Recently a clinical prediction rule (CPR) for lumbar regional spinal thrust manipulation (STM) has shown predictive success in patients with back pain who met specific selection criteria. The purpose of this study was to compare the effectiveness of STM and mechanical diagnosis and therapy (MDT) in patients who are positive for the STM CPR. Following initial examination, 31 participants were randomized to the STM group (n = 16) and to the MDT group (n = 15). Two weeks following initial examination, four participants chose to cross over from the STM group to the MDT group. The Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire work subscale (FABQw), and the Numerical Pain Rating Scale (NPRS) were administered initially, and at 2-weeks and 4 week follow-up (discharge). Data were analyzed to determine changes in ODI and NPRS scores from initial examination through one month. Of the 31 participants, one patient who met only three of five selection criteria and four others who chose to switch groups were removed from the analysis. Both groups exhibited statistically significant improvements in ODI and NPRS scores from baseline to final visit but there was no significant difference in scores between groups at 4 weeks. In this sample of patients, the selection criteria for this CPR were not exclusive for lumbopelvic STM. Mechanical diagnosis and therapy was an equally viable choice for these patients.

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Background: Physical therapy intervention is often sought to treat cervical spine conditions and a comprehensive physical therapy examination has been associated with more favourable outcomes. The cervical relocation test (CRT) is one method used to assess joint position sense (PS) integrity of the cervical spine. Previous research has found significant differences in the CRT between symptomatic and asymptomatic subjects. Impaired kinaesthetic awareness in the cervical spine may be associated with degenerative joint disease, chronicity of the complaint and increased susceptibility to re-injury. Purpose: The purpose of this study was to determine the intertester and intratester reliability of cervical relocation using the cervical range of motion instrument (CROM) and an affixed laser (AL) device among subjects with and without a history of neck pain. In addition, it was hypothesised that those individuals with a history of neck pain would have greater difficulty on the CRT. Methods: A total of 50 asymptomatic subjects (n550) were assigned to two researchers. The CRT was performed for each tester by the subject rotating the cervical spine for three trials to the right and left for the CROM and AL.

Objective: To determine the correlation between the Quebec Task Force Classification (QTFC) system and outcome in patients with non-specific low back pain (LBP). Methods: Forty-nine patients who were treated in outpatient physical therapy clinics of Catholic Health System (CHS) of Western New York (WNY) were classified according to the QTFC at the initial examination by physical therapists (PTs) with training in Mechanical Diagnosis and Therapy (MDT). The patient's perceived level of function was assessed with the Focus On Therapeutic Outcomes (FOTO) tool at the initial examination, 2 weeks following the initiation of physical therapy and again at discharge. Results: A linear regression model between acuity and change in FOTO score was performed and demonstrated statistical significance (P<0·05) as the more favorable outcome was found with the more acute patients. Spearman correlations between change in FOTO score and QTFC, duration of treatment and acuity of condition, and number of visits and change in FOTO score were not found to be statistically significant. Conclusions: The patients treated in this study demonstrated functional improvement in an average of eight visits, indicating efficacious care. Future research is needed to determine prioritized intervention strategies for designated LBP classifications.

This single-subject case study was conducted as a part of a randomized trial investigating the efficacy of mechanical diagnosis and therapy (MDT) and spinal thrust manipulation (STM) in patients who meet a clinical prediction rule (CPR) for spinal manipulation. Following initial examination, a patient who met the CPR was treated initially with STM and then eventually with MDT. The Oswestry Disability Questionnaire (ODI), Fear-Avoidance Beliefs Questionnaire, and the Numerical Pain Rating Scale (NPRS) were administered at the initial examination and at a two-week follow-up. Data were analyzed based on changes in the pain rating scale, ODI, and straight leg raise scores from initial examination to discharge. In accordance with a study protocol in which the patient was part of, this patient was changed from STM to MDT after the second physical therapy visit due to failure of overall improvement. The patient received MDT during the third session and continued with this approach until discharge. This patient responded favorably to MDT presenting with a 20 degrees improvement in SLR on the left and 10 degrees on the right, 6 points lower on the NPRS, and a 4% decrease on the OSW after a total of 6 visits.