Scholars@Duke
Daniel I. Rhon

Daniel I. Rhon

Adjunct Assistant Professor in the Department of Orthopaedic Surgery
Orthopaedic Surgery
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Selected Publications

Associations between smoking history, baseline pain interference and symptom distribution, and physical function at discharge, in individuals seeking care for musculoskeletal pain.

Journal Article Addict Behav · November 2024 OBJECTIVE: Study of the association between smoking and pain intensity has produced conflicting results; with less focus on pain interference. Different pain constructs could have varying associations with smoking behaviors. This study sought to investigat ... Full text Link to item Cite

Cost-effectiveness of Risk Stratified Care vs Usual Care for Low Back Pain in the Military Health System.

Journal Article Spine (Phila Pa 1976) · September 6, 2024 STUDY DESIGN: Cost-effectiveness of two trial interventions for low back pain. OBJECTIVE: To investigate the incremental cost-effectiveness between risk-stratified and usual care for low back pain. SUMMARY OF BACKGROUND DATA: A recent trial compared risk-s ... Full text Link to item Cite

Assessing the transparency in reporting of clinical trials investigating manual therapy interventions for low back pain: A methodological review.

Journal Article J Eval Clin Pract · July 7, 2024 RATIONALE: Low back pain (LBP) is a common condition with a significant societal burden. Manual therapy is an effective treatment for LBP and recommended in clinical practice guidelines. While the quantity of literature supporting the use of manual therapy ... Full text Link to item Cite

General and Pain-Associated Psychological Distress Phenotypes Among Patients With Low Back Pain in the Military Health System.

Journal Article Arthritis Care Res (Hoboken) · July 2024 OBJECTIVE: The primary objective was to describe rates of general and pain-related psychological distress for individuals with low back pain (LBP) in the Military Health System (MHS). We identified common phenotypes defined by rates of general and pain-rel ... Full text Link to item Cite

Self-acknowledged limitations in exercise therapy trials for low back pain.

Journal Article J Eval Clin Pract · June 4, 2024 RATIONALE: Despite the widespread recommendation to engage in therapeutic exercise for the treatment of low back pain (LBP), there is conflicting evidence regarding clinical outcomes and effectiveness. Poor methodological quality may be to blame for reduci ... Full text Link to item Cite

Adverse Events Reported in Trials Assessing Manual Therapy to the Extremities: A Systematic Review.

Journal Article J Integr Complement Med · June 2024 Objective: This review aimed to describe the quality and comprehensiveness of adverse event (AE) reporting in clinical trials incorporating manual therapy (MT) as an intervention for extremity conditions using the Consolidated Standards of Reporting Trials ... Full text Link to item Cite

Seventeen-Year National Pain Prevalence Trends Among U.S. Military Veterans.

Journal Article J Pain · May 2024 U.S. military veterans experience higher pain prevalence than nonveterans. However, it is unclear how the disparities in pain prevalence have changed over time because previous trend studies are limited to veterans using the Veterans Health Administration. ... Full text Link to item Cite

Minimal important clinical difference values are not uniformly valid in the active duty military population recovering from shoulder surgery.

Journal Article J Shoulder Elbow Surg · April 16, 2024 BACKGROUND: There are multiple methods for calculating the minimal clinically important difference (MCID) threshold, and previous reports highlight heterogeneity and limitations of anchor-based and distribution-based analyses. The Warfighter Readiness Surv ... Full text Link to item Cite

Evaluating and Characterizing the Scope of Care for Interventions Labeled as Manual Therapy in Low Back Pain Trials: A Scoping Review.

Journal Article Phys Ther · April 2, 2024 OBJECTIVE: The purpose of this scoping review was to evaluate and characterize the scope of care for low back pain that falls under the specific label of manual therapy. METHODS: PubMed database, Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied ... Full text Link to item Cite

Reproducibility of Exercise Interventions in Randomized Controlled Trials for the Treatment of Rotator Cuff-Related Shoulder Pain: A Systematic Review.

Journal Article Arch Phys Med Rehabil · April 2024 OBJECTIVE: To determine the reproducibility of exercise therapy interventions in randomized controlled trials for rotator cuff-related shoulder pain (RCRSP). DATA SOURCES: Data sources included Medline, Cumulative Index to Nursing and Allied Health Literat ... Full text Link to item Cite

Can a Psychologic Profile Predict Successful Return to Full Duty After a Musculoskeletal Injury?

Journal Article Clin Orthop Relat Res · April 1, 2024 BACKGROUND: Psychologic variables have been shown to have a strong relationship with recovery from injury and return to work or sports. The extent to which psychologic variables predict successful return to work in military settings is unknown. QUESTIONS/P ... Full text Link to item Cite

How Reproducible Are Manual Therapy Interventions in Trials for Low Back Pain? A Scoping Review.

Journal Article J Orthop Sports Phys Ther · April 2024 OBJECTIVES: To assess the reproducibility of manual therapy interventions used in clinical trials for low back pain (LBP), and summarize knowledge gaps in assessing the reproducibility of manual therapy interventions for LBP. DESIGN: Scoping review. LITERA ... Full text Link to item Cite

The majority of clinical trials assessing mobilization and manipulation for neck pain lack a pragmatic approach: a systematic review of 174 trials.

Journal Article J Man Manip Ther · March 25, 2024 BACKGROUND: Disorders of the cervical spine are some of the costliest musculoskeletal conditions to manage globally. Joint mobilization and manipulation have been shown to be an effective treatment for neck pain. However, the generalizability and clinical ... Full text Link to item Cite

The influence of exercise therapy dosing on pain and functional outcomes in patients with subacromial pain syndrome: A systematic review.

Journal Article Shoulder Elbow · March 2024 BACKGROUND: The objective was to identify exercise therapy dosing parameters for subacromial pain syndrome (SAPS) associated with improved pain and function outcomes (via effect sizes) and determine the extent of exercise intervention reproducibility. METH ... Full text Link to item Cite

The Influence of Active, Passive, and Manual Therapy Interventions for Low Back Pain on Opioid Prescription and Health Care Utilization.

Journal Article Phys Ther · March 1, 2024 OBJECTIVE: The aim of this study was to explore associations between the utilization of active, passive, and manual therapy interventions for low back pain (LBP) with 1-year escalation-of-care events, including opioid prescriptions, spinal injections, spec ... Full text Link to item Cite

What are patients' perspectives on the value of physical therapy? A prospective cohort study.

Journal Article Musculoskeletal Care · March 2024 PURPOSE: To assess and identify patients' perceptions about the overall value of physical therapy services for musculoskeletal conditions and how these values were associated with their outcomes. METHODS: The association between the perceived value of phys ... Full text Link to item Cite

Trials and tribulations of transparency related to inconsistencies between plan and conduct in peer-reviewed physiotherapy publications: A methodology review.

Journal Article J Eval Clin Pract · February 2024 RATIONALE: The physiotherapy profession strives to be a leader in providing quality care and strongly recognizes the value of research to guide clinical practice. Adherence to guidelines for research reporting and conduct is a significant step towards high ... Full text Link to item Cite

Evaluation of Transparency and Openness Guidelines in Physical Therapist Journals.

Journal Article Phys Ther · January 1, 2024 OBJECTIVE: The goals of this study were to evaluate the extent that physical therapist journals support open science research practices by adhering to the Transparency and Openness Promotion (TOP) guidelines and to assess the relationship between journal s ... Full text Link to item Cite

Preoperative conservative treatment is insufficiently described in clinical trials of lumbar fusion: a scoping review.

Journal Article Eur Spine J · January 2024 PURPOSE: To identify how pre-surgical conservative care is characterized and reported in randomized controlled trials of adults undergoing elective lumbar fusion, including duration and type of treatment. METHODS: The study design is a scoping review. Data ... Full text Link to item Cite

Associations between smoking history, baseline pain interference and symptom distribution, and physical function at discharge, in individuals seeking care for musculoskeletal pain.

Journal Article Addict Behav · November 2024 OBJECTIVE: Study of the association between smoking and pain intensity has produced conflicting results; with less focus on pain interference. Different pain constructs could have varying associations with smoking behaviors. This study sought to investigat ... Full text Link to item Cite

Cost-effectiveness of Risk Stratified Care vs Usual Care for Low Back Pain in the Military Health System.

Journal Article Spine (Phila Pa 1976) · September 6, 2024 STUDY DESIGN: Cost-effectiveness of two trial interventions for low back pain. OBJECTIVE: To investigate the incremental cost-effectiveness between risk-stratified and usual care for low back pain. SUMMARY OF BACKGROUND DATA: A recent trial compared risk-s ... Full text Link to item Cite

Assessing the transparency in reporting of clinical trials investigating manual therapy interventions for low back pain: A methodological review.

Journal Article J Eval Clin Pract · July 7, 2024 RATIONALE: Low back pain (LBP) is a common condition with a significant societal burden. Manual therapy is an effective treatment for LBP and recommended in clinical practice guidelines. While the quantity of literature supporting the use of manual therapy ... Full text Link to item Cite

General and Pain-Associated Psychological Distress Phenotypes Among Patients With Low Back Pain in the Military Health System.

Journal Article Arthritis Care Res (Hoboken) · July 2024 OBJECTIVE: The primary objective was to describe rates of general and pain-related psychological distress for individuals with low back pain (LBP) in the Military Health System (MHS). We identified common phenotypes defined by rates of general and pain-rel ... Full text Link to item Cite

Self-acknowledged limitations in exercise therapy trials for low back pain.

Journal Article J Eval Clin Pract · June 4, 2024 RATIONALE: Despite the widespread recommendation to engage in therapeutic exercise for the treatment of low back pain (LBP), there is conflicting evidence regarding clinical outcomes and effectiveness. Poor methodological quality may be to blame for reduci ... Full text Link to item Cite

Adverse Events Reported in Trials Assessing Manual Therapy to the Extremities: A Systematic Review.

Journal Article J Integr Complement Med · June 2024 Objective: This review aimed to describe the quality and comprehensiveness of adverse event (AE) reporting in clinical trials incorporating manual therapy (MT) as an intervention for extremity conditions using the Consolidated Standards of Reporting Trials ... Full text Link to item Cite

Seventeen-Year National Pain Prevalence Trends Among U.S. Military Veterans.

Journal Article J Pain · May 2024 U.S. military veterans experience higher pain prevalence than nonveterans. However, it is unclear how the disparities in pain prevalence have changed over time because previous trend studies are limited to veterans using the Veterans Health Administration. ... Full text Link to item Cite

Minimal important clinical difference values are not uniformly valid in the active duty military population recovering from shoulder surgery.

Journal Article J Shoulder Elbow Surg · April 16, 2024 BACKGROUND: There are multiple methods for calculating the minimal clinically important difference (MCID) threshold, and previous reports highlight heterogeneity and limitations of anchor-based and distribution-based analyses. The Warfighter Readiness Surv ... Full text Link to item Cite

Evaluating and Characterizing the Scope of Care for Interventions Labeled as Manual Therapy in Low Back Pain Trials: A Scoping Review.

Journal Article Phys Ther · April 2, 2024 OBJECTIVE: The purpose of this scoping review was to evaluate and characterize the scope of care for low back pain that falls under the specific label of manual therapy. METHODS: PubMed database, Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied ... Full text Link to item Cite

Reproducibility of Exercise Interventions in Randomized Controlled Trials for the Treatment of Rotator Cuff-Related Shoulder Pain: A Systematic Review.

Journal Article Arch Phys Med Rehabil · April 2024 OBJECTIVE: To determine the reproducibility of exercise therapy interventions in randomized controlled trials for rotator cuff-related shoulder pain (RCRSP). DATA SOURCES: Data sources included Medline, Cumulative Index to Nursing and Allied Health Literat ... Full text Link to item Cite

Can a Psychologic Profile Predict Successful Return to Full Duty After a Musculoskeletal Injury?

Journal Article Clin Orthop Relat Res · April 1, 2024 BACKGROUND: Psychologic variables have been shown to have a strong relationship with recovery from injury and return to work or sports. The extent to which psychologic variables predict successful return to work in military settings is unknown. QUESTIONS/P ... Full text Link to item Cite

How Reproducible Are Manual Therapy Interventions in Trials for Low Back Pain? A Scoping Review.

Journal Article J Orthop Sports Phys Ther · April 2024 OBJECTIVES: To assess the reproducibility of manual therapy interventions used in clinical trials for low back pain (LBP), and summarize knowledge gaps in assessing the reproducibility of manual therapy interventions for LBP. DESIGN: Scoping review. LITERA ... Full text Link to item Cite

The majority of clinical trials assessing mobilization and manipulation for neck pain lack a pragmatic approach: a systematic review of 174 trials.

Journal Article J Man Manip Ther · March 25, 2024 BACKGROUND: Disorders of the cervical spine are some of the costliest musculoskeletal conditions to manage globally. Joint mobilization and manipulation have been shown to be an effective treatment for neck pain. However, the generalizability and clinical ... Full text Link to item Cite

The influence of exercise therapy dosing on pain and functional outcomes in patients with subacromial pain syndrome: A systematic review.

Journal Article Shoulder Elbow · March 2024 BACKGROUND: The objective was to identify exercise therapy dosing parameters for subacromial pain syndrome (SAPS) associated with improved pain and function outcomes (via effect sizes) and determine the extent of exercise intervention reproducibility. METH ... Full text Link to item Cite

The Influence of Active, Passive, and Manual Therapy Interventions for Low Back Pain on Opioid Prescription and Health Care Utilization.

Journal Article Phys Ther · March 1, 2024 OBJECTIVE: The aim of this study was to explore associations between the utilization of active, passive, and manual therapy interventions for low back pain (LBP) with 1-year escalation-of-care events, including opioid prescriptions, spinal injections, spec ... Full text Link to item Cite

What are patients' perspectives on the value of physical therapy? A prospective cohort study.

Journal Article Musculoskeletal Care · March 2024 PURPOSE: To assess and identify patients' perceptions about the overall value of physical therapy services for musculoskeletal conditions and how these values were associated with their outcomes. METHODS: The association between the perceived value of phys ... Full text Link to item Cite

Trials and tribulations of transparency related to inconsistencies between plan and conduct in peer-reviewed physiotherapy publications: A methodology review.

Journal Article J Eval Clin Pract · February 2024 RATIONALE: The physiotherapy profession strives to be a leader in providing quality care and strongly recognizes the value of research to guide clinical practice. Adherence to guidelines for research reporting and conduct is a significant step towards high ... Full text Link to item Cite

Evaluation of Transparency and Openness Guidelines in Physical Therapist Journals.

Journal Article Phys Ther · January 1, 2024 OBJECTIVE: The goals of this study were to evaluate the extent that physical therapist journals support open science research practices by adhering to the Transparency and Openness Promotion (TOP) guidelines and to assess the relationship between journal s ... Full text Link to item Cite

Preoperative conservative treatment is insufficiently described in clinical trials of lumbar fusion: a scoping review.

Journal Article Eur Spine J · January 2024 PURPOSE: To identify how pre-surgical conservative care is characterized and reported in randomized controlled trials of adults undergoing elective lumbar fusion, including duration and type of treatment. METHODS: The study design is a scoping review. Data ... Full text Link to item Cite

Trials Investigating Exercise for Low Back Pain Lack Pragmatic Application: A Systematic Review.

Journal Article Archives of physical medicine and rehabilitation · January 2024 ObjectiveTo systematically review the orientation of trials analyzing exercise for low back pain (LBP) on the efficacy-effectiveness spectrum.Data sourcesPubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid ... Full text Cite

Pragmatism in manual therapy trials for knee osteoarthritis: a systematic review.

Journal Article Arch Physiother · 2024 INTRODUCTION: Manual therapy is an often-utilized intervention for the management of knee osteoarthritis (OA). The interpretation of results presented by these trials can be affected by how well the study designs align applicability to real-world clinical ... Full text Link to item Cite

Timing of Outcomes and Expectations After Knee Surgery in the US Military: A Systematic Review.

Journal Article Sports Health · December 26, 2023 CONTEXT: Knee injury and subsequent surgery are widespread in the military setting. Associations between knee surgery and expected outcomes over time have not been consolidated and characterized systematically by procedure type across the body of literatur ... Full text Link to item Cite

Predicting Subsequent Injury after Being Cleared to Return to Work from Initial Lumbar or Lower Extremity Injury.

Journal Article Med Sci Sports Exerc · December 1, 2023 PURPOSE: The purpose of this study is to develop a model to predict re-injury after being cleared to return to full duty from an initial injury. METHODS: This was a prediction model derivation cohort study. Military service members cleared for unrestricted ... Full text Link to item Cite

Measures of sleep are not routinely captured in trials assessing treatment outcomes in knee osteoarthritis - A scoping systematic review and call to action.

Journal Article Osteoarthr Cartil Open · December 2023 OBJECTIVE: To identify and map the extent to which trials for pain interventions in individuals with knee osteoarthritis (OA) track measures of sleep, characterize the type of sleep measure assessed, and assess their influence on pain-related effect sizes. ... Full text Link to item Cite

What factors do physical therapists consider when determining patient prognosis: A mixed methods study.

Journal Article Musculoskeletal Care · December 2023 INTRODUCTION: A prognosis provides valuable information to expected progress and anticipated outcome over the course of care. Although it is known that physical therapists can accurately prognose, it is unknown what factors are utilised in clinical practic ... Full text Link to item Cite

Barriers and facilitators to implementation of musculoskeletal injury mitigation programmes for military service members around the world: a scoping review.

Journal Article Inj Prev · November 27, 2023 INTRODUCTION: Musculoskeletal injury (MSK-I) mitigation and prevention programmes (MSK-IMPPs) have been developed and implemented across militaries worldwide. Although programme efficacy is often reported, development and implementation details are often o ... Full text Link to item Cite

The relationships between pain-associated psychological distress, pain intensity, patient expectations, and physical function in individuals with musculoskeletal pain: A retrospective cohort study.

Journal Article PM R · November 2023 INTRODUCTION: The presence of pain-associated psychological distress (PAPD) in musculoskeletal disorders, including negative mood, fear-avoidance, and lack of positive affect/coping, is associated with prolonged disability. The importance of considering ps ... Full text Link to item Cite

Measures of sleep disturbance are not routinely captured in trials for chronic low back pain: a systematic scoping review of 282 trials.

Journal Article J Clin Sleep Med · November 1, 2023 STUDY OBJECTIVES: To investigate the extent to which sleep measures are reported in intervention trials for chronic low back pain. METHODS: A systematic scoping review was conducted. Ovid MEDLINE, Cochrane CENTRAL, and CINAHL were queried for trials publis ... Full text Link to item Cite

Post-lumbar surgery prescription variation and opioid-related outcomes in a large US healthcare system: an observational study.

Journal Article Spine J · September 2023 BACKGROUND CONTEXT: Spinal decompression and fusion procedures are one of the most common procedures performed in the United States (US) and remain associated with high postsurgical opioid burden. Despite guidelines emphasizing nonopioid pharmacotherapy st ... Full text Link to item Cite

Only 1% of Total Knee Arthroplasty Clinical Trials Report Patient Opioid Use Before or After Surgery: A Systematic Review.

Journal Article Clin J Pain · September 1, 2023 OBJECTIVES: Many clinical trials report significant improvements in osteoarthritis-related pain and function after total knee arthroplasty (TKA). Opioids are commonly prescribed for pain management of knee osteoarthritis and also perioperative pain after s ... Full text Link to item Cite

The Effectiveness of a Mindfulness-Based Intervention Integrated with Physical Therapy (MIND-PT) for Postsurgical Rehabilitation After Lumbar Surgery: A Protocol for a Randomized Controlled Trial as Part of the Back Pain Consortium (BACPAC) Research Program.

Journal Article Pain Med · August 4, 2023 BACKGROUND: Improving pain management for persons with chronic low back pain (LBP) undergoing surgery is an important consideration in improving patient-centered outcomes and reducing the risk of persistent opioid use after surgery. Nonpharmacological trea ... Full text Link to item Cite

The Back Pain Consortium (BACPAC) Research Program: Structure, Research Priorities, and Methods.

Journal Article Pain Med · August 4, 2023 In 2019, the National Health Interview survey found that nearly 59% of adults reported pain some, most, or every day in the past 3 months, with 39% reporting back pain, making back pain the most prevalent source of pain, and a significant issue among adult ... Full text Link to item Cite

What is the incidence of subsequent adjacent joint injury after patellofemoral pain?

Journal Article Clin Rehabil · August 2023 OBJECTIVE: To investigate the incidence of subsequent lumbar spine, hip, and ankle-foot injuries after a diagnosis of patellofemoral pain. DESIGN: Retrospective cohort study. SETTING: Military Health System. PARTICIPANTS: Individuals (n = 92,319) ages 17-6 ... Full text Link to item Cite

Effect of Risk-Stratified Care on Disability Among Adults With Low Back Pain Treated in the Military Health System: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · July 3, 2023 IMPORTANCE: Tailored treatments for low back pain (LBP) based on stratifying risk for poor prognosis have emerged as a promising approach to improve quality of care, but they have not been validated in trials at the level of individual randomization in US ... Full text Link to item Cite

Patient-centeredness and acceptability of remotely delivered physical therapy care for musculoskeletal disorders in four large hospitals within the Military Health System

Journal Article BMC Digital Health · June 22, 2023 AbstractBackgroundPhysical therapy services delivered remotely are becoming more common. The purpose was to summarize the acceptability and patient-center ... Full text Cite

Incomplete reporting of manual therapy interventions and a lack of clinician and setting diversity in clinical trials for neck pain limits replication and real-world translation. A scoping review.

Journal Article J Man Manip Ther · June 2023 INTRODUCTION: Neck pain is a leading cause of disability, and manual therapy (MT) is a common intervention used across disciplines and settings to treat it. While there is consistent support for MT in managing neck pain, questions remain about the feasibil ... Full text Link to item Cite

Does Surgery for Cruciate Ligament and Meniscus Injury Increase the Risk of Comorbidities at 2 Years in the Military System?

Journal Article J Knee Surg · April 2023 This study aims to determine whether surgery for cruciate ligament (anterior or posterior) or meniscus injury increased risks of subsequent comorbidities in beneficiaries of the Military Health System. The study was a retrospective case-control design in w ... Full text Link to item Cite

Intervention Fidelity in Pain Pragmatic Trials for Nonpharmacologic Pain Management: Nuanced Considerations for Determining PRECIS-2 Flexibility in Delivery and Adherence.

Journal Article J Pain · April 2023 Nonpharmacological treatments are considered first-line pain management strategies, but they remain clinically underused. For years, pain-focused pragmatic clinical trials (PCTs) have generated evidence for the enhanced use of nonpharmacological interventi ... Full text Link to item Cite

Reproducibility of resistance exercise therapy interventions in trials for chronic low back pain is challenging: A systematic review.

Journal Article Musculoskeletal Care · March 2023 OBJECTIVE: Determine reproducibility of resistance exercise regimens in trials for CLBP and determine if recently available checklists are effective. METHODS: Four databases (Medline, PubMed, Cochrane and CINAHL) were searched for keywords related to back ... Full text Link to item Cite

Home Exercise Programs Are Infrequently Prescribed in Trials of Supervised Exercise for Individuals With Low Back Pain: A Scoping Review of 292 Randomized Controlled Trials.

Journal Article J Orthop Sports Phys Ther · March 2023 OBJECTIVES: To (1) determine how often home exercise programs (HEPs) are prescribed in supervised exercise trials for low back pain (LBP) and (2) describe characteristics of the HEP programs (design, purpose, dose, and adherence). DESIGN: Scoping review. L ... Full text Link to item Cite

A novel Home Exercise Assessment Tool (HEAT) to assess recall and performance: A reliability study.

Journal Article Physiother Theory Pract · February 2023 BACKGROUND: A reliable and valid tool to measure short-term recall does not exist. OBJECTIVE: The purpose of this study was o assess the reliability of a novel tool designed to evaluate the immediate recall and performance of prescribed exercises. This rel ... Full text Link to item Cite

The Influence of Therapeutic Exercise after Ankle Sprain on the Incidence of Subsequent Knee, Hip, and Lumbar Spine Injury.

Journal Article Med Sci Sports Exerc · February 1, 2023 PURPOSE: This study aimed to investigate the burden of knee, hip, and lumbar spine disorders occurring in the year after an ankle sprain and the influence therapeutic exercise (TE) has on this burden. METHODS: A total of 33,361 individuals diagnosed with a ... Full text Link to item Cite

Understanding barriers to adherence to home exercise programs in patients with musculoskeletal neck pain.

Journal Article Musculoskelet Sci Pract · February 2023 BACKGROUND: Home exercise program (HEP) prescription is commonplace in physical therapy (PT). Adherence to HEPs is generally poor, with non-adherence as high as 70%. Poor adherence may negatively impact outcomes. OBJECTIVES: To (i) qualitatively assess pat ... Full text Link to item Cite

Leveraging the Short-Term Benefits of Manual Therapy which Includes Exercise Over Exercise Therapy Alone Appears Justified for Knee Osteoarthritis.

Journal Article J Orthop Sports Phys Ther · January 2023 Letter to the Editor-in-Chief in response to JOSPT article "The Benefits of Adding Manual Therapy to Exercise Therapy for Improving Pain and Function in Patients with Knee or Hip Osteoarthritis: A Systematic Review with Meta-analysis" by Runge et al. J Ort ... Full text Link to item Cite

The influence of pain-related comorbidities on pain intensity and pain-related psychological distress in patients presenting with musculoskeletal pain.

Journal Article Braz J Phys Ther · 2023 BACKGROUND: Musculoskeletal pain (MSP) is the largest contributor to chronic pain and frequently occurs alongside other medical comorbidities. OBJECTIVE: Explore the relationships between the presence of pain-related comorbidities, pain intensity, and pain ... Full text Link to item Cite

What are the unsupervised exercise adherence rates in clinical trials for knee osteoarthritis? A systematic review.

Journal Article Braz J Phys Ther · 2023 BACKGROUND: Exercise is an effective intervention for knee osteoarthritis (OA), and unsupervised exercise programs should be a common adjunct to most treatments. However, it is unknown if current clinical trials are capturing information regarding adherenc ... Full text Link to item Cite

The influence of manual therapy dosing on outcomes in patients with hip osteoarthritis: a systematic review.

Journal Article J Man Manip Ther · December 2022 OBJECTIVE: To 1) Determine if specific dosing parameters of manual therapy are related to improved pain, disability, and quality of life outcomes in patients with hip osteoarthritis and 2) to provide recommendations for optimal manual therapy dosing based ... Full text Link to item Cite

Exercise therapy reporting in clinical trials for chronic neck pain: A systematic review.

Journal Article Musculoskeletal Care · December 2022 OBJECTIVE: The aim of this systematic review was to assess the reproducibility of exercise therapy used in clinical trials for chronic neck pain (CNP) based on reported items from the Template for Intervention Description and Replication (TIDieR) and the C ... Full text Link to item Cite

The Blind Men, the Elephant, and the Continuing Education Course: Why Higher Standards Are Needed in Physical Therapist Professional Development.

Journal Article J Orthop Sports Phys Ther · October 2022 SYNOPSIS: Evidence-based practice and implementing clinical practice guidelines are familiar themes for musculoskeletal rehabilitation clinicians. Yet, many clinicians continue to eschew recommended treatments. One explanation could be that physical therap ... Full text Link to item Cite

An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach.

Journal Article Musculoskeletal Care · September 2022 INTRODUCTION/OBJECTIVES: Therapeutic alliance (TA) is an integral part of building a patient and clinician relationship. TA begins at the initial encounter; however, the specific TA behavioural practices that are most impactful and linked to pain reduction ... Full text Link to item Cite

Proposing six criteria to improve reproducibility of "usual care" interventions in back pain trials: a systematic review.

Journal Article J Clin Epidemiol · September 2022 OBJECTIVES: The aim of this study is to determine how usual care is defined in clinical trials for low back pain and the components of care that inform its definition. Six components were proposed and assessed for inclusion: type of practitioner providing ... Full text Link to item Cite

How Common is Subsequent Posterior Tibial Tendon Dysfunction or Tarsal Tunnel Syndrome After Ankle Sprain Injury?

Journal Article J Knee Surg · September 2022 Posterior tibial tendon dysfunction (PTTD) and tarsal tunnel syndrome (TTS) are debilitating conditions reported to occur after ankle sprain due to their proximity to the ankle complex. The objective of this study was to investigate the incidence of PTTD a ... Full text Link to item Cite

Pain Catastrophizing Predicts Opioid and Health-Care Utilization After Orthopaedic Surgery: A Secondary Analysis of Trial Participants with Spine and Lower-Extremity Disorders.

Journal Article J Bone Joint Surg Am · August 17, 2022 BACKGROUND: Most individuals undergoing elective surgery expect to discontinue opioid use after surgery, but many do not. Modifiable risk factors including psychosocial factors are associated with poor postsurgical outcomes. We wanted to know whether pain ... Full text Link to item Cite

Epidemiology of Meniscus Injuries in the Military Health System and Predictive Factors for Arthroscopic Surgery.

Journal Article J Knee Surg · August 2022 Meniscus injuries occur at a higher rate in the military than the general population. Appropriate management and rehabilitation of meniscus injuries is important for maintaining readiness. The purpose of this study was to describe the health burden of meni ... Full text Link to item Cite

Prevalence and extent of low back pain and low back-related disability in non-care-seeking working-age adults.

Journal Article Musculoskelet Sci Pract · August 2022 OBJECTIVE: To explore the prevalence and extent of low back pain (LBP) and low back-related disability in working-age adults not seeking care. METHODS: A convenience sample of 101 working-age adults not seeking care for LBP completed the Oswestry Disabilit ... Full text Link to item Cite

Relationship Between Attitudes and Beliefs About Sleep, Sleep Disturbance, and Pain Interference in Patients With Spinal Pain.

Journal Article Clin J Pain · August 1, 2022 OBJECTIVES: Sleep impairments are a strong predictor of pain, making sleep a potential interest when treating patients with spine pain. Typical beliefs about the importance of sleep in patients seeking care for spinal pain are unknown. The purpose of this ... Full text Link to item Cite

Over Half of Clinical Trials of Mobilization and Manipulation for Patients With Low Back Pain May Have Limited Real-World Applicability: A Systematic Review of 132 Clinical Trials.

Journal Article J Orthop Sports Phys Ther · August 2022 OBJECTIVE: To evaluate the existing body of trials assessing manual therapy for low back pain (LBP) to determine where it falls on the efficacyeffectiveness continuum. DESIGN: Methodology systematic review. LITERATURE SEARCH: PubMed, CINAHL (Cumulative Ind ... Full text Link to item Cite

Differences in Outcomes between Patellar Dislocations Managed in Emergent versus Non-Emergent Care Settings.

Journal Article J Knee Surg · August 2022 Patellar dislocations occur at a much higher rate in military than civilian populations. Past population-level studies have shown that surgical management is as good as or superior to conservative care and may reduce future reoccurrences. Although in acute ... Full text Link to item Cite

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

Journal Article J Knee Surg · August 2022 Concomitant cruciate and meniscus injuries of the knee are generally associated with acute trauma and commonly treated with surgical intervention. Comorbidities (simultaneous presence of two or more medical conditions) may be acquired from changes in activ ... Full text Link to item Cite

A Population-Level Summary of Health Care Utilization for the Management of Patellar Tendinopathy in the Military Health System.

Journal Article J Knee Surg · August 2022 Patellar tendinopathy (PT) is a common nontraumatic orthopaedic disorder of the knee suffered by many service members. Understanding the make-up of usual care for PT at the system level can better frame current clinical gaps and areas that need improvement ... Full text Link to item Cite

Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory.

Journal Article Mil Med · July 1, 2022 Pragmatic clinical trials (PCTs) are well-suited to address unmet healthcare needs, such as those arising from the dual public health crises of chronic pain and opioid misuse, recently exacerbated by the COVID-19 pandemic. These overlapping epidemics have ... Full text Link to item Cite

Challenges With Engaging Military Stakeholders for Clinical Research at the Point of Care in the U.S. Military Health System.

Journal Article Mil Med · July 1, 2022 The DoD has a specific mission that creates unique challenges for the conduct of clinical research. These unique challenges include (1) the fact that medical readiness is the number one priority, (2) understanding the role of military culture, and (3) unde ... Full text Link to item Cite

Continuing Education Courses for Orthopedic and Sports Physical Therapists in the United States Often Lack Supporting Evidence: A Review of Available Intervention Courses.

Journal Article Phys Ther · June 3, 2022 OBJECTIVE: The purpose of this study was to characterize the extent to which orthopedic and sports-related continuing education course descriptions approved for physical therapists in the United States taught interventions supported by evidence. METHODS: A ... Full text Link to item Cite

TIDieR-telehealth: precision in reporting of telehealth interventions used in clinical trials - unique considerations for the Template for the Intervention Description and Replication (TIDieR) checklist.

Journal Article BMC Med Res Methodol · June 2, 2022 BACKGROUND: Recent international health events have led to an increased proliferation of remotely delivered health interventions. Even with the pandemic seemingly coming under control, the experiences of the past year have fueled a growth in ideas and tech ... Full text Link to item Cite

What do patients referred to physical therapy for a musculoskeletal condition expect? A qualitative assessment.

Journal Article Musculoskelet Sci Pract · June 2022 BACKGROUND: Patient expectations related to physical therapy outcomes are commonly collected through surveys and close-ended questionnaires. These methods may not optimally capture patients' expectations for physical therapy, especially in the patients' ow ... Full text Link to item Cite

Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial.

Journal Article J Man Manip Ther · April 2022 OBJECTIVE: To determine if thoracic spine manipulation (TSM) improves pain and disability in individuals with cervicogenic headache (CeH). METHODS: A randomized controlled crossover trial was conducted on 48 participants (mean age: 34.4 years) with CeH sym ... Full text Link to item Cite

The relationship between knee radiographs and the timing of physical therapy in individuals with patellofemoral pain.

Journal Article PM R · April 2022 BACKGROUND: Routine knee radiographs are discouraged for individuals with nontraumatic knee pain, but they are often still ordered despite limited evidence of their value in guiding treatment choices. Radiograph utilization may delay the use of physical th ... Full text Link to item Cite

Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems.

Journal Article Learn Health Syst · April 2022 INTRODUCTION: Pragmatic clinical trials (PCTs) can overcome implementation challenges for bringing evidence-based therapies to people living with pain and co-occurring conditions, providing actionable information for patients, providers, health systems, an ... Full text Link to item Cite

Engaging Education About Risks of Opioid Use With Patients Before Elective Surgery of the Lower Extremity Did Not Reduce Postoperative Opioid Utilization: A Randomized Controlled Trial.

Journal Article J Am Acad Orthop Surg · April 1, 2022 INTRODUCTION: After elective orthopaedic surgery, many individuals go on to become long-term opioid users. Mitigating this risk has become a priority for surgeons, other members of the medical care team, and healthcare systems. The purpose of this study wa ... Full text Link to item Cite

Improving Clinical Prediction Model Methods.

Journal Article Med Sci Sports Exerc · April 1, 2022 Full text Link to item Cite

The Military Orthopedics Tracking Injuries and Outcomes Network: A Solution for Improving Musculoskeletal Care in the Military Health System.

Journal Article Mil Med · March 28, 2022 INTRODUCTION: Musculoskeletal injuries are an endemic amongst U.S. Military Service Members and significantly strain the Department of Defense's Military Health System. The Military Health System aims to provide Service Members, military retirees, and thei ... Full text Link to item Cite

Cost-effectiveness of Physical Therapy vs Intra-articular Glucocorticoid Injection for Knee Osteoarthritis: A Secondary Analysis From a Randomized Clinical Trial.

Journal Article JAMA Netw Open · January 4, 2022 IMPORTANCE: Physical therapy and glucocorticoid injections are initial treatment options for knee osteoarthritis, but available data indicate that most patients receive one or the other, suggesting they may be competing interventions. The initial cost diff ... Full text Link to item Cite

Much work remains to reach consensus on musculoskeletal injury risk in military service members: A systematic review with meta-analysis.

Journal Article Eur J Sport Sci · January 2022 Musculoskeletal injuries are the most common reason military service members cannot perform their military duties. Not only are they costly and associated with long-term disability, often long after completion of military service, but injuries also adverse ... Full text Link to item Cite

Does Engaging Patients with Relevant Education About Long-Term Opioid Use Before Spine Surgery Affect Long-term Opioid Use? A Randomized Controlled Trial.

Journal Article Spine (Phila Pa 1976) · January 1, 2022 STUDY DESIGN: Parallel-arm randomized controlled trial. OBJECTIVE: To assess the effectiveness of an enhanced video education session highlighting risks of opioid utilization on longterm opioid utilization after spine surgery. SUMMARY OF BACKGROUND DATA: L ... Full text Link to item Cite

Nonoperative Care Including Rehabilitation Should Be Considered and Clearly Defined Prior to Elective Orthopaedic Surgery to Maximize Optimal Outcomes.

Journal Article Arthrosc Sports Med Rehabil · January 2022 UNLABELLED: Orthopaedic surgery has revolutionized the expectations for restoration of physical function after musculoskeletal injury and, along with physical therapy, has transformed the limits of recovery. Many orthopaedic procedures have a high success ... Full text Link to item Cite

Recovery, Rehabilitation, and Return to Full Duty in a Military Population After a Recent Injury: Differences Between Lower-Extremity and Spine Injuries.

Journal Article Arthrosc Sports Med Rehabil · January 2022 PURPOSE: To compare readiness to return to duty in soldiers following recent lower-extremity versus spine injury. The secondary purposes were to provide normative data for the Selective Functional Movement Assessment Top Tier movements (SFMA-TTM) and asses ... Full text Link to item Cite

Use of Non-Specific Knee Diagnoses and Incidence of Obscure Knee Injuries in a Large Government Health System.

Journal Article Clin Epidemiol · 2022 PURPOSE: Within a large government health system, to assess the practice of using non-specific diagnoses for knee disorders and determine how often they appear as the only diagnosis without more specificity. The secondary purpose was to identify the incide ... Full text Link to item Cite

Predictive models for musculoskeletal injury risk: why statistical approach makes all the difference.

Journal Article BMJ Open Sport Exerc Med · 2022 OBJECTIVE: Compare performance between an injury prediction model categorising predictors and one that did not and compare a selection of predictors based on univariate significance versus assessing non-linear relationships. METHODS: Validation and replica ... Full text Link to item Cite

More Than 1 in 3 Patients With Chronic Low Back Pain Continue to Use Opioids Long-term After Spinal Fusion: A Systematic Review.

Journal Article Clin J Pain · December 1, 2021 OBJECTIVE: A common expectation for patients after elective spine surgery is that the procedure will result in pain reduction and minimize the need for pain medication. Most studies report changes in pain and function after spine surgery, but few report th ... Full text Link to item Cite

Delayed Rehabilitation Is Associated With Recurrence and Higher Medical Care Use After Ankle Sprain Injuries in the United States Military Health System.

Journal Article J Orthop Sports Phys Ther · December 2021 OBJECTIVE: To investigate the influence of time taken to begin musculoskeletal rehabilitation on injury recurrence and ankle-related medical care use at 1 year after ankle sprain. DESIGN: Retrospective cohort study of all beneficiaries of the US Military H ... Full text Link to item Cite

A High-Sensitivity International Knee Documentation Committee Survey Index From the PROMIS System: The Next-Generation Patient-Reported Outcome for a Knee Injury Population.

Journal Article Am J Sports Med · November 2021 BACKGROUND: Patient-reported outcomes (PROs) measure progression and quality of care. While legacy PROs such as the International Knee Documentation Committee (IKDC) survey are well-validated, a lengthy PRO creates a time burden on patients, decreasing adh ... Full text Link to item Cite

Are We Able to Determine Differences in Outcomes Between Male and Female Servicemembers Undergoing Hip Arthroscopy? A Systematic Review.

Journal Article Orthop J Sports Med · November 2021 BACKGROUND: Female servicemembers sustain higher rates of lower extremity injuries as compared with their male counterparts. This can include intra-articular pathology in the hip. Female patients are considered to have worse outcomes after hip arthroscopy ... Full text Link to item Cite

The influence of a MOBile-based video Instruction for Low back pain (MOBIL) on initial care decisions made by primary care providers: a randomized controlled trial.

Journal Article BMC Fam Pract · October 9, 2021 BACKGROUND: Adherence to guidelines for back pain continues to be a challenge, prompting strategies focused on improving education around biopsychosocial frameworks. OBJECTIVE: Assess the influence of an interactive educational mobile app for patients on i ... Full text Link to item Cite

Manual Therapy: Always a Passive Treatment?

Journal Article J Orthop Sports Phys Ther · October 2021 The use of manual therapy as an intervention has garnered intense debate, one that is often mired in a straw-man argument that manual therapy is a purely passive intervention. When passive interventions are equated with low-value care, it is easy to deride ... Full text Link to item Cite

How sleep can help maximize human potential: The role of leaders.

Journal Article J Sci Med Sport · October 2021 OBJECTIVE: During multi-domain operations (MDO), soldiers need the physical supremacy, cognitive dominance, and emotional resilience to help defend and win our nation's wars. Optimal sleep has been shown to boost physical performance and cognitive processi ... Full text Link to item Cite

Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial.

Journal Article J Transl Med · August 18, 2021 BACKGROUND: The prevalence of chronic pain conditions is growing. Low back pain was the primary cause of disability worldwide out of 156 conditions assessed between 1990 and 2016, according to the Global Burden of Disease Study. Conventional medical approa ... Full text Link to item Cite

Timing of physical therapy for individuals with patellofemoral pain and the influence on healthcare use, costs and recurrence rates: an observational study.

Journal Article BMC Health Serv Res · July 29, 2021 BACKGROUND: Early physical therapy has been shown to decrease downstream healthcare use, costs and recurrence rates in some musculoskeletal conditions, but it has not been investigated in individuals with patellofemoral pain. The purpose was to evaluate ho ... Full text Link to item Cite

Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes.

Journal Article J Sci Med Sport · July 2021 OBJECTIVES: To assess the risk of lateral ankle sprain (LAS) in male and female tactical athletes across different military occupations in the US military. DESIGN: Retrospective cohort. METHODS: The Defense Medical Epidemiology Database was queried for the ... Full text Link to item Cite

Usual Medical Care for Patellofemoral Pain Does Not Usually Involve Much Care: 2-Year Follow-up in the Military Health System.

Journal Article J Orthop Sports Phys Ther · June 2021 OBJECTIVES: To identify the most common type and timing of interventions used to initially manage patellofemoral pain (PFP), and whether exercise therapy as an initial treatment was associated with a decreased likelihood of recurrence of PFP. DESIGN: Retro ... Full text Link to item Cite

The influence of prior opioid use on healthcare utilization and recurrence rates for non-surgical patients seeking initial care for patellofemoral pain.

Journal Article Clin Rheumatol · March 2021 INTRODUCTION/OBJECTIVES: Prior opioid use can influence outcomes for patients with musculoskeletal disorders. The purpose of this study was to compare downstream medical utilization-based outcomes (costs, visits, recurrent episodes) after an initial diagno ... Full text Link to item Cite

Adherence to Stepped Care for Management of Musculoskeletal Knee Pain Leads to Lower Health Care Utilization, Costs, and Recurrence.

Journal Article Am J Med · March 2021 OBJECTIVES: This study aimed to report compliance with stepped care management of patellofemoral pain and determine whether adherence to stepped care results in decreased recurrence and lower health care utilization. METHODS: A total of 60,730 participants ... Full text Link to item Cite

Generating the American Shoulder and Elbow Surgeons Score Using Multivariable Predictive Models and Computer Adaptive Testing to Reduce Survey Burden.

Journal Article Am J Sports Med · March 2021 BACKGROUND: The preferred patient-reported outcome measure for the assessment of shoulder conditions continues to evolve. Previous studies correlating the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) to t ... Full text Link to item Cite

Sex and Mental Health Disorder Differences Among Military Service Members With Patellofemoral Syndrome.

Journal Article J Am Board Fam Med · 2021 BACKGROUND: Mental health disorders are associated with persistent knee pain, but the association between these conditions has had little investigation in the military. The purpose of this study was to identify rates of mental health disorders in patients ... Full text Link to item Cite

Fractures and Chronic Recurrence are Commonly Associated with Ankle Sprains: a 5-year Population-level Cohort of Patients Seen in the U.S. Military Health System.

Journal Article Int J Sports Phys Ther · 2021 BACKGROUND: Whereas ankle-foot injuries are ubiquitous and affect ~16% of military service-members, granularity of information pertaining to ankle sprain subgroups and associated variables is lacking. The purpose of this study was to characterize and conte ... Full text Link to item Cite

A Sequential Multiple-Assignment Randomized Trial (SMART) for Stepped Care Management of Low Back Pain in the Military Health System: A Trial Protocol.

Journal Article Pain Med · December 12, 2020 BACKGROUND: The Defense Health Agency has prioritized system-level pain management initiatives within the Military Health System (MHS), with low back pain as one of the key focus areas. A stepped care model focused on nonpharmacologic treatment to promote ... Full text Link to item Cite

Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes.

Journal Article Pain Med · December 12, 2020 BACKGROUND: The NIH-DOD-VA Pain Management Collaboratory (PMC) supports 11 pragmatic clinical trials (PCTs) on nonpharmacological approaches to management of pain and co-occurring conditions in U.S. military and veteran health organizations. The Stakeholde ... Full text Link to item Cite

Comparison of Physical Therapy and Physician Pathways for Employees with Recent Onset Musculoskeletal Pain: A Randomized Controlled Trial.

Journal Article PM R · November 2020 BACKGROUND: Life expectancy of the U.S. population will continue to rise, increasing the workforce demands in the treatment of musculoskeletal pathologies. With a declining primary care physician workforce, physical therapists (PT) may be in a unique situa ... Full text Link to item Cite

Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better.

Journal Article J Orthop Sports Phys Ther · November 2020 OBJECTIVES: To determine the relationship between health care use and the magnitude of change in patient-reported outcomes in individuals who received treatment for subacromial pain syndrome. The secondary objective was to determine the value of care, as m ... Full text Link to item Cite

Musculoskeletal Injuries and United States Army Readiness. Part II: Management Challenges and Risk Mitigation Initiatives.

Journal Article Mil Med · September 18, 2020 INTRODUCTION: Noncombat injuries ("injuries") threaten soldier health and United States (U.S.) Army medical readiness, accounting for more than twice as many outpatient medical encounters among active component (AC) soldiers as behavioral health conditions ... Full text Link to item Cite

Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact.

Journal Article Mil Med · September 18, 2020 INTRODUCTION: Noncombat injuries ("injuries") greatly impact soldier health and United States (U.S.) Army readiness; they are the leading cause of outpatient medical encounters (more than two million annually) among active component (AC) soldiers. Noncomba ... Full text Link to item Cite

Sex and Occupation Are Salient Risk Factors for Lateral Ankle Sprain Among Military Tactical Athletes

Journal Article · August 23, 2020 ABSTRACTIntroductionLateral ankle sprains (LAS) are ubiquitous among tactical athletes and a substantial burden in the military. With the changes in operational demand and the beginning of ... Full text Cite

Are Exercise and Physical Therapy Common Forms of Conservative Management in the Year Before Lumbar Spine Surgery?

Journal Article Archives of physical medicine and rehabilitation · August 2020 ObjectiveTo quantify and compare utilization of opioids, exercise therapy, and physical therapy in the year before spine surgery.DesignA retrospective cohort of surgical and claims data.SettingBeneficiaries of the Military Health ... Full text Cite

The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review.

Journal Article Am J Sports Med · June 2020 BACKGROUND: The effectiveness of blood flow restriction training (BFRT) as compared with other forms of training, such as resistance training, has been evaluated in the literature in clinical and nonclinical populations. However, the safety of this interve ... Full text Link to item Cite

Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.

Journal Article N Engl J Med · April 9, 2020 BACKGROUND: Both physical therapy and intraarticular injections of glucocorticoids have been shown to confer clinical benefit with respect to osteoarthritis of the knee. Whether the short-term and long-term effectiveness for relieving pain and improving ph ... Full text Link to item Cite

Utility of catastrophizing, body symptom diagram score and history of opioid use to predict future health care utilization after a primary care visit for musculoskeletal pain.

Journal Article Fam Pract · February 19, 2020 BACKGROUND: Self-report information about pain and pain beliefs are often collected during initial consultation for musculoskeletal pain. These data may provide utility beyond the initial encounter, helping provide further insight into prognosis and long-t ... Full text Link to item Cite

Predicting Opioid Use, Increased Health Care Utilization and High Costs for Musculoskeletal Pain: What Factors Mediate Pain Intensity and Disability?

Journal Article J Pain · 2020 This study determined the predictive capabilities of pain intensity and disability on health care utilization (number of condition-specific health care visits, incident, and chronic opioid use) and costs (total condition-specific and overall medical costs) ... Full text Link to item Cite

Identification of Risk Factors Prospectively Associated With Musculoskeletal Injury in a Warrior Athlete Population.

Journal Article Sports Health · 2020 BACKGROUND: Musculoskeletal injuries are a primary source of disability. Understanding how risk factors predict injury is necessary to individualize and enhance injury reduction programs. HYPOTHESIS: Because of the multifactorial nature of musculoskeletal ... Full text Link to item Cite

The Risk of Prior Opioid Exposure on Future Opioid Use and Comorbidities in Individuals With Non-Acute Musculoskeletal Knee Pain.

Journal Article J Prim Care Community Health · 2020 OBJECTIVES: Due to their potentially deleterious effects, minimizing the use of opioids for musculoskeletal pain is a priority for healthcare systems. The objective of this study was to examine the risk of future opioid prescription use based on prior opio ... Full text Link to item Cite

Patients' perceptions with musculoskeletal disorders regarding their experience with healthcare providers and health services: an overview of reviews.

Journal Article Arch Physiother · 2020 OBJECTIVES: This overview of reviews aimed to identify (1) aspects of the patient experience when seeking care for musculoskeletal disorders from healthcare providers and the healthcare system, and (2) which mechanisms are used to measure aspects of the pa ... Full text Link to item Cite

Arthroscopy for Management of Femoroacetabular Impingement Syndrome in the Military Health System: A 10-Year Epidemiological Overview of Cases with 2-year Follow-up.

Journal Article Mil Med · December 1, 2019 INTRODUCTION: With the rapid rise in arthroscopy rates for the management of Femoroacetabular Impingement (FAI) Syndrome, it is important to understand current surgical rates and the impact of these surgeries within the Military Health System (MHS). The pu ... Full text Link to item Cite

NIH-DoD-VA Pain Management Collaboratory.

Journal Article Pain Med · December 1, 2019 Full text Link to item Cite

Does Disordered Sleep Moderate the Relationship Between Pain, Disability and Downstream Health Care Utilization in Patients With Low Back Pain?: A Longitudinal Cohort From the US Military Health System.

Journal Article Spine (Phila Pa 1976) · November 1, 2019 STUDY DESIGN: Prospective cohort. OBJECTIVE: The purpose of this study was to evaluate the influence of disordered sleep on the relationship between pain and health care utilization (HCU) and pain-related disability and HCU in individuals with low back pai ... Full text Link to item Cite

Which patients do not seek additional medical care after a self-management class for low back pain? An observational cohort.

Journal Article Clin Rehabil · November 2019 OBJECTIVES: (1) To identify baseline variables associated with patients that sought no additional care during the 12 months following a single self-management education session for low back pain (LBP), and (2) in those who sought care, to determine whether ... Full text Link to item Cite

Nonoperative Management Prior to Hip Arthroscopy for Femoroacetabular Impingement Syndrome: An Investigation Into the Utilization and Content of Physical Therapy.

Journal Article J Orthop Sports Phys Ther · August 2019 BACKGROUND: There has been a significant increase in surgeries for femoroacetabular impingement syndrome in recent years, but little is known about the use of physical therapy prior to surgery. OBJECTIVES: To investigate the use of physical therapy prior t ... Full text Link to item Cite

Comorbid Insomnia and Sleep Apnea are Associated with Greater Downstream Health Care Utilization and Chronic Opioid Use after Arthroscopic Hip Surgery

Journal Article Pain Physician · July 11, 2019 Background: There is a relationship between sleep, pain, and chronic opioid utilization. This has been poorly explored in general, and especially in patients undergoing orthopaedic surgery. Fewer studies have investigated this relationship based on ... Full text Cite

Comorbid Insomnia and Sleep Apnea are Associated with Greater Downstream Health Care Utilization and Chronic Opioid Use after Arthroscopic Hip Surgery.

Journal Article Pain Physician · July 2019 BACKGROUND: There is a relationship between sleep, pain, and chronic opioid utilization. This has been poorly explored in general, and especially in patients undergoing orthopaedic surgery. Fewer studies have investigated this relationship based on a sleep ... Link to item Cite

The two-year incidence of hip osteoarthritis after arthroscopic hip surgery for femoroacetabular impingement syndrome.

Journal Article BMC Musculoskelet Disord · June 1, 2019 BACKGROUND: One of the reported goals of hip preservation surgery is to prevent or delay the onset of osteoarthritis. This includes arthroscopic surgery to manage Femoroacetabular Impingement (FAI) Syndrome. The purpose of this study was to describe the pr ... Full text Link to item Cite

Comorbidities in the first 2 years after arthroscopic hip surgery: substantial increases in mental health disorders, chronic pain, substance abuse and cardiometabolic conditions.

Journal Article Br J Sports Med · May 2019 OBJECTIVES: We aimed to identify the rate of seven comorbidities (mental health disorders, chronic pain, substance abuse disorders, cardiovascular disorders, metabolic syndrome, systemic arthropathy and sleep disorders) that occurred within 2 years after h ... Full text Link to item Cite

The Influence of a Guideline-Concordant Stepped Care Approach on Downstream Health Care Utilization in Patients with Spine and Shoulder Pain.

Journal Article Pain Med · March 1, 2019 BACKGROUND: Stepped care approaches are emphasized in guidelines for musculoskeletal pain, recommending less invasive or risky evidence-based intervention, such as manual therapy (MT), before more aggressive interventions such as opioid prescriptions. The ... Full text Link to item Cite

Risk of post-traumatic knee osteoarthritis after knee injury in military service members.

Journal Article Musculoskeletal Care · March 2019 PURPOSE: The aims of the present study were: (a) to identify the incidence of osteoarthritis (OA) after a traumatic knee injury; (b) identify the risk of post-traumatic osteoarthritis (PTOA) based on the type of injury; and (c) identify the time from injur ... Full text Open Access Link to item Cite

Perceptions and Response to Conservative Treatment of Low Back Pain in Soldiers During Initial Entry Training: A Convergence Mixed Methods Study.

Journal Article Mil Med · March 1, 2019 Low back pain (LBP) is a common condition suffered by military personnel. Psychosocial factors play a role in LBP prognosis and can be addressed with self-management tools. This study's purpose was to (1) describe clinical changes in psychosocial factors o ... Full text Link to item Cite

Differences in Characteristics and Downstream Drug Use Among Opioid-Naïve and Prior Opioid Users with Low Back Pain.

Journal Article Pain Pract · February 2019 BACKGROUND: Recent clinical practice guidelines have suggested conservative treatment approaches, including physical therapy, are indicated as first-line treatment for patients with low back pain (LBP); however, LBP continues to be managed with opioids, de ... Full text Link to item Cite

Dry needling in addition to standard physical therapy treatment for sub-acromial pain syndrome: a randomized controlled trial protocol.

Journal Article Braz J Phys Ther · 2019 BACKGROUND: Trigger point dry needling interventions are utilized by physical therapists to manage shoulder pain. Observational studies have shown positive short-term outcomes in patients with subacromial pain syndrome receiving trigger point dry needling. ... Full text Link to item Cite

Predictors of the effects of treatment for shoulder pain: protocol of an individual participant data meta-analysis.

Journal Article Diagn Progn Res · 2019 BACKGROUND: Shoulder pain is one of the most common presentations of musculoskeletal pain with a 1-month population prevalence of between 7 and 26%. The overall prognosis of shoulder pain is highly variable with 40% of patients reporting persistent pain 1  ... Full text Link to item Cite

CONSERVATIVE TREATMENT CONTINUUM FOR MANAGING FEMOROACETABULAR IMPINGEMENT SYNDROME AND ACETABULAR LABRAL TEARS IN SURGICAL CANDIDATES: A CASE SERIES.

Journal Article Int J Sports Phys Ther · December 2018 BACKGROUND/PURPOSE: Femoroacetabular impingement Syndrome (FAIS) and the often-associated acetabular labral tears (ALTs) are challenging to treat and consensus to guide effective management is lacking. Recent guidelines suggest physical therapy is benefici ... Link to item Cite

Does Health Care Utilization Before Hip Arthroscopy Predict Health Care Utilization After Surgery in the US Military Health System? An Investigation Into Health-Seeking Behavior.

Journal Article J Orthop Sports Phys Ther · November 2018 BACKGROUND: The influence of prior patterns of health care utilization on future health care utilization has had minimal investigation in populations with musculoskeletal disorders. OBJECTIVES: The purpose of this study was to explore the relationship betw ... Full text Link to item Cite

Incidence of Musculoskeletal Injury in US Army Unit Types: A Prospective Cohort Study.

Journal Article J Orthop Sports Phys Ther · October 2018 BACKGROUND: Musculoskeletal injuries during military service are a primary source of disability, resulting in 2.4 million annual health care visits and 25 million limited-duty days. While the injury incidence during basic training is well documented, there ... Full text Link to item Cite

Effectiveness and Downstream Healthcare Utilization for Patients That Received Early Physical Therapy Versus Usual Care for Low Back Pain: A Randomized Clinical Trial.

Journal Article Spine (Phila Pa 1976) · October 1, 2018 STUDY DESIGN: Randomized controlled trial. OBJECTIVE: The aim of this study was to compare early physical therapy versus usual care in patients with low back pain. SUMMARY OF BACKGROUND DATA: Early physical therapy (PT) has been associated with reduced dow ... Full text Link to item Cite

Most Military Service Members Return to Activity Duty With Limitations After Surgery for Femoroacetabular Impingement Syndrome: A Systematic Review.

Journal Article Arthroscopy · September 2018 PURPOSE: Determine which proportion of active-duty service members return to duty (RTD), RTD without limitations, which surgical intervention returns these personnel at a better proportion and with the ability to perform their military duties after surgery ... Full text Link to item Cite

Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up.

Journal Article Am J Sports Med · May 2018 BACKGROUND: Arthroscopic hip surgery has risen 18-fold in the past decade; however, there is a dearth of clinical trials comparing surgery with nonoperative management. PURPOSE: To determine the comparative effectiveness of surgery and physical therapy for ... Full text Link to item Cite

Comparison of Downstream Health Care Utilization, Costs, and Long-Term Opioid Use: Physical Therapist Management Versus Opioid Therapy Management After Arthroscopic Hip Surgery.

Journal Article Phys Ther · May 1, 2018 BACKGROUND: Physical therapy and opioid prescriptions are common after hip surgery, but are sometimes delayed or not used. OBJECTIVE: The objective of this study was to compare downstream health care utilization and opioid use following hip surgery for dif ... Full text Link to item Cite

The Influence of Exercise Dosing on Outcomes in Patients With Knee Disorders: A Systematic Review.

Journal Article J Orthop Sports Phys Ther · March 2018 Study Design Systematic review. Background Therapeutic exercise is commonly used to treat individuals with knee disorders, but dosing parameters for optimal outcomes are unclear. Large variations exist in exercise prescription, and research related to spec ... Full text Link to item Cite

Developing predictive models for return to work using the Military Power, Performance and Prevention (MP3) musculoskeletal injury risk algorithm: a study protocol for an injury risk assessment programme.

Journal Article Inj Prev · February 2018 BACKGROUND: Musculoskeletal injuries are a primary source of disability in the US Military, and low back pain and lower extremity injuries account for over 44% of limited work days annually. History of prior musculoskeletal injury increases the risk for fu ... Full text Link to item Cite

Leveraging healthcare utilization to explore outcomes from musculoskeletal disorders: methodology for defining relevant variables from a health services data repository.

Journal Article BMC Med Inform Decis Mak · January 31, 2018 BACKGROUND: Large healthcare databases, with their ability to collect many variables from daily medical practice, greatly enable health services research. These longitudinal databases provide large cohorts and longitudinal time frames, allowing for highly ... Full text Link to item Cite

The influence of dosing on effect size of exercise therapy for musculoskeletal foot and ankle disorders: a systematic review.

Journal Article Braz J Phys Ther · 2018 OBJECTIVE: The purpose of this review was to identify doses of exercise therapy associated with greater treatment effect sizes in individuals with common musculoskeletal disorders of the foot and ankle, namely, achilles tendinopathy, ankle sprains and plan ... Full text Link to item Cite

Physical therapists familiarity and beliefs about health services utilization and health seeking behaviour.

Journal Article Braz J Phys Ther · 2018 BACKGROUND: Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. OBJECTIVES: The purposes of this study were to identify physical therapists' characteri ... Full text Open Access Link to item Cite

Utilization of Manipulative Treatment for Spine and Shoulder Conditions Between Different Medical Providers in a Large Military Hospital.

Journal Article Arch Phys Med Rehabil · January 2018 OBJECTIVE: To describe the use of manipulative treatment for shoulder and spine conditions among various provider types. DESIGN: Retrospective observational cohort. SETTING: Single military hospital. PARTICIPANTS: Consecutive sample of patients (N=7566) se ... Full text Link to item Cite

Health seeking behavior as a predictor of healthcare utilization in a population of patients with spinal pain.

Journal Article PLoS One · 2018 BACKGROUND: The global burden of low back pain is growing rapidly, accompanied by increasing rates of associated healthcare utilization. Health seeking behavior (HSB) has been suggested as a mediator of healthcare utilization. The aims of this study were t ... Full text Link to item Cite

Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule.

Journal Article Perioper Med (Lond) · 2018 BACKGROUND: Prescription opioid use at high doses or over extended periods of time is associated with adverse outcomes, including dependency and abuse. The aim of this study was to identify mediating variables that predict chronic opioid use, defined as th ... Full text Link to item Cite

Translational manipulation under anesthesia for patients with frozen shoulder: a case series study with five-year health care utilization and post-manipulative arthroscopic findings.

Journal Article J Man Manip Ther · December 2017 STUDY DESIGN: Case series study. OBJECTIVES: Although there have been no reported complications from translational manipulation under anesthesia (tMUA) for individuals with adhesive capsulitis (AC) there are no cases reporting surgical findings post tMUA. ... Full text Link to item Cite

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

Journal Article Mil Med · July 2017 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. Although U.S. Military Health Systems perform periodic ge ... Full text Link to item Cite

Post-operative opioid pain management patterns for patients who receive hip surgery.

Journal Article Subst Abuse Treat Prev Policy · March 16, 2017 BACKGROUND: Identifying optimal, post-operative opioid management strategies is a priority of health providers and government agencies. At present, there are no studies we are aware of that have formally investigated opioid prescribing patterns for post-op ... Full text Open Access Link to item Cite

Soldier Readiness Processing: Time for a New Paradigm in Managing Musculoskeletal Injuries After Deployment?

Journal Article Mil Med · March 2017 BACKGROUND: The drowning impact that musculoskeletal injuries (MSI) have on Soldier readiness, deployability, and escalating health care costs is growing. These injuries are associated with approximately 25 million lost duty days each year. The need to cur ... Full text Link to item Cite

Unique Contributions of Body Diagram Scores and Psychosocial Factors to Pain Intensity and Disability in Patients With Musculoskeletal Pain.

Journal Article J Orthop Sports Phys Ther · February 2017 Study Design Retrospective cross-sectional cohort of military patients with musculoskeletal pain. Background Body diagrams are used to document symptoms and can also serve as a proxy to assess psychological influence. However, literature to support this is ... Full text Link to item Cite

The influence of smoking on recovery from subacromial pain syndrome: a cohort from the Military Health System.

Journal Article US Army Med Dep J · 2017 BACKGROUND: Smoking rates are higher in the military population than in the civilian sector. Smoking is associated with poor prognosis for many musculoskeletal injuries. The purpose of this study was to investigate the effects of smoking on recovery from a ... Link to item Cite

Association of Physical Inactivity, Weight, Smoking, and Prior Injury on Physical Performance in a Military Setting.

Journal Article J Athl Train · November 2016 CONTEXT:  Although inactivity, being overweight, smoking, and a history of injury are identified as risk factors for poor health and injury, few authors have examined their association on physical performance. Young adults may be more likely to adopt healt ... Full text Link to item Cite

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

Journal Article Am J Prev Med · November 2016 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 ... Full text Link to item Cite

Application of Athletic Movement Tests that Predict Injury Risk in a Military Population: Development of Normative Data.

Journal Article Mil Med · October 2016 UNLABELLED: Performance on movement tests helps to predict injury risk in a variety of physically active populations. Understanding baseline measures for normal is an important first step. OBJECTIVES: Determine differences in physical performance assessmen ... Full text Link to item Cite

Correction.

Journal Article BMJ Open · May 4, 2016 Full text Link to item Cite

Low Back Pain Incidence and Rate of Chronicity in U.S. Army Soldiers

Conference Medicine & Science in Sports & Exercise · May 2016 Full text Cite

A multicenter randomised, 1-year comparative effectiveness, parallel-group trial protocol of a physical therapy approach compared to corticosteroid injection on pain and function related to knee osteoarthritis (PTA Trial).

Journal Article BMJ Open · March 31, 2016 INTRODUCTION: Corticosteroid injections (CSIs) are commonly used as an initial or a primary intervention for knee osteoarthritis (OA). Consistent evidence indicates CSIs offer symptom relief with conflicting reports regarding long-term efficacy. Physical t ... Full text Link to item Cite

Two-year outcomes after arthroscopic surgery compared to physical therapy for femoracetabular impingement: A protocol for a randomized clinical trial.

Journal Article BMC Musculoskelet Disord · February 4, 2016 BACKGROUND: As the prevalence of hip pathology in the younger athletic population rises, the medical community continues to investigate effective intervention options. Femoracetabular impingement is the morphologically abnormal articulation of the femoral ... Full text Link to item Cite

COMParative Early Treatment Effectiveness between physical therapy and usual care for low back pain (COMPETE): study protocol for a randomized controlled trial.

Journal Article Trials · September 23, 2015 BACKGROUND: Low back pain is among the leading causes of medical visits and lost duty days among members of the United States Armed Forces and represents the highest 5-year risk of permanent disability in the US Army. For certain elements of care, the timi ... Full text Link to item Cite

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study.

Journal Article Clin Orthop Relat Res · September 2015 BACKGROUND: Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskel ... Full text Link to item Cite

One-year outcome of subacromial corticosteroid injection compared with manual physical therapy for the management of the unilateral shoulder impingement syndrome: a pragmatic randomized trial.

Journal Article Ann Intern Med · August 5, 2014 BACKGROUND: Corticosteroid injections (CSIs) and physical therapy are used to treat patients with the shoulder impingement syndrome (SIS) but have never been directly compared. OBJECTIVE: To compare the effectiveness of 2 common nonsurgical treatments for ... Full text Link to item Cite

Manual physical therapy and perturbation exercises in knee osteoarthritis.

Journal Article J Man Manip Ther · November 2013 OBJECTIVES: Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-toler ... Full text Link to item Cite

Clinical reasoning and advanced practice privileges enable physical therapist point-of-care decisions in the military health care system: 3 clinical cases.

Journal Article Phys Ther · September 2013 BACKGROUND AND PURPOSE: Physical therapists frequently make important point-of-care decisions for musculoskeletal injuries and conditions. In the Military Health System (MHS), these decisions may occur while therapists are deployed in support of combat tro ... Full text Link to item Cite

Differential diagnosis and management of ankylosing spondylitis masked as adhesive capsulitis: a resident's case problem.

Journal Article J Orthop Sports Phys Ther · October 2012 STUDY DESIGN: Resident's case problem. BACKGROUND: Ankylosing spondylitis is a potentially debilitating seronegative spondyloarthropathy, with inflammatory low back pain as the most commonly reported symptom. In the absence of low back pain, identification ... Full text Link to item Cite

A manual physical therapy approach versus subacromial corticosteroid injection for treatment of shoulder impingement syndrome: a protocol for a randomised clinical trial.

Journal Article BMJ Open · January 1, 2011 INTRODUCTION: Corticosteroid injections (CSI) are a recommended and often-used first-line intervention for shoulder impingement syndrome (SIS) in primary care and orthopaedic settings. Manual physical therapy (MPT) offers a non-invasive approach with negli ... Full text Link to item Cite

A physical therapist experience, observation, and practice with an infantry brigade combat team in support of Operation Iraqi Freedom.

Journal Article Mil Med · June 2010 BACKGROUND: In 2005 the first physical therapists were employed in direct support of infantry brigade combat teams (BCTs) during a combat deployment. The initiative sought to bring soldiers direct access to specialized musculoskeletal care at the places th ... Full text Link to item Cite

Clinician perception of the impact of deployed physical therapists as physician extenders in a combat environment.

Journal Article Mil Med · May 2010 UNLABELLED: Physical therapists (PTs) serve as physician extenders performing direct access evaluations for musculoskeletal conditions. The previous war-time mission of PTs was limited to level III medical care. Recently PTs began providing care at levels ... Full text Link to item Cite

Lumbar spinal stenosis.

Journal Article N Engl J Med · June 12, 2008 Link to item Cite

Clinical hip tests and a functional squat test in patients with knee osteoarthritis: reliability, prevalence of positive test findings, and short-term response to hip mobilization.

Journal Article J Orthop Sports Phys Ther · November 2004 STUDY DESIGN: One group pretest-posttest exploratory design. OBJECTIVES: Primary purposes of this study were to examine the short-term effect of hip mobilizations on pain and range of motion (ROM) measurements in patients with knee osteoarthritis (OA) and ... Full text Link to item Cite