Inside the Science

In S1E5 of Inside the Science, I'm joined by Ms. Audrey Long, author of Does it matter which exercise? A randomized controlled trial of exercise for low back pain which was published in Spine in 2004. Although it's over 15 years old it is a fundamental study for any clinician who evaluates and treats patients with low back pain. Being how common comparative effectiveness studies which show results where all the groups are improved but none more than the others, this study shows a different result. Comparing groups with a matched program to their directional preference, a non-matched program and a control group who received "evidence based" nondirectionally-specific exercises this trial revealed stark differences in patient responses. Hear Audrey acknowledge its limitations, how she uses this study with her patient education and how she'd encourage clinicians to be careful to not exaggerate its findings.

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In S1E4 of Inside the Science, we summarize and discuss with the author, Dr. Ron Donelson, the study, A Prospective Study of Centralization of Lumbar and Referred Pain: A Predictor of Symptomatic Discs and Annular Competence. This paper hypothesized that the morphology and image findings of lumbar discs could be predicted by MDT therapists based on their symptom response. Dr. Donelson gives some background to the study, the limitations, big takeaways and an additional paper the avid clinician will want to read.

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In S1E3 we summarize a systematic review of the Sharp-Purser test by Dr. Cody Mansfield. We share its four aims including to determine its diagnostic accuracy, its reliability, its safety and patterns of use. We share sensitivity, specificity, positive and negative likelihood ratios and we hear from Dr. Mansfield as to what prompted this work.

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In S1E2 we highlight a case report by Dr. Cody Mansfield entitled, Cervical myelopathy causing numbness and paresthesias in lower extremities: A case report identifying the cause of a false positive Sharp–Purser test. Differential diagnosis, the diagnostic accuracy and safety and appropriateness of utilizing the Sharp-Purser test are all major themes in this paper. Subscribers to the premium version will hear more details on this case, how this case prompted a systematic review of the Sharp-Purser test which we'll highlight in S1E3, the big takeaways and additional studies which will further focus on screening for red flags, special test sensitivity, and other, related special tests.

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S1E1 includes a review of the JMMT 2019 study, The Cost Impact of Quality-Assured Mechanical Assessment in Primary Low Back Pain Care. Subscribers of Inside the Science premium will hear Dr. Donelson share the motivation behind conducting and publishing this study, limitations, the implications, additional studies and the big takeaways for those clinicians treating patients with low back pain.

We hope to deliver this content to the committed professional who wants to improve his/her care and we hope to do it in a way that is easily accessible, the world over, in today's technological age.

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