e132 Abstracts / Manual Therapy 25 (2016) e57ee169
or clinically significant improvements in pain or function, with mixed results
demonstrated in the single-subject experimental design and improvements
noted in the case report. Only three studies reported clinical and statistically
significant improvements in measures of psychological function, whilst two
studies documented a statistically significant change in physical perfor-
mance over three month follow up in a chronic low back pain population.
Conclusion: The evidence regarding the utility and benefit of PNE in a
CLBP group is difficult to quantify due to the heterogeneity in bothdelivery,
study design and outcome measures utilised. Although results appear
promising, all studies involved had small sample sizes and employed a
number of co-interventions with delivery of PNE. Low to moderate quality
evidence exists for the utility of PNE in CLBP, either in isolation or in
conjunction with physiotherapeutic interventions, and group education
appears to be similarly effective.
Implications: PNE is gaining support as a useful adjunct to usual phys-
iotherapy to improve pain cognitions, function and patient outcomes.
However, limited research exists to date to support its widespread
administration. Further research is needed with larger scale trials to
evaluate its utility and best practice in a surgical and chronic low back pain
population.
Funding acknowledgements: HEEM Clinical Scholarship
Ethics approval: Not applicable - literature review.
Disclosure of interest: None Declared
Keywords: Low back pain, Pain neuroscience education, Spinal surgery
Intergrating Research into practice
PO1-LL-047
TRUNK KINEMATICS AND MOTOR CONTROL IN ATHLETES WITH AND
WITHOUT PATELLOFEMORAL PAIN DURING A LATERAL STEP-DOWN
TEST
M. Corkery, E. Cohen, M. Esposito, R. Newton, M. Rogazzo, C. Rudnick, B.
Salanitro, R. Santilli, S.-C. Yen. Department of Physical Therapy, Movement
and Rehabilitatation Sciences, Northeastern University, Boston, United States
Background: Patellofemoral pain syndrome (PFPS) is a clinically chal-
lenging condition commonly occurring in athletes. PFPS has been associ-
ated with hip muscle weakness and altered lower extremity kinematics.
However, the relationship between PFPS and trunk control is unclear.
Purpose: The purpose of our study was to examine the relationship be-
tween trunk kinematics, motor control and PFPS.
Methods: A cross-sectional design was used. A total of 20 athletes were
recruited (10 healthy and 10 with PFPS) to participate in this study. All
subjects completed a questionnaire with questions pertaining to de-
mographics, activity level, medical history, pain intensity and location.
Knee pain was assessed using a numerical pain rating scale (0-10) and
function was assessed using the Lower Extremity Functional Scale. Trunk
endurance and neuromuscular control were assessed using the sidelying
plank and double leg lowering tests respectively. A lateral step down test
was used to assess and compare movement patterns between groups.
Three dimensional motion analysis was used to evaluate kinematics while
subjects performed 3 consecutive step down movements. Ranges of upper
trunk transverse rotation, trunk abduction-adduction, flexion-extension,
pelvic lateral drop, and pelvic transverse rotation in each cycle were
calculated. Descriptive statistics were compiled and linear mixed models
were used to detect between-group differences in these variables. The
correlation between repetitive cycles were modelled as autoregressive
(AR1).
Results: Weight, height, and body-mass index were not significantly
different between the two groups. The range of trunk abduction-adduction
showed a significant between-group difference (p ¼ 0.04; Healthy Group:
3.2±1.2º; PFPS group: 4.7±2.6º). No other significant differences were
detected in other variables.
Conclusion: PFPS may affect trunk control in the frontal plane during a
lateral step down. The presence of this altered kinematic movement
pattern of the trunk may be a significant clinical finding and associated
with patellofemoral pain syndrome in athletes.
Implications: These findings may aid in the development of screening and
intervention techniques to reduce the prevalence of PFPS in an athletic
population. Further research into the relationship between trunk kine-
matics, motor control and PFPS is needed.
Funding acknowledgements: This study was funded by a Northeastern
University Provost Office Undergraduate Research and Creative Endeavors
Award. We would like to thank the athletes who participated in the study
and Kristin Kapuza and Laura Olsavsky for their assistance.
Ethics approval: This study was approved by the Northeastern University
Institutional Review Board.
Disclosure of interest: None Declared
Keywords: None
Intergrating Research into practice
PO1-LL-048
THE EFFECT OF MANIPULATIVE MANUAL THERAPY, IN IMPROVING
RANGE OF MOTION AND REDUCING THE INTENSITY OF PAIN IN
SUBJECTS WITH ANKLE SPRAIN e A SYSTEMATIC REVIEW
F. Silveira 1, L. Teixeira 2, L.C. Nogueira 2, 3, *. 1 Escola de Osteopatia de Madrid,
Spain; 2 UNISUAM, Brazil; 3 IFRJ, Rio de Janeiro, Brazil
* Corresponding author.
Background: Decrease in dorsiflexion movement is a common finding
after the episode of ankle sprain (AS). Joint techniques are commonly used
to restore joint mobility and decreased pain.
Purpose: this study aims to conduct a systematic review of the literatur-
eon the effect of manual therapy in improving joint range of motion and
reduced pain.
Methods: A systematic review was conducted following the PRISMA's
recommendations. A search of the journals was carried out by a reviewer
in PEDro databases, Pubmed and Science Direct. Between 1999 and 2013,
using the descriptors “ankle sprain” combined with “manipulation” or
“mobilization”. We selected only full texts of randomized controlled trials,
in English and Portuguese. Later two reviewers perform the analysis of the
journals and the extraction of data and in the case of disagreement a third
reviewer could be called. PEDro scale was used for the methodological
quality check. The clinical improvements seen as a positive outcome was
the range of motion and pain intensity after therapeutic intervention.
Initially, forty-five articles were identified in databases. Forty articles were
excluded for not presenting information on the diagnosis, treatment mo-
dality or does not meet the eligibility criteria. Five articles were selected for
analysis.
Results: The joint mobilization techniques showed satisfactory results for
improved dorsiflexion range. Collins et al. (2004) demonstrated
improvement in joint mobility in 16 patients with subacute AS, after
further sliding of the talus combined with active movement and weight
bearing with ten repetitions in 3 sets. Bill Vicenzino et al. (2006) also
identified improvement after the completion of 10 oscillations in 4 series
using the same technique in 16 patients with chronic AS. Koon Yeo and
Wright (2011) identified improved range of motion after 3 sessions in 13
subjects with AS during subacute phase, using higher slip talus without
weight bearing for 3 sets of one minute with intensity grade 3 Beazell et
al. (2012) identified the similar effects after performing sessions 4 mo-
bilizations compared with manipulation in 43 patients with chronic AS.
However, Cosby et al. (2011) do not find favorable results in 17 subjects
with acute AS after a single application with the subsequent sliding of the
talus intensity II and duration of thirty seconds. For pain, reduction pa-
rameters have not been found satisfactory in the study data. Collins et al.,
Cosby et al. and Beazell et al., did not identify no decrease in pain in-
tensity. Koon Yeo and Wright (2011) found greater pressure pain
threshold, but there was no difference in pain intensity by subjective
evaluation.
Conclusion: Based on the results, this study suggests that joint mobili-
zation techniques with subsequent slip associated talus or no weight
bearing, increase dorsiflexion range regardless of the intensity applied,
except for cases of acute AS. However, the decrease in pain intensity re-
mains inconclusive.
Funding acknowledgements: This study was unfunded.
Ethics approval: Ethical approval was not required.
 Abstracts / Manual Therapy 25 (2016) e57ee169
Disclosure of interest: None Declared
Keywords: Ankle sprain, Manipulative therapy, Physical Therapy
Intergrating Research into practice
PO1-LL-049
DIAGNOSTIC ACCURACY OF NEUROPATHIC PAIN ASSESSMENT
METHODS FOR THE DIAGNOSIS OF NEUROPATHIC PAIN IN KNEE OR
HIP OSTEOARTHRITIS: A SYSTEMATIC REVIEW
H. French 1, *, K. Smart 2, F. Doyle 3. 1 School of Physiotherapy, Royal College of
Surgeons in Ireland, Ireland; 2 Physiotherapy Department, St Vincent's
University Hospital, Ireland; 3 Division of Population Health Sciences
(Psychology), Royal College of Surgeons in Ireland, Dublin, Ireland
* Corresponding author.
Background: Emerging evidence suggests a possible neuropathic
component to OA-related pain which is commonly determined by self-
report screening questionnaires. Guidelines were developed in 2008 by
the IASP Special Interest Group on Neuropathic Pain (NeuPSIG) for grading
the certainty of a diagnosis of neuropathic pain in clinical presentations of
pain, based on the presence/absence of four criteria1.
Purpose: To evaluate the diagnostic accuracy of neuropathic pain
screening methods for identifying neuropathic pain in patients with
knee and/or hip OA using the NeuPSIG neuropathic pain grading
system.
Methods: PubMed, CINAHL, Embase and PsychInfo databases and Google
Scholar were systematically searched by two independent reviewers
from 2008 onwards. Interventional and observational studies published
in English language involving human participants aged 18 or over with
hip and/or knee OA were eligible for inclusion. Diagnostic accuracy of
neuropathic pain using an experimental/index test, against the diagnostic
reference standard of NeuPSIG guidelines was a further inclusion
criterion.
Results: Following screening by two independent reviewers, 27 poten-
tially eligible studies were identified; nine were available as fulletext, the
majority of which were conducted on a knee OA population. None of the
full-text studies used the NeuPSIG guidelines as a reference standard to
diagnose neuropathic pain. Neuropathic questionnaires only were the
most common method used to identify neuropathic pain (n¼6), whilst
three studies also used quantitative sensory testing. One study assessed
response to lignocaine injection as an indicator of neuropathic pain.
Conclusion: The diagnostic accuracy of assessment methods for identi-
fying neuropathic pain in patients with hip/knee OA is unknown.
Implications: Appropriately designed studies are needed to test the
diagnostic accuracy of available assessment methods in line with NeuPSIG
guidelines.
References
1. Treede RD, Jensen TS, Campbell JN, et al. Neuropathic pain: redefinition
and a grading system for clinical and research purposes. Neurology.
2008;70:1630-1635.
Funding acknowledgements: No funding was received for this study
Ethics approval: No ethics approval was required for this systematic
review.
Disclosure of interest: None Declared
Keywords: Neuropathic pain, Osteoarthritis, Systematic review
Intergrating Research into practice
PO1-LL-053
RELATIONSHIPS BETWEEN DIFFERENT EVALUATION TECHNIQUES IN
LOWER MEDIAL LONGITUDINAL ARCH SUBJECTS
A. Gomez-Conesa*, J.C. Zuil-Escobar, C. Martínez-Cepa, J.A. Martín-
Urrialde.
* Corresponding author.
Background: The foot has important impact absorption and ground reac-
tion force transmission functions in both gait and bipedal standing position.
e133
The medial longitudinal arch is formed by the calcaneus, the talus, the
navicular, the three cuneiform bones and the first three metatarsal bones4
and it is supported by the plantar aponeurosis, by means of the windlass
mechanism and the extrinsic and intrinsic muscles.
The evaluation of the medial longitudinal arch is neccesary in Physical
Therapy. Changes in its height affect several lower limb functions and are
related to lower limb injuries
Purpose: To evaluate the correlation between the navicular drop test, the
foot posture index-6 and several footprint parameters in lower medial
longitudinal arch subjects. In addition, reliability was also studied
Methods: A correlation study was carried out in 30 lower limb subjects (17
women and 13 men; 22.4±3.6 years). The navicular drop test, the arch
angle, the Staheli index, the Chippaux-Smirnak index and the foot posture
index-6 were collected in the dominant foot. The Pearson correlation co-
efficients (r) and the intraclass correlation coefficient were calculated.
Results: Strong statistical correlations (p< .05) were obtained between the
navicular drop test and the footprints parameters (r¼j0.650-0.722j) and
between the navicular drop test and the foot posture index (r¼0.743).
Excellent intrarater and interrater reliability were obtained for all the
parameters (CCI¼0.941-0.94)
Conclusion: The navicular drop test showed strong correlations with the
arch angle, the Staheli index, the Chippaux-Smirnak index and the foot
posture index-6.
Implications: The navicular dropt is an easy, reproducible and well-
correlated test in lower medial longitudinal arch subjects
Funding acknowledgements: None
We have no funding research
Ethics approval: Work approved by the Ethics Committee of CEU San
Pablo University (Madrid- Espan ~ a). All patients signed an informed con-
sent document in accordance with the ethical code of the World Medical
Association (Helsinki Declaration).
Disclosure of interest: None Declared
Keywords: Foot posture index-6, Footprint, Medial longitudinal arch
Intergrating Research into practice
PO1-LL-055
RELATIONSHIP BETWEEN MYOFASCIAL TRIGGER POINTS AND MUSCLE
FUNCTION IN THE LOWER EXTREMITIES. DESCRIPTIVE AND
CORRELATIONAL STUDY
s Moreno*, C. Hidalgo García, S. Pe
A. Ruiz De Escudero Zapico, J.M. Trica rez
n, E. Este
Guille banez de Miguel, A. Casasnovas Rocha, L. Ceballos Laita, P.
Pardos Aguilella, M. Santos, L. Ventura Trallero.
* Corresponding author.
Background: Musculoskeletal pain is a major cause of morbidity in the
current society, in which one in every three patients with musculo-
skeletal pain is diagnosed as myofascial pain syndrome. The myofascial
trigger points can be an independent cause of pain which is often not
associated with another clinical diagnosis, but may be related to many
musculoskeletal or visceral conditions. Although some myofascial
trigger points can be spontaneously painless, they can cause a restric-
tion of joint movement and/or cause weakness. For these reasons, it
was considered relevant to perform a study to give insight about the
relation between the presence of myofascial trigger points and muscle
function.
Purpose: We hypothesized that subjects with active or latent myofascial
trigger points have a greater muscle shortening, decreased muscle
strength and decreased pressure pain threshold compared with subjects
who do not have myofascial trigger points, so we had the aim of studying
the relationship between the prevalence of myofascial trigger points and
muscle function of the lower extremities.
Methods: 54 subjects volunteered for the study, they were interviewed to
determine the compliance with the inclusion criteria which mainly was
the absence of important lower extremity dysfunction. First a history
taking with personal information and data such as weight, height, BMI and
fat mss percentage, was performed. After, pain and overall muscle function
was assessed, by measuring muscle strength by a dynamometer, muscle