About

Mark D Bishop, PT, PhD, FAPTA, is a distinguished professional associated with UF Health. His credentials include a Doctor of Physical Therapy degree, a PhD, and recognition as a Fellow of the American Physical Therapy Association (FAPTA). His professional focus encompasses research and practice within the field of physical therapy, contributing to advancements in clinical and academic settings. As a member of the UF Health community, he is involved in teaching, research, and service, supporting the development of future healthcare professionals and advancing knowledge in his area of expertise.

Research topics

• Medicine
• Internal medicine
• Psychiatry
• Physical therapy
• Clinical psychology
• Surgery
• Anesthesia
• Emergency medicine

Selected publications

• Association between changes in conditioned pain modulation efficiency and pain sensitivity: a randomized controlled trial

  Frontiers in Pain Research · 2026-03-26

  articleOpen accessSenior author

  Conditioned pain modulation (CPM) reflects endogenous inhibitory capacity and may demonstrate neuroplastic adaptations with repeated activation. However, the association between CPM efficiency changes and pain sensitivity remains unclear. This planned secondary analysis examined whether improvements in CPM efficiency were associated with changes in quantitative sensory testing (QST) measures and psychological factors in healthy adults. Study design, participants, and primary intervention effects have been reported previously in the primary trial publication. Sixty participants (aged 18–75 years) were randomized to high CPM exposure (five sessions), low CPM exposure (two sessions), or no CPM exposure groups. Multiple linear regression examined associations between changes in CPM efficiency and QST measures (thermal and pressure pain thresholds, tolerance, and ratings) and psychological factors (depression, anxiety, fear of pain, affect, and expectations), controlling for group and age. Improvements in CPM efficiency significantly predicted increases in heat pain threshold temperature ( β = −1.90, p < 0.001, R 2 = 0.43) and heat tolerance temperature ( β = −0.56, p = 0.010, R 2 = 0.34), indicating that participants required higher temperatures to detect and tolerate pain. However, pain intensity ratings at these thresholds remained unchanged. Age independently predicted smaller threshold improvements ( β = −0.11, p < 0.001). No associations emerged between CPM changes and pressure pain measures, aftersensations, or psychological factors. CPM-induced neuroplasticity selectively enhanced thermal nociceptive detection through descending modulation without altering suprathreshold pain intensity encoding or affecting mechanical pain pathways. CPM induced with thermal stimuli functions as a thermal-specific biomarker rather than a global pain sensitivity indicator, with implications for clinical assessment and interventions targeting descending inhibitory pathways.

  PublisherOA PDFDOI

• Impact of repeated exposure to CPM on CPM efficiency and pain sensitivity in healthy adults: a randomized controlled trial

  Frontiers in Pain Research · 2025-11-13 · 1 citations

  articleOpen accessSenior author

  Conditioned pain modulation (CPM) is a behavioral measure of diffuse noxious inhibitory control (DNIC), an endogenous central pain modulatory mechanism in which one pain stimulus suppresses the perception of another. CPM efficiency is reduced in individuals with chronic pain and serves as a potential predictor for the development of chronic pain conditions. Current research indicates that CPM, traditionally viewed as a static metric, may exhibit protocol-dependent variability in its effects on pain sensitivity, potentially through neuroplastic mechanisms and central pain processing pathways. This randomized controlled trial (NCT05783362) investigated whether repeated activation of central pain modulatory systems enhances CPM efficiency. The secondary aim examined associations between repeated CPM exposure and pain-related psychological factors. Sixty healthy participants (52% female; ages 18–75) were randomly allocated to High Exposure (HE), Low Exposure (LE), or No Exposure (NE) CPM intervention groups. Pre- and post-intervention measures included CPM efficiency and pain sensitivity across thermal and pressure pain tests. Two-way ANOVA analyses revealed significant main effects for both time ( p < 0.001, η 2 = 0.23) and intervention ( p = 0.030, η 2 = 0.107) on CPM efficiency when comparing HE and LE groups from pre- to post-intervention. One-way ANOVA analysis at the final visit showed that HE demonstrated significantly higher CPM efficiency compared to LE ( p = 0.02, Cohen's d = 0.73), while comparisons between HE and NE approached but did not reach statistical significance ( p = 0.053–0.060; medium-to-large effect sizes, Cohen's d > 0.70). This was supported by increased heat threshold pain intensity ratings ( p < 0.001, η 2 = 0.13), suggesting broader adaptations in pain processing that strengthen descending pain control mechanisms. Other QST measures and psychological variables remained unchanged, suggesting the specificity of the modulatory enhancement. Results support the plasticity of endogenous pain modulation and suggest potential therapeutic applications for pain management interventions. Clinical Trial Registration https://clinicaltrials.gov/study/NCT05783362 , identifier NCT05783362.

  PublisherOA PDFDOI

• Foundational Principles of Treatment

  2025-07-22

  book-chapter

  The physical therapist’s management of a patient’s injury or pain condition has evolved in recent years. Today’s physical therapist understands the science of pain in greater detail and uses an active approach grounded in appropriately dosed exercise, compared to the emphasis on passive care that existed years ago. Passive interventions such as manual therapy and other modalities have a role in contemporary care. That role is short-lived 1 and should be primarily used to create pain reduction early in the course of care, allowing for a window of opportunity for well-tolerated loading programs. Moreover, an early decrease in symptoms can enhance the patient’s belief that the care will be effective. Early improvement in pain ratings can enhance the therapeutic alliance between the patient and therapist and improve adherence and patient-reported outcomes.

  PublisherDOI

• Manual Therapy

  2025-07-22

  book-chapter1st authorCorresponding

  The manual therapies are a very old discipline that developed in parallel in many cultures across the world. Muscle-biased techniques, for example, have been represented in foundational documents of traditional Chinese medicine and Sanskrit writings from India. Early texts by Hippocrates describe the use of joint- and muscle-biased techniques. More recent history saw the development of osteopathy and chiropractic philosophies and theories. Today, there is a staggering variety of practices within manual therapy used by many different professions to manage musculoskeletal disorders. These therapies include techniques biased toward the joints, the soft tissues (including muscle and fascia), and neurovascular structures. Manual therapy is embedded within the inception of the physical therapy profession and is described in the profession’s early literature. 1 Specifically, the physical therapy profession evolved during World War I with the rehabilitation needs of wounded soldiers, and massage was considered an integral component for the management of these patients. Historically, physical therapists were trained in manual therapy by physicians. 2 , 3 Well-known physical therapists in the field of manual therapy, such as Freddy Kaltenborn, Geoffrey Maitland, Stanley Paris, Gregory Grieve, and David Lamb, all trained under or were influenced by orthopedic physicians such as James Mennell, James Cyriax, and Allan Stoddard. 1 Subsequently, the early physical therapy clinical decision-making approach to manual therapy was heavily influenced by osteopathic and orthopaedic physicians. In this chapter, the present traditional and more current theories regarding why manual therapy is effective for some patients presenting with musculoskeletal disorders will be presented, along with the general principles for the successful implementation of manual therapy into clinical practice. The evidence specific to the risk and general efficacy of manual therapy will be presented along with the modern definition of the broader context of how Orthopedic Manual Physical Therapy is described today.

  PublisherDOI

• A systematic review of social functioning and peer relationships in adolescents with chronic pain

  Journal of Pediatric Psychology · 2025-02-28 · 5 citations

  review

  OBJECTIVE: There is a need for a systematic review on social functioning and peer relationships among adolescents with chronic pain (ACP) given the high prevalence of chronic pain in adolescence and integral role of peer relationships in adolescent development. This review aims to examine the methods used to evaluate social functioning, the types and extent of peer relationship difficulties, and pain characteristics and sociodemographic factors related to social functioning in ACP. METHODS: A systematic literature search of PubMed, PsycINFO, CINAHL, Web of Science, and Cochrane databases was performed. Included studies were written in English, presented original, quantitative, peer-reviewed research, had a primary focus on social functioning or peer relationships in ACP, and included study participants between the ages of 10 and 18 years. The review was registered in PROSPERO (No. CRD42022364870). RESULTS: Twenty-eight articles were included in the review. All studies used self-, parent-, or peer-report questionnaires to evaluate social functioning. Most (89%) of the studies were cross-sectional. Findings suggest that ACP experience social difficulties frequently characterized by loneliness, social anxiety, withdrawal, and peer victimization. Studies examining the associations between social functioning and sociodemographic variables, pain location, and pain-related characteristics yielded mixed findings. Study quality was mixed, with 57.14% rated as "good." CONCLUSIONS: Findings from this review emphasize the increased risk of reduced social connectedness and the complexity of underlying mechanisms associated with poorer social functioning among ACP. Additional research utilizing longitudinal methodologies is needed to understand potential moderators and directionality of associations between chronic pain and social functioning.

  PublisherDOI

• Impact of Propranolol and Psychologically Informed Intervention on Pain Sensitivity: Secondary Analysis from the Biopsychosocial Influence on Shoulder Pain Preclinical Randomized Trial

  Journal of Pain Research · 2025-04-01 · 1 citations

  articleOpen access1st authorCorresponding

  Purpose: Measures of pain sensitivity have potential relevance for patient care. We previously identified a subgroup of people at risk for ongoing pain characterized by genetic AND psychological factors. Here, we report planned secondary analyses examining the effect of personalized interventions on pain sensitivity outcomes. Patients and Methods: Two hundred and sixty-one healthy individuals with the COMT SNP rs6269 AA genotype and Pain Catastrophizing Scale scores of 5 or higher received exercise-induced muscle injury, followed by a randomly assigned treatment: (1) general education and placebo; (2) personalized psychological intervention and placebo; (3) general education and propranolol; or (4) personalized psychological intervention and propranolol. Pain sensitivity outcomes (pressure pain thresholds (PPT), suprathreshold heat rating, temporal summation, and conditioned pain modulation efficiency) were compared using a mixed effect model to examine difference among groups, adjusted for age, sex and race. Results: No main effects for group assignment were noted (p > 0.05 for all), when considered as 4 groups or 2 collapsed groups (ie propranolol vs placebo or personalized psychologic vs general education). Interaction terms were then entered into our models in an exploratory fashion. For PPT outcomes interactions were noted for, sex and time, and race and time (p<0.015). For temporal summation outcomes, interactions were noted for sex and group and race and group (p < 0.015). Conclusion: Results indicated no statistically reliable changes in pain sensitivity when considering matched vs unmatched treatment groups. Caution is needed in this interpretation given that the trial was not powered to specifically identify these differences. Exploratory analysis of interactions among ethnic/racial and gender identities by treatment, however, showed the potential for differential effects for specific pain sensitivity measures. Significant interactions across modalities suggest analysis of higher order interactions/intersectionality could be of great interest for testing efficacy of personalized interventions in future trials.

  PublisherDOI

• Enhancing Pain Relief: The Role of Repeated Conditioned Pain Modulation and Mind-Body Interaction

  Journal of Pain · 2025-04-01

  articleSenior author
  PublisherDOI

• A Survey of Pain and Musculoskeletal Dysfunction Prevalence After Gender-Confirming Surgery of the Urogenital System

  Journal of Women s & Pelvic Health Physical Therapy · 2024-10-01 · 1 citations

  articleOpen accessSenior author

  Purpose: We sought to (1) explore the prevalence of pain, and movement and urogenital dysfunction reported following gender confirming vaginoplasty (V) and phalloplasty (P), (2) identify which providers were consulted for pain, and movement and urogenital dysfunction after surgery, and (3) compare these factors between people receiving V and P surgeries. Methods: A custom internet survey, built in REDCap, was distributed through LGBTQIA+ organizations across the US. The survey collected demographic information, types of surgery, postsurgical impairments (pain and urogenital dysfunction), and activity limitations, along with the types of providers seen and interventions provided. Summary statics were calculated and proportions or means and standard deviations based on the data structure. Nonparametric measures were used to test associations between postsurgical care, gender identity, and geographic location. Results: 584 responses remained after data cleaning of which 89 people reported having vaginoplasty (V) and 118 had phalloplasty (P). The average age of respondents was 28.6 ± 5.2 years. 70% of respondents reported pain, 25% difficulty moving, 23% bowel or bladder dysfunction, and 9% dyspareunia. Significantly more respondents who had V reported dyspareunia, while more respondents who had P reported incontinence. 20%, 29%, 15%, and 13% of included respondents received care from a physical therapist for pain, difficulty moving, incontinence, and dyspareunia, respectively. Discussion: These results indicate that both individuals who undergo V or P procedures report musculoskeletal pain, movement problems, and pelvic floor dysfunction following GCS. Notably, these issues are commonly addressed in cisgender patients by physical rehabilitation providers. However, less than half of our sample were referred to a physical therapist.

  PublisherOA PDFDOI

• Delayed Recovery After Exercise-Induced Pain in People with Chronic Widespread Muscle Pain Related to Cortical Connectivity

  Brain Sciences · 2024-10-30 · 2 citations

  articleOpen access1st authorCorresponding

  BACKGROUND/OBJECTIVES: There is a subset of patients with pain who become worse after exercise. To explore this, we examined the responses of people with chronic primary pain to a standardized high intensity exercise protocol used to induce delayed onset muscle soreness (DOMS). METHODS: Ten participants with a diagnosis of chronic widespread muscle pain (CWMP) were matched by age and reported gender to ten participants without muscle pain (i.e., no pain (NP)). Participants completed a standardized DOMS protocol. Pain intensity in the arm at rest and with movement was assessed using daily electronic diaries. Peak pain, the timing of peak pain, and the time to recovery were compared between groups. Associations of pain variables with the functional connectivity of the sensorimotor (SMN), cerebellum, frontoparietal control (FPN), and default mode network (DMN) both within network nodes and the rest of the brain was assessed. RESULTS: Significant differences in peak pain, the time to peak pain, and the time to recovery were noted between groups for both pain at rest and pain with movement after controlling for catastrophizing and pain resilience. Connectivity across the SMN, FPN, and DMN was associated with all pain-related variables. Significant group differences were identified between groups. CONCLUSIONS: A standardized muscle "injury" protocol resulted in more pain, a longer time to peak pain, and a longer time to resolve pain in the patient group compared to the NP group. These differences were associated with differences in connectivity across brain regions related to sensorimotor integration and appraisal. These findings provide preliminary evidence of the dysregulation of responses to muscle (micro)trauma in people with chronic pain.

  PublisherOA PDFDOI

• Constraining solar wind transport model parameters using Bayesian analysis

  arXiv (Cornell University) · 2024-12-10

  preprintOpen access1st authorCorresponding

  We apply nested-sampling (NS) Bayesian analysis [AshtonEA22] to a model for the transport of MHD-scale solar wind fluctuations. The dual objectives are to obtain improved constraints on parameters present in the turbulence transport model (TTM) and to support comparisons of distinct versions of the TTM. The TTMs analysed are essentially 1D steady-state presented in [BreechEA08] that describe the radial evolution of the energy, correlation length, and normalized cross helicity of the fluctuations, together with the proton temperature, in prescribed background solar wind fields. Modelled effects present in the TTM include nonlinear turbulence interactions, shear driving, and energy injection associated with pickup-ions. These effects involve adjustable parameters that we seek to constrain. Bayesian analysis supports the efficient searching of a parameter space for the 'best' set of TTM parameter values. More advanced use provides the parameter's posterior distribution: its probability given the data, and the model. This can be used to understand the uncertainty in the provided 'best' values for the parameters and therefore the uncertainty in the suggested TTM solutions/predictions. By using NS, we can calculate the Bayesian evidence for each TTM and objectively determine which best fits the given observational data. Based on the analysis of the datasets and TTM employed, we recommend use of the 2D TTM with von Karman-Howarth parameters $α\approx 0.16$ and $β\approx 0.10$ and parameter assumptions from existing literature. It is important to include the pickup ion effects in the lengthscale evolution equation by assuming $Z^{2β/α}λ= const$ is locally conserved. This work is readily extended to more sophisticated solar wind models. Although more work is required to generate datasets with associated errors, which is necessary for accurate Bayesian modelling.

  PublisherOA PDFDOI

Recent grants

• NIH Grant R01AT006334

  NIH · $1.6M · 2017

• NIH Grant K01AR054331

  NIH · $554k · 2014

Frequent coauthors

• Steven Z. George

  Clinical Research Institute

  70 shared

• Joel E. Bialosky

  University of Florida

  42 shared

• Jason M. Beneciuk

  Brooks Rehabilitation Clinical Research Center

  34 shared

• Michael E. Robinson

  University of Florida

  32 shared

• Jorge Hugo Villafañe

  31 shared

• Meryl Alappattu

  University of Florida

  25 shared

• Silvia Turroni

  University of Bologna

  16 shared

• Andrea Battaglino

  16 shared

Education

• Ph.D., Physical Therapy

  University of Florida

  1990

• M.S., Physical Therapy

  University of Florida

  1987

• B.S., Physical Therapy

  University of Florida

  1985