This article examines the benefits of a student run free clinic (SRFC) as a service learning experience for students in medicine, pharmacy, occupational therapy, physical therapy and physician assistant programs. We hypothesized that students who participate in an interprofessional service learning course and volunteer at a SRFC would demonstrate significant increases in perceptions and attitudes for working in interprofessional health care teams and clinical reasoning skills compared to students who did not participate. Three assessments were administered to an experimental and control group of pre-clinical students from medical, occupational therapy, physical therapy, pharmacy and physician assistant programs before and after participation in an interprofessional service-learning course and volunteering at the SRFC. The tools were the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS) and the Self-Assessment of Clinical Reflection and Reasoning (SACRR). Students who completed the course had improvements in interprofessional perceptions and attitudes (p = 0.03) and perceptions of clinical reasoning skills when compared to the control group (p = 0.002). This study is novel as it examined students' perceptions of interprofessional attitudes and clinical reasoning following participation in an interprofessional service-learning course and participation in a SRFC.

Study Design Single blinded, randomized clinical trial for the evaluation of lumbosacral orthoses (LSOs) in the management of lower back pain (LBP). Objective To evaluate the effects of two types of LSO on self-rated disability in patients with lower back pain. Summary of Background Data LSOs are commonly used for the management of LBP, but their effectiveness may vary due to design. An inextensible LSO (iLSO) reduce trunk motion and increases trunk stiffness, whereas an extensible LSO (eLSO) does not. Methods 98 participants with LBP were randomized to three groups: 1) Standard care group (SC), which included medication and physical therapy (n=29), 2) SC with eLSO (eLSO group) (n=32), and 3) SC with iLSO (iLSO group) (n=37). Outcome measures were evaluated before and after 2 weeks of treatment: modified Oswestry Disability Index (ODI), Patient Specific Activity Score (PSAS), pain ratings, and Fear and Avoidance Beliefs Questionnaire (FABQ). Results There were no statistically significant differences between groups at baseline. Compared to the SC alone, iLSO group showed greater improvement on the ODI scores (p=.01), but not the eLSO group. The ODI scores improved by a mean of 2.4 (95% CI −2.2, 7.1), 8.1 (95% CI 2.8, 13.4), and 14.0 (95% CI 8.2, 19.8) points for SC, eLSO, and iLSO groups respectively. Individuals wearing the iLSO had 4.7 times higher odds of achieving 50% or greater improvement in the ODI scores compared to those assigned to SC (95% CI 1.2, 18.5, p=0.03). Both the eLSO and iLSO groups had a greater improvement in the PSAS scores compared to SC (p=.05 and p=.01, respectively), but the change did not meet the minimal clinically important difference. Pain ratings improved for all three groups, with no statistical difference between them. Finally, no significant differences across groups were found for the FABQ. Conclusions An iLSO led to greater improvement in ODI scores in comparison with SC and an eLSO. We surmise that the likely mechanism responsible for this difference in outcome was the added trunk stiffness and motion restriction by the iLSO.

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Low back pain (LBP) is one of the most common and costly medical conditions in the United States; various studies have reported up to 80% of the adult population will experience a significant episode of LBP sometime within their lifetime. Although many cases of LBP are related to the musculoskeletal system and appropriate for the care of the physical therapist (PT), some episodes of LBP have a systemic cause. Thus, it is the role of the PT to ensure each patient is appropriate for physical therapy intervention throughout the episode of care. When the patient's condition is not appropriate for physical therapy intervention, it is the PT's responsibility to refer the patient to other medical professions to ensure optimal patient care. The purpose of this case report is to describe a patient referred to PT who was diagnosed with ankylosing spondylitis. The patient presented initially to physical therapy with a diagnosis of LBP. However, after several visits her symptoms were inconsistent with mechanical LBP and thus required further medical consultation.

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