Physical Therapy Commons^™

Predicting Clinical Outcomes Of Non-Specific Low Back Pain By Studying The Interaction Of Clinical And Demographic Factors Of A Retrospective Data Set, Erica Michelle Fernandes

Dissertations

The purpose of this research is to investigate demographic factors, including age, gender, body mass index (BMI), race, marital status, insurance type, severity of disease (initial pain level), and clinical factors such as number of visits (no. of visits) at physical therapy (PT), length of time at PT and the type of clinician either physical therapist versus physical therapy assistant (PTA), that most predict PT clinical outcomes in patients with nonspecific low back pain (NSLBP) and see if there is an interaction between demographic and clinical variables.

Methods

The current study is a retrospective, cross-sectional, observational study using secondary electronic …

The Sympathetic And Clinical Effects Of Dry Needling To The Thoracolumbar Junction Multifidi: A Randomized Controlled Trial, Nicole Clark, Cheryl J. Hill, Joshua Cleland, Thomas Massie, Shane Koppenhaver

Internet Journal of Allied Health Sciences and Practice

Purpose: The primary aim of this study was to investigate the neurophysiological effects of dry needling (DN) to the thoracolumbar junction multifidi when compared with a placebo. The secondary objective was to determine if there is a relationship between post-treatment pain and disability and the magnitude of sympathetic nervous system activity. Methods: Participants were eligible if they had low back pain, limited flexibility in at least one hamstring, and had not previously received DN. Participants completed the Numeric Pain Rating Scale and Oswestry Disability Index, underwent pressure pain threshold testing, and were randomized to a DN or sham …

The Association Of Acute Stress And Lower Quarter Emg During A Single Leg Balance Dexterity Task, Ted W. Gehrig Iii, Robert I. Dudley, Jo Armour Smith, Lida Gharibvand, Lee S. Berk, Everett B. Lohman Iii

Physical Therapy Faculty Articles and Research

Background

Research Question

Methods

Gray Matter Morphology And Pain-Related Disability In Young Adults With Low Back Pain, Jo Armour Smith, Rongwen Tain, Isaac Chrisman, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Structural neuroplasticity in the brain may contribute to the persistence of low back pain (LBP) symptoms and the disability associated with them. It is not known if structural adaptations are evident early in the lifespan in young adults with LBP. This study compared gray matter in cortical sensorimotor regions in young adults with and without persistent LBP and identified gray matter and clinical predictors of pain-related disability. Eighty-two individuals with and without a history of LBP participated. Peak and average gray matter density in cortical sensorimotor regions of interest was quantified using voxel-based morphometry. Pain-related disability, pain intensity, pain duration, …

Toward Facilitating The Collection And Utilization Of Patient-Reported Outcomes In The Military Health System: Lessons Learned From A Pragmatic Clinical Trial On Physical Therapy Management For Low Back Pain, Emma H. Beisheim-Ryan, Brad D. Hendershot, Timothy C. Mauntel, Sara R. Gorczynski, Ryan W. Smith, Andrea Crunkhorn, Shawn Farrokhi, Christopher L. Dearth

Physical Therapy Faculty Articles and Research

"In pursuit of delivering 'the right care to the right patient at the right time,' the Military Health System (MHS) advocates for collecting and using patient-reported outcomes (PROs) to help demonstrate value-based care.1 PROs identify patients’ perceptions of their health, function, and well-being, which can enhance patient-centered communication and guide data-driven healthcare. 2 The MHS recognizes the value of incorporating PRO data into clinical decision-making and has established a number of platforms for PRO collection across health conditions (eg, behavioral health, traumatic brain injury, musculoskeletal injuries). The Military Orthopedics Tracking Injuries and Outcomes Network (MOTION)3 was started as a research …

Effects Of Thoracic Spine Mobilization On The Lumbar Spine Rotation Angle During Trunk Rotation, Toru Yasuda, Ryota Yoshida, Hironobu Kuruma

Asian Journal of Physical Therapy

Objectives: Limitations in the thoracic spine movement can cause excessive lumbar rotation and back pain; however, it is unclear whether increasing thoracic rotation reduces excessive lumbar rotation. This study aimed to examine the effect of thoracic spine mobilization on the rotation angle of the lumbar spine during trunk rotation. Methods: Twenty healthy volunteers participated in this study. We identified and then mobilized three restricted vertebrae in the thoracic spine through a physical examination using a facet joint traction mobilization technique. Rotational movements of both the thoracic and lumbar spine were assessed pre- and post-intervention. Measurement items included: (1) lumbar rotational …

Effects Of A Trunk Harness On Lumbopelvic Stability And Muscle Activity During Prone Hip Extension Exercise, Taro Toraiwa, Sirinda Jaotawiparta, Misaki Suzuki, Hironobu Kuruma

Asian Journal of Physical Therapy

Background: Therapeutic exercise is essential in patients with low back pain and lumbopelvic instability. Intra-abdominal pressure is necessary for ideal dynamic stabilization patterns. However, accurate performance of such exercises is a challenge. A trunk harness can help stabilize and alter muscular patterns. This study aimed to examine the effects of using a trunk harness on lumbopelvic stability and muscle activity during prone hip extension in healthy individuals and patients with low back pain. Methods: Sixteen patients with low back pain and 15 healthy individuals performed prone hip extension under control, Dynamic Neuromuscular Stabilization(DNS)-maneuver, and DNS-maneuver + harness conditions. Lumbopelvic kinematic …

Low Back Pain And The Lumbar Multifidus Muscle, Richard E. Sroka

Graduate Research Theses & Dissertations

Low back pain (LBP) is common, debilitating, and costly to treat. In the United States alone, LBP treatment costs are estimated at 100-200 billion annually. Physical therapists often provide conventional core strengthening exercise (CCSE) to address the symptoms of LBP. On the other hand, however, a low rate of success is reported for individuals treated for their LBP. Despite numerous studies conducted on LBP treatments, patient outcomes are mixed and 60-86% of people have recurrent LBP episodes. This rating may be attributed to the complexity of the exercise that makes correct performance challenging and can potentially reduce patient compliance. An …

Understanding The Biering-Sørensen Test: Contributors To Extensor Endurance In Young Adults With And Without A History Of Low Back Pain, Jonathan Shaw, Jesse V. Jacobs, Linda R. Van Dillen, George J. Beneck, Jo Armour Smith

Physical Therapy Faculty Articles and Research

The Biering-Sørensen test is commonly used to assess paraspinal muscle endurance. Research using a single repetition of the test has provided conflicting evidence for the contribution of impaired paraspinal muscle endurance to low back pain (LBP). This study investigated how Sørensen test duration, muscle activation, and muscle fatigability are affected by multiple repetitions of the test and determined predictors of Sørensen test duration in young adults with and without a history of LBP. Sixty-four young individuals performed three repetitions of the Sørensen test. Amplitude of activation and median frequency slope (fatigability) were calculated for the lumbar and thoracic paraspinals and …

Greater Number Of Weekly Stairs Climbed Is Associated With Lower Low Back Pain Prevalence Among Female But Not Male Physical Therapists, Amy H. Amabile, Sharon L. Larson, Lisa T. Hoglund, John P. Guarnieri, Maureen Mcdonald, Madeline R. Reich

Department of Physical Therapy Faculty Papers

INTRODUCTION: Certain cardiovascular health benefits of stair climbing are now widely accepted, but no prior studies have as yet been found linking the quantity of stairs climbed to low back pain (LBP) morbidity. Low back pain is a common musculoskeletal impairment, and research has begun to show an association between LBP and gluteus maximus (GM) weakness. With stair climbing being the activity which most activates GM, the aim of the present research was to assess the relationship between stair ambulation and LBP prevalence. The hypothesis of this cross-sectional study was that individuals with LBP would report a significantly lower numbers …

The Influence Of Personality Type On Patient Outcome Measures And Therapeutic Alliance In Patients With Low Back Pain, William J. Hanney, Fahim Dhalla, Chase Kelly, Alicia Tomberlin, Morey J. Kolber, Abigail T. Wilson, Paul A. Salamh

HPD Articles

Background: Low back pain (LBP) has been shown to have various biological, psychological, and social factors that affect prognosis. However, it is unclear how personality may influence self-reported outcome measures and therapeutic alliance (TA). Methods: Eysenck’s personality inventory was used to assess personality, while the numeric pain rating scale (NPRS), Oswestry Disability Index (ODI), Tampa Scale of Kinesiophobia (TSK), Global Rating of Change (GROC), and the Working Alliance Inventory (WAI) measured patient progress and relationship strength. All outcome measures were formulated in a single survey that both the therapist and patient completed electronically. Results: Sixty-seven patients with LBP and twenty-two …

Lumbopelvic Biomechanics And Muscle Performance In Individuals With Unilateral Transfemoral Amputation: Implications For Lower Back Pain, Jason Ciccotelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many people with lower extremity amputation (LEA) experience lower back pain (LBP). The amount of pain they experienced can be debilitating and severely interferes with activities of daily living. Previous studies have explored LBP in populations without LEA, and the evidence is also growing within the limb loss population. However, the mechanism for the high prevalence of LBP after LEA remains unclear. The lower back muscles, specifically the multifidi muscles, play an important role in stabilization of the spine during motion, and LBP has been associated with decreased mobility in patient populations, but the degree of dysfunction in the spinal …

Multi-Disciplinary Biopsychosocial Approach In Low Back Pain Benchmark Study, Liza Beth Cocanougher Short Rn, Ms

MSN Capstone Projects

Low back pain (LBP) is the third most common reason people seek care in America and is the primary reason for missed work days. Working in a pain clinic for eight years and managing research studies directed toward improving low back pain in patients was the motivation for choosing the evidence based intervention in this population. The health care professionals (HCP) in the pain clinic usually have a conversation with the patients who have acute or subacute onset of LBP about their disease and give them a written handout with exercises and ask them to perform these exercises at home. …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

The General Population's Perception Of Factors Associated With Positive Or Negative Perceptions Of Physical Therapy Care In Those With Low Back Pain, Jada M. Strowbridge

Honors Undergraduate Theses

Low back pain (LBP) has a global impact on health and is a substantial contributor to long term disability. The economic burden of LBP is immense and it is advancing annually. Costs attributing to LBP in the United States is about $84.1 to $624.8 billion. Physical therapy is commonly recommended for those with LBP since it is linked to improved clinical outcomes. However, patient perceptions can influence how this treatment approach is perceived. It is unclear if these perceptions can influence outcomes for patients suffering from LBP. Therefore, the purpose of this study is to identify the factors associated with …

Conservative Management Of Low Back Pain, Se Won Lee, Dan Nguyen, Denny Mack, Eric Aguila, Mary Thomas, Karyn Doddy

HCA Healthcare Journal of Medicine

Low back pain (LBP) is frequently encountered in outpatient clinics and affects individual patients and society in general with decreased physical function, quality of life, disability, and/or economic burden. Although most acute LBP resolves on its own, recurrent and chronic LBP is a common reason for outpatient clinic visits. This review explores pragmatic approaches to LBP in the clinical setting, focusing on recognizing prognostic factors, initial approaches to evaluation, including selective imaging, and conservative management including patient education, therapeutic exercises and bracing.

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

What Do People Post On Social Media Relative To Low Back Pain? A Content Analysis Of Australian Data, Edel T. O'Hagan, Adrian C. Traeger, Samantha Bunzli, Hayley B. Leake, Siobhan M. Schabrun, Benedict Wand, Sean O'Neill, Ian A. Harris, James H. Mcauley

Physiotherapy Papers and Journal Articles

Objective: Low back pain is the leading contributor to the global disability burden. The Global Spine Care Initiative (GSCI) recommend patient-centred care to stem the cost of low back pain. One way to enhance patientcentred care is by better understanding what is relevant for people with low back pain. Exploring social media posts about low back pain could offer this insight and provide valuable information for health care professionals to facilitate active participation in patient-centred care.

Methods: We used an inductive content analysis method. In the form of social media posts, data on Twitter and Instagram were collected from June …

Lower Extremity Kinetics And Muscle Activation During Gait Are Significantly Different During And After Pregnancy Compared To Nulliparous Females, Jennifer J. Bagwell, Nicholas Reynolds, Michelle Walaszek, Hannah Runez, Kristina Lam, Jo Armour Smith, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

Low back, pelvic, and lower extremity pain are common during and after pregnancy. Understanding differences in mechanics between pregnant and non-pregnant females is a first step toward identifying potential pathological mechanisms. The primary purpose of this study was to compare joint kinetics and muscle activation during gait between females during and after pregnancy to nulliparous females.

Methods

Twenty pregnant females completed testing on three occasions (second trimester, third trimester, and post-partum), while 20 matched, nulliparous controls were tested once. Motion capture, force data, and surface electromyography were averaged across seven trials during gait. Lower extremity kinematics, lower extremity moments …

Financial Impact Associated With Implementation Of The Low Back Pain Clinical Practice Guideline In Outpatient Physical Therapist Practice, Heidi Kosakowski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Dysfunction and disability arising from low back pain (LBP) affects more people than any other condition globally, and results in changes to the quality of life for many individuals. The financial burden of managing low back pain is among the highest both in the United States and globally. Clinical practice guidelines (CPGs) provide recommendations on patient management strategies and have the potential to simultaneously improve patient outcomes and lower health care costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs that are incurred after physical therapist care. A retrospective observational study was conducted that examined …

Neurophysiological Effects Of Dry Needling To The Thoracolumbar Junction Multifidi In Subjects With Low Back Pain And Decreased Hamstring Length, Nicole Ginette Clark

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: Dry needling is becoming increasingly popular in the treatment of neuromusculoskeletal conditions. The neurophysiological effect of treatment, specifically those related to the sympathetic nervous system (SNS) is considered a relevant physiological mechanism contributing to a patient’s rehabilitation. The primary purpose of this study was toinvestigate the neurophysiological effects of dry needling, as measured by sympathetic outflow and muscular flexibility. A secondary purpose of this study was to determine if changes in SNS activity correlate with clinically meaningful improvements in pain and disability. Design: This was a prospective, double-blind randomized clinical trial. Subjects: The study sample consisted of …

Structural And Tissue-Level Adaptations Of Lumbar Intervertebral Discs In Humans With Inducible Low Back Pain Symptoms, Christian Isaiah Weber

McKelvey School of Engineering Graduate Student Theses & Dissertations

Low back pain (LBP) is a devastating musculoskeletal ailment that impacts majority of the global population. Up to 95% of cases are considered nonspecific where the origin is unclear. Although there is a diagnosis with these cases, there lacks specificity that would help individuals with treatment and pain management. Imaging techniques such as magnetic resonance imaging (MRI) are primarily utilized in the diagnosis of LBP as it illuminates internal structures of the spine. One important structure clearly identified with MRI is the intervertebral disc (IVD) that is susceptible to injury and disease. Further, diagnostic imaging is performed lying down where …

Spine Kinematics And Muscle Activities In Non-Specific Chronic Low Back Pain Subgroups In Sitting, Mansoor Ahmed Alameri

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Although, non-specific chronic low back pain (NSCLBP) has been associated with motor control impairments, little is known about the possible driving mechanisms of pain development overtime during prolonged sitting period. Therefore, the purpose of this study was to examine the differences in lumbosacral postures and muscle activities in adults with and without NSCLBP, and their role on pain development during a 1-hour of prolonged sitting task.

Methods: Twenty NSCLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern (FP) disorder, and 10 with active extension pattern (AEP) disorder], and 10 healthy controls participated in …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes In Paraspinal Muscle Strength After Intramuscular Fine Wire Electrode Insertion, Szu-Ping Lee, Vincent Dinglasan, Anthony Duong, Russell Totten, Jo Armour Smith

Physical Therapy Faculty Articles and Research

Objective

To examine how insertion and presence of intramuscular fine‐wire electromyography electrodes (IFWE) in lumbar multifidus affect paraspinal muscle strength, endurance, and activation in persons with and without recurrent lower back pain (RLBP) during activities that require high levels of muscle contraction.

Design

Case‐control with randomization of conditions.

Setting

Clinical Research Laboratory.

Participants

Forty participants age 18‐40 were recruited (18 female; mean age = 25.5 yr); 20 with a history of RLBP were compared to a matching control group of 20 without RLBP.

Interventions

Each participant was tested under three conditions over three sessions. On Session 1, the baseline condition, …

Risk Factors For The Elevation Of Psychosocial Barriers In The Recovery Of Lumbar Pathology, Christopher Keating, Cameron Hui, Gerard Smith, Tingting Zhan

Department of Physical Therapy Faculty Papers

Background/Purpose: The prevalence of low back pain (LBP) continues to rise and an appreciation for a biopsychosocial approach, which takes in multiple facets of a patient presentation, may significantly impact this increase. To the best our knowledge, there are no studies evaluating the relationship between the STarTBack Screening Tool (SBT) and the access point the patient enters the health system. Our hypothesis is that patients that access care through the medical model will exhibit greater psychosocial risk.

Methods: A retrospective analysis of 1404 cases of LBP utilizing past medical history, demographic information, and SBT data. A linear regression model to …

Perceived Body Distortion Rather Than Actual Body Distortion Is Associated With Chronic Low Back Pain In Adults With Cerebral Palsy: A Preliminary Investigation, Hirofumi Yamashita, Tomohiko Nishigami, Akira Mibu, Katsuyoshi Tanaka, Masahiro Manfuku, Hikaru Fukuhara, Koichi Yoshino, Yoichi Seto, Benedict Wand

Physiotherapy Papers and Journal Articles

Objectives: The aim of the present study was to investigate whether distorted body perception is a feature of the low back pain experience in people with Cerebral Palsy (CP) and whether any distortions noted are confounded by the presence of motor and postural impairments commonly seen in CP.

Methods: Forty‐five individuals participated in this study: fifteen adults with CP with LBP (CP_Pain group), fifteen adults with CP without LBP (CP_noPain group), and fifteen age‐matched adults with LBP but no CP (Pain group). Body perception was evaluated using the Fremantle Back Awareness Questionnaire (FreBAQ) and by assessing two‐point discrimination (TPD) thresholds …

Reviewing The Diagnostic Classifications Used For Low Back Pain In Physiotherapy-Related Research., Steve Milanese, David Worth

Internet Journal of Allied Health Sciences and Practice

Background: The evidence-to-practice gap, where clinical practice does not reflect the findings from research evidence, has been identified as a concern in allied health disciplines such as physiotherapy. Failure to provide care according to current (research) evidence raises the potential that patients are receiving care that is either not needed, is ineffective, less effective than current research indicates, or potentially harmful. For research evidence to be translatable to clinical practice, the research should be seen to be applicable, i.e. the clinician should be able to recognise that the research study sample reflects their patient population. Method: This study presents …

Risk Factors Associated With Low Back Pain In Golfers: A Systematic Review And Meta-Analysis, Jo Armour Smith, Andrew Hawkins, Marybeth Grant-Beuttler, Richard Beuttler, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Context:

Low back pain is common in golfers. The risk factors for golf-related low back pain are unclear but may include individual demographic, anthropometric, and practice factors as well as movement characteristics of the golf swing.

Objective:

The aims of this systematic review were to summarize and synthesize evidence for factors associated with low back pain in recreational and professional golfers.

Data Sources:

A systematic literature search was conducted using the PubMed, CINAHL, and SPORTDiscus electronic databases through September 2017.

Study Selection:

Studies were included if they quantified demographic, anthropometric, biomechanical, or practice variables in individuals with and without golf-related …

Fms Squat Assessment And 2d Video Motion Analysis As Screening Indicators Of Low Back Pain: A Cross Sectional Case- Study, Tracy Donlon, Britanny Franklin, Courtney Machamer, Christina Mogelnicki, Jeffrey Verneus, Christopher Taber

Exercise Science Faculty Publications

Aim: Low back pain (LBP) is a disabling condition to individuals in the United States and physical therapy (PT) has been proven to be a beneficial treatment by analyzing their movement patterns. The main objective of this study was to analyze the deep squat component of the Functional Movement Screen (FMS) as an indicator of LBP while simultaneously using 2-D analysis. Method: This cross-sectional case study included 36 participants that completed a total of six deep squats. Three raters scored the FMS score of each participant. Results: The association between FMS score and the presence of LBP showed to be …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes Of Paraspinal Muscle Performance After Lumbar Multifidus Intramuscular Fine Wire Electrode Insertion, Anthony Duong, Vincent Dinglasan, Russell Totten

UNLV Theses, Dissertations, Professional Papers, and Capstones

STUDY DESIGN: Case control study. BACKGROUND: Recurrent low back pain (RLBP) is associated with paraspinal muscle dysfunction. Intramuscular electromyography (EMG) is a common tool for studying activation of the deep lumbar paraspinal muscles such as multifidi muscles, but it is currently currently unclear how muscle performance and activation are affected by the pain and micro-injury associated with intramuscular fine-wire electrode (IFWE) insertion and how it interacts with the presence of RLBP. OBJECTIVES: The purpose of this study was to examine how IFWE insertion into the lumbar multifidus affects paraspinal muscle strength and endurance in subjects with and without RLBP. METHODS: …