Intra-rater reliability of rehabilitative ultrasound imaging of erector spinae and gluteus medius muscles in patients with low back pain.

Background: Low back pain (LBP) is one of the most common conditions in the United States. Dysfunctional patterns of the erector spinae (ES) and gluteus medius (GM) muscles often accompany episodes of LBP.

Objectives: To evaluate the intra-rater reliability of rehabilitative ultrasound imaging (RUSI) in obtaining thickness measurements of the ES and GM muscles at rest and during submaximal contraction.

The Impact of Anterior Pelvic Tilt on Return to Duty/Return to Run in Active Duty Personnel After Hip Arthroscopy for Femoroacetabular Impingement.

Introduction: Annually, 300,000 soldiers are rendered medically nondeployable because of musculoskeletal injuries (MSKIs). Of this population, nearly 10,000 (3.3%) involve injuries to the hip.

Sleep and Military Leaders: Examining the Values, Beliefs, and Quality of Sleep and the Impact on Occupational Performance.

Introduction: Sleep deprivation is rampant within the military population, and insufficient sleep can lead to physical and mental health problems impacting soldier's readiness and deployability. Past research has shown the importance of leadership's role in subordinates' sleep health. Understanding the values, beliefs, and quality of military leader sleep is essential to the development of effective interventions to optimize occupational performance and overall sleep health.

Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings.

Background: Lumbar muscle dysfunction is commonly implicated in low back pain (LBP). Shear-wave elastography (SWE) uses ultrasound technology to quantify absolute soft tissue stiffness (shear modulus), thereby allowing for estimation of individual muscle contraction and function.

Objectives: To compare resting and contracted stiffness of lumbar spine musculature in individuals with and without LBP using SWE.

Normative parameters and anthropometric variability of lumbar muscle stiffness using ultrasound shear-wave elastography.

Background: Quantifying stiffness of the lumbar spine musculature using shear-wave elastography (SWE) maybe beneficial in the diagnosis and treatment of non-specific low back pain (LBP). The primary purpose of this study was to establish normative parameter and variance estimates of lumbar spine muscle stiffness at rest and during submaximal contraction levels using SWE in healthy individuals. A second aim was to determine the relationship between lumbar spine muscle stiffness and a variety of demographic, anthropometric, and medical history variables.

The Impact of Behavioral and Psychological Factors on Physical Fitness in Medical and Nursing Students.

Physical activity improves general health and quality of life. A stressful academic environment can increase both physical and mental health disruptions in medical and nursing students, negatively impacting physical activity and fitness. We explored the relationship between the fitness profiles of 202 medical and graduate nursing students with self-reported levels of general and emotional health to elucidate the role of the psychosocial factors involved in choosing to exercise.

Reliability of ultrasound shear-wave elastography in assessing low back musculature elasticity in asymptomatic individuals.

Patients with low back pain commonly exhibit impaired morphology and function of spinal musculature that may be quantifiable using shear-wave elastography (SWE). The purpose of this study was to assess the intra-rater and test-retest reliability of SWE elasticity measures of the lumbar erector spinae and multifidus muscles during rest and differing levels of contraction in asymptomatic individuals. This single-group repeated-measures design involved a baseline measurement session and a follow-up session 3 days later.

Physical Performance Limitations After Severe Lower Extremity Trauma in Military Service Members.

Objectives: To characterize the type and magnitude of lower extremity physical performance deficits in military service members who have undergone rehabilitation after limb salvage or transtibial amputation.

Design: Cross-sectional prospective.

Setting: Level I trauma military medical and rehabilitation center.

Evaluation of a Novel Field Expedient Musculoskeletal Readiness Screening Tool in an Army Basic Training Population.

Background: Musculoskeletal injuries present a significant challenge to military readiness accounting for over 29% of ambulatory medical visits and 25 million limited duty days across the U.S. Army.

Effects of Low-Load Exercise on Postneedling-Induced Pain After Dry Needling of Active Trigger Point in Individuals With Subacromial Pain Syndrome.

Background: The application of dry needling usually is associated with postneedling-induced pain. A postneedling intervention to reduce this adverse event is needed.

Objective: To determine the effectiveness of low-load exercise on reducing postneedling-induced pain after dry needling of active trigger points (TrPs) in the infraspinatus muscle in subacromial pain syndrome.

Ultrasound Detection of Soft Tissue Abscesses Performed by Non-Physician U.S. Army Medical Providers Naïve to Diagnostic Sonography.

Background: Patients commonly present to emergency rooms and primary care clinics with cellulitic skin infections with or without abscess formation. In military operational units, non-physician medical personnel provide most primary and initial emergency medical care. The objective of this study was to determine if, after minimal training, Army physician assistants and medics could use portable ultrasound (US) machines to detect superficial soft tissue abscesses.

Effect of Lumbar Progressive Resistance Exercise on Lumbar Muscular Strength and Core Muscular Endurance in Soldiers.

Objectives: Low back pain is common, costly, and disabling for active duty military personnel and veterans. The evidence is unclear on which management approaches are most effective. The purpose of this study was to assess the effectiveness of lumbar extensor high-intensity progressive resistance exercise (HIPRE) training versus control on improving lumbar extension muscular strength and core muscular endurance in soldiers.

Effects of dry needling to the symptomatic versus control shoulder in patients with unilateral subacromial pain syndrome.

Background: Initial reports suggest that treating myofascial trigger points in the infraspinatus with dry needling may be effective in treating patients with shoulder pain. However, to date, high quality clinical trials and thorough knowledge of the physiologic mechanisms involved is lacking.

Objectives: To examine the effect of dry needling to the infraspinatus muscle on muscle function, nociceptive sensitivity, and shoulder range of motion (ROM) in the symptomatic and asymptomatic shoulders of individuals with unilateral subacromial pain syndrome.

The association between dry needling-induced twitch response and change in pain and muscle function in patients with low back pain: a quasi-experimental study.

Objective: To investigate the relationship between dry needling-induced twitch response and change in pain, disability, nociceptive sensitivity, and lumbar multifidus muscle function, in patients with low back pain (LBP).

Design: Quasi-experimental study.

Setting: Department of Defense Academic Institution.

THE EFFICACY OF AN EIGHT-WEEK CORE STABILIZATION PROGRAM ON CORE MUSCLE FUNCTION AND ENDURANCE: A RANDOMIZED TRIAL.

Background: Body armor is credited with increased survival rates in soldiers but the additional axial load may negatively impact the biomechanics of the spine resulting in low back pain. Multiple studies have found that lumbar stabilization programs are superior to generalized programs for patients with chronic low back pain. It is not known if such programs produce objective changes in trunk muscle function with wear of body armor.

Risk Factors for Low Back Pain and Spine Surgery: A Retrospective Cohort Study in Soldiers.

Introduction: Musculoskeletal low back pain (LBP) is commonly treated symptomatically, with practice guidelines advocating reserving surgery for cases that fail conservative care. This study examined medical comorbidities and demographic variables as risk factors for chronic/recurrent LBP, spinal surgery, and time to surgery.

Methods: A 2015 retrospective cohort study was conducted in U.

Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series.

Objectives: Severe lower extremity trauma accounts for large healthcare costs and often results in elective amputation and poor long-term outcomes. The purpose of this case series is to describe an orthopedic manual physical therapy (OMPT) approach combined with a return to run (RTR) clinical pathway consisting of high-intensity functional rehabilitation with a custom energy-storing orthosis.

Methods: Three consecutive male patients, aged 21-23 years, with severe lower extremity musculoskeletal injuries were treated with a combined intervention that included a mean (SD) of 12 (2·1) OMPT sessions and 24 (8·7) functional rehabilitation sessions over a mean of 6 weeks (1·0).

Carpal Tunnel Syndrome in an Adolescent With Obesity.

Purpose: Carpal tunnel syndrome (CTS) is typically found in adults and may be associated with a variety of metabolic conditions including obesity. Obesity is a growing problem among today's youth, and adult diseases often associated with obesity are now being found in a younger population. This case study describes a young adolescent girl with obesity and CTS.

ULTRASOUND IMAGING MEASUREMENT OF THE TRANSVERSUS ABDOMINIS IN SUPINE, STANDING, AND UNDER LOADING: A RELIABILITY STUDY OF NOVICE EXAMINERS.

Background: Military personnel and first responders (police and firefighters) often carry large amounts of gear. This increased load can negatively affect posture and lead to back pain. The ability to quantitatively measure muscle thickness under loading would be valuable to clinicians to assess the effectiveness of core stabilization treatment programs and could aid in return to work decisions.

PERFORMANCE OPTIMIZATION AND INJURY PREVENTION STRATEGIES FOR THE ARMY PHYSICAL FITNESS TEST: TECHNIQUE MATTERS.

Unlabelled: The Army Physical Fitness Test (APFT) is a biannual training requirement for all soldiers. The Army has made significant overall fitness gains by developing functional and comprehensive Physical Readiness Training (PRT) programs, but more emphasis on individualized physical fitness test taking technique is warranted in order to optimize performance. The purpose of this clinical commentary is to provide clinicians with several examples of APFT performance enhancement techniques that can potentially be applied not only in the Army, but throughout the military and in the sports community where general fitness assessments are routinely administered.

The reliability of rehabilitative ultrasound imaging in the measurement of infraspinatus muscle function in the symptomatic and asymptomatic shoulders of patients with unilateral shoulder impingement syndrome.

Background: Rehabilitative ultrasound Imaging (RUSI) is increasingly used in the management of musculoskeletal conditions as it provides an objective measure of muscle function while being less invasive than needle electromyography. While research has documented the ability to reliably measure trunk muscles in patients with back pain, no study to date has used RUSI to quantify infraspinatus muscle function in patients with shoulder impingement syndrome (SIS).

Hypothesis/purpose: The purpose of this study was to examine the intra-rater and inter-rater reliability of measuring infraspinatus muscle thickness with RUSI and to compare such measures during resting versus contracted muscle states and in the symptomatic versus asymptomatic shoulders in patients with SIS.

Changes in lumbar multifidus muscle function and nociceptive sensitivity in low back pain patient responders versus non-responders after dry needling treatment.

Background: Little is known about the physiologic mechanism of dry needling. While some evidence suggests that dry needling may decrease nocioceptive sensitivity and facilitate muscle function, no studies to date have examined these physiologic changes compared to clinical outcomes.

Objective: To examine changes in lumbar multifidus (LM) muscle function and nociceptive sensitivity after dry needling in patients with LBP and to determine if such changes differ in patients that exhibit improved disability (responders) and those that do not (non-responders).

Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: A randomized controlled study.

Background: Thoracic SMT can improve symptoms in patients with subacromial impingement syndrome. However, at this time the mechanisms of SMT are not well established. It is possible that changes in pain sensitivity may occur following SMT.