STUDY DESIGN: Descriptive bibliometric analysis. BACKGROUND: Content and bibliometric studies are useful for describing the publication patterns of a given profession, such as physical therapy, within the medical and allied health fields. However, few studies have conducted these analyses on specialty physical therapy journals. OBJECTIVES: To conduct a content and bibliometric assessment of publications within the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) and report publication and citation trends over multiple years. METHODS: All available JOSPT manuscripts published from 1980 through 2009 were reviewed. Only research reports, topical reviews, and case reports were included in the current analysis. Articles were coded by 2 independent reviewers based on type, participant characteristics, research design, purpose, clinical condition, and intervention. We obtained additional citation information (eg, authors and institutions) from a subset of articles published from 1992 through 2009 using bibliometric software. RESULTS: Of the 2233 available JOSPT publications, 1732 (77.6%) met criteria for inclusion. Of these, 1172 (67.7%) were research reports, 351 (20.3%) topical reviews, and 209 (12.1%) case reports. Over the last 30 years there has been a significant increase in the number of articles published and the percentage of research reports, systematic reviews, articles focused on prognosis, and articles including symptomatic participants. Percentage decreases were observed for topical or nonsystematic reviews and articles focused on anatomy/physiology. Top institutions, authors, and cited papers from 1992 through 2009 were identified in the bibliometric analyses. CONCLUSION: JOSPT has shown publication trends for increased percentage of experimental and clinically relevant research. However, there may be a need for increased publication of randomized controlled trials and studies focused on diagnosis, prognosis, and treatment, if goals of evidence-based practice are to be met.

J Orthop Sports Phys Ther 2011;41(12):920-931. doi:10.2519/jospt.2011.3808

KEY WORDS: citation analysis, publication trends, research

STUDY DESIGN: Secondary analysis, cross-sectional study. OBJECTIVES: To (1) compare differences in individual comorbidity rates among patients with cervical, lumbar, and extremity pain complaints and (2) compare rates based on total number and severity in these same patient groups. BACKGROUND: Comorbidities can impact recovery, prognosis, and potentially hinder participation in rehabilitation. Few studies have compared comorbidity rates among patients with different anatomical region of pain, to determine whether specific screening is warranted in physical therapy settings. METHODS: Included in the analyses were 2375 patients who reported complete demographic, clinical, and comorbidity information using Patient Inquiry software. Comorbidity data were collected from the Functional Comorbidity Index (18 items) and 6 additional comorbidities, to assess the presence of medical disease across multiple body systems. Comorbidities were further classified as “nonsevere” or “severe,” based on inclusion in the Charlson Comorbidity Index. Chi-square analyses investigated differences in the rates of total number and severe comorbidities. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated on rates with statistically significant differences (P<.001), using the lumbar spine as the reference group. RESULTS: Of the 24 comorbid conditions included in this analysis, 3 nonsevere medical conditions (degenerative disc disease, obesity, and headache) had different rates among anatomical region. A lower rate for degenerative disc disease was associated with the extremity conditions (Χ² = 66.3; OR = 0.40; 95% CI: 0.32, 0.50). Higher rate of headache (Χ² = 115.3; OR = 3.01; 95% CI: 2.45, 3.70) and lower rate of obesity (Χ² = 16.2; OR = 0.64; 95% CI: 0.51, 0.80) were associated with cervical conditions. There were no differences among the 3 anatomical regions for total number or severe comorbidities. CONCLUSION: Focused screening for degenerative disc disease, obesity, and headache may be warranted. However, the same strategy was not supported for total number or severe comorbidities, at least when considering comparative rates from this cohort. Physical therapists should consider the potential influence of total number and severe comorbidities equally for all anatomical regions of musculoskeletal pain. LEVEL OF EVIDENCE: Differential diagnosis/symptom prevalence, level 3b.

J Orthop Sports Phys Ther 2011;41(7):477-485, Epub 7 June 2011. doi:10.2519/jospt.2011.3686

KEY WORDS: comorbidity, medical screening, musculoskeletal pain

STUDY DESIGN: Cross-sectional. BACKGROUND: In the examination of patients with unilateral shoulder pain, pain provocation testing to compare the involved and uninvolved sides has been considered useful. However, side-to-side comparisons of experimental pain sensitivity in patients with unilateral shoulder pain are not widely reported in the literature. OBJECTIVES: To compare experimental pain sensitivity between the involved and uninvolved sides in patients with unilateral shoulder pain. METHODS: In consecutive patients seeking operative treatment for shoulder pain, sensitivity measures of bilateral pressure pain threshold at the shoulder and forearm, and thermal pain threshold, tolerance, and temporal summation at the forearm, were examined. Pressure sensitivity was tested with a Fischer pressure algometer, and thermal sensitivity with a computer-controlled Medoc neurosensory analyzer. The involved and uninvolved sides were compared with an analysis of variance. Influence of sex and location of testing were considered as covariates in the analysis. RESULTS: Fifty-nine consecutively recruited participants completed experimental pain sensitivity testing. Participants reported significantly lower pressure pain thresholds in the involved side compared to the uninvolved side (F_1,56 = 4.96, P = .030). In addition, female compared to male participants demonstrated lower pressure pain thresholds in the bilateral shoulder regions (F_1,56 = 10.84, P = .002). There was no difference in thermal pain sensitivity between sides. Average clinical pain intensity was negatively correlated with pressure pain threshold at the involved local site (r = –0.284, P = .029), indicating an influence of clinical pain intensity on local pressure pain. CONCLUSION: The results of this study provide evidence for higher experimental pressure pain sensitivity in the involved side of patients with unilateral shoulder pain and no difference between sides for thermal pain sensitivity. Females demonstrated higher pain sensitivity than males to pressure stimuli at the local shoulder region but not at the distal regions. Future studies should incorporate multiple stimuli when describing the pain profile of clinical populations.

J Orthop Sports Phys Ther 2011;41(3):165-173, Epub 10 November 2010. doi:10.2519/jospt.2011.3416

KEY WORDS: clinical examination, pain, shoulder pain