Impact of 24-Hr Diet and Physical Activity Control on Short-Term Precision Error of Dual-Energy X-Ray Absorptiometry Physique Assessment.

Dual-energy X-ray absorptiometry (DXA) is a popular technique used to quantify physique in athletic populations. Due to biological variation, DXA precision error (PE) may be higher than desired. Adherence to standardized presentation for testing has shown improvement in consecutive-day PE. However, the impact of short-term diet and physical activity standardization prior to testing has not been explored. This warrants investigation, given the process may reduce variance in total body water and muscle solute, both of which can have high daily flux amongst athletes. Twenty (n = 10 males, n = 10 females) recreationally active individuals (age: 30.7 ± 7.5 years; stature: 176.4 ± 9.1 cm; mass: 74.6 ± 14.3 kg) underwent three DXA scans; two consecutive scans on 1 day, and a third either the day before or after. In addition to adhering to standardized presentation for testing, subjects recorded all food/fluid intake plus activity undertaken in the 24 hr prior to the first DXA scan and replicated this the following 24 hr. International Society of Clinical Densitometry recommended techniques were used to calculate same- and consecutive-day PE. There was no significant difference in PE of whole-body fat mass (479 g vs. 626 g) and lean mass (634 g vs. 734 g) between same- and consecutive-day assessments. Same- and consecutive-day PE of whole-body fat mass and lean mass were less than the smallest effect size of interest. Inclusion of 24-hr standardization of diet and physical activity has the potential to reduce biological error further, but this needs to be verified with follow-up investigation.

Protocol Standardization May Improve Precision Error of InBody 720 Body Composition Analysis.

BACKGROUND: Bioelectrical impedance analysis (BIA) is a popular technique which can be used to track longitudinal changes in body composition. However, precision of the technique has been questioned, especially among athletic populations where small but meaningful changes are often observed. Guidelines exist which attempt to optimize precision of the technique but fail to account for potentially important variables. Standardization of dietary intake and physical activity in the 24 hr prior to assessment has been proposed as an approach to minimizing the error of impedance-derived estimates of body composition. METHODS: Eighteen recreational athletes, male (n = 10) and female (n = 8), underwent two consecutive BIA tests to quantify within-day error, and a third test (the day before or after) to quantify between-day error. All food and fluid intake plus physical activity from the 24 hr prior to the first BIA scan was replicated during the following 24 hr. Precision error was calculated as the root mean square standard deviation, percentage coefficient of variation, and least significant change. RESULTS: There were no significant differences in precision error of within- and between-day fat-free mass, fat mass, and total body water. Differences in precision error of fat-free mass and total body water, but not fat mass, were less than the smallest effect size of interest. CONCLUSION: The 24-hr standardization of dietary intake and physical activity may be an effective approach to minimizing precision error associated with BIA. However, further research to confirm the validity of this protocol compared to nonstandardized or randomized intake is warranted.

Modelling the age-related trajectory of performance in Para swimmers with physical, vision and intellectual impairment.

This study is the first to provide information on the age-related trajectories of performance in Para swimmers with physical, vision and intellectual impairment. Race times from long-course swim meets between 2009 and 2019 were obtained for Para swimmers with an eligible impairment. A subset of 10 661 times from 411 Para swimmers were included in linear mixed effects modelling to establish the relationship between age and performance expressed relative to personal best time and world record time. The main findings were: (a) age has the most noticeable influence on performance between the ages of 12-20 years before performances stabilize and peak in the early to late twenties, (b) women have faster times relative to personal best and world record time than men during early adolescence and their performances stabilize, peak and decline at younger ages, and (c) Para swimmers from different sport classes show varying age-related trajectories in performance after maturation and when training-related factors are more likely to explain competitive swim performance. The results of this study can guide talent identification and development of Para swimmers at various stages of their career and help to inform decision-making on the allocation of sport class and sport class status in Para swimming classification.

Passive drag in Para swimmers with physical impairments: Implications for evidence-based classification in Para swimming.

The inherent hydrodynamic resistance force, or passive drag, of a swimmer directly influences how they move through the water. For swimmers with physical impairments, the strength of association between passive drag and swimming performance is unknown. Knowledge on this factor could improve the World Para Swimming classification process. This study established the relationship between passive drag and 100 m freestyle race performance in Para swimmers with physical impairments. Using a cross-sectional study design, an electrical-mechanical towing device was used to measure passive drag force in 132 international-level Para swimmers. There was a strong, negative correlation between normalized passive drag force and 100 m freestyle race speed in the combined participant cohort (ρ = -0.77, p < 0.001). Type of physical impairment was found to affect the relationship between passive drag and 100 m freestyle race speed when included in linear regression (R2  = 0.65, χ2  = 11.5, p = 0.025). These findings contribute to the body of evidence that passive drag can provide an objective assessment of activity limitation in Para swimmers with physical impairments. The effect of physical impairment type on the relationship between passive drag and swimming performance should be accounted for in Para swimming classification.

Improving the objectivity of the current World Para Swimming motor coordination test for swimmers with hypertonia, ataxia and athetosis using measures of movement smoothness, rhythm and accuracy.

The current protocol for classifying Para swimmers with hypertonia, ataxia and athetosis involves a physical assessment where the individual's ability to coordinate their limbs is scored by subjective clinical judgment. The lack of objective measurement renders the current test unsuitable for evidence-based classification. This study evaluated a revised version of the Para swimming assessment for motor coordination, incorporating practical, objective measures of movement smoothness, rhythm error and accuracy. Nineteen Para athletes with hypertonia and 19 non-disabled participants performed 30 s trials of bilateral alternating shoulder flexion-extension at 30 bpm and 120 bpm. Accelerometry was used to quantify movement smoothness; rhythm error and accuracy were obtained from video. Para athletes presented significantly less smooth movement and higher rhythm error than the non-disabled participants (p < 0.05). Random forest algorithm successfully classified 89% of participants with hypertonia during out-of-bag predictions. The most important predictors in classifying participants were movement smoothness at both movement speeds, and rhythm error at 120 bpm. Our results suggest objective measures of movement smoothness and rhythm error included in the current motor coordination test protocols can be used to infer impairment in Para swimmers with hypertonia. Further research is merited to establish the relationship of these measures with swimming performance.

Establishing the reliability of instrumented trunk impairment assessment methods to enable evidence-based classification in Para swimming.

This study examined the reliability of instrumented trunk assessment methods across two experiments to develop and improve evidence-based classification in Para swimming. Trunk coordination, range of motion (ROM), and strength were assessed in 38 non-disabled participants. Each test battery was completed on two occasions to determine inter-session reliability. Intra-session reliability was also determined in Experiment Two. Absolute agreement of two-way mixed intraclass correlation coefficients (ICC 3,1) was calculated to assess reliability. Standard errors of measurement (SEMs) were also reported to facilitate comparisons between different outcomes. Trunk coordination measures had low-to-moderate reliability (inter-session ICCs = 0.00-0.60; intra-session ICCs = 0.14-0.65) and variable SEMs (5-60%). Trunk ROM demonstrated moderate-to-excellent reliability (inter-session ICCs = 0.61-0.93; intra-session ICCs = 0.87-0.95) and good SEMs (<10%). Trunk strength measures demonstrated good-to-excellent reliability (ICCs = 0.87-0.98) and good SEMs (<10%). The strength values obtained for the load cell and hand-held dynamometer (HHD) were significantly different from each other with the HHD underestimating strength. Modifications provided in Experiment Two improved the reliability of strength and ROM assessments but did not improve coordination measures. Further research involving para swimmers is required to establish the validity of the methods.

Seasonal Changes in Breathing Pattern, Trunk Stabilization, and Muscular Power in Paralympic Swimmers.

The purpose of this study was to monitor the changes in breathing pattern, trunk muscle stabilization, and upper-body muscular power in Paralympic swimmers throughout a competitive season over three time points: October (T1), March (T2), and August (T3). Six top-level Paralympic swimmers voluntarily participated in this study. The Friedman test, the Bonferroni-Dunn multiple comparison post hoc analysis, and Kendall's W concordance coefficient for the measure of effect were used. A significant difference was found in the breathing pattern, trunk stability, and upper-body power variables from the T1 to T3 season (p < .05). However, no significant changes were found in the T2 season. A long-term assessment of these fitness parameters may be of practical importance for better tailoring the training programs of top-level Paralympic swimmers.

The impact of limb deficiency impairment on Para swimming performance.

Swimmers with limb deficiency are a core population within Para Swimming, accordingly this study examined the contribution of limb segments to race performance in these swimmers. Data were obtained for 174 male Para swimmers with limb deficiency. Ensemble partial least squares regression showed accurate predictions when using relative limb segment lengths to estimate Para swimmers' personal best race performances. The contribution of limb segments to performance in swim events was estimated using these regression models. The analysis found swim stroke and event distance to influence the contributions of limb segments to performance. For freestyle swim events, these changes were primarily due to the increased importance of the hand, and decreased importance of the foot and shank, as the distance of the event increased. When comparing swim strokes, higher importance of the thigh and shank in the 100 m breaststroke compared with other swim strokes confirms the separate SB class. Varied contributions of the hand, upper arm and foot suggest that freestyle could also be separated from backstroke and butterfly events to promote fairer classification. This study shows that swim stroke and event distance influence the activity limitation of Para swimmers with limb deficiency suggesting classification should account for these factors.

A battery of strength tests for evidence-based classification in Para swimming.

This study examined the validity of isometric strength tests for evidence-based classification in Para swimming. Thirty non-disabled participants and forty-two Para swimmers with physical impairment completed an isometric strength test battery designed to explain activity limitation in the freestyle discipline. Measures pertaining to dominant and non-dominant limb strength and symmetry were derived from four strength tests that were found to be reliable in a cohort of non-disabled participants (ICC = 0.85-0.97; CV = 6.4-9.1%). Para swimmers had lower scores in strength tests compared with non-disabled participants (d = 0.14-1.00) and the strength test battery successfully classified 95% of Para swimmers with physical impairment using random forest algorithm. Most of the strength measures had low to moderate correlations (r = 0.32 to 0.53; p ≤ 0.05) with maximal freestyle swim speed in Para swimmers. Although, fewer correlations were found when Para swimmers with hypertonia or impaired muscle power were analysed independently, highlighting the impairment-specific nature of activity limitation in Para swimming. Collectively, the strength test battery has utility in Para swimming classification to infer loss of strength in Para swimmers, guide minimum eligibility criteria, and to define the impact that strength impairment has on Para swimming performance.

Peak Age and Performance Trajectories in Para Powerlifters.

OBJECTIVE: This study established the age-related performance trajectories in Para powerlifters, thereby presenting valuable information for athlete development. DESIGN: Data on athlete date of birth, body mass, and weight lifted in competition were analyzed for 2079 athletes between 1994 and 2019. RESULTS: Age-related performance trajectories showed that men and women lift their heaviest weights in competition at 36 and 41 yrs of age, respectively. This correspond to the mean age of competitors in the heaviest bodyweight categories at elite competitions (men 36 yrs, women 43 yrs), who were older than competitors in lighter bodyweight categories. It is possible that para powerlifters "move up" bodyweight categories as they get older and before lifting their heaviest weights in competition. High-performing athletes lifted their heaviest weight in competition 2.6 yrs earlier than lower performing peers, and the best performances in most bodyweight categories were achieved by athletes between 31 and 35 yrs of age. CONCLUSIONS: These results suggest that para powerlifters should reach their peak performance in their early to mid-30s and before age-related changes to neural and hormonal processes impact muscular strength. This information can help coaches and athletes evaluate their strategies for achieving success in para powerlifting.

Passive Heating Increases Bench-Pull Power Output in Highly Trained Swimmers.

PURPOSE: Determine the effects of skin temperature change on bench-pull power following a passive warm-up intervention with highly trained swimmers using multiple heated clothing garments. METHODS: Using a crossover design, 8 high-performance swimmers (mean [SD]; age, 22.4 [4.4] y; body mass, 74.9 [8.1] kg; height, 1.79 [0.09] m; world record ratio, 107.3% [5.1%]) completed a pool-based warm-up followed by a 35-minute transition phase before completing 3 repetitions at 50% of 1-repetition maximum of the bench-pull exercise. During transition, swimmers wore either a warm (control) or a heated (heat) clothing condition. RESULTS: Following heating, mean skin temperature was 0.7 °C higher in heat (P = .011), though no change was seen in tympanic temperature. Bench-pull mean and peak power improved by 4.5% and 4.7% following heating, respectively. A large repeated-measures correlation was observed between skin temperature and mean (r [90% CI] = .94 [.65 to .99], P < .01) and peak (r [90% CI] = .89 [.45 to .98], P < .01) power output. Thermal sensation and comfort at all regions were higher with heating (P ≤ .02). CONCLUSION: Combined upper- and lower-limb passive heating can increase whole-body skin temperature and improve short-duration upper-limb power output during the bench-pull exercise. Improvements in power output were directly related to the skin temperature increase facilitated by the heated clothing.

Froude Efficiency and Velocity Fluctuation in Forearm-Amputee Front Crawl: Implications for Para Swimming Classification.

PURPOSE: The impact of physical impairment on Froude efficiency and intracyclic velocity fluctuation in Para swimmers is not well documented. Identification of differences in these variables between disabled and nondisabled swimmers could help develop a more objective system for assigning Para swimmers to classes for competition. This study quantifies Froude efficiency and intracyclic velocity fluctuation in unilateral forearm-amputee front crawl swimmers and evaluates associations between these variables and performance. METHODS: Ten unilateral forearm-amputee swimmers completed front crawl trials at 50- and 400-m pace; three-dimensional video analysis provided mass center, and wrist and stump velocities. Intracyclic velocity fluctuation was calculated as follows: 1) maximum-minimum mass center velocity, expressed as percent of mean velocity, and 2) coefficient of variation in mass center velocity. Froude efficiency was the ratio between mean swimming velocity and wrist plus stump velocity during each segment's respective 1) underwater phase and 2) propulsive underwater phase. RESULTS: Forearm amputees' intracyclic velocity fluctuation (400 m: 22% ± 7%, 50 m: 18% ± 5%) was similar to published values for nondisabled swimmers, whereas Froude efficiencies were lower. Froude efficiency was higher at 400-m (0.37 ± 0.04) than 50-m pace (0.35 ± 0.05; P < 0.05) and higher for the unaffected limb (400 m: 0.52 ± 0.03, 50 m: 0.54 ± 0.04) than the residual limb (400 m: 0.38 ± 0.03, 50 m 0.38 ± 0.02; P < 0.05). Neither intracyclic velocity fluctuation nor Froude efficiency was associated with swimming performance. CONCLUSIONS: Froude efficiency may be a valuable measure of activity limitation in swimmers with an upper limb deficiency and a useful metric for comparing swimmers with different types and severity of physical impairment.

Swimming performance, physiology, and post-activation performance enhancement following dryland transition phase warmup: A systematic review.

BACKGROUND: In swimming, the period between the end of the swimming warmup and the beginning of competition is critical to performance, here termed the transition phase. Several options are available during this phase, necessitating a systematic review to understand if optimal strategies exist. OBJECTIVES: To synthesise and critically evaluate the current literature investigating land-based warmup interventions on subsequent performance in competitive swimmers. METHODS: A search of three electronic databases (PubMed, EBSCO SPORTDiscus and Web of Science) was conducted to identify original studies until February 2022. Selection criteria dictated that (i) a control condition was used, (ii) participants were ≥ 15 years of age, (iii) a pool-based warmup was done prior to the land-based warmup. A total of 25 articles met the selection criteria. RESULTS: Reducing the transition phase duration by at least half led to consistently faster time-trial times of between 1.1-1.5% for all included studies. Passive warmups using clothing interventions resulted in mostly faster time-trial's of 0.4-0.8% with increases in skin temperature frequent, though little change occurred in core temperature. The methodology of passive respiratory warmups were vastly different with positive time-trial's effects ranging between 0.9-1.1% for two studies, though one reported no meaningful difference. Active warmups led to consistently faster time-trial's between 0.7-0.9%, though the unpinning factors are not clear. Warmups which combined passive and active options frequently led to faster time-trial's between 0.8-3%. Upper and combined limb post-activation performance enhancement led to mostly unfavourable time-trial changes. Lower limb exclusive protocols results were inconsistent, with limited beneficial effects on time-trial or start performance reported following plyometric protocols. However, there does appear merit in heavier loaded lower limb protocols. CONCLUSION: Each of a reduced transition phase length, and passive, active or combination warmup have demonstrated improvements in swimming performance. Conversely, PAPE protocols should be used with caution, especially when including the upper limbs.

The effect of COVID-19 lockdown on psychiatric admissions: role of gender.

BACKGROUND: The UK went into nationwide lockdown on 24 March 2020, in response to COVID-19. The direct psychiatric effects of this are relatively unknown. AIMS: We examined whether the first UK lockdown changed the demographics of patients admitted to psychiatric hospitals (to include gender, legality, route of admission and diagnoses), independent of seasonal variation.. METHOD: We conducted an anonymous review of psychiatric admissions aged ≥18 years in the 6-month period after the announcement of the first UK lockdown (March to August 2020), and in the previous year (March to August 2019), in Kent and Medway NHS and Social Care Partnership Trust in-patient facilities. The number of admissions were compared, along with factors that may help to explain the psychological effects of national lockdown. RESULTS: There was no significant increase in total number of admissions or the gender percentage. However, there was a 11.8% increase in formal sectioning under the Mental Health Act 1983. This increase was sustained and statistically significant across all 6 months. A sustained decrease in admissions via the crisis team was also observed as being statistically significant. Separate diagnoses saw changes in percentage of admissions between March and May. The most statistically significant was schizophrenia admissions for men in April (18.7%), and women in March (18.4%). CONCLUSIONS: Our findings highlight the effect of COVID-19 on the legal status of psychiatric admissions, and emphasise the importance of having a robust, adaptable and open psychiatric service that caters to the ongoing needs of patients, regardless of government restrictions.

Utility of an Isometric Midthigh Pull Test to Assess Lower Body Muscular Strength in Professional Netball Players.

PURPOSE: This study established the relationship between isometric midthigh pull (IMTP) peak force and court-based jumping, sprinting, and change of direction (COD) performance in professional netball players. The change in IMTP peak force in response to sport-specific training was also examined. METHODS: IMTP peak force and court-based jumping, sprinting, and COD were collected in 18 female athletes contracted to a Suncorp Super Netball team. Linear regression models established the relationship between absolute and normalized strength values and court-based performance measures in the participant cohort. Changes in IMTP peak force and court-based performance measures were examined following 2 consecutive preseason training blocks in a subset of participants. RESULTS: The IMTP peak force values normalized to body mass were found to be determinants of court-based jumping, sprinting, and COD performance in the participant cohort (R2 = .34-.65, P ≤ .016). The participants showed increases in absolute (mean ± SE = 398 ± 68.5 N, P < .001, Hedge g = 0.70 [-0.05 to 1.35]) and normalized IMTP peak force (mean ± SE = 4.6 ± 0.78 N·kg-1, P < .001, Hedge g = 0.47 [-0.04 to 0.97]) over 2 consecutive training blocks that coincided with improvements in jumping, sprinting, and COD performances. CONCLUSION: IMTP peak force is a determinant of court-based jumping, sprinting, and COD performance and is sensitive to training in professional netball players. These results support the utility of the IMTP test to monitor the development and maintenance of maximal lower body muscular strength in these athletes.

Body composition in professional female netball players within and between seasons: a cohort study.

BACKGROUND: There is limited information on the physique attributes of female netball players from the highest playing standards and the typical body composition changes that occur with training and competition in these athletes. The purpose of this study was to examine the body composition of professional female netball players and changes that occur within and between national premier netball seasons. METHODS: Dual-energy X-ray absorptiometry (DXA) assessments were conducted in 20 female netball players (age = 26.5 [4.7] years, body mass = 77.3 [9.7] kg, stature = 182.7 [9.5] cm) contracted to a Suncorp Super Netball team. Total body lean mass, fat mass, bone mass and bone mineral density were derived for 127 assessments collected over three seasons. Linear mixed effects modelling was used to examine changes in body composition measures within and between seasons. RESULTS: Goal circle players were heavier (12.3 [3.5] kg, p < 0.001, g = 1.51) and taller (15.0 [2.7] cm, p < 0.001, g = 2.30) than midcourt players, and midcourt players had greater lean mass (3.1 [1.6] %, p = 0.07, g = 0.85) and less fat mass (-3.3 [1.7] %, p = 0.06, g = -0.84) than goal circle players when values were normalised to body mass. Players achieved increases in lean mass (2,191 [263] g, p < 0.01, g = 0.45) and decreases in fat mass (-835 [351] g, p = 0.09, g = -0.16) following a preseason preparation period. There were no changes in lean mass (-394 [295] g, p = 0.54, g = 0.07) or fat mass (102 [389] g, p = 0.99, g = 0.04) from the start to the end of the 14-week competition period. CONCLUSIONS: Professional female netball players achieve small changes in lean mass and fat mass during preseason preparation and maintain their physique over the competitive season. The results of this study can inform practitioners on the training content necessary to promote or maintain desired body composition changes in these athletes.

Designing success: Applying Cognitive Work Analysis to optimise a para sport system.

Within the last decade, Para sport has experienced increased growth, global popularity, and scientific research. Likewise, there is increasing application of systems ergonomics methods to optimise sports performance. Despite this, few studies have attempted to analyse Para sport as a complex system. The aim of this study was to apply a systems ergonomics framework to redesign a current Para sport system via a multi staged approach. The Cognitive Work Analysis framework was used to model and redesign the Para sport system, via the insertion of design interventions. The findings offer insights into the complexity of the Para sport system via the multiple interacting factors that influence the performance of the system. In addition, the design interventions had substantial influence on the Para sport system by creating multiple new processes, functions, measures, and purposes, and enhanced multiple components of the existing system. This study provides a unique contribution to ergonomic science and extends system ergonomics theory and methods in sport. This study has practical implications for policy development by providing a template that can be used by others wanting to optimise able-bodied sport, Para sport, and non-sport systems.

Maximal Fully Tethered Swim Performance in Para Swimmers With Physical Impairment.

The assessment of swimming propulsion should be a cornerstone of Paralympic swimming classification. However, current methods do not objectively account for this component. PURPOSE: To evaluate the swimming propulsion of swimmers with and without physical impairment using a 30-second maximal fully tethered freestyle swim test. METHODS: Tethered forces were recorded during maximal fully tethered swimming in 80 competitive swimmers with (n = 70) and without (n = 10) physical impairment. The relationships between absolute and normalized tether forces and maximal freestyle swim speed were established using general additive models. RESULTS: Para swimmers with physical impairment had lower absolute and normalized tether forces than able-bodied swimmers, and there were moderate positive correlations found between tether forces and sport class (τ = .52-.55, P < .001). There was a nonlinear relationship between tether force and maximal freestyle swim speed in the participant cohort (adjusted R2 = .78-.80, P < .001). Para swimmers with limb deficiency showed stronger relationships between tether force and maximal freestyle swim speed (adjusted R2 = .78-.82, P < .001) than did Para swimmers with hypertonia (adjusted R2 = .54-.73, P < .001) and impaired muscle power (adjusted R2 = .61-.70, P < .001). CONCLUSIONS: Physical impairments affect Para swimmers' tether forces during maximal fully tethered freestyle swimming, explaining a significant proportion of their activity limitation. It is recommended that maximal fully tethered swimming be included in Paralympic swimming classification as an objective assessment of swimming propulsion.

Active Drag as a Criterion for Evidence-based Classification in Para Swimming.

INTRODUCTION: Paralympic classification should provide athletes with an equitable starting point for competition by minimizing the impact their impairment has on the outcome of the event. As swimming is an event conducted in water, the ability to overcome drag (active and passive) is an important performance determinant. It is plausible that the ability to do this is affected by the type and severity of the physical impairment, but the current World Para Swimming classification system does not objectively account for this component. The aim of this study was to quantify active and passive drag in Para swimmers and evaluate the strength of association between these measures and type of physical impairment, swimming performance, and sport class. METHODS: Seventy-two highly trained Para swimmers from sport classes S1 to S10 and 14 highly trained nondisabled swimmers were towed by a motorized winch while the towing force was recorded. Passive drag was measured with the arms held by the side; active drag was determined during freestyle swimming using an assisted towing method. RESULTS: Active and passive drag were higher in Para swimmers with central motor and neuromuscular impairments than for nondisabled swimmers and were associated with severity of swim-specific impairment (sport class) and maximal freestyle performance in these swimmers (r = -0.40 to -0.50, P ≤ 0.02). Para swimmers with anthropometric impairments showed similar active and passive drag to nondisabled swimmers, and between swimmers from different sport classes. CONCLUSIONS: Para swimmers with central motor and neuromuscular impairments are predisposed to high active drag during freestyle swimming that impacts on their performance. It is recommended that drag measures be considered in revised classification for these swimmers, but not for those with anthropometric impairments.

Interdisciplinary spinal pain clinics in primary care: Outcomes from one service

BACKGROUND AND OBJECTIVES: Management of spinal pain in Australia is a common problem that often requires input from a range of health providers. Interdisciplinary care can be difficult to access, and care can easily become fragmented. A novel approach of setting up an interdisciplinary clinic in a primary care setting was analysed in this study. METHODS: Follow-up of patients 2­3 years after attending the clinic was undertaken. Specialist general practitioners (GPs) referring to the clinic were invited to give feedback. RESULTS: Forty-three patients participated in the study. Approximately half of patients reported clinically significant reductions in their overall pain and disability levels. GPs and participants broadly supported the clinic approach. DISCUSSION: Complex spinal pain interdisciplinary assessment in a primary care setting shows reasonable long-term outcomes comparable to more intensive interventions. Further exploration and fine-tuning of this model would seem a sensible option as current models of care are under strain.