Carey E. Rothschild

Background: Chronic low back pain (CLBP) is associated with psychological risk and resilience factors that drive pain, distress, and disability. Pain Resilience Therapy (PRT) is a novel strengths-based approach; however, its risk and resilience outcomes compared with recognized approaches remain unclear. Objective: To examine the effectiveness of PRT compared to Pain Neuroscience Education (PNE) on psychological risk and resilience factors in adults with CLBP. Design: Secondary data analysis from a randomized controlled trial. Methods: This secondary analysis included data from 60 adults with CLBP randomized to eight telehealth sessions of PRT or PNE delivered over four weeks. Psychological risk and resilience factors were assessed at baseline and at the 90-day follow-up using the OSPRO-YF, which estimates scores of 11 validated questionnaires across three domains: negative mood, negative/maladaptive coping, and positive affect/coping. Between-group differences were examined using ANCOVA with baseline adjustment. Treatment response was quantified using relative risk, absolute risk reduction, and number needed to treat. Results: PRT produced significantly greater improvements than PNE across eight of eleven outcomes, including anxiety, fear avoidance, pain catastrophizing, kinesiophobia, pain-related anxiety, self-efficacy for rehabilitation, and pain acceptance, with medium-to-large effect sizes (ηp² = 0.088–0.316). Both groups improved in depressive symptoms and pain self-efficacy. Trait anger did not significantly change in either group. The number needed to treat for PRT was 2 for self-efficacy for rehabilitation and 3 for pain catastrophizing, kinesiophobia, and pain acceptance. Conclusions: PRT demonstrated greater effectiveness across eight psychological risk and resilience factors than PNE, warranting further investigation in larger trials.

Female participation in sport as a masters athlete has grown considerably in recent years. Functional losses and physiological changes in the cardiovascular, musculoskeletal, and endocrine systems that occur with female aging require recognition and thoughtful exercise prescription. In working with this population, the strength and conditioning professional should be able to recognize the biology of aging, factors affecting recovery and performance, and application of appropriate training parameters to keep the female athlete in their sport while mitigating the effects of aging and maximizing performance. This special populations article outlines key age-related changes in the female athlete and presents comprehensive, practical training guidelines for this growing population.

Objective: To investigate the prevalence of musculoskeletal injury (MSI) in collegiate marching band and color guard members and the associated factors. Methods: An electronic survey was developed and delivered via the Qualtrics survey platform to collegiate marching band and color guard members in the United States. Information collected included demographics; years of experience; training and performance characteristics; footwear worn; instrument played/equipment used; participation in stretching/strengthening programs; injury prevalence and type; treatment sought for injury; and participation time lost due to injury. Results: There were 1,379 (792 female, 587 male) members of 21 collegiate marching bands who completed the survey. Respondents had an average age of 19.8 yrs, height 171.9 cm, weight 72.3 kg, and BMI 24.4 kg/m2. Twenty-five percent of respondents reported sustaining a MSI as a result of participating in marching band or color guard. Females were 20% more likely to sustain a MSI and 87.7% of MSI involved the lower extremity. A significant difference in BMI was found between those who did and did not sustain a MSI (p=0.014). Conclusions: Members of collegiate marching band and color guard may be at risk of sustaining a MSI due to the repetitive nature of the activities performed during practice and performance. The lower extremity is more prone to injury, and a higher BMI may be a risk factor for MSI in this population.

Context: The popularity of running barefoot or in minimalist shoes has recently increased because of claims of injury prevention, enhanced running efficiency, and improved performance compared with running in shoes. Potential risks and benefits of running barefoot or in minimalist shoes have yet to be clearly defined. Objective: To determine the methodological quality and level of evidence pertaining to the risks and benefits of running barefoot or in minimalist shoes. Data Sources: In September 2013, a comprehensive search of the Ovid MEDLINE, SPORTDiscus, and CINAHL databases was performed by 2 independent reviewers. Study Selection: Included articles were obtained from peer-reviewed journals in the English language with no limit for year of publication. Final inclusion criteria required at least 1 of the following outcome variables: pain, injury rate, running economy, joint forces, running velocity, electromyography, muscle performance, or edema. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Two reviewers appraised each article using the Downs and Black checklist and appraised each for level of evidence. Results: Twenty-three articles met the criteria for this review. Of 27 possible points on the Downs and Black checklist, articles scored between 13 and 19 points, indicating a range of evidence from very limited to moderate. Moderate evidence supports the following biomechanical differences when running barefoot versus in shoes: overall less maximum vertical ground reaction forces, less extension moment and power absorption at the knee, less foot and ankle dorsiflexion at ground contact, less ground contact time, shorter stride length, increased stride frequency, and increased knee flexion at ground contact. Conclusion: Because of lack of high-quality evidence, no definitive conclusions can be drawn regarding specific risks or benefits to running barefoot, shod, or in minimalist shoes.

D in light, “minimalist” shoes. Advocates of barefoot running believe that a more primitive style of running may result in fewer running-related injuries and even possibly improve performance. To identify the current interest level and participation in barefoot or minimalist shod running, an electronic survey was developed and dispersed to 6,082 runners. The survey instrument examined demographics, motivating factors, used resources, perceived barriers, and expectations in runners who add barefoot or in minimalist shod running to their training. Seven hundred eighty-five (13%) runners completed the survey. Six hundred and thirty (75.7%) indicated they were at least somewhat interested in running barefoot or in minimalist shoes. One hundred seventy-two (21.9%) runners had previously tried barefoot running, whereas 239 (30.4%) had previously tried minimalist shoes. The primary motivating factor for those running barefoot or in minimalist shoes (n = 283) was to prevent future injury (n = 97, 34.3%). Advice from friends (n = 68, 24.5%) or books (n = 68, 24.5%) was the most commonly used resource in transitioning to barefoot or minimalist shod running. Fear of possible injury (n = 424, 54%) was the most prevalent perceived barrier in transitioning to barefoot or minimalist shod running. An overwhelming 671 (85.5%) indicated that they were at least somewhat likely to continue with or to add barefoot or minimalist shod running if provided sufficient instruction. Runners who are men, of younger age, and who consider themselves elite runners are somewhat more likely to be interested in barefoot or minimalist shod running....