Search

The professional literature contains relatively few randomized-control studies that have assessed the efficacy of physical therapy approaches to the management of patients with chronic low back pain (CLBP). The purposes of this study were: 1) to investigate the effects of physical agents, joint manipulation, low-tech exercise, and high-tech exercise on objective measures of CLBP; 2) to track the length of CLBP relief; and 3) to determine treatment cost-effectiveness. Two-hundred-fifty subjects (68 females, 182 males; ages 34-51 years) with CLBP following an L5 laminectomy were randomly assigned into five separate groups for a treatment period of 8 weeks. Chronic low back pain status was measured by modified-modified Schober, Cybex Liftask, and Oswestry procedures. Results revealed that: 1) only low-tech and high-tech exercise produced significant improvements (p < .05) in CLBP, 2) the mean period of CLBP relief ranged from 1.6 weeks (control) to 91.4 weeks (low-tech exercise), and 3) low-tech exercise was most cost-effective. It was concluded that: 1) low-tech and high-tech exercise were the only effective treatments for CLBP, 2) low-tech exercise produced the longest period of CLBP relief, and 3) low-tech exercise was the most cost-effective form of treatment. Clinically, low-tech exercise may be the treatment method of choice for the effective management of chronic low back pain.

In addition to the distinction of representing the United States in international athletic competition, the opportunity to be a member of the United States Olympic Committee (USOC) Medical Team epitomizes the paramount professional experience in the field of sports medicine. J Orthop Sports Phys Ther 1996;24(5):293. doi:10.2519/jospt.1996.24.5.293

The following article is adapted with permission of the Michigan Physical Therapy Association. Timm KE. President's message: The hot (pack) potato. Michigan Phys Ther Shorelines 1994;22(3):3, 9. Figuratively, many orthopaedic and sports physical therapists who treat patients under worker's compensation are currently playing a game of hot potato. The hot potato is the hot pack, which represents passive treatment approaches. While the American Physical Therapy Association (APTA) continues to combat misconceptions about physical therapy and passive treatments, a larger problem exists—many physical therapists who treat patients under worker's compensation are still holding onto the “hot (pack) potato,” which is burning the reputation of the profession. J Orthop Sports Phys Ther 1995;21(3):131. doi:10.2519/jospt.1995.21.3.131

The author details why physical therapists must play an active role in the legislative and political processes guiding workers compensation. Their involvement protects the profession and the best interests of the workers therapists treat. Without fiscal and political proactivity, physical therapy risks becoming ineligible to participate in the workers compensation arena. J Orthop Sports Phys Ther 1993;17(1):1. doi:10.2519/jospt.1993.17.1.1

This article describes a system for data collection using an isokinetic lifting task simulation device and reports normative data findings based on a standardized lifting posture. The test population included 2688 normal subjects (1236 females, 1452 males; ages 10-79 years) from five different occupational categories who were tested on a Liftask device using a flexed knees-flexed back lifting posture. Testing consisted of four maximal lifting repetitions preceded by three gradient submaximal repetitions plus one maximal effort at the speeds of 6, 12, 18, 24, 30, and 36 inches/sec. Data on peak force, peak force as percent of body weight, height of peak force, average force, average force as percent of body weight, average power, and total work were categorized by sex and age decade for reporting as normative experimental results. In general, overall performance decreased in an inverse proportion to test speed while height of peak force and average power increased in direct proportion to speed. Also, subject performance increased from the 10-19 decade to the 20-29 decade before decreasing with age through the 70-79 decade. The results may be useful for clinical reference purposes as normative data for the purposes of performance comparisons during isokinetic lifting with a flexed knee-flexed back posture.J Orthop Sports Phys Ther 1988;10(5):156-166.

This article presents the case histories of two back patients, one who had undergone three separate spinal surgeries and one who was status post-cerebrovascular accident, that were successfully rehabilitated using the Cybex® Trunk Extension/Flexion Isokinetic System.

This article investigates the concept of physiological overflow during speed-specific isokinetic exercise. The idea was tested on 30 volunteers; 14 female, 16 male; mean age 24.5 years, age range 17-29 years; who were subjected to a repeated m o r e s experimental design. Testing involved 5 repetitions of knee extension/flexion at the velocity spectrum speeds of 80, 7 20, 180,240, and 300 degrees /sec preceded by a warm-up at 3 gradient submaximal repetitions and 1 maximal effort at each speed. The experimental treatment consisted of isokinetic exercise of the knee musculature to the level of 50% quadriceps fatigue at the speed of 180 degrees /sec in a format of 3sessions per week over a period of 8 weeks. Analysis of variance testing with repeated measures revealed statistically significant differences in quadriceps and hamstrings function for peak torque, torque acceleration energy, and watts average power at all velocity spectrum speeds over the period of experimentation. It was concluded that a +/-120 degrees /sec physiological overflow of exercise effects to both slower and faster speeds existed during the program of isokinetic activity. J Orthop Sports Phys Ther 1987;9(3):106-110.

The following case study is an excerpt from a larger body of data being generated through an ongoing investigation into the applications of a Cybex® II velocity spectrum in the fields of orthopaedic physical therapy and sports medicine for the rehabilitation of the postsurgical knee patient.

This article describes isokinetic exercise based upon exercise performance to a level of 50% muscle fatigue. This format provides an objective means for treatment program progression which may enhance clinical rehabilitation efficiency. J Orthop Sports Phys Ther 1987;8(10):505-506.