Journal of Orthopaedic & Sports Physical Therapy最新文献

{"title":"Spinal Manipulative Therapy for Nonspecific Low Back Pain: Does Targeting a Specific Vertebral Level Make a Difference?: A Systematic Review With Meta-analysis.","authors":"Peter Westlund Sørensen, Casper Glissmann Nim, Erik Poulsen, Carsten Bogh Juhl","doi":"10.2519/jospt.2023.11962","DOIUrl":"10.2519/jospt.2023.11962","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> We aimed to examine whether targeting spinal manipulative therapy (SMT), by applying the intervention to a specific vertebral level, produces superior clinical outcomes than a nontargeted approach in patients with nonspecific low back pain. <b>DESIGN:</b> Systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> MEDLINE, Embase, CENTRAL, CINAHL, Scopus, PEDro, and Index to Chiropractic Literature were searched up to May 31, 2023. <b>STUDY SELECTION CRITERIA:</b> Randomized controlled trials comparing targeted SMT (mobilization or manipulation) to a nontargeted approach in patients with nonspecific low back pain, and measuring the effects on pain intensity and patient-reported disability. <b>DATA SYNTHESIS:</b> Data extraction, risk of bias, and evaluation of the overall certainty of evidence using the GRADE approach were performed by 2 authors independently. Meta-analyses were performed using the restricted maximum likelihood method. <b>RESULTS:</b> Ten randomized controlled trials (n = 931 patients) were included. There was moderate-certainty evidence of no difference between targeted SMT and a nontargeted approach for pain intensity at postintervention (weighted mean difference = -0.20 [95% CI: -0.51, 0.10]) and at follow-up (weighted mean difference = 0.05 [95% CI: -0.26, 0.36]). For patient-reported disability, there was moderate-certainty evidence of no difference at postintervention (standardized mean difference = -0.04 [95% CI: -0.36, 0.29]) and at follow-up (standardized mean difference = -0.05 [95% CI: -0.24, 0.13]). Adverse events were reported in 4 trials, and were minor and evenly distributed between groups. <b>CONCLUSION:</b> Targeting a specific vertebral level when administering SMT for patients with nonspecific low back pain did not result in improved outcomes on pain intensity and patient-reported disability compared to a nontargeted approach. <i>J Orthop Sports Phys Ther 2023;53(9):1-11. Epub: 28 July 2023. doi:10.2519/jospt.2023.11962</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9977120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Pain and Movement Dysfunction Associated With Nonarthritic Hip Joint Pain - 2023 Revision Using the Evidence to Guide Musculoskeletal Rehabilitation Practice.","authors":"","doi":"10.2519/jospt.2023.0505","DOIUrl":"10.2519/jospt.2023.0505","url":null,"abstract":"<p><p>Nonarthritic hip joint pain is a collection of conditions involving intra-articular structures of the hip, including femoroacetabular impingement syndrome (FAIS), developmental dysplasia of the hip (DDH), hip instability, acetabular labral tears, osteochondral lesions, loose bodies, and ligamentum teres tears. Pain in the hip region can also involve non-musculoskeletal, lumbosacral spine, intra-articular, and extra-articular sources. Treatment for people with nonarthritic hip joint pain should focus on impairments and be evidence based, with assessments at baseline and at least one other follow-up point that includes discharge. Here we present, for clinicians, the most up-to-date information to guide their work to manage nonarthritic hip pain. <i>J Orthop Sports Phys Ther 2023;53(9):1-3. doi:10.2519/jospt.2023.0505</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10167813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Neurocognitive and Functional Tests to Improve Return-to-Sport Decisions Following ACL Reconstruction.","authors":"Dustin R Grooms, Meredith Chaput, Janet E Simon, Cody R Criss, Gregory D Myer, Jed A Diekfuss","doi":"10.2519/jospt.2023.11489","DOIUrl":"10.2519/jospt.2023.11489","url":null,"abstract":"<p><p><b>SYNOPSIS:</b> Neuroplasticity after anterior cruciate ligament (ACL) injury alters how the nervous system generates movement and maintains dynamic joint stability. The postinjury neuroplasticity can cause neural compensations that increase reliance on neurocognition. Return-to-sport testing quantifies physical function but fails to detect important neural compensations. To assess for neural compensations in a clinical setting, we recommend evaluating athletes' neurocognitive reliance by augmenting return-to-sport testing with combined neurocognitive and motor dual-task challenges. In this Viewpoint, we (1) share the latest evidence related to ACL injury neuroplasticity and (2) share simple principles and new assessments with preliminary data to improve return-to-sport decisions following ACL reconstruction. <i>J Orthop Sports Phys Ther 2023;53(8):1-5. Epub: 16 May 2023. doi:10.2519/jospt.2023.11489</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9650613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth With a Sport-Related Knee Injury Exhibit Significant and Persistent Knee-Related Quality-of-Life Deficits at 12-Month Follow-up Compared to Uninjured Peers.","authors":"Christina Y Le, Jean-Michel Galarneau, Stephanie R Filbay, Carolyn A Emery, Patricia J Manns, Jackie L Whittaker","doi":"10.2519/jospt.2023.11611","DOIUrl":"10.2519/jospt.2023.11611","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> We aimed to compare knee-related quality of life (QOL) between youth with and without an intra-articular, sport-related knee injury at baseline (≤4 months postinjury), 6-month, and 12-month follow-up, and assess the association between clinical outcomes and knee-related QOL. <b>DESIGN:</b> Prospective cohort study. <b>METHODS:</b> We recruited 86 injured and 64 uninjured youth (similar age, sex, sport). Knee-related QOL was assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) QOL subscale. Linear mixed models (95% confidence interval [CI]; clustered on sex and sport) compared KOOS QOL between study groups over the study period, considering sex-based differences. We also explored the association of injury type (anterior cruciate ligament [ACL]/meniscus injury or other), knee extensor strength (dynamometry), moderate-to-vigorous physical activity (accelerometer), intermittent knee pain (Intermittent and Constant Osteoarthritis Pain [ICOAP] measure), and fear of reinjury (17-item Tampa Scale of Kinesiophobia) with knee-related QOL. <b>RESULTS:</b> Participant median (range) age was 16.4 (10.9-20.1) years, 67% were female, and 56% of injuries were ACL ruptures. Injured participants had lower mean KOOS QOL scores at baseline (-61.05; 95% CI: -67.56, -54.53), 6-month (-41.37; 95% CI: -47.94, -34.80), and 12-month (-33.34; 95% CI: -39.86, -26.82) follow-up, regardless of sex. Knee extensor strength (6- and 12-month follow-up), moderate-to-vigorous physical activity (12-month follow-up), and ICOAP (all time points) were associated with KOOS QOL in injured youth. Additionally, having an ACL/meniscus injury and higher Tampa Scale of Kinesiophobia scores were associated with worse KOOS QOL in injured youth. <b>CONCLUSION:</b> Youth with a sport-related knee injury have significant, persistent knee-related QOL deficits at 12-month follow-up. Knee extensor strength, physical activity, pain, and fear of reinjury may contribute to knee-related QOL. <i>JOSPT 2023;53(8):1-10. Epub: 20 June 2023. doi:10.2519/jospt.2023.11611</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9843715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Reviews 2 - Synthesizing the Evidence: Linking Evidence to Practice.","authors":"Steven J Kamper","doi":"10.2519/jospt.2023.0702","DOIUrl":"10.2519/jospt.2023.0702","url":null,"abstract":"","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10203270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance, Motor Control, and Mindfulness-Based Exercises Are Effective for Treating Chronic Nonspecific Neck Pain: A Systematic Review With Meta-Analysis and Dose-Response Meta-Regression.","authors":"Juliane Mueller, Jonas Weinig, Daniel Niederer, Sarah Tenberg, Steffen Mueller","doi":"10.2519/jospt.2023.11820","DOIUrl":"10.2519/jospt.2023.11820","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> We aimed to analyze the effects and dose-response relationship of the most effective exercises for improving pain and disability in people with chronic nonspecific neck pain. <b>DESIGN:</b> Intervention systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> We searched the PubMed, PEDro, and CENTRAL databases from their inception to September 30, 2022. <b>STUDY SELECTION CRITERIA:</b> We included randomized controlled trials that involved people with chronic neck pain adopting a longitudinal exercise intervention and assessed one pain and/or disability outcome. <b>DATA SYNTHESIS:</b> Restricted maximum-likelihood random-effects meta-analyses were modeled separately for resistance, mindfulness-based, and motor control exercises; standardized mean differences (Hedge's <i>g</i>, standardized mean difference [SMD]) were effect estimators. Meta-regressions (dependent variable: effect sizes of the interventions; independent variables: training dose and control group effects) were conducted to explore the dose-response relationship for therapy success of any exercise type. <b>RESULTS:</b> We included 68 trials. Compared to true control, effects on pain and disability were significantly larger for resistance exercise (pain: SMD, -1.27; 95% confidence interval [CI]: -2.26, -0.28; |² = 96%; disability: SMD, -1.76; 95% CI: -3.16, -0.37; |² = 98%), motor control exercise (pain: SMD, -2.29; 95% CI: -3.82, -0.75; |² = 98%; disability: SMD, -2.42; 95% CI: -3.38, -1.47; |² = 94%), and Yoga/Pilates/Tai Chi/Qui Gong exercise (pain: SMD, 1.91; 95% CI:-3.28, -0.55; |² = 96%; disability: SMD, -0.62; 95% CI: -0.85, -0.38; |² = 0%). Yoga/Pilates/Tai Chi/Qui Gong exercise was more effective than other exercises (SMD, -0.84; 95% CI: -1.553, -0.13; |² = 86%) for reducing pain. For disability, motor control exercise was superior to other exercises (SMD, -0.70; 95% CI: -1.23, -0.17; |² = 98%). There was no dose-response relationship for resistance exercise (<i>R</i>² = 0.32). Higher frequencies (estimate = -0.10) and longer durations (estimate = -0.11) of motor control exercise had larger effects on pain (<i>R</i>² = 0.72). Longer sessions (estimate = -0.13) of motor control exercise had larger effects on disability (<i>R</i>² = 0.61). <b>CONCLUSION:</b> Resistance, mindfulness-based, and motor control exercises were effective for reducing neck pain (very low- to moderate-certainty evidence). Higher frequencies and longer duration of sessions had a significant effect on pain for motor control exercise. <i>J Orthop Sports Phys Ther 2023;53(8):1-41. Epub: 20 June 2023. doi:10.2519/jospt.2023.11820</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcome Measures for Adults and Adolescents With Patellofemoral Pain: A Systematic Review of Construct Validity, Reliability, Responsiveness, and Interpretability Using the COSMIN Methodology.","authors":"Lisa T Hoglund, David A Scalzitti, Dhinu J Jayaseelan, Lori A Bolgla, Susan Flannery Wainwright","doi":"10.2519/jospt.2023.11730","DOIUrl":"10.2519/jospt.2023.11730","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> We aimed to appraise the construct validity, reliability, responsiveness, and interpretability of patient-reported outcome measures (PROMs) used to assess function and pain in adults and adolescents with patellofemoral pain (PFP). <b>DESIGN:</b> Systematic review of measurement properties <b>LITERATURE SEARCH:</b> We searched the PubMed, CINAHL, Scopus, SPORTDiscus, and Cochrane Library databases from inception to January 6, 2022. <b>STUDY SELECTION CRITERIA:</b> We included studies that assessed the measurement properties of English-language PROMs for PFP and their cultural adaptations and translations. <b>DATA SYNTHESIS:</b> Using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology, we determined overall ratings and quality of evidence for construct validity, internal consistency, reliability, measurement error, and responsiveness. We extracted data related to interpretability for clinical use. <b>RESULTS:</b> After screening 7066 titles, 61 studies for 33 PROMs were included. Only 2 PROMs had evidence of \"sufficient\" or \"indeterminate\" quality for all measurement properties. The Knee injury and Osteoarthritis Outcome Score patellofemoral subscale (KOOS-PF) had \"low\" to \"high\" quality evidence for a rating of \"sufficient\" for 4 measurement properties. The Lower Extremity Functional Scale (LEFS) had very low-quality evidence for a \"sufficient\" rating for 4 measurement properties. The KOOS-PF and LEFS were rated \"indeterminate\" for structural validity and internal consistency. The KOOS-PF had the best interpretability with reported minimal important change and 0% ceiling and floor effects. No studies examined cross-cultural validity. <b>CONCLUSION:</b> The KOOS-PF and LEFS had the strongest measurement properties among PROMs used for PFP. More research is needed, particularly regarding structural validity and interpretability of PROMs. <i>J Orthop Sports Phys Ther 2023;53(8):1-20. Epub: 20 June 2023. doi:10.2519/jospt.2023.11730</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Reviews 1 - Gathering the Evidence: Linking Evidence to Practice.","authors":"Steven J Kamper","doi":"10.2519/jospt.2023.0701","DOIUrl":"10.2519/jospt.2023.0701","url":null,"abstract":"","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9899428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Broken Machines or Active Bodies? Part 3. Five Recommendations to Shift the Way Clinicians Communicate With People Who Are Seeking Care for Osteoarthritis.","authors":"Samantha Bunzli, Nicholas F Taylor, Penny O'Brien, Jason A Wallis, J P Caneiro, Robyn Woodward-Kron, David J Hunter, Peter F Choong, Michelle M Dowsey, Nora Shields","doi":"10.2519/jospt.2023.11881","DOIUrl":"10.2519/jospt.2023.11881","url":null,"abstract":"<p><p><b>SYNOPSIS:</b> In parts 1 and 2 of this series, we highlighted the dominant impairment way of talking about osteoarthritis: talking that frames osteoarthritis as a disease of cartilage worsened by physical activity that can only be \"cured\" by replacing the joint. An alternative understanding that counters common misconceptions about osteoarthritis, and links physical activity and healthy lifestyles to improvements in symptoms is likely a prerequisite for sustainable behavior change. It is insufficient to tell people with osteoarthritis that regular physical activity is important; people need to understand and experience <i>how</i> physical activity can help. Here, we offer suggestions for how clinicians can shift from focusing on what people cannot do because of osteoarthritis, toward focusing on what people <i>can</i> do to improve their health and maintain \"active bodies.\" <i>J Orthop Sports Phys Ther 2023;53(7):1-6. doi:10.2519/jospt.2023.11881</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9727459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description, Prediction, and Causation in Sport and Exercise Medicine Research: Resolving the Confusion to Improve Research Quality and Patient Outcomes.","authors":"Justin M Losciale, Garrett S Bullock, Gary S Collins, Amelia J H Arundale, Tom Hughes, Nigel K Arden, Jackie L Whittaker","doi":"10.2519/jospt.2023.11773","DOIUrl":"10.2519/jospt.2023.11773","url":null,"abstract":"<p><p><b>SYNOPSIS:</b> Researchers often assign a label (such as a risk factor or predictor) to a characteristic that is statistically associated with an outcome (such as future injury). Labeling signifies that the characteristic has an established clinical value. More often than not, these labels are assigned prematurely and haphazardly. The rampant practice conflates research goals, the ultimate clinical value of the findings, and many <i>risk factors/predictors</i> that may not warrant the label. To address these issues and improve injury prevention research, we (1) outline the problem; (2) clarify the key differences between the research goals of description, causation, and prediction/prognosis (along with labeling conventions); (3) differentiate the clinical implications for each label; and (4) frame an appropriate scientific process to follow before applying a label. <i>J Orthop Sports Phys Ther 2023;53(7):1-7. Epub: 26 April 2023. doi:10.2519/jospt.2023.11773</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9850189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}