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Background: The heterogeneity of persons with temporomandibular disorders (TMD) and the lack of effective treatments have called for a biopsychosocial model and the development of a more personalised treatment approach. Emphasis on phenotypes might be a beneficial approach. Objective: Identifying phenotypes among persons with TMD using potential prognostic factors, including personal characteristics and responses to clinical tests. Additionally, examining the distribution of TMD diagnoses within the identified phenotypes. Methods: A cross‐sectional study including 208 persons (85% females) seeking physiotherapy for problems in the temporomandibular area. All participants were examined clinically and answered questionnaires electronically. The phenotypes were identified using latent class analysis based on seven potential prognostic factors selected within pain, function and psychological domains. Table analysis was used to explore the distribution of TMD diagnoses within the identified phenotypes. Results: Most participants fit into one of three identified phenotypes. Phenotype 1 (32%) was characterised by functional disability, low psychosocial scores and low risk for developing chronicity and future work disability; Phenotype 2 (29%) by parafunctional habits, low psychosocial score and seeking treatment to reduce pain; and Phenotype 3 (39%) by high levels of mental distress, fear avoidance and a large risk of future work disability. Intra‐articular disorders dominated Phenotype 1, myalgia and TMD‐related headache Phenotype 2, while Phenotype 3 included all the different TMD diagnoses. Conclusion: The knowledge about the three identified phenotypes might be useful for clinicians treating persons with TMD and for the development of preventive strategies and more personalised treatment. [ABSTRACT FROM AUTHOR]

Background: Recent studies with data‐driven approaches have established common pain trajectories. It is uncertain whether these trajectory patterns are consistent over time, and if a shorter measurement period will provide accurate trajectories. Methods: We included 1,124 patients with non‐specific neck pain in chiropractic practice. We classified patients into pre‐defined trajectory patterns in each of four quarters of the follow‐up year (persistent, episodic, and recovery) based on measures of pain intensity and frequency from weekly SMS. We explored the shifts between patterns and compared patients with stable and shifting patterns on baseline characteristics and clinical findings. Results: 785 (70%) patients were in the same pattern in 1st and 4th quarters. Patients with episodic pattern in the 1st quarter shifted to other patterns more frequently than patients in the other patterns. A stable persistent pattern was associated with reduced function and higher scores on psychosocial factors. There was a decreased frequency of patients classified as persistent pattern (75% to 63%) and an increase of patients in recovery pattern (4% to 15%) throughout the four quarters. The frequency of patients classified as episodic remained relatively stable (21% to 24%). Conclusions: We found an overall stability of the persistent pattern, and that episodic patterns have more potential for shifts. Shifts mostly occurred between patterns closest in pain variation. The deviation in pattern distribution compared with previous studies suggests that the duration of measurement periods has an impact on the results of the classification. Significance: Having persistent pain and having very minor pain is relatively stable over one year, while episodic pain has more potential for shifts. The duration of measurement periods appears to have an impact on the results of the classification. The given criteria resulted in a reduced frequency of episodic pattern due to shorter measurement periods. Our findings contribute to improved understanding and predicting NP using a combination of patient characteristics and trajectory patterns. [ABSTRACT FROM AUTHOR]

Purpose: To explore the efficacy of a low-impact exercise programme for participants with degenerative spinal stenosis awaiting surgery, aiming to improve physical functioning without deterioration of symptoms. Material and methods: Forty participants with symptomatic and radiological degenerative lumbar spinal stenosis and self-reported walking limitations, participated in the study completed the last ten weeks before surgery. The participants were assigned to one of two groups: one exercise group where participants were committed to the exercise programme (n = 26) and a control group with no exercise programme (n = 14). The main outcome measures were 30 seconds Sit-to-Stand (repetitions) and Leg Pain (NRS, 0–10). Results: The exercise group reported 3.1 weekly bouts of exercise. At follow-up the Leg Pain improved slightly more in the exercise group compared with the control group (mean difference 1.2 (95% CI −2.2, −0.1), p=.029). No changes or group differences were observed for 30sSit-to-Stand or for the secondary outcome measures. Conclusion: The results suggest that a low-impact exercise programme is feasible by a group of patients with LSS and walking limitations. There were no attenuation of symptoms. However, the programme did not lead to improved physical capacity. The results suggest that exercise with higher intensity could be tested. [ABSTRACT FROM AUTHOR]

Background: Amyoplasia, the most common form of arthrogryposis is characterized by typical deformities of the joints and replacement of skeletal muscles by fibrous tissue and fat. There is sparse literature on adaptation to adult life with amyoplasia. Purpose: To describe physical function and activity strategies in adults with amyoplasia, as this knowledge is important for relevant function-enhancing measures. Materials and methods: Twenty-two adults (20-91 years) with amyoplasia participated. Demographic factors and clinical history were registered. Body proportions were measured. Joint mobility and muscle strength in the upper limbs were examined. The Functional Independent Measure was used to assess performance of activities of daily living. Compensatory strategies were described. Results: The majority had undergone comprehensive conservative and surgical treatment. Mean height was below typical. Range of motion was below lower limit of normal in most joints, passive range of motion was mainly larger than active. Muscle strength was reduced for most movements. Seven were independent in all activities. Need of assistance was highest regarding bathing and dressing. A variety of compensatory strategies were used. Conclusions: Adults with amyoplasia are heterogeneous regarding function. Independence in everyday life requires a combination of muscle strength to move against gravity, ability to passive joint motion, and use of compensatory strategies. Implications for rehabilitation: The ability to joint motion in the upper extremities is essential for independency in activities of daily living, especially when the muscle strength is impaired. Training of muscle strength is recommended, whenever possible, as muscle strength to move against gravity makes the performing of everyday tasks easier. The use of compensatory techniques, adaptions to the environment and relevant, often custom made, assistive devices is required to perform activities of daily living. Living an active life with physical challenges like in amyoplasia requires flexible and individually adapted solutions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of a conductive education (CE) course followed by conventional practice, on gross motor function, other functional skills, quality of life, and parents’ experiences of family-centered services in young children with cerebral palsy (CP). Methods: Twenty-one children with CP, 3-6 years old, were randomized to one 3-week CE course followed by conventional practice or conventional practice on a waiting list. Outcomes were measured 4 months after baseline. A web-based log collected data on the conventional practice. Results: No additional improvements in the children’s outcome were found. However, parents in the CE group reported that they received more information than parents in the waiting list group (p = 0.01). Children in both groups performed high amount of conventional practice at home. Conclusions: A 3-week CE course did not add any improvements in the children’s functioning, possibly explained by the large amount of conventional practice reported of both groups. [ABSTRACT FROM AUTHOR]

Background:Degenerative spinal stenosis is a common lumbar condition in the elderly population. Clinical decision-making in the physiotherapy settings is based on assessments of the patients physical status. The purpose of this study was to examine how self-reported measures on symptoms and physical function relate to responses on physical performance tests. Methods:A total of 103 patients with LSS completed a comprehensive questionnaire and physical performance tests (functional leg-strength and dynamic balance). Associations between the subscales Symptom Severity (SYMP) and Physical Function (FUNC) from the Spinal Stenosis Questionnaire, and the performance tests were examined. Univariate correlation and multivariable linear regression analyses were applied. Results:The associations between SYMP or FUNC and the performance tests were moderate (?0.3 < rho < 0.6). The multivariable analyses showed that One-leg-Stand, 30s sit-to-stand were significantly associated with SYMP (< 0.001 < p < 0.03), whereas Stairclimb, was significantly associated with FUNC (< 0.001 < p < 0.005). The explained variance was fair for both adjusted models (R2 = 0.31 andR2 = 0.38). Conclusions:The present study indicates that both self-reported symptoms and walking limitation are associated with leg strength, while only symptoms are associated with balance. The results suggest that a combination of simple performance tests will add information needed to map the patients disability and guide interventions.Implications for RehabilitationOne-leg-standing, 30-s sit-to-stand and stair climb test are easy to use and applicable for examining physical function in patients with lumbar spinal stenosis (LSS).Simple performance tests add information needed to map the patients’ disability and guide interventions.Leg strength is a key factor for both symptoms and walking ability. Also, balance is of importance for the symptoms in LSS patients. [ABSTRACT FROM PUBLISHER]