The quality of the research on interreliability and intrareliability of spinal palpatory diagnostic procedures needs to be improved. Pain provocation tests are most reliable. Soft tissue paraspinal palpatory diagnostic tests are not reliable.

At 16 senior centers, we studied the effectiveness of exercise and cognitive-behavioral programs, compared with a discussion control program, in reducing falls and injuries among 230 older adults. After 1 year of the programs, we observed no significant difference in time to first fall. Even though a relatively high percentage (38.6%) suffered at least one fall, only 7.8% of these community-residing elderly required medical attention. Secondary outcome measures such as strength, balance, fear of falling, and perceived health did not significantly change.

Social learning theory has generated two different approaches for the assessment of expectancies. Bandura argues that expectancies are specific and do not generalize. Therefore, he prefers measures of specific efficacy expectations. Others endorse the role of generalized expectancies measured by locus of control scales. The present study examines specific versus generalized expectancies as mediators of changes in exercise behavior among 60 older adult patients with Chronic Obstructive PuLmonary Disease. The patients were given a prescription to increase exercise and randomly assigned to experimental groups or control groups. All groups received attention but only experimental groups received training to increase their exercise. After 3 months, groups given specific training for compliance with walking significantly increased their activity in comparison to the control group receiving only attention. These changes were mediated by changes in perceived efficacy for Walking, with efficacy expectations for other behaviors changing as a function of their similarity to walking. A generalized health locus of control expectancy measure was less clearly associated with behavior change. The results are interpreted as supporting Bandura's version of social theory. We previously reported that behavioral and cognitive-behavioral interventions are useful for helping Chronic Obstructive Pulmonary Disease (COPD) patients maintain a daily exercise program (Atkins, Kaplan, Timms, Reinsch, & Lofback, in press). In this paper, we investigate the mediation of Requests for reprints should be sent to

For subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.

Patients suffering from chronic obstructive pulmonary disease (COPD) can benefit from exercise; however, noncompliance with exercise is a common problem. In order to increase compliance to an exercise program, we randomly assigned COPD patients to one of five experimental groups: behavior modification, cognitive-behavior modification, cognitive modification, attention control, and no-treatment control. In the experimental groups, the patients participated in six sessions designed to increase their adherence to an exercise prescription. The no-treatment control group was given an exercise prescription but did not receive training on how to implement the exercise program. Over the first 3 months of the program, the three treated groups showed significant increases in exercise in comparison to the notreatment group. In addition, the cognitive-behavior modification group walked significantly more than any other treatment or control group. After 3 months, the three treated groups showed significant increases in exercise tolerance in comparison to the two control groups. In addition, significant differences between the groups were observed for a general Health Status Index and for changes in self-efficacy