Adhesive capsulitis (AC) affects approximately 1% of the general population. Current research lacks clear guidance on the dosage of manual therapy and exercise interventions.The purpose of this sys...

Drummond, C, Lebedeva, V, Kirker, K, and Masaracchio, M. Sling exercise in the management of chronic low back pain: A systematic review and meta-analysis. J Strength Cond Res 38(10): 1822–1833, 2024—The purpose of this systematic review is to assess the effectiveness of sling exercise therapy (SET) in individuals with chronic low back pain (LBP). Eligible studies were randomized clinical trials or prospective cohort studies published in the English language that assessed SET on measures of pain, disability, or muscle attributes in chronic LBP. The search identified 1,204 studies, with 12 studies meeting the inclusion criteria. The average score was 7.3 on the Cochrane Risk of Bias Criteria. Meta-analysis comparing SET with general exercise revealed a nonsignificant effect for pain (mean difference [MD] 0.14; 95% confidence interval [CI]: −0.58, 0.87). Meta-analysis comparing SET with motor control training/lumbar stabilization revealed a significant effect favoring SET for pain (MD −4.13; 95% CI: −7.82 to −0.45) and disability (MD −3.19; 95% CI: −4.63 to −1.76). Meta-analysis comparing SET with no treatment revealed a significant effect favoring SET for pain (MD −1.05; 95% CI: −2.82 to −0.71). Meta-analysis comparing SET plus modalities with modalities revealed a significant effect favoring the SET plus modalities group for pain (MD −1.19; 95% CI: −1.48 to −0.89) and a nonsignificant effect for disability (MD −6.67; 95% CI: −17.25 to 3.92). Sling exercise therapy was more effective than all comparisons for various muscle attributes. The overall level of evidence ranged from very low to moderate. Sling exercise therapy is effective in reducing pain, disability, and improving core muscle activation, strength, thickness, and onset in patients with chronic LBP. Because SET demonstrated comparable outcomes with common active interventions, it provides an opportunity to implement pain-free exercises based on the patient's initial functional level early in the plan of care.

Lumbar spinal stenosis (LSS) has a substantial impact on mobility, autonomy, and quality of life. Previous reviews have demonstrated inconsistent results and/or have not delineated between specific...

To investigate physical therapist adherence to the Academy of Orthopaedic Physical Therapy's (AOPT) clinical practice guidelines (CPGs) for the management of neck and low back pain (LBP) and to compare adherence among varying clinical specializations. Electronic cross-sectional survey. The survey was sent to 17,348 AOPT members and 7,000 American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) members. Participants selected the best diagnosis and intervention(s) for six case vignettes based on the current AOPT CPGs for neck and LBP. Diagnostic and intervention adherence rates were reported as total percentages and delineated by the highest level of clinical specialization - fellowship training (PTFs), orthopedic residency training (PTRs), Board Certified Clinical Specialist in Orthopaedic Physical Therapy (PTSs), orthopedic background without clinical specialization (PTOs). Binary logistic regression analyses were performed to determine the effects of clinical specialization (PTFs, PTRs, or PTSs) compared to PTOs on the likelihood of guideline adherence for all six cases. Of the 159 participants who responded to the survey, 152 were eligible and 145 completed demographic data. Participant responses declined as the survey progressed from 125 completing case one to 106 completing case six. The odds ratio from binary logistic regression analyses were not significant for any specialization in all six cases (OR = 0.16; 95% CI: 0.02, 1.11; p = 0.064). The results of this manuscript demonstrated variable adherence rates across subgroups of patients with neck and LBP with no significant association between clinical specialization and adherence. Adherence to CPGs is dependent on the clinical presentation of various patient cohorts.

Background/Objectives: The purpose of this umbrella review was to assess the risk of bias and the methodological and reporting quality of systematic reviews that evaluated the effects of thoracic spine manipulation (TSM) on individuals with mechanical neck pain. Methods: To be included, publications needed to be systematic reviews including studies with participants with neck pain >18 years old; at least two groups where the experimental intervention was TSM; assessed pain and/or function; and were published in English. Reviews limited to narrative, scoping, or retrospective studies, or those with cervical radiculopathy, were excluded. An electronic search was conducted in May 2025 using PubMed, CINAHL (EBSCO Host), and the Cochrane Library to identify relevant articles from inception to May 2025. Quality and risk of bias were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020), and Risk of Bias in Systematic Reviews (ROBIS). Findings were summarized narratively and graphically. Results: Seven reviews (27 unique studies; 1394 participants, aged 18–62 years) met the inclusion criteria. Some evidence supported TSM for short-term improvement in neck pain, but confidence in results was low to critically low based on the AMSTAR 2 results. Four reviews had a high overall risk of bias, and three had a low risk. Reporting compliance varied widely (0–100%). Conclusions: While all the included systematic reviews suggested that TSM is a viable short-term option for individuals with neck pain, the overall confidence in these results ranged from low to critically low, making it difficult to draw firm conclusions about the true benefit of TSM in clinical practice. Registered prospectively in PROSPERO (CRD420251034330).