Clinical tests predictive of temporary low back pain development during the prolonged standing test in physical therapy students.

Low back pain among physical therapists is a common musculoskeletal disorder that first occurs early in their career or as a student. This observational prospective study assessed the ability of hip and lumbopelvic neuromuscular control, endurance and hip range of motion tests to predict the development of transient low back pain development during a standing task. Seventy-two physical therapy students without low back pain completed nine performance tests and a 2-hour standing test on two separate days. Participants were classified as transient pain developers (PD) if they reported a ≥ 10mm increase in low back pain on a visual analog scale. Transient back pain was reported by 37.5% of students during the standing test. A cluster of three positive tests, self-rated active hip abduction (somewhat difficult or more), bilateral total hip internal rotation greater than 81 degrees, and non-dominant limb single-leg squat (moderate deviations), demonstrated an increased probability (94.9%) of identifying PDs. Negative findings on the same three tests decreased the probability to 10.7%. Overall, the classification accuracy for the three-test model was 72.2%. The sensitivity for the model was 63% and the specificity was 77.8%.

A 3-test cluster of poor hip and lumbopelvic neuromuscular control and increased hip internal rotation range of motion is an effective screening tool for identifying physical therapy students who are most likely and least likely to develop transient LBP during 2 hours of standing.

Assessing Effectiveness of Physical Therapy Clinical Education Site Visits: Clinical Instructor and Student Perspectives.

INTRODUCTION: Video, phone, or in-person site visits are used to assess clinical education in entry-level physical therapy education programs. The perspectives of students and clinical instructors (CIs) related to site visits were examined in this article using 2 consecutive surveys. The first included items related to in-person and phone call site visits. The second added video calls. The research purpose was to assess the CI and student perspectives on the effectiveness of site visits and explore the differences between in-person, video, and phone visits. REVIEW OF LITERATURE: Published literature about the effectiveness of site visits is scarce. Two recent articles explored the director of clinical education and student perspectives of site visits. Future research concentrating on the clinician perspective of site visits was recommended. SUBJECTS: A convenience sample of 104 CIs and 97 doctor of physical therapy students were recruited by email for the 2 surveys. METHODS: A mixed-methods, triangular, validating, quantitative data model was used. Respondents answered open-ended questions and rated items on 5-point Likert scales. Descriptive and chi-square statistics were calculated, and themes were developed using qualitative analysis. RESULTS: No significant difference was found in preference of site visit method between students and CIs. CIs rated the effectiveness of site visits similarly for all methods. Students rated in-person site visits as the most effective in the first survey and video calls as the most effective in the second survey. Qualitative analysis showed that CIs and students preferred in-person visits when the student was struggling. Considering closed-ended and open-ended questions on both surveys, CIs and students would rather meet individually with the faculty member. DISCUSSION AND CONCLUSION: The results of this study suggest that any type of site visit can be effective; in-person visits should be considered when students are struggling, and the site visitor should meet privately with the student and CI.

Concentric and Eccentric Force Changes with Elastic Band and Isotonic Heavy Resistance Training: A Randomized Controlled Trial.

BACKGROUND: Inclusion of resistance training as part of a general fitness program to improve health, and lower risk of disease and injury is well established. Two common options to improve strength are elastic bands and weights. Comparison between elastic bands (as the sole resistance) to isotonic strengthening for concentric and eccentric strength outcomes following the use of low repetitions/heavy resistance has not been reported. HYPOTHESIS/PURPOSE: The purpose was to examine the effects of a four-week isotonic low repetitions/heavy resistance strengthening program compared to a low repetitions/heavy resistance elastic band strengthening program on shoulder external rotation, hip abduction, and elbow flexion concentric and eccentric isokinetic force production in college aged untrained females. STUDY DESIGN: Randomized Trial. METHODS: Twenty healthy females performed pre-and-post isokinetic (60 degrees/second) concentric/eccentric testing of the elbow flexors, shoulder external rotators, and hip abductors. Participants were randomly assigned to a four-week independent low repetitions/heavy resistance strengthening program performed with either elastic bands or isotonic exercises. RESULTS: A significant (p < 0.05) effect of time was found for eccentric elbow flexor and concentric and eccentric hip abduction force production in the elastic band group with post-test values greater than pre-test values. A significant (p < 0.05) effect of time was found for elbow flexor concentric and eccentric force production in the isotonic group with post-test values greater then pre-test values. No significant (p>0.05) effect of time was found for shoulder external rotator concentric and eccentric forces for both groups, the isotonic group's hip abduction concentric and eccentric force production and elastic band group's elbow flexion concentric force production. No significant effect of intervention (p >0.05) on concentric or eccentric elbow flexors, shoulder external rotators, or hip abductors force production was found, with pre-test and post-test values being similar between groups. CONCLUSION: Health care practitioners and coaches can consider the prescription of a heavy resistance training program with elastic bands or isotonic exercises for an independent exercise program and expect similar concentric and eccentric muscle force changes. LEVEL OF EVIDENCE: Level 2b.

The Validity, Reliability, Measurement Error, and Minimum Detectable Change of the 30-Second Fast-Paced Walk Test in Persons with Knee Osteoarthritis: A Novel Test of Short-Distance Walking Ability.

OBJECTIVE: To develop and establish the reliability, validity, measurement error, and minimum detectable change of a novel 30-second fast-paced walk test (30SFW) in persons with knee osteoarthritis (OA) that is easy to administer and can quantify walking performance in persons of all abilities. METHODS: Twenty females with symptomatic knee OA (mean age [SD] 58.30 [8.05] years) and 20 age- and sex-matched asymptomatic controls (57.25 [8.71] years) participated in the study. Participants completed questionnaires of demographic and clinical data, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the 36-item Short Form Health Survey (SF-36) followed by 30SFW performance. Participants returned 2-7 days later and performed the 30SFW again. RESULTS: The knee OA group reported function that was worse than controls (all KOOS subscales; P < 0.0001). The 30SFW intrarater and interrater reliability were excellent [ICC (2,1) = 0.95-0.99]. Knee OA participants walked a shorter distance in the 30SFW than controls (mean [SD]: OA 44.4 m [9.5 m]; control 58.1 m [7.8 m]; P < 0.0001). Positive strong correlations were found between the 30SFW and the KOOS-Activity of Daily Living, SF-36-Physical Functioning, and SF-36-Physical Health Composite scores (P < 0.0001). A nonsignificant, weak correlation between 30SFW and SF-36-Mental Health scores was present (r = 0.32, P = 0.05). CONCLUSION: The 30SFW has excellent intrarater and interrater reliability. The 30SFW demonstrated excellent known groups, convergent, and discriminant validity as a measure of short-distance walking ability in persons with knee OA. Clinicians and researchers should consider using the 30SFW to quantify walking ability in persons with knee OA and assess walking ability change.