In this research recap, look at the current research on rehabilitation for chronic pain in pediatric patients.

Applying the evidence to your clinical practice:

• How do you assess and treat psychosocial factors in pediatric patients?
• What differs in your treatment of pediatric patients compared to adults?
• How do you involve parents in the treatment of chronic pain in pediatric patients?

Links to the studies:

PMID: 36587243
PMID: 36376953

Blog posts:
How Can We Help Adolescents with Persistent Low Back Pain?

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In this research recap, I challenge the common belief that surgery is always needed after an ACL tear. I also look at psychosocial factors that influence return to sport success.

Applying the evidence to your clinical practice:

• What criteria do you use to determine whether surgery is appropriate or not?
• How do you transition a patient from the clinic to the field? What criteria do you use to determine when someone is ready to return to sport?

Links to the studies:

PMID: 36328403
PMID: 36590562

Blog posts:
Is Surgery Necessary after an ACL Tear?
What Psychological Factors Influence ACL Return to Sport?

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In this episode, I speak with Dr. Nicole Surdyka about current misconceptions in ACL rehab, return to sport treatment, and injury prevention strategies. We kick off by discussing clinical debates on social media and in person. We discuss issues around one-size-fits-all treatment approaches in any stage of treating athletes (prehab, in-clinic rehab, return to sport). Nicole also shares her experiences of mentorship and entrepreneurship.

*This episode was recorded in 2020 and aired on the first iteration of the Clinical Gap Podcast on November 4, 2020.

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In this episode, I speak with Dr. Patrick Berner, PT, DPT, RDN about integrating nutrition into physical therapy practice. Patrick is one of only a handful of dual DPT/RDN clinicians in the United States. He provides a valuable perspective for any physio seeking to provide a comprehensive plan of care for patients. Patrick discusses the importance of broaching nutrition conversation, the challenges of navigating nutrition research, and the benefits of building a collaborative approach and bridging the worlds of physical therapy nutrition.

*This episode was recorded in 2020 and aired on the first iteration of the Clinical Gap Podcast on October 21, 2020.

Website, Twitter, LinkedIn

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In this episode, I discuss a few key strategies for supporting health behavior change. I primarily focus on motivational interviewing and social support. These are foundational concepts that can be applied to any patient and clinical encounter.

Relevant studies:
Behavior Change (PMID 27464877)
Motivational Interviewing (PMID 33835006)
Social Support (PMID 17082973)

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In this research recap, I focus on several aspects of exercise, exploring mechanics, the warm-up, and dosing tendons.

Applying the evidence to your clinical practice:

1. How do you determine the appropriate load for treating tendinopathies?
2. When do you change a patient's or client's spine posture during exercise?
3. How do you warm-up patient's or client's for exercise?
4. How does the severity of an ACL tear influence your education and treatment decisions?

Links to the studies:

PMID: 34196903
PMID: 33799053
PMID: 28147703
PMID: 28045756

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Strength, power, and mobility are all vital components of health. How much of each do we need? How do we effectively and efficiently measure each? In this episode, I look at some research on effective objective methods of assessing strength and power. There is more ambiguity with mobility. 


Research articles mentioned:

• Grip Strength: An Indispensable Biomarker For Older Adults
• Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies
• Test-Retest Reliability of the One-Repetition Maximum (1RM) Strength Assessment: a Systematic Review
• Does Strength-Promoting Exercise Confer Unique Health Benefits?
• The ramp power test: a power assessment during a functional task for older individuals
• The sit-to-stand muscle power test: An easy, inexpensive and portable procedure to assess muscle power in older people
• Maximal anaerobic power test in athletes of different sport disciplines
• Jump test performance and sarcopenia status in men and women, 55 to 75 years of age
• The countermovement jump to monitor neuromuscular status: A meta-analysis

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In this episode, I discuss why we aren't very good at making predictions. There are many personal and environmental factors that impact the consistency of our judgments and decisions as well. Bias and noise both impact clinical decisions, but there are a few strategies you can use to minimize their influences.

Books mentions (and highly recommended)
Thinking, Fast and Slow
The Undoing Project: A Friendship That Changed Our Minds
Noise: A Flaw in Human Judgment
Superforecasting: The Art and Science of Prediction

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In this episode, I cover my recent publication Clinical decision making in physical therapy – Exploring the ‘heuristic’ in clinical practice. I cover some content on rationality that I had to cut out in the final version and how it can help your clinical practice.

After two years of work and many rewrites, this project has finally been published.

The paper integrates many of the decision-making theories and principles developed by Daniel Kahneman and Amos Trevesky with clinical decision-making strategies developed by Gerd Gigerenzer and Pat Croskerry.

While those great minds have taught us much about decision-making, heuristics, and bias, those topics have barely been explored in PT. In this perspective, we discuss the use of heuristics and bias in physical therapy practice.

Here are the highlights:

1️⃣Intuition and heuristics guide clinical decision-making in physical therapy.

2️⃣ System 2 thinking and executive override are vital for novice clinicians.

3️⃣ Busy clinical environments, sleep deprivation, and fatigue impair decision-making.

4️⃣ Experts can rely more on intuition and less on clinical information than novices.

5️⃣ External perspectives from mentors and colleagues can help reduce personal bias.

I learned a lot working with @daleyfurter and writing this paper (including all of the rationality content I had to cut for the final version).

Find the full text online until December 8

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This episode explores the fear-avoidance model of pain. I look at different coping and avoidance strategies people use when they experience pain.

I also provide a brief overview of PNE. How can we best integrate PNE and what are some misunderstandings about it?

Lastly, I contrast risk and resilience and how those concepts influence our clinical assessment and education. 

PMID: 20425199
PMID: 35959703

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