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Background: Chronic pain is considered to be a major health issue globally, whereof Italy is one of the highest ranked countries regarding chronic pain prevalence in Europe. Chronic pain has a negative impact on quality of life and functions on a biological, social, and psychological level, which concerns all health professionals. For this reason, health care providers have an important role working with these patients. Aim: This study aims to explore and bring knowledge about Italian physical therapists’ experiences of working with patients with chronic pain. Design: A qualitative method with an exploratory and descriptive design, based on semi structured interviews was used for the purpose of understanding the physical therapists’ experiences of working with patients with chronic pain. Furthermore, the data was analyzed by a qualitative content analysis and had an inductive approach. Results: The analysis generated five categories: The importance of trust and relations, Professional challenges and positive potentials, Physical therapists’ reflection on their own contribution, Physical therapists’ and patients’ different viewpoints and The view on the profession.   Conclusion: This study revealed that Italian physical therapists regard themselves to play a crucial part in the work with patients with chronic pain. It emphasizes the essential parts of the work of gaining the patient’s trust and forming an alliance. Despite the physical therapists’ contribution to these patients, there exist factors that frequently prevent the rehabilitation from being successful. The results could be of value for future physical therapists working with chronic pain. Keywords: Physical therapy, experience, chronic pain, Italy / Bakgrund: Långvarig smärta beräknas vara ett stort globalt hälsoproblem och Italien är ett av de länder i Europa med högst prevalens. Långvarig smärta har en negativ inverkan på livskvalitet och biologiska, sociala samt psykologiska funktioner. Detta berör alla vårdgivare, som har en betydelsefull roll i att upprätthålla och förbättra funktionen samt livskvaliteten hos dessa patienter. Syfte: Denna studie syftar till att utforska och tillföra kunskap om italienska fysioterapeuters upplevelser och erfarenheter av att arbeta med patienter med långvarig smärta. Metod: En kvalitativ metod med explorativ och deskriptiv design, baserad på sju semistrukturerade intervjuer användes i syfte att få djupare förståelse för fysioterapeuters upplevelser och erfarenheter av att arbeta med patienter med långvarig smärta. Vidare, analyserades data med en kvalitativ innehållsanalys med en induktiv ansats. Resultatsammanfattning: Dataanalysen genererade i fem kategorier: The importance of trust and relations, Professional challenges and positive potentials, Physical therapists’ reflection on their own contribution, Physical therapists’ and patients’ different viewpoints och The view on the profession.   Slutsats: Denna studie påvisar att fysioterapeuter i Italien anser sig har en betydelsefull roll för patienter med långvarig smärta. Trots många utmaningar upplevde fysioterapeuterna deras insats som väsentlig för att förbättra patienternas vy på livet och deras livskvalitet. Studien ger insikt i vilka erfarenheter och upplevelser fysioterapeuterna har i arbetet med patientgruppen. Resultatet belyser svårigheter och möjligheter med att arbeta med dessa patienter, vilket kan vara värdefullt för hur fysioterapeuter arbetar med långvarig smärta i framtiden. Nyckelord: Physical therapy, experience, chronic pain, Italy

The Long March is a review of the origins and development of the Physical Therapy profession in the United States since the beginning of the 20th century. It shows the evolution experienced since that time of its professional profile, name and academic training received. It is shown how the relationship between the physical therapist and physician has grown and evolved into a relationship of mutual respect and of improvement in the professional practice.On the other hand, the principal milestones in the long march of the physical therapy profession from the time of its birth as a profession that was totally dependent on the physician to its current status as a profession with professionals having a deep science base and high university level training who are able to practice and freely govern their profession without external control are presented.

As an exploratory, developmental injury intervention study, this research investigated the efficacy of providing psychological intervention in the form of relaxation and guided imagery to a group of orthopedic patients recovering from major knee surgery. Utilizing a prospective, experimental research design with 30 subjects randomly assigned to either an intervention, placebo, or control group, this study employed physiological as well as psychological outcome measures. Intervention consisted of 10 individual mental practice sessions for intervention group members as an adjunct to physical therapy. Content of these sessions was intentionally designed to facilitate physiotherapy goals. Imagery protocols with which to deliver these standardized sessions were also designed to directly parallel established physical rehabilitation protocols. Placebo group participants were exposed to nonspecific intervention factors of attention and support, while control group members completed their physical therapy as usual. Results of this study revealed that for this sample of anterior cruciate ligament (ACL) orthopedic patients, psychological injury intervention in the form of relaxation and guided imagery contributed to statistically significant better physical and psychological outcomes. Strength and extension improvement, as well as reduction in state, trait, and reinjury anxiety, were superior for the intervention group as compared to placebo and control groups from preintervention (2 weeks postsurgery) to post-intervention (24 weeks postsurgery). Other benefits of the intervention, according to subject self-report, included pain and stress management, empowerment, control of recovery, and overall body wellness . Implications of these research findings are discussed, as well as suggestions offered for subsequent injury intervention research.

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in finding ways to improve balance in seniors, the high incidence of falls continues to plague this demographic. Many of the current treatments to improve balance are too expensive, not accessible, or not motivating for seniors. This research project explored the effect of using a readily available video-game system to address these barriers. The Wii Fit gaming system was used with participants three times each week for 30 minutes and the resulting changes were documented. The Berg Balance Scale and Timed Up and Go test, both frequently used by professionals to assess balance in seniors, were used to document balance change. Every participant showed improvement. The Activities-specific Balance Confidence scale, which is used to measure a person's fear of falling, was also used to assess the participant's confidence in their balance as well as the level of fear associated with falling. The results of this test were positive but not to the extent of the balance tests. Finally, each participant was interviewed to assess how easy to use the participants felt the Wii Fit was as well as the motivational qualities of the Wii Fit as a balance tool. Answers given by the participants in the interview were generally positive. These results indicate that the Wii Fit gaming system may be beneficial for improving balance in seniors.

Competitive swimmers frequently injure their shoulders. The risk factors for shoulder injuries in competitive swimmers have not been clearly identified. The primary purposes of this study were to describe the characteristics of female collegiate swimmers at the onset of a swim season, identify the risk factors of shoulder injury in female collegiate swimmers, characterize the swim volume of female collegiate swimmers, and determine if swim volume is a predictor of shoulder injury. A prospective longitudinal cohort multi-center design was utilized. Female collegiate swimmers [n=53, mean age=19.3+/– 1.2] from four NCAA Division II universities were recruited to participate in this study. Preseason screening data that included demographics and sport history, swimming characteristics, and a musculoskeletal assessment was collected on 106 shoulders. Participants completed a weekly survey to track exposure data over the course of the season. Shoulder injury data was also collected. A shoulder injury was defined as swimming-related shoulder pain that resulted in one or more limited or modified athletic practices or competitions. Female swimmers reported a history of shoulder pain in 18/106 (17.0%) shoulders, and 14/106 (13.2%) of swimmers presented with obvious scapular dyskinesis at preseason. No differences in shoulder characteristics were found between swimmers with a history of shoulder pain and those without and those with obvious dyskinesis compared to those with normal scapular motion. There was a positive correlation between anterior glenohumeral laxity and shoulder external rotation range of motion (r=0.37, p Previous injury was the sole predictor of new shoulder injury in the group studied. Further research into the predictors of shoulder injury in female collegiate swimmers is warranted.

Purpose: The purpose of this study was to investigate the relationship between anthropometric measurements, proximal and distal lower extremity muscle performance, core muscle endurance, lower extremity flexibility, and neuromuscular control with the incidence of injury in recreational runners over one season. Also, when a relationship was established, we sought to evaluate the predictive validity for any of the variables being investigated for risk of injury in this population. Study Design: Prospective cohort Methods: Anthropometric measurements, proximal and distal isometric lower extremity muscle performance, isometric core muscle endurance, lower extremity flexibility and neuromuscular control were measured in 75 recreational runners prior to the start of a graded marathon training program. Incidence of injury was tracked over the course of 18 weeks, May 2014 – October 2014. Data was analyzed comparing the differences between injured and non-injured groups. Results: There were 33 repetitive stress injuries yielding a gross injury rate of 46% (male n=13, female n=20). Of all the variables analyzed, 5 variables emerged as possible a predictors including age, dominant limb rear foot posture, non dominant limb ankle DF ROM (extended), limb difference of Y balance scale composite scores and limb difference in the 6 M hop test. These variables were entered into a binary logistic regression analysis. Results of the regression indicated only the composite Y balance score difference variable as yielding a significant contribution (p = 0.01), with and predictive validity, (OR = 1.46, 95% CI =1.127 – 1.892). The model predicted 69.2% of the injuries with a specificity of 82% and sensitivity of 54.5%. A cutoff point of 3.6% was determined using a receiver operating characteristic curve. Runners were 3 times more likely to get injured with an asymmetry ≥ 3.6%. Conclusions: An asymmetry of lower extremity neuromuscular control ≥ 3.6% measured by the Y balance scale has been identified as a potential risk factor for injury in recreational runners. Clinical Relevance: This test can be performed as part of a pre-training screening or physical and may be helpful in identifying recreational runners at risk for injury.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Rehabilitation Robotics (RR) has become a more widely used and better understood treatment intervention and research tool in the last 15 years. Traditional research involves pre and post-test outcomes, making it difficult to analyze changes in behavior during the treatment process. Harnessing kinematics captured throughout each treatment allows motor learning to be quantified and questions of application and dosing to be answered. Objective: The aims of this secondary analysis were: (i) to investigate the impact of treatment presentation during RR on upper extremity movement time (mt) in children with hemiplegic cerebral palsy (CP) and (ii) to investigate the impact of training structure (dose and intensity) on mt in children with CP participating in RR. Methods: Subjects completed 16 intervention sessions of RR (2 x week; 8 weeks) with a total of 1,024 repetitions of movement per session and three assessments: pre, post and 6 month f/u. During each assessment and intervention, subjects completed “one-way record” assessments tracking performance on a planar task without robotic assistance. Kinematics from these records were extracted to assess subject performance over the course of and within sessions. Results: For all participants, a significant decrease in mt was found at post-test and follow-up. No significant differences were found in mt for age, severity or group placement. A significant interaction was found between treatment day, block and group (p = .033). Significant mt differences were found between the three blocks of intervention within individual days (p = .001). Specifically, significant differences were found over the last block of treatment (p = .032) and between successive treatment days (p = .001). Conclusion: The results indicate that for children with CP participating in RR, the number of repetitions per session is important. We hypothesized that children’s performance would plateau during a treatment day as attention waned, the opposite proved to be true. Despite the high-number of repetitions and associated cognitive demand, subjects’ performance actually trended upwards throughout the 1,024 repetitions suggesting that children were able to tolerate and learn from a high volume of repetitions.