The Journal of orthopaedic and sports physical therapy
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J Orthop Sports Phys Ther · May 2009
Characterization of acute and chronic whiplash-associated disorders.
The development of chronic pain and disability following whiplash injury is common and contributes substantially to personal and economic costs related with this condition. Emerging evidence demonstrates the clinical presence of alterations in the sensory and motor systems, including psychological distress in all individuals with a whiplash injury, regardless of recovery. However, individuals who transition to the chronic state present with a more complex clinical picture characterized by the presence of widespread sensory hypersensitivity, as well as significant posttraumatic stress reactions. Based on the diversity of the signs and symptoms experienced by individuals with a whiplash condition, clinicians must take into account the more readily observable/measurable differences in motor, sensory, and psychological dysfunction. The implications for the assessment and management of this condition are discussed. Further review into the pathomechanical, pathoanatomical, and pathophysiological features of the condition also will be discussed. ⋯ Level 5.J
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J Orthop Sports Phys Ther · Apr 2009
Comparative StudyThe relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology.
Cross-sectional. ⋯ Presence of symptoms longer than 3 months, average pain intensity, flexion ROM index (strongest contributor in multivariate model), and fear-of-pain scores all contributed to baseline shoulder function. The immediate clinical relevance of these findings is unclear but they do provide direction for prospective studies.
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J Orthop Sports Phys Ther · Mar 2009
The physical therapist as a musculoskeletal specialist in the emergency department.
Because patients with musculoskeletal injuries commonly seek intervention in the emergency department (ED), it has been proposed that practitioners with expertise in musculoskeletal practice can be of benefit in this setting. This clinical commentary describes the rationale for utilizing physical therapists as musculoskeletal specialists in the ED. ⋯ Furthermore, early access to physical therapy, as can be provided in the ED setting, has the potential to positively influence patient recovery. Based on prior research and recent evolution of practice, further consideration of physical therapists as consultants in the ED is warranted, and, therefore, additional dialogue on the subject should be encouraged.
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J Orthop Sports Phys Ther · Mar 2009
Maximal voluntary isometric neck strength deficits in adults with whiplash-associated disorders and association with pain and fear of movement.
Controlled laboratory study using a cross-sectional, repeated-measures design. ⋯ The MCU demonstrated good test-retest properties for healthy subjects and individuals with WAD. Cervical strength was lower in individuals with WAD; however, the strength deficits were not clearly linked with psychological factors.
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J Orthop Sports Phys Ther · Jan 2009
Randomized Controlled Trial Clinical TrialThoracic spine manipulation for the management of patients with neck pain: a randomized clinical trial.
Randomized clinical trial. ⋯ The results of our study suggest that thoracic spine thrust manipulation results in superior clinical benefits that persist beyond the 1-mont follow-up period for patients with acute neck pain. Future studies should continue to investigate the effects of thoracic spine thrust manipulation, as compared to other physical therapy interventions, in a population with mechanical neck pain.