Physical therapists commonly use screening tests to identify upper motoneuron lesions such as cord compressive myelopathy (CCM), the presence of which neces- sitates appropriate medical referral. Signs and symptoms of CCM include sensory... more
Physical therapists commonly use screening tests to identify upper motoneuron lesions such as cord compressive myelopathy (CCM), the presence of which neces- sitates appropriate medical referral. Signs and symptoms of CCM include sensory and ataxic changes of the lower extremities, poorly coordinated gait, weakness, tetraspas- ticity, clumsiness, spasticity, hyperreflexia, and primitive reflexes. Clinical tests and measures such as Hoffmann sign,
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The lower extremity neuromuscular recovery of a 31-year-old male physical therapy student during the initial 2-weeks following anterior cruciate ligament reconstruction was evaluated by measuring involved side vastus medialis (VM),... more
The lower extremity neuromuscular recovery of a 31-year-old male physical therapy student during the initial 2-weeks following anterior cruciate ligament reconstruction was evaluated by measuring involved side vastus medialis (VM), gluteus maximus (GMAX) and gastrocnemius (GASTROC) electromyographic (EMG) signals (1000 Hz), plantar forces (50 Hz), and knee pain as the subject performed a series of volitional, maximal effort unilateral, isometric leg presses (6 sec) in a modified continuous passive motion device. Data were standardized to pre-operative values and graphically plotted for split middle technique, celeration line assessment. From 1-8 hours post-surgery, EMG amplitudes and plantar forces decreased, pain increased, and plantar force location shifted toward the forefoot. From 9-12 hours post-surgery, EMG amplitudes and plantar forces increased and pain decreased. By 24 hours post-surgery, pain decreased to pre-operative levels. From 24-72 hours post-surgery, EMG amplitudes ...
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Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary... more
Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent surgical decision-making. Summarise/evaluate the current diagnostic accuracy of various clinical tests germane to hip FAI/ALT pathology. A computer-assisted literature search of MEDLINE, CINAHL and EMBASE databases using keywords related to diagnostic accuracy of the hip joint, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the search and reporting phases of the study. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 (QUADAS-2). Random effects models were used to summarise sensitivities (SN), specificities (SP), diagnostic odds ratio (DOR) and respective confidence intervals (...
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ABSTRACT Contexte Les questionnaires centrés sur le patient jouent un rôle important dans la mesure des résultats en pratique médicale, mais leur fiabilité et leur validité doivent être vérifiées de façon systématique. Parmi eux, le... more
ABSTRACT Contexte Les questionnaires centrés sur le patient jouent un rôle important dans la mesure des résultats en pratique médicale, mais leur fiabilité et leur validité doivent être vérifiées de façon systématique. Parmi eux, le questionnaire d'évaluation subjective du genou, mis au point par l'IKDC (Comité international de documentation du genou), permet d'appréhender les symptômes et la fonction lors des activités quotidiennes. La présente étude avait pour objectif de valider cet instrument dans une vaste population de patients porteurs de diverses pathologies du genou. Méthodes Mille cinq cent trente-quatre patients suivis pour des pathologies du genou à la consultation de médecine sportive d'un grand centre médical ont rempli le questionnaire IKDC. La structure factorielle a été déterminée grâce à une analyse factorielle exploratoire avec rotation promax. La cohérence interne des dimensions ainsi identifiées a été évaluée par le coefficient alpha de Cronbach. La validité concomitante a été appréciée en corrélant les dimensions du questionnaire IKDC aux sous-échelles du SF-12. Enfin, les caractéristiques des items ont été analysées grâce au modèle de réponse graduée de la théorie des réponses aux items (analyse G-IRT). Résultats L'analyse factorielle exploratoire a permis d'identifier deux dimensions appelées ici « Symptômes et Genou » et « Niveau d'Activité ». L'analyse factorielle confirmatoire a démontré la participation de 15 des 18 items à ces dimensions. La cohérence interne était bonne pour les deux dimensions (alpha de Cronbach : 0,87 pour Symptômes et Genou et 0,88 pour Niveau d'Activité). Les deux dimensions étaient significativement corrélées au score SF-12 total ; toutefois, les corrélations étaient plus étroites avec la sous-échelle somatique qu'avec la sous-échelle psychocognitive du SF-12. Discussion L'analyse G-IRT a mis en évidence un profil de réponse bien défini pour la plupart des items, des niveaux plus élevés du trait latent (fonction du genou) correspondant à un caractère plus adaptatif des paramètres cliniques reflétant la douleur, les symptômes, la fonction et l'activité sportive. Conclusion Le questionnaire IKDC est un instrument fiable et valide dont l'utilisation dans une population plus large de patients mérite d'être envisagée.
ObjectivesThe purpose of this study was to measure the intraobserver and interobserver reliability of magnetic resonance detection of cervical spondylotic myelopathy with and without operational guidelines.
Research Interests: Complementary and Alternative Medicine, Magnetic Resonance Imaging, Humans, Female, Male, and 12 moreMagnetic Resonance, Cervical Vertebrae, Clinical Sciences, Aged, Middle Aged, Observer Variation, Reproducibility of Results, Cervical Spine, Spinal Stenosis, Manipulative, Magnetic resonance image, and Severity of Illness Index
Abstract: When a patient presents with pain in the different regions of the spine, the clinician executes a region-appropriate basic examination that includes appropriate historical cues and specific physical examination tests that can... more
Abstract: When a patient presents with pain in the different regions of the spine, the clinician executes a region-appropriate basic examination that includes appropriate historical cues and specific physical examination tests that can be used to identify red flags. The clinical tests include a specific examination of the sensory and motor systems. Test outcomes are best interpreted in context with the entire examination profile, where the sensitivity and specificity of these tests can influence their utility in uncovering red flags. These red flags can be categorized based on the nature and severity or the specific elements of the patient’s presentation. Many general red flags can be observed in any region of the spine, while specific red flags must be categorized and discussed for each spinal region. This categorization can guide the clinician in the direction of management, whether that management is aimed at redirecting the patient’s care to another specialist, reconsidering the presentation and observing for clusters of findings that may suggest red flags, or managing the patient within the clinician’s specialty in context with the severity of the patient’s presentation.
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ObjectiveThe purpose of this study was to examine the immediate effects of spinal manipulative therapy (SMT) on trunk proprioception in subjects with asymptomatic chronic low back pain (CLBP) and determine if those effects lasted 1 week.
Research Interests: Complementary and Alternative Medicine, Treatment Outcome, Probability, Low back pain, Proprioception, and 22 moreHumans, Movement, Chronic Disease, Female, Male, Young Adult, Follow-up studies, Electromyography, Clinical Sciences, Aged, Middle Aged, Adult, Randomized Controlled Trial, Spinal Manipulative Therapy, Physical examination, Chronic Low Back Pain, Reference Values, Cross-Over Studies, Pain Measurement, Pain Threshold, Manipulative, and Severity of Illness Index
The purpose of this study was to compare quality of life health identifiers in patients with and without osteoarthritis (OA) while controlling for the potentially confounding variables of gender, age, race, education, and income. Data... more
The purpose of this study was to compare quality of life health identifiers in patients with and without osteoarthritis (OA) while controlling for the potentially confounding variables of gender, age, race, education, and income. Data were obtained for comparison from the Behavioral Risk Factor Surveillance System (BRFSS) database. Patients with and without OA were analyzed for differences in exercise and
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ObjectiveThe knowledge of 3-dimensional spine coupling characteristics is important for treating patients with spinal pain. The purpose of this study was to examine the coupling directional pattern of the thoracic spine by systematic... more
ObjectiveThe knowledge of 3-dimensional spine coupling characteristics is important for treating patients with spinal pain. The purpose of this study was to examine the coupling directional pattern of the thoracic spine by systematic review. This review could help determine the use of coupling knowledge for manual therapy treatment.
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Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003. To examine perioperative morbidity and mortality for patients with and without diabetes mellitus following lumbar... more
Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003. To examine perioperative morbidity and mortality for patients with and without diabetes mellitus following lumbar spinal fusion. Diabetes has been associated with worse outcomes in a variety of orthopedic procedures including spinal surgery. There is limited evidence that diabetic patients have more complications following lumbar fusion with little published data to support this conclusion. Data from 197,461 patients who underwent lumbar fusion were included. Over 11,000 patients (5.6%) with a postoperative diagnosis of diabetes mellitus were identified. Selected variables were used for comparison of patients with and without diabetes. Bivariate statistical analyses compared postoperative complication rates while multivariate statistics were used to determine likelihood of complications with diabetes. Bivariate analysis demonstrated that diabetes was significantly associated with postoperative infection, need for transfusion, pneumonia, in-hospital mortality, and nonroutine discharge (P <or= 0.001). Adjusted multivariate regression analyses, however, suggested no difference in mortality although infection, transfusion, and nonroutine discharge continued to be highly significant (P <or= 0.002). Significantly higher inflation adjusted total charges were also present with patients with diabetes as well as increased lengths of stay (P < 0.001). This nationally representative study of inpatients in the United States provides evidence that diabetes is associated with increased risk for postoperative complications, nonroutine discharge, increased total hospital charges, and length of stay following lumbar fusion. Prospective studies to determine causality as well as the potential impact of diabetes control on these variables have not yet been done.
Research Interests: Biomedical Engineering, Spine, Treatment Outcome, Risk assessment, Humans, and 23 moreHospital costs, United States, Female, Pneumonia, Male, Risk factors, Length of Stay, Clinical Sciences, Aged, Middle Aged, Adult, Time Factors, Odds ratio, Retrospective Studies, Risk Factors, Risk Assessment, Blood Transfusion, Hospital Mortality, Type 2 Diabetes Mellitus, Spinal Fusion, Case Control Studies, Cohort Studies, and lumbar vertebrae
Clinical cervical spine instability (CCSI) is controversial and difficult to diagnose. Within the literature, no clinical or diagnostic tests that yield valid and reliable results have been described to differentially diagnose this... more
Clinical cervical spine instability (CCSI) is controversial and difficult to diagnose. Within the literature, no clinical or diagnostic tests that yield valid and reliable results have been described to differentially diagnose this condition. The purpose of this study was to attempt to obtain consensus on symptoms and physical examination findings that are associated with CCSI. One hundred seventy-two physical therapists who were Orthopaedic Certified Specialists (OCS) or Fellows of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT) participated in the survey. This study was a 3-round Delphi survey designed to obtain consensual symptoms and physical examination findings for CCSI. The symptoms that reached the highest consensus among respondents were "intolerance to prolonged static postures," "fatigue and inability to hold head up," "better with external support, including hands or collar," "frequent need for self-manipulation...
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To measure selected psychometric properties of individual item responses from the National Health and Nutrition Examination Surveys (NHANES) activities of daily living (ADL) instrument among a population of patients with low back pain... more
To measure selected psychometric properties of individual item responses from the National Health and Nutrition Examination Surveys (NHANES) activities of daily living (ADL) instrument among a population of patients with low back pain (LBP). The study group consisted of 926 individual attendees of a traditional medical appointment. All subjects had self-reported LBP and completed questions within the NHANES ADL instrument, a 16-item questionnaire designed to represent the internal latent construct of ADL. Data analyses included exploratory factor analysis, internal consistency measures, and polytomous (graded) item response theory. The NHANES ADL instrument is a unidimensional and internally consistent measure of ADL. Graded item response theory analyses indicated that although some variability exists, all 16 single items were sensitive measures of the latent construct of ADL. Most item responses demonstrated high discrimination. Individual use of selected items of the NHANES ADL in...
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The National Health and Nutrition Examination Surveys (NHANES) activity of daily living (ADL) instrument is a 16-item questionnaire designed to represent the internal latent construct of activities of daily living. The purpose of the... more
The National Health and Nutrition Examination Surveys (NHANES) activity of daily living (ADL) instrument is a 16-item questionnaire designed to represent the internal latent construct of activities of daily living. The purpose of the present study was to measure selected psychometric properties (dimensionality, internal consistency and individual item response) of the NHANES ADL instrument on a population of patients who reported frequent severe headaches. The study group consisted of 672 attendees of a traditional medical appointment with a report of severe headaches. Data analyses included exploratory factor analysis, internal consistency measures and graded item response theory. The NHANES ADL instrument is a uni-dimensional and internally consistent measure of activities of daily living. Graded item response theory analyses indicated that all 16 single items were sensitive measures of the latent construct of activities and daily living. Selected items demonstrated high discrimin...
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Work-related musculoskeletal disorders (MSDs) can produce ergonomic pain in several different regions of the body, including the shoulder, elbow, wrist and hand, lumbar spine, knee, and ankle/foot. Each family of disorders is distinctive... more
Work-related musculoskeletal disorders (MSDs) can produce ergonomic pain in several different regions of the body, including the shoulder, elbow, wrist and hand, lumbar spine, knee, and ankle/foot. Each family of disorders is distinctive in presentation and requires diagnosis-specific interventions. Because of the complex nature of these disorders, management approaches may not always eliminate symptoms and or completely restore patient function to a level found prior to symptom onset. As a consequence, ergonomic measures should be implemented to reduce the overload on tissue and contribute to patient recovery. However, functional limits may persist and the clinician must make further decisions regarding a person's functional status in the chronic stages of the patient's care.
The purpose of this study was to validate an item bank of questions associated with activities of daily living (ADL), using graded item response theory (G-IRT), in a sample of community-dwelling survivors of a stroke. The study sample... more
The purpose of this study was to validate an item bank of questions associated with activities of daily living (ADL), using graded item response theory (G-IRT), in a sample of community-dwelling survivors of a stroke. The study sample consisted of 364 community-dwelling individuals who reported a recent history of stroke. Sixteen line items from the 1999-2000 National Health and Nutrition Examination Surveys (NHANES) survey were analyzed using factor analysis, internal analyses of consistency, and G-IRT. The 16 line items demonstrated unidimensionality and were internally reliable. Thirteen line items demonstrated good discrimination and suitable thresholds. The majority of items exhibited appropriate sensitivity across the entire spectrum of functional severity indicating that these items closely reflected the relationship of decreased function with increased severity of illness. Each of the 13 items is scale independent, is valid for measurement of functional impairment, and may b...
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Erudition of clinical "skills" used by manually trained physical therapists involves the complex domain of cognitive, affective, and psychomotor concepts. The purpose of the study was to obtain consensus among manual therapy... more
Erudition of clinical "skills" used by manually trained physical therapists involves the complex domain of cognitive, affective, and psychomotor concepts. The purpose of the study was to obtain consensus among manual therapy educators regarding stand-alone skills required during competent application of manual therapy and to distill these stand-alone skills into smaller but more homogeneous skill sets. Eighty manual therapy educators in entry-level and post-entry-level educational programs completed a three-round Delphi survey aimed at developing consensus among experts in the field regarding the stand-alone skills that are important to a learners' development of manual therapy competencies. From the Delphi outcomes, a principal component factor analysis distilled eight component skill sets that were associated with orthopedic manual therapy (OMT) proficiency: (1) manual joint assessment, (2) proficiency of fine sensorimotor characteristics, (3) manual patient manageme...
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Minimal clinically important differences (MCID) are patient derived scores that reflect changes in a clinical intervention that are meaningful for the patient. At present, there are a number of different methods to obtain an MCID, as... more
Minimal clinically important differences (MCID) are patient derived scores that reflect changes in a clinical intervention that are meaningful for the patient. At present, there are a number of different methods to obtain an MCID, as there a number of different factors that can influence the MCID value. This clinimetric corner outlines the hidden challenges associated with identifying a viable MCID and possible suggestions to improve the future development of these single scores.
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... Copyright © WS Maney & Son Ltd 2010. Mode of administration bias. Chad Cook. Duke University, USA. ... often attempt to please the clinician or researcher or withhold negative information to best model the intervention provided,... more
... Copyright © WS Maney & Son Ltd 2010. Mode of administration bias. Chad Cook. Duke University, USA. ... often attempt to please the clinician or researcher or withhold negative information to best model the intervention provided, 12 thereby generating overly optimistic responses ...
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THE OBJECTIVES OF THIS STUDY WERE TO: (1) determine the association of a within-session finding after traction of the hip with self-report of well-being, pain, and self-report of function at 9 weeks; and (2) to determine if the... more
THE OBJECTIVES OF THIS STUDY WERE TO: (1) determine the association of a within-session finding after traction of the hip with self-report of well-being, pain, and self-report of function at 9 weeks; and (2) to determine if the interactions between the within-session finding and the outcome measure are different between groups of patients with hip OA who receive and who do not receive manual therapy. Data were retrospectively analysed in 70 subjects who were part of a randomized control trial. Correlation analyses of within-session findings from the initial visit after traction of a concordantly painful hip were compared to self-report measures for function, pain, and well-being at 9 weeks. A comparison of slope coefficients between manual therapy and non-manual therapy groups was performed to determine the interactive aspects of the within-session finding. Although the correlations for the manual therapy group were higher than for the supervised neglect group, none of the correlati...
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A battery of tests is commonly used to measure disability with and recovery from concussion. A number of different concussion-oriented assessment tests exist and each is considered useful. To the authors' knowledge, no study has... more
A battery of tests is commonly used to measure disability with and recovery from concussion. A number of different concussion-oriented assessment tests exist and each is considered useful. To the authors' knowledge, no study has compared the scores of these tests during recovery in the middle school and high school aged population to see how each change over time. The purposes of this study were to analyze clinical data of concussed middle school and high school aged athletes to determine the concurrent and predictive validity for post-concussion syndrome (PCS) of the Post-Concussion Symptom Scale (PCSS), Balance Error Scoring System (BESS), and the five subscales of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The study was a retrospective chart review performed on middle school and high school aged individuals with a diagnosis of concussion from the years 2008-2010 within the Akron Children's Hospital Sports Medicine system. To be eligible for i...
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Numerous outcomes measures can be used to capture and differentiate change in different constructs comprising recovery. Consequently, patients are often burdened by completing a number of measures which involves considerable time and... more
Numerous outcomes measures can be used to capture and differentiate change in different constructs comprising recovery. Consequently, patients are often burdened by completing a number of measures which involves considerable time and effort. The purpose of this longitudinal, observational study was to identify the number of dimensions in a battery of self-report findings in a patient population who received shoulder injections to investigate the association of the instruments. Ninety-nine subjects, with diagnoses of adhesive capsulitis, labral injuries, rotator cuff injuries, and osteoarthritis completed outcomes measures including five different forms of pain intensity measures, the McGill Short Form Questionnaire, and the Disabilities of the Arm, Shoulder, and Hand Questionnaire. Change scores were calculated at 4 weeks and an exploratory factor analysis (EFA) with varimax rotation was used to analyze dimensionality. The relationship between the raw scores of the seven measures wa...
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Quadriceps rupture off the patella is traditionally repaired by a transosseous tunnel technique, although a single-row suture anchor repair has recently been described. This study biomechanically tested a new transosseous equivalent (TE)... more
Quadriceps rupture off the patella is traditionally repaired by a transosseous tunnel technique, although a single-row suture anchor repair has recently been described. This study biomechanically tested a new transosseous equivalent (TE) double-row suture anchor technique compared with the transosseous repair for quadriceps repair. After simulated quadriceps-patella avulsion in 10 matched cadaveric knees, repairs were completed by either a three tunnel transosseous (TT = 5) or a TE suture anchor (TE = 5) technique. Double-row repairs were done using two 5.5 Bio-Corkscrew FT (fully threaded) (Arthrex, Inc., Naples, FL, USA) and two 3.5 Bio-PushLock anchors (Arthrex, Inc., Naples, FL, USA) with all 10 repairs done with #2 FiberWire suture (Arthrex, Inc., Naples, FL). Cyclic testing from 50 to 250 N for 250 cycles and pull to failure load (1 mm/s) were undertaken. Gap formation and ultimate tensile load (N) were recorded and stiffness data (N/mm) were calculated. Statistical analysis w...
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Although uncommon, closed cervical fractures (CCFs) may present in orthopedic clinical settings despite previous workup. The objective of this study was to describe the characteristics associated with missed CCF. The study was a... more
Although uncommon, closed cervical fractures (CCFs) may present in orthopedic clinical settings despite previous workup. The objective of this study was to describe the characteristics associated with missed CCF. The study was a retrospective database exploration of a cohort of subjects within a department of surgery with cervical pain. The sample consisted of 162 patients seen for a surgical consult for a number of cervical conditions. The examination time frame represented a clinical examination and imaging confirmation of diagnosis after an original initial visit by another provider. Descriptive and diagnostic accuracy values including sensitivity/specificity and positive/negative likelihood ratios (LR+/LR-) were calculated for each targeted variable. Clustered analyses were calculated using the patient history and situational characteristics. Eleven patients in the sample were diagnosed with CCF (6.7%). Six variables were significantly associated with a missed CCF. Using these s...
Research Interests: Employment, Emergency Medical Services, Humans, Female, Male, and 13 moreNeck Pain, Regression Analysis, Cluster Analysis, Cervical Vertebrae, Middle Aged, Adult, Time Factors, Retrospective Studies, Age Factors, Sensitivity and Specificity, Likelihood Functions, Marital Status, and Spinal fractures
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A variety of self-report and physical performance-based outcome measures are commonly used to assess progress and recovery in the lower leg, ankle, and foot. A requisite attribute of any outcome measure is its ability to detect change in... more
A variety of self-report and physical performance-based outcome measures are commonly used to assess progress and recovery in the lower leg, ankle, and foot. A requisite attribute of any outcome measure is its ability to detect change in a condition, a construct known as "responsiveness". There is a lack of consistency in how responsiveness is defined in all outcome measures. The purpose of this study was to review the currently used recovery outcome measures for lower leg, ankle and foot conditions in order to determine and report recommended responsiveness values. A systematic literature search that included electronic searches of PubMed, CINAHL and SportDiscus as well extensive cross-referencing was performed in January, 2013. Studies were included if each involved: 1) a prospective, longitudinal study of any design; 2) any condition associated with the lower leg, ankle or foot; 3) a measure of responsiveness; and 4) was an acceptable type of outcome measure (eg. self-r...
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Dizziness after a sports-related concussion is very common and is associated with prolonged recovery. The events in sports that cause concussion include strong mechanical forces exerted to the head and neck, potentially injuring the... more
Dizziness after a sports-related concussion is very common and is associated with prolonged recovery. The events in sports that cause concussion include strong mechanical forces exerted to the head and neck, potentially injuring the cervical region, the peripheral vestibular and central nervous system, all of which can contribute to a sensation of dizziness. The purpose of this study was to identify proper clinically administered tests and measures that are useful in differentiating between cervicogenic and other causes of dizziness after a sports-related concussion. The Delphi method. The workgroup identified the initial list of suggested clinical tests and the initial list of content experts on dizziness and/or concussion through a search of peer-reviewed and grey literature. The respondent group included all invited experts who opted to participate. A sequential three-round process was used for elicitation of consensus opinions from the targeted content experts. The respondent gr...
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ABSTRACT
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Many musculoskeletal management philosophies advocate the exploration of the relationship between the patient's chief complaint (CC) and the physical examination findings that reproduce/reduce/change that CC. Geoffrey Maitland... more
Many musculoskeletal management philosophies advocate the exploration of the relationship between the patient's chief complaint (CC) and the physical examination findings that reproduce/reduce/change that CC. Geoffrey Maitland developed the concept "comparable sign(s) (CS), which are physical examination findings related to the CC(s) that are reproduced during an examination/treatment. These include observed abnormalities of movement, postures or motor control, abnormal responses to movement, static deformities, and abnormal joint assessment findings. There are no studies that have explored the potential clinical relationships between the patient's CC and a CS, thus this exploratory study evaluated the associations, outcomes, and prevalence of the findings. This cohort study involved 112 subjects age 54.3 years (SD = 13.4 years), with neck (25.9%) or low back pain (74.1%) who were treated with physiotherapy for an average of 42 days. Data analysis revealed 88.4% identif...
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A strong understanding of diagnostic imaging has been advocated for physical therapists. There have been recent changes in physical therapy curricula and increased opportunities to utilize imaging during clinical practice. The aim of this... more
A strong understanding of diagnostic imaging has been advocated for physical therapists. There have been recent changes in physical therapy curricula and increased opportunities to utilize imaging during clinical practice. The aim of this study was to explore the ability of practicing clinicians to accurately identify selected musculoskeletal conditions on plain-film radiograph (X-ray), magnetic resonance imaging (MRI), and computed tomography scan (CT scan). Further, to determine whether improvements in identification of pathology occur when the clinical scenario is added to the imaging and whether there are related training/exposure factors. A cross- sectional electronic survey was sent out to physical therapists in the state of Ohio. Participants were asked to identify conditions (cervical fracture, anterior cruciate ligament tear, and avascular necrosis of the femoral head) first given diagnostic images only, and then given the images and a clinical scenario. Eight hundred sixty...
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The aim of the present study was to identify predictive characteristics related to patients with neck impairments who have a high risk of a poor prognosis (lowest functional recovery compared to visit utilization) as well as those who are... more
The aim of the present study was to identify predictive characteristics related to patients with neck impairments who have a high risk of a poor prognosis (lowest functional recovery compared to visit utilization) as well as those who are at low risk of a poor prognosis (highest functional recovery compared to visit utilization). A retrospective cohort of 3,137 patients with neck pain who were seen for physiotherapy care was included in the study. All patients were seen at physiotherapy clinics in the United States and were provided with care in a manner in which the physiotherapists felt was appropriate and necessary. Univariate and multivariate multinomial regression analyses were used to identify significant patient characteristics predictive of treatment response. Statistically significant predictors of high-risk categorization included longer duration of symptoms, surgical history and lower comparative levels of disability at baseline. Statistically significant predictors of lo...