Kieran O'Sullivan

University of Limerick | UL · school of allied health

Context : Ladies Gaelic Football (LGF) is the fastest growing female sport in Europe and camogie is among the most popular female team sports in Ireland. Intercounty is considered the elite level, with high physical and technical demands that inevitably involve a risk of injury. At the elite level, an injury incidence as high or higher as professio...

Introduction Musculoskeletal pain is a significant public health concern in Europe. With the advent of the digital age, online health information-seeking behaviour has become increasingly important, influencing health outcomes and the ability of individuals to make well-informed decisions regarding their own well-being or of those they are responsi...

Background Chronic musculoskeletal pain is a key societal challenge in Ireland, affecting one in three adults over the age of 50, with societal and healthcare costs of over €5.34 billion per year. Physical activity can form a key part of the management of people living with chronic pain, along with providing a myriad of health-enhancing and disease...

A sports injury need not imply objective or subjective signs of tissue damage. Pain and impaired performance can count as an injury, which is often measured by the inability to play or participate in training and/or competition. Pain in the presence, and in the absence, of objective tissue damage is common in sports, but there are important differe...

Aim To summarize current literature on the definition, categorization and measurement of social support in studies of work‐related musculoskeletal disorders among hospital nurses. Design A scoping review. Data Sources A literature search of four databases (CINAHL, Medline, Embase and Web of Science) was employed to map the evidence between Januar...

Background Disordered sleep and persistent musculoskeletal pain are highly comorbid. Behavioural interventions such as Cognitive Behavioural Therapy for Insomnia (CBT-I) have shown promise in the management of both disordered sleep and persistent musculoskeletal pain. The aim of this review was to examine how CBT-I is delivered in randomised contro...

Background Parents may seek out health information online when their adolescent has nonspecific back pain to better understand treatment options. Such information directed towards consumers has not been previously analysed. Methods A descriptive cross‐sectional content analysis was performed to describe the treatments recommended on consumer websi...

Objective To systematically map the coach education (CE) component of injury prevention programmes (IPPs) for youth field sports by identifying and synthesising the design, content and facilitation strategies used to address competency drivers and behaviour change. Design Scoping review. Data sources PubMed, PsycInfo, EMBASE, CINAHL, SportDiscus...

Background There is limited knowledge about when and how adolescents with low back pain (LBP) interact with health care providers. This limits our understanding of how to best help these young patients. This study aimed to understand when and how care-seeking adolescents with LBP interact with health care providers and which health literacy compete...

Background The paraspinal muscles, including multifidus (MF) and erector spinae (ES) play key roles in the stability and movement of the lumbar spine. This study aimed to determine the intra-rater reliability of the ES and MF muscle thickness measures of the rehabilitative ultrasound imaging (RUSI) in people with active extension pattern (AEP) non-...

The study compared superficial trunk muscle activity and postural control among an active extension subgroup of people with nonspecific chronic low back pain (AE-NSCLBP) with painfree controls during functional tasks. Thirty-two people (17 people with low back pain [LBP] and 15 painfree controls) participated in this study. Muscle activity of 5 tru...

OBJECTIVE: To identify which psychological and psychosocial constructs to include in a core outcome set to guide future clinical trials in the tendinopathy field. DESIGN: Modified International Delphi study. METHODS: In 3 online Delphi rounds, we presented 35 psychological and psychosocial constructs to an international panel of 38 clinician/resear...

Aims: Low back pain (LBP) is a common health problem in pre-professional dancers which could hamper the dancers' professional career. However, pre-professional dancers are not often studied, although they may have their own pain perceptions and coping strategies towards LBP. Considering the biopsychosocial nature of LBP, it is important to increas...

PURPOSE: As a result of COVID-19 and the associated lockdowns in Ireland limited rugby training and matches occurred during the 2020/21 nine-month season (September to May). In October 2020 collective training and rugby matches were suspended for the season. This study aimed to assess the potential impact of this lack of training and playing on mat...

Objective: The study explores the attitudes of people with chronic health conditions towards the use of group-based telerehabilitation. Design: A qualitative research study. Setting: The setting involved semi-structured focus groups via videoconferencing software. Participants: A purposive sample of 18 people with chronic health conditions i...

We evaluated the effects of Cognitive Behavioural Therapy (CBT) alone or with additional interventions on pain, disability, kinesiophobia, anxiety, stress, depression, quality of life, and catastrophizing of patients with chronic neck pain (CNP). Nineteen studies met the inclusion criteria, and fourteen studies were quantitatively analysed. Risk of...

Purpose: Building clinical reasoning skills is important to effectively implement psychologically informed practice. We developed a multidimensional clinical reasoning form (CRF) to be used by physiotherapists in a psychologically informed practice training programme for low back pain. In this paper we describe the development of the CRF, how the...

PURPOSE: This study aimed to establish the profile of injuries sustained in Senior Cup schoolboy (under 19) Rugby Union in accordance with the definition of injury outlined in the 2007 World Rugby Consensus Statement. To design and implement efficacious injury prevention strategies, the scope of injury risk must be established. METHODS: Schools par...

Background: Low back pain is the leading cause of years lived with disability globally, but most interventions have only short-lasting, small to moderate effects. Cognitive functional therapy (CFT) is an individualised approach that targets unhelpful pain-related cognitions, emotions, and behaviours that contribute to pain and disability. Movement...

Objectives: To describe injury incidence and surveillance practices in elite adult female field-based team sports. Design: Systematic literature review. Methods: This review was prospectively registered (PROSPERO CRD42022318642). CINAHL, PubMed, MEDLINE, Scopus, SPORTDiscus, Web of Science, Open Grey and Google Scholar were searched from incep...

Purpose: The six-minute walk test (6MWT) can assess walking function but is time-consuming. We investigate the correlation of performance over the first two minutes of the 6MWT (2MWT#) and the 6MWT. We also evaluate the 2MWT#'s ability to predict 6MWT results, assess correlations to secondary explanatory outcomes, and assess the ability to discrim...

Background and objectives: Persistent non-specific back pain is now established as a biopsychosocial phenomenon that can be meaningfully affected by individuals' cognitions, emotions, lifestyle factors, and family and social relationships. Recent guidelines for the treatment of adolescents with persistent non-specific back pain, as well as those f...

Objective To highlight the necessity for on-going vigilance of serious pathology when assessing and managing people with spinal pain. Methods A case report of a young male patient who sought physiotherapy treatment for his acute thoracic pain. Following physiotherapy assessment, it seemed unlikely that the pain was related to a musculoskeletal pro...

Background Telehealth could enhance rehabilitation for people with chronic health conditions. This review examined the psychometric properties of performance-based measures of physical function administered via telehealth among people with chronic health conditions using the Consensus-Based Standards for the Selection of Health Measurement Instrume...

Objectives To describe the epidemiology of back injury in elite male Gaelic football athletes between 2008-2016. Design Prospective cohort study. Setting Injury data from the National GAA Injury Surveillance Database. Participants Elite male Gaelic football athletes. Main outcome measures Incidence of injury as a rate per 1000 hours of exposure...

Objective Low back pain (LBP) is highly prevalent in rowing and can be associated with significant disability and premature retirement. A previous qualitative study in rowers revealed a culture of concealment of pain and injury due to fear of judgement by coaches or teammates. The aim of this study was to explore rowers' perspectives in relation to...

Background Back pain (BP) is a major cause of absenteeism in National Health Service (NHS) staff in the UK. However, the back beliefs of NHS staff with BP are unknown. Objectives To explore the BP beliefs of UK NHS staff presenting with BP, and how these beliefs are constructed. Method Purposive sampling of NHS staff with BP who had self-referred...

Background Eccentric exercise is thought to improve joint flexibility, but the size of the effect is not known. We aimed to quantify the overall effect of eccentric exercise on joint flexibility in adults. Design Systematic review, meta-analysis. Data sources AMED, CINAHL, MEDLINE, EMBASE, SportDiscus. Participants Adults. Intervention Eccentri...

Objective: To compare muscle strength and flexibility among a subgroup of women with extension-related chronic nonspecific low back pain (CNLBP) with healthy controls. Methods: In this case-control study, 32 subjects with and without extension-related CNLBP were tested (n = 16 in each group). Gluteal, abdominal, paravertebral, and hamstring stre...

Purpose: To investigate the impact of eastward travel across 7 time zones on sleep, jet lag, and recovery in elite soccer athletes. Methods: Twenty-one male and 20 female athletes (21.5 [1.7] y) traveled from Ireland to Taiwan to represent their national team at the World University Games 2017. Daily monitoring via actigraphy and subjective slee...

Background Rates of injury among endurance sporting participants are high, as are subjective health complaints (SHCs - e.g. poor sleep, low mood). However, there is limited prospective data evaluating the relationship between SHCs and rates of new injury. Objective To examine longitudinal associations between SHCs, sleep quantity and new injury wi...

Guidelines advocate a combined physical and psychological approach to managing non-specific chronic low back pain (NSCLBP), referred to as psychologically informed practice (PIP). PIP is underpinned by patient-centered principles and skilled communication. Evidence suggests that a physiotherapist-focused style of communication prevails in physiothe...

Objectives To quantify the incidence, location and severity of injuries in Gaelic football and to identify potential moderators of those injuries. Design Systematic review and meta-analysis. Methods A comprehensive search strategy of six electronic databases was undertaken independently by two researchers in March 2020. Studies must have prospect...

Purpose Psychological, social and lifestyle (multidimensional) factors predict low back pain (LBP). The Short Form Örebro Musculoskeletal Questionnaire (SFÖQ) helps clinicians identify these factors in people with LBP and was mandated in a physiotherapy department at one NHS Hospital Trust in the UK. This study examined (i) use of the SFÖQ by physi...

Background The shoulder has been reported as a frequent location of injury in adult professional and amateur rugby, with match injury incidence rates ranging from 1.8 to 3 per 1000 player-hours (h). An increased understanding of the incidence and mechanism of shoulder injuries in school rugby players is vital to establish effective injury preventiv...

Athletes are increasingly required to travel domestically and internationally, often resulting in travel fatigue and jet lag. Despite considerable agreement that travel fatigue and jet lag can be a real and impactful issue for athletes regarding performance and risk of illness and injury, evidence on optimal assessment and management is lacking. Th...

Lumbo-pelvic proprioception in sitting is impaired in subgroups of low back pain-But the clinical utility of the differences is unclear. A systematic review and meta-analysis

Background This study describes the use of complementary and alternative medicine (CAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report CAM use is also examined. Methods Cross-sectional European Social Survey Round 7...

BACKGROUND: Combined physical and psychological programmes (CPPP) are recommended for people with disabling low back pain (LBP). Cognitive Functional Therapy (CFT) is a physiotherapist-led low intensity CPPP with positive effects in previous studies. The clinical and cost effectiveness of CFT has not previously been evaluated in a randomised contro...

Background Altered spinal postures and altered motor control observed among people with non-specific low back pain have been associated with abnormal processing of sensory inputs. Evidence indicates that patients with non-specific low back pain have impaired lumbo-pelvic proprioceptive acuity compared to asymptomatic individuals. Objective To syst...

Background While pain is common in older adults, the association with physical activity is unclear. Currently, the role physical activity plays in impacting pain developing over time is not well‐defined. Methods Latent transition analysis (LTA) is a model‐based approach to identifying underlying subgroups in a population, longitudinally, based on...

Work absence due to back pain is best predicted by beliefs and attitudes. Lots of money is spent on training in the NHS trying to prevent back pain; this study explores the effect of that training on back pain beliefs. 151 NHS employees were surveyed using the Back Pain Attitudes Questionnaire before and after manual handling training. NHS employee...

OBJECTIVE To systematically review the efficacy of blood flow restriction training (BFRT) on individuals with knee osteoarthritis (OA). DESIGN Systematic review with meta-analysis. LITERATURE SEARCH Eight electronic databases were searched by one researcher. STUDY SELECTION CRITERIA Randomised clinical trials (RCTs) comparing BFRT to regular res...

In late 2019, a previously unknown coronavirus, SARS-CoV-2 (the coronavirus that causes COVID-19), was reported in Wuhan, China. Similar to the polio virus epidemic, the fear, uncertainty, and collective response associated with COVID-19 have disrupted daily life on a global scale. In this editorial, we argue that it is time for musculoskeletal phy...

Background While pain is very common in older adults, the associated impact on daily life, including usage of medication and healthcare, varies considerably and often pain remains inadequately treated. It is not clear what is associated with this variation. Methods Latent class analysis (LCA) is a model‐based approach to identifying underlying sub...

Objective To evaluate the reporting of eligibility criteria and baseline participant characteristics in randomised controlled trials investigating the effects of exercise interventions in tendinopathy. Methods Randomised controlled trials investigating the effects of exercise therapy compared to a non-exercising intervention in upper and lower lim...

Objectives: Limited research has been conducted on sleep problems in elite athletes at international competition, and how this relates to their general health and well-being. Methods: Sixty-five elite international athletes (37 males, 28 females, 21.8 ± 2.1 years) from different sports completed validated sleep (Athlete Sleep Screening Questionnair...

Objective Tendinopathy is often a disabling, and persistent musculoskeletal disorder. Psychological factors appear to play a role in the perpetuation of symptoms and influence recovery in musculoskeletal pain. To date, the impact of psychological factors on clinical outcome in tendinopathy remains unclear. Therefore, the purpose of this systematic...

Objectives: Low back pain (LBP) is common in rowers and leads to considerable disability and even retirement. The athlete voice can help clinicians to better understand sport-related pain disorders. We aimed to capture the lived experience of LBP in rowers. Methods: Cross-sectional qualitative study using a grounded theory approach. Adult compet...

Objective: Persistent low back pain (PLBP) is a common and costly health problem worldwide. Better strategies to manage it are required. The purpose of this study was to longitudinally evaluate absenteeism, pain, and disability in nurses with PLBP following a cognitive functional therapy (CFT) intervention. Methods: In this case-series pilot stu...

Purpose Despite widespread use, the impact of manual handling (MH) training on low back pain (LBP) beliefs is unclear, with some data suggesting MH instructors hold outdated beliefs about LBP. This study aimed to examine the effect of MH training on a range of LBP beliefs. Materials and methods Ethics committee approval (University of Limerick) wa...

Background: Previous studies have found a negative association between a conditioning pain modulating (CPM) response and pain catastrophizing among pain-free subjects. This study investigated the difference in CPM response between patients with chronic low back pain (CLBP) and healthy controls, and the association between pain catastrophizing and...

Aim: To compare repositioning error, habitual and self-perceived optimal sitting posture, between patients with low back pain presenting with a directional preference into extension and asymptomatic individuals. Method: Fifteen patients with low back pain were matched with 15 asymptomatic individuals. Lumbo-pelvic repositioning error, pain, functio...

Background: Cognitive Functional Therapy (CFT) is a physiotherapist-led individualized intervention for people with people with non-specific chronic low back pain (CLBP), involving biopsychosocial pain education, graded movement exposure and lifestyle coaching. Methods: A multicentre randomized controlled trial (RCT), including 206 participants...

Introduction: The purpose of this study was to investigate the effects of shortened-length versus through-range exercise training on upper quarter posture in primary school students with Forward Head Posture (FHP). Materials and Methods: Sixty pain-free participants with FHP were randomly allocated to one of three groups; shortened-length training...

Introduction: The purpose of this study was to investigate the effects of shortened-length versus through-range exercise training on upper quarter posture in primary school students with Forward Head Posture (FHP). Materials and Methods: Sixty pain-free participants with FHP were randomly allocated to one of three groups; shortened-length training...

Background and aims To systemically review the literature to compare freestyle lifting technique, by muscle activity and kinematics, between people with and without low back pain (LBP). Methods Five databases were searched along with manual searches of retrieved articles by a single reviewer. Studies were included if they compared a freestyle lift...

Background: Pain is common in older adults, and associated with increased morbidity and reduced quality of life. Recent research has highlighted different classes of older adults with pain, each with differing impacts on their life. It has not yet been investigated if, and how, such classes change over time and what influences individuals to prosp...

Objectives: To examine the association between subjective health complaints, sleep quantity and new injury within an endurance sport population. Design: Prospective cohort study. Methods: Ninety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Over 52-week period participant...

Background One-size-fits-all interventions reduce chronic low back pain (CLBP) a small amount. An individualised intervention called cognitive functional therapy (CFT) was superior for CLBP compared with manual therapy and exercise in one randomised controlled trial (RCT). However, systematic reviews show group interventions are as effective as one...

Purpose: Physiotherapists often feel insecure when managing patients with chronic low back pain associated with psychological factors. This uncertainty could hinder physiotherapists in fostering strong patient-therapist alliances in chronic low back pain practice. The purpose of this study was to explore associations between patient-rated alliance,...

Purpose: The purpose of this study was to compare kinematics of the lower extremity and lumbar spine during a single leg landing task between female volleyball athletes with and without persistent low back pain (LBP). Methods: In this cross sectional study, 36 volunteer female volleyball athletes with (n = 18) and without (n = 18) LBP were recru...

Objectives: To investigate dance exposure, sleep, general health and injury in elite adolescent Irish dancers. Design: Prospective study. Setting: Six Irish dance schools in Ireland. Participants: Thirty-seven elite Irish dancers, aged 13-17, competing at the highest championship level for at least the previous year. Main outcome measures:...

Background : Guidelines advocate that non-specific chronic low back pain (NSCLBP) be considered within a multi-dimensional bio-psychosocial (BPS) framework. This BPS approach advocates incorporating the patient's perspective as part of the treatment process. 'Agenda setting' has been introduced as the key to understanding patients' concerns in medi...

Background: Persistent strength deficits secondary to Achilles tendinopathy (AT) have been postulated to account for difficulty engaging in tendon-loading movements, such as running and jumping, and may contribute to the increased risk of recurrence. To date, little consensus exists on the presence of strength deficits in AT. Consequently, researc...

Posture is a frequent topic of discussion for patients, clinicians, the media, and society. A common belief is that spinal pain is caused by sitting, standing, or bending "incorrectly." Despite the absence of strong evidence to support these common beliefs, a large posture industry has flourished, with many interventions and products claiming to "c...

Introduction Low back pain (LBP) is the leading cause of disability globally and its costs exceed those of cancer and diabetes combined. Recent evidence suggests that individualised cognitive and movement rehabilitation combined with lifestyle advice (cognitive functional therapy (CFT)) may produce larger and more sustained effects than traditional...

Objectives: To investigate the prevalence of clinically relevant sleep problems in elite multi-sport athletes and their associations with sleep hygiene, general health, mood, chronotype, and injury. Design: Cross-sectional study. Setting: During the competitive season in athletes' home environment. Participants: Elite multi-sport Irish athle...

Aim: To investigate the beliefs of healthcare students about how harmful common daily activities are perceived to be for their lower back. Method: A cross-sectional survey of Physiotherapy, Occupational Therapy and General Nursing pre-registration students in Ireland. Two hundred and forty two students completed the modified Photograph Series of Da...