Journal of Orthopaedic and Sports Physical Therapy

OBJECTIVE: To (i) determine the rate of satisfactory response to non-operative treatment for non-arthritic hip-related pain, and (ii) evaluate the specific effect of various elements of physical therapy and non-operative treatment options aside from physical therapy. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: Seven databases and reference lists of eligible studies through February 2022. STUDY SELECTION CRITERIA: Randomized controlled trials and prospective cohort studies that compared a non-operative management protocol to any other treatment for patients with femoroacetabular impingement syndrome, acetabular dysplasia, acetabular labral tear, and/or non-arthritic hip pain not otherwise specified...

BACKGROUND : Generic self-report measures do not reflect the complexity of a person's pain-related behaviour. Since variations in a person's fear of movement and avoidance behaviour may arise from contextual and motivational factors, a person-centred evaluation is required-addressing the cognitions, emotions, motivation and actual behaviour of the person. CLINICAL QUESTION : Most musculoskeletal rehabilitation clinicians will recognise that different people with chronic pain have very different patterns of fear and avoidance behaviour...

OBJECTIVE: To evaluate whether cognitive functional therapy (CFT) is an effective treatment for adults with chronic low back pain (LBP) DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: CENTRAL, CINAHL, MEDLINE, Embase, clinicaltrials.gov, EU clinical trials register (to March 2022). STUDY SELECTION CRITERIA: Randomised controlled trials evaluating CFT for adults with LBP. DATA SYNTHESIS: The primary outcomes were pain intensity and disability. Secondary outcomes were psychological status, patient satisfaction, global improvement, and adverse events...

OBJECTIVE: To summarise the effectiveness of management strategies and rehabilitation approaches for knee joint structural and molecular biomarker outcomes following anterior cruciate ligament (ACL) and/or meniscal tear. DESIGN: Intervention systematic review LITERATURE SEARCH: MEDLINE, EMBASE, CINAHL, CENTRAL, and SportDiscus up to November 3-2021. STUDY SELECTION CRITERIA: Randomized controlled trials (RCT) investigating the effectiveness of management strategies or rehabilitation approaches for structural/molecular biomarkers of knee joint health following ACL and/or meniscal tear...

OBJECTIVES: To (i) evaluate whether the defining characteristics of previously-reported Achilles tendinopathy subgroups were reproducible in a cohort with midportion Achilles tendinopathy and, (ii) compare recovery trajectories and outcomes. DESIGN: Prospective single cohort study METHODS: Participants (n=114, (Mean±SD) age 47±12, 57F) received the Silbernagel protocol and were evaluated at baseline, 8-, 16-, and 24 weeks. Subgroups were identified using mixture modeling. Main effects of group and time, and interaction effects were evaluated using linear mixed models for 23 outcome measures representing symptoms, lower extremity function, tendon structure, psychological factors, and patient-related factors...

OBJECTIVE: To describe age-, sex-, and graft source-specific reference values for patient-reported, physical function, and strength outcome measures in adolescents at 5-7 months after anterior cruciate ligament reconstruction (ACLR). DESIGN: Cross-sectional study METHODS: Data were collected at 3 universities and 2 children's hospitals. Participants completed at least one of the International Knee Documentation Committee (IKDC) Subjective Evaluation Form, Pediatric IKDC (PEDI-IKDC), Knee Injury and Osteoarthritis Outcomes Score (KOOS), and ACL Return to Sport after Injury Scale (ACL-RSI)...

Objective: To analyze the effect of trunk-focused exercise programs (TEPs) and moderator factors on chronic non-specific low back pain (LBP). Design. Systematic review with meta-analyses. Design: Systematic review with meta-analyses. Literature search: We searched the PubMed, Scopus, EMBASE, SPORTDiscus, and CENTRAL databases until June 2022. Study selection criteria: We included randomized controlled trials comparing TEPs to control or general exercises. SData synthesis: We used random effects models to calculate the standardized mean difference (SMD) plus confidence interval (CI), and heterogeneity (I2) for pain, disability, quality of life, and trunk performance...

Objectives: To (i) determine how often home exercise programs (HEPs) are prescribed in supervised exercise trials for low back pain (LBP) and (ii) describe characteristics of the HEP programs (design, purpose, dose, and adherence). Design: Scoping review. Literature search: PubMed, CINAHL, and Ovid MEDLINE were searched from January 1, 2010 to August 17, 2021. Study selection criteria: Randomized controlled trials (RCTs) that included adults with LBP who received exercise interventions. Data synthesis: The presence or absence of a prescribed HEP and any details of the HEP including design, dose, and adherence were extracted and summarized...

SYNOPSIS: The most effective lower limb injury prevention programs include strength training, balance exercises, and instructions on how to land safely from a jump or hop. Yet, the programs are not 100% effective-lower extremity noncontact injuries continue to be a significant problem. We suggest that adding cognitive training to motor tasks that currently comprise current lower limb injury prevention programs might help clinicians, athletes, and coaches continue to make inroads into preventing knee injuries...

OBJECTIVE: To describe the application and examine the influence of a continuous quality improvement intervention, which had a goal of standardizing care to reduce the proportion of patients who do not have a meaningful improvement in patient-reported outcomes following total knee arthroplasty (TKA). DESIGN: Continuous quality improvement. METHODS: A physical therapy (PT) care guideline was initiated in 2013 for patients following TKA. The Knee Outcome Survey - Activities of Daily Living (KOS-ADL) was measured at every visit, and scores were extracted from a clinical outcomes database to calculate the proportion of patients who did not achieve a minimal clinically important difference...

SYNOPSIS: Central sensitization is an umbrella-term for facilitated synaptic plasticity. This editorial explains wind-up, classical central sensitization, and long-term potentiation. Wind-up and LTP are generally considered homosynaptic, while classical central sensitization is classified as heterosynaptic. Wind-up is very short lived and unlikely to play a significant role in chronic musculoskeletal pain, however, both LTP and classical central sensitization could potentially be involved in chronic pain. J Orthop Sports Phys Ther 2023;53(2):55-58...

Recently, injury prevention experts developed a guideline for rehabilitation clinicians to use to help you avoid getting another knee injury. Here, we explain what the guidelines say about which exercises you should do to stay injury-free, how often to do the exercises, and when to do the exercises. J Orthop Sports Phys Ther 2023;53(2):105. doi:10.2519/jospt.2023.0503 .

SYNOPSIS: This editorial introduces JOSPT Open , a new gold open-access journal in the JOSPT stable. In 2023, JOSPT Open will publish its inaugural issue. The journal aims to cover all aspects of musculoskeletal rehabilitation and associated areas related to musculoskeletal health, including clinical biomechanics, diagnostic imaging, epidemiology, physical activity, sports science, and pain neuroscience. JOSPT Open welcomes diverse approaches to studying interesting and important clinical questions, and innovative approaches to translating knowledge to practice...

Knee and anterior cruciate ligament (ACL) injuries are common and can be severe. Some knee injuries carry long-term implications for the health of active people, including a risk of osteoarthritis and physical inactivity. Preventing injuries from occurring is critical to helping people stay active and healthy through their life. Here we present for clinicians, the most up-to-date information to guide their work to prevent knee and ACL injuries. J Orthop Sports Phys Ther 2023;53(2):103-104. doi:10.2519/jospt...

OBJECTIVES: To identify factors associated with nonresponse to neuromuscular training (NMT) warm-up programs among youth exposed to NMT warm-ups. METHODS: This is a secondary analysis of youth (aged 11-18 years) in the intervention groups of 4 randomized controlled trials in high school basketball, youth community soccer, and junior high school physical education. Youth who were exposed to NMT and who sustained an injury during the study were considered nonresponders . Odds ratios (ORs) were based on generalized estimating equations logistic regression controlling for clustering by team/class and adjusted for age, weight, height, balance performance, injury history, sex, and sport (soccer/basketball/physical education)...

Author response to the JOSPT Letter to the Editor-in-Chief "Leveraging the short-term benefits of manual therapy which includes exercise over exercise therapy alone appears justified for knee osteoarthritis" J Orthop Sports Phys Ther 2023;53(1):50-51. doi:10.2519/jospt.2023.0201-R .

The Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for orthopaedic and sports physical therapy management and prevention of musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This guideline focuses on the exercise-based prevention of knee injuries and provides an update on the 2018 guideline, J Orthop Sports Phys Ther...

SYNOPSIS: Central sensitization is an umbrella term for facilitated synaptic plasticity. This editorial (1) explains the differences between homosynaptic and heterosynaptic plasticity, (2) explains the role of glia cells in dorsal horn neuroplasticity, and (3) briefly discusses the clinical relevance of central sensitization and nociplastic pain. Part 5 covers wind-up, classical central sensitization, and long-term potentiation. J Orthop Sports Phys Ther 2023;53(1):1-4. doi:10.2519/jospt.2023.11569 .

Letter to the Editor-in-Chief in response to JOSPT article "The Benefits of Adding Manual Therapy to Exercise Therapy for Improving Pain and Function in Patients with Knee or Hip Osteoarthritis: A Systematic Review with Meta-analysis" by Runge et al. J Orthop Sports Phys Ther 2023;53(1):49-50. doi:10.2519/jospt.2023.0201 .

Lateral elbow tendinopathy (LET) is an overuse injury of the common extensor tendon that occurs in active people. Modifiable risk factors include repetitive movements of the elbow, forearm, and hand, and tasks like handling heavy tools, which may overload the tendon. The clinical course of LET varies considerably. Some people experience a single, brief episode of symptoms, whereas others have persistent or recurring episodes of LET. J Orthop Sports Phys Ther 2023;53(1):5-6. doi:10.2519/jospt.2023.0501 .