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      Diagnosis and treatment of movement system impairment syndromes

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Highlights

          • Impaired movements and alignments may be associated with musculoskeletal conditions.

          • Signs of impaired alignments and movements may be seen before there are symptoms.

          • Treatment is based on using the findings of making the MSI diagnosis to correct the performance of daily activities.

          Abstract

          Background

          Diagnoses and treatments based on movement system impairment syndromes were developed to guide physical therapy treatment.

          Objectives

          This masterclass aims to describe the concepts on that are the basis of the syndromes and treatment and to provide the current research on movement system impairment syndromes.

          Results

          The conceptual basis of the movement system impairment syndromes is that sustained alignment in a non-ideal position and repeated movements in a specific direction are thought to be associated with several musculoskeletal conditions. Classification into movement system impairment syndromes and treatment has been described for all body regions. The classification involves interpreting data from standardized tests of alignments and movements. Treatment is based on correcting the impaired alignment and movement patterns as well as correcting the tissue adaptations associated with the impaired alignment and movement patterns. The reliability and validity of movement system impairment syndromes have been partially tested. Although several case reports involving treatment using the movement system impairment syndromes concept have been published, efficacy of treatment based on movement system impairment syndromes has not been tested in randomized controlled trials, except in people with chronic low back pain.

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          Most cited references86

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          Physical activity and low back pain: a U-shaped relation?

          Being physically active is often suggested to be important in the prevention and management of low back pain. This simple view does not take into account that the relation between the level of activity and back pain may be a U-shaped curve - i.e. both inactivity and excessive activities (back-unhealthy activity) present an increased risk for back pain. We explored the U-shaped association between physical activity and chronic low back pain (3 months duration) by analyzing cross-sectional data from the Dutch population-based Musculoskeletal Complaints and Consequences Cohort study (DMC(3), 1998) of a sex-age stratified sample of 25 years and older (n=3364). Type of activity (daily routine, leisure time and sport activity), intensity of and time spent on these activities, and back exertion of sport activities were taken into account. Physical activity was not associated with chronic low back pain (CLBP) when studied by the dimension of activity, by the intensity or by the duration of physical activity. Only engaging in sport activity was associated with less CLBP (OR 0.78: 95% CI 0.66-0.93). The extremes of the total physical activity pattern were associated with CLBP. A moderate increased risk for CLBP was found for both participants with a sedentary lifestyle (OR 1.31: 95% CI 1.08-1.58) and for those being involved in physical strenuous activities (OR 1.22: 95% CI 1.00-1.49). This was especially true for women (sedentary: OR 1.44: 95% CI 1.10-1.83; physically active: OR 1.36: 95% CI 1.04-1.78). This study provides some evidence that the relation between physical activity and CLBP is U-shaped.
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            Symptoms of depression as a prognostic factor for low back pain: a systematic review.

            It has been proposed that depression plays an important role in the course of low back pain; however, there is considerable uncertainty on its predictive value.
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              The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective.

              Football (soccer), the most popular sport worldwide, is associated with a high injury risk, and the knee joint is often affected. Several studies have found female players to be more susceptible to knee injury, anterior cruciate ligament (ACL) injury in particular, compared to their male counterparts. There is, however, some controversy regarding the magnitude of this risk increase and a few studies have found no differences. The influence of age and activity type on gender-related differences in injury risk is only scarcely investigated. In this paper, the literature reporting gender-specific ACL injury risk in football is reviewed. A literature search yielded 33 relevant articles that were included for review. These show that female players have a 2-3 times higher ACL injury risk compared to their male counterparts. Females also tend to sustain their ACL injury at a younger age than males, and a limiting factor in the existing literature is that age is not adjusted for in comparisons of ACL injury risk between genders. Furthermore, the risk increase in females is primarily evident during match play, but type of exposure is also rarely adjusted for. Finally, the studies included in this review share important methodological limitations that are discussed as a starting point for future research in the field.
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                Author and article information

                Contributors
                Journal
                Braz J Phys Ther
                Braz J Phys Ther
                Brazilian Journal of Physical Therapy
                Departamento de Fisioterapia da Universidade Federal de Sao Carlos
                1413-3555
                1809-9246
                27 September 2017
                Nov-Dec 2017
                27 September 2017
                : 21
                : 6
                : 391-399
                Affiliations
                [a ]Washington University School of Medicine, Program in Physical Therapy, St. Louis, USA
                [b ]Universidade Cidade de São Paulo (UNICID), Masters and Doctoral Programs in Physical Therapy, São Paulo, SP, Brazil
                [c ]Pontifícia Universidade Católica de Minas Gerais (PUC-MG), Departamento de Fisioterapia, Belo Horizonte, MG, Brazil
                Author notes
                [* ]Corresponding author at: Program in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO 63108, USA.Program in Physical Therapy, Washington University School of MedicineCampus Box 8502, 4444 Forest Park BoulevardSt. LouisMO63108USA sahrmanns@ 123456wustl.edu
                Article
                S1413-3555(17)30366-0
                10.1016/j.bjpt.2017.08.001
                5693453
                29097026
                daf16b5f-4e84-48bf-9298-7ab2ad88a447
                © 2017 Associaç˜ao Brasileira de Pesquisa e Pós-Graduaç˜ao em Fisioterapia. em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved.
                History
                : 24 August 2017
                : 30 August 2017
                Categories
                Masterclass

                classification,movement system,impairment,rehabilitation,musculoskeletal,pain

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