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Background. To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives. The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design. A mixed, prospective design was used in the study. Method. Phase 1 (2006-2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008-2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results. Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%-100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations. Although a true international collaboration, the limited sample size should be recognized. Conclusions. It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought. [ABSTRACT FROM AUTHOR]

Background. Children report low back pain (LBP) as young as 8 years. Preventing LBP in children may prevent or delay adult incidence. Objectives. The purpose of this study was to determine whether education and daily exercise affect LBP episodes in children compared with education alone. Design. This was a prospective, multicenter cluster randomized controlled trial. Setting. The study was conducted at 7 New Zealand primary schools. Participants. Children (n=708), aged 8 to 11 years, from 7 schools stratified by sample size (36, 114, 151, 168, 113, 45, 83) were randomized and allocated to 2 masked groups: intervention (4 schools, n=469) or control (3 schools, n=239). Interventions. Participants in the intervention group were taught 4 spinal movements for daily practice. Both groups participated in education that emphasized “back awareness.” Measurements. Low back pain history at baseline was assessed. Children reported episodes of LBP during the previous week on trial days 7, 21, 49, 105, 161, and 270. Analysis was at the individual participant level, with adjustment for school clusters. There were no significant differences between groups in the odds of reporting no LBP in the previous week during the study period (odds ratio [OR] =0.72; 95% confidence interval [95% CI]=0.46, 1.14; P=.l6). The intervention group reported significantly fewer episodes of LBP (OR=0.54; 95% CI=0.39, 0.74; /p<.001) and significantly fewer lifetime first episodes of LBP (n=86 [34%]) compared with the control group (n=58 [47%]) (OR=0.60; 95% CI=0.39, 0.91; P=.02). The odds of an episode of LBP were greater in participants with a history of LBP (OR=4.21; 95% 0=3.07, 5.78; P<.001). Low back pain episodes decreased across the trial period for both groups (OR=0.89; 95% CI=0.84, 0.95; 7J<.001). Adherence to exercise was poor. Limitations. Replication in other settings is needed. Conclusions. Regular exercise and education appear to reduce LBP episodes in children aged 8 to 11 years compared with education alone. [ABSTRACT FROM AUTHOR]