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Patients with predominant inflammatory pain, with high levels of psychosocial factors, increased central sensitization and not improving after a trial of MWM, were recognized as non-responders. Improvement of different aspects of movement (e.g. ROM, less fear) are the most common outcomes observed.

This study provides factors believed to be important in the decision making process when using MWM clinically.

This study provides factors believed to be important in the decision making process when using MWM clinically.

Sensorimotor impairment in neck pain sufferers is well established. Recent research has identified impairment in head and trunk co-ordination in this population. Presently, no clinically appropriate testing exists to quantify such impairment.

To determine if a simple and clinically relevant test of head-trunk co-ordination can identify dysfunction in neck pain subjects when compared to healthy controls.

Cross-sectional observational study.

Thirty-one neck pain and 29 healthy control subjects were assessed using head- and chest-mounted lasers with a target positioned 90cm away. Subjects were required to rotate the trunk at least 45° with the head laser to be kept as accurately as possible in the centre of the target while sitting and standing. Elacestrant Maximal deviation of the head to the left and right of the target’s centre with each trunk movement was measured.

The neck pain group demonstrated significantly greater head deviation from the centre in all but one test direction (p= <0.03). Head deviation to the same side as trunk rotation was larger in the neck pain group for both sitting and standing (p= <0.01). No significant differences existed between testing in sitting and standing.

Differences in trunk-head control exist in persons suffering from neck pain compared to healthy individuals, which can be demonstrated using simple equipment suggesting clinical utility of the measure. Performing the task in standing would seem most suitable as it can avoid influence by reduced thoracic mobility. Further research is required to establish the clinical suitability of this test.

Differences in trunk-head control exist in persons suffering from neck pain compared to healthy individuals, which can be demonstrated using simple equipment suggesting clinical utility of the measure. Performing the task in standing would seem most suitable as it can avoid influence by reduced thoracic mobility. Further research is required to establish the clinical suitability of this test.

Diastasis of the rectus abdominis muscle is often evaluated in clinical practice but it is unknown which clinical method has the best measurement properties.

The aim of this study was to determine (i) the criterion validity of the callipers, tape measure and finger-width to evaluate the inter-recti distance of the abdominal muscles compared to ultrasound; and (ii) inter-rater and retest reliability of these methods.

Measurement study.

Two physiotherapists assessed the inter-recti distance of rectus abdominis on 50 women postnatally using the three clinical methods. These measurements were compared to ultrasound and assessed for inter-rater and retest reliability.

Callipers had very good positive correlations with ultrasound (r=0.85 to 0.99) and narrow limits of agreement (LOA) (<6mm). Finger-width and tape measure had moderate to very good correlation with ultrasound (tape measure r=0.82 to 0.98; finger-width r=0.75 to 0.98) with wider limits of agreement (tape measure LOA <8mm; finger-width LOA <18mm). Callipers demonstrated excellent inter-rater (ICC=0.80 to 0.99) and retest (ICC=1.00) reliability. Inter-rater reliability testing was very good for tape measure (ICC=0.80 to 0.97) and moderate to very good (ICC=0.44 to 0.85) for finger-width. Retest reliability demonstrated very good reliability (ICC=0.99 to 1.00) for both finger-width and tape measure. The largest inter-recti distances, strongest correlations and reliability were found at the level of the lower umbilicus.

Callipers, tape measure and finger-width are valid and reliable methods of measuring inter-recti distance in postnatal women. Validity, and relative and absolute reliability were found to be the strongest using the callipers.

Callipers, tape measure and finger-width are valid and reliable methods of measuring inter-recti distance in postnatal women. Validity, and relative and absolute reliability were found to be the strongest using the callipers.

A cross-sectional observational multicenter pilot-study was performed within care as usual in three rehabilitation centers in the Netherlands.

To explore the relationship between Waddell Non-organic Signs (NOS) and Central Sensitization (CS) in patients with chronic back pain.

A possible relationship between NOS and CS is theoretically plausible, but it has never been tested.

A cross-sectional observational multicenter pilot-study was performed in three rehabilitation centers in the Netherlands. Patients with chronic back pain were included. Main measures were Waddell’s NOS, a battery of eight clinical tests performed during a physical examination, and Central Sensitization Inventory (CSI), a questionnaire measuring symptoms originating from CS. Analyses included Spearman correlation and univariate multiple regression analysis with NOS as dependent variable, CSI as independent, and controlled for confounders (psychosocial variables).

Data of n=56 patients (59% female, mean age 42.6 years) were obtained. Correlation between NOS and CSI was rs=0.34 (p=0.01). After controlling for confounders, CSI did not independently predict NOS.

In this pilot study, CS was moderately related to NOS, but CS did not independently contribute to NOS after controlling for confounders. The results suggest that NOS may not exclusively be non-organic tests, although questions remain. The results of this pilot study can help to develop larger studies to allow replication and more detailed analyses.

In this pilot study, CS was moderately related to NOS, but CS did not independently contribute to NOS after controlling for confounders. The results suggest that NOS may not exclusively be non-organic tests, although questions remain. The results of this pilot study can help to develop larger studies to allow replication and more detailed analyses.