Background and Purpose. This study investigated the relationship between balance measures and ankle range of motion (ROM) in community-dwelling elderly women with no health problems. Identification of modifiable factors associated with balance may enable clinicians to design treatments to help reduce the risk of falls in elderly people. Subjects. The sample consisted of 34 women between the ages of 64 and 87 years (X̄=74.7, SD=6.0). Methods. Goniometry was used to determine bilateral ankle active-assistive range of motion (AAROM) and passive range of motion. Balance capabilities were measured with the Functional Reach Test (FRT) and the Tinetti Performance-Oriented Mobility Assessment (POMA). Balance data for the FRT, POMA balance subtest, POMA gait subtest, and POMA total score were correlated with ankle ROM using the Pearson product moment correlation coefficient (PCC). Results. Correlations between ROM and balance scores were found, ranging from .29 to .63. The POMA gait subtest and FRT resulted in higher correlations with ROM than did the POMA balance subtest (left total AAROM PCC=.63, .51, and .31). Correlations using composite ankle ROM scores were higher than individual motions. The strongest correlation existed between bilateral, total ankle AAROM and the POMA gait subtest scores (PCC=.63) Conclusion and Discussion. Correlations exist between ankle ROM and balance in community-dwelling elderly women. Additional research is needed to determine whether treatment directed at increasing ankle ROM can improve balance.

Background: Spinal fractures are typically considered a contraindication to mechanical diagnosis and therapy (MDT). Objective and importance: The purpose of this case study is to illustrate how MDT was used safely and effectively to treat lumbar pain in a patient with multiple lumbar transverse process fractures. Clinical presentation: The subject was a 24-year-old female with left L2-5 transverse process fractures, sustained 10 weeks prior in a pedestrian versus motor vehicle accident. Intervention (and technique): After collaboration with her physiatrist, an MDT examination revealed a presentation consistent with the lumbar derangement syndrome. Conclusion: After three visits, utilizing patient generated forces with the extension principle of treatment, her pain, Oswestry disability index (ODI) score, and function all improved.

Study Design: A prospective methodological interrater reliability study. Objectives: To calculate the interrater reliability among clinicians newly trained in a classification system for acute low back pain and to determine the level of agreement at key junctures within the classification algorithm. Background: The utility of a classification system for patients with low back pain depends on its reliability and generalizability. To be practical, clinicians must be able to apply the system after a reasonable amount of training. Identifying key points in the classification algorithm where disagreement occurs can lead to better operational definitions. Methods: Four physical therapists read an article and attended a 1-day training session in the classification system. Randomly paired therapists classified patients referred for treatment of acute low back pain and noted decisions at key junctures in the system algorithm. Results: Forty-five patients were classified. Repeated examinations did not increase the patient's pain (P Ͼ.05). For 3 out of the 4 therapists, the interrater reliability showed a kappa value of 0.45. The fourth therapist, excluded from the overall analysis, exhibited a bias towards the immobilization classification. Among the 3 therapists, major disagreement occurred with the determination of symmetry with trunk side bending and the effects of repeated movements. Conclusions: Three out of 4 clinicians newly trained in the system showed moderate reliability. The reliability was slight when the fourth therapist was included. Refinement of the operational definitions and criteria for determining lumbar capsular patterns are needed. One day of training is probably not adequate for all therapists, especially for those biased towards specific low back pain syndromes.