Journal of Orthopaedic & Sports Physical Therapy最新文献

{"title":"Beware of the \"Moving Target\" - Uninvolved Limb Strength Increases to Exceed Preoperative Values During Rehabilitation After ACL Reconstruction in Male Professional and Recreational Athletes.","authors":"Olivia Barbosa, Roula Kotsifaki, Rodney Whiteley, Enda King, Vasileios Korakakis","doi":"10.2519/jospt.2023.11961","DOIUrl":"10.2519/jospt.2023.11961","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To describe the changes in quadriceps and hamstrings muscle strength in the uninvolved limb of male professional and recreational athletes during rehabilitation after anterior cruciate ligament reconstruction (ACLR) and compare to preoperative strength values. <b>DESIGN:</b> Prospective longitudinal study. <b>METHODS:</b> During rehabilitation, 665 participants who underwent unilateral ACLR performed a strength test preoperatively and every 6 weeks after surgery for up to 9 months. Isokinetic quadriceps and hamstrings strength of the uninvolved limb were measured at an angular velocity of 60°/s and normalized to body weight (N·m/kg). <b>RESULTS:</b> Quadriceps and hamstrings strength of the uninvolved limb gradually increased during rehabilitation until 6 months post-ACLR, and plateaued thereafter. Postoperative quadriceps' strength significantly exceeded preoperative values by 3 months for professional (2.99 N·m/kg; 95% confidence interval [CI]: 2.93, 3.04; <i>P</i> = .007) and by 6 months for recreational athletes (2.77 N·m/kg; 95% CI: 2.71, 2.83; <i>P</i><.001), and hamstrings exceeded presurgery levels by 4.5 months (1.71 N·m/kg; 95% CI: 1.67, 1.74; <i>P</i><.001 and 1.43 N·m/kg; 95% CI: 1.40, 1.46; <i>P</i> = .002, professional and recreational athletes respectively). <b>CONCLUSION:</b> In male professional and recreational athletes, uninvolved limb quadriceps and hamstrings strength gradually improved after ACLR, until 6 months after surgery. The uninvolved limb's strength may present as a \"moving target\" that requires consistent monitoring during rehabilitation. <i>J Orthop Sports Phys Ther 2024;54(4):1-9. Epub 14 December 2023. doi:10.2519/jospt.2023.11961</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"258-266"},"PeriodicalIF":6.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810637","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":"Influence of Preoperative Pain, Cognitions, and Quantitative Sensory Testing Measures on the Effects of Perioperative Pain Neuroscience Education for People Receiving Surgery for Lumbar Radiculopathy: Secondary Analysis of a Randomized Controlled Trial.","authors":"Wouter Van Bogaert, Iris Coppieters, Jo Nijs, Ronald Buyl, Kelly Ickmans, Maarten Moens, Lisa Goudman, Koen Putman, Eva Huysmans","doi":"10.2519/jospt.2024.12051","DOIUrl":"10.2519/jospt.2024.12051","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To explore whether preoperative pain intensity, pain cognitions, and quantitative sensory measures influence the established effectiveness of perioperative pain neuroscience education (PPNE) on health-related quality of life at 1 year after surgery for lumbar radiculopathy. <b>DESIGN:</b> Secondary analysis of a triple-blinded randomized controlled trial. <b>METHODS:</b> Participants (n = 90) were Dutch-speaking adults (18-65 years) who were scheduled for surgery for lumbar radiculopathy in 3 Belgian hospitals. They were randomized (1:1) to receive PPNE (n = 41) or perioperative biomedical education (n = 49). Linear mixed models were built for health-related quality of life (ie, SF-6D utility values, Physical and Mental Component of the 36-item Short Form Health Survey) using the following independent variables: therapy, time, and preoperative scores for back and leg pain intensity, pain catastrophizing, kinesiophobia, hypervigilance, and quantitative sensory measures. <b>RESULTS:</b> The impact of PPNE on SF-6D utility values over time was influenced by kinesiophobia (F = 3.30, <i>P</i> = .02) and leg pain intensity (F = 3.48, <i>P</i> = .02). Regardless of the intervention, back pain intensity negatively influenced SF-6D values over time (F = 3.99, <i>P</i> = .009). The Physical Component scores were negatively impacted by back pain intensity (F = 9.08, <i>P</i> = .003) and were influenced over time by leg pain intensity (F = 2.87, <i>P</i> = .04). The Mental Component scores were negatively impacted by back pain intensity (F = 6.64, <i>P</i> = .01) and pain catastrophizing (F = 5.42, <i>P</i> = .02), as well as hypervigilance (F = 3.16, <i>P</i> = .03) and leg pain intensity (F = 3.12, <i>P</i> = .03) over time. <b>CONCLUSION:</b> PPNE may be more effective than perioperative biomedical education in improving postoperative health utility values in patients who reported higher kinesiophobia and leg pain intensity before surgery for lumbar radiculopathy. <i>J Orthop Sports Phys Ther 2024;54(4):1-10. Epub 8 January 2024. doi:10.2519/jospt.2024.12051</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"279-288"},"PeriodicalIF":6.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378695","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":"Dry Needling Versus Manual Therapy for Patients With Mechanical Neck Pain: A Randomized Controlled Trial.","authors":"Jeevan Pandya, Emilio J Puentedura, Shane Koppenhaver, Josh Cleland","doi":"10.2519/jospt.2024.12091","DOIUrl":"10.2519/jospt.2024.12091","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To compare the short- and intermediate-term effects of dry needling to manual therapy on pain, disability, function, and patient-perceived improvement in patients with mechanical neck pain. <b>DESIGN:</b> A single (therapist) blinded randomized controlled trial. <b>METHODS:</b> Seventy-eight patients (mean ± SD age, 50.74 ± 13.81) were randomly assigned to one of the 2 groups: (1) dry needling and therapeutic exercises (DN + Exercises) and (2) manual therapy and therapeutic exercises (MT + Exercises). Both groups received 7 treatment sessions over a maximum of 6 weeks. Outcome measures, collected at baseline, 2 weeks, discharge (7th treatment session), and 3 months after discharge, were as follows: Neck Disability Index (NDI), numeric pain-rating scale (NPRS), Patient-Specific Functional Scale (PSFS), global rating of change (GROC), Fear-Avoidance Belief Questionnaire (FABQ), and Deep Neck Flexor Endurance Test (DNFET). Data were analyzed with mixed-model analysis of covariance (ANCOVA), using pretest scores as covariates, and a Mann-Whitney U test for GROC scores. <b>RESULTS:</b> The ANCOVA revealed significant group-by-time interaction for all variables. Significant between-group differences, favoring MT + Exercises, were observed at all 3 time points on the NDI (2 weeks: F_1,446 = 172.68, <i>P</i>≤.001, [Formula: see text] = .27; discharge: F_1,446 = 254.15, <i>P</i>≤.001, [Formula: see text] = .36; and 3 months: F_1,446 = 339.40, <i>P</i>≤.001, [Formula: see text] = .43). Results for the MT + Exercises group exceeded recommended minimal clinically important difference for all variables, at all follow-up points. <b>CONCLUSION:</b> MT + Exercises was more effective, both in the short term and intermediate term, than DN + Exercises in reducing pain, disability, and improving function in patients with mechanical neck pain. <i>J Orthop Sports Phys Ther 2024;54(4):1-12. Epub 29 January 2024. doi:10.2519/jospt.2024.12091</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"267-278"},"PeriodicalIF":6.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571921","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":"How Reproducible Are Manual Therapy Interventions in Trials for Low Back Pain? A Scoping Review.","authors":"Jon J Ruzich, Mareli Klopper, Chris M Dohrmann, Daniel I Rhon, Jodi L Young","doi":"10.2519/jospt.2024.12201","DOIUrl":"10.2519/jospt.2024.12201","url":null,"abstract":"<p><p><b>OBJECTIVES:</b> To assess the reproducibility of manual therapy interventions used in clinical trials for low back pain (LBP), and summarize knowledge gaps in assessing the reproducibility of manual therapy interventions for LBP. <b>DESIGN:</b> Scoping review. <b>LITERATURE SEARCH:</b> PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Embase were searched for trials from inception through April 2023. <b>STUDY SELECTION CRITERIA:</b> Randomized controlled trials were included if they described the use of manual therapy to treat LBP in adults 18 to 65 years old and were accessible in English. <b>DATA SYNTHESIS:</b> The Consensus on Exercise Reporting Template (CERT) checklist, used for exercise reporting, was previously modified for manual therapy reporting. This 11-item modified CERT was used to extract details of manual therapy reporting in the included trials. Frequency counts were calculated to identify items most and least commonly reported. <b>RESULTS:</b> Of 128 trials, none reported all 11 items of the modified CERT. The most commonly reported items were the description of how the application of manual therapy was decided (n = 113, 88.3%) and a description of adjunct interventions provided (n = 82, 64.1%). The least reported items were the description of an associated home program (n = 27, 21.1%) and a detailed description of the application of manual therapy (n = 22, 17.2%). <b>CONCLUSION:</b> Reporting of manual therapy interventions in trials investigating LBP was poor overall, limiting the reproducibility of these treatments. Using a checklist designed explicitly for manual therapy intervention reporting may improve reproducibility of these interventions and help align clinical outcomes with experimental findings. <i>J Orthop Sports Phys Ther 2024;54(4):1-10. Epub 29 January 2024. doi:10.2519/jospt.2024.12201</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"248-257"},"PeriodicalIF":6.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571922","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":"Surveying the Moral Landscape: How Ethical Frameworks Influence the Structure of Return-to-Sport Decision Making.","authors":"C Nathan Vannatta","doi":"10.2519/jospt.2024.12310","DOIUrl":"10.2519/jospt.2024.12310","url":null,"abstract":"<p><p><b>SYNOPSIS</b>: Similar to all areas of health care, sports medicine has ethical considerations when making decisions-return to sport being one. Despite a general consensus on criteria to determine when an athlete is ready to return to sport, there are various scenarios that clinicians encounter that may not fall into a clear \"yes\" or \"no\" decision. These scenarios leave the clinician asking what is the \"right\" decision in a given circumstance? A line of questioning that invokes a moral dimension in supporting athletes when they are returning to sport. To address the moral aspect of a clinical decision, ethical frameworks and theories can guide decisions and resolve ethical dilemmas. The aim of this Viewpoint is to briefly describe 4 ethical frameworks and explore how they might apply in a clinical scenario to guide different ethical analyses and influence the final decision. <i>J Orthop Sports Phys Ther 2024;54(4):1-4. Epub 14 February 2024. doi:10.2519/jospt.2024.12310</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"230-233"},"PeriodicalIF":6.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730847","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":"Knee Confidence, Fear of Movement, and Psychological Readiness for Sport in Individuals With Knee Conditions: A Systematic Review and Meta-analysis.","authors":"Harvi F Hart, Kay M Crossley, Adam G Culvenor, Michaela C M Khan, Thomas J West, Joshua B Kennedy, Jamon L Couch, Jackie L Whittaker","doi":"10.2519/jospt.2024.12070","DOIUrl":"10.2519/jospt.2024.12070","url":null,"abstract":"<p><p><b>OBJECTIVES</b>: To (1) compare activity-related psychological factors between individuals with and without knee conditions, and (2) assess associations between these factors and objective measures of function in individuals with knee conditions. <b>DESIGN</b>: A priori registered systematic review with meta-analysis. <b>LITERATURE SEARCH</b>: MEDLINE-Ovid, Embase-Ovid, Scopus-Elsevier, CINAHL-EBSCO, SPORTDiscus-EBSCO, and Cochrane Library were searched to May 27, 2022. <b>STUDY SELECTION CRITERIA</b>: We included peer-reviewed primary data studies (observational and experimental) of human participants with and without knee conditions reporting knee confidence, fear of movement/avoidance beliefs, and/or psychological readiness to return to sport (RTS) or reporting correlations between these factors and objective measures of function in knee conditions. <b>DATA SYNTHESIS:</b> Where possible, data were pooled by knee conditions, otherwise performed narrative syntheses. The Downs and Black checklist assessed the methodological quality of the included studies. <b>RESULTS</b>: Forty studies (3546 participants with knee conditions; 616 participants without knee conditions) were included. There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis (standardized mean difference [SMD], 0.46; 95% confidence interval [CI]: 0.41, 0.52), but not in individuals with patellofemoral pain (SMD, 0.66; 95% CI: -7.98, 9.29) when compared with those without knee conditions. There was very low-certainty evidence of no differences in psychological readiness to RTS after anterior cruciate ligament reconstruction (SMD, -1.14; 95% CI: -2.97, 0.70) compared to no knee condition, and negligible to weak positive correlations between psychological readiness to RTS and objective measures of function. <b>CONCLUSION:</b> There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis compared to those without, and very low-certainty evidence of no correlations between these factors and objective measures of function following anterior cruciate ligament reconstruction. <i>J Orthop Sports Phys Ther 2024;54(4):1-14. Epub 29 January 2024. doi:10.2519/jospt.2024.12070</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"234-247"},"PeriodicalIF":6.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571924","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":"A Profile of Isometric Cervical Strength in Elite Professional Male Rugby Players.","authors":"Mairead Liston, Colm Fuller, Darren Dahly, Deborah Falla, Rod McLoughlin, Caithriona Yeomans, Nicol van Dyk, Eanna Falvey","doi":"10.2519/jospt.2024.11830","DOIUrl":"10.2519/jospt.2024.11830","url":null,"abstract":"<p><p><b>OBJECTIVES:</b> To (1) provide position-specific normative data for isometric cervical muscle strength and endurance in professional, male rugby players and (2) assess the relationship between age, height, weight, and playing position with cervical muscle strength and endurance. <b>DESIGN:</b> Cross-sectional study. <b>METHODS:</b> Professional rugby players completed peak isometric cervical strength testing followed by a test of cervical muscle endurance. Descriptive statistics for continuous variables with strength normalized to body weight were performed. Multiple linear regression was used to estimate associations between strength measurements. <b>RESULTS:</b> In total, 136 players participated including front-row forwards (27%), other forwards (28%), and backs (45%). Front-row forwards had significantly greater peak isometric cervical muscle strength than other position groups, with backs having the lowest strength. Extension produced the highest force for all 3 position groups (429 N ± 104 N), whereas flexion produced the least (275 N ± 65 N). Age was associated with increased isometric cervical muscle strength. There was a statistically significant relationship between peak flexion strength and flexion endurance (<i>P</i> = .003). The average time for the endurance tests were 55.7 (±17.1) seconds and 52.9 (±20.1) seconds for extension and flexion, respectively. Other forwards had lower cervical extension muscle endurance than backs and front-row forwards. <b>CONCLUSIONS:</b> Normative values for peak and endurance isometric strength in professional rugby players illustrate significant differences between playing position. Consider age, body weight, and intraindividual variability when interpreting cervical strength and endurance results. <i>J Orthop Sports Phys Ther 2024;54(3):1-8. Epub 29 January 2024. doi:10.2519/jospt.2024.11830</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"201-208"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571939","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":"Preseason Measures of Cervical Spine Function, Vestibulo-Ocular Reflex, Dynamic Balance, and Divided Attention in Youth Ice Hockey Players.","authors":"Robert F Graham, Paul H Eliason, Amanda M Black, Stacy Sick, Geoff M Schneider, Olivia A Galea, Carolyn A Emery, Kathryn J Schneider","doi":"10.2519/jospt.2023.11958","DOIUrl":"10.2519/jospt.2023.11958","url":null,"abstract":"<p><p><b>OBJECTIVES:</b> Report typical scores and examine preseason cervical spine, vestibulo-ocular reflex, dynamic balance, and divided attention measures in competitive youth ice hockey players aged 10 to 18 years with and without a previous concussion history. <b>DESIGN:</b> Cross-sectional secondary analysis. <b>METHODS:</b> The exposure of interest was self-reported history of concussion. The main outcomes were cervical spine measures (Cervical Flexor Endurance [CFE; seconds], Cervical Flexion-Rotation Test [normal/abnormal], Anterolateral Cervical Spine Strength [kilograms], Head Perturbation Test (/8), and Joint Position Error [JPE; centimeters]), vestibulo-ocular reflex (Dynamic Visual Acuity [logMAR], Head Thrust Test [Positive/Negative]), dynamic balance (Functional Gait Assessment [/30]) and divided attention (Walking While Talking Test [seconds]). Multivariable linear or logistic regression, adjusted for age-group, sex, level of play, and clustered by team, were used to assess potential differences by concussion history. <b>RESULTS:</b> We included data from 2311 participants in this study (87.2% male, 12.8% female, 39.0% reported a previous concussion). No differences by concussion history were found across any of the measures (<i>P</i> values range: 0.17-0.99). Measures of cervical spine function and divided attention differed by age group (eg, Median Left Anterolateral Cervical Spine Strength [kilograms] for males: U13 = 7.46, U15 = 9.10, U18 = 9.67). <b>CONCLUSION:</b> Clinical outcomes scores in youth ice hockey players did not differ by concussion history. Performance on cervical spine strength, CFE, and JPE test outcomes may improve with age, highlighting the importance of developmental considerations when interpreting test scores. <i>J Orthop Sports Phys Ther 2024;54(3):1-11. Epub 30 November 2023. doi:10.2519/jospt.2023.11958</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"190-200"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464030","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":"How Movement Is Assessed Matters. Changes in Forward Bending During Cognitive Functional Therapy Treatment for People With Chronic Low Back Pain.","authors":"Ruth Chang, Anne Smith, Peter Kent, Peter O'Sullivan, Mark Hancock, Amity Campbell","doi":"10.2519/jospt.2023.12023","DOIUrl":"10.2519/jospt.2023.12023","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To investigate forward bending range of motion (ROM) and velocity in patients with low back pain who were receiving Cognitive Functional Therapy and determine (1) the amount and timing of change occurring at the trunk and pelvis (global angles), and lumbar spine (intersensor angle), and (2a) differences in changes between participants with and without sensor biofeedback, and (2b) participants with and without baseline movement limitation. <b>DESIGN:</b> Observational study. <b>METHODS:</b> Two hundred sixty-one participants attended Cognitive Functional Therapy treatment and wore sensors at the T12 and S2 spine levels while performing forward bending. Measures included ROM and velocity from both sensors, and the intersensor angle. Regression models estimated changes over time. Time-group interactions tested participants who were subgrouped by treatment and baseline movement. <b>RESULTS:</b> During the 90-day evaluation period, most change occurred in the first 21 days. Changes in ROM observed at T12 (3.3°, 95% CI: 1.0°, 5.5°; <i>P</i> = .001) and S2 (3.3°, 95% CI: 1.2°, 5.4°; <i>P</i> = .002) were similar. Intersensor angle remained similar (0.2°, 95% CI: -2.0°, -1.6°; <i>P</i> = .81). Velocity measured at T12 and S2, and the intersensor angle increased 8.5°/s (95% CI: 6.7°/s, 10.3°/s; <i>P</i><.0001), 5.3°/s (95% CI: 4.0°/s, 6.5°/s; <i>P</i><.0001), and 3.4°/s (95% CI: 2.4°/s, 4.5°/s; <i>P</i><.0001), respectively, for 0 to 21 days. There were minimal differences in participants who received biofeedback. Larger increases occurred in participants with restricted ROM and slower velocity at baseline. <b>CONCLUSION:</b> During 0 to 21 days, we observed changes at the trunk and pelvis (especially in people with reduced ROM), and velocity changes across all measures (especially in people with baseline movement limitations). Biofeedback did not augment the changes. When targeting forward bending in people with low back pain, clinicians should monitor changes in velocity and global ROM. <i>J Orthop Sports Phys Ther 2024;54(3):1-13. Epub 19 December 2023. doi:10.2519/jospt.2023.12023</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"209-221"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810759","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":"Performance of ChatGPT Compared to Clinical Practice Guidelines in Making Informed Decisions for Lumbosacral Radicular Pain: A Cross-sectional Study.","authors":"Silvia Gianola, Silvia Bargeri, Greta Castellini, Chad Cook, Alvisa Palese, Paolo Pillastrini, Silvia Salvalaggio, Andrea Turolla, Giacomo Rossettini","doi":"10.2519/jospt.2024.12151","DOIUrl":"10.2519/jospt.2024.12151","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To compare the accuracy of an artificial intelligence chatbot to clinical practice guidelines (CPGs) recommendations for providing answers to complex clinical questions on lumbosacral radicular pain. <b>DESIGN:</b> Cross-sectional study. <b>METHODS:</b> We extracted recommendations from recent CPGs for diagnosing and treating lumbosacral radicular pain. Relative clinical questions were developed and queried to OpenAI's ChatGPT (GPT-3.5). We compared ChatGPT answers to CPGs recommendations by assessing the (1) internal consistency of ChatGPT answers by measuring the percentage of text wording similarity when a clinical question was posed 3 times, (2) reliability between 2 independent reviewers in grading ChatGPT answers, and (3) accuracy of ChatGPT answers compared to CPGs recommendations. Reliability was estimated using Fleiss' kappa (κ) coefficients, and accuracy by interobserver agreement as the frequency of the agreements among all judgments. <b>RESULTS:</b> We tested 9 clinical questions. The internal consistency of text ChatGPT answers was unacceptable across all 3 trials in all clinical questions (mean percentage of 49%, standard deviation of 15). Intrareliability (reviewer 1: κ = 0.90, standard error [SE] = 0.09; reviewer 2: κ = 0.90, SE = 0.10) and interreliability (κ = 0.85, SE = 0.15) between the 2 reviewers was \"almost perfect.\" Accuracy between ChatGPT answers and CPGs recommendations was slight, demonstrating agreement in 33% of recommendations. <b>CONCLUSION:</b> ChatGPT performed poorly in internal consistency and accuracy of the indications generated compared to clinical practice guideline recommendations for lumbosacral radicular pain. <i>J Orthop Sports Phys Ther 2024;54(3):1-7. Epub 29 January 2024. doi:10.2519/jospt.2024.12151</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":" ","pages":"222-228"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571935","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}