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Playing a musical instrument necessitates stability in the hands, neck, shoulders, and trunk, involving both isotonic and isometric movements, muscular endurance, and various other physical demands. Musicians, especially those engaged in professional or educational pursuits, often dedicate several hours each day to practicing and performing. Despite the substantial physical challenges associated with musical performance, the realm of performing arts medicine lacks comprehensive research and practical methodologies tailored to adequately address the conditioning requirements of musicians. Musculoskeletal discomfort is prevalent among professional musicians, predominantly affecting the upper body. Instrumental players encounter issues such as musculoskeletal overuse, nerve entrapment, focal dystonia, and other playing-related musculoskeletal disorders, which can persist for extended periods. Consequently, this article aims to present a specialized strength and conditioning regimen tailored for instrumental musicians participating in large music ensembles, specifically symphony orchestras and wind bands. The guide will identify the mechanics inherent to playing these instruments and the prevalent injuries associated with them. Using this information, a strength and conditioning protocol suitable for the application within a symphony orchestra and wind band music classrooms will be presented. [ABSTRACT FROM AUTHOR]

To determine the efficacy of IASTM of the gastrocnemius-soleus complex in comparison to a traditional stretching intervention on dorsiflexion ROM. Sixty healthy participants were randomly allocated to one of 3 groups: IASTM (n = 20), stretching (n = 20), or control group (n = 20). The dependent variables for this study was dorsiflexion range of motion (ROM) via three measurement methods which included Modified root position 1- knee extended (MRP1), Modified root position 2- knee flexed (MRP2), and weight bearing lunge test (WBLT). A multivariate analysis of variance (MANOVA) was utilized to analyze the ROM differences between the groups (IASTM, stretching, and control groups), with a post-hoc Tukey and pairwise least significant difference tests to assess individual pairwise differences between the groups. The MANOVA found significant ROM differences between the three intervention groups (F 6,110 = 2.40, p =.032). Statistically significant differences were identified between both the IASTM and control as well as the stretching and control group through the WBLT and MRP2 assessments, but not in the MRP1 assessment. Further, there was no statistically significant difference between the IASTM and stretching groups using any of the three methods. A single session of IASTM or stretching increased ankle dorsiflexion ROM in WBLT and MRP2. No significant difference was noted in the MRP1. Both IASTM and stretching appear to have a greater effect on soleus muscle flexibility as evidenced by ROM gains measured with the knee in a flexed position. No clinically significant difference was identified between the intervention groups in weight-bearing conditions; thus empowering patients with the use of self-stretching would seemingly be reasonable and efficient. Combined effects of stretching and IASTM warrant further investigation for increasing dorsiflexion range of motion as a summative effect is unknown. [ABSTRACT FROM AUTHOR]

Introduction. Low back pain (LBP) is one of the most common medical conditions in the United States. Clinical practice guidelines recommend active treatment approaches; however, there continues to be a significant disparity in how patients with LBP are treated. Therefore, the purpose of this systematic review is to evaluate the reported efficacy of active treatment approaches as recommended by clinical practice guidelines on LBP treatment on patient outcomes. Methods. Between the months of June and August 2015, a comprehensive search of the PubMed, Medline (EBSCO Host), and CINAHL (EBSCO Host) databases was performed. The search was restricted to articles that were published in a peer-reviewed journal, published in the English language, examined patient outcomes with a determined scale, determined the usage of an established clinical practice guideline for LBP treatment, reported at least one outcome measure, and specified either nonspecific or acute LBP. Results. Fifty-three articles were initially identified, with 4 articles ultimately meeting the criteria after screening. Articles scored between 17 and 20 points based on a maximum total score of 26 on the modified Downs and Black checklist. Conclusion. Studies identified in this review indicate that adherence to an active treatment approach as recommended by clinical practice guidelines may result in improved patient outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: An alternative approach to facilitate movement and control through the trunk and pelvis is belly dancing. Investigations of belly dancing mechanics indicate similar muscular activation patterns of those known to influence chronic low back pain (cLBP). However, no documented studies have examined its effectiveness as a treatment for cLBP. OBJECTIVE: The purpose of this study was to investigate the influence of a standardized belly dance program in women with cLBP. METHODS: A single subject design was used to evaluate weekly outcomes during a three-week baseline period, six-week belly dance program, and again at a two-month follow-up. Outcome measures for pain, disability, function, and fear-avoidance beliefs were utilized. RESULTS: Two subjects completed the program. No significant differences were noted during the baseline assessment period. At two months, subject one demonstrated change scores of -1.12, -1%, and 2.2 for pain, disability, and function respectively while subject two demonstrated change scores of 5.4, 5%, and 1.1 for pain, disability, and function, respectively. Subject one showed a clinically significant change score for both fear avoidance of work and physical activity, with score changes of 4 and 3.3, respectively. CONCLUSION: The results of this study suggest a standardized belly dance program may positively influence pain and function in women with cLBP. [ABSTRACT FROM AUTHOR]

Lumbar spinal stenosis (LSS) is an increasingly prevalent condition that has major health and economic implications. While there are many options for the treatment of LSS, exercise is widely considered a first-line intervention as it is associated with reduced complications and cost as compared to more invasive options. Currently, it is not clear if exercise is an effective approach to managing pain and perceived disability in patients with symptomatic LSS. Therefore, the purpose of this systematic review is to evaluate the published literature that has investigated exercise as a primary intervention for LSS. A search was conducted in electronic databases including PubMed, PEDro, SPORTDiscus, CINAHL, and AMED using the key words lumbar spinal stenosis, exercise, physical therapy, rehabilitation, and conservative treatment. Inclusion criteria consisted of published randomized controlled trials written in English that included exercise as the primary treatment in at least one of the groups, and had reported measures of pain and disability clearly stated. The search identified 310 studies of which 5 met all the inclusion parameters. Exercise appears to be an efficacious intervention for pain, disability, analgesic intake, depression, anger, and mood disturbance among patients with LSS. Further research is needed to determine which type of exercise is the most effective in managing symptoms associated with lumbar spinal stenosis. [ABSTRACT FROM AUTHOR]

Context: Therapeutic ultrasound is a widely used modality, however, little is known about the knowledge level of athletic trainers regarding therapeutic ultrasound. Objective: To examine athletic trainers' perceived and actual knowledge of therapeutic ultrasound concepts. Design: Cross-sectional. Setting: Web-based. Patients or Other Participants: Randomly selected collegiate athletic trainers (35.55 ± 8.86 years). Intervention: The questionnaire included: Likert scale questions regarding perceived knowledge of the educational competencies related to therapeutic ultrasound; actual knowledge questions regarding theory/textbook validated knowledge; frequency of use questions; and demographics. Main Outcome Measures: Correlations. Results: Athletic trainers in collegiate settings reported fairly high confidence in their knowledge of the application-related therapeutic ultrasound competencies. Athletic trainers reported less confidence in their knowledge of the theory-related competencies. The actual knowledge mean score was 15.50 ± 2.88 out of 22 possible points. The 13 questions that were answered correctly by less than 75% of the participants related to insufficient parameters, safety concerns, and theory/book knowledge. Weak to moderate positive relationships were found between actual knowledge scores and perceived knowledge scores, age group, and number of therapeutic modalities courses taken. Weak to moderate positive relationships were found between perceived knowledge scores and both age group and number of courses taken. Conclusions: Athletic trainers were more confident with application-based questions than they were with theory-based questions. Though overall confidence in their knowledge of therapeutic ultrasound concepts was high, actual knowledge scores were relatively poor. Actual knowledge scores were higher in older age groups and in those who had taken more therapeutic modalities courses. The use of inadequate intensities and inadequate treatment durations, as outlined by Draper in 1998, were still seen. While a self-assessment tool may be helpful for some, this study suggests that more research is needed regarding whether athletic trainers have an accurate understanding of their need for continuing education in this area. [ABSTRACT FROM AUTHOR]

The article discusses the systematic review on the risks and benefits of running barefoot compared to running in minimalist shoes. Topics discusses include the sources of the study are the databases Ovid MEDLINE, SportDiscus, and CINAHL, the articles obtained were appraised using the Downs and Black checklist and investigated the variable differences of kinetic, kinematic, running economy and Electromyography EMG, and the results indicate that minimalist shoes cannot replicate barefoot running.

Chronic low back pain (cLBP) is common and has a tremendous economic impact. With the prevalence and incidence of low back pain (LBP) on the rise, individuals often seek alternative treatments. Yoga is a widely used complementary and alternative medicine treatment for LBP. However, its efficacy as an intervention for LBP has not been thoroughly investigated. Therefore the purpose of this study was to systematically review the current literature for randomized controlled trials that assess the outcomes of Yoga as an intervention for individuals with cLBP. An electronic database search was performed for studies related to the efficacy of yoga in treatment for cLBP. Studies included were randomized control trials, published in English, from a peer-reviewed journal that identified yoga as the primary treatment focus for LBP in at least one group and included participants with at least a 12-week (3-month) history of symptoms. Our search revealed 185 articles. Of these, 10 met the inclusion criteria. We concluded Yoga intervention appears to be an efficacious intervention in alleviating cLBP. Yoga was demonstrated to significantly improve quality of life and reduce disability, stress, depression, and medication usage associated with cLBP in 8 of the 10 analyzed trials when compared with usual care, self-care book, or exercises. However, more research is necessary before recommendations can be made. [ABSTRACT FROM PUBLISHER]

Background: Gluteal injuries, proximal hamstring injuries, and pelvic floor disorders have been reported in the literature among runners. Some suggest that hip, pelvis, and/or groin injuries occur in 3.3% to 11.5% of long distance runners. The purpose of this case report is to describe the differential diagnosis and treatment approach for a patient presenting with combined hip and pelvic pain. Case description: A 45-year-old female distance runner was referred to physical therapy for proximal hamstring pain that had been present for several months. This pain limited her ability to tolerate sitting and caused her to cease running. Examination of the patient's lumbar spine, pelvis, and lower extremity led to the initial differential diagnosis of hamstring syndrome and ischiogluteal bursitis. The patient's primary symptoms improved during the initial four visits, which focused on education, pain management, trunk stabilization and gluteus maximus strengthening, however pelvic pain persisted. Further examination led to a secondary diagnosis of pelvic floor hypertonic disorder. Interventions to address the pelvic floor led to resolution of symptoms and return to running. Outcomes: Pain level on the Visual Analog Scale decreased from 7/10 to 1/10 over the course of treatment. The patient was able to return to full sport activity and improved sitting tolerance to greater then two hours without significant discomfort. Discussion: This case suggests the interdependence of lumbopelvic and lower extremity kinematics in complaints of hamstring, posterior thigh and pelvic floor disorders. This case highlights the importance of a thorough examination as well as the need to consider a regional interdependence of the pelvic floor and lower quarter when treating individuals with proximal hamstring pain. [ABSTRACT FROM AUTHOR]

Background: Gluteal injuries, proximal hamstring injuries, and pelvic floor disorders have been reported in the literature among runners. Some suggest that hip, pelvis, and/or groin injuries occur in 3.3% to 11.5% of long distance runners. The purpose of this case report is to describe the differential diagnosis and treatment approach for a patient presenting with combined hip and pelvic pain. Case description: A 45-year-old female distance runner was referred to physical therapy for proximal hamstring pain that had been present for several months. This pain limited her ability to tolerate sitting and caused her to cease running. Examination of the patient's lumbar spine, pelvis, and lower extremity led to the initial differential diagnosis of hamstring syndrome and ischiogluteal bursitis. The patient's primary symptoms improved during the initial four visits, which focused on education, pain management, trunk stabilization and gluteus maximus strengthening, however pelvic pain persisted. Further examination led to a secondary diagnosis of pelvic floor hypertonic disorder. Interventions to address the pelvic floor led to resolution of symptoms and return to running. Outcomes: Pain level on the Visual Analog Scale decreased from 7/10 to 1/10 over the course of treatment. The patient was able to return to full sport activity and improved sitting tolerance to greater then two hours without significant discomfort. Discussion: This case suggests the interdependence of lumbopelvic and lower extremity kinematics in complaints of hamstring, posterior thigh and pelvic floor disorders. This case highlights the importance of a thorough examination as well as the need to consider a regional interdependence of the pelvic floor and lower quarter when treating individuals with proximal hamstring pain. [ABSTRACT FROM AUTHOR]

The article discusses minimally invasive surgery (MIS) knee arthroplasty (KA) and offers an accelerated rehabilitation protocol developed to compliment MIS strategies for KA. It states that MIS is defined by C. M. McAllister and J. D. Stepanian as KA performed with no quadriceps tendon dissection, patella aversion, or tibiofemoral joint dislocation. It highlights MIS KA techniques, such as subvastus, midvastus, and sparing approaches.

Background and Purpose: Pressure Pain Threshold (PPT) is used to objectively assess pain in clinical settings and is a recommended part of physical therapist education. An individual who is experienced in administering PPT will frequently train a student on the technique; however, optimal educational approaches for this instruction have not yet been identified. Therefore, the purpose of this case report is to describe 2 educational approaches (unstructured lecture and structured feedback with clinical relevance) in training 2 separate cohorts of Doctor of Physical Therapy students in PPT. The primary outcome of interest was the inter-rater reliability of PPT between an experienced and novice examiner., Case Description: Cohort 1 (n = 37) received a traditional lecture approach consisting of watching a prerecorded video online, an in-person lecture with demonstration of the technique, and time to practice. Cohort 2 (n = 34) received the prerecorded video online and lecture with demonstration; however, key additions included a clinical relevance discussion along with structured peer-to-peer and instructor-to-student feedback using a competency-based checklist. PPT was assessed by each student (novice examiner) and one instructor (experienced examiner). Inter-rater reliability of PPT between a novice and experienced examiner was evaluated., Outcomes: Inter-rater reliability improved from poor/moderate (intraclass correlation coefficient low back = 0.46 [0.16-0.68], quadriceps = 0.54 [0.26-0.73]) to good (low back = 0.84 [0.67-0.92], quadriceps = 0.90 [0.79-0.95]) after the addition of structured feedback., Discussion: Structured feedback from peers and instructors may be useful when learning PPT and improving inter-rater reliability, which has implications for training students within a laboratory or classroom. However, this case study would need to be replicated in an experimental design to examine the effects of varying types of feedback on learning outcomes., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Academy of Physical Therapy Education, APTA.)

Introduction . Low back pain (LBP) is one of the most common medical conditions in the United States. Clinical practice guidelines recommend active treatment approaches; however, there continues to be a significant disparity in how patients with LBP are treated. Therefore, the purpose of this systematic review is to evaluate the reported efficacy of active treatment approaches as recommended by clinical practice guidelines on LBP treatment on patient outcomes. Methods . Between the months of June and August 2015, a comprehensive search of the PubMed, Medline (EBSCO Host), and CINAHL (EBSCO Host) databases was performed. The search was restricted to articles that were published in a peer-reviewed journal, published in the English language, examined patient outcomes with a determined scale, determined the usage of an established clinical practice guideline for LBP treatment, reported at least one outcome measure, and specified either nonspecific or acute LBP. Results . Fifty-three articles were initially identified, with 4 articles ultimately meeting the criteria after screening. Articles scored between 17 and 20 points based on a maximum total score of 26 on the modified Downs and Black checklist. Conclusion . Studies identified in this review indicate that adherence to an active treatment approach as recommended by clinical practice guidelines may result in improved patient outcomes., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Lumbar spinal stenosis (LSS) is an increasingly prevalent condition that has major health and economic implications. While there are many options for the treatment of LSS, exercise is widely considered a first-line intervention as it is associated with reduced complications and cost as compared to more invasive options. Currently, it is not clear if exercise is an effective approach to managing pain and perceived disability in patients with symptomatic LSS. Therefore, the purpose of this systematic review is to evaluate the published literature that has investigated exercise as a primary intervention for LSS. A search was conducted in electronic databases including PubMed, PEDro, SPORTDiscus, CINAHL, and AMED using the key words lumbar spinal stenosis, exercise, physical therapy, rehabilitation, and conservative treatment. Inclusion criteria consisted of published randomized controlled trials written in English that included exercise as the primary treatment in at least one of the groups, and had reported measures of pain and disability clearly stated. The search identified 310 studies of which 5 met all the inclusion parameters. Exercise appears to be an efficacious intervention for pain, disability, analgesic intake, depression, anger, and mood disturbance among patients with LSS. Further research is needed to determine which type of exercise is the most effective in managing symptoms associated with lumbar spinal stenosis.