In this episode, we talked about:

1. The value of hard work for physiotherapists

Michel D. Landry is a Professor in the Departments of Physiotherapy and Global Health at the Western Norway University of Applied Sciences (Bergen, Norway).  He was the Chair of the Department of Physical Therapy and Associate Dean for Global Health in the College of Health Professions at Virginia Commonwealth University (VCU) in Richmond, Virginia, from 2021-23, and was a Professor and Division Chief of Duke University’s Doctor of Physical Therapy Division in Durham, North Carolina from 2011-2021.  At Duke, he successfully led an essential rebuild of the program that is now one of the top physical therapy programs in the United States.  Before arriving at Duke University, he was a tenure-track Assistant Professor at the University of Toronto (2007-2011), where he was also a Career Scientist at the Ontario Ministry of Health and Long-Term Care.  He has held senior clinical management positions within the private rehabilitation sector in Ontario (Canada) and leadership positions within international humanitarian aid and development agencies in conflict, emergency, and disaster settings.  Dr. Landry is a past president of the Canadian Physiotherapy Association and the current President of World Physiotherapy, the global body that represents 700,000 physiotherapists around the world.  He delivered the 2020 Enid Graham Memorial Lecture, and in 2023, he received the Dean’s Award of Excellence from the University of Ottawa’s Alumni of the Faculty of Health Sciences for his commitment to global health and physiotherapy. 

Connect with Dr. Mike Landry

X: @drmikelandry                                                                 

www.drmikelandry.ca

insta: mikelandryphysio

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about:

Dr. Whittaker is an Associate Professor in the Faculty of Medicine at the University of British Columbia (UBC), Senior Research Scientist at Arthritis Research Canada, and recognized as a Clinical Specialist in Musculoskeletal Physiotherapy by the Canadian Physiotherapy Association. Dr. Whittaker’s research focuses on long-term athlete welfare with a specific focus on musculoskeletal health after sport-related injuries. This includes research to improve injury care pathways, understand the consequences of injuries, and develop approaches to optimize function and healthy behaviours after injury. Two themes that cross cut Jackie’s research are exposing and overcoming gendered environments that disadvantage female athletes, and partnering with people on the front lines including athletes, family members, coaches, trainers, and health care providers to ensure her research produces solutions that are acceptable, relevant, and empowering.

Resources: 

I had the pleasure and privilege of attending the annual Canadian Physiotherapy Association Congress in Beautiful Vancouver in April. This episode compiles 8 interviews I conducted during the congress with clinicians. I think this is one of the best ways to involve more clinicians in the discussion of pain and physiotherapy. Last year, I asked about their views on and approaches to pain. This year, I asked them about their feelings about treating pain, what they wish to learn more about, and a memorable experience as a clinician. I also have a student interview at the end.

Timestamp

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 

This episode showcases how Virtual Reality, VR in short, can be used to facilitate, advance, and even transform pain education, management, and research. You'll hear about a few different applications of VR in physiotherapy, including using VR as a tool for pain neuroscience education, VR for phantom limb pain, and VR for research. We also highlight the current literature related to these applications. Note that this episode is a limited demonstration of how VR can be used in different aspects of pain care and there are a lot more out there. Interested listeners can refer to the review papers I have cited in the episode description.

Timestamps:

Relevant resources:

VR for pain overview:

1. Ahmadpour, N., et al. (2019). Virtual Reality interventions for acute and chronic pain management. The international journal of biochemistry & cell biology, 114, 105568.

VR for phantom limb pain:

1. Limakatso, K., et al. (2020). The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial. Physiotherapy, 109, 65-74.

SilicoLabs: www.silicolabs.ca

Reality Health: https://reality.health/home/

1. Skidmore, N., et al. (2024). Acceptability and Feasibility of Virtual Reality to Promote Health Literacy in Primary Care from the Health Professional’s view: A Qualitative Study. Patient Education and Counseling, 108179.

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Neil Pearson is a physical therapist, yoga therapist, author, researcher, Clinical Associate Professor at the University of British Columbia, faculty in three IAYT-accredited yoga therapy programs, board member for International Association of Yoga Therapists and pain care advocate. He is the founding chair of the Canadian Physiotherapy Association’s Pain Science Division, and the recipient of awards honouring his work in pain care, patient education and physiotherapy by Queen’s University, the Canadian Pain Society, and Physiotherapy Associations of BC and Canada, including the Canadian 2021 Medal of Distinction. Neil is involved in research studying the effects of yoga and pain-informed movement practices on people with knee osteoarthritis, and has written numerous peer-reviewed papers on yoga, yoga therapy and pain, including a white paper describing the position of yoga therapy within comprehensive integrated pain management. He is a consultant to Partners in Canadian Veterans Rehabilitation Services, and to Lifemark’s 300+ clinics in Canada. Neil is a past board member for Pain BC, Canada’s premier non-profit transforming the way pain is understood and treated. He co-authored – Yoga and Science in Pain Care 2019, authored the patient education ebook, Understand Pain Live Well Again in 2008, and is lead contributor to many free patient resources offered by Pain BC. Neil provides physiotherapy and yoga therapy to veterans at the Broken Squirrel Clinic in Courtenay, BC.

In this episode, we talked about what pain-informed movement is, its underlying cognitive and neurophysiological mechanisms to help chronic patients move more with more ease, and practical considerations on implementing pain-informed movement. Enjoy!

Relevant resources:

1. www.paincareaware.com

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Peter Stilwell is a Postdoctoral Researcher at McGill University in the School of Physical and Occupational Therapy, where he holds a Fellowship from the Canadian Institutes of Health Research (CIHR). His research is focused on the topics of pain, suffering, and person-centered care. For the past two years, he was the Ronald Melzack Fellow in Chronic Pain Research at the Alan Edwards Centre for Research on Pain (AECRP) at McGill. He was recently awarded the MSCA Fellowship from the European Union, which he will start later this year at the University of Southern Denmark. He has a Doctor of Chiropractic degree from the Canadian Memorial Chiropractic College (CMCC) and has worked mostly with people living with persistent spinal pain and he placed an emphasis on patient education, exercise, and supported self-management. In addition to his research and clinical background, he has been heavily involved in teaching, student supervision, and community-based initiatives, including co-creating and facilitating a highly successful free health education and walking program that attracted over 1700 members.

Dr. Timothy Wideman is an associate professor at the School of Physical and Occupational Therapy, at McGill University. The overarching goal of his research program is to improve the lives of people living with pain. His lab works toward this goal by focusing on three streams of research including understanding and targeting biopsychosocial risk factors for prolonged pain and disability, improving entry-level pain education for health professionals through large-scale knowledge translation initiatives, and understanding and addressing pain-related suffering.

In this episode, we talked about an alternative framework to the biopsychosocial model for a whole-person approach to pain care, how metaphors are commonly used languages to describe pain, and the emerging theoretical research to better understand pain-related suffering.

Resources:

Twitter: @Peter_Stilwell

Website: www.drpeterstilwell.com 

Open access paper on pain-related suffering: https://pubmed.ncbi.nlm.nih.gov/34852304/

Painful metaphors: https://mh.bmj.com/content/47/2/235

Dr. Timothy H Wideman website: https://www.mcgill.ca/spot/timothy-h-wideman

Tim’s twitter: @TH_Wideman

Paper published in 2023 on inclusive definition of pain-related suffering and targeted care: https://www.jpain.org/article/S1526-5900(22)00459-X/fulltext

Barker KL, et. al. Divided by a lack of common language? A qualitative study exploring the use of language by health professionals treating back pain. BMC Musculoskelet Disord. 2009; 10(123): 1-10.

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Tyson Beach is currently a teaching professor at the University of Waterloo, teaching courses on the biomechanics and assessment of human movement, exercise prescription, and low-back disorders. His previous research focused on quantitative motion analyses, prevention of work-related musculoskeletal disorders, and advancing fundamental knowledge of spinal mechanics, control, and injury causation. He also collaborates with other knowledge producers (researchers) and users (practitioners) to design, implement, and evaluate physical activity and exercise programs for workers and athletes.

In this episode, we discussed the literature on exercise interventions for low back disorders. Continuing the discussion from previous episodes (Ep19-20), we talked about factors affecting how people lift, movement-related strategies to manage low back disorders, and how we can encourage people to participate in physical activity.

Note that this episode presents perspectives in movement-based strategies for low back disorders through the lens of biomechanics and exercise. It is not an attempt to address the topic exhaustively, nor does it attempt to address all of low back disorders. 

Relevant articles

1. Carnegie, D. R., et al. (2023). Can we enable individuals to reach further down without rounding their backs before beginning a lift? Examining the influence of starting foot and trunk position on reach depth. Ergonomics, 1-30.

Discussion flow

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topics are researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Tyson Beach is currently a teaching professor at the University of Waterloo, teaching courses on the biomechanics and assessment of human movement, exercise prescription, and low-back disorders. His previous research focused on quantitative motion analyses, prevention of work-related musculoskeletal disorders, and advancing fundamental knowledge of spinal mechanics, control, and injury causation. He also collaborates with other knowledge producers (researchers) and users (practitioners) to design, implement, and evaluate physical activity and exercise programs for workers and athletes.

This episode is a continuation of the discussion from the last episode. We continued to discuss important factors to consider when reading the literature relating to lifting and spine flexion. In this episode, we went more in-depth in spine biomechanics during lifting in different contexts.

Relevant articles (Part 2)

1. Frost, D. M., et al. (2015). Exercise-based performance enhancement and injury prevention for firefighters: contrasting the fitness-and movement-related adaptations to two training methodologies. J. Strength Cond. Res., 29(9), 2441-2459.

Discussion flow

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Tyson Beach is currently a teaching professor at the University of Waterloo, teaching courses on the biomechanics and assessment of human movement, exercise prescription, and low-back disorders. His previous research focused on quantitative motion analyses, prevention of work-related musculoskeletal disorders, and advancing fundamental knowledge of spinal mechanics, control, and injury causation. He also collaborates with other knowledge producers (researchers) and users (practitioners) to design, implement, and evaluate physical activity and exercise programs for workers and athletes.

In this episode, we discussed the epidemiological and biomechanical literature around lifting with spinal flexion. Acknowledging that biomechanics is only one of the many factors in low back disorders, the goal of the discussion is to highlight the nuances in understanding biomechanics literature rather than to provide a definitive answer to this topic.

Relevant articles (Part 1)

1. Saraceni, N., et al. (2020). To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review with meta-analysis. JOSPT, 50(3), 121-130.

Discussion flow

(00:01:35) Introduction

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Lucas Lima is a research associate at the Alan Edwards Centre for Research on Pain at McGill University. He is a physiotherapist with a PhD and postdoctoral training in pain neuroscience. His latest research, published in the Science Translational Medicine journal, has garnered significant media attention for challenging current practices in acute musculoskeletal pain management, specifically the suggestion that NSAID’s might increase the risk of developing chronic pain.

In this episode, we talked about what inflammation is, recent evidence on the relationship between inflammation and chronification of acute pain, the benefits of exercise to prevent chronic pain, improve recovery of present and future injury, and evidence-based recommendations on NSAIDs and cryotherapy (icing) post-injury.

Resources

Main paper: https://www.science.org/doi/full/10.1126/scitranslmed.abj9954

Pain center Youtube page: https://youtu.be/751NtSbCh6Q?si=U7rFeRfYXzPgkUFZ

Dr. Lima's email: [email protected]

Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8