Diana De Carvalho

Research:

My research examines the relationship between prolonged sitting and low back pain (LBP), with a particular focus on the biomechanical mechanisms underlying pain and injury in sedentary work environments. LBP is associated with reduced productivity and quality of life, as well as substantial health care costs, and may represent one of the earliest adverse health outcomes associated with prolonged sedentary behavior.

Despite the prevalence of sitting-related back pain, important questions remain about the pathways linking prolonged sitting to pain and tissue injury, particularly under occupationally relevant durations and conditions. My research program addresses these gaps through the study of human spinal biomechanics, with an emphasis on seated postures and their implications for tissue loading, passive tissue strain and creep, and altered neuromuscular control.

A complementary focus of my work is the development and evaluation of strategies to prevent or mitigate the adverse effects of prolonged sitting. These include movement-break interventions and ergonomic approaches designed to promote healthier movement and loading patterns in occupational settings.

Research Techniques/Methods

• Electromyography
• Seat pressure/Force Plates
• Accelerometers/wearable sensors
• Motion Capture
• Patient Reported Outcome Measures
• Systematic Reviews and Meta-analyses
• Laboratory controlled observational studies

Training:

Please contact me if you are interested in learning about current opportunities for:

• Volunteering
• Undergraduate Theses/Undergraduate Medical Education Research Projects
• MSc Theses
• PhD Theses

Education:

• BSc, University of Guelph
• DC, Canadian Memorial Chiropractic College
• MSc, University of Waterloo
• PhD, University of Waterloo

Awards:

• David Winter Early Career Award, Canadian Society for Biomechanics (2022)
• Alumni of the Year award, Canadian Memorial Chiropractic College (2021)
• First Place – Louis Sportelli Research Awards, 15^th Biennial Congress of the WFC (2019)
• Newfoundland and Labrador Chiropractic Association Chiropractor of the Year (2017)

Professional Activities and Networks:

• Senior Mentor for the Chiropractic Academy of Research Leadership 
• Canadian Society for Biomechanics 

Selected Publications:

*For a full list please visit Google Scholar Link

Frey M, Summers A, Power SD, Duarte F, De Carvalho D. Does heat-capsaicin induced low back pain result in changes to neural oscillations and inflammatory blood markers compared to placebo? An experimental cross-over study. 2025. Frontiers in Pain Research. Vol 6:1-11. https://doi.org/10.3389/fpain.2025.1621810

Sany S, Wilke A, Frey M, De Carvalho D. The impact of participant instructions on lumbopelvic rhythm outcome variables during forward spine flexion and return. Journal of Applied Biomechanics. (published online ahead of print 2025). 1-9.  https://doi-org.qe2a-proxy.mun.ca/10.1123/jab.2024-0245

Frey M, Breen A, Rix J, De Carvalho D. Concurrent validity of skin-based motion capture systems in measuring dynamic lumbar segmental angles. 2025. Journal of Biomechanics. 180, 112503. https://doi.org/10.1016/j.jbiomech.2025.112503

Furlong, B, Cashin A, Kamper S, Davidson S, Bursey K, Abdelshaheed C, De Carvalho D, Hall, A. Analgesic effects of non-surgical and non-interventional treatments for low back pain: A systematic review and meta-analysis of placebo-controlled randomised trials. BMJ Evidence Based Medicine. 2025 Mar 18. DOI: 10.1136/bmjebm-2024-112974

Howarth, S. J., McCreath Frangakis, E., Hirsch, S., & De Carvalho, D. (2024). Evaluating Test–Retest Reliability and Measurement Error of the Lumbar Flexion Relaxation Ratio Within and Between Days. Measurement in Physical Education and Exercise Science, 1–10. https://doi.org/10.1080/1091367X.2024.2377101

De Carvalho D, Mackey S, To D, Summers A, Frey M, Romme K, Hogg-Johnson S, and Howarth S. Is the flexion relaxation ratio a reliable, valid, and responsive measure for individuals with and without non-specific spine pain? A systematic review and meta-analysis. Scientific Reports. 2024 Feb 8 (14) 3260. https://doi.org/10.1038/s41598-024-52900-z

De Carvalho D, Randhawa K, Verville L, Hogg-Johnson S, Howarth S, Mior S, and Côté P. The vehicle seating intervention trial: Cross-over randomized controlled trial to evaluate the impact of two car seat configurations on spine posture. Journal of Applied Biomechanics 2023 Oct 4:1-10. https://doi.org/10.1123/jab.2023-0040 Epub ahead of print. PMID: 37793656.

Landry M, Mackey S, Hossain I, Fairbridge N, Greene A, Borgaonkar M, Cullen K, Pace D, and De Carvalho D. An estimation of the endoscopist's musculoskeletal injury risk for right and left lateral decubitus positions during colonoscopy: a field-based ergonomic study. BMC Musculoskeletal Disorders. 2023. 24:475. https://doi.org/10.1186/s12891-023-06606-4

De Carvalho D and Callaghan JP. Does a break from sitting change biomechanical outcome measures or transient pain? A laboratory-based experimental study. WORK: A Journal of Prevention, Assessment and Rehabilitation. 2023;75(2):553-566. Doi: 10.3233/WOR-211266.

De Carvalho D and Callaghan J. The effect of spinal manipulation on biomechanical factors and perceived pain during prolonged sitting: A laboratory-controlled cross-sectional study. Chiropractic & Manual Therapies. 30, 62(2022). https://doi.org/10.1186/s12998-022-00472-y

De Carvalho D, Callaghan J. Effect of office chair design features on lumbar spine posture, muscle activity, and perceived pain during prolonged sitting. Ergonomics. 2022 DOI: 10.1080/00140139.2022.2152113

Williams JM, Frey M, Breen A, and De Carvalho D. Systematic analysis of different low pass filter cut-off frequencies on lumbar spine kinematics data and the impact on the agreement between accelerometers and an optoelectronic system. J Biomech. 2022. 145.  https://doi.org/10.1016/j.jbiomech.2022.111395

Mackey S, Howarth SJ, Frey M, and De Carvalho D. An investigation of the flexion relaxation ratio in adults with and without a history of self-reported low back pain and transient sitting-induced pain. J Electromyogr Kinesiol. 2022 Oct 23;67:102719. https://doi.org/10.1016/j.jelekin.2022.102719

De Carvalho D, de Luca K, Funabashi M, Breen A, Wong A, Johansson M, Ferreira M, Swab M, Adams J, Kawchuk G and Hartvigsen J. Association of exposures to seated postures with immediate increases in back pain: a systematic review of studies with objectively measured sitting time. 2019 NCMIC/JMPT Research Award.  JMPT, 2020; 43(1):1-12.  https://doi.org/10.1016/j.jmpt.2019.10.001