Peter B O'Sullivan

Curtin University · School of Physiotherapy and Exercise Science

Lumbar side bending movements coupled with extension or flexion is a known low back pain (LBP) risk factor in certain groups, for example, athletes participating in sports such as hockey, tennis, gymnastics, rowing and cricket. Previous research has shown that sagittal spinal postures influence the degree of spinal rotation, with less rotation demo...

The primary objective of this study was to determine the lifetime and point prevalence of low back pain, the related pain intensity and the rowing-related aggravating factors for low back pain in adolescent rowers who participated in school-level competitions. The secondary objective was to determine whether between-gender differences existed in th...

This study compared regional lumbar (upper and lower), pelvis, trunk and lower limb kinematics between elite male adolescent players with and without a history of LBP during the kick and flat serves, as well as regional lumbar mobility and serving kinematics relative to end range. Seven players with a history of LBP and confirmed L4/L5 injury and 1...

Unlabelled: A total of 24 participants with non-specific chronic low back pain (NSCLBP) sat for 2 h while their seated posture and low back discomfort (LBD) were analysed. A total of 16 pain developers (PDs), whose LBD increased by at least two points on the numeric rating scale, repeated the procedure 1 week later, while receiving postural biofee...

Sit-to-stand (STS) is a functional dynamic task, requiring movement of the lumbar spine, however, little is known about whether regional differences or between-gender differences exist during this task. The aim of this study was to confirm whether kinematic differences existed within regions of the lumbar spine during STS and also to determine whet...

Cognitive functional therapy (CFT) is a person-centered biopsychosocial physiotherapy intervention that has recently demonstrated large, durable effects in reducing pain and disability in people with chronic low back pain (CLBP). However, exploration of the treatment process from the patients’ perspectives, including the process of gaining control...

Objective The objective was to investigate the effectiveness of cognitive functional therapy (CFT) in the management of people with chronic nonspecific low back pain (LBP) and explore the variability in available trials to understand the factors which may affect the effectiveness of the intervention. Methods A systematic review with meta-analyses...

Purpose: Psychosocial factors are a barrier to recovery for people with musculoskeletal pain and psychosocial screening tools are consistently recommended by best practice guidelines to assist in identification. However, many physiotherapists do not use these tools. Presently, the perspectives on psychosocial screening tools of Australian physioth...

OBJECTIVE: To investigate forward bending range of motion (ROM) and velocity in patients with low back pain who were receiving Cognitive Functional Therapy and determine (1) the amount and timing of change occurring at the trunk and pelvis (global angles), and lumbar spine (intersensor angle), and (2a) differences in changes between participants wi...

Background Wearable sensor technology may allow accurate monitoring of spine movement outside a clinical setting. The concurrent validity of wearable sensors during multiplane tasks, such as lifting, is unknown. This study assessed DorsaVi Version 6 sensors for their concurrent validity with the Vicon motion analysis system for measuring lumbar fle...

Phase: Australian people living with chronic pain (n=206; 90% female) and carers (n=10; 40% female) described their pain care priorities (eDelphi, Round 1). A coding framework was inductively derived from 842 pain care priorities (9 categories, 52 priorities) including: validation; communication; multidisciplinary approaches; holistic care; partne...

Objectives Previous studies in a high-income country have demonstrated that people with and without low back pain (LBP) have an implicit bias that bending and lifting with a flexed lumbar spine is dangerous. These studies present two key limitations: use of a single group per study; people who recovered from back pain were not studied. Our aims wer...

Study design: Multiround wiki-based Delphi expert panel survey. Objective: To provide proof of concept for an alternative method for creating sets of nationally-agreed point-of-care clinical indicators, and obtain consensus among end-user groups on "appropriate care" for the assessment, diagnosis, acute, and ongoing care of people with low back...

Objective To investigate how often changes in an individual's volitional spinal movement related to changes in low back pain and activity limitation in studies that accommodated individual heterogeneity. Design Etiology systematic review. Literature Search MEDLINE, Embase, CINAHL, and AMED were searched from inception to January 2020. Study Sele...

Objective The purpose of this study was to determine whether sagittal neck sitting posture subgroup membership in late adolescence was a risk factor for persistent neck pain (PNP) in young adults. Methods There were 686 participants enrolled in the Raine study at the 17- and 22-year follow-ups. At 17 years of age, posture was measured by photograp...

Are you careful with how you label an athlete’s pain? Musculoskeletal pain in athletes is common, but not always associated with injury (ie, tissue damage).1 Damage occurs when load exceeds tissue tolerance, such as ligament tear or a fracture. However, pain in athletes that occurs in the absence of trauma and tissue damage is still often labelled...

Background: The prevalence of musculoskeletal symptoms among sedentary workers is high. Interventions that promote occupational standing or walking have been found to reduce occupational sedentary time, but it is unclear whether these interventions ameliorate musculoskeletal symptoms in sedentary workers. Objectives: To investigate the effective...

Adolescent low back pain has received limited research attention despite its potentially considerable impact on quality of life. The role of diagnostic triage to identify serious or specific pathology and/or order relevant investigations is considered. An overview of contemporary pain mechanisms is provided, with specific reference to the wide rang...

Background: Psychologic factors are associated with pain and disability in patients with chronic shoulder pain. Recent research regarding the association of affective psychologic factors (emotions) with patients' pain and disability outcome after surgery disagrees; and the relationship between cognitive psychologic factors (thoughts and beliefs) a...

Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain an...

Objective: Musculoskeletal pain (MSP) conditions are the biggest cause of disability and internationally, Indigenous peoples experience a higher burden. There are conflicting reports about Aboriginal Australians and MSP. We conducted a systematic review to describe the prevalence, associated factors, impacts, care access, health care experiences,...

Background: Recent investigations have suggested that disrupted body-image may contribute to the lumbopelvic pain experience. The changes in body shape and size associated with pregnancy suggest that pregnancy-related lumbopelvic pain might be a problem in which alterations in body-image are particularly relevant. Objectives: To investigate if s...

We assessed whether participants are able to perform abdominal bracing during lifting, and described its effects on trunk muscle activity and body kinematics. Fourteen participants performed 10 lifts (symmetrical lifting of a 15 kg load from floor level), 5 with abdominal bracing and 5 without. Activity of the lumbar multifidus (LM) and internal o...

Background: Clinical guidelines for the management of rotator cuff disease are not clear. Surgeon surveys in the USA and UK lack agreement regarding surgical indications. Physical examination tests aid surgical decision-making but also lack robust evidence. Study aims were to evaluate: Western Australian orthopaedic surgeons' perceptions about sur...

Objectives: Addressing disparities in low back pain care (LBP) is an important yet largely unaddressed issue. One avenue to addressing disparities, recommended by clinical guidelines, is to ensure that LBP information is culturally appropriate. Our objectives were, first, to develop LBP information that was culturally appropriate for Aboriginal Au...

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Background: Increasing rates of surgery for rotator cuff disease have been reported in the past decade in a number of countries worldwide. Rising surgery rates do not correspond with equivalent increases in shoulder pain prevalence. The aims of the study were: to investigate trends in population-adjusted surgical rates for rotator cuff disease in...

iii) Background: Clinicians and patients have commonly reported that the clinician-patient interaction is an important factor in the outcome of musculoskeletal pain. Clinician-patient interaction incorporates factors such as clinician empathy and listening, patient-clinician communication, shared goals, confidence and trust in clinicians, non-verba...

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Background: Cognitive Functional Therapy has been shown to reduce pain and disability in people with chronic low back pain. Objectives: To investigate participants' experience of Cognitive Functional Therapy by comparing those who reported larger or smaller improvements with treatment, potentially yielding insight into the implementation of this...

Objectives: To explore the existence of subgroups in a cohort with chronic low back pain (n=294) based upon data from multiple psychological questionnaires, and profile subgroups on data from multiple dimensions. Methods: Psychological questionnaires considered as indicator variables entered into latent class analysis included: Depression, Anxie...

There is a high prevalence of low back pain (LBP) in adolescent male rowers. In this study, regional lumbar spinal kinematics and self-reported LBP intensity were compared between 10 adolescent rowers with moderate levels of LBP relating to rowing with 10 reporting no history of LBP during a 15-minute ergometer trial using an electromagnetic tracki...

Background: Musculoskeletal physiotherapy involves both "specific" and "non-specific" effects. "Non-specific" variables associated with the patient, therapist and setting may influence clinical outcomes. Recent quantitative research has shown that "non-specific" factors including patient-therapist interactions can influence treatment outcomes. It...

Background and aims Investigation of the multidimensional correlates of pressure pain threshold (PPT) requires the study of large cohorts, and thus the use of multiple raters, for sufficient statistical power. Although PPT testing has previously been shown to be reliable, the reliability of multiple raters and investigation for systematic bias betw...

Adolescent tennis players are at risk of low back pain (LBP). Recent research has demonstrated a potential mechanical aetiology during serves; however, groundstrokes have also been suggested to load this region. Therefore, this study compared lumbar mechanics between players with and without a history of LBP during open and square stance tennis for...

Background Low back pain (LBP) is prevalent among adolescent rowers. This study evaluated the efficacy of a cognitive functional approach to reduce LBP in this population. Methods Thirty-six adolescent male rowers reporting LBP participated. Nineteen were randomly allocated to the intervention group to receive a cognitive functional approach target...

This study investigated the association between menstrual pain severity and psychophysical measures of cold and pressure pain sensitivity. A cross-sectional design was utilised with young women (n=432) from the Western Australian Pregnancy Cohort (Raine) Study. Menstrual pain severity and oral contraception use was obtained from questionnaires at 2...

This paper systematically reviews the effect of chair backrests and reducing seated hip flexion on low back discomfort (LBD) and trunk muscle activation. Prolonged sitting commonly exacerbates low back pain (LBP). Several modifications to seated posture and chair design have been recommended, including using chairs with backrests and chairs that re...

Previous research in Irish dancing (ID) has recorded high levels of pain/injury. Screening protocols in other genres have been developed to identify at-risk dancers. The aims of the study were to examine the factors that relate to absence from dancing because of musculo-skeletal pain/injury in ID, and to inform guidelines for the development of an...

Non-specific chronic low back pain (NSCLBP) is a very common and costly musculoskeletal disorder associated with a complex interplay of biopsychosocial factors. Cognitive functional therapy (CFT) represents a novel, patient-centred intervention which directly challenges pain-related behaviours in a cognitively integrated, functionally specific and...

The objectives of this study were to explore the existence of subgroups in a cohort with chronic low back pain (n=294) based upon results of multimodal sensory testing, and profile subgroups on demographic, psychological, lifestyle, and general health factors. Bedside (two-point discrimination; brush/vibration/pinprick perception; temporal summatio...

Patient-therapist interactions in musculoskeletal physiotherapy: a qualitative systematic review and meta-synthesis. PROSPERO 2014:CRD42014014336 Available from The systematic review aims to investigate patient and physiotherapist perceptions of facilitators and barriers to a good patient-physiotherapist interaction/relationship in musculoskeletal-...

The objectives of this study were to explore the existence of subgroups in a cohort with chronic low back pain (n 5 294) based on the results of multimodal sensory testing and profile subgroups on demographic, psychological, lifestyle, and general health factors. Bedside (2-point discrimination, brush, vibration and pinprick perception, temporal su...

Perspective: In this systematic review of RCTs in NSCSP, only small differences in pain or disability were observed between physical, behavioural and/or psychologically informed and combined interventions.

Background: Occupational sedentary behaviour is an important contributor to overall sedentary risk. To date, there is limited evidence for effective workplace interventions to reduce occupational sedentary time and increase light activity during work hours. Further, very few studies have examined how changes in sedentary behaviour can impact muscul...

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Multiple dimensions across the biopsychosocial spectrum are relevant in the management of non-specific chronic low back pain (NSCLBP). Cognitive functional therapy is a behaviourally targeted intervention which combines normalisation of movement and abolition of pain behaviours with cognitive reconceptualisation of the NSCLBP problem, while also ta...

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What are physiotherapists' perceptions about identifying and managing the cognitive, psychological and social factors that may act as barriers to recovery for people with low back pain (LBP)? Systematic review and qualitative metasynthesis of qualitative studies in which physiotherapists were questioned, using focus groups or semi-structured interv...

Despite its growing popularity, scant research exists concerning musculoskeletal pain and injury in Irish dancing (ID). This study aimed to record the biopsychosocial characteristics of elite adult Irish dancers and to investigate potential relationships between these characteristics and musculoskeletal pain and injury. One hundred and four profess...

Back pain is the leading cause of disability in the western world and a major reason for activity avoidance and athlete retirement. In spite of enormous and increasing costs, current approaches to management are fuelling rather than reducing the burden of the problem.1 This was highlighted by the huge media interest generated recently over the demi...

Lumbopelvic pain (LPP) is common in pregnancy but the sensitisation factors underlying the condition are largely unknown. This study characterised the somatosensory profile of pregnant and non-pregnant women and the relationship between pain, hypersensitivity and commonly used manual clinical tests. Thirty-nine pregnant and 22 non-pregnant women we...

In Irish dance, the foot and ankle are the structures most commonly affected by pain and injury, but there is scant research examining the potential factors placing Irish dancers at risk of sustaining pain and injury in the foot and ankle. An observational study examining the factors linked to pain and injury in the foot and ankle in elite adult Ir...

Background: Back pain beliefs (BPBs) are an important modifiable factor related to disability associated with low back pain (LBP). Back pain beliefs have not been characterized in baby boomers, a group at risk for decreased activity levels and reduced productivity. Objective: The aims of this study were: (1) to identify factors related to BPBs a...

Objectives: The Tampa Scale of Kinesiophobia (TSK) has been used to identify people with back pain who have high levels of "fear of movement" to direct them into fear reduction interventions. However, there is considerable debate as to what construct(s) the scale measures. Somatic Focus and Activity Avoidance subscales identified in factor analyti...