Profile of excellence.

Foundation dollars often serve multiple purposes. In recent years, Foundation research grants awarded to recipients from the University of Pittsburgh not only have produced scientific research evidence for the effectiveness of classification-based physical therapy intervention, they also have provided valuable research training for physical therapists enrolled in Pittsburgh's postprofessional doctoral program in physical therapy.

Major John Childs is an emerging investigator who received his doctorate in 2003 and was mentored by Julie Fritz, PT, PhD, ATC, another Foundation recipient. He also received research training on a Foundation grant awarded to Timothy Flynn, PT, PhD, OCS, in 2000, and on the Foundation-funded clinical research center grant awarded to Anthony Delitto, PT, PhD, FAPTA, in 1997.

Major John Childs, PT, PhD, MBA, OCS, FAAOMPT, Wilford Hall Medical Center, Lackland Air Force Base, Tex, a Foundation 2002 PODS I doctoral scholarship and 2004 research grant recipient, published an article in the Annals of Internal Medicine (Childs JD, Fritz JM, Flynn TW, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med. 2004;141[12]:920-928).

This article reports on Foundation-funded research in which Childs and other physical therapist researchers validated a clinical prediction rule that determined the likelihood that a patient with low back pain will benefit from spinal manipulation. Factors in the prediction rule include symptom duration, symptom location, fear-avoidance beliefs, lumbar mobility, and hip rotation range of motion. According to the study, those patients who had a positive result on the rule, defined as meeting at least 4 out of 5 criteria, had the best results. To find out more details about this research, to view an online instructional video on the prediction rule, and to access the full-text version of this article, go to www.apta.org/ Foundation/news/spinal_manipulation.

This research was supported by a 2002 Foundation research grant awarded to Fritz, University of Pittsburgh, and by the Wilford Hall Medical Center Commander's Intramural Research Funding Program. Childs received his doctorate in 2003, and was a co-investigator on Fritz's grant.

Childs received the Excellence in Research Award from the American Academy of Orthopaedic and Manual Physical Therapists in 2003 and the Outstanding Research Platform Presentation Award at the Annual Conference of the Texas Physical Therapy Association in 2004 for a presentation that reported the results of his research on the clinical prediction rule.

He also co-authored another publication in 2004 from his research on Fritz's Foundation-funded grant:

   Whitman JM, Fritz JM, Childs JD. The
   influence of experience and specialty
   certifications on clinical outcomes for
   patients with low back pain treated
   within a standardized physical therapy
   management program. J Orthop Sports
   Phys Ther. 2004;34(11):662-675.

He has 2 articles in press and 4 more manuscripts in review related to his Foundation-funded research with Fritz.

Childs and Major Deydre Teyhen, PT, PhD, OCS, received funding for a project, "Screening Soldiers at Risk for Chronic, Disabling Episodes of Low Back Pain," from the US Army Center for Health Promotion and Preventive Medicine from October 1, 2003, to September 30, 2004. Childs believes that one of the reasons this project was funded was because his grant proposal presented considerable preliminary work on the classification of patients with low back pain from the Foundation-funded research of Delitto (1997 clinical research center grant), Flynn (2000 research grant), and Fritz (2002 research grant).

In 2004, Childs received a 1-year, $40,000 research grant from the Foundation for his project, "The Effectiveness of an Extension-Oriented Intervention in Patients With Low Back Pain: A Randomized Clinical Trial." The purpose of this project was to determine whether backward betiding exercises were helpful to patients with low back pain. Preliminary evidence presented in the grant proposal for this project came from the Foundation-funded research of Delitto and Fritz.

Childs is completing another project--"Development of a Clinical Prediction Rule to Identify Patients With Neck Pain Likely to Benefit From Thoracic Spine Manipulation"--that is supported by a $7,500 grant from APTA's Orthopaedic Section, for the period April 1, 2004, to March 31, 2005. Experience with developing prediction rules while working on Flynn's and Fritz's Foundation-funded research grants allowed him to compete successfully for the Orthopaedic Section grant in which he will develop a similar prediction rule for identifying patients with neck pain who are likely to benefit from thoracic spine manipulation.

Childs currently has 3 grants planned for submission in 2005 to federal funding agencies, including the NIH and Department of Defense's congressionally directed Medical Research Program. "It's very simple," he stated. "The research that our team has published during the past several years could not have happened without the Foundation's support. This progress will likely culminate in multimillion dollar funding from federal agencies in the immediate future."