PT Inquest

Back again (sorry). This time talking about PFP. A lot of people confuse the subtle differences of all the factors that underlie the heading "strength". Many are not interchangeable and should be thought about as separate constructs. This episode looks at how rate of force development may be a large factor in rehabilitation, specifically regarding PFP.

Hip rate of force development and strength are impaired in females with patellofemoral pain without signs of altered gluteus medius and maximus morphology. Nunes GS, Barton CJ, Serrão FV. J Sci Med Sport. 2017 May 24. pii: S1440-2440(17)30440-1. doi: 10.1016/j.jsams.2017.05.014. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Sorry everyone. Erik has a bit too much going on these next couple weeks so we need to take a short 4 week break. We promise to resume with the next 10 episodes after that. If you want to catch Erik at his courses in Australia in early August or the small Portland course he is doing in September, go to http://thesciencept.com and click on the courses link.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Can someone do poorly on static balance tests and NOT be an ACL injury risk? I mean, if they're having a hard time there they MUST be having issues during sport, right? Can poor coordination during one task predict poor coordination in another? What about more dynamic tests? IS JW ON DRUGS?!

No association between static and dynamic postural control and ACL injury risk among female elite handball and football players: a prospective study of 838 players. Steffen K, Nilstad A, Krosshaug T, Pasanen K, Killingmo A, Bahr R. Br J Sports Med. 2017 Feb;51(4):253-259. doi: 10.1136/bjsports-2016-097068.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

WE ARE BACK FROM BREAK and bringing with us some biologics! When talking biologics like PRP and "stem cells" sloppy research abounds. This reality isn't really fair to anyone trying to find a deeper understanding of what may or may not be going on here. Can we do better with this process? Can physical therapists apply some of these same reporting guidelines to their on research to provide a better "fair test"? Do you find this episode...Bohrium?

Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO): Platelet-Rich Plasma and Mesenchymal Stem Cells. Murray IR, Geeslin AG, Goudie EB, Petrigliano FA, LaPrade RF. J Bone Joint Surg Am. 2017 May 17;99(10):809-819. doi: 10.2106/JBJS.16.00793.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

We all love evidence-based medicine (EBM) with its three pillars and levels of evidence and science-sounding stuff. But why do we even have it? And does it mean what we think it means? 25 years later, have we really changed very much as a profession? Erik liked this article so much that he should marry it! Unfortunately marrying a document is not yet legal in the State of Oregon.

See everyone in 3 months! Going on break...

Progress in evidence-based medicine: a quarter century on. Djulbegovic B, Guyatt GH. Lancet. 2017 Feb 16. pii: S0140-6736(16)31592-6. doi: 10.1016/S0140-6736(16)31592-6. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Meniscal repairs are notorious for having a mix of opinions regarding postoperative precautions. Should we be restricting weight bearing? Range of motion? Both? Neither? Does any of it matter? Why or why not? Wait for the drop!

Rehabilitation Protocols After Isolated Meniscal Repair. O'Donnell K, Freedman KB, Tjoumakaris FP. Am J Sports Med. 2016 Oct 1:363546516667578. doi: 10.1177/0363546516667578. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

The prevalence of low-value healthcare is a huge burden on the global healthcare system. Sure, unnecessary care drives up costs and diverts scarce resources away from where they could provide more overall societal benefit, but are there other harms as well? Do physical therapists unknowingly make this problem worse, especially when it comes to treating diagnoses like low back pain? Are there broader ethical concerns to consider when engaging in simple promotion of a healthcare profession? Will JW abandon a hockey team's state championship game just to record an episode of PT Inquest?! Also "Corinthian"...

Wise choices: making physiotherapy care more valuable. Traeger AC, Moynihan R, Maher CG. J of Physiotherapy. Available online 28 February 2017. OPEN SOURCE!!!

Links relative to the discussion: AMA Code of Medical Ethics APTA Code of Ethics for the Physical Therapist

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

One of the most dreaded perceived complications after shoulder surgery is the development of developing frozen shoulder. Can we spot those who are at increased risk? If we can, is there anything we can do about it? Can a study be more awkward than Erik?

Incidence and prognostic factors for postoperative frozen shoulder after shoulder surgery: a prospective cohort study. Koorevaar RC, Van't Riet E, Ipskamp M, Bulstra SK. Arch Orthop Trauma Surg. 2017 Mar;137(3):293-301. doi: 10.1007/s00402-016-2589-3. Epub 2017 Jan 28.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

I know my treatment doesn't work across a large population but what about subgroups?! Ah yes. Subgroups. Subgroups are absolutely a thing but how do we go about defining them? Do we just track everyone we treat then look back to see who responded and who didn't? Or is it more complicated than that? Find out on this dynamite episode of Nobel proportions!

Evaluation of Evidence of Statistical Support and Corroboration of Subgroup Claims in Randomized Clinical Trials. Wallach JD, Sullivan PG, Trepanowski JF, Sainani KL, Steyerberg EW, Ioannidis JP. JAMA Intern Med. 2017 Feb 13. doi: 10.1001/jamainternmed.2016.9125. [Epub ahead of print]

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

The quad index (side to side strength comparison of the quadriceps) is one of the best known correlations to knee function, but can you test it accurately in the clinic? Do you need an expensive electromechanical dynamometer or can you get by with simpler tools? Also, are you going to CSM?

Diagnostic Accuracy of Handheld Dynamometry and 1-Repetition-Maximum Tests for Identifying Meaningful Quadriceps Strength Asymmetries. Sinacore JA, Evans AM, Lynch BN, Joreitz RE, Irrgang JJ, Lynch AD. J Orthop Sports Phys Ther. 2017 Feb;47(2):97-107. doi: 10.2519/jospt.2017.6651.

Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us.

Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission