Abstract:
The intervertebral disc has been implicated as an etiology of chronic spine pain based on clinical, basic science, and epidemiological research. Unfortunately, there is no way to determine with absolute certainty whether or not the disc is a spinal pain generator. Recent advances in the neurobiology of pain processing further underscore the possibility that we may never know the source of a patient's pain. At our current level of understanding, from an empirical standpoint, discography is thought of as the best tool to evaluate disc-related pain. This paper systematically assesses the quality of clinical studies evaluating the diagnostic accuracy of discography with respect to chronic spinal pain. (more)

Abstract:
Psychologists have studied the cognitive processes involved in decision making extensively and have identified many factors that lead people astray. Because doctors’ decisions have profound effects on their patients’ health, these decisions should be of the best possible quality. All doctors should therefore be aware of possible pitfalls in medical decision making and take steps to avoid these unnecessary errors. In this article, I present five examples of cognitive biases that can affect medical decision making and offer suggestions for avoiding them. (more)

Abstract:
When clinicians think "overhead athlete," swimming is one of the sports that come to mind. Some of the other sports include throwing and pitching, volleyball, and tennis. In the past, the mechanics of the "overhead athlete" were sometimes viewed collectively. Most of the “overhead” sports are mechanically at risk during humeral abduction and elevation with external rotation. That is not the case with the swimmer. It is now clear that the requirements of each sport are distinct, and the precise requirements are able to be defined. Thus, this chapter provides an opportunity to describe the specific biomechanics of swimming as they relate to the clinician. (more)

Abstract:
There is a concern that comorbidity or frailty in older people could limit the usefulness of currently available exercise tests for chronic lung disease. This study evaluated the feasibility and reproducibility of the incremental shuttle walking test (SWT) in people aged 70 years or over, compared exercise tolerance with other disability markers, and assessed whether the SWT is responsive to change after bronchodilators. (more)

Abstract:
Low back pain is a highly prevalent and disabling condition worldwide. Clinical guidelines for the management of patients with acute low back pain recommend first-line treatment consisting of advice, reassurance and simple analgesics. Exercise is also commonly prescribed to these patients. The primary aim of this study was to evaluate the short-term effect of adding the McKenzie method to the first-line care of patients with acute low back pain. (more)

Abstract:
The purpose of this study was to assess the efficacy of spinal manipulation for patients with back or neck pain. No trial scored 60 or more points (maximum score 100) suggesting that most were of poor quality. Eighteen studies (51%) showed favourable results for manipulation. In addition, five studies (14%) reported positive results in one or more subgroups. Of the four studies with 50-60 points, one reported that manipulation was better, two reported that manipulation was better in only a subgroup, and one reported that manipulation was no better or worse than reference treatment. Eight trials attempted to compare manipulation with some placebo, with inconsistent results. Although some results are promising, the efficacy of manipulation has not been convincingly shown. Further trials are needed, but much more attention should be paid to the methods of study. (more)

Abstract:
Clinical practice guidelines state that the tissue source of low back pain cannot be specified in the majority of patients, but there has been no systematic review of the accuracy of diagnostic tests used to identify the source of low back pain. The aim of this systematic review was therefore to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint or sacroiliac joint (SIJ) as the source of low back pain. (more)

Abstract:
The aim of this paper was to characterize structural balance of the body in people with systemic vertigo after applying rehabilitation exercise, such as motor-visual coordination on a posturographic platform and balance exercise. The rehabilitation program resulted in a decrease of the range of sways, improved visuomotor coordination and thus also improved balance. (more)

Abstract:
Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health — a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector. (more)

Abstract:
With the introduction of minimally invasive techniques and the pressure of insurance regulations, postoperative rehabilitation after total hip and knee arthroplasty has been placed on an accelerated track. As surgeons turn to more aggressive postoperative protocols and early entry into outpatient therapies, we introduce a pre- and postoperative program involving the Pilates method. While this technique appears safe and effective anecdotally, further controlled trials are necessary to prove its validity. (more)

Abstract:
The Back School is a widely accepted and effective method for treating low back pain, whereas no scientific evidence exists about the effects of the Pilates CovaTech method. With this study we wanted to evaluate the efficacy of this new method in patients with low back pain. (more)

Abstract:
Online CE raises several questions. What is it? Do people learn via online media? Is it a good thing? What are the obstacles? Where does it belong and where does it not belong? What does the future hold for online CE? The purpose of this article is to explore these issues and allow the reader to identify if and where online CE belongs in their learning experience. (more)

Abstract:
While running is a natural extension of walking, the magnitude of difference mandates that running be studied separately. Therefore, the purpose of this chapter is to first describe the terminology and timing of the running phases, then to describe the ROM and muscle activation patterns in the lower extremity while running, followed by a description of the pressures borne by the foot. These discussions will focus on the “training pace” of recreational runners (approximately a 6.5-minute mile) in order to offer the widest applicability to the clinician. Once the mechanics of the training pace are discussed, then the relative differences to faster and slower paces will be introduced. (more)

Abstract:
The purpose of this study was to compare the effectiveness of thoracic manipulations with instructions for physiotherapeutic exercises for the treatment of neck pain in occupational health care. A statistically significant difference was found in self-reported worst pain by VAS at the 12 month follow-up in favour of the thoracic manipulation group. (more)

Abstract:
Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. (more)

Abstract:
This 1-year, randomised controlled intervention trial evaluated the effects of a wide forearm support surface and a trackball on upper body pain severity and incident musculoskeletal disorders among 182 call centre operators at a large healthcare company. Participants were randomised to receive (1) ergonomics training only, (2) training plus a trackball, (3) training plus a forearm support, or (4) training plus a trackball and forearm support. Outcome measures were weekly pain severity scores and diagnosis of incident musculoskeletal disorder in the upper extremities or the neck/shoulder region based on physical examination performed by a physician blinded to intervention. (more)

Abstract:
College football players sustain an average of 3 subconcussive blows to the head per game. While concussions correlate with decreases in standardized neurocognitive test scores, it is not known whether repetitive, subconcussive microtrauma associated with participation in a full season of collision sport affects neurocognitive test scores. This paper studied 58 members of a Division III collegiate football team who had no known concussion during the season. They voluntarily completed the SAC and ImPACT instruments preseason, midseason, and postseason. A repeated measures analysis of variance was used to compare the scores at the 3 time intervals (P < .05). (more)

Abstract:
Concern has been expressed that preventive measures in older people might increase frailty by increasing survival without improving health. We investigated the impact of exercise on the probabilities of health improvement, deterioration and death in community-dwelling older people. (more)

Abstract:
Golf is not a sport known for its high injury level; however, injuries do occur. Such mishaps usually involve overuse-type injuries that are more common among amateur golfers than among professional golfers. This article attempts to provide an overview of golf injuries to the elbow, with a concentration on incidence, proper diagnosis, adequate treatment (including rehabilitation), and prevention strategies. (more)

Abstract:
A communication plan to facilitate dissemination of and provide education on the revised "Code of Ethics" (Code) and "Standards of Ethical Conduct for the Physical Therapist Assistant" (Standards), adopted at the 2009 House of Delegates in June, is now available. The two APTA core documents have been expanded to better delineate the ethical obligations of all PTs and PTAs. The new "Code" and "Standards" go into effect July 1, 2010. (more)

Abstract:
The objective was to evaluate the effectiveness and cost effectiveness of specially trained physiotherapists in the assessment and management of defined referrals to hospital orthopaedic departments. (more)

Abstract:
Research suggests that clinical examination of the lumbar spine and pelvis is unable to predict the results of diagnostic injections used as reference standards. The purpose of this study was to assess the diagnostic accuracy of a clinical examination in identifying symptomatic and asymptomatic sacroiliac joints using double diagnostic injections as the reference standard. (more)

Abstract:
Vestibular rehabilitation (VR) is an excellent therapy for dizziness patients. However, despite being well-managed, sometimes the results are not suitable. The aim of this study was to evaluate VR outcome between patients according to dizziness etiology. The study design was a retrospective review of medical records. (more)

Abstract:
Nonpharmacologic interventions are important adjuncts to treatment modalities for patients with cancer pain. This article reviews several nonpharmacologic and complementary and alternative modalities commonly used by patients with cancer pain. It focuses on those having empirical support or promising preliminary evidence, with the goal of familiarizing physicians with therapies that may complement regular oncologic care. (more)

Abstract:
The McKenzie management strategy of mechanical diagnosis and therapy (MDT) is commonly used for the assessment and management of spinal problems. Within this system, 'derangement syndrome' is the most common classification, for which the conceptual model is an intra-discal displacement. However, the reduction of an intra-discal displacement by MDT has never been documented. The purpose of this study was to compare, using magnetic resonance imaging (MRI), the nucleus pulposus (NP) profiles before and after the use of this approach. (more)

Abstract:
The McKenzie management strategy of mechanical diagnosis and therapy (MDT) is commonly used for the assessment and management of spinal problems. Within this system, 'derangement syndrome' is the most common classification, for which the conceptual model is an intra-discal displacement. However, the reduction of an intra-discal displacement by MDT has never been documented. The purpose of this study was to compare, using magnetic resonance imaging (MRI), the nucleus pulposus (NP) profiles before and after the use of this approach. (more)

Abstract:
Pulmonary rehabilitation is a relatively recent practice in pulmonary medicine, which is classically described as a multidisciplinary program of care for patients with chronic respiratory impairment. There is solid evidence of effectiveness for the pulmonary rehabilitation and, with lower level of evidence, for some of its specific components, such as exercise tolerance, symptoms, Health-Related Quality of Life, and health care need, with indirect evidence of positive effects on survival. One quarter to one third of patients do not have benefits from pulmonary rehabilitation, studies failing to identify any important predictors of treatment success or failure. Outcomes assessment in pulmonary rehabilitation is of main importance to evaluate its evidence-based effectiveness. (more)

Abstract:
Chemotherapy-induced peripheral neuropathy (CIPN) continues to be a significant, debilitating symptom resulting from the administration of neurotoxic chemotherapy for the treatment of cancer. CIPN is an important consequence of cancer treatment because of its potential impact on physical functioning and quality of life. Despite investigations concerning pharmacologic and nonpharmacologic approaches to either preventing or minimizing the neurotoxicity resulting from certain chemotherapeutic agents, evidence to support the interventions is lacking. This article presents information concerning CIPN and summarizes the evidence for pharmacologic and nonpharmacologic approaches to the prevention and treatment of CIPN. (more)

Abstract:
In the industrial world, non-specific back and neck pain (BNP) is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits? (more)

Abstract:
Peak muscle power may be improved similarly using light, moderate, or heavy resistances, whereas there is a dose-response relationship between training intensity and muscle strength and endurance changes. Therefore, using heavy loads during explosive resistance training may be the most effective strategy to achieve simultaneous improvements in muscle strength, power, and endurance in older adults. (more)

Abstract:
Complaints of dizziness in a patient are not uncommon. The prevalence of dizziness in the community ranges from 1.8% in young adults to more than 30% in the elderly. The physiotherapist often uncovers a complaint of dizziness in the course of providing treatment for another disorder. The purpose of this article is to present the possible causes for complaints of dizziness and offer a process for the physical therapist to determine the appropriate course of action. (more)

Abstract:
To describe the relationship of the pronator teres, flexor carpi radialis, flexor digitorum superficialis, and flexor carpi ulnaris muscles to the medial collateral ligament at 30 degrees, 90 degrees, and 120 degrees of elbow flexion, we dissected 11 cadaveric specimens. (more)

Abstract:
This statement provides practical guidelines for the 6-minute walk test (6MWT). Specifically, it reviews indications, details factors that influence results, presents a brief step-by-step protocol, outlines safety measures, describes proper patient preparation and procedures, and offers guidelines for clinical interpretation of results. These recommendations are not intended to limit the use of alternative protocols for research studies. We do not discuss the general topic of clinical exercise testing. (more)

Abstract:
The purpose of this study was to determine functional and psychological benefits of a 12 week supervised group exercise programme during treatment for early stage breast cancer, with six month follow-up. The study concluded that supervised group exercise provided functional and psychological benefit after a 12 week intervention and six months later. Clinicians should encourage activity for their patients. Policy makers should consider the inclusion of exercise opportunities in cancer rehabilitation services. (more)

Abstract:
For older adults, hospitalization frequently results in deterioration of mobility and function. Nevertheless, there are little data about how older adults exercise in the hospital and definitive studies are not yet available to determine what type of physical activity will prevent hospital related decline. Strengthening exercise may prevent deconditioning and Pilates exercise, which focuses on proper body mechanics and posture, may promote safety. (more)

Abstract:
Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physical therapy has been clinically observed to improve treatment of these patients; however, it is not a standard treatment regime. The purpose of this study is to investigate the efficacy of PT treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection. (more)

Abstract:
The purpose of this study was to determine whether outcomes could be changed after poor response to non-specific exercise therapy when the prescription was changed to specific, directional-preference exercises (McKenzie method). (more)

Abstract:
The distance walked in the 6-min walk test (6MWT) predicts mortality in patients with severe COPD. Little is known about its prognostic value in patients with a wider range of COPD severity, living in different countries, and the potential additional impact of oxygen desaturation measured during the test. We therefore enrolled 576 stable COPD outpatients in Spain and the United States and observed them for at least 3 years (median, 60 months). (more)

Abstract:
Interventions that treat more than one aspect of lower back pain would have significant benefits for this patient population. Yoga and Pilates which have both been gaining in popularity over the last decade are 2 mind-body exercise interventions that address both the physical and mental aspects of pain with core strengthening, flexibility and relaxation. (more)

Abstract:
The objective was to determine whether a golf-specific warm up programme (both immediately prior to play and after performing it 5 times a week for 5 weeks) improved performance in 10 male golfers compared with 10 controls matched for age, sex, and handicap. (more)

Abstract:
How athletes from different sports perform on balance tests is not well understood. When prescribing balance exercises to athletes in different sports, it may be important to recognize performance variations. The objective was to compare static and dynamic balance among collegiate athletes competing or training in soccer, basketball, and gymnastics. (more)

Abstract:
Fatigue is a relevant problem of cancer patients during and after treatment. Several studies have shown that exercise can improve quality of life and functional status of cancer patients undergoing chemo- or radiotherapy. However, there is a lack of information about the effects of this intervention on persistent cancer-related fatigue. Therefore, we assessed the effects of an exercise program on cancer-related fatigue after treatment. (more)

Abstract:
Survey studies have shown that physicians believe managed care is having significant impact on many of their professional obligations. METHODS: Primary care physicians were asked about the impact of managed care on: (1) physician-patient relationships, (2) the ability of physicians to carry out their professional ethical obligations, and (3) quality of patient care. Many physicians surveyed believe managed care has significant negative effects on the physician-patient relationship, the ability to carry out ethical obligations, and on quality of patient care. These results have implications for health care system reform efforts. (more)

Abstract:
The purpose of this discussion is to outline the clinical benefits of physical therapy in treating patients with cancer. A detailed explanation of lymphedema, its causes and current treatment techniques will be discussed, along with the use of physical therapy intervention in addressing orthopedic problems associated with surgical procedures, radiation therapy and breast reconstructive surgery. (more)

Abstract:
Patients with COPD have an increased risk of cardiovascular disease. Whilst pulmonary rehabilitation has proven benefit for exercise tolerance and quality of life, any effect on cardiovascular risk has not been fully investigated. The study investigated whether pulmonary rehabilitation, through the exercise and nutritional intervention, would address these factors. (more)

Abstract:
This research article is the recipient of the inaugural John Medeiros Award given by JMMT. This pivotal work is critical for all therapists working with patients with low back pain. The purpose of this study was to begin to compare common methods currently used to classify patients with non-specific low back pain during initial examination in the outpatient physical therapy setting. (more)

Abstract:
People over the age of 70 carry the greatest burden of chronic disease, disability and healthcare use. Participation in physical activity is crucial for health, and walking accounts for much of the physical activity undertaken by sedentary individuals. Pedometers are a useful motivational tool to encourage increased walking, and they are cheap and easy to use. The aim of this pilot study was to evaluate the feasibility of the use of pedometers plus a theory-based intervention to assist sedentary older women to accumulate increasing amounts of physical activity, mainly through walking. (more)

Abstract:
The authors assessed the relationship between physiologic parameters, computed tomography patterns, 6 minute walk distance (6MWD) and the distance-saturation product [DSP; defined as the product of the 6MWD and the lowest oxygen saturation during the 6 minute walk test (6MWT)]. In addition, they investigated factors affecting 6MWD in patients with pulmonary sarcoidosis. (more)

Abstract:
A cognitive behavioral approach was previously compared to a biomechanical approach (the McKenzie method) for the treatment of patients with back and neck pain in a randomized trial. Few differences between the treatment interventions were found. The aim of this secondary analysis was to determine if any clinical characteristics distinguished those patients who responded best to the McKenzie approach. (more)

Abstract:
The objectives were to present a progressively increasing negative-work exercise program via eccentric ergometry early after anterior cruciate ligament reconstruction (ACL-R) and to suggest the potential of negative work to amplify the return of quadriceps size and strength. (more)

Abstract:
Maintenance of muscle strength and physical performance in later life is an important component of healthy aging. The objective of this study was to investigate the relationship between customary physical activity, muscle strength and physical performance in older men and women. (more)

Abstract:
This paper offers a contemporary, evidence-based perspective on the issue of adverse neurovascular events related to cervical spine manual therapy. The purpose of this perspective is to challenge traditional thought and practice and to recognize areas where practice and research should develop. By considering the themes presented in this paper, the clinician can broaden his or her approach to neurovascular assessment in line with contemporary evidence and thought. (more)

Abstract:
Sarcopenia is the loss of muscle mass that happens to everyone with age. However, the rate of sarcopenia and the severity of its sequelae vary greatly according to health status, physical activity, and possibly diet. In this review, Dr. Roubenoff discusses the potential mechanisms of sarcopenia and some ideas about prevention and treatment. (more)

Abstract:
Lymphedema, a chronic condition that occurs as a result of the body's inability to drain lymph fluid from the tissues, is a common treatment-related side effect experienced by cancer patients. In this review, many of the important aspects of lymphedema with which clinicians who treat cancer patients should be familiar are outlined, including the anatomy, pathophysiology, diagnosis and management of this condition. The authors also identify some of the resources available both to cancer patients with lymphedema and to the clinicians who treat them. It is hoped that this review will convey the importance of the early identification and management of this incurable disorder because this is essential to minimizing its complications. (more)

Abstract:
The goal of this study was to quantify systematically and to characterize the range of ethics issues affecting rehabilitation professionals' day-to-day clinical practice, and to assess the preferences of rehabilitation clinicians for ethics education. The authors found that ethical issues in the rehabilitation setting are common, and reflect both the dynamic nature of the health care environment and the team model of care. Ongoing, interactive educational interventions are warranted to address these issues. (more)

Abstract:
The purpose of this study is to analyze the EMG activity in eight shoulder muscles of both the right and left arms during the golf swing. The results reveal that the infraspinatus and supraspinatus act predominantly at the extremes of shoulder range of motion, the subscapularis and pectoralis major during acceleration, the latissimus dorsi during forward swing, and the anterior deltoid during forward swing and follow-through. The middle and posterior deltoids appear to be relatively noncontributory, without any specific timing patterns. This data is an expansion of an earlier pilot study and allows us to more accurately develop an exercise program for optimal performance as well as for prevention and rehabilitation. (more)

Abstract:
The objective of this study was to determine which proposed risk factor, work activity (industrial v clerical), body mass index (BMI), or other demographic factors had the most influence on the prevalence of median mononeuropathy at the wrist, and if there was an interaction between the risk factors. The authors concluded that obesity, industrial work, and age are independent risk factors that influence the prevalence of median mononeuropathies among active workers. (more)

Abstract:
Chronic obstructive pulmonary disease (COPD) constitutes a growing health care problem worldwide. Integrated disease management (IDM) of mild to moderate COPD patients has been demonstrated to improve exercise capacity and health status after one year, but long-term results are currently lacking in primary care. (more)

Abstract:
Benign Paroxysmal Positional Vertigo (BPPV) is one of the most frequent diseases of the vestibular system, and it is characterized by episodes of recurrent vertigo triggered by head movements or position changes. There are several approaches for treatment, but efficacy is still being discussed. This paper assesses the effectiveness of the specific maneuvers available to the treatment of BPPV. (more)

Abstract:
UK guidelines for domiciliary oxygen have suggested the six-minute walk test or shuttle walk tests as suitable functional measures for the clinical assessment of ambulatory oxygen (AO). The endurance shuttle walk test (ESWT) is used increasingly as an assessment tool within pulmonary rehabilitation (PR), but its potential as an investigative test for AO has not been explored. Using the same test for both PR and AO assessment is appealing since it would improve efficiency and act to standardise outcome measures in this patient population. The aim of this study was to examine the responsiveness and repeatability of the ESWT to AO and to compare the response with that of the six-minute walk test (6MWT). (more)

Abstract:
The methodological issues associated with studies investigating the diagnostic utility of clinical tests have mandated the development of the STARD (Standards for Reporting of Diagnostic Accuracy) and QUADAS (Quality Assessment of Diagnostic Accuracy Studies) criterion lists. The purpose of this paper is to outline the STARD and QUADAS criterion lists and to discuss how these methodological quality assessment tools can assist the clinician in ascertaining clinically useful information from a diagnostic accuracy study. (more)

Abstract:
The study discusses the case of a patient whose lumbar disc derangement syndrome resolved after treatment that included McKenzie diagnosis and therapy, spinal mobilization, and spinal manipulation. Also, it gives an overview of the McKenzie method in general, and more specifically for evaluation and management of derangement syndrome. (more)

Abstract:
The aim of this project was primarily to assess the feasibility of individual exercise programs for older hospitalised patients at risk of functional decline, and secondarily to evaluate impact on discharge outcomes. (more)

Abstract:
A variety of occupational groups have been shown to experience elevated risks of work-related musculoskeletal disorders (WMSD). Little information on WMSD is available in hotel restaurant workers. The authors concluded that WMSD-related pain is common among hotel restaurant workers in Taiwan, but it does not appear to interfere with job performance or daily living. Self-treatment and alternative therapies that have not been evaluated for effectiveness are commonly employed by hotel restaurant workers. (more)

Abstract:
There was a clinically and statistically significant (p < 0.05) difference in the recovery of the quadriceps and the gait parameters according to the type of operation that had been performed: the patients who had had reconstruction of the anterior cruciate ligament with use of an autologous patellar-ligament graft did poorly compared with the other patients. (more)

Abstract:
The purpose of this systematic review was to determine the quality of the research and to assess the reliability of different types of physical examination procedures used in the assessment of patients with non-specific low back pain. Pre-established criteria were used to judge the quality of the studies and satisfactory reliability, and conclusions emphasised high quality studies (> or = 60% methods score). (more)

Abstract:
Altered spinal mobility is thought to be related to current or past episodes of low back pain; however evidence of that relationship in younger subjects has not been established. The purpose of this study was to compare lumbar segmental mobility in asymptomatic and symptomatic subjects during posterior to anterior (PA) manual spinal mobilization and a self-initiated prone press-up (PU) maneuver. We hypothesized that persons with central low back pain would have an altered lumbar segmental mobility pattern compared to those without pain. (more)

Abstract:
Various conservative treatment options for repetitive strain injury are widely used, despite questionable evidence of their effectiveness. This systematic review evaluates the effectiveness of these treatment options for relieving symptoms of repetitive strain injury and improving activities of daily living. (more)

Abstract:
The trapezius and serratus anterior muscles are considered to be the only upward rotators of the scapula and are important for normal shoulder function. Electromyographic studies have been performed for these muscles during active and low-intensity exercises, but they have not been analyzed during high intensity exercises. The objective was to identify high-intensity exercises that elicit the greatest level of EMG activity in the trapezius and serratus anterior muscles. (more)

Abstract:
The objectives of this paper were to determine the reporting of symptoms, the medical outcome and the work status of meat plant workers diagnosed with clinical carpal tunnel syndrome (CTS). Forty-seven cases of CTS were identified from a previously reported study, and were matched by age, gender and hand use. Cases and controls were followed up for 24 months. Occupation-related CTS in meat packers appears to be transient and responsive to conservative measures, with a surgical rate comparable to other occupations. (more)

Abstract:
Although the effectiveness of manipulative therapy for treating back and neck pain has been demonstrated, the validity of many of the procedures used to detect joint dysfunction has not been confirmed. Practitioners of manual medicine frequently employ motion palpation as a diagnostic tool, despite conflicting evidence regarding its utility and reliability. The introduction of various spinal models with artificially introduced 'fixations' as an attempt to introduce a 'gold standard' has met with frustration and frequent mechanical failure. Because direct comparison against a 'gold standard' allows the validity, specificity and sensitivity of a test to be calculated, the identification of a realistic 'gold standard' against which motion palpation can be evaluated is essential. The objective of this study was to introduce a new, realistic, 'gold standard', the congenital block vertebra (CBV) to assess the validity of motion palpation in detecting a true fixation. (more)

Abstract:
Therapeutic approaches developed from the Pilates method are becoming increasingly popular; however, there have been no reports on their efficacy. This study investigates the efficacy of a therapeutic exercise approach in a population with chronic low back pain (LBP). (more)

Abstract:
Our aim was to improve the accuracy and completeness of reporting of studies of diagnostic accuracy in order to allow readers to assess the potential for bias in a study and to evaluate the generalizability of its results. The Standards for Reporting of Diagnostic Accuracy (STARD) steering committee searched the literature to identify publications on the appropriate conduct and reporting of diagnostic studies and extracted potential items into an extensive list. Researchers, editors and members of professional organizations shortened this list during a 2-day consensus meeting with the goal of developing a checklist and a generic flow diagram for studies of diagnostic accuracy. (more)

Abstract:
Clinical provocative tests of the neck, which position the neck and arm inorder to aggravate or relieve arm symptoms, are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review. A comprehensive search was conducted in order to identify all possible studies fulfilling the inclusion criteria. This review suggests that, when consistent with the history and other physical findings, a positive Spurling's, traction/neck distraction, and Valsalva's might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue. (more)

Abstract:
The objective of this paper was to examine the effects of 2 manual therapy methods compared with one counselling session with a physiotherapist with "advice-only to stay active" for treating low back pain/leg pain and disability. Participants with acute to chronic first or recurrent low back pain, excluding those with "red flag" criteria, were assigned randomly to one of the 3 intervention groups: an orthopaedic manual therapy group, a McKenzie method group, and an "advice only to be active" group. (more)

Abstract:
The objective of this review was to provide a comprehensive reference for MCC based on a critical evaluation of the current data. The authors investigated the importance of sentinel lymph node biopsy as a staging tool for MCC to assess the status of the regional lymph node basin and to determine the need for additional therapy to the lymph node basin. In an attempt to standardize prospective data collection with the intention to define prognostic indicators, the authors also present histopathologic profiles for primary MCC and sentinel lymph nodes. The controversies regarding the appropriate surgical approach to primary MCC, the use of adjuvant radiation therapy, and the effectiveness of adjuvant chemotherapy were examined critically. Finally, the authors have provided treatment guidelines based on the available evidence and their multidisciplinary experience. (more)

Abstract:
This report describes work-related upper extremity musculoskeletal disorders in four radiologists and identifies risk factors and preventive measures for these syndromes. It concludes that current technology renders staff radiologists at risk for work-related, upper extremity musculoskeletal disorders, including carpal and cubital tunnel syndromes. Proper equipment, ergonomics, and professional consultation should be used in all radiology departments. (more)

Abstract:
The objectives of this study were to compare the effectiveness of 2 rehabilitation programs for acute hamstring strain by evaluating time needed to return to sports and reinjury rate during the first 2 weeks and the first year after return to sport. A third objective was to investigate the relationship between functional testing performance and time to return to sports and reinjury rates after return to sport. (more)

Abstract:
It has been documented that both muscle mass and strength decline with age. This decline is associated with an increased risk of falls, hip fractures, and adverse physiological changes, such as glucose intolerance and a loss of bone mineral density. Consequently, these changes may predispose elderly individuals to osteoporosis, atherosclerosis, and diabetes as well as to functional limitations in activities of daily living. (more)

Abstract:
The purpose of this study was to evaluate the cost effectiveness of physiotherapy, manual therapy, and care by a general practitioner for patients with neck pain. The manual therapy group showed a faster improvement than the physiotherapy group and the general practitioner care group up to 26 weeks, but differences were negligible by follow up at 52 weeks. The cost effectiveness ratios and the cost utility ratios showed that manual therapy was less costly and more effective than physiotherapy or general practitioner care. (more)

Abstract:
Researchers of work-related musculoskeletal disorders are increasingly asked about the evidentiary base for mechanical exposure reductions. Mixed messages can arise from the different disciplinary cultures of evidence, and these mixed messages make different sets of findings incommensurate. Interventions also operate at different levels within workplaces and result in different intensities of mechanical exposure reduction. Heterogeneity in reporting intervention processes and in measuring relevant outcomes makes the synthesis of research reports difficult. As a means of synthesizing the current understanding of measures, this paper describes a set of intervention and observation nodes for which relevant workplace indicators prior to, during, and after mechanical exposure reduction can provide useful information. (more)

Abstract:
Men and women both enjoy the game of golf. Special considerations are made for women, such as the courses on the professional tours. Thus, one can ask what differences might exist between men and women golfers. This study compares the electromyographic firing patterns of normal shoulder musculature in men and women professional golfers. Eight shoulder muscles (pectoralis major, latissimus dorsi, supraspinatus, infraspinatus, subscapularis, anterior, middle and posterior deltoids) were studied using indwelling electromyography. (more)

Abstract:
Wrist injury is common in golfers and normally occurs at the impact of the club with the ball. The unusual case is reported of a low handicap golfer with wrist pain aggravated by the putting stroke. The condition was resolved with treatment. The likely mechanism for the injury is discussed. (more)

Abstract:
Age-related decline in muscle power may be an early indicator of balance deficits and fall risk, even in nonfrail adults. This study examined the dose-dependent effect of power training on balance performance in healthy older adults. Power training improves balance, particularly using a low load, high velocity regimen, in older adults with initial lower muscle power and slower contraction. (more)

Abstract:
The trunk is the most common area of injury during the golf swing. This study describes and compares the muscle firing patterns in the trunk during the golf swing. The high and constant activity of these muscles indicate the need for an effective preventive and rehabilitative exercise program for the golfer (more)

Abstract:
Despite individual differences among the subjects’ swings, we observed reproducible patterns of trunk muscle activity throughout all phases of the golf swing. Our findings demonstrate the importance of the trunk muscles in stabilizing and controlling the loading response for maximal power and accuracy in the golfer’s swing. This study provides a basis for developing a rehabilitation program for golfers that stresses strengthening of the trunk muscles and coordination exercises. (more)

Abstract:
The aim was to develop a standardised and externally paced field walking test, incorporating an incremental and progressive structure, to assess functional capacity in patients with chronic airways obstruction. The authors concluded that the shuttle walking test constitutes a standardised incremental field walking test that provokes a symptom limited maximal performance. It provides an objective measurement of disability and allows direct comparison of patients' performance. (more)

Abstract:
Chronic instability after lateral ankle sprain has been shown to cause balance deficits during quiet standing. Although static balance assessment in those with ankle instability has been thoroughly examined in the literature, few researchers have studied performance on more dynamic tasks. Our purpose was to determine if the Star Excursion Balance Tests (SEBTs), lower extremity reach tests, can detect deficits in subjects with chronic ankle instability. (more)

Abstract:
The authors investigated whether frontal cerebral rhythms of the two hemispheres are implicated in fine motor control and balance. It was found that the body sway area displayed similar values in the successful and unsuccessful putts. (more)

Abstract:
Cancer of unknown origin (CUO) is defined by the absence of any primary tumour in biopsy-proved metastatic cancer. CUO accounts for a 5-10% of all malignancies. These tumors have a specific biology with clinical characteristics of rapid progression and atypical metastases. Diagnostic evaluation is directed at the identification of treatable subset. Accurate diagnostic workup is crucial because both prognosis and survival rates depend mainly on detection of the primary tumor site. Although these patients undergo extensive imaging procedures, nuclear medicine techniques are under-utilized despite their ability of providing molecular information. Positron emission tomography has an emerging role in this clinical challenge along with other nuclear medicine methods including, bone scan, thyroid scintigraphy. (more)