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.

Severe stress in an elderly woman causes a temporary "broken" heart.

This novel cardiac syndrome has clinical features that mimic those of acute myocardial infarction. The typical patient is a postmenopausal woman.

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.

Development of a clinical prediction rule for diagnosing hip osteoarthritis in individuals with unilateral hip pain.

Study Design: Prospective cohort/predictive validity study.

Objective: To determine the diagnostic accuracy of common clinical examination items and to construct a preliminary clinical prediction rule for diagnosing hip osteoarthritis (OA) in individuals with unilateral hip pain.

Background: The current gold standard for the diagnosis of hip OA is a standing anteroposterior (AP) radiograph of the pelvis.

Rotator cuff fatigue and glenohumeral kinematics in participants without shoulder dysfunction.

Context: Researchers have established that superior migration of the humeral head increases after fatigue of the rotator cuff muscles. In these studies, the investigators used imaging techniques to assess migration of the humeral head during statically held shoulder positions. Their results may not represent the amount of superior humeral head migration that occurs during dynamic arm elevation.

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.

Patient satisfaction with dental hygiene providers in US military clinics.

Purpose: Military service members receive their dental care from military dental clinics. The purposes of this study were to assess satisfaction and to identify predictors of patient satisfaction with the hygiene provider in military dental treatment facilities.

Methods: Standardized surveys were administered from 2000 through 2004 by the Tri-Service Center for Oral Health Studies.

Development of a clinical prediction rule for classifying patients with patellofemoral pain syndrome who respond to patellar taping.

Study Design: Predictive validity/diagnostic test study.

Objective: To determine the predictive validity and interrater reliability of selected clinical exam items and to develop a clinical prediction rule (CPR) to determine which patients respond successfully to patellar taping.

Background: Patellar taping is often used to treat patients with PFPS.

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.

Risk determination for patients with direct access to physical therapy in military health care facilities.

Study Design: Nonexperimental, retrospective, descriptive design.

Objectives: This study was designed to ascertain whether direct access to physical therapy placed military health care beneficiaries at risk for adverse events related to their management.

Background: Military health care beneficiaries have the option at most US military hospitals and clinics to first enter the health care system through physical therapy by direct access, without referral from another privileged health care provider.

The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain.

Study Design: Randomized controlled trial among patients with low back pain (LBP).

Objectives: (1) Determine the reliability of real-time ultrasound imaging for assessing activation of the lateral abdominal muscles; (2) characterize the extent to which the abdominal drawing-in maneuver (ADIM) results in preferential activation of the transverse abdominis (TrA); and (3) determine if ultrasound biofeedback improves short-term performance of the ADIM in patients with LBP.

Background: Ultrasound imaging is reportedly useful for measuring and training patients to preferentially activate the TrA muscle.

Screening for vertebrobasilar insufficiency in patients with neck pain: manual therapy decision-making in the presence of uncertainty.

Growing evidence supports the effectiveness of manual therapy interventions in patients with neck pain; however, considerable attention has also been afforded to the potential risks such as vertebrobasilar insufficiency (VBI). Despite the existence of guidelines advocating specific screening procedures, research does not support the ability to accurately identify patients at risk. The logical question becomes, "How does one proceed in the absence of certainty?" Given the lack of clear direction for decision making in the peer-reviewed literature, this commentary discusses the uncertainties that exist regarding the ability to identify patients at risk for VBI.

A description of physical therapists' knowledge in managing musculoskeletal conditions.

Background: Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions.

The influence of experience and specialty certifications on clinical outcomes for patients with low back pain treated within a standardized physical therapy management program.

Study Design: Secondary analysis of a randomized trial.

Objectives: To examine the influence of experience and specialty certification on outcomes for patients with low back pain receiving a standardized manipulation or stabilization exercise intervention program.

Background: Little research has examined the impact of therapist-related factors on the outcomes of clinical care for patients with low back pain.

Identification of individuals with patellofemoral pain whose symptoms improved after a combined program of foot orthosis use and modified activity: a preliminary investigation.

Background And Purpose: In patients with patellofemoral pain syndrome (PFPS), the authors determined which aspects of the examination could be used to identify those patients most likely to respond to off-the-shelf foot orthoses and instruction in activity modification.

Participants And Methods: Fifty participants were enrolled in the study, and data for 5 individuals were excluded from analysis. Thirty-four men and 11 women completed the study.

The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain.

Objective: To determine the relationship between an audible pop and symptomatic improvement with spinal manipulation in patients with low back pain (LBP).

Design: A prospective cohort study.

Setting: Two outpatient physical therapy clinics located in military medical centers.