for spine using universally accepted scientific metrics.
  • Multiscale Research into FBM Mechanisms – to identify multiscale responses (biomechanical, molecular, cellular, and/or neural mechanisms) that underlie the physiological effects and/or biological response related to Force-Based Manipulations and spine pain.
  • Biomarker Development of FBMs – to identify biomarkers (molecular, imaging, neural, etc.) that serve as proxies for the physiological effects and/or biological response related to FBM and spine pain.

Applications that focus on non-mechanistic research or clinical/patient centered outcomes will be considered nonresponsive to this call. In addition to focusing on a High Priority Area (above), Flex Grants could include, but are not limited to: new investigators generating preliminary data, new collaborative teams generating an initial set of preliminary data for a collaboration, or investigators or teams that have received a non-fundable score on an NIH R01 proposal due to lack of sufficient data or have specific weaknesses that can be address by Flex Grant funds. We encourage applicants to visit our partner network, ForceNET website for a helpful short video describing “What is a Force-Based Manipulation”. 

SPINEWORK RFA Important Dates

Key Dates:

  • Posted: June 1, 2025
  • Expiration Date: Oct 2, 2026  
  • Letter of Intent Due: July 15, by 11:59 PM (EST) (Earlier LOI submissions are encouraged to provide feedback on the grant application).  
  • Due: August 1 by 11:59 PM (EST)  
  • Funding Amount: up to $75,000 total costs available* (funding for 1-2 grants/year is anticipated)

*The SPINEWORK pilot award funding mechanism offered through NCCIH grant # U24 AT011978. 

Eligibility

Investigators may contact the SPINEWORK Pilot Working Group leader (Beth Winkelstein; [email protected]) to determine their eligibility and appropriateness of their project. 

Principal Investigators must 

  1. Be members of the SPINEWORK network. There is no financial cost to join SPINEWORK, please email [email protected] if you are interested in joining. 
  2. Be eligible to submit a grant to NIH and to receive NIH funding. Foreign Institutions (non-domestic) entities are not eligible to apply. Non-domestic (non-U.S.) components of U.S. organizations are not eligible to apply. Foreign components (e.g., international collaborators and consultants), as defined in the NIH Grants Policy Statement, are allowed. 
  3. Have a faculty or regular rank academic appointment. Investigators at any stage of their career may apply. 

Additional consideration will be given to: 

  • Early career stage investigators (as PI).
  • Collaborative interdisciplinary efforts between public/private universities and Integrative Medicine Institutions (i.e., chiropractic, massage, acupuncture, etc.) 
  • Work that addresses the intersections between health inequalities and mechanisms of FBM treatment for spine pain is encouraged. 

Amount and Period of Support 

Funding will be provided for one year with the possibility of a six-month no-cost extension. Funding is available in an amount of up to $75,000 total costs. All pilot projects solicited through this funding opportunity will be made as a fixed amount subaward of the parent U24 grant. Funds are encouraged to be used for all costs directly towards the research project, including 

  • Faculty salary 
  • Research-related costs (e.g., participant incentives, lab supplies) 
  • Fees for database access 
  • Contracts for research-related service (e.g., recruitment services, survey administration)
  • Small equipment costs
  • Publication costs
  • Travel to NIH/U24 sponsored conferences/symposia to present work. 

The number of awards will depend on the requested budgets, availability of funds, and the receipt of a sufficient number of high-quality proposals. 

Application Submission Process 

Letter of Intent 

Interested applicants must submit a letter of intent that includes the following information: 

  1. 1-page with title and description of the project (max. 300 words), relevance to research in mechanisms underlying force-based spine manipulations, and names of investigators/institutions. LOIs should be single-spaced, with at least 0.5-inch margins, and should use 11point Arial or Times fonts.
  2. Submit LOI by September 1, 11:59 PM (EST) via SPINEWORK website. File name should read: “Flex-LOI-PI Last Name” 
  3. LOIs will be evaluated by SPINEWORK’s Scientific Review Committee considering the SPINEWORK mission, and relevant applicants will be encouraged to submit a full proposal. The initial evaluation will only consider mission relevance and if a project is better suited to another network the appropriate connections will be made. 

Flex Grant Pilot Award Application

If an LOI is recommended for full submission, applicants should submit the documents below in a single PDF file: 

Submit your Flex Grant application 

If you have problems with the Google Form, please e-mail [email protected]. 

Applications should be single-spaced, with at least 0.5-inch margins, and should use 11-point Arial or Times fonts. 

The single PDF file should contain: 

  1. PHS 398 Face Page (signed by authorized institutional official). 
  2. PHS 398 Budget pages 4 & 5 
  3. NIH Biosketch (key personnel only) -5 page limit 
  4. Abstract. A 300 word abstract summarizing the pilot project and the relevance to FBM mechanistic research. 
  5. Research Proposal-Specific Aims (1 page), Significance/Innovation, Preliminary Data if any, and a brief description of Methods (3 pages). 
  6. Planned Extramural Grant Application (one paragraph). Description and timeframe of NIH extramural grant proposals that will be anticipated to be submitted as a result of this seed funding. Include the specific NIH funding agency, grant mechanism (e.g. R03, R21, R01, K99), and expected submission date. 
  7. References (no page limit) 
  8. Resources / Environment (1 page)
  9. Budget and budget justification (no page limit). Include description of expertise of investigators/mentors and research staff. The pilot award funds must go directly towards the research project. Funds may be used for all costs directly associated with completion of the research project including applicant and research staff (if proposed) salaries and fringe benefits, project-related research costs (e.g., participant incentives, survey recruitment and administration, printing), database access, small equipment, travel (for data collection and/or conference attendance), conference registration. 
  10. NIH Biosketch (key personnel only) -5 page limit 
  11. Other Support (key personnel only) 
  12. JUST-IN-TIME information. If you are notified that your application is under consideration for funding after the initial SPINEWORK review panel, then the following documents must be added to your original SINGLE FILE PDF (and re-submitted) before complete evaluation and any funding decision can be made. 

If animal models are involved, the pilot project application should provide a description of the plan use of animals in the project and the Institutional Animal Care and Use Committee (IACUC) approval in the same file with select PHS pages. If human subject research is involved, the PHS398 Human Subjects and Clinical Trials Information page Institutional Review Board (IRB) approval from the institution and human subjects training (e.g., CITI) for all involved in the human subjects study should be included in the same PDF as the other required documents. In addition, SPINEWORK will send the following templates to the applicant(s) to complete: Data and Safety Monitoring Plan (DSMP) and Study Accrual and Retention Plan (SARP). Applicants should recognize that IACUC or IRB approval may require a considerable amount of time, so it is strongly recommended that documents be submitted to your institution at the time of your application submission to avoid prolonged processing delays.

Review Process 

  1. Each application will be assessed by a SPINEWORK panel of cross-institutional peer reviewers.
  2. Evaluation Process: 
    1. Applications that meet eligibility requirements will be reviewed using the following criteria:
      1. relevance to FBM research and SPINEWORK research priorities; 
      2. standard NIH review criteria (Overall Impact, Significance, Investigators, Innovation, Approach (e.g., study design and procedures, data management, and statistical analysis) and Environment,
      3. relevant consideration of DEI efforts 
      4. probability of developing/strengthening a line of research and of future funding. The highest priority will be given to those requests that are deemed most promising to receive extramural funding. 
    2. Funding decisions will be made by the SPINEWORK Scientific Review Committee and the Executive Committee based on combined reviewer assessments and programmatic considerations, and in consultation with NIH/NCCIH staff. 
  3. If applicable, applications with fundable scores will be required to demonstrate human subjects or IACUC research compliance to NIH standards prior to receiving funding. 

Expectations of SPINEWORK Flex Grant Recipients during the funding period 

Funds will be awarded as subcontracts from the University of Pennsylvania. For Multi-PI projects between institutions, applications should be submitted with a PI designated from each institution. If invited for a full application, each PI/institution will submit their own budget and scope of work; however, the total costs for the entire project may not exceed $75,000. 

  1. PI agrees to prepare an NIH grant application with the goal of submitting at least one manuscript related to the project. The format and content of each will be shared in the required progress report with the SPINEWORK pilot award working group. Scientific presentations and publications related to this application should acknowledge SPINEWORK/NIH funding with acknowledgement of NIH grant number. 
  2. A one-page progress report on the status of the work (and the funds spent to date) must be sent to the SPINEWORK (submitted to [email protected]) at 6 months after the release of funds. The SPINEWORK leadership will request periodic check-ins with PI throughout the project period to provide support as needed.
  3. A final progress report which includes summary of findings must be submitted to SPINEWORK at 12 months past the funding date. The summary should include details of anticipated NIH submission (e.g. R03, R21, R01, K99). 
  4. PI or other team member agrees to present research findings at a SPINEWORK and/or NIH steering committee meeting (virtually or in-person). 

For RFA-related questions, please send any questions about project relevance/applicability or process to [email protected]. In addition, please feel free to contact MPI and Pilot Grant Working Group Leader (Dr. Beth Winkelstein; [email protected]) or U24 MPI (Dr. Victor Barocas; [email protected]).