Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and leading cause of disability. This update to the 2012 Academy Orthopaedic Physical Therapy (AOPT), formerly Section American Association (APTA), clinical practice guideline (CPG) for LBP. The overall objective this was provide recommendations on interventions delivered by physical therapists or studied in care settings that included therapy providers. It also focused...

Background: Fear of reinjury and lack confidence influence return-to-sport outcomes after anterior cruciate ligament (ACL) reconstruction. The physical, psychosocial, functional recovery patients reporting fear or as their primary barrier to resuming sports participation is unknown. Purpose: To compare physical impairment, functional, psychosocial measures between subgroups based on status reinjury/lack in the stage determine association impairment with function for each subgroup at 6 months...

Cross-sectional.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 would decrease rehabilitation be inversely related function.Fear can prevent return to sports after ACL reconstruction, but it has not been studied rehabilitation.Demographic data responses on shortened version Tampa Scale for Kinesiophobia (TSK-11), 8-Item Short-Form Health...

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 do not at 1 year following anterior cruciate ligament reconstruction, (2) determine the factors most strongly associated with return-to-sport status a multivariate model, (3) explore discriminatory value sport postsurgery. Background Demographic, physical impairment,...

BackgroundEvidence in the musculoskeletal rehabilitation literature suggests that psychosocial factors can influence pain levels and functional outcome.

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 Kinesiophobia (TSK) Pain Catastrophizing (PCS) have been used to determine in these patients. However, TSK PCS factor structures not described with ACLR. This study investigated 2 groups of post-ACLR if the use shortened questionnaires is warranted.Cross-sectional which completed measures during early...

Study Design Clinical measurement, cross-sectional. Background Pain-associated psychological distress adversely influences outcomes for patients with musculoskeletal pain. However, assessment of pain-associated (ie, yellow flags) is not routinely performed in orthopaedic physical therapy practice. A standardized flag tool will better inform treatment decision making related to psychologically informed Objectives To describe the development a concise, multidimensional application clinical...

Psychological distress can negatively influence disability, quality of life, and treatment outcomes for individuals with hip knee osteoarthritis (OA). Clinical practice guidelines recommend a comprehensive disease management approach to OA that includes the identification, evaluation, psychological distress. However, uncertainty around best screening assessment methods, poor understanding heterogeneity in those OA, lack guidance on how scale have limited growth care models effectively...

Background Mental health characteristics such as negative mood, fear avoidance, unhelpful thoughts regarding pain, and low self-efficacy are associated with symptom intensity capability among patients hip knee osteoarthritis (OA). Knowledge gaps remain the conceptual statistical overlap of these constructs which most strongly in people OA. Further study underlying factors can inform us mental assessments to prioritize how incorporate them into whole-person, psychologically informed care....

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 influence psychological variables have on function recovery in individuals with pathologies. While has been shown predict disability for patients low-back cervical pain, this not consistently reported pain. Methods Measures One hundred forty-two subjects (78 male, 64 female; mean...

Study Design Observational, prospective cohort. Background Musculoskeletal pain is a common reason to seek health care, and earlier nonpharmacological treatment enhancement of personalized care options are 2 high-priority areas. Validating concise assessment tools an important step toward establishing better pathways. Objectives To determine the predictive validity Optimal Screening for Prediction Referral Outcome (OSPRO) individuals with neck, low back, shoulder, or knee pain. Methods A...

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 this study was to investigate the association knee impairment and psychological variables in subjects reconstruction. Hypothesis: After controlling for demographic variables, contribute Study Design: Cross-sectional study; Level evidence, 4a. Methods: Fifty-eight...

Plyometric exercise is used during rehabilitation after anterior cruciate ligament (ACL) reconstruction to facilitate the return sports participation. However, clinical outcomes have not been examined, and high loads on lower extremity could be detrimental knee articular cartilage.To compare immediate effect of low- high-intensity plyometric ACL function, cartilage metabolism, other clinically relevant measures.Randomized controlled trial; Level evidence, 2.Twenty-four patients who underwent...

Background Musculoskeletal pain conditions incur high costs and produce significant personal public health consequences, including disability opioid-related mortality. Persistence of high-cost care utilization for musculoskeletal may help identify system inefficiencies that could limit value care. The objective this study was to factors associated with persistent among individuals seeking pain. Methods This a retrospective cohort Medical Expenditure Panel Survey data (2008–2013) included...

Psychological factors influence or are associated with physical function, pain, and health care costs among individuals musculoskeletal pain conditions. Recent clinical practice guidelines recommend screening for psychological (also referred to as "yellow flags") in therapy help understand prognosis inform shared decision making treatment.Despite the urgings of evidence on outcomes, yellow flags is uncommon practice. Clinicians may feel uncertain about how integrate tools into practice,...

1Department of Orthopaedic Surgery, Duke University, Durham, NC, USA 2Duke Clinical Research Institute, 3Duke-Margolis Institute for Health Policy, T. A. Lentz, Assistant Professor, Department 300 W. Morgan Street, NC 27701, USA, Email: [email protected] This CORR Insights® is a commentary on the article "Among People Presenting Musculoskeletal Specialty Care, Is There an Association Accommodation Aging and Other Mindset Factors With Levels Comfort Capability?" by Hunter colleagues available...

Cross-sectional study.To examine the effect of different normalization methods on unilateral seated shot put test results.The could assist clinical decision making in upper extremity rehabilitation, but results must be normalized to compare across patients. The based body size and upper-limb dominance is unknown.One hundred twenty-five collegiate athletes (63 males) performed with each extremity. Anthropometric measures (height, mass, arm length) distance thrown were recorded. Normalization...

Abstract Background Musculoskeletal pain is a societal epidemic because it highly prevalent and leading contributor to disability; however, physical therapists are still challenged when predicting which patients at high risk for persistent symptoms. Objective The objectives of this study were identify patient characteristics predictive musculoskeletal 12 months following therapist care determine the influence anatomical region. Design design included secondary analysis cohort study. Methods...

In the United States, value-based purchasing has created need for healthcare systems to prospectively identify patients at risk high utilization beyond a physical therapy episode musculoskeletal pain. The purpose of this study was determine predictors pain-related subsequent an index pain.This assessed data from Optimal Screening Prediction Referral and Outcome (OSPRO) longitudinal cohort that recruited individuals with primary complaint neck, low back, knee or shoulder pain in (n = 440)....

Purpose There is an increased need for determining which patients with musculoskeletal pain benefit from additional diagnostic testing or psychologically informed intervention. The O ptimal S creening P rediction of R eferral and utcome (OSPRO) cohort studies were designed to develop validate standard assessment tools review systems yellow flags. This profile paper provides a description future plans the validation cohort. Participants Patients (n=440) primary complaint spine, shoulder knee...

Abstract Early physical therapy models hold great promise for delivering high-value care individuals with musculoskeletal pain. However, existing therapist practice and research standards are misaligned value-based principles, which limits the potential growth sustainability of these models. This Perspective describes how value proposition early can be improved by redefining harm, embracing a prognostic approach to clinical decision making, advocating system-wide guideline-adherent pain...