Scholars@Duke
Steven Zachary George

Steven Zachary George

Laszlo Ormandy Distinguished Professor of Orthopaedic Surgery
Orthopaedic Surgery
steven.george@duke.edu
200 Morris Street, Office 6510, Durham, NC 27701
200 Morris Street, Office 6510, Durham, NC 27701
Office hours By appointment only  

Selected Publications

Attacking the Research-Practice Barrier.

Journal Article Phys Ther · December 6, 2024 Full text Link to item Cite

Prevalence and Factors Associated With High-Impact Chronic Pain in Knee Osteoarthritis: The Johnston County Health Study.

Journal Article J Pain · December 2024 Pain is a hallmark symptom of knee osteoarthritis (KOA), yet intensity and severity vary widely among individuals. There is a knowledge gap in understanding key characteristics of high-impact chronic pain (HICP) within the context of KOA. Therefore, our fi ... Full text Link to item Cite

Sleep and circadian rhythm disturbances as risk and progression factors for multiple chronic overlapping pain conditions: a protocol for a longitudinal study.

Journal Article Pain Rep · December 2024 INTRODUCTION: Chronic overlapping pain conditions (COPCs), such as chronic low back pain (cLBP) and fibromyalgia, frequently cooccur and incur substantial healthcare costs. However, to date, much focus has been placed on individual anatomically based chron ... Full text Link to item Cite

Which patient level factors predict persistent pain after reverse total shoulder arthroplasty?

Journal Article J Orthop Surg Res · November 22, 2024 BACKGROUND: Reverse total shoulder arthroplasty (RTSA) is commonly performed to reduce pain and restore shoulder function in patients with severe shoulder conditions. While most patients experience significant pain relief and functional improvement followi ... Full text Link to item Cite

Can Patient-Reported Outcomes Measurement Information System estimate high-impact chronic pain after total shoulder arthroplasty?

Journal Article JSES International · November 1, 2024 Background: Identification of high-impact chronic pain (HICP) among patients receiving total shoulder arthroplasty (TSA) may allow for the design and implementation of tailored pain interventions to address the negative impact on postoperative outcomes and ... Full text Cite

Understanding the Multifactorial Influences on Postsurgical Pain After Rotator Cuff Repair: A Retrospective Cohort Study.

Journal Article Orthopaedic journal of sports medicine · November 2024 BackgroundThe experience of chronic postsurgical pain (CPSP) can vary widely among patients after rotator cuff repair (RCR).PurposeTo determine the prevalence and predictive factors of CPSP at 6 months after RCR.Study designCohor ... Full text Cite

Beyond the Surgery: The Impact of Coping Strategies on Persistent Pain After Rotator Cuff Repair.

Journal Article Journal of clinical medicine · November 2024 Background: Rotator cuff repair is widely recognized as one of the most painful orthopedic surgeries, yet postoperative pain management in these patients is often underexplored. This study aimed to explore the relationship between pain outcomes and ... Full text Cite

Adapting to change: experiences and recommendations from the Pain Management Collaboratory on modifying statistical analysis plans.

Journal Article Pain Med · November 1, 2024 BACKGROUND: Best practices for clinical trials stipulate that statistical analysis plans (SAPs) need to be finalized before initiation of any analysis. However, there is limited guidance about when changes to SAPs are acceptable and how these changes shoul ... Full text Link to item Cite

The implementation of a pain navigator program in the department of Veterans Affairs' (VA) health care systems: a cluster randomized pragmatic clinical trial.

Journal Article Pain Med · November 1, 2024 OBJECTIVE: This manuscript describes the uptake of the AIM-Back Pain Navigator Pathway (PNP) designed to encourage use of non-pharmacologic care options within the Veterans Health Administration (VHA). DESIGN: This manuscript describes the implementation o ... Full text Link to item Cite

Utility of the PICOTS framework to assess clinical trial disruptions: monitoring the impact of COVID-19 in the Pain Management Collaboratory.

Journal Article Pain Med · November 1, 2024 OBJECTIVE: Despite careful design of clinical trials, unforeseen disruptions can arise. The PICOTS (Patient population, Intervention, Comparator, Outcomes, Timepoints, Setting) framework was used to assess disruptions in pain management research imposed by ... Full text Link to item Cite

Transition from acute to chronic low back pain in a community-based cohort.

Journal Article J Pain · October 11, 2024 The transition from acute to chronic low back pain (LBP) in community settings is not well understood. The purpose of this study was to assess the feasibility of recruitment and estimate the transition and continuation of chronic LBP. We also explored char ... Full text Link to item Cite

Utility of Patient Reported Outcome Measurement Information System measures in predicting shoulder arthroplasty in patients with shoulder osteoarthritis.

Journal Article J Shoulder Elbow Surg · October 2024 BACKGROUND: The decision to treat shoulder osteoarthritis (OA) definitively with shoulder arthroplasty (SA) is multifactorial, considering objective findings, subjective information, and patient goals. The first goal of this study was to determine if Patie ... Full text Link to item Cite

My View of PTJ: 10 Months Later….

Journal Article Physical therapy · October 2024 Full text Cite

Personal characteristic differences among Doctor of Physical Therapy students with unique sociodemographic factors.

Journal Article BMC Med Educ · September 27, 2024 BACKGROUND: The Association of American Medical Colleges suggests an Experiences-Attributes-Metrics framework for holistic review, but there is minimal research on demographic and personal characteristic attributes and the interplay between these Attribute ... 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

Developing a Computer Vision Model to Automate Quantitative Measurement of Hip-Knee-Ankle Angle in Total Hip and Knee Arthroplasty Patients.

Journal Article J Arthroplasty · September 2024 BACKGROUND: Increasing deformity of the lower extremities, as measured by the hip-knee-ankle angle (HKAA), is associated with poor patient outcomes after total hip and knee arthroplasty (THA, TKA). Automated calculation of HKAA is imperative to reduce the ... Full text Link to item Cite

Clinimetric Properties of the Working Alliance Inventory and Credibility Expectancy Questionnaire: Screening Options for Musculoskeletal Pain.

Journal Article Arch Phys Med Rehabil · August 2024 OBJECTIVE: To investigate clinimetric properties of 2 surveys used to evaluate common factors in the patient-provider relation and present screener options for the assessment of common factors and report their correlation with pain and functional outcomes. ... Full text Link to item Cite

Measurement Properties of Two Questionnaires Assessing Fear-Avoidance in Patients With Chronic Low Back Pain.

Journal Article Eval Health Prof · July 22, 2024 The Fear-Avoidance Components Scale (FACS) and the Fear of Daily Activities Questionnaire (FDAQ) assess fear-avoidance model components. However, the questionnaires are not available in Brazilian Portuguese. This study aimed to translate the original Engli ... 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

Author Response to Sahrmann.

Journal Article Phys Ther · June 4, 2024 Full text Link to item Cite

Characterizing Acute Low Back Pain in a Community-Based Cohort.

Journal Article medRxiv · March 23, 2024 Acute low back pain (LBP) is a common experience, however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, three acute LBP severity ca ... Full text Link to item Cite

Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations.

Journal Article Lancet Rheumatol · March 2024 The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to tr ... Full text Link to item Cite

If You Build It, Will They Come? Patient and Provider Use of a Novel Hybrid Telehealth Care Pathway for Low Back Pain.

Journal Article Physical therapy · February 2024 ObjectiveThe purpose of this study was to describe the referrals and use of a hybrid care model for low back pain that includes on-site care by physical therapists, physical activity training, and psychologically informed practice (PiP) delivered ... Full text Cite

Hip-focused physical therapy versus spine-focused physical therapy for older adults with chronic low back pain at risk for mobility decline (MASH): a multicentre, single-masked, randomised controlled trial.

Journal Article Lancet Rheumatol · January 2024 BACKGROUND: Previously, we identified a population of older adults with chronic low back pain, hip pain, and hip muscle weakness who had worse 12-month low back pain and functional outcomes than age-matched adults with only low back pain, indicating an inc ... Full text Link to item Cite

My View of PTJ.

Journal Article Phys Ther · January 1, 2024 Full text Link to item Cite

Acute Intermittent Hypoxia Did Not Alter Pain Sensitivity or Pain Intensity Ratings for Individuals with Chronic Low Back Pain: A Pilot Study.

Journal Article J Pain Res · 2024 AIMS AND OBJECTIVE: The purpose of this pilot study was to explore whether AIH produces changes in pain sensitivity or in reports of self-reported pain intensity for individuals with low back pain. METHODS: In a quasi-experimental, cross-over design we com ... Full text Link to item Cite

Telehealth delivery of physical therapist-led interventions for persons with chronic low back pain in underserved communities: lessons from pragmatic clinical trials.

Journal Article Front Pain Res (Lausanne) · 2024 In this perspective, we present our experience developing and conducting two pragmatic clinical trials investigating physical therapist-led telehealth strategies for persons with chronic low back pain. Both trials, the BeatPain Utah and AIM-Back trials, ar ... Full text Link to item Cite

Authors' reply

Journal Article LANCET RHEUMATOLOGY · 2024 Cite

Characterizing Acute Low Back Pain in a Community-Based Cohort: Results from a Feasibility Cohort Study.

Journal Article J Pain Res · 2024 INTRODUCTION: Acute low back pain (LBP) is a common experience; however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, two acute-LBP ... Full text Link to item Cite

Effect of a Patient Engagement, Education, and Restructuring of Cognitions (PEERC) approach on conservative care in rotator cuff related shoulder pain treatment: a randomized control trial.

Journal Article BMC Musculoskelet Disord · December 1, 2023 BACKGROUND: Despite similar outcomes for surgery and physical therapy (PT), the number of surgeries to treat rotator cuff related shoulder pain (RCRSP) is increasing. Interventions designed to enhance treatment expectations for PT have been shown to improv ... Full text Link to item Cite

PRISM-Pain Recovery and Integrative Systems Model: A Process-Based Cognitive-Behavioral Approach for Physical Therapy.

Journal Article Phys Ther · October 3, 2023 UNLABELLED: The Academy of Orthopedic Physical Therapy Pain Education Manual supports the advancement of modern pain content, and the National Institutes of Health Federal Pain Research Strategy has called for new models for pain management. This Perspecti ... Full text Link to item Cite

Partner engagement for planning and development of non-pharmacological care pathways in the AIM-Back trial.

Journal Article Clin Trials · October 2023 BACKGROUND/AIMS: Embedded pragmatic clinical trials are increasingly recommended for non-pharmacological pain care research due to their focus on examining intervention effectiveness within real-world settings. Engagement with patients, health care provide ... Full text Open Access Link to item Cite

Do You PROMIS (Patient Reported Outcomes Measurement Information System)? Physical Function and Pain Interference Scores After Total Knee and Hip Arthroplasty.

Journal Article Arthroplast Today · October 2023 BACKGROUND: Physical function and pain outcomes vary after arthroplasty. We investigated differences in postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) scores for patients un ... Full text Link to item Cite

Back Pain Consortium (BACPAC): Protocol and Pilot Study Results for a Randomized Comparative-Effectiveness Trial of Antidepressants, Fear Avoidance Rehabilitation, or the Combination for Chronic Low Back Pain and Comorbid High Negative Affect.

Journal Article Pain Med · August 4, 2023 OBJECTIVE: Patients with chronic low back pain (CLBP) and comorbid depression or anxiety disorders are highly prevalent. Negative affect (NA) refers to a combination of negative thoughts, emotions, and behaviors. Patients with CLBP with high NA have greate ... Full text Link to item Cite

Circulating Inflammatory Biomarkers Predict Pain Change Following Exercise-Induced Shoulder Injury: Findings From the Biopsychosocial Influence on Shoulder Pain Preclinical Trial.

Journal Article J Pain · August 2023 Shoulder pain is a highly prevalent musculoskeletal condition that frequently leads to suboptimal clinical outcomes. This study tested the extent to which circulating inflammatory biomarkers are associated with reports of shoulder pain and upper-extremity ... 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

Pain associated psychological distress is more strongly associated with shoulder pain and function than tear severity in patients undergoing rotator cuff repair.

Journal Article JSES Int · July 2023 BACKGROUND: Psychological distress has been associated with declining shoulder function in patients with rotator cuff tears (RCTs). Thus, we aimed to 1) evaluate the absence or presence of differences in shoulder pain, function, or pain-associated psycholo ... Full text Link to item Cite

The Psychologically Informed Practice Consultation Roadmap: A Clinical Implementation Strategy.

Journal Article Phys Ther · July 1, 2023 Psychologically informed practice (PiP) includes a special focus on psychosocial obstacles to recovery, but research trials have revealed significant difficulties in implementing PiP outside of research environments. Qualitative studies have identified pro ... Full text Link to item Cite

Psychologically Informed Practice: The Importance of Communication in Clinical Implementation.

Journal Article Phys Ther · July 1, 2023 There has been increasing interest in the secondary prevention of chronic pain and pain-associated disability over the past 3 decades. In 2011, psychologically informed practice (PiP) was suggested as a framework for managing persistent and recurrent pain, ... Full text Link to item Cite

Biomarkers and longitudinal changes in lumbar spine degeneration and low back pain: the Johnston County Osteoarthritis Project.

Journal Article Osteoarthritis Cartilage · June 2023 OBJECTIVE: To determine if baseline biomarkers are associated with longitudinal changes in the worsening of disc space narrowing (DSN), vertebral osteophytes (OST), and low back pain (LBP). DESIGN: Paired baseline (2003-2004) and follow-up (2006-2010) lumb ... Full text Link to item Cite

Can Patient-Reported Outcome Measurement Information System Measures Estimate High Impact Chronic Pain After Total Joint Arthroplasty?

Journal Article J Arthroplasty · June 2023 BACKGROUND: High impact chronic pain (HICP) is not typically measured following orthopedic surgeries, but has a substantial negative impact on postoperative quality of life. This analysis determined which Patient-Reported Outcome Measurement Information Sy ... Full text Link to item Cite

Effectiveness of spinal manipulation and biopsychosocial self-management compared to medical care for low back pain: a randomized trial study protocol.

Journal Article BMC Musculoskelet Disord · May 25, 2023 BACKGROUND: Chronic low back pain (cLBP) is widespread, costly, and burdensome to patients and health systems. Little is known about non-pharmacological treatments for the secondary prevention of cLBP. There is some evidence that treatments addressing psyc ... Full text Link to item Cite

Mind-Body Exercise Performed by Physical Therapists for Reducing Pain and Disability in Low Back Pain: A Systematic Review With Meta-analysis.

Journal Article Arch Phys Med Rehabil · May 2023 OBJECTIVE: To assess the effectiveness of mind-body (MB) exercise interventions provided by physical therapists for reducing pain and disability in people with low back pain (LBP). DATA SOURCES: MEDLINE, Embase, CINAHL, and the Cochrane Library were search ... Full text Link to item Cite

Investigating the hypoalgesic effects of spinal manipulative therapy using hidden pain conditioning and positive expectation in patients with chronic low back pain: protocol for a randomised controlled trial.

Journal Article BMJ Open · April 12, 2023 INTRODUCTION: Placebo effects are responses capable of modulating pain and influencing treatment response. Two mechanisms are commonly related to placebo effects: expectations and conditioning. However, the research in this field is focused on laboratory s ... Full text Link to item Cite

Working Alliance Inventory (WAI) and its relationship to patient-reported outcomes in painful musculoskeletal conditions.

Journal Article Disabil Rehabil · April 2023 PURPOSE: Therapeutic alliance (TA) has been positively correlated to improvements in patient outcomes. This study examined the Working Alliance Inventory (WAI) relationship with changes in disability and pain intensity for patients receiving physical thera ... 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

High-Impact Chronic Pain Transition in Lumbar Surgery Recipients.

Journal Article Pain Med · March 1, 2023 OBJECTIVE: High-impact chronic pain (HICP) is a term that characterizes the presence of a severe and troubling pain-related condition. To date, the prevalence of HICP in lumbar spine surgery recipients and their HICP transitions from before to after surger ... Full text Open Access Link to item Cite

Intervention delivery for embedded pragmatic clinical trials: Development of a tool to measure complexity.

Journal Article Contemp Clin Trials · March 2023 BACKGROUND: Conducting an embedded pragmatic clinical trial in the workflow of a healthcare system is a complex endeavor. The complexity of the intervention delivery can have implications for study planning, ability to maintain fidelity to the intervention ... Full text Link to item Cite

Pain and Disability Following Exercise-Induced Injury in Prognostic and Intervention Studies: The Why May Be More Important Than the How.

Journal Article Clin J Pain · March 1, 2023 OBJECTIVES: In preclinical prognostic studies, the description of expected outcomes during an informed consent process indicates that the extent of pain and disability experienced and recovery time is unknown. In intervention studies, the consent process s ... Full text Link to item Cite

Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury.

Journal Article Pain · February 2023 AbstractPrior cohort studies validated that a subgroup defined by a specific COMT genotype and pain catastrophizing is at increased risk for heightened responses to exercise-induced or surgically induced shoulder pain. In this clinical trial, we u ... Full text Cite

Treatment effect modifiers for individuals with acute low back pain: secondary analysis of the TARGET trial.

Journal Article Pain · January 1, 2023 Treatment effect modifiers identify patient characteristics associated with treatment responses. The purpose of this secondary analysis was to identify potential treatment effect modifiers for disability from the TARGET trial that compared usual care (cont ... Full text Link to item Cite

Additional effect of pain neuroscience education to spinal manipulative therapy on pain and disability for patients with chronic low back pain: a randomized controlled trial.

Journal Article Braz J Phys Ther · 2023 BACKGROUND: Spinal manipulative therapy (SMT) demonstrates small effects on pain intensity in low back pain. Combining SMT with a psychosocial intervention like pain neuroscience education (PNE) could promote additional effect. OBJECTIVES: To evaluate the ... Full text Link to item Cite

Predictors of Lumbar Spine Degeneration and Low Back Pain in the Community: The Johnston County Osteoarthritis Project.

Journal Article Arthritis Care Res (Hoboken) · October 2022 OBJECTIVE: To determine the incidence and worsening of lumbar spine structure and low back pain (LBP) and whether they are predicted by demographic characteristics or clinical characteristics or appendicular joint osteoarthritis (OA). METHODS: Paired basel ... Full text Link to item Cite

Four Variables Were Sufficient for Low Back Pain: Determining Which Patient-Reported Tools Pain and Disability Improvements.

Journal Article J Orthop Sports Phys Ther · October 2022 OBJECTIVE: To predict 30- and 180-day improvements in disability and pain for patients seeking physical therapy care for low back pain (LBP). DESIGN: Longitudinal cohort. METHODS: Baseline assessment was completed by 259 patients with chief complaint of LB ... Full text Link to item Cite

Patient-centered outcomes: Domain importance predicts health care use following physical therapy.

Journal Article PM R · September 2022 INTRODUCTION: Identifying patients with musculoskeletal pain who are at risk for additional health care use is important for improving the value of physical therapists' services. We previously identified three subgroups based on the importance attached by ... Full text Link to item Cite

Biomarker clusters differentiate phenotypes of lumbar spine degeneration and low back pain: The Johnston County Osteoarthritis Project.

Journal Article Osteoarthr Cartil Open · September 2022 OBJECTIVE: Describe the association between biomarkers and lumbar spine degeneration (vertebral osteophytes [OST], facet joint osteoarthritis [FOA], and disc space narrowing [DSN]), for persons with and without low back pain (LBP) and determine whether clu ... Full text Link to item Cite

Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study.

Journal Article J Orthop Surg Res · August 19, 2022 BACKGROUND: Patient-Reported Outcomes Measurement Information System (PROMIS) domains for sleep disturbance, anxiety, and dyspnea have been under-reported for total joint arthroplasty (TJA). The aims of this study were to report postoperative differences f ... Full text Open Access 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

High-impact chronic pain transition in surgical recipients with cervical spondylotic myelopathy.

Journal Article J Neurosurg Spine · July 1, 2022 OBJECTIVE: High-impact chronic pain (HICP) is a recently proposed metric that indicates the presence of a severe and troubling pain-related condition. Surgery for cervical spondylotic myelopathy (CSM) is designed to halt disease transition independent of c ... Full text Open Access Link to item Cite

Can Patient-Reported Outcome Measurement Information System Measures Differentiate Patients Who Will Undergo Hip and Knee Total Joint Arthroplasty: A Retrospective Case-Control Study.

Journal Article J Arthroplasty · June 2022 BACKGROUND: The Patient-Reported Outcome Measurement Information System (PROMIS) can be used to monitor patients in population-health-based programs. However, it is unknown which measures are most appropriate to differentiate patients who will undergo hip ... Full text Link to item Cite

Heterogeneity of pain-related psychological distress in patients seeking care for shoulder pathology.

Journal Article J Shoulder Elbow Surg · April 2022 BACKGROUND: Psychological distress is associated with disability and quality of life for patients with shoulder pain. However, uncertainty around heterogeneity of psychological distress has limited the adoption of shoulder care models that address psycholo ... Full text Link to item Cite

Chronic Pain Prevalence and Factors Associated With High Impact Chronic Pain following Total Joint Arthroplasty: An Observational Study.

Journal Article J Pain · March 2022 Hip, knee, and shoulder arthroplasty are among the most frequently performed orthopaedic procedures in the United States. High impact and bothersome chronic pain rates following total joint arthroplasty (TJA) are unknown; as are factors that predict these ... Full text Link to item Cite

Low Risk for Persistent Back Pain Disability Is Characterized by Lower Pain Sensitivity and Higher Physical Performance.

Journal Article Phys Ther · March 1, 2022 OBJECTIVE: The STarT Back Tool (SBT) predicts risk for persistent low back pain (LBP)-related disability based on psychological distress levels. Other non-psychological factors associated with LBP, such as pain sensitivity and physical performance, may fur ... Full text Link to item Cite

Development of Reliable and Valid Negative Mood Screening Tools for Orthopaedic Patients with Musculoskeletal Pain.

Journal Article Clin Orthop Relat Res · February 1, 2022 BACKGROUND: Negative mood is an important risk factor for poor clinical outcomes among individuals with musculoskeletal pain. Screening for negative mood can aid in identifying those who may need additional psychological interventions. Limitations of curre ... Full text Link to item Cite

Efficient Screening for Fear of Movement in Outpatient Settings: Short Form and Computer Adaptive Tests for Fear Avoidance and Negative Pain Coping.

Journal Article Phys Ther · February 1, 2022 OBJECTIVE: The purpose of this study was to develop screening measures using item response theory (IRT) for 2 factors highly relevant to fear of movement (FoM): fear avoidance and negative pain coping. METHODS: A total of 431 patients with neck (n = 93), s ... Full text Link to item Cite

Procedural Drift: An Underappreciated Element of Clinical Treatment Fidelity.

Journal Article J Orthop Sports Phys Ther · February 2022 Procedural fidelity involves delivering the correct guideline-supported treatment choice, in its designed manner, over the full care episode of the patient. Procedural drift is a subcomponent of procedural fidelity that involves performing the right treatm ... Full text Link to item Cite

The Manual Therapy and Strengthening for the Hip (MASH) Trial: Protocol for a Multisite Randomized Trial of a Subgroup of Older Adults With Chronic Back and Hip Pain.

Journal Article Phys Ther · January 1, 2022 OBJECTIVE: Chronic low back pain (CLBP) is a disabling and costly condition for older adults that is difficult to properly classify and treat. In a cohort study, a subgroup of older adults with CLBP who had elevated hip pain and hip muscle weakness was ide ... Full text Open Access Link to item Cite

Association of Biomarkers with Individual and Multiple Body Sites of Pain: The Johnston County Osteoarthritis Project.

Journal Article J Pain Res · 2022 INTRODUCTION: Biochemical biomarkers may provide insight into musculoskeletal pain reported at individual or multiple body sites. The purpose of this study was to determine if biomarkers or pressure-pain threshold (PPT) were associated with individual or m ... Full text Open Access Link to item Cite

Willingness to use nonpharmacologic treatments for musculoskeletal pain in the emergency department: a cross-sectional study.

Journal Article Pain Rep · 2022 OBJECTIVES: Pain is an individual experience that should incorporate patient-centered care. This study seeks to incorporate patient perspectives toward expanding nonpharmacologic treatment options for pain from the emergency department (ED). METHODS: In th ... Full text Open Access Link to item Cite

Moving toward patient-centered care in the emergency department: Patient-reported expectations, definitions of success, and importance of improvement in pain-related outcomes.

Journal Article Acad Emerg Med · November 2021 OBJECTIVES: Musculoskeletal pain is a common emergency department (ED) presentation, and patient-centered care may improve quality of life, treatment satisfaction, and outcomes. Our objective was to investigate the expectations, definitions of success, and ... Full text Link to item Cite

Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021.

Journal Article J Orthop Sports Phys Ther · November 2021 Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopa ... Full text Open Access Link to item Cite

Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States.

Journal Article Subst Abuse Treat Prev Policy · September 28, 2021 BACKGROUND: The opioid misuse epidemic focused national attention on reducing opioid overprescribing. The purpose of this study is to describe the relationship of time and state-level interventions and opioid filling surrounding total hip arthroplasty (THA ... Full text Open Access Link to item Cite

Use of Patient-Reported Outcomes Measurement Information System (PROMIS) measures to characterise health status for patients seeking care from an orthopaedic provider: a retrospective cohort study.

Journal Article BMJ Open · September 2, 2021 OBJECTIVES: Characterise the health status of patients newly consulting an orthopaedic specialist across eight clinical subspecialties. DESIGN: Retrospective cohort. SETTING: 18 orthopaedic clinics, including 8 subspecialties (14 ambulatory and 4 hospital ... Full text Open Access Link to item Cite

The influence of a cognitive behavioural approach on changing patient expectations for conservative care in shoulder pain treatment: a protocol for a pragmatic randomized controlled trial.

Journal Article BMC Musculoskelet Disord · August 24, 2021 BACKGROUND: Despite similar outcomes for surgery and conservative care, the number of surgeries to treat rotator cuff related shoulder pain has increased. Interventions designed to enhance treatment expectations for conservative care have been shown to imp ... Full text Open Access Link to item Cite

Predicting Recurrent Care Seeking of Physical Therapy for Musculoskeletal Pain Conditions.

Journal Article Pain Med · August 6, 2021 OBJECTIVE: Musculoskeletal pain conditions are a leading cause of pain and disability internationally and a common reason to seek health care. Accurate prediction of recurrence of health care seeking due to musculoskeletal conditions could allow for better ... Full text Link to item Cite

Back and neck pain: in support of routine delivery of non-pharmacologic treatments as a way to improve individual and population health.

Journal Article Transl Res · August 2021 Chronic back and neck pain are highly prevalent conditions that are among the largest drivers of physical disability and cost in the world. Recent clinical practice guidelines recommend use of non-pharmacologic treatments to decrease pain and improve physi ... Full text Link to item Cite

Star-Shape Kinesio Taping Is Not Better Than a Minimal Intervention or Sham Kinesio Taping for Pain Intensity and Postural Control in Chronic Low Back Pain: A Randomized Controlled Trial.

Journal Article Arch Phys Med Rehabil · July 2021 OBJECTIVE: This study investigated the effects of star-shape Kinesio taping (KT) compared with both sham KT and minimal intervention (MI) on pain intensity and postural control. DESIGN: Randomized controlled trial. SETTING: Outpatient physical therapy. PAR ... Full text Link to item Cite

Static and Dynamic Pain Sensitivity in Adults With Persistent Low Back Pain: Comparison to Healthy Controls and Associations With Movement-evoked Pain Versus Traditional Clinical Pain Measures.

Journal Article Clin J Pain · July 1, 2021 OBJECTIVES: Despite its impact, individual factors associated with persistent low back pain (LBP) remain poorly understood. This study investigated static and dynamic pain sensitivity in adults with persistent LBP versus pain-free controls; and investigate ... Full text Link to item Cite

Can PROMIS measures be used to create subgroups for patients seeking orthopaedic care?

Journal Article Bone Jt Open · July 2021 AIMS: Patient-reported outcome measures have become an important part of routine care. The aim of this study was to determine if Patient-Reported Outcomes Measurement Information System (PROMIS) measures can be used to create patient subgroups for individu ... Full text Open Access Link to item Cite

Author Response to Quintner and Cohen.

Journal Article Phys Ther · June 2, 2021 Full text Link to item Cite

Empirically derived back pain subgroups differentiated walking performance, pain, and disability.

Journal Article Pain · June 1, 2021 Low back pain (LBP) is a leading cause of disability. However, the processes contributing to disability are not well understood. Therefore, this study (1) empirically derived LBP subgroups and (2) validated these subgroups using walking performance, pain, ... Full text Link to item Cite

Sensory and Psychological Factors Predict Exercise-Induced Shoulder Injury Responses in a High-Risk Phenotype Cohort.

Journal Article J Pain · June 2021 Our prior studies identified a high-risk phenotype (ie, high pain sensitivity variant of the catechol-O-methyltransferase gene (Single Nucleotide Polymorphism [SNP] rs6269) and pain catastrophizing scores) for shoulder pain. The current study identified se ... Full text Link to item Cite

Electronic health record-integrated approach for collection of patient-reported outcome measures: a retrospective evaluation.

Journal Article BMC health services research · June 2021 BackgroundThe integration of Patient Reported Outcome Measures (PROMs) into clinical care presents many challenges for health systems. PROMs provide quantitative data regarding patient-reported health status. However, the most effective model for ... Full text Cite

Resilience and pain catastrophizing among patients with total knee arthroplasty: a cohort study to examine psychological constructs as predictors of post-operative outcomes.

Journal Article Health Qual Life Outcomes · May 1, 2021 BACKGROUND: Patients' psychological health may influence recovery and functional outcomes after total knee arthroplasty (TKA). Pain catastrophizing, known to be associated with poor function following TKA, encompasses rumination, magnification, and helples ... Full text Link to item Cite

Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine.

Journal Article Lancet Rheumatol · May 2021 Chronic pain is a leading cause of disability globally and associated with enormous health-care costs. The discrepancy between the extent of tissue damage and the magnitude of pain, disability, and associated symptoms represents a diagnostic challenge for ... Full text Open Access Link to item Cite

The association between the supply of select nonpharmacologic providers for pain and use of nonpharmacologic pain management services and initial opioid prescribing patterns for Medicare beneficiaries with persistent musculoskeletal pain.

Journal Article Health Serv Res · April 2021 OBJECTIVE: To test the relationship between the supply of select nonpharmacologic providers (physical therapy (PT) and mental health (MH)) and use of nonpharmacologic services among older adults with a persistent musculoskeletal pain (MSP) episode. DATA SO ... Full text Link to item Cite

Stratified care to prevent chronic low back pain in high-risk patients: The TARGET trial. A multi-site pragmatic cluster randomized trial.

Journal Article EClinicalMedicine · April 2021 BACKGROUND: Many patients with acute low back pain (LBP) first seek care from primary care physicians. Evidence is lacking for interventions to prevent transition to chronic LBP in this setting. We aimed to test if implementation of a risk-stratified appro ... Full text Open Access Link to item Cite

Assessment of Common Comorbidity Phenotypes Among Older Adults With Knee Osteoarthritis to Inform Integrated Care Models.

Journal Article Mayo Clin Proc Innov Qual Outcomes · April 2021 OBJECTIVE: To establish the frequency of concordant, discordant, and clinically dominant comorbidities among Medicare beneficiaries with knee osteoarthritis (KOA) and to identify common concordant condition subgroups. PARTICIPANTS AND METHODS: We used a 5% ... Full text Open Access Link to item Cite

Determination of Pain Phenotypes in Knee Osteoarthritis Using Latent Profile Analysis.

Journal Article Pain Med · March 18, 2021 OBJECTIVE: To identify clinical phenotypes of knee osteoarthritis (OA) using measures from the following domains: 1) multimorbidity; 2) psychological distress; 3) pain sensitivity; and 4) knee impairment or pathology. DESIGN: Data were collected from 152 p ... Full text Link to item Cite

Risk Factors Associated With Transition From Acute to Chronic Low Back Pain in US Patients Seeking Primary Care.

Journal Article JAMA Netw Open · February 1, 2021 IMPORTANCE: Acute low back pain (LBP) is highly prevalent, with a presumed favorable prognosis; however, once chronic, LBP becomes a disabling and expensive condition. Acute to chronic LBP transition rates vary widely owing to absence of standardized opera ... Full text Open Access Link to item Cite

The Impact of State Level Public Policy, Prescriber Education, and Patient Factors on Opioid Prescribing in Elective Orthopedic Surgery: Findings From a Tertiary, Academic Setting.

Journal Article Mayo Clin Proc Innov Qual Outcomes · February 2021 BACKGROUND: The United States is in the midst of an opioid misuse epidemic. There have been recent changes to North Carolina's public policy leading to institutional education attempting to reduce high-risk opioid prescribing. This study investigated wheth ... Full text Open Access Link to item Cite

Adding Physical Impairment to Risk Stratification Improved Outcome Prediction in Low Back Pain.

Journal Article Phys Ther · January 4, 2021 OBJECTIVE: Identifying subgroups of low back pain (LBP) has the potential to improve prediction of clinical outcomes. Risk stratification is one such strategy that identifies similar characteristics indicative of a common clinical outcome trajectory. The p ... Full text Open Access Link to item Cite

Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations.

Journal Article Pain Rep · 2021 Although certain risk factors can identify individuals who are most likely to develop chronic pain, few interventions to prevent chronic pain have been identified. To facilitate the identification of preventive interventions, an IMMPACT meeting was convene ... Full text Link to item Cite

Prevalence and predictors of no-shows to physical therapy for musculoskeletal conditions.

Journal Article PLoS One · 2021 OBJECTIVES: Chronic pain affects 50 million Americans and is often treated with non-pharmacologic approaches like physical therapy. Developing a no-show prediction model for individuals seeking physical therapy care for musculoskeletal conditions has sever ... Full text Open Access Link to item Cite

Derivation of a Risk Assessment Tool for Prediction of Long-Term Pain Intensity Reduction After Physical Therapy.

Journal Article J Pain Res · 2021 RATIONALE: Risk assessment tools can improve clinical decision-making for individuals with musculoskeletal pain, but do not currently exist for predicting reduction of pain intensity as an outcome from physical therapy. AIMS AND OBJECTIVE: The objective of ... Full text Open Access Link to item Cite

Implementation of Psychologically Informed Physical Therapy for Low Back Pain: Where Do We Stand, Where Do We Go?

Journal Article J Pain Res · 2021 Low back pain continues to be a leading cause of disability and cost throughout the world. Evidence-based guidelines recommend use of non-pharmacological interventions to address decreases in physical function due to low back pain. Psychologically informed ... Full text Link to item Cite

Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.

Journal Article Pain Med · December 12, 2020 BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain ... Full text Open Access Link to item Cite

Strategy for addressing research-site overlap in pragmatic clinical trials: lessons learned from the NIH-DOD-VA Pain Management Collaboratory (PMC).

Journal Article Trials · December 11, 2020 BACKGROUND: The Pain Management Collaboratory (PMC) is a multi-site network of pragmatic clinical trials (PCTs) focused on nonpharmacological approaches to pain management, conducted in health care systems of the US Department of Defense (DoD) and Departme ... Full text Link to item Cite

Transforming low back pain care delivery in the United States.

Journal Article Pain · December 2020 Low back pain (LBP) continues to be a challenging condition to manage effectively. Recent guideline recommendations stress providing non-pharmacological care early, limiting diagnostic testing, and reducing exposure to opioid pain medications. However, the ... Full text Link to item Cite

What General and Pain-associated Psychological Distress Phenotypes Exist Among Patients with Hip and Knee Osteoarthritis?

Journal Article Clin Orthop Relat Res · December 2020 BACKGROUND: Psychological distress can negatively influence disability, quality of life, and treatment outcomes for individuals with hip and knee osteoarthritis (OA). Clinical practice guidelines recommend a comprehensive disease management approach to OA ... Full text Link to item Cite

Reporting and utilization of Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures in orthopedic research and practice: a systematic review.

Journal Article J Orthop Surg Res · November 23, 2020 BACKGROUND: The Patient-Reported Outcomes Measurement Information SystemⓇ (PROMISⓇ) is a dynamic system of psychometrically sound patient-reported outcome (PRO) measures. There has been a recent increase in the use of PROMIS measures, yet little has been w ... Full text Open Access Link to item Cite

Introduction of a psychologically informed educational intervention for pre-licensure physical therapists in a classroom setting.

Journal Article BMC Med Educ · October 23, 2020 BACKGROUND: There is an increasing need for physical therapists to address psychosocial aspects of musculoskeletal pain. Psychologically informed practice is one way to deliver this type of care through the integration of biopsychosocial interventions into ... Full text Open Access Link to item Cite

Longitudinal Monitoring of Pain Associated Distress With the Optimal Screening for Prediction of Referral and Outcome Yellow Flag Tool: Predicting Reduction in Pain Intensity and Disability.

Journal Article Arch Phys Med Rehabil · October 2020 OBJECTIVE: To investigate the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool for longitudinal monitoring of pain associated distress with the goal of improving prediction of 50% reduction in pain intensity and disabili ... Full text Open Access Link to item Cite

Plasma Concentrations of Select Inflammatory Cytokines Predicts Pain Intensity 48 Hours Post-Shoulder Muscle Injury.

Journal Article Clin J Pain · October 2020 OBJECTIVES: The relationship between elevated inflammatory cytokine levels and peak pain intensity following acute musculoskeletal injury has not been fully elucidated in high risk subgroups. Identifying the role that these cytokines have on pain responses ... Full text Link to item Cite

Depression and Functional Outcomes in Patients Presenting to the Emergency Department With Low Back Pain.

Journal Article Acad Emerg Med · August 2020 OBJECTIVES: Low back pain (LBP) is a common reason for patients to present to emergency departments (EDs). Our objective was to describe the associations between depressive symptoms, pain severity, and functional impairment up to 3 months after initial ED ... Full text Link to item Cite

FEAR-AVOIDANCE AND SELF-EFFICACY PSYCHOSOCIAL FACTORS ARE ALTERED AFTER PARTIAL MENISCECTOMY AND ASSOCIATED WITH REHABILITATION OUTCOMES.

Journal Article Int J Sports Phys Ther · August 2020 BACKGROUND: Little research has examined how psychosocial factors change over time and influence rehabilitation outcomes following meniscectomy. This information can inform the need to assess and address psychosocial factors in meniscectomy rehabilitation. ... Link to item Cite

Different Phenotypes of Osteoarthritis in the Lumbar Spine Reflected by Demographic and Clinical Characteristics: The Johnston County Osteoarthritis Project.

Conference Arthritis Care Res (Hoboken) · July 2020 OBJECTIVE: To determine if associations between demographic and clinical characteristics and appendicular joint osteoarthritis (OA) reflect different phenotypes of OA in the lumbar spine. METHODS: Participants were from the Johnston County OA Project. Demo ... Full text Link to item Cite

Importance of Outcome Domain for Patients With Musculoskeletal Pain: Characterizing Subgroups and Their Response to Treatment.

Journal Article Phys Ther · May 18, 2020 BACKGROUND: Patient-centered care models allow for the ability to tailor treatment to outcomes of importance to patients. OBJECTIVE: The purposes of this study were to (1) define patient subgroups based on outcomes of importance; (2) determine whether pati ... Full text Link to item Cite

Inflammatory, Structural, and Pain Biochemical Biomarkers May Reflect Radiographic Disc Space Narrowing: The Johnston County Osteoarthritis Project.

Journal Article J Orthop Res · May 2020 The purpose of this work is to determine the relationship between biomarkers of inflammation, structure, and pain with radiographic disc space narrowing (DSN) in community-based participants. A total of 74 participants (37 cases and 37 controls) enrolled i ... Full text Link to item Cite

The Association Between the Supply of Nonpharmacologic Providers, Use of Nonpharmacologic Pain Treatments, and High-risk Opioid Prescription Patterns Among Medicare Beneficiaries With Persistent Musculoskeletal Pain.

Journal Article Med Care · May 2020 BACKGROUND: Opioids are prescribed more frequently than nonpharmacologic treatments for persistent musculoskeletal pain (MSP). We estimate the association between the supply of physical therapy (PT) and mental health (MH) providers and early nonpharmacolog ... Full text Link to item Cite

Value-Based Care for Musculoskeletal Pain: Are Physical Therapists Ready to Deliver?

Journal Article Phys Ther · April 17, 2020 Early physical therapy models hold great promise for delivering high-value care for individuals with musculoskeletal pain. However, existing physical therapist practice and research standards are misaligned with value-based principles, which limits the pot ... 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

Comparison of brain structure between pain-susceptible and asymptomatic individuals following experimental induction of low back pain.

Journal Article Spine J · February 2020 BACKGROUND CONTEXT: Peripheral differences often do not adequately account for variation in reports of pain intensity in people with musculoskeletal pain. PURPOSE: Here we sought to determine the extent to which structural differences in the brain (grey ma ... 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

Psychometric Evaluation of the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) Tool: Factor Structure, Reliability, and Validity.

Journal Article J Pain · 2020 Psychological characteristics consistently predict clinical outcomes for musculoskeletal pain conditions. The Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool assesses negative mood, fear-avoidance, and positive affect/c ... Full text Link to item Cite

Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery.

Journal Article J Pain · 2020 Shoulder surgery is a primary intervention for shoulder pain, yet many individuals experience persistent postoperative pain. Previously, we found individuals categorized as having a high-risk phenotype (comprised of COMT variation and pain catastrophizing) ... Full text Link to item Cite

Framework for improving outcome prediction for acute to chronic low back pain transitions.

Journal Article Pain Rep · 2020 Clinical practice guidelines and the Federal Pain Research Strategy (United States) have recently highlighted research priorities to lessen the public health impact of low back pain (LBP). It may be necessary to improve existing predictive approaches to me ... Full text Open Access Link to item Cite

Physical therapy and opioid use for musculoskeletal pain management: competitors or companions?

Journal Article Pain Rep · 2020 Musculoskeletal (MSK) pain conditions are highly prevalent and a leading cause of disability globally. When people with MSK pain seek health care, they often receive treatment not aligned with best practices, including initial management options such as op ... Full text Open Access Link to item Cite

Cluster subgroups based on overall pressure pain sensitivity and psychosocial factors in chronic musculoskeletal pain: Differences in clinical outcomes.

Journal Article Physiother Theory Pract · December 2019 Objective: We aimed to empirically derive psychosocial and pain sensitivity subgroups using cluster analysis within a sample of individuals with chronic musculoskeletal pain (CMP) and to investigate derived subgroups for differences in pain and disability ... 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

The Role of Social Support and Psychological Distress in Predicting Discharge: A Pilot Study for Hip and Knee Arthroplasty Patients.

Journal Article J Arthroplasty · November 2019 BACKGROUND: Bundled payment initiatives for joint replacement have prompted re-evaluation of the continuum of care with emphasis on anticipating disposition needs. The purpose of this study is to investigate the role of social support and psychological dis ... Full text Link to item Cite

Comorbidity Subgroups Among Medicare Beneficiaries Seeking Health Care for Musculoskeletal Pain.

Journal Article J Gerontol A Biol Sci Med Sci · July 12, 2019 BACKGROUND: Treatment of musculoskeletal pain in older adults may be more effective if it incorporates integrated management of comorbid health conditions. The purpose of this study was to define empirically derived comorbidity subgroups among Medicare ben ... Full text Link to item Cite

Study protocol for targeted interventions to prevent chronic low back pain in high-risk patients: A multi-site pragmatic cluster randomized controlled trial (TARGET Trial).

Journal Article Contemp Clin Trials · July 2019 BACKGROUND: Low back pain (LBP) is one of the most prevalent and potentially disabling conditions for which people seek health care. Patients, providers, and payers agree that greater effort is needed to prevent acute LBP from transitioning to chronic LBP. ... Full text Link to item Cite

Low Back Pain Treatment by Athletic Trainers and Athletic Therapists: Biomedical or Biopsychosocial Orientation?

Journal Article J Athl Train · July 2019 CONTEXT: Low back pain (LBP) remains a societal burden due to consistently high rates of recurrence and chronicity. Recent evidence suggested that a provider's treatment orientation influences patient beliefs, the clinical approach, and subsequently, rehab ... Full text Link to item Cite

Treatment monitoring as a component of psychologically informed physical therapy: A case series of patients at high risk for persistent low back pain related disability.

Journal Article Musculoskelet Sci Pract · June 2019 BACKGROUND: Psychologically Informed Physical Therapy (PIPT) aims to identify individuals at high risk for transitioning to chronicity and merge impairment-focused physical therapy with cognitive behavioral therapy principles. Treatment monitoring is an im ... Full text Link to item Cite

Targeted interventions to prevent transitioning from acute to chronic low back pain in high-risk patients: development and delivery of a pragmatic training course of psychologically informed physical therapy for the TARGET trial.

Journal Article Trials · May 6, 2019 BACKGROUND: Low back pain (LBP) is a public health concern because it is highly prevalent and the leading cause of disability worldwide. Psychologically informed physical therapy (PIPT) is a secondary prevention approach that first aims to identify individ ... Full text Link to item Cite

Risk and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients With Newly Diagnosed Musculoskeletal Pain in the Neck, Shoulder, Knee, or Low Back.

Journal Article Ann Intern Med · April 2, 2019 BACKGROUND.: Musculoskeletal pain is a common condition, raising the concern these patients may transition to chronic opioid use. However, the incidence of and risk factors for chronic opioid use among patients with new musculoskeletal pain are not fully u ... Full text Link to item Cite

The use of STarT back screening tool to predict functional disability outcomes in patients receiving physical therapy for low back pain.

Journal Article Spine J · April 2019 BACKGROUND CONTEXT: The STarT Back Screening Tool (SBST) categorizes risk of future disability in patients with low back pain (LBP). Previous studies evaluating the use of SBST in physical therapy (PT) populations do not reflect the ethnic and socioeconomi ... Full text Link to item Cite

Fear avoidance and self-efficacy at 4 weeks after ACL reconstruction are associated with early impairment resolution and readiness for advanced rehabilitation.

Journal Article Knee Surg Sports Traumatol Arthrosc · February 2019 PURPOSE: To examine the association of fear avoidance and self-efficacy psychological factors within 4 weeks after anterior cruciate ligament (ACL) reconstruction with knee impairment resolution and readiness for advanced rehabilitation at 12 weeks post-su ... Full text Link to item Cite

Optimization of Movement: A Dynamical Systems Approach to Movement Systems as Emergent Phenomena.

Journal Article Phys Ther · January 1, 2019 The term "movement system" has been defined as "represent(ing) the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts."5 Although we do not dispute ... Full text Link to item Cite

Factors associated with persistently high-cost health care utilization for musculoskeletal pain.

Journal Article PLoS One · 2019 BACKGROUND: Musculoskeletal pain conditions incur high costs and produce significant personal and public health consequences, including disability and opioid-related mortality. Persistence of high-cost health care utilization for musculoskeletal pain may h ... Full text Link to item Cite

Patient-defined outcomes for pain, fatigue, emotional distress, and interference with activities did not differ by age for individuals with musculoskeletal pain.

Journal Article Pain Rep · 2019 INTRODUCTION: Age impacts the prevalence and experience of musculoskeletal pain; however, it is unknown whether this factor impacts patient's anticipated outcomes after treatment. OBJECTIVE: Using the Patient-Centered Outcomes Questionnaire (PCOQ), the pri ... Full text Link to item Cite

Association of Early Physical Therapy With Long-term Opioid Use Among Opioid-Naive Patients With Musculoskeletal Pain.

Journal Article JAMA Netw Open · December 7, 2018 IMPORTANCE: Nonpharmacologic methods of reducing the risk of new chronic opioid use among patients with musculoskeletal pain are important given the burden of the opioid epidemic in the United States. OBJECTIVE: To determine the association between early p ... Full text Link to item Cite

Prolonged Reduction in Shoulder Strength after Transcutaneous Electrical Nerve Stimulation Treatment of Exercise-Induced Acute Muscle Pain.

Journal Article Pain Pract · November 2018 OBJECTIVES: Transcutaneous electrical nerve stimulation (TENS) is commonly used for reducing musculoskeletal pain to improve function. However, peripheral nerve stimulation using TENS can alter muscle motor output. Few studies examine motor outcomes follow ... Full text Link to item Cite

Prediction of healthcare utilization following an episode of physical therapy for musculoskeletal pain.

Journal Article BMC Health Serv Res · August 20, 2018 BACKGROUND: In the United States, value-based purchasing has created the need for healthcare systems to prospectively identify patients at risk for high healthcare utilization beyond a physical therapy episode for musculoskeletal pain. The purpose of this ... Full text Link to item Cite

The Central Sensitization Inventory and Pain Sensitivity Questionnaire: An exploration of construct validity and associations with widespread pain sensitivity among individuals with shoulder pain.

Journal Article Musculoskelet Sci Pract · August 2018 BACKGROUND: The Central Sensitization Inventory (CSI) and Pain Sensitivity Questionnaire (PSQ) are alternatives to quantitative sensory testing (QST) for inferring central sensitization. OBJECTIVE: Explore 1) comparative validity of the CSI and PSQ with QS ... Full text Link to item Cite

Optimal Screening for Prediction of Referral and Outcome (OSPRO) for Musculoskeletal Pain Conditions: Results From the Validation Cohort.

Journal Article J Orthop Sports Phys Ther · June 2018 Study Design Observational, prospective cohort. Background Musculoskeletal pain is a common reason to seek health care, and earlier nonpharmacological treatment and enhancement of personalized care options are 2 high-priority areas. Validating concise asse ... Full text Link to item Cite

Prediction of Persistent Musculoskeletal Pain at 12 Months: A Secondary Analysis of the Optimal Screening for Prediction of Referral and Outcome (OSPRO) Validation Cohort Study.

Journal Article Phys Ther · May 1, 2018 BACKGROUND: Musculoskeletal pain is a societal epidemic because it is highly prevalent and a leading contributor to disability; however, physical therapists are still challenged when predicting which patients are at high risk for persistent symptoms. OBJEC ... Full text Link to item Cite

Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

Journal Article Phys Ther · May 1, 2018 There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical ... Full text Link to item Cite

Response

Journal Article Journal of Orthopaedic and Sports Physical Therapy · May 1, 2018 Cite

REGARDING "UNRAVELING THE MECHANISMS OF MANUAL THERAPY" RESPONSE

Journal Article JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY · May 1, 2018 Link to item Cite

Red flag screening for low back pain: nothing to see here, move along: a narrative review.

Journal Article Br J Sports Med · April 2018 Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. ... Full text Link to item Cite

Expectancy Reduces Symptoms but not Functional Impairment Following Exercise-induced Musculoskeletal Injury.

Journal Article Clin J Pain · January 2018 OBJECTIVES: To quantify the extent to which the participant-provider interaction influences the response to sham treatment following exercised-induced acute musculoskeletal pain. MATERIALS AND METHODS: In total, 40 participants between the ages of 18 and 3 ... Full text Link to item Cite

Unraveling the Mechanisms of Manual Therapy: Modeling an Approach.

Journal Article J Orthop Sports Phys Ther · January 2018 Synopsis Manual therapy interventions are popular among individual health care providers and their patients; however, systematic reviews do not strongly support their effectiveness. Small treatment effect sizes of manual therapy interventions may result fr ... Full text Link to item Cite

Benefits and Threats to Using Social Media for Presenting and Implementing Evidence.

Journal Article J Orthop Sports Phys Ther · January 2018 As a potential high-yield tool for disseminating information that can reach many people, social media is transforming how clinicians, the public, and policy makers are educated and find new knowledge associated with research-related information. Social med ... Full text Link to item Cite

Can a power law improve prediction of pain recovery trajectory?

Journal Article Pain Rep · 2018 INTRODUCTION: Chronic pain results from complex interactions of different body systems. Time-dependent power laws have been used in physics, biology, and social sciences to identify when predictable output arises from complex systems. Power laws have been ... Full text Link to item Cite

Genetic and psychological factors interact to predict physical impairment phenotypes following exercise-induced shoulder injury.

Journal Article J Pain Res · 2018 BACKGROUND: We investigated interactions between genetic and psychological factors in predicting shoulder impairment phenotypes. We hypothesized that pro-inflammatory genes would display stronger relationships compared with pain-related genes when combined ... Full text Link to item Cite

Influence of Initial Provider on Health Care Utilization in Patients Seeking Care for Neck Pain.

Journal Article Mayo Clin Proc Innov Qual Outcomes · December 2017 OBJECTIVE: To examine patients seeking care for neck pain to determine associations between the type of provider initially consulted and 1-year health care utilization. PATIENTS AND METHODS: A retrospective cohort of 1702 patients (69.25% women, average ag ... Full text Open Access Link to item Cite

Comparison of 2 Lumbar Manual Therapies on Temporal Summation of Pain in Healthy Volunteers.

Journal Article J Pain · November 2017 UNLABELLED: The purpose of this study was to compare the immediate change in temporal summation of heat pain (TSP) between spinal manipulation (SMT) and spinal mobilization (MOB) in healthy volunteers. Ninety-two volunteers (24 male; 23.8 ± 5.3 years) were ... Full text Link to item Cite

Predicting Low Back Pain Outcomes: Suggestions for Future Directions.

Journal Article J Orthop Sports Phys Ther · September 2017 Chronic low back pain (LBP) is a common and costly musculoskeletal pain condition, and effective treatment of LBP represents a significant goal of physical therapists. Establishing a targeted track of treatment for patients with LBP at high risk for chroni ... Full text Link to item Cite

The Optimal Screening for Prediction of Referral and Outcome (OSPRO) in patients with musculoskeletal pain conditions: a longitudinal validation cohort from the USA.

Journal Article BMJ Open · June 8, 2017 PURPOSE: There is an increased need for determining which patients with musculoskeletal pain benefit from additional diagnostic testing or psychologically informed intervention. The Optimal Screening for Prediction of Referral and Outcome (OSPRO) cohort st ... Full text Link to item Cite

Effects of functional taping compared with sham taping and minimal intervention on pain intensity and static postural control for patients with non-specific chronic low back pain: a randomised clinical trial protocol.

Journal Article Physiotherapy · June 2017 OBJECTIVES: To investigate the immediate and 1-month effects of functional taping to lumbar spine for pain intensity and postural control in patients with chronic non-specific low back pain. DESIGN: Randomised clinical trial. PARTICIPANTS: One hundred and ... Full text Link to item Cite

Biopsychosocial influence on shoulder pain: Rationale and protocol for a pre-clinical trial.

Journal Article Contemp Clin Trials · May 2017 BACKGROUND: Chronic musculoskeletal pain conditions are a prevalent and disabling problem. Preventing chronic musculoskeletal pain requires multifactorial treatment approaches that address its complex etiology. Prior cohort studies identified a high risk s ... 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

Application of a Value Model for the Prevention and Management of Chronic Musculoskeletal Pain by Physical Therapists.

Journal Article Phys Ther · March 1, 2017 For physical therapists, establishing value of care is vitally important in the management of musculoskeletal pain. Value has become an important outcome measure in health care, largely as the result of payment reform efforts aimed at reducing wasteful spe ... 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

Pain Management: Road Map to Revolution.

Journal Article Phys Ther · February 1, 2017 Steven Z. George, PT, PhD, is a profound scholar whose contributions to the science of musculoskeletal pain rehabilitation have been both impactful and innovative to the area of clinical practice, as well as the profession at large. Highly regarded as an e ... Full text Link to item Cite

Patient-defined desired outcome, success criteria, and expectation in outpatient physical therapy: a longitudinal assessment.

Journal Article Health Qual Life Outcomes · January 31, 2017 BACKGROUND: Patient-centered approaches offer an alternative method in evaluating treatment outcomes. This study investigated; 1) if patient's criteria for success (satisfaction of clinical outcomes) changes from pre to post treatment, 2) whether patients ... Full text Link to item Cite

Optimism Moderates the Influence of Pain Catastrophizing on Shoulder Pain Outcome: A Longitudinal Analysis.

Journal Article J Orthop Sports Phys Ther · January 2017 Study Design Secondary analysis of prospectively collected data. Background An abundance of evidence has highlighted the influence of pain catastrophizing and fear avoidance on clinical outcomes. Less is known about the interaction of positive psychologica ... Full text Link to item Cite

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis.

Journal Article J Pain · January 2017 UNLABELLED: Identification of patient characteristics influencing treatment outcomes is a top low back pain (LBP) research priority. Results from the STarT Back trial support the effectiveness of prognostic stratified care for LBP compared with current bes ... Full text Link to item Cite

Fear of Reinjury in Athletes.

Journal Article Sports Health · 2017 CONTEXT: A sports injury has both physical and psychological consequences for the athlete. A common postinjury psychological response is elevated fear of reinjury. OBJECTIVE: To provide an overview of the implications of fear of reinjury on the rehabilitat ... Full text Link to item Cite

Association between physical activity and pain processing in adults with chronic low back pain compared to pain-free controls.

Journal Article J Back Musculoskelet Rehabil · 2017 BACKGROUND: Pain sensitivity has been negatively associated with physical activity levels. Few studies have examined associations between experimentally induced pain sensitivity and physical activity in adults with chronic low back pain and pain-free contr ... Full text Link to item Cite

Pain sensitivity and torque used during measurement predicts change in range of motion at the knee.

Journal Article J Pain Res · 2017 OBJECTIVE: To determine the extent to which changes in knee range of motion (ROM) after a stretching program are related to sensory factors at the time of testing and the amount of force used during the measurement of ROM, rather than changes in soft-tissu ... Full text Link to item Cite

Clinical Outcomes, Utilization, and Charges in Persons With Neck Pain Receiving Guideline Adherent Physical Therapy.

Journal Article Eval Health Prof · December 2016 In efforts to decrease practice variation, clinical practice guidelines for neck pain have been published. The purpose of this study was to determine the effect of receiving guideline adherent physical therapy (PT) on clinical outcomes, health care utiliza ... Full text Open Access Link to item Cite

Association of Quadriceps Strength and Psychosocial Factors With Single-Leg Hop Performance in Patients With Meniscectomy.

Journal Article Orthop J Sports Med · December 2016 BACKGROUND: Clinicians use the single-leg hop test to assess readiness for return to sports after knee injury. Few studies have reported the results of single-leg hop testing after meniscectomy. Additionally, the contributions of impairments in quadriceps ... Full text Link to item Cite

Biopsychosocial Influence on Shoulder Pain: Influence of Genetic and Psychological Combinations on Twelve-Month Postoperative Pain and Disability Outcomes.

Journal Article Arthritis Care Res (Hoboken) · November 2016 OBJECTIVE: To identify novel combinations of genetic and psychological factors that predicted 12-month postoperative pain and disability outcomes following arthroscopic shoulder surgery. METHODS: A prospective presurgical cohort (n = 150) was recruited to ... Full text Link to item Cite

Psychological Factors Are Related to Pain Intensity in Back-Healthy People Who Develop Clinically Relevant Pain During Prolonged Standing: A Preliminary Study.

Journal Article PM R · November 2016 BACKGROUND: An induced-pain paradigm has been used to examine risk factors for the development of low back pain (LBP) during prolonged standing in back-healthy people (standing paradigm). Previous studies that used induced-pain methods suggest that pain in ... Full text Link to item Cite

Photobiomodulation delays the onset of skeletal muscle fatigue in a dose-dependent manner.

Journal Article Lasers Med Sci · September 2016 Photobiomodulation (PBM) therapy has been implicated as an effective ergogenic aid to delay the onset of muscle fatigue. The purpose of this study was to examine the dose-response ergogenic properties of PBM therapy and its ability to prolong time to task ... Full text Link to item Cite

The Development of a Technology-Based Hierarchy to Assess Chronic Low Back Pain and Pain-Related Anxiety From a Fear-Avoidance Model.

Journal Article J Pain · August 2016 UNLABELLED: Previous studies have not examined the assessment of chronic low back pain (CLBP) and pain-related anxiety from a fear avoidance model through the use of motion-capture software and virtual human technologies. The aim of this study was to devel ... Full text Link to item Cite

Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions.

Journal Article Phys Ther · August 2016 BACKGROUND: The STarT Back Screening Tool is a validated multidimensional screening measure and risk stratification tool for people with low back pain. OBJECTIVE: The study objective was to compare relationships between a modified STarT Back Screening Tool ... Full text Link to item Cite

A value proposition for early physical therapist management of neck pain: a retrospective cohort analysis.

Journal Article BMC Health Serv Res · July 12, 2016 BACKGROUND: Neck pain is one of the most common reasons for entry into the healthcare system. Recent increases in healthcare utilization and medical costs have not correlated with improvements in health. Therefore there is a need to identify management str ... Full text Open Access Link to item Cite

Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity.

Journal Article Phys Ther · July 2016 BACKGROUND: Because of its high global burden, determining biopsychosocial influences of chronic low back pain (CLBP) is a research priority. Psychological factors such as pain catastrophizing are well established. However, cognitive factors such as workin ... Full text Link to item Cite

Predicting Pain and Disability After Shoulder Arthroscopy: Rotator Cuff Tear Severity and Concomitant Arthroscopic Procedures.

Journal Article Clin J Pain · May 2016 OBJECTIVES: Study the influence of concomitant arthroscopic procedures and rotator cuff tear (RCT) severity on daily pain intensity and disability after shoulder arthroscopy. MATERIALS AND METHODS: A sample of 145 patients (mean age, 42.66±17.6; number of ... Full text Link to item Cite

Development of a Yellow Flag Assessment Tool for Orthopaedic Physical Therapists: Results From the Optimal Screening for Prediction of Referral and Outcome (OSPRO) Cohort.

Journal Article J Orthop Sports Phys Ther · May 2016 Study Design Clinical measurement, cross-sectional. Background Pain-associated psychological distress adversely influences outcomes for patients with musculoskeletal pain. However, assessment of pain-associated psychological distress (ie, yellow flags) is ... Full text Link to item Cite

Older Age as a Prognostic Factor of Attenuated Pain Recovery After Shoulder Arthroscopy.

Journal Article PM R · April 2016 BACKGROUND: Shoulder pain and surgery are common among older adults. However, the extent to which older age affects recovery after shoulder surgery is not well understood. OBJECTIVE: To assess influence of older age on postoperative recovery factors 3 and ... Full text Link to item Cite

Low- Versus High-Intensity Plyometric Exercise During Rehabilitation After Anterior Cruciate Ligament Reconstruction.

Journal Article Am J Sports Med · March 2016 BACKGROUND: Plyometric exercise is used during rehabilitation after anterior cruciate ligament (ACL) reconstruction to facilitate the return to sports participation. However, clinical outcomes have not been examined, and high loads on the lower extremity c ... Full text Link to item Cite

Preoperative physical therapy treatment did not influence postoperative pain and disability outcomes in patients undergoing shoulder arthroscopy: a prospective study.

Journal Article J Pain Res · 2016 BACKGROUND: There is limited literature investigating preoperative physical therapy (pre-op PT) treatment on pain intensity and disability after musculoskeletal surgery. The purposes of the present cohort study were to describe patient characteristics for ... Full text Link to item Cite

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

Journal Article J Pain · January 2016 UNLABELLED: The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults unde ... Full text Link to item Cite

Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.

Journal Article J Pain · December 2015 UNLABELLED: Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however response to TENS in older adults comp ... Full text Link to item Cite

Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain.

Journal Article Arch Phys Med Rehabil · October 2015 OBJECTIVE: To determine the effect of clinical presentations of neck pain on short-term physical therapy outcomes. DESIGN: Retrospective analysis of pair-matched groups from a clinical cohort. SETTING: Thirteen outpatient physical therapy clinics in 1 heal ... Full text Open Access Link to item Cite

Pain Sensitivity and Pain Catastrophizing Are Associated With Persistent Pain and Disability After Lumbar Spine Surgery.

Journal Article Arch Phys Med Rehabil · October 2015 OBJECTIVE: To examine whether pain sensitivity and pain catastrophizing are associated with persistent pain and disability after lumbar spine surgery. DESIGN: Prospective observational cohort study. SETTING: Academic medical center. PARTICIPANTS: Patients ... Full text Link to item Cite

Knowledge of injury prevention and prevalence of risk factors for throwing injuries in a sample of youth baseball players.

Journal Article Int J Sports Phys Ther · August 2015 BACKGROUND: Information on baseball injury prevention and pitch count recommendations is growing, however, the incidence of throwing injuries continues to rise. This study is the first to assess knowledge of safe throwing guidelines and risk factors from t ... Link to item Cite

Pragmatic Implementation of a Stratified Primary Care Model for Low Back Pain Management in Outpatient Physical Therapy Settings: Two-Phase, Sequential Preliminary Study.

Journal Article Phys Ther · August 2015 BACKGROUND: The effectiveness of risk stratification for low back pain (LBP) management has not been demonstrated in outpatient physical therapy settings. OBJECTIVE: The purposes of this study were: (1) to assess implementation of a stratified care approac ... Full text Link to item Cite

Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations.

Journal Article Pain · July 2015 Although certain risk factors can identify individuals who are most likely to develop chronic pain, few interventions to prevent chronic pain have been identified. To facilitate the identification of preventive interventions, an IMMPACT meeting was convene ... Full text Link to item Cite

Development of a Review-of-Systems Screening Tool for Orthopaedic Physical Therapists: Results From the Optimal Screening for Prediction of Referral and Outcome (OSPRO) Cohort.

Journal Article J Orthop Sports Phys Ther · July 2015 STUDY DESIGN: Literature review and cross-sectional study. BACKGROUND: Direct access to physical therapy necessitates greater responsibility to determine appropriateness of care by recognizing the potential for concomitant disease or systemic involvement. ... Full text Link to item Cite

Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing.

Journal Article Clin J Pain · July 2015 OBJECTIVES: Examine the validity of an induced pain paradigm in which people stand while performing simulated light work tasks (standing paradigm). MATERIALS AND METHODS: Initially, people with low back pain (LBP) reported the quality and location of their ... Full text Link to item Cite

Implications of early and guideline adherent physical therapy for low back pain on utilization and costs.

Journal Article BMC Health Serv Res · April 9, 2015 BACKGROUND: Initial management decisions following a new episode of low back pain (LBP) are thought to have profound implications for health care utilization and costs. The purpose of this study was to evaluate the impact of early and guideline adherent ph ... Full text Link to item Cite

Clinical characteristics of patients with cancer referred for outpatient physical therapy.

Journal Article Phys Ther · April 2015 BACKGROUND: Cancer rehabilitation is a developing area, with an increasing number of survivors of cancer in the United States. The increase in survivorship occurs alongside impairments arising directly from cancer or from treatment-related side effects. OB ... Full text Link to item Cite

The comparative effects of spinal and peripheral thrust manipulation and exercise on pain sensitivity and the relation to clinical outcome: a mechanistic trial using a shoulder pain model.

Journal Article J Orthop Sports Phys Ther · April 2015 STUDY DESIGN: Single-blind randomized trial. OBJECTIVES: To compare the effects of cervical and shoulder thrust manipulation (TM) and exercise on pain sensitivity, and to explore associations with clinical outcomes in patients with shoulder pain. BACKGROUN ... Full text Link to item Cite

Psychological predictors of recovery from low back pain: a prospective study.

Journal Article BMC Musculoskelet Disord · March 7, 2015 BACKGROUND: Recovery from low back pain (LBP) is an important outcome for patients and clinicians. Psychological factors are known to impact the course of LBP but have not been extensively investigated for predicting recovery. The purposes of this study we ... Full text Link to item Cite

Painful intercourse is significantly associated with evoked pain perception and cognitive aspects of pain in women with pelvic pain.

Journal Article Sex Med · March 2015 INTRODUCTION: Evidence suggests that painful intercourse, pain-related psychosocial factors, and altered pain processing magnify the pain experience, but it is not clear how these factors are related to each other. AIM: The aims were to (i) characterize di ... Full text Link to item Cite

Range of motion as a predictor of clinical shoulder pain during recovery from delayed-onset muscle soreness.

Journal Article J Athl Train · March 2015 CONTEXT: Athletic trainers use clinical pain and range of motion (ROM) to gauge recovery after musculoskeletal injury. Limited evidence to date suggests which shoulder ROM measures can predict symptomatic relief and functional recovery after delayed-onset ... Full text Link to item Cite

Comparison of physical impairment, functional, and psychosocial measures based on fear of reinjury/lack of confidence and return-to-sport status after ACL reconstruction.

Journal Article Am J Sports Med · February 2015 BACKGROUND: Fear of reinjury and lack of confidence influence return-to-sport outcomes after anterior cruciate ligament (ACL) reconstruction. The physical, psychosocial, and functional recovery of patients reporting fear of reinjury or lack of confidence a ... Full text Link to item Cite

Effect of a perspective-taking intervention on the consideration of pain assessment and treatment decisions.

Journal Article J Pain Res · 2015 OBJECTIVES: Pain is often poorly managed, highlighting the need to better understand and treat patients' pain. Research suggests that pain is assessed and treated differently depending on patient sex, race, and/or age. Perspective-taking, whereby one envis ... Full text Link to item Cite

Biopsychosocial influence on shoulder pain: risk subgroups translated across preclinical and clinical prospective cohorts.

Journal Article Pain · January 2015 Tailored treatment based on individual risk factors is an area with promise to improve options for pain relief. Musculoskeletal pain has a biopsychosocial nature, and multiple factors should be considered when determining risk for chronic pain. This study ... Full text Link to item Cite

Subgrouping for patients with low back pain: a multidimensional approach incorporating cluster analysis and the STarT Back Screening Tool.

Journal Article J Pain · January 2015 UNLABELLED: Early screening for psychological distress has been suggested to improve patient management for individuals experiencing low back pain. This study compared 2 approaches to psychological screening (ie, multidimensional and unidimensional) so tha ... Full text Link to item Cite

Incremental Effects of Telephone Call Center and Healthcare Utilization Database Use to Improve Follow-up Rate in the Prevention of Low Back Pain in the Military Trial.

Journal Article US Army Med Dep J · 2015 BACKGROUND: Studies that have relied exclusively on web-based surveys to secure follow-up have yielded inadequate follow-up rates, resulting in the need to explore whether supplementing with other methods results in incremental improvements. The primary pu ... Link to item Cite

Near-infrared light therapy to attenuate strength loss after strenuous resistance exercise.

Journal Article J Athl Train · January 2015 CONTEXT: Near-infrared (NIR) light therapy is purported to act as an ergogenic aid by enhancing the contractile function of skeletal muscle. Improving muscle function is a new avenue for research in the area of laser therapy; however, very few researchers ... Full text Link to item Cite

Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services.

Journal Article J Orthop Sports Phys Ther · December 2014 STUDY DESIGN: Retrospective analysis of episodes of care. OBJECTIVE: To assess the implications of practice setting (hospital outpatient settings versus private practice) on clinical outcomes and efficiency of care in the delivery of physical therapy servi ... Full text Open Access Link to item Cite

Content and bibliometric analyses of the Journal of Manual & Manipulative Therapy.

Journal Article J Man Manip Ther · November 2014 BACKGROUND: Article characteristics and trends have been elucidated for other physical therapy-focused journals using content and bibliometric analysis. These findings are important for assessing the current state of a journal and for guiding future public ... Full text Link to item Cite

Incidence and risk factors for first-time incident low back pain: a systematic review and meta-analysis.

Journal Article Spine J · October 1, 2014 BACKGROUND CONTEXT: Great effort has been made toward limiting low back pain (LBP). Recent focus has included factors involved with secondary and tertiary prevention, with less attention given to primary prevention. PURPOSE: This review provided a current ... Full text Link to item Cite

Inflammatory genes and psychological factors predict induced shoulder pain phenotype.

Journal Article Med Sci Sports Exerc · October 2014 PURPOSE: The pain experience has multiple influences, but little is known about how specific biological and psychological factors interact to influence pain responses. The current study investigated the combined influences of genetic (pro-inflammatory) and ... Full text Link to item Cite

Resistance exercise, disability, and pain catastrophizing in obese adults with back pain.

Journal Article Med Sci Sports Exerc · September 2014 PURPOSE: The purpose of this study was to compare the effects of two different resistance exercise protocols on self-reported disability, fear avoidance beliefs, pain catastrophizing, and back pain symptoms in obese, older adults with low back pain (LBP). ... Full text Link to item Cite

The STarT Back Screening Tool for prediction of 6-month clinical outcomes: relevance of change patterns in outpatient physical therapy settings.

Journal Article J Orthop Sports Phys Ther · September 2014 STUDY DESIGN: Observational cohort. OBJECTIVES: To describe changes in STarT Back Tool (SBT) categorization following 4 weeks of outpatient physical therapy and to evaluate predictive capabilities of SBT categorization when administered at multiple time po ... Full text Link to item Cite

Investigation of central pain processing in postoperative shoulder pain and disability.

Journal Article Clin J Pain · September 2014 BACKGROUND: Measures of central pain processing like conditioned pain modulation and suprathreshold heat pain response (SHPR) have been described to assess different components of central pain modulatory mechanisms. Central pain processing potentially play ... Full text Link to item Cite

Pain sensitivity subgroups in individuals with spine pain: potential relevance to short-term clinical outcome.

Journal Article Phys Ther · August 2014 BACKGROUND: Cluster analysis can be used to identify individuals similar in profile based on response to multiple pain sensitivity measures. There are limited investigations into how empirically derived pain sensitivity subgroups influence clinical outcome ... Full text Link to item Cite

Inter-rater reliability of select physical examination procedures in patients with neck pain.

Journal Article Physiother Theory Pract · July 2014 This study evaluated the inter-rater reliability of select examination procedures in patients with neck pain (NP) conducted over a 24- to 48-h period. Twenty-two patients with mechanical NP participated in a standardized examination. One examiner performed ... Full text Link to item Cite

The role of anger in psychosocial subgrouping for patients with low back pain.

Journal Article Clin J Pain · June 2014 BACKGROUND: Low back pain (LBP) is a common and costly condition that often becomes chronic if not properly addressed. Recent research has shown that psychosocial symptoms can complicate LBP, necessitating more comprehensive screening measures. AIM: The pr ... Full text Link to item Cite

Back strength predicts walking improvement in obese, older adults with chronic low back pain.

Journal Article PM R · May 2014 OBJECTIVE: To compare the effects of 4 months of isolated lumbar resistance exercise and total body resistance exercise on walking performance in obese, older adults with chronic low back pain. A secondary analysis examined whether responsiveness to traini ... Full text Link to item Cite

The impact of patients' gender, race, and age on health care professionals' pain management decisions: an online survey using virtual human technology.

Journal Article Int J Nurs Stud · May 2014 BACKGROUND: Previous literature indicates that biases exist in pain ratings. Healthcare professionals have been found to use patient demographic cues such as sex, race, and age when making decisions about pain treatment. However, there has been little rese ... Full text Link to item Cite

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

Journal Article Spine J · April 2014 BACKGROUND CONTEXT: Effective strategies for preventing low back pain (LBP) have remained elusive, despite annual direct health care costs exceeding $85 billion dollars annually. In our recently completed Prevention of Low Back Pain in the Military (POLM) ... Full text Link to item Cite

Future directions in painful knee osteoarthritis: harnessing complexity in a heterogeneous population.

Journal Article Phys Ther · March 2014 This perspective article proposes a conceptual model for the pain experience for individuals diagnosed with knee osteoarthritis (OA). Pain in knee OA is likely a heterogeneous, multifactorial phenomenon that involves not only the OA disease process but als ... Full text Link to item Cite

Psychological influences predict recovery following exercise induced shoulder pain.

Journal Article Int J Sports Med · March 2014 Predicting recovery following muscle injury can be difficult because it involves consideration of multiple factors. Our objective was to determine if psychological factors, sex, and peak pain and disability ratings could be predictive of delayed recovery f ... Full text Link to item Cite

Spinal manipulative therapy-specific changes in pain sensitivity in individuals with low back pain (NCT01168999).

Journal Article J Pain · February 2014 UNLABELLED: Spinal manipulative therapy (SMT) is effective for some individuals experiencing low back pain; however, the mechanisms are not established regarding the role of placebo. SMT is associated with changes in pain sensitivity, suggesting related al ... Full text Open Access Link to item Cite

Experimental pain responses support peripheral and central sensitization in patients with unilateral shoulder pain.

Journal Article Clin J Pain · February 2014 OBJECTIVE: The aims of this study were to (1) examine the pattern of experimental pain responses in the affected and nonaffected extremities in patients with shoulder pain and (2) explore the intraindividual association between sensitization states derived ... Full text Link to item Cite

Suprathreshold heat pain response predicts activity-related pain, but not rest-related pain, in an exercise-induced injury model.

Journal Article PLoS One · 2014 Exercise-induced injury models are advantageous for studying pain since the onset of pain is controlled and both pre-injury and post-injury factors can be utilized as explanatory variables or predictors. In these studies, rest-related pain is often conside ... Full text Link to item Cite

Biopsychosocial influence on exercise-induced injury: genetic and psychological combinations are predictive of shoulder pain phenotypes.

Journal Article J Pain · January 2014 UNLABELLED: Chronic pain is influenced by biological, psychological, social, and cultural factors. The current study investigated potential roles for combinations of genetic and psychological factors in the development and/or maintenance of chronic musculo ... Full text Link to item Cite

Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain.

Journal Article J Manipulative Physiol Ther · 2014 OBJECTIVE: The purposes of this study were to use functional magnetic resonance imaging to investigate the immediate changes in functional connectivity (FC) between brain regions that process and modulate the pain experience after 3 different types of manu ... Full text Link to item Cite

Patient-reported upper extremity outcome measures used in breast cancer survivors: a systematic review.

Journal Article Arch Phys Med Rehabil · January 2014 OBJECTIVES: (1) To identify English-language published patient-reported upper extremity outcome measures used in breast cancer research and (2) to examine construct validity and responsiveness in patient-reported upper extremity outcome measures used in br ... Full text Link to item Cite

Development of a preliminary clinical prediction rule to identify patients with neck pain that may benefit from a standardized program of stretching and muscle performance exercise: a prospective cohort study.

Journal Article Int J Sports Phys Ther · December 2013 BACKGROUND AND PURPOSE: Neck pain is a significant problem and many treatment options exist. While some studies suggest exercise is beneficial for individuals with non-specific neck pain clinicians have few tools to assist in the decision making process. T ... Link to item Cite

Pain assessment and treatment decisions for virtual human patients.

Journal Article Cyberpsychol Behav Soc Netw · December 2013 Laypeople and healthcare professionals use demographic cues when making pain management decisions. These decisions can negatively affect patient outcomes. This study examined whether laypeople base their pain management decisions in part on pain-related po ... Full text Link to item Cite

Assessing the influence of treating therapist and patient prognostic factors on recovery from axial pain.

Journal Article J Man Manip Ther · November 2013 BACKGROUND: Limited research exists regarding the influence of a treating physical therapist on patient recovery (deemed therapist effects). Recent randomized clinical trials data provide an indication of small therapist effects for manual therapy; however ... Full text Link to item Cite

Effect of two different exercise regimens on trunk muscle morphometry and endurance in soldiers in training.

Journal Article Phys Ther · September 2013 BACKGROUND: Limited evidence exists on how strength and endurance exercises commonly used to prevent low back pain affect muscle morphometry and endurance. OBJECTIVE: The purpose of this study was to analyze the effects of 2 exercise regimens on the morpho ... Full text Link to item Cite

Stability of conditioned pain modulation in two musculoskeletal pain models: investigating the influence of shoulder pain intensity and gender.

Journal Article BMC Musculoskelet Disord · June 10, 2013 BACKGROUND: Several chronic pain populations have demonstrated decreased conditioned pain modulation (CPM). However there is still a need to investigate the stability of CPM paradigms before the measure can be recommended for implementation. The purpose of ... Full text Link to item Cite

The STarT back screening tool and individual psychological measures: evaluation of prognostic capabilities for low back pain clinical outcomes in outpatient physical therapy settings.

Journal Article Phys Ther · March 2013 BACKGROUND: Psychologically informed practice emphasizes routine identification of modifiable psychological risk factors being highlighted. OBJECTIVE: The purpose of this study was to test the predictive validity of the STarT Back Screening Tool (SBT) in c ... Full text Link to item Cite

Temporal summation of second pain: variability in responses to a fixed protocol.

Journal Article Eur J Pain · January 2013 BACKGROUND: Temporal summation of second pain (TSSP) is relevant for the study of central sensitization, and refers to increased pain evoked by repetitive stimuli at a constant intensity. While the literature reports on participants whose pain ratings incr ... Full text Link to item Cite

Return to preinjury sports participation following anterior cruciate ligament reconstruction: contributions of demographic, knee impairment, and self-report measures.

Journal Article J Orthop Sports Phys Ther · November 2012 STUDY DESIGN: Cross-sectional cohort. OBJECTIVES: (1) To examine differences in clinical variables (demographics, knee impairments, and self-report measures) between those who return to preinjury level of sports participation and those who do not at 1 year ... Full text Link to item Cite

Impact of psychosocial factors, pain, and functional limitations on throwing athletes who return to sport following elbow injuries: a case series.

Journal Article Physiother Theory Pract · November 2012 BACKGROUND AND PURPOSE: The purpose of this case series is to explore the possibility that: (1) throwing athletes respond to fear-avoidance model (FAM) measures differently than patients in other orthopedic populations; and (2) there is an association betw ... Full text Link to item Cite

Basis for spinal manipulative therapy: a physical therapist perspective.

Journal Article J Electromyogr Kinesiol · October 2012 Physical therapists internationally provide spinal manipulative therapy (SMT) to patients with musculoskeletal pain complaints. SMT has been a part of physical therapist practice since the profession's beginning. Early physical therapist clinical decision ... Full text Link to item Cite

Low back pain subgroups using fear-avoidance model measures: results of a cluster analysis.

Journal Article Clin J Pain · October 2012 OBJECTIVES: The purpose of this secondary analysis was to test the hypothesis that an empirically derived psychological subgrouping scheme based on multiple Fear-Avoidance Model (FAM) constructs would provide additional capabilities for clinical outcomes i ... Full text Link to item Cite

Changes in pain sensitivity following spinal manipulation: a systematic review and meta-analysis.

Journal Article J Electromyogr Kinesiol · October 2012 Spinal manipulation (SMT) is commonly used for treating individuals experiencing musculoskeletal pain. The mechanisms of SMT remain unclear; however, pain sensitivity testing may provide insight into these mechanisms. The purpose of this systematic review ... Full text Link to item Cite

Dynamic, but not static, pain sensitivity predicts exercise-induced muscle pain: covariation of temporal sensory summation and pain intensity.

Journal Article Neurosci Lett · September 20, 2012 Cross-section studies suggest that measures of pain sensitivity, derived from quantitative sensory testing (QST), are elevated in persons with chronic pain conditions. However, little is known about whether development of chronic pain is preceded by elevat ... Full text Link to item Cite

Neurochemical analysis of primary motor cortex in chronic low back pain.

Journal Article Brain Sci · September 1, 2012 The involvement of the primary motor cortex (M1) in chronic low back pain (LBP) is a relatively new concept. Decreased M1 excitability and an analgesic effect after M1 stimulation have been recently reported. However, the neurochemical changes underlying t ... Full text Link to item Cite

Abdominal and lumbar multifidus muscle size and symmetry at rest and during contracted States. Normative reference ranges.

Journal Article J Ultrasound Med · July 2012 OBJECTIVES: The purpose of this study was to establish reference values for abdominal and lumbar multifidus muscles at rest and while contracted in a sample of active healthy adults. METHODS: Three hundred forty participants (mean age ± SD, 21.8 ± 3.9 year ... Full text Link to item Cite

Editorial Board Response

Journal Article Physical Therapy · June 1, 2012 Full text Cite

Pain-related fear and catastrophizing predict pain intensity and disability independently using an induced muscle injury model.

Journal Article J Pain · April 2012 UNLABELLED: Timing of assessment of psychological construct is controversial and results differ based on the model of pain induction. Previous studies have not used an exercise-induced injury model to investigate timing of psychological assessment. Exercis ... Full text Link to item Cite

Low back pain.

Journal Article J Orthop Sports Phys Ther · April 2012 The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World H ... Full text Link to item Cite

Preliminary results of patient-defined success criteria for individuals with musculoskeletal pain in outpatient physical therapy settings.

Journal Article Arch Phys Med Rehabil · March 2012 OBJECTIVES: (1) To investigate patient-defined parameters of treatment success in an outpatient physical therapy setting with musculoskeletal pain, (2) to determine whether patient-defined treatment success was influenced by selected demographic and clinic ... Full text Link to item Cite

Single-item screens identified patients with elevated levels of depressive and somatization symptoms in outpatient physical therapy.

Journal Article Qual Life Res · March 2012 OBJECTIVE: Develop efficient and accurate screening tools to identify elevated levels of depressive or somatization symptoms, which can adversely affect functional status outcomes. METHODS: We conducted a secondary analysis of prospectively collected depre ... Full text Link to item Cite

Analysis of shortened versions of the tampa scale for kinesiophobia and pain catastrophizing scale for patients after anterior cruciate ligament reconstruction.

Journal Article Clin J Pain · January 2012 OBJECTIVE: Recent work suggests that psychological influence on pain intensity and knee function should be considered for patients after anterior cruciate ligament reconstruction (ACLR). The Tampa Scale for Kinesiophobia (TSK) and Pain Catastrophizing Scal ... Full text Link to item Cite

Predictors of occurrence and severity of first time low back pain episodes: findings from a military inception cohort.

Journal Article PLoS One · 2012 Primary prevention studies suggest that additional research on identifying risk factors predictive of low back pain (LBP) is necessary before additional interventions can be developed. In the current study we assembled a large military cohort that was init ... Full text Link to item Cite

Investigating patient expectations and treatment outcome in a chronic low back pain population.

Journal Article J Pain Res · 2012 OBJECTIVE: This study aimed to measure the outcomes that patients consider clinically meaningful across four treatment domains - (1) pain, (2) fatigue, (3) emotional distress, and (4) level of interference - and determine if patients met their own success ... Full text Link to item Cite

Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models.

Journal Article J Pain · January 2012 UNLABELLED: Recent reports suggest deficits in conditioned pain modulation (CPM) and enhanced suprathreshold heat pain response (SHPR) potentially play a role in the development of chronic pain. The purpose of this study was to investigate whether central ... Full text Link to item Cite

Magnitude of spinal muscle damage is not statistically associated with exercise-induced low back pain intensity.

Journal Article Spine J · December 2011 BACKGROUND CONTEXT: Findings on imaging of noncontractile anatomic abnormalities and the intensity of low back pain have weak associations because of false-positive rates among asymptomatic individuals. This association might be stronger for contractile ti ... Full text Open Access Link to item Cite

Content and bibliometric analysis of articles published in the Journal of Orthopaedic & Sports Physical Therapy.

Journal Article J Orthop Sports Phys Ther · December 2011 STUDY DESIGN: Descriptive bibliometric analysis. BACKGROUND: Content and bibliometric studies are useful for describing the publication patterns of a given profession, such as physical therapy, within the medical and allied health fields. However, few stud ... Full text Link to item Cite

Heightened pain sensitivity in individuals with signs and symptoms of carpal tunnel syndrome and the relationship to clinical outcomes following a manual therapy intervention.

Journal Article Man Ther · December 2011 Neurophysiological responses related to lessening of pain sensitivity are a suggested mechanism of manual therapy. Prior studies have observed generalized lower pain thresholds associated with carpal tunnel syndrome (CTS) in comparison to healthy controls. ... Full text Link to item Cite

Change in psychosocial distress associated with pain and functional status outcomes in patients with lumbar impairments referred to physical therapy services.

Journal Article J Orthop Sports Phys Ther · December 2011 STUDY DESIGN: Prospective, longitudinal, observational cohort design. OBJECTIVE: The primary aim was to examine the association between changes in psychosocial distress (PD), and functional status (FS) and pain intensity at discharge from physical therapy. ... Full text Link to item Cite

Using intake and change in multiple psychosocial measures to predict functional status outcomes in people with lumbar spine syndromes: a preliminary analysis.

Journal Article Phys Ther · December 2011 BACKGROUND: Managing patients with lumbar spine syndromes who are seeking outpatient physical therapy represents a complex problem where psychosocial constructs such as fear-avoidance beliefs regarding physical activities or work activities, somatization, ... Full text Link to item Cite

Brief psychosocial education, not core stabilization, reduced incidence of low back pain: results from the Prevention of Low Back Pain in the Military (POLM) cluster randomized trial.

Journal Article BMC Med · November 29, 2011 BACKGROUND: Effective strategies for the primary prevention of low back pain (LBP) remain elusive with few large-scale clinical trials investigating exercise and education approaches. The purpose of this trial was to determine whether core stabilization al ... Full text Link to item Cite

Longitudinal changes in psychosocial factors and their association with knee pain and function after anterior cruciate ligament reconstruction.

Journal Article Phys Ther · September 2011 BACKGROUND: Evidence in the musculoskeletal rehabilitation literature suggests that psychosocial factors can influence pain levels and functional outcome. OBJECTIVE: The purpose of this study was to examine changes in select psychosocial factors and their ... Full text Link to item Cite

Total number and severity of comorbidities do not differ based on anatomical region of musculoskeletal pain.

Journal Article J Orthop Sports Phys Ther · July 2011 STUDY DESIGN: Secondary analysis, cross-sectional study. OBJECTIVES: To (1) compare differences in individual comorbidity rates among patients with cervical, lumbar, and extremity pain complaints and (2) compare rates based on total number and severity in ... Full text Link to item Cite

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

Journal Article BMC Musculoskelet Disord · June 13, 2011 BACKGROUND: Achieving adequate follow-up in clinical trials is essential to establish the validity of the findings. Achieving adequate response rates reduces bias and increases probability that the findings can be generalized to the population of interest. ... Full text Link to item Cite

Exercise-induced pain intensity predicted by pre-exercise fear of pain and pain sensitivity.

Journal Article Clin J Pain · June 2011 OBJECTIVES: Our primary goals were to determine whether preexisting fear of pain and pain sensitivity contributed to post-exercise pain intensity. METHODS: Delayed-onset muscle pain was induced in the trunk extensors of 60 healthy volunteers using an exerc ... Full text Open Access Link to item Cite

Immediate reduction in temporal sensory summation after thoracic spinal manipulation.

Journal Article Spine J · May 2011 BACKGROUND CONTEXT: Spinal manipulative techniques (SMT) have shown clinical effectiveness in some patients with musculoskeletal pain. PURPOSE: We performed the current experiment to test whether regional pain modulation is to be expected from thoracic SMT ... Full text Link to item Cite

Bibliometric analysis of articles published from 1980 to 2009 in Physical Therapy, journal of the American Physical Therapy Association.

Journal Article Phys Ther · May 2011 BACKGROUND: Recent evidence demonstrates growth in both the quality and quantity of evidence in physical therapy. Much of this work has focused on randomized controlled trials and systematic reviews. OBJECTIVE: The purpose of this study was to conduct a co ... Full text Link to item Cite

Effect of fear-avoidance beliefs of physical activities on a model that predicts risk-adjusted functional status outcomes in patients treated for a lumbar spine dysfunction.

Journal Article J Orthop Sports Phys Ther · May 2011 STUDY DESIGN: Retrospective analysis of a prospective, longitudinal cohort study of 30 858 patients being treated for a lumbar spine dysfunction in outpatient physical therapy. OBJECTIVES: To determine effect of adding a single-item screening variable clas ... Full text Link to item Cite

Psychologically informed interventions for low back pain: an update for physical therapists.

Journal Article Phys Ther · May 2011 A central theme of current evidence-based guidelines for managing low back pain is endorsement of the resumption of activities despite the presence of pain. This task can be challenging for both therapists and patients, and there are many essentially psych ... Full text Link to item Cite

Relationship between categorization with the STarT Back Screening Tool and prognosis for people receiving physical therapy for low back pain.

Journal Article Phys Ther · May 2011 BACKGROUND: The STarT Back Screening Tool (SBT) was recently developed for primary care providers to use as a screening tool for subgrouping people with low back pain (LBP) on the basis of modifiable prognostic factors. The use of the SBT in physical thera ... Full text Link to item Cite

Author response

Journal Article Physical Therapy · May 1, 2011 Full text Cite

Fear-avoidance beliefs and clinical outcomes for patients seeking outpatient physical therapy for musculoskeletal pain conditions.

Journal Article J Orthop Sports Phys Ther · April 2011 STUDY DESIGN: Prospective cohort. OBJECTIVE: To investigate fear-avoidance beliefs across different anatomical regions for patients with musculoskeletal pain. BACKGROUND: Fear-avoidance beliefs were first widely studied in patients with low back pain. The ... Full text Link to item Cite

Depressive symptoms, anatomical region, and clinical outcomes for patients seeking outpatient physical therapy for musculoskeletal pain.

Journal Article Phys Ther · March 2011 BACKGROUND: Clinical guidelines advocate the routine identification of depressive symptoms for patients with pain in the lumbar or cervical spine, but not for other anatomical regions. OBJECTIVE: The purpose of this study was to investigate the prevalence ... Full text Link to item Cite

Thermal and pressure pain sensitivity in patients with unilateral shoulder pain: comparison of involved and uninvolved sides.

Journal Article J Orthop Sports Phys Ther · March 2011 STUDY DESIGN: Cross-sectional. BACKGROUND: In the examination of patients with unilateral shoulder pain, pain provocation testing to compare the involved and uninvolved sides has been considered useful. However, side-to-side comparisons of experimental pai ... Full text Link to item Cite

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

Journal Article J Ultrasound Med · March 2011 OBJECTIVE: The purpose of this study was to determine the inter-rater reliability of ultrasound imaging for assessing trunk muscle morphologic characteristics at rest and while contracted among different pairs of novice raters. The secondary purpose was to ... Full text Link to item Cite

Self-reported pain and disability outcomes from an endogenous model of muscular back pain.

Journal Article BMC Musculoskelet Disord · February 2, 2011 BACKGROUND: Our purpose was to develop an induced musculoskeletal pain model of acute low back pain and examine the relationship among pain, disability and fear in this model. METHODS: Delayed onset muscle soreness was induced in 52 healthy volunteers (23 ... Full text Open Access Link to item Cite

Placebo response to manual therapy: something out of nothing?

Journal Article J Man Manip Ther · February 2011 The mechanisms through which manual therapy inhibits musculoskeletal pain are likely multifaceted and related to the interaction between the intervention, the patient, the practitioner, and the environment. Placebo is traditionally considered an inert inte ... Full text Link to item Cite

Socioeconomic status influences the relationship between fear-avoidance beliefs work and disability.

Journal Article Pain Med · February 2011 OBJECTIVE: Biopsychosocial models are currently accepted for study of low back pain (LBP), but there is little evidence investigating socioeconomic status (SES) influence on disability, pain intensity, and physical impairment. The present study examined SE ... Full text Link to item Cite

Clinical Investigation of Pain-related Fear and Pain Catastrophizing for Patients With Low Back Pain.

Journal Article Clin J Pain · February 2011 OBJECTIVE: to investigate select psychometric properties of fear-avoidance model measures commonly used to assess pain-related fear and catastrophizing in clinical studies of low back pain. METHODS: a convenience sample was recruited from patients (n=80) s ... Full text Link to item Cite

Sex differences in experimental and clinical pain sensitivity for patients with shoulder pain.

Journal Article Eur J Pain · February 2011 Previous research demonstrates that men and women differ in the way that they perceive and process pain. Much of this work has been done in healthy adults with a lack of consensus in clinical pain populations. The purpose of this study was to investigate h ... Full text Link to item Cite

Comparison of work-related fear-avoidance beliefs across different anatomical locations with musculoskeletal pain.

Journal Article J Pain Res · 2011 BACKGROUND: The influence of work-related fear-avoidance on pain and function has been consistently reported for patients with musculoskeletal low back pain. Emerging evidence suggests similar influences exist for other anatomical locations of musculoskele ... Full text Link to item Cite

Stability of behavioral estimates of activity-dependent modulation of pain.

Journal Article J Pain Res · 2011 Temporal sensory summation of pain (TSSP) is a proxy measure of windup in humans and results in increased ratings of pain caused by a repetitive, low-frequency noxious stimulus. Aftersensations (ASs) are pain sensations that remain after TSSP has been indu ... Full text Link to item Cite

Fear of movement, quality of life, and self-reported disability in obese patients with chronic lumbar pain.

Journal Article Pain Med · January 2011 OBJECTIVE: To compare fear of movement between obese and non-obese individuals seeking therapy for chronic low back pain and to examine whether fear of movement predicted disability due to back pain, self-reported walking disability, and flexibility. DESIG ... Full text Link to item Cite

Suprathreshold heat pain response is associated with clinical pain intensity for patients with shoulder pain.

Journal Article J Pain · January 2011 UNLABELLED: Quantitative sensory testing (QST) has become commonly used for the assessment of pain in subjects with clinical conditions. However, there is no consensus about which type of QST is the best predictor of clinical pain responses. The purposes o ... Full text Link to item Cite

Identifying patient fear-avoidance beliefs by physical therapists managing patients with low back pain.

Journal Article J Orthop Sports Phys Ther · December 2010 STUDY DESIGN: Cross-sectional. OBJECTIVES: To evaluate the accuracy with which physical therapists identify fear-avoidance beliefs in patients with low back pain by comparing therapist ratings of perceived patient fear-avoidance to the Fear-Avoidance Belie ... Full text Link to item Cite

Investigating patient characteristics on pain assessment using virtual human technology.

Journal Article Eur J Pain · November 2010 Pain assessment and treatment is challenging and can be influenced by patient demographic characteristics. Few research studies have been able to specifically examine these influences experimentally. The present study investigated the effects of patients' ... Full text Link to item Cite

Comparison of graded exercise and graded exposure clinical outcomes for patients with chronic low back pain.

Journal Article J Orthop Sports Phys Ther · November 2010 STUDY DESIGN: Quasi-experimental clinical trial. OBJECTIVES: This study compared outcomes from graded exercise and graded exposure activity prescriptions for patients participating in a multidisciplinary rehabilitation program for chronic low back pain. Ou ... Full text Link to item Cite

Preference, expectation, and satisfaction in a clinical trial of behavioral interventions for acute and sub-acute low back pain.

Journal Article J Pain · November 2010 UNLABELLED: The equivalency of behavioral interventions has led to the consideration of whether patient-related factors influence clinical trial outcomes. The primary purpose of this secondary analysis was to determine if treatment preference and patient e ... Full text Link to item Cite

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

Journal Article Phys Ther · October 2010 BACKGROUND: The US Army has traditionally utilized bent-knee sit-ups as part of physical training and testing. It is unknown whether the short-term effects of a core stabilization exercise program without sit-up training may result in decreased musculoskel ... Full text Link to item Cite

Morbid obesity is associated with fear of movement and lower quality of life in patients with knee pain-related diagnoses.

Journal Article PM R · August 2010 OBJECTIVE: To compare fear of movement in patients with different body mass index (BMI) values referred for rehabilitative care of the knee and to examine whether this fear contributed to self-reported knee-related function. We hypothesized that fear of mo ... Full text Link to item Cite

Pain catastrophizing predicts pain intensity during a neurodynamic test for the median nerve in healthy participants.

Journal Article Man Ther · August 2010 Psychological factors within the Fear-Avoidance Model of Musculoskeletal Pain (FAM) predict clinical and experimental pain in both symptomatic and asymptomatic individuals. Clinicians routinely examine individuals with provocative testing procedures that e ... Full text Link to item Cite

Dynamic nature of the placebo response.

Journal Article J Orthop Sports Phys Ther · August 2010 Traditionally, placebo has been associated with using an inert substance, in part so the subsequent response could be attributed to the target treatment, controlling for the confound of a “placebo effect.” ,, Placebo’s link with inert substances is so stro ... Full text Link to item Cite

Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with shoulder pain.

Journal Article Arch Phys Med Rehabil · July 2010 OBJECTIVE: To investigate the reliability and validity of 2 commonly used measures of pain related fear in patients with shoulder pain. DESIGN: A preplanned secondary analysis of a prospective single-arm trial involving a repeated-measures design. SETTING: ... Full text Link to item Cite

A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain.

Journal Article J Orthop Sports Phys Ther · April 2010 STUDY DESIGN: Validity and test-retest reliability of questionnaires related to the fear-avoidance model (FAM). OBJECTIVE: To investigate test-retest reliability, construct redundancy, and criterion validity for 4 commonly used FAM measures. BACKGROUND: Fe ... Full text Link to item Cite

Supra-threshold scaling, temporal summation, and after-sensation: relationships to each other and anxiety/fear.

Journal Article J Pain Res · March 31, 2010 This study investigated the relationship of thermal pain testing from three types of quantitative sensory testing (ie, supra-threshold stimulus response scaling, temporal summation, and after-sensation) at three anatomical sites (ie, upper extremity, lower ... Full text Link to item Cite

Relationship of intersession variation in negative pain-related affect and responses to thermally-evoked pain.

Journal Article J Pain · February 2010 UNLABELLED: The purpose of this study was to determine whether session-specific measures of negative pain-related affect would account for longitudinal variability in the ratings of the evoked thermal pain. Pain-free subjects rated pain evoked on the poste ... Full text Open Access Link to item Cite

The relationship of the audible pop to hypoalgesia associated with high-velocity, low-amplitude thrust manipulation: a secondary analysis of an experimental study in pain-free participants.

Journal Article J Manipulative Physiol Ther · February 2010 OBJECTIVE: High-velocity, low-amplitude (HVLA) manipulation is an effective treatment of low back pain (LBP); however, the corresponding mechanisms are undetermined. Hypoalgesia is associated with HVLA manipulation and suggests specific mechanisms of actio ... Full text Link to item Cite

Spinal manipulative therapy has an immediate effect on thermal pain sensitivity in people with low back pain: a randomized controlled trial.

Journal Article Phys Ther · December 2009 BACKGROUND: Current evidence suggests that spinal manipulative therapy (SMT) is effective in the treatment of people with low back pain (LBP); however, the corresponding mechanisms are unknown. Hypoalgesia is associated with SMT and is suggestive of specif ... Full text Link to item Cite

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

Journal Article Med Sci Sports Exerc · November 2009 PURPOSE: Core stabilization exercises target abdominal and trunk muscles without the excessive loading that occurs during sit-ups. However, core stabilization exercise programs (CSEP) have not been widely adopted in the US Army partially because of the per ... Full text Link to item Cite

The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model.

Journal Article Man Ther · October 2009 Prior studies suggest manual therapy (MT) as effective in the treatment of musculoskeletal pain; however, the mechanisms through which MT exerts its effects are not established. In this paper we present a comprehensive model to direct future studies in MT. ... Full text Link to item Cite

A randomized sham-controlled trial of a neurodynamic technique in the treatment of carpal tunnel syndrome.

Journal Article J Orthop Sports Phys Ther · October 2009 STUDY DESIGN: Randomized, controlled trial. OBJECTIVES: To assess the believability of a novel sham intervention for a neurodynamic technique (NDT) in participants with signs and symptoms of carpal tunnel syndrome (CTS). Additionally, we wished to assess a ... Full text Link to item Cite

A randomized sham-controlled trial of a neurodynamic technique in the treatment of carpal tunnel syndrome.

Journal Article The Journal of orthopaedic and sports physical therapy · October 1, 2009 STUDY DESIGN: Randomized, controlled trial. OBJECTIVES: To assess the believability of a novel sham intervention for a neurodynamic technique (NDT) in participants with signs and symptoms of carpal tunnel syndrome (CTS). Additionally, we wished to assess a ... Cite

Development of a self-report measure of fearful activities for patients with low back pain: the fear of daily activities questionnaire.

Journal Article Phys Ther · September 2009 BACKGROUND: Self-report measures for assessing specific fear of activities have not been reported in the peer-reviewed literature, but are necessary to adequately test treatment hypotheses related to fear-avoidance models. OBJECTIVE: This study described p ... Full text Link to item Cite

Physical therapy utilization of graded exposure for patients with low back pain.

Journal Article J Orthop Sports Phys Ther · July 2009 SYNOPSIS: The fear-avoidance model of musculoskeletal pain suggests that elevated pain-related fear is a precursor to chronic low back pain. Recent prospective studies support the predictive validity of this model, and treatment approaches based on the mod ... Full text Link to item Cite

Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting.

Journal Article Eur Spine J · July 2009 The general population has a pessimistic view of low back pain (LBP), and evidence-based information has been used to positively influence LBP beliefs in previously reported mass media studies. However, there is a lack of randomized trials investigating wh ... Full text Link to item Cite

Mental health symptoms in combat medic training: a longitudinal examination.

Journal Article Mil Med · June 2009 Mental health symptoms in military populations are rising and constitute a significant health concern. This study examined the prevalence of depression, anxiety, and suicidal ideation in soldiers (N = 3,792) undergoing combat medic training. At the start o ... Full text Link to item Cite

Effects of upper extremity neural mobilization on thermal pain sensitivity: a sham-controlled study in asymptomatic participants.

Journal Article J Orthop Sports Phys Ther · June 2009 STUDY DESIGN: A single-blinded, quasi-experimental, within- and between-sessions assessment. OBJECTIVES: To investigate potential mechanisms of neural mobilization (NM), using tensioning techniques in comparison to sham NM on a group of asymptomatic volunt ... Full text Link to item Cite

Pain assessment and treatment disparities: a virtual human technology investigation.

Journal Article Pain · May 2009 Pain assessment and treatment is influenced by patient demographic characteristics and nonverbal expressions. Methodological challenges have limited the empirical investigation of these issues. The current analogue study employed an innovative research des ... Full text Link to item Cite

Clinical outcomes for patients classified by fear-avoidance beliefs and centralization phenomenon.

Journal Article Arch Phys Med Rehabil · May 2009 OBJECTIVES: To (1) determine the prevalence of pain pattern classification subgroups (centralization, noncentralization, and not classified) observed during the initial evaluation of patients experiencing high versus low Fear-Avoidance Beliefs Questionnair ... Full text Link to item Cite

The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology.

Journal Article J Orthop Sports Phys Ther · April 2009 STUDY DESIGN: Cross-sectional. OBJECTIVES: This study examined the baseline relationship of pain intensity, physical impairment, and pain-related fear to shoulder function. BACKGROUND: There is no consensus regarding the influence psychological variable ha ... Full text Link to item Cite

Author response

Journal Article Physical Therapy · April 1, 2009 Full text Cite

Psychologic influence on experimental pain sensitivity and clinical pain intensity for patients with shoulder pain.

Journal Article J Pain · March 2009 UNLABELLED: Pain-related fear and pain catastrophizing are 2 central psychologic factors in fear-avoidance models. Our previous studies in healthy subjects indicated that pain-related fear, but not pain catastrophizing, was associated with cold pressor pai ... Full text Link to item Cite

Response to Keele team's response letter

Journal Article Pain · March 1, 2009 Full text Cite

Clinical prediction rules for physical therapy interventions: a systematic review.

Journal Article Phys Ther · February 2009 BACKGROUND AND PURPOSE: Clinical prediction rules (CPRs) involving physical therapy interventions have been published recently. The quality of the studies used to develop the CPRs was not previously considered, a fact that has potential implications for cl ... Full text Link to item Cite

A comparison of laboratory measures of escape and avoidance behavior.

Journal Article J Pain · January 2009 UNLABELLED: Escape and avoidance of the onset of pain and exacerbations of pain can be difficult to distinguish in certain circumstances. This investigation compared measures of participants' (N = 61, 50.8% women) escape and avoidance behavior during an is ... Full text Link to item Cite

Factors associated with function after anterior cruciate ligament reconstruction.

Journal Article Sports Health · January 2009 BACKGROUND: Many individuals do not resume unrestricted, preinjury sports participation after anterior cruciate ligament reconstruction, thus a better understanding of factors associated with function is needed. The purpose of this study was to investigate ... Full text Link to item Cite

The association of pain and fear of movement/reinjury with function during anterior cruciate ligament reconstruction rehabilitation.

Journal Article J Orthop Sports Phys Ther · December 2008 STUDY DESIGN: Cross-sectional. OBJECTIVES: To measure fear of movement/reinjury levels and determine the association with function at different timeframes during anterior cruciate ligament (ACL) reconstruction rehabilitation. We hypothesized that fear of m ... Full text Link to item Cite

A randomized trial of behavioral physical therapy interventions for acute and sub-acute low back pain (NCT00373867).

Journal Article Pain · November 15, 2008 Psychological factors consistent with fear-avoidance models are associated with the development of chronic low back pain (LBP). As a result, graded activity (GA) and graded exposure (GX) have been suggested as behavioral treatment options. This clinical tr ... Full text Link to item Cite

Fear of pain, pain catastrophizing, and acute pain perception: relative prediction and timing of assessment.

Journal Article J Pain · September 2008 UNLABELLED: Pain-related fear and catastrophizing are important variables of consideration in an individual's pain experience. Methodological limitations of previous studies limit strong conclusions regarding these relationships. In this follow-up study, w ... Full text Link to item Cite

How spinal manipulative therapy works: why ask why?

Journal Article J Orthop Sports Phys Ther · June 2008 Full text Link to item Cite

Evidence for a biopsychosocial influence on shoulder pain: pain catastrophizing and catechol-O-methyltransferase (COMT) diplotype predict clinical pain ratings.

Journal Article Pain · May 2008 The experience of pain is believed to be influenced by social, cultural, environmental, psychological, and genetic factors. Despite this assertion, few studies have included clinically relevant pain phenotypes when investigating interactions among these va ... Full text Link to item Cite

The influence of expectation on spinal manipulation induced hypoalgesia: an experimental study in normal subjects.

Journal Article BMC Musculoskelet Disord · February 11, 2008 BACKGROUND: The mechanisms thorough which spinal manipulative therapy (SMT) exerts clinical effects are not established. A prior study has suggested a dorsal horn modulated effect; however, the role of subject expectation was not considered. The purpose of ... Full text Link to item Cite

Investigation of elevated fear-avoidance beliefs for patients with low back pain: a secondary analysis involving patients enrolled in physical therapy clinical trials.

Journal Article J Orthop Sports Phys Ther · February 2008 STUDY DESIGN: Secondary analysis. OBJECTIVE: To investigate the Fear-Avoidance Beliefs Questionnaire (FABQ) for its ability to predict 6-month outcomes for patients with low back pain (LBP) participating in physical therapy clinical trials. BACKGROUND: Con ... Full text Link to item Cite

Biopsychosocial influence on exercise-induced delayed onset muscle soreness at the shoulder: pain catastrophizing and catechol-o-methyltransferase (COMT) diplotype predict pain ratings.

Journal Article Clin J Pain · 2008 OBJECTIVE: The experience of pain is believed to be influenced by psychologic and genetic factors. A previous study suggested pain catastrophizing and catechol-O-methyltransferase (COMT) genotype influenced clinical pain ratings for patients seeking operat ... Full text Link to item Cite

A survey of sports medicine physicians regarding psychological issues in patient-athletes.

Journal Article Am J Sports Med · December 2007 PURPOSE: To determine the extent to which sports medicine physicians encounter and discuss psychological issues among athletes they treat and to evaluate physicians' perceptions of the availability and efficacy of sport psychologists and other mental healt ... Full text Link to item Cite

Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009).

Journal Article BMC Musculoskelet Disord · September 14, 2007 BACKGROUND: There are few effective strategies reported for the primary prevention of low back pain (LBP). Core stabilization exercises targeting the deep abdominal and trunk musculature and psychosocial education programs addressing patient beliefs and co ... Full text Link to item Cite

Risk and physical therapy.

Journal Article J Orthop Sports Phys Ther · September 2007 Full text Link to item Cite

Influence and stability of pain scale anchors for an investigation of cold pressor pain tolerance.

Journal Article J Pain · June 2007 UNLABELLED: Variable use of pain scale anchors may influence recalled pain ratings, rating consistency, and agreement between actual rating change and ratings of pain relief. This investigation examined change in events that represent maximal pain scale an ... Full text Link to item Cite

Sex differences in pain drawing area for individuals with chronic musculoskeletal pain.

Journal Article J Orthop Sports Phys Ther · March 2007 STUDY DESIGN: Cross-sectional. OBJECTIVES: To (1) determine the association between pain severity and pain drawing area for men and women; (2) determine if sex differences exist in pain severity or pain drawing area; (3) determine the relative influence of ... Full text Link to item Cite

Participant perception of recovery as criterion to establish importance of improvement for constraint-induced movement therapy outcome measures: a preliminary study.

Journal Article Phys Ther · February 2007 BACKGROUND AND PURPOSE: Changes in function following constraint-induced movement therapy (CIMT) are characterized primarily by improvements in performance; however, the importance of these outcome measures to the participant may be unclear. The primary pu ... Full text Link to item Cite

An evaluation of the measurement of pain catastrophizing by the coping strategies questionnaire.

Journal Article Eur J Pain · January 2007 Measurement and conceptual issues of pain catastrophizing have been raised in the literature. The issues of construct redundancy and measurement overlap have received particular attention, with suggestions that measures of pain catastrophizing are confound ... Full text Link to item Cite

Sex and pain-related psychological variables are associated with thermal pain sensitivity for patients with chronic low back pain.

Journal Article J Pain · January 2007 UNLABELLED: Biologic and psychological associations with evoked pain sensitivity have been extensively studied in healthy subjects but not among subjects with clinical pain syndromes. This study involved patients with chronic low back pain and investigated ... Full text Link to item Cite

Fear of pain influences outcomes after exercise-induced delayed onset muscle soreness at the shoulder.

Journal Article Clin J Pain · January 2007 OBJECTIVES: This study investigated whether anxiety, fear of pain, or pain catastrophizing were predictive of pain-related outcomes after induced delayed onset muscle soreness (DOMS) at the shoulder. METHODS: Healthy participants (19 males and 23 females) ... Full text Link to item Cite

Outcomes following plyometric rehabilitation for the young throwing athlete: a case report.

Journal Article Physiother Theory Pract · 2007 The current literature offers limited evidence supporting sport-specific plyometric rehabilitation for young throwing athletes. The purposes of this case report were to 1) describe the focused differential diagnosis of a young throwing athlete with shoulde ... Full text Link to item Cite

Immediate effects of spinal manipulation on thermal pain sensitivity: an experimental study.

Journal Article BMC Musculoskelet Disord · August 15, 2006 BACKGROUND: The underlying causes of spinal manipulation hypoalgesia are largely unknown. The beneficial clinical effects were originally theorized to be due to biomechanical changes, but recent research has suggested spinal manipulation may have a direct ... Full text Link to item Cite

Fear of pain, not pain catastrophizing, predicts acute pain intensity, but neither factor predicts tolerance or blood pressure reactivity: an experimental investigation in pain-free individuals.

Journal Article Eur J Pain · July 2006 Previous studies of the Fear-Avoidance Model of Exaggerated Pain Perception have commonly included patients with chronic low back pain, making it difficult to determine which psychological factors led to the development of an "exaggerated pain perception". ... Full text Link to item Cite

Sex differences in predictors of outcome in selected physical therapy interventions for acute low back pain.

Journal Article J Orthop Sports Phys Ther · June 2006 STUDY DESIGN: Secondary analysis of pooled data from 3 randomized trials. OBJECTIVE: This study investigated sex differences in response to physical therapy intervention for acute low back pain. BACKGROUND: Sex differences in experimental pain sensitivity ... Full text Link to item Cite

Fear: a factor to consider in musculoskeletal rehabilitation.

Journal Article J Orthop Sports Phys Ther · May 2006 Full text Link to item Cite

Fear-avoidance beliefs and temporal summation of evoked thermal pain influence self-report of disability in patients with chronic low back pain.

Journal Article J Occup Rehabil · March 2006 INTRODUCTION: Quantitative sensory testing has demonstrated a promising link between experimentally determined pain sensitivity and clinical pain. However, previous studies of quantitative sensory testing have not routinely considered the important influen ... Full text Link to item Cite

Fear-avoidance beliefs as measured by the fear-avoidance beliefs questionnaire: change in fear-avoidance beliefs questionnaire is predictive of change in self-report of disability and pain intensity for patients with acute low back pain.

Journal Article Clin J Pain · February 2006 OBJECTIVES: The purposes of this study were to investigate the association among measures of fear-avoidance beliefs, pain intensity, and lumbar flexion and to determine if changes in these measures were predictive of treatment outcome following physical th ... Full text Link to item Cite

The centralization phenomenon and fear-avoidance beliefs as prognostic factors for acute low back pain: a preliminary investigation involving patients classified for specific exercise.

Journal Article J Orthop Sports Phys Ther · September 2005 STUDY DESIGN: Secondary analysis of a prospective cohort of patients with acute low back pain (LBP). OBJECTIVES: To determine if the centralization phenomenon and fear-avoidance beliefs predict measurement of pain and disability 6 months after entering the ... Full text Link to item Cite

Distinguishing patient satisfaction with treatment delivery from treatment effect: a preliminary investigation of patient satisfaction with symptoms after physical therapy treatment of low back pain.

Journal Article Arch Phys Med Rehabil · July 2005 OBJECTIVE: To investigate the discrepancy between ratings of pain intensity and patient satisfaction by evaluating a questionnaire item that assesses patient satisfaction with treatment effect. DESIGN: Inception cohort. SETTING: Ambulatory care. PARTICIPAN ... Full text Link to item Cite

Sex differences in the associations among psychological factors and pain report: a novel psychophysical study of patients with chronic low back pain.

Journal Article J Pain · July 2005 UNLABELLED: Previous studies have consistently suggested that there are sex differences in pain report, but there is no consensus regarding sex differences in the associations among psychological factors and pain report. This cross-sectional study used a n ... Full text Link to item Cite

Clinical examination variables discriminate among treatment-based classification groups: a study of construct validity in patients with acute low back pain.

Journal Article Phys Ther · April 2005 BACKGROUND AND PURPOSE: Treatment-based classification (TBC) provides matched interventions for patients with acute low back pain (LBP) through key history and clinical findings. This study investigated the discriminant validity of TBC by determining wheth ... Link to item Cite

Multidimensional success criteria and expectations for treatment of chronic pain: the patient perspective.

Journal Article Pain Med · 2005 OBJECTIVE: The study's primary objective is to define treatment success from the patient perspective across four domains (pain, fatigue, emotional distress, interference with daily activities) using the Patient Centered Outcomes Questionnaire (PCOQ). Secon ... Full text Link to item Cite

Muscle adaptations with immobilization and rehabilitation after ankle fracture.

Journal Article Med Sci Sports Exerc · October 2004 UNLABELLED: INTRODUCTION/ PURPOSE: The widespread occurrence of muscular atrophy during immobilization and its reversal presents an important challenge to rehabilitation medicine. We used 3D-magnetic resonance imaging (MRI) in patients with surgically-stab ... Full text Link to item Cite

Sex differences in pain anchors revisited: further investigation of "most intense" and common pain events.

Journal Article Eur J Pain · August 2004 Recent research suggests that the interpretation of maximal endpoints of pain scales vary between sexes. The purposes of this study were to investigate sex differences in (a) maximal endpoints of pain scales and (b) bias, discrimination, and the "better th ... Full text Link to item Cite

Physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs.

Journal Article Phys Ther · June 2004 BACKGROUND AND PURPOSE: Elevated fear-avoidance beliefs are believed to be a precursor of chronic disability, yet effective intervention options have not been described in the literature. The purpose of this case report is to describe physical therapist ma ... Link to item Cite

The effect of a fear-avoidance-based physical therapy intervention for patients with acute low back pain: results of a randomized clinical trial.

Journal Article Spine (Phila Pa 1976) · December 1, 2003 STUDY DESIGN: A randomized clinical trial with 4-week and 6-month follow-up periods. OBJECTIVE: To compare the effect of a fear-avoidance-based physical therapy intervention with standard care physical therapy for patients with acute low back pain. SUMMARY ... Full text Link to item Cite

The relationship between lumbar lordosis and radiologic variables and lumbar lordosis and clinical variables in elderly, African-American women.

Journal Article J Spinal Disord Tech · April 2003 Several authors have hypothesized that there is a link between lumbar lordosis and low back pain. These relationships have not been previously described in a sample consisting exclusively of elderly, African-American women. The purpose of this study was to ... Full text Link to item Cite

Identifying psychosocial variables in patients with acute work-related low back pain: the importance of fear-avoidance beliefs.

Journal Article Phys Ther · October 2002 BACKGROUND AND PURPOSE: Psychosocial factors are known to affect recovery from acute low back pain. The factors with the greatest influence and the optimal methods of measurement and interpretation have not been established. The purpose of this study was t ... Link to item Cite

Characteristics of patients with lower extremity symptoms treated with slump stretching: a case series.

Journal Article J Orthop Sports Phys Ther · August 2002 STUDY DESIGN: Prospective case series. OBJECTIVES: The purpose of this case series was to describe the criteria used to determine if patients were to receive slump stretch treatment within a treatment-based classification system and to describe selected sy ... Full text Link to item Cite

Management of the athlete with low back pain.

Journal Article Clin Sports Med · January 2002 The evaluation of an athlete with LBP using the classification system proposed by Delitto et al has been outlined. For outpatient orthopaedic practice, evidence in the literature is available documenting the reliability and the effectiveness of treatment g ... Full text Link to item Cite

A comparison of fear-avoidance beliefs in patients with lumbar spine pain and cervical spine pain.

Journal Article Spine (Phila Pa 1976) · October 1, 2001 STUDY DESIGN: A prospective consecutive cohort study of patients with cervical spine pain and patients with lumbar spine pain referred to an academic medical center. OBJECTIVES: To investigate the presence of fear-avoidance beliefs in a sample of patients ... Full text Link to item Cite

The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status.

Journal Article Pain · October 2001 Fear-avoidance beliefs have been identified as an important psychosocial variable in patients with chronic disability doe to low back pain. The importance of fear-avoidance beliefs for individuals with acute low back pain has not been explored. Seventy-eig ... Full text Link to item Cite

The use of a classification approach to identify subgroups of patients with acute low back pain. Interrater reliability and short-term treatment outcomes.

Journal Article Spine (Phila Pa 1976) · January 2000 STUDY DESIGN: A prospective, consecutive, cohort study of patients with acute low back pain classified into subgroups based on examination data and treated with a specific treatment approach. OBJECTIVE: To calculated the interrater reliability of a classif ... Full text Link to item Cite