Description:

Presented by: Dr. Steven Z. George, PT, PhD (Director of Musculoskeletal Research, Duke Clinical Research Institute; Vice Chair of Clinical Research, Orthopaedic Surgery)

Abstract:

Musculoskeletal (MSK) pain is commonly chronic or recurrent and a significant cause of global disability.  The overall theme for the 2018 Kaleckas Lecture will be to consider how future approaches for MSK care may have to change to better individualize and target treatment.  The speaker will review historical foundations for MSK screening, starting with the emphasis of predicting return to work for patients with low back pain and then transitioning to predicting functional or pain related outcomes for patients with broader MSK conditions like neck, shoulder, and knee pain.  Studies supporting multiple tools will be included in this review.  The speaker will then consider how foundational work in this area has influenced current approaches and how changes may be necessary to better account for outcome prediction in a personalized medicine era.  That is, the practitioner, clinician, and patient are often interested in a wider range of outcomes for prediction than typically considered when screening for outcomes.  The speaker will then present a conceptual framework of predicting MSK outcomes that has enough structure that it can be applied in a standard fashion but also has the desired flexibility for predicting different outcomes.  The speaker will present data from the recently completed Optimal Screening for Prediction of Referral and Outcome (OSPRO) cohort studies (funded by the Orthopaedic Section of the American Physical Therapy Association) to provide empirical support for this conceptual framework.

Bio:

Dr. George’s primary interest is research involving biopsychosocial models for the prevention and treatment of chronic musculoskeletal pain disorders. His long term goals are to 1) improve accuracy for predicting who is going to develop chronic pain; and 2) identify non-pharmacological treatment options that limit the development of chronic pain conditions. Dr. George is an active member of the American Physical Therapy Association, American Pain Society, and International Association for the Study of Pain often attending annual conferences and serving on committees. Dr. George’s research projects have been supported by the National Institutes of Health, Department of Defense, Brooks Rehabilitation, Orthopaedic Section of the American Physical Therapy Association, University of Florida, and Foundation for Physical Therapy. Dr. George and his collaborators have authored over 185 peer-reviewed publications in leading physical therapy, rehabilitation, and pain research journals. He currently serves as a Contributing Editor for Physical Therapy and an International Editorial Review Board Member for Journal of Orthopaedic & Sports Physical Therapy. Dr. George is also a member of the Advisory Council for the National Center for Complimentary and Integrative Health. Dr. George is a past recipient of the J. Brooks Brown Research Award and has been recognized with prestigious research awards from the American Physical Therapy Association, American Pain Society and International Association for the Study of Pain. In 2016 Dr. George was recognized by the Florida Physical Therapy Association with the Scholarly Impact on Practice Award. This award acknowledges dedicated scholarly activity that has made a meaningful difference to clinical practice by physical therapists in Florida. Also in 2016 the American Physical Therapy Association recognized Dr. George as the Jules M. Rothstein Golden Pen Award for Scientific writing in recognition of his contributions to Physical Therapy and as the 21st John H.P. Maley Lecturer for making significant contribution to the profession in clinical practice.

Current Projects:

• Developing and testing psychologically informed physical therapy interventions for patients with low back pain

• Testing the efficacy of personalized approaches for pain management, including targeting treatment to pain related genetic and psychological factors that increase the risk of persistent post-operative shoulder pain

• Investigating efficacy of manual therapy through their effect on pain sensitivity and pain modulation

• Developing and validating review of systems and yellow flag assessment tools for predicting musculoskeletal pain outcomes and future health care utilization patterns