The improvement of turning ability is a key objective for fall-risk reduction in individuals with impaired dynamic stability

Turning difficulty is a sign of balance instability and may be indicative of elevated fall risk. Features extracted from the 90° turn suggest that this turn type is the most unstable type of turn in older adults with compromised balance control. Since the 90° turn is also the most common type of turn executed during activities of daily living, we recommend targeting movement strategies specific to 90° turning during therapeutic intervention. Specific neuro-rehabilitation strategies to improve/optimize turning ability in individuals with compromised stability may significantly contribute to fall-risk reduction. The adoption of quantitative tools for the assessment and monitoring of turning quality is advisable

Graded exposure treatment for adolescents with chronic pain (GET Living): Protocol for a randomized controlled trial enhanced with single case experimental design

Chronic musculoskeletal pain in adolescence is a significant public health concern with 3-5% of adolescents suffering from significant pain-related disability. Pain-related fear and avoidance of activities has been found to have a significant influence on pain outcomes in children and adolescents and is a risk factor for less favorable response to treatment. To address this need, we developed graded exposure treatment for youth with chronic pain (GET Living). We describe the rationale, design, and implementation of a two-group randomized controlled trial (RCT) enhanced with single-case experimental design (SCED) methodology with a sample of 74 adolescents with chronic musculosketal pain and their parent caregivers. GET Living includes education, behavioral exposures, and parent intervention jointly delivered by pain psychology and physical therapy providers. The multidisciplinary pain management control group includes pain psychology delivered education and pain self-management skills training (e.g., relaxation, cognitive skills) and separate physical therapy. Assessments include brief daily diaries (baseline to discharge, 7-days at 3-month and 6-month follow-up), comprehensive in-person evaluations at baseline and discharge, and questionnaire across all time points (baseline, discharge, 3-month and 6-month follow-up). Primary outcome is pain-related fear avoidance. Secondary outcome is functional disability. We also outline all additional outcomes, exploratory outcomes, covariates, and implementation measures. The objective is to offer a mechanism-based, targeted intervention to youth with musculoskeletal pain to enhance likelihood of return to function.status: Published onlin