Hello, and thanks for listening to Spinal Columns, the official newsletter of CANSpine. Today is Tuesday, December 16th, 2025. This podcast comes to you from the School of Physical Therapy in the Faculty of Health Science at Western University. For this episode, we have three updates from the group to share.

First up, a new systematic review tackles the question, can physical tests predict recovery from low back pain? This work, led by Alison Rushton, also saw engagement from David Walton. The review synthesized evidence from prospective longitudinal studies that evaluated physical measures of physical functioning as prognostic factors in adults with low back pain. After screening, they included 42 studies in a narrative synthesis. The findings indicate low-quality evidence for no predictive ability of high isometric back extension endurance, high handgrip strength, and the fingertip-to-floor test for good long-term outcomes. The review also reported very low-quality evidence for inconsistent predictive ability for other measures, such as lumbar range of motion. The authors concluded there is a lack of high-quality evidence on the predictive ability of these physical measures, noting that the included studies often had a high risk of bias.

Next, shifting focus to adolescent populations, a new publication addresses the question, what should guide an adolescent's return to sport after spinal fusion? This work, a study protocol to which Alison Rushton contributed, notes that rehabilitation following surgery for adolescent idiopathic scoliosis can be inconsistent. The authors plan to use a nominal group technique, a structured method for group brainstorming and decision-making, to develop expert consensus on the topic. The study will bring together surgeons, physiotherapists, and nurses to define rehabilitation content and milestones for the period between 3 and 12 months after surgery. The goal is to use this consensus to create future guidance for a graded return to sport, exercise, and physical activity.

Finally, we turn to a question about measurement. In spinal pain research, what outcomes are measured most consistently? This question was the focus of a new systematic review led by Tom Noblet and Alison Rushton, which also had support from David Walton. The authors conducted a systematic search to find published core outcome sets for spinal pain, which are agreed-upon sets of measures that researchers are encouraged to use. They found 13 such studies covering the cervical, thoracolumbar, and lumbar spinal regions. The review showed that patient-reported outcomes were the most frequent type of measure recommended. Across the different core outcome sets, the most consistently endorsed domains were physical function, pain intensity, participation in work or daily activities, and disability. The authors also noted that few of the identified sets included psychological, social, environmental, or physiological domains.

And that brings us to the close of today's updates. The work presented shows a focus on clarifying and standardizing approaches in spinal care. We began with a review that located a lack of high-quality evidence for the predictive ability of some physical tests for low back pain. We then heard about a protocol designed to create consensus on return-to-sport guidance for adolescents after spinal fusion. Finally, we looked at a review identifying which outcome domains, such as physical function and pain intensity, appear most consistently across core outcome sets in spinal pain research.

Thank you for listening to Spinal Columns, the official newsletter of CANSpine.