Gwendolen Jull

University of Queensland | UQ · School of Health and Rehabilitation Sciences

OBJECTIVES: To (1) investigate whether different labels for neck pain after a motor vehicle crash (MVC) influenced recovery expectations and management beliefs, (2) explore reasons for low recovery expectations and greater likelihood for lodging a claim, and (3) explore the moderating effect of neck pain history and sociodemographic characteristics...

BACKGROUND Musculoskeletal conditions, including low back pain (LBP), neck pain and knee osteoarthritis, are the greatest contributors to years lived with disability worldwide. Resources aiming to aid both patients and healthcare professionals (HCPs) exist but are poorly implemented and adopted. OBJECTIVE To develop and implement MyPainHub, an evi...

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: Neck pain is one of the most common and burdensome symptoms associated with migraine. Many individuals with migraine and neck pain seek neck treatment, but evidence for such treatment is limited. Most studies have treated this population as a homogenous group, providing uniform cervical interventions that have yet to show clinically...

Introduction: Cervicogenic headache, first proposed as a distinct headache in 1983, is a secondary headache to a primary cervical musculoskeletal disorder. Research into physical impairments was integral to clinical diagnosis and to develop and test research informed conservative management as the first line approach. Purpose: This narrative pre...

Inconsistent reporting of outcomes in clinical trials of treatments for whiplash associated disorders (WAD) hinders effective data pooling and conclusions about treatment effectiveness. A multidisciplinary International Steering Committee recently recommended 6 core outcome domains: Physical Functioning, Perceived Recovery, Work and Social Function...

Background: Manual scapular repositioning may result in change in neck pain and cervical rotation range. However, the reliability of such changes performed by examiners remains unknown. Objective: To evaluate the reliability of changes in neck pain and cervical rotation range following manual scapular repositioning performed by two examiners and...

Background: A common observation in persons with neck pain is scapular downward rotation (SDR) with altered muscle behavior. Evidence of changes in axioscapular muscles in neck pain patients remains inconclusive, which may reflect population heterogeneity in previous studies. Research question: Are there differences in behavior of the axioscapul...

Background Local neck treatments and sensorimotor training can improve cervical proprioception and balance, but it remains unclear what treatments and treatment combination achieve the best outcomes. Objectives To investigate the most effective interventions to improve disturbances in joint position sense (JPS) and balance and their effects on nec...

Background Currently, teaching methods for developing physical assessment and palpation skills in manual therapy is challenging for both learners and educators. 3D digital technologies such as virtual reality (VR) may facilitate and/or address these challenges. However, their current usage in improving learning outcomes in manual therapy education...

Chronic non-specific neck pain (CINP) is common, but the etiology remains unclear. This study aimed to examine the relationship between cervical muscle composition (cervical multifidus and longus capitis/longus colli), morphometry, range of movement, muscle function, and disability severity (Neck Disability Index) in patients with CINP. Methods: Fr...

Objectives To systematically identify, synthesise and appraise studies on the measurement properties of patient reported outcome measures (PROMs) for anxiety, depression, fear of movement, pain catastrophizing, posttraumatic stress, self-efficacy, and stress in people with whiplash associated disorders (WAD). Study design and setting PsycINFO, Med...

Background Clavicular and scapular orientations vary between neck pain patients as do clinical features and responses (changes in pain and rotation range) to scapular repositioning. Associations between these factors are unknown. Objectives To identify subgroups of neck pain patients based on three-dimensional (3D) measures of clavicular and scapu...

Chronic neck pain is associated with sensorimotor dysfunctions, which may develop symptoms, affect daily activities, and prevent recovery. Feasible, reliable, and valid objective methods for the assessment of sensorimotor functions are important to identify movement impairments and guide interventions. The aim of this study was to investigate the d...

Background Scapular dyskinesis is often observed in patients with neck pain. However, it is unknown whether clavicular, scapular and spinal kinematics vary with different types of scapular dyskinesis during arm movement. Research question Are there differences in clavicular, scapular and spinal kinematics during unilateral arm elevation and loweri...

Background Establishing a set of uniform classification criteria (CC) for cervical radiculopathy (CR) is required to aid future recruitment of homogenous populations to clinical trials. Objectives To establish expert informed consensus on CC for CR. Design A pre-defined four round e-Delphi study in accordance with the guidance on Conducting and R...

Background and aims: Pain drawings are commonly used in the clinical assessment of people with cervical radiculopathy. This study aimed to assess: 1) the agreement of clinical interpretation of pain drawings and MRI findings in identifying the affected level of cervical radiculopathy 2) the agreement of these predictions based on the pain drawing...

Objective: The Neck Disability Index (NDI) is a self-rated disability tool originally developed for whiplash associated disorders and validated in cervical musculoskeletal conditions. It is now commonly used to assess neck disability in migraine but it is unknown whether NDI scores relate to migraine and hypersensitivity, cervical musculoskeletal...

Background Clinicians seek to identify associations between pain behaviours to understand if symptoms are related or separate conditions. This study determined whether the temporal behaviour of migraine related neck pain related to i) the presence of cervical musculoskeletal function or ii) migraine hypersensitivity. Methods Cross-sectional study...

Background: Currently, teaching methods for developing complex physical assessment and palpation skills in manual therapy is challenging for both learners and educators. 3D digital technologies such as virtual reality (VR), augmented reality (AR) and mixed reality may facilitate and/or address these challenges. However, their current usage and/or r...

Background Neck pain is common and disabling amongst individuals with migraine. Cervical musculoskeletal interventions are often sought but there is currently no evidence to support such interventions for this population. Improved understanding of how cervical musculoskeletal impairments present in migraine can elucidate neck pain mechanisms and gu...

Objective To investigate the frequency and clinical aspects of patients with neck pain who responded and did not respond to scapular repositioning and to determine the clinical features associated with a positive response. Design Cross-sectional study. Setting Research unit, Department of Physical Therapy, Chiang Mai University. Participants Vol...

Introduction Musculoskeletal (MSK) conditions constitute the highest burden of disease globally, with healthcare services often utilised inappropriately and overburdened. The aim of this trial is to evaluate the effectiveness of a novel clinical PAthway of CarE programme (PACE programme), where care is provided based on people’s risk of poor outcom...

Biomechanical modelling and physiological studies suggest that various spinal muscle layers differ in their contribution to spine movement and stiffness. This study aimed to investigate the activation of deep and superficial muscles in stable and unstable task conditions. Nine healthy participants performed a task of controlling a metal ball on a p...

Objectives To compare neck, trunk, and lower extremity muscle activity in standing in persons with neck pain (NP) to healthy controls and determine associations with postural sway. Methods Participants included 25 persons with NP and 25 controls. Surface electromyography was recorded bilaterally from neck (sternocleidomastoid, SCM; splenius capiti...

Ist die Kritik an Hands-on berechtigt und sollten wir sie aus der physiotherapeutischen Praxis verbannen? Prof. em. Dr. Gwendolen Jull aus Australien argumentiert evidenzbasiert pro Hands-on: Der Beitrag der Manuellen Therapie (MT) ist ihrer Meinung nach zu wertvoll, um darauf verzichten zu können. Der Nutzen der MT ist belegt und die Forschung ist...

Objective: To identify how frequently the neck pain associated with migraine presents with a pattern of cervical musculoskeletal dysfunction akin to cervical musculoskeletal disorders, and to determine if pain hypersensitivity impacts on cervical musculoskeletal function in persons with migraine. Background: Many persons with migraine experience...

Objectives Neck pain commonly accompanies recurrent headaches such as migraine, tension-type and cervicogenic headache. Neck pain may be part of the headache symptom complex or a local source. Patients commonly seek neck treatment to alleviate headache, but this is only indicated when cervical musculoskeletal dysfunction is the source of pain. Clin...

Abstract Objectives: The purpose of this systematic review is to identify and synthesize studies evaluating performance-based functional outcome measures designed to evaluate the functional abilities of patients with neck pain. Design: Systematic review Data Sources: A literature search using PubMed, Scopus, CINAHL, EMBASE, COCHRANE, Google Scholar...

Objective The purpose of this systematic review was to critically appraise and synthesise the psychometric properties of Global Rating of Change (GROC) scales for assessment of patients with neck pain. Design Systematic review. Data sources A search was performed in four databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019. Data extra...

Background The popularity of the Internet as a source of health-related information for low back pain (LBP) is growing. Although research has evaluated information quality in health-related websites, few studies have considered whether content and presentation match consumer preferences. Objective The aim of this study was to evaluate whether LBP...

People with back pain regularly search for information online; however, the quality of this online information is often poor. We established a list of the most important messages about diagnosis, imaging, and self-care for people with low back pain, based on consensus opinion and prioritised in order of importance. A list of key messages was derive...

Objective: Inconsistent reporting of outcomes in clinical trials of treatments for Whiplash Associated Disorders (WAD) hinders effective data pooling and conclusions that can be drawn about the effectiveness of tested treatments. The aim of this study was to provide recommendations for core outcome domains that should be included in clinical trial...

Aims: Neck pain is common in migraine and tension type headache (TTH). This review aimed to examine the evidence for cervical musculoskeletal impairments in these headaches. Methods: Databases PubMed (Medline), EMBASE, CINAHL, SCOPUS, and Web of Science were searched from inception to December 2018. Observational studies using a comparator group...

Sensorimotor control of neck muscles differs between individuals with and without pain. Differences in the primary motor cortex (M1) maps of these muscles may be involved. This study compared M1 representations of deep (DNF) and superficial (SNF) neck flexor muscles between 10 individuals with neck pain (NP) and 10 painfree controls. M1 organisatio...

Objectives: Headaches can be associated with rhinosinusitis and may present a diagnostic challenge because of symptomatic overlap with other recurring headaches. Neck pain has received extensive attention in migraine, tension-type and cervicogenic headache but not as a comorbid feature of headache in those with rhinosinusitis. This study investigat...

Background Neck pain is a major health issue with high rates of recurrence. It presents with a variety of altered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods are used. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review has assessed the effect of exerc...

Neck pain commonly accompanies migraine and tension-type headache, but the literature is divided on whether this neck pain is a headache symptom or is associated with cervical musculoskeletal dysfunction. Clarification is essential for hypotheses on the pathogenesis of these headaches and their variants and for decisions on suitability of local nec...

Background: Impaired cervical joint position sense and balance are associated with neck pain. Specific therapeutic exercise and manual therapy are effective for improving neck pain and functional ability but their effects on joint position sense and balance impairments remain uncertain. Changes in the joint position sense and balance may need to b...

Background: Neck muscle vibration can influence cervical proprioception and sensorimotor function. It is hypothesized to affect motor performance differently in persons with and without neck pain. Study design: Cross-sectional study. Objective: To clarify the extent to which vibration-induced motor responses of neck muscles affect static stand...

As a potential high-yield tool for disseminating information that can reach many people, social media is transforming how clinicians, the public, and policy makers are educated and find new knowledge associated with research-related information. Social media is available to all who access the internet, reducing selected barriers to acquiring origin...

Objective: To determine the distribution of higher psychological risk features within movement-based subgroups for people with Low Back Pain (LBP) DESIGN: Cross-sectional observational study SETTING: Participants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiot...

Background: Little is known of how different psychosocial factors relate with movement-based low back pain (LBP) subgroups Objective: To determine the distribution of higher psychological risk features within movement-based subgroups Design: Cross-sectional observational study Methods: 102 people seeking treatment for LBP, recruited from physiothe...

The biopsychosocial model came to prominence in 1977 when it was introduced by Engel1 who argued against the reductionist biomedical model of disease and for concomitant consideration of behavioural, psychological and social dimensions in understanding a person's medical condition. This conceptual model was initially proposed within the field of ps...

Rapid advances in the basic, clinical, and behavioral sciences are molding developments in conservative management of musculoskeletal disorders. Curiously, there seems to be discord developing between approaches to the assessment and management of patients, depending on whether they present with an extremity or spinal disorder. This viewpoint will...

There have been many advances in the management of neck pain disorders, but a personal frustration as a clinician and researcher in the field is that the incidence of full recovery following a whiplash injury as a result of a motor vehicle crash has not increased and, subsequently, the rate of transition to chronic neck pain has not lessened. The c...

Background The evidence for the effect of treatments of neck pain is modest. In the absence of causal treatments, a possibility is to tailor the treatment to the individuals’ functional limitations and symptoms. The aim was to evaluate treatment effects of a tailored treatment versus a non-tailored treatment. Our hypothesis was that tailored treatm...

Background context: A previous study demonstrated that in seniors, the presence of cervical musculoskeletal impairment was not specific to cervicogenic headache but was present in various recurrent headache types. Physiotherapy treatment is indicated in those seniors diagnosed with cervicogenic headache but could also be adjunct treatment for thos...

Background: Continuing professional development (CPD) is a fundamental component of physiotherapy practice. Follow-up sessions provide opportunity for the refinement of skills developed during CPD workshops. However, it is necessary to identify if such opportunity translates to improved physiotherapist performance and patient outcomes. Objectives:...

Background: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. Objectives: To identify which physical examinati...

Background: The craniocervical flexion test assesses the deep cervical flexor muscles (longus capitis, longus colli). Ideally, electromyography (EMG) studies measure activity in both deep and superficial (sternocleidomastoid, anterior scalene) flexors during the test, but most studies confine recordings to superficial muscle activity as the techni...

Objective To investigate whether a 12-week physical therapist-delivered combined pain coping skills training and exercise (PCST+EX) is more efficacious and cost-effective than either treatment alone for knee OA.Methods This was an assessor-blinded, 3-arm randomized controlled trial in 222 (73 PCST+EX, 75 EX, 74 PCST) people aged ≥50 years with knee...

Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood. This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and foll...

Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin...

Classification systems for low back pain (LBP) aim to guide treatment decisions. In physiotherapy, there are five classification schemes for LBP which consider responses to clinical movement examination. Little is known of the relationship between the schemes. To investigate overlap between subgroups of patients with LBP when classified using diffe...

Study design: Retrospective secondary analysis of data. Objectives: To investigate the external validity of the whiplash clinical prediction rule (CPR). Background: We recently derived a whiplash CPR to consolidate previously established prognostic factors for poor recovery from a whiplash injury and predicted 2 recovery pathways. Prognostic f...

To investigate changes in clinical (physical and psychological) features of individuals with chronic whiplash associated disorder who had previously underwent cervical radiofrequency neurotomy at the time point when the effects of radiofrequency neurotomy had dissipated and pain returned. Prospective cohort observational trial of consecutive patien...

People with low back pain (LBP) seek education and information from the Internet. Existing LBP websites are often of poor quality, and disparities have been identified between patient and health-care provider evaluations of LBP websites. This study aimed to identify health-care provider perspectives on desirable content for a proposed LBP website a...

This preliminary study determined if magnetic resonance imaging (MRI) markers of cervical muscle degeneration [elevated muscle fatty infiltration (MFI), cross-sectional area (CSA), and reduced relative muscle CSA (rmCSA)] could be modified with exercise in patients with chronic whiplash. Five women with chronic whiplash undertook 10 weeks of neck e...

Background: Apart from the cranio-cervical flexion test and the deep neck flexor endurance test, evidence related to reliability of cervical movement control dysfunction tests is lacking. Objectives: This study investigated the inter- and intra-tester reliability of a battery of cervical movement control dysfunction tests and the effect of clini...