Mark Werneke

CentraState Medical Center · Department of Rehabilitation

Research Objectives To examine associations between frequency of telerehabilitation i.e., any few, most or all, and outcomes of functional status, number of visits, and patient satisfaction during COVID-19 and to compare functional status outcomes by telerehabilitation delivery mode i.e., synchronous, asynchronous, mixed, for patients with low back...

Research Objectives Calibrate items from the Dizziness Handicap Inventory (DHI) patient-reported outcome measure (PROM) to create an item response theory (IRT)-based item bank and assess its reliability, validity, and efficiency using computerized adaptive test (CAT) and short form (SF) administration modes. Design A retrospective cohort including...

Research Objectives To calibrate items from the original 16-item Activities-Specific Balance Confidence (ABC) Scale to create an item response theory (IRT)-based item bank and scoring metric and assess its reliability, validity, and efficiency using computerized adaptive test (CAT) and short form (SF) administration modes. Design Retrospective coh...

Objective The objective of this study was to report the item response theory (IRT) calibration of an 18-item bank to measure general physical function (GPF) in a wide range of conditions and evaluate the validity of the derived scores. Methods All 18 items were administered to a large sample of patients (n=2337) who responded to the items in the c...

We would like to thank the authors of the article ‘Pain provocation following sagittal plane repeated movements in people with chronic low back pain: Associations with pain sensitivity and psychological profiles’[1]for attempting to further explore the use and value of patient generated repeated movements in the assessment of low back pain patients...

Study Design Retrospective cohort. Background Patient-classification subgroupings may be important prognostic factors explaining outcomes. Objectives To determine effects of adding classification variables (McKenzie syndrome and pain patterns, including centralization and directional preference; Symptom Checklist Back Pain Prediction Model [SCL B...

Study Design Retrospective analysis of cross-sectional data. Objective To describe the development of a new self-report Neck Functional Status Questionnaire (NFSQ) and to assess its psychometric properties and practical application. The NFSQ was designed to assess functional status in patients with cervical (spine) disorders who seek outpatient th...

Study design: Longitudinal, prospective, observational cohort. Objective: To examine associations between McKenzie training, functional status (FS) at discharge, and number of physical therapy visits (utilization) in patients receiving physical therapy for low back pain. Background: The McKenzie method is commonly used in treating patients wit...

Study design: Retrospective cohort. Objectives: In subjects with neck pain, the present study aimed (1) to describe the prevalence of centralization (CEN), noncentralization (non-CEN), directional preference (DP), and no directional preference (no DP); (2) to determine if age, sex, fear-avoidance beliefs about physical activity, number of comorb...

Study design: Inter-rater chance-corrected agreement study. Objective: The aim was to examine the association between therapists' level of formal precredential McKenzie postgraduate training and agreement on the following McKenzie classification variables for patients with low back pain: main McKenzie syndromes, presence of lateral shift, derang...

Fecal incontinence and constipation affect men and women with all ages. Our purpose was to perform a psychometric analysis of the Fecal Incontinence and Constipation Questionnaire (FICQ) in patients seeking outpatient rehabilitation services due to pelvic floor dysfunction (PFD). Retrospective analysis of cross-sectional data from 644 patients (mea...

We are saddened by the passing of Robin Anthony McKenzie on May 13, 2013. J Orthop Sports Phys Ther 2013;43(7):442. doi:10.2519/jospt.2013.0106

In remembrance of Dennis L. Hart, PT, PhD. J Orthop Sports Phys Ther 2012;42(6):489–490. doi:10.2519/jospt.2012.0109

Retrospective analysis of longitudinal, observational cohort data. To compare discriminating ability and minimal clinically important improvement (MCII) calculated using functional status (FS) measures estimated from the lumbar computerized adaptive test (LCAT) and Modified Oswestry Low Back Pain Disability Questionnaire (ODQ). The LCAT and ODQ are...

Because multiple sclerosis (MS) is a multidimensional chronic disease, effective management of the illness requires a multidimensional approach. We describe a wellness program that was designed to facilitate positive health choices throughout the course of MS and present initial data analyses. We hypothesized that over the course of the program, pa...

Managing patients with lumbar spine syndromes who are seeking outpatient physical therapy represents a complex problem where psychosocial constructs such as fear-avoidance beliefs regarding physical activities or work activities, somatization, and depressive symptoms may affect functional status (FS) outcomes. The purpose of this study was to deter...

Prospective, longitudinal, observational cohort design. The primary aim was to examine the association between changes in psychosocial distress (PD), and functional status (FS) and pain intensity at discharge from physical therapy. Patients with lumbar impairments seeking physical therapy commonly demonstrate elevated PD. However, it is not clear i...

To estimate inter-rater agreement of physical therapists trained in MDT approach and participating in practice-based evidence (PBE) research to identify 72 physical therapy interventions in video demonstrations on a single model and clinical vignettes. PBE is a well designed observational study and demonstrating clinician observational consistency...

Develop efficient and accurate screening tools to identify elevated levels of depressive or somatization symptoms, which can adversely affect functional status outcomes. We conducted a secondary analysis of prospectively collected depressive and somatization symptoms (Symptom Checklist 90-Revised) data from 10,920 patients receiving outpatient phys...

Study design: Retrospective analysis of a prospective, longitudinal cohort study of 30 858 patients being treated for a lumbar spine dysfunction in outpatient physical therapy. Objectives: To determine effect of adding a single-item screening variable classifying patients with elevated versus not-elevated scores of fear-avoidance beliefs of phys...

Clinical guidelines advocate the routine identification of depressive symptoms for patients with pain in the lumbar or cervical spine, but not for other anatomical regions. The purpose of this study was to investigate the prevalence and impact of depressive symptoms for patients with musculoskeletal pain across different anatomical regions. Design...

Aims were (1) to determine the proportion of patients with lumbar impairments who could be classified at intake by McKenzie syndromes (McK) and pain pattern classification (PPCs) using Mechanical Diagnosis and Therapy (MDT) assessment methods, manipulation, and stabilization clinical prediction rules (CPRs) and (2) for each Man CPR or Stab CPR cate...

Outcomes instrument validation study. We evaluated administrative efficiency and psychometric adequacy of a computerized adaptive test (CAT) for patients with lumbar spine impairments seeking rehabilitation in outpatient therapy clinics. CATs promise efficient outcomes data collection in clinical applications with little loss of measurement precisi...

Prospective, longitudinal, observational cohort. Primary aims were to determine (1) baseline prevalence of directional preference (DP) or no directional preference (no-DP) observed for patients with low back pain whose symptoms centralized (CEN), did not centralize (non-CEN), or could not be classified (NC), and (2) to determine if classifying pati...

Secondary analysis of a prospective observational cohort study. To evaluate whether depression and somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R), which have been shown to identify chronic disability in individuals with nonspecific low back pain, are applicable to a different population of individuals with low back pain; and...

A computerized adaptive test (CAT) provides a way of efficiently estimating functional status in people with specific impairments. The purpose of this study was to describe meaningful interpretations of functional status (FS) estimated using a lumbar CAT developed using items from the Back Pain Functional Scale (BPFS) and selected physical function...

In the interest of full disclosure, Dr Dennis Hart is a director of Focus on Therapeutic Outcomes, Inc (FOTO), which develops outcome measures and services for physical therapy and rehabilitation . The work by Costa et al1 represents a step forward in the assessment of treatments that are helpful for patients with lumbar spine impairments. The str...

This paper traces the development, testing and use of CATs in outpatient rehabilitation from the perspective of one proprietary international medical rehabilitation database management company, Focus On Therapeutic Outcomes, Inc. (FOTO). Between the FOTO data in the United States and Maccabi Healthcare Services data in Israel, over 1.5 million CATs...

Letters to the Editor-in-Chief of the JOSPT as follows:"Centralization" and "Directional Preference" Are Not Synonyms and Author's ResponseFactor Analysis Findings for the NDI and Author's ResponseJ Orthop Sports Phys Ther 2009;39(11):827-831. doi:10.2519/jospt.2009.0204.

To (1) determine the prevalence of pain pattern classification subgroups (centralization, noncentralization, and not classified) observed during the initial evaluation of patients experiencing high versus low Fear-Avoidance Beliefs Questionnaire for physical activity (FABQ-PA) scores, (2) examine the association between discharge pain intensity and...

Screening people for elevated levels of fear-avoidance beliefs is uncommon, but elevated levels of fear could worsen outcomes. Developing short screening tools might reduce the data collection burden and facilitate screening, which could prompt further testing or management strategy modifications to improve outcomes. The purpose of this study was t...

Retrospective, observational cohort design. Purpose 1 was to determine the association between age, symptom chronicity, and prevalence of centralization in a sample of patients with nonserious cervical or lumbar spinal syndromes referred to a hospital-based outpatient rehabilitation clinic. Purpose 2 was to examine if classifying these patients at...

To equate physical functioning (PF) items with Back Pain Functional Scale (BPFS) items, develop a computerized adaptive test (CAT) designed to assess lumbar spine functional status (LFS) in people with lumbar spine impairments, and compare discriminant validity of LFS measures (theta(IRT)) generated using all items analyzed with a rating scale Item...

Tests and measures, if confounded by behavioral signs, cloud interpretation of physical test results during clinical examination. The purpose of this study was to determine whether common behavioral signs and pain responses (i.e. centralization and non-centralization) were associated during initial examination. Observational and designed to cross-t...

Quebec Task Force Classification (QTFC) and pain pattern classification (PPC) procedures, including centralization and noncentralization, are common classification procedures. Classification was done to estimate validity of data obtained with QTFC and PPC procedures for differentiating patient subgroups at intake and for use in predicting rehabilit...

Secondary analysis of a previously described cohort of prospective, consecutive patients with acute neck or low back pain referred to outpatient rehabilitation was performed. To estimate discriminant validity and relative precision of two classification procedures (first visit vs multiple visit) in discriminating short-term pain intensity and perce...

Two hundred twenty-three consecutive adults with acute low back pain with or without referred spinal symptoms were treated conservatively and followed prospectively for 1 year. To investigate the predictive value of centralization phenomenon (CP) with psychosocial variables previously identified as important risk factors for patients with acute ons...

Occurrence and treatment responses associated with the centralization phenomenon were analyzed prospectively in 289 patients with acute neck and back pain with or without referred spinal symptoms. To document symptom changes to mechanical assessment during initial evaluation and during consecutive visits. Using standard operational definitions, pat...

This prospective study investigated the relationship between behavioral sign scores (from Waddell) and the return to work status of chronic low-back pain patients who completed a work-oriented physical rehabilitation program without formal facility-related psychologic or social services. Further, the authors monitored the effect of this program on...