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Psychometric Properties of the Deep Muscle Contraction Scale for Assessment of the Drawing in Maneuver in Patients With Chronic Nonspecific Low Back Pain.
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Psychometric Properties of the Deep Muscle Contraction Scale for Assessment of the Drawing in Maneuver in Patients With Chronic Nonspecific Low Back Pain.

J Orthop Sports Phys Ther. 2017 May 13;:1-28

Authors: Oliveira CB, Filho RFN, Franco MR, Morelhão PK, Araujo AC, Pinto RZ

Abstract
Study Design A prospective cohort study. Background Motor control dysfunctions have been commonly reported in patients with chronic non-specific low back pain (LBP). Physiotherapists need clinical tools with adequate psychometric properties to assess such patients in clinical practice. The deep muscle contraction (DMC) scale is a clinical rating scale for assessing patients' ability to voluntarily contract deep abdominal muscles. Objectives To investigate the intra-rater reliability, floor and ceiling effects, internal and external responsiveness and correlation analysis (with ultrasound measures) of the DMC scale in patients with chronic non-specific LBP undergoing a lumbar stabilization exercise program. Methods Sixty-two patients with chronic non-specific LBP were included. At baseline, self-report questionnaires were administered to patients and a trained assessor evaluated the abdominal muscle recruitment with the DMC scale and ultrasound imaging. Four ratios of the change in abdominal muscle thickness between the rest and contracted states were calculated through the ultrasound measures. After one week, the same ultrasound measures and DMC scale were collected again for the reliability analysis. Proportion of patients with the lowest or highest score in the DMC scale was calculated to investigate floor and ceiling effects. All patients underwent to a lumbar stabilization program administered twice a week, for eight weeks. After the treatment period, all the measures were collected again with addition of the global perceived effect scale (GPES) to assess the internal and external responsiveness of the measures. Correlation coefficients between ultrasound ratios and DMC scale and subscales scores were also calculated. Results The DMC scale and the four ratios of abdominal muscles thickness intra-rater reliability varied between moderate to excellent. The DMC scale showed no floor or ceiling effects. Results of the internal responsiveness for the DMC scale showed large effect sizes (effect size >0.80), whereas the external responsiveness was below the proposed threshold (area under the curve <0.70). Moderate significant correlation against some ultrasound ratios were found for DMC subscales. Conclusion DMC scale demonstrated to be a reliable tool, with no ceiling and floor effect, and able to detect change in the ability to contract the deep abdominal muscles after a lumbar stabilization exercises program. J Orthop Sports Phys Ther, Epub 13 May 2017. doi:10.2519/jospt.2017.7140.

PMID: 28504068 [PubMed - as supplied by publisher]




Effectiveness of Inclusion of Dry Needling Into a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial.
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Effectiveness of Inclusion of Dry Needling Into a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial.

J Orthop Sports Phys Ther. 2017 May 13;:1-43

Authors: Espí-López GV, Serra-Añó P, Vicent-Ferrando J, Sánchez-Moreno-Giner M, Arias-Buría JL, Cleland J, Fernández-de-Las-Peñas C

Abstract
Study Design Randomized controlled trial. Background Evidence suggests that multimodal interventions including exercise therapy may be effective for patellofemoral pain (PFP), however no study has investigated the effects of trigger point dry needling (TrP-DN) in people with PFP. Objectives To compare the effects of adding TrP-DN into a manual therapy and exercise program on pain, function, and disability in individuals with PFP. Methods Individuals with PFP (n=60) recruited from a public hospital in Valencia (Spain) were randomly allocated to manual therapy and exercises (n=30) or manual therapy and exercise plus TrP-DN (n=30). Both groups received the same manual therapy and strengthening exercise program for 3 sessions (once a week for 3 weeks). The manual therapy and exercise plus TrP-DN group also received TrP-DN to active TrPs within the vastus medialis and vastus lateralis muscles. The pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS, 0-100 scale) was used as the primary outcome. Secondary outcomes included other subscales of KOOS, the Knee Society Score (KSS), the International Knee Documentation Committee (IKDC), and the numerical pain rate scale (NPRS). Patients were assessed at baseline, 15 days (post-treatment) and 3 months follow-up. Analysis was with mixed ANCOVAs adjusted for baseline scores. Results At 3 months, 58 subjects (97%) completed the follow-up. No significant between-groups differences (all, P>0.391) were observed for any outcome: KOOS-P, mean difference -2.1 (95%CI -4.6, 0.4); IKDC, 2.3 (-0.1, 4.7); knee pain intensity, 0.3 (-0.2, 0.8). Both groups experienced similar moderate-to-large within-group improvements in all outcomes (Standardized Mean Differences of 0.6 to 1.1), however only the KOOS-SP subscale surpassed the pre-specified minimum important change. Conclusions The current clinical trial suggests that the inclusion of 3 sessions of TrP-DN into a manual therapy and exercise program did not result in improved outcomes for pain and disability in individuals with PFP at 3-month follow-up. Level of Evidence Therapy, Level 1b. Prospectively registered July 27, 2015 on www.clinicaltrials.gov (NCT02514005). J Orthop Sports Phys Ther, Epub 13 May 2017. doi:10.2519/jospt.2017.7389.

PMID: 28504067 [PubMed - as supplied by publisher]




The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-Analysis.
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The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

J Orthop Sports Phys Ther. 2017 May 13;:1-36

Authors: Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J

Abstract
Study Design Systematic review and meta-analysis. Background Running is a healthy and popular activity worldwide, but data regarding its association with osteoarthritis (OA) are conflicting. Objectives To evaluate the association of hip and knee OA with running and to explore the influence of running intensity on this association. Methods PubMed, EMBASE and Cochrane Library databases were used to identify studies investigating the occurrence of OA of the hip and/or knee among runners. Studies comparing this occurrence between runners and controls (sedentary, non-running individuals) were meta-analyzed. Runners were regarded as 'competitive' if they were reported as professionals/elite athletes, or participated in International competitions. Recreational runners were individuals running in a non-professional (amateur) manner. The prevalence and odds ratio (95% CI) for OA between runners (at competitive and recreational level) and controls were calculated. Subgroup analyses were conducted for OA location (hip or knee), gender and years of exposure to running (less or more than 15 years). Results Twenty-four studies (n=123,173 individuals) were included and 16 (n=112,192 individuals) were meta-analyzed. The overall prevalence (95% CI) of hip and knee OA was 13.3% (11.62-15.2) in competitive runners, 3.5% (3.38-3.63) in recreational runners and 10.23% (9.89-10.58) in controls. The odds ratio (95% CI) for hip and/or knee OA between recreational runners and controls was 0.66 (0.57-0.76). The odds ratio (95% CI) for hip and/or knee OA in competitive runners was higher than that in recreational runners (OR (95% CI) 1.34 (0.97-1.86) and 0.66 (0.57-0.76) respectively (controls as reference group); p=0.0001). Conclusions Recreational runners had a lower occurrence of OA compared with competitive runners and controls. These results indicated that a more sedentary lifestyle or long exposure to high-volume and/or high-intensity running are both associated with hip and/or knee OA. However, it was not possible to determine whether these associations are causative or confounded by other risk factors, such as previous injury. Level of Evidence Etiology/Harm, Level 2a. J Orthop Sports Phys Ther, Epub 13 May 2017. doi:10.2519/jospt.2017.7137.

PMID: 28504066 [PubMed - as supplied by publisher]