Prevention of low back pain in the military cluster randomized trial: effects of brief psychosocial education on total and low back pain-related health care costs.

Background Context: Effective strategies for preventing low back pain (LBP) have remained elusive, despite annual direct health care costs exceeding $85 billion dollars annually. In our recently completed Prevention of Low Back Pain in the Military (POLM) trial, a brief psychosocial education program (PSEP) that reduced fear and threat of LBP reduced the incidence of health care-seeking for LBP.

Purpose: The purpose of this cost analysis was to determine if soldiers who received psychosocial education experienced lower health care costs compared with soldiers who did not receive psychosocial education.

Relationships among self-reported shoe type, footstrike pattern, and injury incidence.

Context: Some runners are experimenting with barefoot or minimalist shoe running to reduce lower extremity overuse injuries. However, there has been little research to examine injury trends associated with barefoot or minimalist shoe running.

Objective: To assess the association of self-reported shoe selection with reported foot strike patterns, compare overall injury incidence associated with different shoe conditions, and identify differences in injury location between different shoe conditions.

Differences in lateral ankle laxity measured via stress ultrasonography in individuals with chronic ankle instability, ankle sprain copers, and healthy individuals.

Study Design: Cross-sectional.

Objective: To use stress ultrasonography to measure the change in anterior talofibular ligament length during the simulated anterior drawer and ankle inversion stress tests.

Background: In approximately 30% of individuals, ankle sprains may eventually develop into chronic ankle instability (CAI) with recurrent symptoms.

Metallic foreign body in a patient with knee pain.

The patient was a 26-year-old man with a history of a nonhealing, complicated right clavicle fracture. He also complained of right medial knee pain that was thought to be insidious in onset and made worse during magnetic resonance imaging, which was done to evaluate the status of the right clavicle fracture. Subsequent to the patient reporting his right knee pain to his orthopaedic surgeon, magnetic resonance imaging of the right knee was ordered.

Reliability of lower quarter physical performance measures in healthy service members.

Introduction: Measures of endurance, flexibility, strength, and power may be of value in predicting injury risk, but application to the military setting has been limited. The purpose of this study was to assess the reliability and precision of lower quarter physical performance measures among novice raters.

Methods: Sixty-four (53 male, 11 female) healthy active duty Soldiers (aged 25.

Predictors of web-based follow-up response in the Prevention Of Low Back Pain In The Military Trial (POLM).

Background: Achieving adequate follow-up in clinical trials is essential to establish the validity of the findings. Achieving adequate response rates reduces bias and increases probability that the findings can be generalized to the population of interest. Therefore, the purpose of this study was to determine the influence of attention, demographic, psychological, and health status factors on web-based response rates in the ongoing Prevention of Low Back Pain in the Military (POLM) trial.

Association between changes in abdominal and lumbar multifidus muscle thickness and clinical improvement after spinal manipulation.

Study Design: Prospective case series.

Objective: To examine the relation between improved disability and changes in abdominal and lumbar multifidus (LM) thickness using ultrasound imaging following spinal manipulative therapy (SMT) in patients with low back pain (LBP).

Background: Although there is a growing body of literature demonstrating physiologic effects following the application of SMT, few studies have attempted to correlate these changes with clinically relevant outcomes.

Inter-rater reliability of ultrasound imaging of the trunk musculature among novice raters.

Objective: The purpose of this study was to determine the inter-rater reliability of ultrasound imaging for assessing trunk muscle morphologic characteristics at rest and while contracted among different pairs of novice raters. The secondary purpose was to compare 3 different measurement techniques for assessing lateral abdominal muscle thickness.

Methods: A single-group repeated measures reliability study was conducted on 21 healthy participants (mean ± SD, 21.

Awareness and compliance with recommended running shoe guidelines among U.S. Army soldiers.

The purpose of this study was to determine awareness and compliance with recommended running shoe selection, sizing, and replacement guidelines among U.S. Army soldiers.

Effects of traditional sit-up training versus core stabilization exercises on short-term musculoskeletal injuries in US Army soldiers: a cluster randomized trial.

Background: The US Army has traditionally utilized bent-knee sit-ups as part of physical training and testing. It is unknown whether the short-term effects of a core stabilization exercise program without sit-up training may result in decreased musculoskeletal injury incidence and work restriction compared with traditional training.

Objective: The objective of this study was to explore the short-term effects of a core stabilization exercise program (CSEP) without sit-up training and a traditional exercise program (TEP) on musculoskeletal injury incidence and work restriction.

Digital fluoroscopic video assessment of glenohumeral migration: Static vs. Dynamic conditions.

The purpose was to compare glenohumeral (GH) migration, during dynamic shoulder elevation and statically held positions using digital fluoroscopic videos (DFV). Thirty male volunteers (25+/-4 years) without right shoulder pathology were analyzed using DFV (30Hz) during arm elevation in the scapular plane. DFV were obtained at the arm at side position, 45 degrees , 90 degrees , and 135 degrees for static and dynamic conditions.

Changes in lateral abdominal muscle thickness during the abdominal drawing-in maneuver in those with lumbopelvic pain.

Study Design: Controlled laboratory study.

Objectives: To determine if changes in transversus abdominis (TrA) and internal oblique (IO) muscle thickness and side-to-side symmetry differ in individuals with and without unilateral lumbopelvic pain while at rest and during the abdominal drawing-in maneuver (ADIM).

Background: Although the ADIM has been found to produce a symmetrical change in TrA and IO muscle thickness in healthy subjects, how these muscles are activated in those with unilateral lumbopelvic pain during the ADIM remains unknown.

Effects of sit-up training versus core stabilization exercises on sit-up performance.

Purpose: Core stabilization exercises target abdominal and trunk muscles without the excessive loading that occurs during sit-ups. However, core stabilization exercise programs (CSEP) have not been widely adopted in the US Army partially because of the perceived deleterious impact they would have on performance during the Army Physical Fitness Test. The purpose was to determine whether performing CSEP in lieu of sit-ups during unit physical training would have detrimental effects on sit-up performance and passing rates on the fitness test.

Comparison of short-term response to two spinal manipulation techniques for patients with low back pain in a military beneficiary population.

Objective: To determine whether military health care beneficiaries with low back pain (LBP) who are likely to respond successfully to spinal manipulation experience a difference in short-term clinical outcomes based on the manipulation technique that is used.

Methods: Sixty patients with LBP identified as likely responders to manipulation underwent a standardized clinical examination and were randomized to receive a lumbopelvic (LP) or lumbar neutral gap (NG) manipulation technique. Outcome measures were a numeric pain rating scale and the modified Oswestry Disability Questionnaire.

Effect of running shoe type on the distribution and magnitude of plantar pressures in individuals with low- or high-arched feet.

Background: Research addressing the effect of running shoe type on the low- or high-arched foot during gait is limited. We sought 1) to analyze mean plantar pressure and mean contact area differences between low- and high-arched feet across three test conditions, 2) to determine which regions of the foot (rearfoot, midfoot, and forefoot) contributed to potential differences in mean plantar pressure and mean contact area, and 3) to determine the association between the static arch height index and the dynamic modified arch index.

Methods: Plantar pressure distributions for 75 participants (40 low arched and 35 high arched) were analyzed across three conditions (nonshod, motion control running shoes, and cushioning running shoes) during treadmill walking.

Ultrasound characteristics of the deep abdominal muscles during the active straight leg raise test.

Objective: To determine whether changes in the transversus abdominis (TrA) and internal oblique (IO) muscles, as seen on ultrasound imaging, during the active straight leg raise (ASLR) test differ between subjects with and without unilateral lumbopelvic pain.

Design: Cross-sectional, case-control study.

Setting: Clinical laboratory.

Dynamic plantar pressure parameters associated with static arch height index during gait.

Background: Although extreme values of arch height have been associated with increased risk for overuse injury, knowledge is limited regarding the association between arch height and plantar pressure distributions during gait. The primary purpose of this study was to explore which plantar pressure measurements during gait were associated with static arch height and arch height index.

Methods: Static arch height, arch height index, and dynamic plantar pressure distributions were collected for 1000 subjects (566 males, 434 females, 30.

Changes in deep abdominal muscle thickness during common trunk-strengthening exercises using ultrasound imaging.

Study Design: Cross-sectional study design.

Objectives: To characterize changes in muscle thickness in the transversus abdominis (TrA) and internal oblique (IO) muscles during common trunk-strengthening exercises, and to determine whether these changes differ based on age.

Background: Although trunk-strengthening exercises have been found to be useful in treating those with low back pain (LBP), our understanding of the relative responses of the TrA and IO muscles during different exercises is limited.

Neck pain: Clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association.

The Orthopaedic Section of the American Physical Therapy Association presents this second set of clinical practice guidelines on neck pain, linked to the International Classification of Functioning, Disability, and Health (ICF). The purpose of these practice guidelines is to describe evidence-based orthopaedic physical therapy clinical practice and provide recommendations for (1) examination and diagnostic classification based on body functions and body structures, activity limitations, and participation restrictions, (2) prognosis, (3) interventions provided by physical therapists, and (4) assessment of outcome for common musculoskeletal disorders.

Rehabilitative ultrasound imaging of the abdominal muscles.

Rehabilitative ultrasound imaging (RUSI) of the abdominal muscles is increasingly being used in the management of conditions involving musculoskeletal dysfunctions associated with the abdominal muscles, including certain types of low back and pelvic pain. This commentary provides an overview of current concepts and evidence related to RUSI of the abdominal musculature, including issues addressing the potential role of ultrasound imaging in the assessment and training of these muscles. Both quantitative and qualitative aspects associated with clinical and research applications are considered, as are the possible limitations related to the interpretation of measurements made with RUSI.

Knowledge in managing musculoskeletal conditions and educational preparation of physical therapists in the uniformed services.

The purpose of this study was to describe knowledge in managing musculoskeletal conditions among physical therapists in the uniformed services based on their educational background and preparation. A cross-sectional design was used. A total of 182 physical therapists in the uniformed services completed a standardized examination that assesses knowledge in managing musculoskeletal conditions.

Fluoroscopic video to identify aberrant lumbar motion.

Study Design: A prospective, case-control design.

Objectives: To develop a kinematic model that characterizes frequently observed movement patterns in patients with low back pain (LBP).

Summary Of Background Data: Understanding arthrokinematics of lumbar motion in those with LBP may provide further understanding of this condition.

A perspective for considering the risks and benefits of spinal manipulation in patients with low back pain.

The purpose of this study was to determine if patients who do not receive manipulation for their low back pain (LBP) are at an increased risk for worsening disability compared to patients receiving an exercise intervention without manipulation. One hundred and thirty-one consecutive patients with LBP were randomly assigned to receive manipulation and an exercise intervention (n = 70) or an exercise intervention without manipulation (n = 61). Patients were classified as to whether they had experienced a worsening in disability upon follow-up.