Foundation team presents findings of FEMA Fire Prevention & Safety grant at ACSM and ACC-RAC conferences

A team from The Vert Mooney Research Foundation (DBA US Spine & Sport Foundation) recently presented findings of a 3-year FEMA Fire Prevention & Safety grant – Implementation of a Regional Firefighter Wellness Initiative – at two national conferences – American College of Sports Medicine (ACSM) in June 2022 and American Chiropractic College – Research Agenda Conference (ACC-RAC) in July 2022.

  1. Lane CL, Mayer JM. Worksite exercise adherence in firefighters: findings during a global pandemic and record wildfire season. American College of Sports Medicine Annual Meeting, San Diego, CA, June 2022 (e-poster).
  2. Mayer JM, Verna JL, Lane CL. Implementation of a firefighter wellness initiative during record wildfires and a global pandemic. Association Chiropractic Colleges – Research Agenda Conference, San Diego, CA, July 2022 (podium).

Abstracts of the presentations are shown below.

ACSM, June 2022

ABSTRACT: Occupational injury is prevalent in firefighters and exercise programming is beneficial to prevent injury and hasten recovery. Yet, implementation of worksite exercise programs has been intermittently successful. PURPOSE: The purpose of this study was to assess adherence factors in firefighters enrolled in a worksite fitness program during a global pandemic and record wildfire season. METHODS: A cross sectional study was conducted in career firefighters (n = 429) from 15 Southern California departments enrolled in a 9-18 month worksite fitness program. Exercise adherence, completed exercise sessions in the intervention period, was compared to baseline age, history of musculoskeletal (MSK) conditions, completion of wellness educational courses and physical fitness measures. ANOVA, T-Tests, or Chi-square were used to assess relationships between exercise adherence and baseline characteristics. RESULTS: Exercise adherence was poorer than anticipated and was attributed to the COVID-19 pandemic and record wildfire season. Significant weak correlations with exercise adherence were noted for age (r = 0.112, p = 0.035), BMI (r = -0.113, p = 0.033), back muscular endurance (r = 0.217, p < 0.000), core muscular endurance (r = 0.113, p = 0.035), and flexibility exercise frequency (r = 0.113, p = 0.035). Those with MSK history had a higher adherence rate than those without (History: 13.2 +/- 22.7%, No History: 4.7 +/- 7.4%, p = 0.021). Those who completed wellness education courses had a higher adherence rate than those who did not (Completed: 29.9 +/- 31.1%, Did Not Complete: 7.2 +/- 14.9%, p < 0.000). No significant relationships were noted between exercise adherence and waist circumference, bodyfat%, Functional Movement Screen, or cardiovascular and resistance exercise frequencies. CONCLUSION: These findings suggest that the most adherent participants were more fit, older, and had a MSK history. However, the poor adherers were less fit, suggesting that firefighters who need exercise programming the most were not adherent. While more research is needed, future iimplementation efforts should minimize delivery barriers, consider a hybrid approach of face-to-face and virtual sessions, and focus on delivering to firefighters who are most vulnerable to MSK conditions.


ACC-RAC, July 2022

ABSTRACT: Objective: Firefighters have elevated rates of cardiovascular, musculoskeletal, and sleep disorders. However, specific guidance on implementing interventions to address these conditions is largely unavailable. The purpose of this project was to implement a firefighter wellness initiative targeting obesity, musculoskeletal injuries, and sleep disorders. Methods: An observational cohort project was conducted in 429 career firefighters from 15 California departments. Assessments included anthropometric, fitness, and patient-reported outcomes that are known health risk indicators. Physical fitness, injury prevention, and educational interventions were customized and triaged according to needs, goals, and risk levels. Interventions were delivered over 9-18 months in one-on-one and group settings, via face-to-face and telehealth sessions. The initiative was implemented during record wildfires and the COVID-19 pandemic, which disrupted delivery. Results: 127 firefighters completed 9-month follow-up assessments. For those at highest risk at baseline, significant improvements (p < 0.05) were observed in waist circumference, muscular endurance, functional movement, exercise frequency, dietary intake, and sleep quality. Conclusion: Improvements in key health risk indicators were observed in firefighters who participated in a wellness initiative. While the relatively low adherence may limit generalizability, the unprecedented environment provided an opportunity to inform future implementation of occupational wellness program

Foundation and Spine & Sport Physical Therapy publish manuscript on telehealth

A manuscript authored by a team from The Vert Mooney Research Foundation (DBA US Spine & Sport Foundation) and Spine & Sport Physical Therapy ( was recently accepted for publication:

Katz R, Schwartz S, Phelps B, Faust S, Mortimer D, Verna JL, Mayer JM. Telehealth in physical therapy practice for musculoskeletal disorders: case series. The APTA Physical Therapy Journal of Policy, Administration, and Leadership, 2022 (accepted for publication).

The manuscript reports on the development and implementation of a telehealth program during the COVID-19 pandemic. The novel aspects of being an early adopter of physical therapy telehealth in a private practice environment, along with research design and analysis via a non-profit foundation, are particularly noteworthy.

An abstract of the accepted manuscript is shown below. The full text manuscript is scheduled to be published in the November 2022 issue of The APTA Physical Therapy Journal of Policy, Administration, and Leadership.



Study Design: Administrative case report.

Objectives: The objectives of this paper are to: 1. summarize the current regulatory considerations for physical therapy telehealth services for musculoskeletal disorders; 2. describe the implementation process of a telehealth program by an outpatient physical therapy organization across its 20 clinics during the SARS-CoV-2 (COVID-19) pandemic; and 3. provide recommendations for regulatory, organizational and research changes needed to support implementation of long-term telehealth services in musculoskeletal physical therapy practice.

Background: The COVID-19 pandemic has greatly disrupted the delivery of healthcare services. Telehealth provides a possible solution for improving delivery of services by enhancing access and fostering patient-centered approaches but has not been well-described in physical therapy practice.

Methods: The implementation processes of telehealth services by a large outpatient physical therapy center in California are described. Three patient cases are summarized for a more detailed description of the experience.

Analysis: Telehealth services were successfully implemented in a large outpatient physical therapy center in response to the COVID-19 pandemic. Initial responses from patients with musculoskeletal disorders and physical therapists about telehealth services were positive.

Conclusions: Telehealth has the potential to enhance physical therapy practice, though its specific structure and magnitude are unclear. Regulatory and organizational changes as well as research trials are needed to help clarify the role of telehealth.

Dr. Charity Lane successfully defends PhD dissertation

Charity L. Lane, Ph.D., CPT, FNS, GFI – Board Member and Director of Program Development of US Spine & Sport Foundation – successfully defended her PhD doctoral dissertation on “An Exploration of Administrative and Shift Leaders’ Perceptions on Barriers and Facilitators to Adoption and Maintenance of Firefighter Physical Fitness Programs”, Health and Human Performance, Concordia University Chicago. The study’s novel findings and subsequent implementation and research recommendations will aid the fire service in shaping robust and sustainable worksite fitness programs aligned to NFPA standards and WFI guidelines.  Congratulations, Dr. Lane!

Dr. Len Matheson receives 2021 AOTA Health Advocate Award

Leonard N. Matheson, PhD recently received the 2021 Health Advocate Award from the American Occupational Therapy Association (AOTA). The Health Advocate Award expresses appreciation for extraordinary contributions of national significance that led to the advancement of health promotion and/or health care. AOTA – a leading body of the Occupational Therapy profession in the world – recognized Dr. Matheson’s contributions as a “Work-Oriented Neurorehabilitation Pioneer, Educator, and Policy Advocate.”

Dr. Matheson is a founding Board Member of The Vert Mooney Research Foundation and President of EPIC Neurorehabilitation & Psychology Services. As a Clinical Psychologist and researcher, his contributions to the field of occupational rehabilitation across many domains are unparalleled. More importantly, he is an outstanding mentor, great friend, and has touched the lives of many people around the world.

Congratulations, Dr. Matheson!

Fire Engineering publishes article by Mayer and Lane

Fire Engineering recently published the article:

Mayer JM, Andres A, Lane CL. Implementation of a regional firefighter wellness initiative during a global pandemic. Fire Engineering, 2021;September:2-6

It discusses the Foundation’s FEMA-funded grant, highlighting experiences with one partner fire department. The article is found at this link:

USSSF Director of Program Development and Board Member, Charity Lane, was recently published in the first 2021 edition of the NSCA TSAC Report (#60) on the topic of Sleep programs in the fire service

USSSF Director of Program Development and Board Member, Charity Lane, was recently published in the first 2021 edition of the NSCA TSAC Report (#60) on the topic of Sleep programs in the fire service.


Lane CL, Melton B. Sleep improvement programs in firefighters – a critically appraised topic. National Strength & Conditioning Association (NSCA) Tactical Strength and Conditioning (TSAC) Report, 2021, 60.

Abstract / page 1: click here

Full text available here – NSCA member access only:

Manuscript published by John Mayer and colleagues: Dagenais S, Hayflinger C, Mayer JM. Economic evaluation of an extended telehealth worksite exercise intervention to reduce lost work time from low back pain in career firefighters. Journal of Occupational Rehabilitation, 2021(Jan 4) (online ahead of print).

Dagenais S, Hayflinger C, Mayer JM. Economic evaluation of an extended telehealth worksite exercise intervention to reduce lost work time from low back pain in career firefighters. Journal of Occupational Rehabilitation, 2021(Jan 4) (online ahead of print).


Found here:



Purpose Low back pain (LBP) is a leading cause of lost work time (LWT) in firefighters and is related to poor muscle endurance. Although exercise can improve muscle endurance, it must be continued to sustain benefits, and it is unknown if it can reduce LWT. This study conducted an economic evaluation of an extended worksite exercise intervention in career firefighters. Methods A randomized controlled trial allocated 264 firefighters to telehealth with remote instruction (“telehealth”), direct exercise supervision (“direct”), or brief education (“control”). The telehealth and direct groups performed worksite exercises twice weekly for 12 months. Outcomes included quality adjusted life years, LWT from LBP (24-h shifts), costs of LWT from LBP, and net monetary benefits. Results A total of 216 firefighters were included in the economic analysis (telehealth n = 71, direct n = 75, control n = 70). Sixteen experienced LWT from LBP (telehealth n = 4, direct n = 4, control n = 8). The mean number of 24-h shifts lost from LBP were 0.05 (telehealth), 0.28 (direct), and 0.43 (control). Mean study intervention costs per participant were $1984 (telehealth), $5269 (direct), and $384 (control). Net monetary benefit was $3573 for telehealth vs. direct, – $1113 for telehealth vs. control, and – $4686 for direct vs. control. Conclusions Worksite exercise reduced LWT from LBP in firefighters. Telehealth was less costly and more effective at reducing LWT from LBP than direct exercise supervision. If the costs of telehealth were further reduced, a positive net monetary benefit might also be achieved when compared to no intervention. Clinical trial registration: ( NCT02362243.

Manuscript published by Foundation team: Mayer JM, Lane CL, Brady O, Chen H, Lu Y, Johnson BVB, Dagenais S. Comparison of supervised and telehealth delivery of worksite exercise for prevention of low back pain in firefighters: a cluster randomized trial. Journal of Occupational and Environmental Medicine. 2020 Aug 10.

Found here:

Objective: This study assessed worksite exercise delivered by on-site supervision (supervised) or telehealth to reduce lost work time (LWT) related to low back pain (LBP) in firefighters. Methods: A cluster randomized controlled trial assigned 264 career firefighters to supervised (n = 86) or telehealth (n = 95) back and core exercises 2X/week for 12 months, or control (n = 83). Results: 58.0% (153/264) of participants reported LBP and 7.6% (20/264) reported LWT related to LBP (control n = 10, supervised n = 5, telehealth n = 5). Participants in the control group experienced 1.15 times as many hours of LWT as the supervised group, and 5.51 times as many hours of LWT as the telehealth group. Conclusions: Worksite exercise, delivered by on-site supervision or telehealth, can reduce LWT related to LBP in career firefighters.

August 11, 2020, San Diego, CA: Foundation partners with West Coast Sports Institute to serve as site for clinical trial on COVID-19

US Spine & Sport Foundation (aka The Vert Mooney Research Foundation), in partnership with West Coast Sports Institute (Santa Clara, CA), has been selected to serve as a site for a multi-site clinical trial on COVID-19. The clinical trial, which is sponsored by Kaleido Biosciences, Inc (Bedford, MA), will test the safety and effects of a food product in adults with mild-moderate COVID-19. Chris Chung, MD of West Coast Sports Institute will serve as Site Principal Investigator and John M. Mayer, DC, PhD, FACSM, Scientific Officer of the Foundation, will serve as Lead Coordinator for this site. As the Foundation expands its research partnerships, this trial provides an opportunity to help find solutions for those affected by the pandemic.

Manuscript published by Foundation team: Matheson LN, Verna JL, Mayer JM. Development and validation of a method to screen for co-morbid depression by non-behavioral health practitioners treating musculoskeletal pain. Work, 2020;6(3) (accepted).

Objectives: To demonstrate the efficacy and validity of a method employed by non-behavioral health practitioners to screen for and appropriately triage musculoskeletal pain patients who also are experiencing depressive illness. Methods: As part of a previously-published psychometric research study conducted in a community-based musculoskeletal pain rehabilitation program, a method was developed for nonbehavioral health practitioners to screen for and appropriately triage patients for co-morbid depressive illness, thus providing the current opportunity to examine the effects of depressive illness on work outcomes. This paper describes the screening method and its application in an observational study of the impact of depressive illness on work outcomes. Results: Among 156 consecutive patients who were presenting with musculoskeletal pain disorders to an outpatient rehabilitation program, 22.3% also were identified to have co-morbid clinical depression.  The screening process allowed all patients to continue in the rehabilitation program.  Those who were already receiving behavioral health care were encouraged to inform care providers of their participation in the program.  Those who were not receiving behavioral health care were successfully triaged to care outside of the clinic.  Depressive illness was found to affect success in the program, confirming the validity of the screening process for outpatient rehabilitation program participants experiencing chronic pain. Conclusions: A simple and effective depression screening process that triages patients without interruption of musculoskeletal treatment can be employed by nonbehavioral health practitioners.  Because return to work outcomes were found to be negatively affected by depressive illness, this approach has the potential to improve overall program efficacy.