Gwendolen Jull | The University of Queensland, Australia (original) (raw)

Papers by Gwendolen Jull

Physiotherapy Canada, 2013

Clinical Reasoning for Manual Therapists, 2004

Journal of Physiotherapy, 2010

BMC Musculoskeletal Disorders - BMC MUSCULOSKELET DISORD, 2010

Australian Journal of Physiotherapy, 1979

Journal of Orthopaedic & Sports Physical Therapy, 2011

Archives of Physical Medicine and Rehabilitation, 2013

To investigate sensory and sensorimotor function in violin and viola players with and without nec... more To investigate sensory and sensorimotor function in violin and viola players with and without neck pain. Prospective, cross-sectional study. University laboratory. Convenience sample of violin players with playing-related neck pain (n=22), violinists without neck pain (n=21), and healthy nonmusician comparison subjects (n=21). Not applicable. Measures include thermal pain thresholds (cold and heat) and pressure pain thresholds (PPTs) over the cervical spine and over a remote region (tibialis anterior muscle). Motor performance tests including reaction times, speed of movement, accuracy, coordination, and tapping speed assessed with a special upper-limb test battery. Musicians with neck pain had significantly lower heat and elevated cold pain thresholds as well as lower PPTs over C5-6 (P<.01) and over the tibialis anterior (P<.05). Motor performance tests revealed no differences between the symptomatic and asymptomatic musicians and nonmusician comparison groups (P>.05). Violin players with neck pain demonstrated signs of sensory impairment, suggesting that playing-related neck pain may be associated with augmented central pain processing consistent with findings in other neck pain groups. No differences were evident in the motor performance tests. Fine motor skills of violin players may be better assessed in the context of playing their musical instruments before definitive conclusions can be drawn about the presence or not of sensorimotor impairments in this group of musicians with playing-related neck pain.

Journal of Manipulative and Physiological Therapeutics, 2000

Recent research into muscle dysfunction in patients with low back pain has led to discoveries of ... more Recent research into muscle dysfunction in patients with low back pain has led to discoveries of impairments in deep muscles of the trunk and back. These muscles have a functional role in enhancing spinal segmental support and control. The muscle impairments are not those of strength but rather problems in motor control. These findings call for a different approach in therapeutic exercise, namely a motor learning exercise protocol. The specific exercise approach has an initial focus on retraining the cocontraction of the deep muscles (ie, the transversus abdominis and lumbar multi-fidus Initial clinical trials point to the effectiveness of the approach in patients with both acute and chronic low back pain in terms of reducing the neuromuscular impairment and in control of pain.

Manual Therapy, 2013

It is incumbent on health care professionals to support patients with chronic musculoskeletal con... more It is incumbent on health care professionals to support patients with chronic musculoskeletal conditions to manage the impact of the condition on their life. Work is a positive health behaviour for which self-management skills are essential. In this paper, self-management is defined and the role of clinicians in promoting self-management for return to work is outlined with examples and tips on how the clinician can incorporate self-management into practice. The clinician is ideally placed to assist individuals with chronic musculoskeletal conditions manage to remain at work or return to work. This can be achieved through such activities as the promotion of the core self-management skills of problem-solving, decision making, resource utilisation, developing a cooperative partnership between clinician and patient and making an action plan.

Physiotherapy Theory and Practice, 1993

Manual Therapy, 2007

The purpose of this study was to verify the performance and suitability of new generation 3D wire... more The purpose of this study was to verify the performance and suitability of new generation 3D wireless orientations sensors to measure cervical range of movement against a criterion standard instrument, an electromagnetic motion analysis system (Fastrak-Polhemus). The wireless orientation sensor (InertiaCube 3) consists of 9 motion-sensing elements: 3 accelerometers, 3 angular velocity rate transducers and 3 magnetometers. Measurements of cervical range of motion in each primary plane, left-lateral flexion, flexion and left rotation were directly compared from both systems in 10 normal asymptomatic subjects. Results showed very high cross-correlations (.99-.97) and low average root mean square errors (0.7-2.5 degrees). We conclude that orientation sensors are a valid, accurate and suitable device for obtaining cervical joint ranges of motion in the primary plane of movement.

Manual Therapy, 2006

Cervical joint position error (JPE) has been used as a measure of cervical afferent input to dete... more Cervical joint position error (JPE) has been used as a measure of cervical afferent input to detect disturbances in sensori-motor control as a possible contributor to a neck pain syndrome. This study aimed to investigate the relationship between cervical JPE, balance and eye movement control. It was of particular interest whether assessment of cervical JPE alone was sufficient to signal the presence of disturbances in the two other tests. One hundred subjects with persistent whiplash-associated disorders (WADs) and 40 healthy controls subjects were assessed on measures of cervical JPE, standing balance and the smooth pursuit neck torsion test (SPNT). The results indicated that over all subjects, significant but weak-to-moderate correlations existed between all comfortable stance balance tests and both the SPNT and rotation cervical JPE tests. A weak correlation was found between the SPNT and right rotation cervical JPE. An abnormal rotation cervical JPE score had a high positive prediction value (88%) but low sensitivity (60%) and specificity (54%) to determine abnormality in balance and or SPNT test. The results suggest that in patients with persistent WAD, it is not sufficient to measure JPE alone. All three measures are required to identify disturbances in the postural control system.

Spine, 2001

A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. To report ... more A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. To report a specific exercise intervention's long-term effects on recurrence rates in acute, first-episode low back pain patients. The pain and disability associated with an initial episode of acute low back pain (LBP) is known to resolve spontaneously in the short-term in the majority of cases. However, the recurrence rate is high, and recurrent disabling episodes remain one of the most costly problems in LBP. A deficit in the multifidus muscle has been identified in acute LBP patients, and does not resolve spontaneously on resolution of painful symptoms and resumption of normal activity. Any relation between this deficit and recurrence rate was investigated in the long-term. Thirty-nine patients with acute, first-episode LBP were medically managed and randomly allocated to either a control group or specific exercise group. Medical management included advice and use of medications. Intervention consisted of exercises aimed at rehabilitating the multifidus in cocontraction with the transversus abdominis muscle. One year and three years after treatment, telephone questionnaires were conducted with patients. Questionnaire results revealed that patients from the specific exercise group experienced fewer recurrences of LBP than patients from the control group. One year after treatment, specific exercise group recurrence was 30%, and control group recurrence was 84% (P < 0.001). Two to three years after treatment, specific exercise group recurrence was 35%, and control group recurrence was 75% (P < 0.01). Long-term results suggest that specific exercise therapy in addition to medical management and resumption of normal activity may be more effective in reducing low back pain recurrences than medical management and normal activity alone.

Spine, 1996

A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain... more A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain and unilateral, segmental inhibition of the multifidus muscle. Patients were allocated randomly to a control or treatment group. To document the natural course of lumber multifidus recovery and to evaluate the effectiveness of specific, localized, exercise therapy on muscle recovery. Acute low back pain usually resolves spontaneously, but the recurrence rate is high. Inhibition of multifidus occurs with acute, first-episode, low back pain, and pathologic changes in this muscle have been linked with poor outcome and recurrence of symptoms. Patients in group 1 received medical treatment only. Patients in group 2 received medical treatment and specific, localized, exercise therapy. Outcome measures for both groups included 4 weekly assessments of pain, disability, range of motion, and size of the multifidus cross-sectional area. Independent examiners were blinded to group allocation. Patients were reassessed at a 10-week follow-up examination. Multifidus muscle recovery was not spontaneous on remission of painful symptoms in patients in group 1. Muscle recovery was more rapid and more complete in patients in group 2 who received exercise therapy (P = 0.0001). Other outcome measurements were similar for the two groups at the 4-week examination. Although they resumed normal levels of activity, patients in group 1 still had decreased multifidus muscle size at the 10-week follow-up examination. Multifidus muscle recovery is not spontaneous on remission of painful symptoms. Lack of localized, muscle support may be one reason for the high recurrence rate of low back pain following the initial episode.

Physiotherapy Canada, 2013

Clinical Reasoning for Manual Therapists, 2004

Journal of Physiotherapy, 2010

BMC Musculoskeletal Disorders - BMC MUSCULOSKELET DISORD, 2010

Australian Journal of Physiotherapy, 1979

Journal of Orthopaedic & Sports Physical Therapy, 2011

Archives of Physical Medicine and Rehabilitation, 2013

To investigate sensory and sensorimotor function in violin and viola players with and without nec... more To investigate sensory and sensorimotor function in violin and viola players with and without neck pain. Prospective, cross-sectional study. University laboratory. Convenience sample of violin players with playing-related neck pain (n=22), violinists without neck pain (n=21), and healthy nonmusician comparison subjects (n=21). Not applicable. Measures include thermal pain thresholds (cold and heat) and pressure pain thresholds (PPTs) over the cervical spine and over a remote region (tibialis anterior muscle). Motor performance tests including reaction times, speed of movement, accuracy, coordination, and tapping speed assessed with a special upper-limb test battery. Musicians with neck pain had significantly lower heat and elevated cold pain thresholds as well as lower PPTs over C5-6 (P<.01) and over the tibialis anterior (P<.05). Motor performance tests revealed no differences between the symptomatic and asymptomatic musicians and nonmusician comparison groups (P>.05). Violin players with neck pain demonstrated signs of sensory impairment, suggesting that playing-related neck pain may be associated with augmented central pain processing consistent with findings in other neck pain groups. No differences were evident in the motor performance tests. Fine motor skills of violin players may be better assessed in the context of playing their musical instruments before definitive conclusions can be drawn about the presence or not of sensorimotor impairments in this group of musicians with playing-related neck pain.

Journal of Manipulative and Physiological Therapeutics, 2000

Recent research into muscle dysfunction in patients with low back pain has led to discoveries of ... more Recent research into muscle dysfunction in patients with low back pain has led to discoveries of impairments in deep muscles of the trunk and back. These muscles have a functional role in enhancing spinal segmental support and control. The muscle impairments are not those of strength but rather problems in motor control. These findings call for a different approach in therapeutic exercise, namely a motor learning exercise protocol. The specific exercise approach has an initial focus on retraining the cocontraction of the deep muscles (ie, the transversus abdominis and lumbar multi-fidus Initial clinical trials point to the effectiveness of the approach in patients with both acute and chronic low back pain in terms of reducing the neuromuscular impairment and in control of pain.

Manual Therapy, 2013

It is incumbent on health care professionals to support patients with chronic musculoskeletal con... more It is incumbent on health care professionals to support patients with chronic musculoskeletal conditions to manage the impact of the condition on their life. Work is a positive health behaviour for which self-management skills are essential. In this paper, self-management is defined and the role of clinicians in promoting self-management for return to work is outlined with examples and tips on how the clinician can incorporate self-management into practice. The clinician is ideally placed to assist individuals with chronic musculoskeletal conditions manage to remain at work or return to work. This can be achieved through such activities as the promotion of the core self-management skills of problem-solving, decision making, resource utilisation, developing a cooperative partnership between clinician and patient and making an action plan.

Physiotherapy Theory and Practice, 1993

Manual Therapy, 2007

The purpose of this study was to verify the performance and suitability of new generation 3D wire... more The purpose of this study was to verify the performance and suitability of new generation 3D wireless orientations sensors to measure cervical range of movement against a criterion standard instrument, an electromagnetic motion analysis system (Fastrak-Polhemus). The wireless orientation sensor (InertiaCube 3) consists of 9 motion-sensing elements: 3 accelerometers, 3 angular velocity rate transducers and 3 magnetometers. Measurements of cervical range of motion in each primary plane, left-lateral flexion, flexion and left rotation were directly compared from both systems in 10 normal asymptomatic subjects. Results showed very high cross-correlations (.99-.97) and low average root mean square errors (0.7-2.5 degrees). We conclude that orientation sensors are a valid, accurate and suitable device for obtaining cervical joint ranges of motion in the primary plane of movement.

Manual Therapy, 2006

Cervical joint position error (JPE) has been used as a measure of cervical afferent input to dete... more Cervical joint position error (JPE) has been used as a measure of cervical afferent input to detect disturbances in sensori-motor control as a possible contributor to a neck pain syndrome. This study aimed to investigate the relationship between cervical JPE, balance and eye movement control. It was of particular interest whether assessment of cervical JPE alone was sufficient to signal the presence of disturbances in the two other tests. One hundred subjects with persistent whiplash-associated disorders (WADs) and 40 healthy controls subjects were assessed on measures of cervical JPE, standing balance and the smooth pursuit neck torsion test (SPNT). The results indicated that over all subjects, significant but weak-to-moderate correlations existed between all comfortable stance balance tests and both the SPNT and rotation cervical JPE tests. A weak correlation was found between the SPNT and right rotation cervical JPE. An abnormal rotation cervical JPE score had a high positive prediction value (88%) but low sensitivity (60%) and specificity (54%) to determine abnormality in balance and or SPNT test. The results suggest that in patients with persistent WAD, it is not sufficient to measure JPE alone. All three measures are required to identify disturbances in the postural control system.

Spine, 2001

A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. To report ... more A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. To report a specific exercise intervention's long-term effects on recurrence rates in acute, first-episode low back pain patients. The pain and disability associated with an initial episode of acute low back pain (LBP) is known to resolve spontaneously in the short-term in the majority of cases. However, the recurrence rate is high, and recurrent disabling episodes remain one of the most costly problems in LBP. A deficit in the multifidus muscle has been identified in acute LBP patients, and does not resolve spontaneously on resolution of painful symptoms and resumption of normal activity. Any relation between this deficit and recurrence rate was investigated in the long-term. Thirty-nine patients with acute, first-episode LBP were medically managed and randomly allocated to either a control group or specific exercise group. Medical management included advice and use of medications. Intervention consisted of exercises aimed at rehabilitating the multifidus in cocontraction with the transversus abdominis muscle. One year and three years after treatment, telephone questionnaires were conducted with patients. Questionnaire results revealed that patients from the specific exercise group experienced fewer recurrences of LBP than patients from the control group. One year after treatment, specific exercise group recurrence was 30%, and control group recurrence was 84% (P < 0.001). Two to three years after treatment, specific exercise group recurrence was 35%, and control group recurrence was 75% (P < 0.01). Long-term results suggest that specific exercise therapy in addition to medical management and resumption of normal activity may be more effective in reducing low back pain recurrences than medical management and normal activity alone.

Spine, 1996

A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain... more A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain and unilateral, segmental inhibition of the multifidus muscle. Patients were allocated randomly to a control or treatment group. To document the natural course of lumber multifidus recovery and to evaluate the effectiveness of specific, localized, exercise therapy on muscle recovery. Acute low back pain usually resolves spontaneously, but the recurrence rate is high. Inhibition of multifidus occurs with acute, first-episode, low back pain, and pathologic changes in this muscle have been linked with poor outcome and recurrence of symptoms. Patients in group 1 received medical treatment only. Patients in group 2 received medical treatment and specific, localized, exercise therapy. Outcome measures for both groups included 4 weekly assessments of pain, disability, range of motion, and size of the multifidus cross-sectional area. Independent examiners were blinded to group allocation. Patients were reassessed at a 10-week follow-up examination. Multifidus muscle recovery was not spontaneous on remission of painful symptoms in patients in group 1. Muscle recovery was more rapid and more complete in patients in group 2 who received exercise therapy (P = 0.0001). Other outcome measurements were similar for the two groups at the 4-week examination. Although they resumed normal levels of activity, patients in group 1 still had decreased multifidus muscle size at the 10-week follow-up examination. Multifidus muscle recovery is not spontaneous on remission of painful symptoms. Lack of localized, muscle support may be one reason for the high recurrence rate of low back pain following the initial episode.