Clinical research network (CRN) update # 10: PTClinResNet investigators publish 3 articles.

Investigators from the CRN study MUSSEL (Muscle-Specific Strengthening Effectiveness Post Lumbar Microdiscectomy) have published 2 papers on the study.

The first article presented the rationale and design for a randomized controlled trial evaluating the effectiveness of a treat ment regimen for people who have undergone a single-level lumbar microdiscectomy. "The Immediate and Long-term Effects of Exercise and Patient Education on Physical Functional, and Quality of Life Outcome Measures After Single-level Lumbar Microdiscectomy: A Randomized Controlled Trial Protocol" was coauthored by David M Selkowitz, PT, PhD; Kornelia Kulig, PT, PhD; Elizabeth M Poppert, PT, DPT, OCS; Sean P Flanagan, PT, PhD, ATC; Ndidiamaka D Matthews, PT, DPT, NCS; George J Beneck, PT, MS, OCS; John M Popovich Jr, PT, DPT, ATC; Jose R Lona, PT, DPT, ATC; Kimiko A Yamada, PT, DPT, ATC; Wendy S Burke PT, MS, DPT, OCS; Carolyn Ervin, PhD; Christopher M Powers, PT, PhD; and the Physical Therapy Clinical Research Network (PTClinResNet). It was published as a study protocol in BM C Musculoskeletal Disorders (2006;7:70).

Kulig and Powers are co-lead investigators of MUSSEL. In addition, Powers received a Foundation doctoral student support grant in 1993 and a research grant in 2001. He currently serves as a member of the Scientific Review Committee (SRC). Coauthors Popovich and Beneck are also recipients of Foundation funding. Popovich was awarded a PODS I in 2005, and Beneck received his PODS I in 2006.

The second article, "Current Status and Correlates of Physicians' Referral Diagnoses for Physical Therapy," was published in the Journal for Orthopaedic and Sports Physical Therapy (2005:35:572-579) and coauthored by Todd E Davenport, PT, DPT; Hugh Watts, MD; Kornelia Kulig, PT, PhD; and Cheryl Resnick, PT, DPT. In this study, 2,183 referral diagnoses from physicians were analyzed with respect to information content as well as corresponding physician and patient demographic information. Less than one third of referral diagnoses in this study reported a specific pathology and anatomical orientation, and these specific diagnoses were provided more commonly by specialist physicians, male physicians, and late-career physicians and were given more often for male patients. The investigators concluded that physical therapists may have the responsibility to perform differential diagnosis more commonly than acknowledged by most state practice acts and third-party payers.

The investigators of STEPS (Strength Training Effectiveness Post-Stroke)--Katherine J Sullivan, PT, PhD;Tara Klassen, PT, NCS; and Sara Mulroy, PT, PhD--have published "Combined Task-Specific Training and Strengthening Effects on Locomotor Recovery Post-stroke: A Case Study" in the Journal of Neurologic Physical Therapy, (2006;30[3]:127-138). This case study of a 38-year-old woman who was 15 months poststroke found that clinically meaningful changes in walking function can occur with a therapeutic program that includes both task-specific and lower-extremity strength training. The authors theorized that possible mechanisms of response to therapy might include improved motor unit activation and increased strength in key muscles used in gait.