Deborah Falla

• BPhty(Hons), PhD
• Professor at University of Birmingham

Non‐insertional Achilles tendinopathy (NIAT) induces morpho‐mechanical changes to the Achilles tendon (AT). Evidence on how triceps surae motor unit firing properties are influenced by altered tendon mechanics in NIAT is limited. This study investigated motor unit firing properties (mean discharge rate (DR), recruitment and de‐recruitment threshold...

Background and Objective Exercise is a crucial component of a multimodal treatment for improving function and reducing pain in patients with non‐specific neck pain. This study aims to investigate the knowledge, attitudes, practices and the influence of professional characteristics of Italian specialised musculoskeletal physiotherapists compared wit...

Purpose The aim of this study was to quantify differences in the shear wave speed (SWS) between a conservatively treated Achilles tendon (AT) after rupture and the unaffected contralateral tendon. Methods Twenty‐nine participants who received conservative treatment following Achilles tendon rupture (ATR) were enrolled. Measurements were taken duri...

Background: It is important to consider the cervical spine as a potential contributor to shoulder pain, indicating the paramount importance of screening the cervical spine in patients with shoulder pain. Objectives: To study the immediate effects of cervical spine screening (CSS) on the shoulder active range of motion, isometric strength and self-r...

Objectives The assessment of the spatial characteristics of pain, such as location and extent, is essential in the clinical evaluation of pain syndromes, especially when managing patient’s with chronic musculoskeletal pain. This study evaluated the convergent validity of pain drawings (PDs) and anatomical checklists (ACLs) in measuring pain locatio...

Introduction Despite significant advancements in research on paediatric pain, a consensus on the primary risk factors (RFs) for the development and persistence of pain in this population has not yet been reached. Objectives This study aims to establish a consensus among experts on the most significant RFs for the onset and persistence of pain in a...

A multitude of variables contribute to the variation of trunk strength in individuals with chronic low back pain (CLBP). This study investigated a range of variables to determine which variables contribute most to variation in trunk isometric strength and gains in strength following resistance training in people with CLBP. Outcome measures were rec...

Introduction Both physical adaptations (e.g., altered neck kinematics and muscle coordination) and psychological features are common in people presenting with neck pain (NP). Additionally, both physical and psychological features may be relevant for the development of persistent or recurrent NP. Although a number of original studies have reported t...

Background Headache conditions have a high prevalence worldwide. Office workers with high and demanding workload, but low physical activity levels are considered vulnerable for suffering from headache. This analysis examines whether exercise combined with health promotion at the workplace is effective for headache relief in office workers. Methods...

Introduction Low back pain (LBP) is a global health concern. Approximately two-thirds of those who recover from LBP experience a relapse within a year, with many chronic cases encountering acute flare-ups (exacerbation). This systematic review will synthesise and analyse whether physical and/or psychological features can predict recurrent episodes...

Many individuals with incomplete spinal cord injury (SCI) exhibit reduced volitional control of trunk muscles, such as impaired voluntary contractions of the erector spinae (ES), due to damage to the neural pathways regulating sensorimotor function. Studies using conventional bipolar electromyography (EMG) showed alterations in the overall, or glob...

Objective To assess the responsiveness of a hand-held dynamometer (HHD) in evaluating changes in trunk isometric strength in people with chronic low back pain (LBP). Background Reduced trunk muscle strength has been associated with pain incidence and severity in people with chronic LBP. Trunk muscle strength is an important functional outcome that...

Background Differences in cervical neuromuscular function are commonly observed between people with and without chronic neck pain. Exercise may improve cervical neuromuscular function of people with neck pain although the evidence for this has not been systematically reviewed. Objective To systematically review the existing evidence on the effect...

Introduction; to the best of the authors knowledge, no past research has established how illness narrative master plots are expressed initially and then if and how they change longitudinally following musculoskeletal trauma. The aim of the present research was to consider how specific master plots were expressed, interact, and change across time fo...

Introduction Temporomandibular disorders (TMDs) are musculoskeletal disorders characterised by jaw pain and typically temporomandibular joint limitations. Resistance training (RT) has been shown to be effective at reducing pain and improving function for different musculoskeletal conditions (eg, neck pain, low back pain); however, the effectiveness...

Recent studies combining high-density surface electromyography (HD-sEMG) and ultrasound imaging have yielded valuable insights into the relationship between motor unit activity and muscle contractile properties. However, limited evidence exists on the relationship between motor unit firing properties and tendon morpho mechanical properties. This st...

Non-insertional Achilles tendinopathy (NIAT) induces morpho-mechanical changes to the Achilles tendon (AT). However, evidence on how triceps surae motor unit firing properties are influenced by altered tendon mechanics in NIAT is limited. This study investigated motor unit firing properties (mean discharge rate (DR), recruitment and de-recruitment...

Goal: This study introduces a novel approach to examine the temporal-spatial information derived from High-Density surface Electromyography (HD-sEMG). By integrating and adapting postural control parameters into a framework for the analysis of myoelectrical activity, new metrics to evaluate muscle fatigue progression were proposed, investigating th...

Background and Objective In the presence of pain, whether clinical or experimentally induced, individuals commonly show impairments in the control of muscle force (commonly known as force steadiness). In this systematic review and meta‐analysis, we synthesized the available evidence on the influence of clinical and experimental pain on force steadi...

In this systematic review, we synthesize the literature investigating the effect of experimentally induced pain in the cervical, shoulder, or orofacial regions on cervical neuromuscular and kinematic features. Databases were searched up to November 1st, 2023. A total of 29 studies using hypertonic saline injection (n = 27) or glutamate injection (n...

We aimed to assess high-density surface electromyography (HDsEMG)-torque relationships in the presence of delayed onset trunk muscle soreness (DOMS) and the effect of these relationships on torque steadiness (TS) and lumbar movement during concentric/eccentric submaximal trunk extension contractions. Twenty healthy individuals attended three labora...

Introduction; to the best of the authors knowledge no past research has established how illness narrative master plots are expressed initially, and then if, and how they change longitudinally following musculoskeletal trauma. The aim of the current research was able to consider how specific master plots were expressed, interact and change across ti...

This cross-sectional study aims to elucidate the neural mechanisms underlying the control of knee extension forces in individuals with anterior cruciate ligament reconstructions (ACLR). Eleven soccer players with ACLR and nine control players performed unilateral isometric knee extensions at 10% and 30% of their maximum voluntary force (MVF). Simul...

Introduction Wearable neuromuscular and biomechanical biofeedback technology has the potential to improve patient outcomes by facilitating exercise interventions. We will conduct a systematic review to examine whether the addition of wearable biofeedback to exercise interventions improves pain, disability and quality of life beyond exercise alone f...

Background: Office workers are specifically vulnerable to headache conditions. Neck pain is reported by almost 80% of patients with headaches. Associations between currently recommended tests to examine cervical musculoskeletal impairments, pressure pain sensitivity and self-reported variables in headache, are unknown. Purpose: The aim of this stud...

Background: Headache and neck pain are closely related. Office-workers are regarded especially vulnerable for both conditions. The objectives of the study are, to examine the effects of a 12-month intervention, consisting of neck exercise and health promotion, on headache outcome variables in office workers in two public departments in Switzerland....

Aim: To determine differences in physical examination findings between people with acute whiplash-associated disorders (WAD) with and without headache. Methods: In this cross-sectional study, participants with acute WAD were evaluated to assess differences in the presence of physical impairments. The following were assessed: pain intensity on ma...

Background: A pain drawing is a self-administered assessment that requires the patient to shade in on a body chart the areas in which he or she experiences pain, regardless of the intensity. Pain drawings have already been validated in several adult populations. Objectives: The aim of this study is to establish adolescents' test-retest reliabili...

We aimed to assess high-density surface electromyography (HDsEMG)-torque relationships in the presence of delayed onset trunk muscle soreness (DOMS) and the effect of these relationships on torque steadiness (TS) and lumbar movement during concentric/eccentric submaximal trunk extension contractions. Twenty healthy individuals attended three labora...

Introduction People with chronic neck pain (CNP) commonly exhibit a range of physical impairments including cervical proprioceptive deficits. Assessing proprioception using a head mounted laser to assess joint position error (JPE) is a reliable and valid measure. However, the responsiveness of this measure has not been assessed. Objective To asses...

Objective To understand whether pain-related factors soon after a whiplash injury can explain the presence of chronic headache. Materials and Methods A prospective study with a follow-up of 6 months was performed including 42 patients with acute whiplash-associated disorders. Neck pain intensity, the Neck Disability Index, the Tampa Scale Kinesiop...

Background Limited knowledge exists on current use of patient reported outcome measures (PROMs) and performance measures for adolescents with idiopathic scoliosis (AIS), as well as health care professionals’ (HCPs) perceived barriers and facilitators towards their use. This study’s objectives were: 1) to explore current practice of HCPs when assess...

Objectives To examine changes in pain outcomes to fully evaluate the effect of adding sensorimotor training to manual therapy and exercise in patients with chronic neck pain and sensorimotor deficits. Concordance was examined between pain distribution and pain intensity and patient-reported outcomes. Methods Participants (n=152) were randomly allo...

Introduction Proprioception can be impaired in people with neck pain. The cervical joint position sense test, which measures joint position error (JPE), is the most common test used to assess neck proprioception. The aim of this systematic review was to assess the measurement properties of this test for the assessment of people with and without nec...

Arm cycling is used for cardiorespiratory rehabilitation but its therapeutic effects on the neural control of the trunk after spinal cord injury (SCI) remain unclear. We investigated the effects of single session of arm cycling on corticospinal excitability, and the feasibility of home-based arm cycling exercise training on volitional control of th...

Objectives The understanding of the role that cognitive and emotional factors play in how an individual recovers from a whiplash injury, is important. Hence, we sought to evaluate if pain-related cognitions (self-efficacy beliefs, expectation of recovery, pain catastrophizing, optimism, and pessimism) and emotions (kinesiophobia) are longitudinally...

Background The clinically relevant healing process of a ruptured and repaired Achilles tendon (AT) can last more than a year. The purpose of this cross-sectional study was to test if shear wave tensiometry is able to detect AT loading changes between a surgically managed AT rupture versus the unaffected contralateral tendon. Our secondary aims were...

Purpose We quantified the relationship between high-density surface electromyographic (HDsEMG) oscillations (in both time and frequency domains) and torque steadiness during submaximal concentric/eccentric trunk extension/flexion contractions, in individuals with and without chronic low back pain (CLBP). Methods Comparisons were made between regio...

Introduction When performing an exercise or a functional test, pain that is evoked by movement or muscle contraction could be a stronger stimulus for changing how individuals move compared to tonic pain. We investigated whether the decrease in muscle force production is larger when experimentally‐induced knee pain is directly associated to the torq...

Changes in spinal kinematic variability have been observed in people with chronic non-specific LBP (CNSLBP) during the performance of various repetitive functional tasks. However, the direction of these changes (i.e., less or more kinematic variability) is still not established. This study aimed to assess differences in kinematic variability of the...

Background and Objective A network analysis can be used to quantitatively assess and graphically describe multiple interactions. This study applied network analyses to determine the interaction between physical and pain‐related factors and fear of movement in people with whiplash‐associated disorders (WAD) during periods of acute and chronic pain....

Introduction Upper quadrant musculoskeletal disorders (UQMD), comprising of cranial, cervical, shoulder and upper extremity disorders, are among the most frequently reported disorders in clinical practice. Thoracic high velocity low amplitude thrust (Tx-HVLAT) manipulation is a form of conservative management recommended in systematic reviews as an...

Abstract: This pilot study aimed to compare the effects of eight weeks of concurrent resistance training (RT) and high-intensity interval training (HIIT) vs. RT alone on muscle performance, mass and quality in adults with type 2 diabetes (T2DM). Twelve T2DM adults were randomly allocated to the RT + HIIT (n = 5) or RT (n = 7) group. Before and afte...

Objective: The Patient-Specific Functional Scale (PSFS) is a patient-reported outcome measure used to assess functional limitations. Recently, the PSFS 2.0 was proposed; this instrument includes an inverse numeric rating scale and an additional list of activities that patients can choose. The aim of this study was to assess the test-retest reliabi...

Arm cycling is used for cardiorespiratory rehabilitation but its therapeutic effects on the neural control of the trunk after spinal cord injury (SCI) remain unclear. We investigated the effects of single session of arm cycling on corticospinal excitability, and the feasibility of home-based arm cycling exercise training on volitional control of th...

Background Kinesiophobia (i.e., fear of movement) can be an important contributor for ongoing pain and disability in people with spine-related pain. It remains unclear whether physical activity interventions/exercise influence kinesiophobia in this population. A systematic review was therefore conducted to synthesize the available evidence on wheth...

Introduction: Adolescent idiopathic scoliosis (AIS) is one of the most common paediatric spinal complaints (2-3% of children < 16 years). Regular physical activity is recommended and has been associated with significant improvements in quality of life, reduced pain, and improved function in AIS. However, participation rates remain low amongst indiv...

Introduction Clinical guidelines recommend conservative treatment for the management of temporomandibular disorders (TMD), and manual therapy directed to temporomandibular structures is commonly applied to reduce pain and improve function. In a recent prospective study, we developed a clinical prediction tool based on an array of predictors to iden...

Introduction Neck-specific exercises (NSEs) are commonly used for the treatment of chronic non-specific neck pain (CNSNP). However, it remains unclear whether baseline features can predict the response to neck-specific exercise (NSE) in people with CNSNP. This systematic review aims to assess whether baseline features such as age, gender, muscle ac...

Background Variability in spine kinematics is a common motor adaptation to pain, which has been measured in various ways. However, it remains unclear whether low back pain (LBP) is typically characterised by increased, decreased or unchanged kinematic variability. Therefore, the aim of this review was to synthesise the evidence on whether the amoun...

Background: Evaluating trunk strength is an important aspect of the physical examination of people with low back pain (LBP). Thus, reliable, valid, and easily applied measurement tools are needed to quantify trunk muscle strength and monitor changes in response to interventions. Objectives: To determine within-day and between-day test re-test re...

Background: Whiplash-associated headache (WAH) is one of the most common symptoms after a whiplash injury, leading to high disability. Nevertheless, the clinical characteristics of WAH have not been well described. Objective: To synthesise the existing literature on the clinical characteristics of WAH. Design: Scoping review. Methods: The pr...

Background: Office workers are specifically vulnerable to headache conditions. Neck pain is reported by almost 80% of patients with headaches. Associations between currently recommended tests to examine cervical musculoskeletal impairments, pressure pain sensitivity and self-reported variables in headache, are unknown. The aim of this study is to...

Purpose Lumbar spinal fusion surgery (LSFS) is common for lumbar degenerative disorders. The objective was to develop clinical prediction rules to identify which patients are likely to have a favourable outcome to inform decisions regarding surgery and rehabilitation. Methods A prospective observational study recruited 600 (derivation) and 600 (in...

Objective: Previous neuroimaging studies have shown that patients with chronic pain display altered functional connectivity across distributed brain areas involved in the processing of nociceptive stimuli. The aim of the present study was to investigate how pain chronification modulates whole-brain functional connectivity during evoked clinical an...

Study design: Retrospective analysis of longitudinal data. Objective: To evaluate clinically relevant change in surgical outcomes for Adolescents with Idiopathic Scoliosis (AIS), comparing those who achieved smallest detectable change (SDC) in pain and function at 1-year post-surgery and those who did not, and to evaluate the influencing factors...

Introduction Scoliosis Research Society-22 revised (SRS-22r) is the common questionnaire used to evaluate health related quality of life (HRQOL) for young people with adolescent idiopathic scoliosis (AIS). The aim of this study is to evaluate its content validity for this population. Methods In-depth semi-structured interviews were conducted with...

ABSTRACT Background The Cervical Radiculopathy Impact Scale (CRIS) and Patient Specific Functional Scale 2.0 (PSFS 2.0) are patient-reported outcome measures (PROMs) used to assess activity limitations in patients with cervical radiculopathy (CR). This study a) compared the CRIS subscale 3 and the PSFS 2.0 in patients with CR with respect to comple...

Psychological stress, social isolation, physical inactivity, and reduced access to care during lockdowns throughout a pandemic negatively impact pain and function. In the context of the first COVID-19 lockdown in Spain, we aimed to investigate how different biopsychosocial factors influence chiropractic patients’ pain-related outcomes and vice-vers...

Background: Work-related low-back disorders (WLBDs) are one of the most frequent and costly musculoskeletal conditions. It has been showed that WLBDs may occur when intervertebral or torso equilibrium is altered by a biomechanical perturbations or neuromuscular control error. The capacity to react to such disturbances is heavily determined by the...

Coronavirus disease (Covid-19) is a highly infectious disease caused by the SARS-CoV-2 virus and is associated with a decrease of respiratory, physical, and psychological function, subsequently affecting quality of life. The aim of the present pilot study was to use ultrasound imaging (USI) to evaluate and compare the thickness of the diaphragm and...

Background: People with whiplash-associated disorders (WAD) commonly present with a variety of physical impairments. However, the reliability of physical tests has not been established for patients with acute WAD. Objective: To assess test-retest reliability of different physical tests in acute WAD. Design: Intra-rater test-retest reliability....

Background: Measurement of neck muscle strength is common during the assessment of people with chronic neck pain (CNP). This systematic review evaluates the measurement properties (reliability, validity, and responsiveness) of neck muscle strength measures in people with CNP. Databases and data treatment: This systematic review followed a PROSPE...

Background: A substantial proportion of individuals with incomplete spinal cord injury (SCI) exhibit reduced volitional control of trunk muscles due to damage of the corticospinal tract, resulting in impaired postural control and function. Studies using conventional bipolar electromyography (EMG) showed altered activity of the trunk muscles in peop...

Background: Movement control tests (MCTs) are clinical tests to evaluate impairment of movement and associated neuromuscular control and are commonly used to evaluate people with neck pain or headache conditions. The aim of this study was to establish inter-rater reliability as well as discriminatory and predictive validity for seven MCTs of the up...

Experimental pain models are frequently used to understand the influence of pain on the control of human movement. In this systematic review, we assessed the effects of experimentally induced pain in the lumbar region of healthy individuals on trunk muscle activity and spine kinematics. Databases were searched from inception up to 31st January 2022...

Background and objective: Traumatic injuries are among the leading causes of death and disability in the world across all age groups. This systematic review aimed to (1) describe the role of post-traumatic stress symptoms (PTSS) on the development of chronic pain and/or pain-related disability following musculoskeletal trauma, and (2) report pain...

The analysis of single motor unit (SMU) activity provides the foundation from which information about the neural strategies underlying the control of muscle force can be identified, due to the one-to-one association between the action potentials generated by an alpha motor neuron and those received by the innervated muscle fibers. Such a powerful a...

The integration of electromyography (EMG) and ultrasound imaging has provided important information about the mechanisms of muscle activation and contraction. Unfortunately, conventional bipolar EMG does not allow an accurate assessment of the interplay between the neural drive received by muscles, changes in fascicle length and torque. We aimed to...

Purpose Conservative management of lumbar radiculopathy (LR) is the first treatment option. To date, systematic reviews and clinical practice guidelines have not considered the most appropriate timing of management. This study aimed to establish consensus on effective conservative treatment modalities across different stages (i.e., acute, sub-acute...

Introduction: Post-traumatic stress symptoms (PTSS) can be triggered following exposure to a traumatic event, such as violence, disasters, serious accidents and injury. Little is known about which interventions provide the greatest benefit for PTSS. This systematic review aims to estimate the effects of early interventions on PTSS following muscul...

Introduction A disturbance in exercise-induced hypoalgesia (EIH) has been observed in patients with chronic whiplash-associated disorders (WAD). Yet, no studies have examined whether EIH occurs in people with acute/subacute WAD. This study will determine whether EIH occurs immediately after and 24 hours after aerobic exercise (AE) and neck-specific...

Motor learning underpins successful motor skill acquisition. Although it is well known that pain changes the way we move, it’s impact on motor learning is less clear. The aim of this systematic review was to synthesize evidence on the impact of experimental and clinical pain on task performance and activity-dependent plasticity measures across lear...

We quantified the relationship between spatial oscillations in surface electromyographic (sEMG) activity and trunk-extension torque in individuals with and without chronic low back pain (CLBP), during two submaximal isometric lumbar extension tasks at 20% and 50% of their maximal voluntary torque. High-density sEMG (HDsEMG) signals were recorded fr...

Purpose To establish intra- and inter-session reliability of high-density surface electromyography (HDEMG)-derived parameters from the thoracic erector spinae (ES) during static and dynamic goal-directed voluntary movements of the trunk, and during functional reaching tasks. Methods Twenty participants performed: 1) static trunk extension, 2) dyna...