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Abstracts THE FABQ MEASURES PATIENT EXPECTATIONS AND NOT FEAR. STUDY DESIGN: A cohort study with 12 months of follow-up. OBJECTIVE: To assess 1) the unidimensionality of the Fear-Avoidance Beliefs Questionnaire (FABQ) and 2) whether single questions in the FABQ predict future sickness absence as well as the whole scale. SUMMARY OF THE BACKGROUND DATA: The fear-avoidance model is a leading model in describing the link between musculoskeletal pain and chronic disability. However, reported measurement properties have been inconsistent regarding the FABQ. METHODS: Individuals (n = 722) sick listed due to musculoskeletal, unspecified or common mental health disorders undergoing rehabilitation was included. A Rasch analysis was applied to evaluate the measurement properties of FABQ and its two subscales (physical activity and work). Linear regression was used to assess how well single items predicted future sickness absence. RESULTS: The Rasch analysis did not support the FABQ or its two subscales representing a unidimensional construct. The 7-point scoring of the items was far too fine meshed and in the present population the data only supported a yes or no or a 3-point response option. The items were invariant to age, whereas two of the items revealed gender differences. The item “I do not think that I will be back to my normal work within 3 months” was the best predictor of future sickness absence. Adding the item “I should not do my regular work with my present pain” improved the prediction model slightly. CONCLUSIONS: The FABQ is not a good measure of fear-avoidance beliefs about work or physical activity, and the predictive property of the FABQ questionnaire is most likely related to expectations rather than fear. Based on these results we do not recommend using the FABQ to measure fear-avoidance beliefs Lene et al. The Fear Avoidance Beliefs Questionnaire (FABQ). Does it really measure fear beliefs? Spine. 2019. WHAT CHANGES DOES SMT BRING ABOUT IN HEALTHY INDIVIDUALS? INTRODUCTION: The effectiveness of spinal manipulative therapy (SMT) for improving athletic performance in healthy athletes is unclear. Assessing the effect of SMT on other
performance outcomes in asymptomatic populations may provide insight into the management of athletes where direct evidence may not be available. Our objective was to systematically review the literature on the effect of SMT on performance-related outcomes in asymptomatic adults.
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METHODS: MEDLINE, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials were systematically searched from 1990 to March 23, 2018. Inclusion criteria was any study examining a performance-related outcome of SMT in asymptomatic adults. Methodological quality was assessed using the SIGN criteria. Studies with a low risk of bias were considered scientifically admissible for a best evidence synthesis. We calculated the between group mean change and 95% confidence intervals.
In this retrospective cohort analysis involving a sample of the paediatric US Medicaid population, researchers assessed the risk of developing asthma in relation to antibiotic fills in the first 2 years of life in these individuals. Participants included children with continuous medical and pharmacy coverage from birth to 2.5 years of age. Those who received a diagnosis of asthma prior to 2.5 years of age were removed from the study. Of 79,582 children included, antibiotic prescriptions filled were 0, 1-2, or ≥ 3 for 29,931 (37.6%), 27,403 (34.4%), and 22,248 (28.0%) children, respectively. A follow-up of 89,545 personyears was performed, during which time 2,381 new cases of asthma were documented. In this Medicaid population, an increased risk of asthma diagnosis from 2.5 to 5 years of age was observed in relation to antibiotic prescriptions filled in the first 2 years of life.
RESULTS: Of 1415 articles screened, 20 studies had low risk of bias, seven were randomized crossover trials, 10 were randomized controlled trials (RCT) and three were RCT pilot trials. Four studies showed SMT had no effect on physiological parameters at rest or during exercise. There was no effect of SMT on scapular kinematics or transversus abdominus thickness. Three studies identified changes in muscle activation of the upper or lower limb, compared to two that did not. Five studies showed changes in range of motion (ROM). One study showed an increase lumbar proprioception and two identified changes in baropodometric variables after SMT. Sport-specific studies show no effect of SMT except for a small increase in basketball free-throw accuracy. CONCLUSION: The preponderance of evidence suggests that SMT in comparison to sham or other interventions does not enhance performance-based outcomes in asymptomatic adult population. All studies are exploratory with immediate effects. In the few studies suggesting a positive immediate effect, the importance of such change is uncertain. Further high-quality performance specific studies are required to confirm these preliminary findings. Corso et al. The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence. Chiropractic & Manual Therapies, 2019
ASSOCIATION BETWEEN EARLYCHILDHOOD ANTIBIOTIC EXPOSURE AND SUBSEQUENT ASTHMA IN THE US MEDICAID POPULATION
Fishman E, Crawford G, DeVries A, et al. Association between early-childhood antibiotic exposure and subsequent asthma in the US Medicaid population. Annals of Allergy, Asthma, and Immunology | August 01, 2019 ARE WE MAXIMISING OUR USE OF ONLINE RESOURCES? Researchers examined the current practices of New Zealand (NZ) healthcare providers in recommending online resources for persistent pain management. In addition, they assessed factors that predict healthcare providers’ recommendations, and investigated common concerns. Via performing an online survey, they collected and analysed data from 213 NZ healthcare providers involved in the management of persistent pain. Recommendation for online resources was reported to be valued by only half of the healthcare providers surveyed, suggesting limited confidence in recommending, or knowledge of, existing online resources for persistent pain management. Recommendations for online resources was positively influenced by specialist interest in treating pain, and level of confidence. Findings suggested the necessity for ongoing education for healthcare providers on evidence-based online resources to promote online resources as a self-management support tool for people with persistent pain.
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