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Adequate abdominal strength prevents work- and sports-related injuries and stabilizes the spine for athletic activities. The double-leg-lowering maneuver (DLLM) is a popular test to assess abdominal strength because of its simplicity; however, its validity and reliability have not been studied thoroughly. To determine the validity and reliability of the DLLM, 4 examiners evaluated 28 subjects. The validity of the DLLM was evaluated with the Nicholas Hand-Held Dynamometer (NHHD) as the gold standard. The DLLM scores were compared to themselves for reliability and to NHHD scores for validity. Reliability for the DLLM was very high (r = 0.932). Validity of the DLLM was low (r = -0.338 to -0.446). The DLLM is reliable, but it has low validity to assess abdominal strength. The DLLM may be a useful tool to assess pelvic tilt motor control for spine stability, but it is not suitable for assessing muscle strength. Key Words. manual muscle test, motor control, trunk flexors, reliability

Objectives: Physical therapists (PTs) may practice in direct access or act as primary care practitioners, which necessitate patients’ screening and management for red, orange and yellow flags. The objective of the project was to assess the American PT’s ability to manage red, orange and yellow flags in patients with low back pain (LBP), and to compare this ability among PTs with different qualifications. Methods: The project was an electronic cross-sectional survey. The investigators contacted 2,861 PTs. Participants made clinical decisions for three vignettes: LBP with red flag for ectopic pregnancy, with orange flag for depression and with yellow flag for fear avoidance behaviour (FAB). The investigators used logistic regression to compare management of warning flags among PTs with distinct qualifications: orthopaedic clinical specialists (PTOs), fellows of the AAOMPT (PTFs), PTOs and PTFs (PTFOs), and PTs without clinical specialization (PTMSs). Results: A total of 410 PTs completed all sections of the survey (142 PTOs, 110 PTFOs, 74 PTFs and 84 PTMSs). Two hundred and seventeen PTs (53%) managed the patient with LBP and symptoms of ectopic pregnancy correctly, 115 PTs (28.5%) of them managed the patient with LBP and symptoms of depression correctly, and 177 (43.2%) managed the patient with LBP and FAB correctly. Discussion: In general, PTs with specialization performed significantly better than PTMSs in all three clinical vignettes. PTs ability to manage patients with warning flags was relatively low. Based on our results, further education on patients with LBP and warning flags is needed. The survey had the potential for non-response and self-selection bias. Level of Evidence: 3b. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to describe the treatment preferences for low back pain (LBP) by physical therapists (PTs) and compare outpatient musculoskeletal therapist (MSPT) and non-outpatient musculoskeletal therapist (NMSPT) choices in Florida. The study uses an electronic survey to evaluate LBP treatments. The study findings show home exercise program, back care education and joint mobilization were among the treatment choices for LBP.

The author comments on a study "The Adoption and Implementation of Evidence-Based Practice (EBP) among Allied Health Professions (AHP)," by Upton and colleagues. He agrees with the study result which revealed that AHPs had moderate EBP knowledge, implementation, and acceptance. He opines that the results of this study cannot be generalized to all new AHP graduates from Scotland, as the the sample size was very small.

Background: Low back pain (LBP) is the most common disorder seen in physical therapy practice. There are several hundred clinical trials on the management of LBP. To summarize these trials, researchers wrote Evidence Based Practice (EBP) guidelines. This article reviewed the implications of EBP guidelines recommendations for physical therapy practice., Objectives: To review the recommendations for conservative management of LBP published in EBP guidelines since 2002., Methods: Searches were performed on the following databases: Google web searching engine, Medline, Cochrane Library, and the Guideline Clearing House. Guidelines published in English and addressing conservative management of LBP were included., Results: Thirteen multidisciplinary and three mono-disciplinary guidelines met the inclusion criteria. LBP was triaged into three groups: with red flags, with radiculopathy, or non-specific. Patients without red flags could be safely managed without specialist referral. Patient education was recommended for all patients with LBP. There was an agreement to advise spine manipulation for patients with acute and sub-acute non-specific LBP. There was a consensus to recommend exercises for acute, sub-acute, and chronic LBP. Few guidelines addressed conservative management of LBP with radiculopathy. Overall, the guidelines did not offer specific advice for manipulation (hypomobility or instability) and exercise (stabilization or directional preference)., Conclusion: Multidisciplinary guidelines focused on primary care and lacked details significant for physical therapy practice. There is a need for mono-disciplinary physical therapy guidelines to improve the balance between evidence and professional relevance.