Pt Inquest

Brought to you by CSMi What happens when you go onto the interwebs and search for information from the websites of reputable organizations (government, hospital, university, professional associations, etc)? Is it accurate? Who defines accurate? What is the purpose of these websites? Credibility, Accuracy, and Comprehensiveness of Internet-Based Information About Low Back Pain: A Systematic Review. Ferreira G, Traeger AC, Machado G, O'Keeffe M, Maher CG. J Med Internet Res. 2019 May 7;21(5):e13357. doi: 10.2196/13357. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi. Following an algorithm in medicine (and other high consequence professions) is shown to result in better outcomes. But isn't that just like following a cookbook? Or is it more about making sure that we don't miss things? Evidence-based algorithm to treat patients with proximal humerus fractures-a prospective study with early clinical and overall performance results. Spross C, Meester J, Mazzucchelli RA, Puskás GJ, Zdravkovic V, Jost B. J Shoulder Elbow Surg. 2019 Jun;28(6):1022-1032. doi: 10.1016/j.jse.2019.02.015. Epub 2019 Apr 16. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi Doing a manipulation on the thoracic spine may help people with cervical radiculopathy but there are a lot of questions to answer here. This paper has an odd presentation of the data and generates concerns when looking at the pretrial registration (https://clinicaltrials.gov/ct2/show/NCT01495728?term=NCT01495728&rank=1). Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial. Young IA, Pozzi F, Dunning J, Linkonis R, Michener LA. J Orthop Sports Phys Ther. 2019 May;49(5):299-309. doi: 10.2519/jospt.2019.8150. Epub 2019 Apr 25. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi Is there a lack of diversity in orthopedics? Is improving diversity around gender the same challenge as improving diversity around race? Why are some areas of medicine improving while others are still having issues? In this episode we look at the specific issues around orthopedics and see if there are lessons that can be learned in the physical therapy profession. The Orthopaedic Workforce Is Not as Diverse as the Population It Serves: Where Are the Minorities and the Women?: AOA Critical Issues Symposium. Harrington MA, Rankin EA, Ladd AL, Mason BS. J Bone Joint Surg Am. 2019 Apr 17;101(8):e31. doi: 10.2106/JBJS.18.01010. Academic Metrics Do Not Explain the Underrepresentation of Women in Orthopaedic Training Programs. Poon S, Nellans K, Crabb RAL, Rothman A, Wendolowski SF, Kiridly D, Gecelter R, Akerman M, Chahine NO. J Bone Joint Surg Am. 2019 Apr 17;101(8):e32. doi: 10.2106/JBJS.17.01372. Due to copyright laws, unless the article is open source we cannot legally post the PDF

Brought to you by CSMi Does the weight of an athlete matter when considering how much force they can handle? Is obesity the cause of disease or just something else that was caused by the cause of disease; whatever that actually is? Here we take a look at understanding predictors versus understanding causation and how this affects interventions for public health. Why causality, and not prediction, should guide obesity prevention policy. Chiolero A. Lancet Public Health. 2018 Oct;3(10):e461-e462. doi: 10.1016/S2468-2667(18)30158-0. Epub 2018 Sep 1. The article mentioned in the Mail Hole: Normalization influences knee abduction moment results: Could it influence ACL-injury research, too? Norcross MF, Johnson ST, Pollard CD, Chang EW, Hoffman MA. J Sci Med Sport. 2017 Apr;20(4):318-321. doi: 10.1016/j.jsams.2016.10.005. Epub 2016 Oct 21. 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 di

Brought to you by CSMi In previous episodes we have talked about many issues around biologics research. This article takes an honest look at PRP for patellar tendinopathy by including two different preparations AND a placebo group. How did it turn out? Not so well for PRP... Platelet-Rich Plasma for Patellar Tendinopathy: A Randomized Controlled Trial of Leukocyte-Rich PRP or Leukocyte-Poor PRP Versus Saline. Scott A, LaPrade RF, Harmon KG, Filardo G, Kon E, Della Villa S, Bahr R, Moksnes H, Torgalsen T, Lee J, Dragoo JL, Engebretsen L. Am J Sports Med. 2019 Apr 30:363546519837954. doi: 10.1177/0363546519837954. [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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi There is a lot of health misinformation out there from simple "wellness" advice to anti-vaccination zealots, but what do we as medical providers do about it? Is it time to wage war? How high are the stakes? How do we make a difference? Do medical journals play a role? Counteracting Health Misinformation: A Role for Medical Journals? Armstrong, PW, Naylor CD. JAMA. Published online April 22, 2019. doi:10.1001/jama.2019.5168 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

There are studies that show that a hip focused exercise program helps for PFP; there are others that show that a knee focused exercise program also works. Is one better than the other? What about just doing ANY kind of exercise? This study takes a look at answering those questions...kind of. Effectiveness of Isolated Hip Exercise, Knee Exercise, or Free Physical Activity for Patellofemoral Pain: A Randomized Controlled Trial. Hott A, Brox JI, Pripp AH, Juel NG, Paulsen G, Liavaag S. Am J Sports Med. 2019 Apr 8:363546519830644. doi: 10.1177/0363546519830644. [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. Brought to you by CSMi Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

"You hate on everything! What do you even do with your patients? Why so negative?" We've heard it all before, and so have the authors of this paper. This open source article explores and defends the position of being skeptic within the medical world. The Case for Being a Medical Conservative. Mandrola J, Cifu A, Prasad V, Foy A. Am J Med. 2019 Mar 6. pii: S0002-9343(19)30167-6. doi: 10.1016/j.amjmed.2019.02.005. [Epub ahead of print] Open Source! 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi Historically is has been typical to expect to return from an ACL reconstruction around 6 months after surgery. We know know that such suggestions are not very well founded. What can a study with over 3500 subjects tell us about how these athletes typically look at this time point? Only one patient out of five achieves symmetrical knee function 6 months after primary anterior cruciate ligament reconstruction. Cristiani R, Mikkelsen C, Forssblad M, Engström B, Stålman A. Knee Surg Sports Traumatol Arthrosc. 2019 Feb 18. doi: 10.1007/s00167-019-05396-4. [Epub ahead of print] Open Source! 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi When we say that a patient is "strong", what does that mean exactly? Can a single muscle do well on one strength test but poorly on another? Are some tests more "functional"? Sometimes it is less about IF they are strong and more about WHEN they are strong... Deficits in rate of torque development are accompanied by activation failure in patients with knee osteoarthritis. Ventura A, Muendle B, Friesenbichler B, Casartelli NC, Kramers I, Maffiuletti NA. J Electromyogr Kinesiol. 2019 Feb;44:94-100. doi: 10.1016/j.jelekin.2018.11.010. Epub 2018 Dec 4. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

In this episode we swap podcast feeds in order to confuse the crap out of you and see if anyone reads the show notes. Hint: Take a look at the release date. For real, listen to the episode though. More info at https://www.ptpintcast.com/  

Brought to you by CSMi This episode explores the application of exercises starting 2 months after total knee replacement. Is working with a PT better than just joining a community program? If there are performance improvements, is there much of an effect on perceived function? How difficult is it to answer these questions? Effectiveness of Later-Stage Exercise Programs vs Usual Medical Care on Physical Function and Activity After Total Knee Replacement: A Randomized Clinical Trial. Piva SR, Schneider MJ, Moore CG, Catelani MB, Gil AB, Klatt BA, DiGioia AM, Almeida GJ, Khoja SS, Sowa G, Irrgang JJ. JAMA Netw Open. 2019 Feb 1;2(2):e190018. doi: 10.1001/jamanetworkopen.2019.0018. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Per

Brought to you by CSMi This episode explores the nature of fixating an injury in a place that normally allows a little movement. Should the fixation also allow some movement? Would this allow faster return to function? Can breaking a screw actually lead to better outcomes? We also explore the need for services like PRISMA. Suture Button Versus Syndesmotic Screw for Syndesmosis Injuries: A Meta-analysis of Randomized Controlled Trials. Shimozono Y, Hurley ET, Myerson CL, Murawski CD, Kennedy JG. Am J Sports Med. 2018 Nov 26:363546518804804. doi: 10.1177/0363546518804804. [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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi This article ruffled some PT feathers. In a head to head match up, many interpreted this RCT to show that surgery beats physical therapy, but is there more to it? Would Erik and JW have been able to put together a better rehab program than what was studied in this paper? Perhaps...perhaps not. This article gives a great opportunity to contrast the quality of research in the surgical and rehabilitation worlds. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. Palmer AJR, Ayyar Gupta V, Fernquest S, et al. BMJ. 2019 Feb 7;364:l185. doi: 10.1136/bmj.l185. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short

Brought to you by CSMi Epidemiology studies are a fascinating snapshot of injuries in a population, but they also provide insight on how we interpret data. How common are lumbar spine injuries amongst elite athletes? How are they defined? How limiting are they? Is there a group we should address and another group we should leave alone? Lumbar Spine Injuries in National Collegiate Athletic Association Athletes: A 6-Season Epidemiological Study. Hassebrock JD, Patel KA, Makovicka JL, Chung AS, Tummala SV, Peña AJ, Williams KE, Hartigan DE, Chhabra A. Orthop J Sports Med. 2019 Jan 23;7(1):2325967118820046. doi: 10.1177/2325967118820046. eCollection 2019 Jan. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Brought to you by CSMi Low value healthcare (like ordering imaging for patients with nonspecific low back pain) is a known issue for healthcare providers. But how big of an issue is it? Are the best providers doing that much better than the worst offenders? Why do they do this? Is there anything we can do about medical overuse and all the problems that come with it? Analysis of Physician Variation in Provision of Low-Value Services. Schwartz AL, Jena AB, Zaslavsky AM, McWilliams JM. JAMA Intern Med. 2019 Jan 1;179(1):16-25. doi: 10.1001/jamainternmed.2018.5086. Medical Overuse as a Physician Cognitive Error: Looking Under the Hood. Korenstein D. JAMA Intern Med. 2019 Jan 1;179(1):26-27. doi: 10.1001/jamainternmed.2018.5136. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of S

Brought to you by CSMi Pain catastrophizing has been shown to have an affect on outcomes specifically after total knee arthroplasty. This article took a good look at the problem and many people interpreted the findings to say that cognitive behavioral therapy (CBT) wasn't effective. Turns out it's much more interesting than that... Pain Coping Skills Training for Patients Who Catastrophize About Pain Prior to Knee Arthroplasty: A Multisite Randomized Clinical Trial. Riddle DL, Keefe FJ, Ang DC, Slover J, Jensen MP, Bair MJ, Kroenke K, Perera RA, Reed SD, McKee D, Dumenci L. JBJS. February 6, 2019 - Volume 101 - Issue 3 - p 218-227 doi: 10.2106/JBJS.18.00621. The effectiveness trial. Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study. Riddle DL, Keefe FJ, Nay WT, McKee D, Attarian DE, Jensen MP. Arch Phys Med Rehabil. 2011 Jun;92(6):859-65. doi: 10.1016/j.apmr.2011.01.003. Epub 2011 Apr 29. The efficacy trial. OPE

Brought to you by CSMi Returning to sport after ACL reconstruction is kind of a complex mess. Strength issues, coordination, soreness, not to mention the psychological factors. How do these things interact? What matters? What should we measure and how? Join us with special guest Ryan Zarzycki from Arcadia University! Psychological Readiness to Return to Sport Is Associated With Knee Kinematic Asymmetry During Gait Following Anterior Cruciate Ligament Reconstruction. Zarzycki R, Failla M, Capin JJ, Snyder-Mackler L. J Orthop Sports Phys Ther. 2018 Dec;48(12):968-973. doi: 10.2519/jospt.2018.8084. Epub 2018 Jul 27. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Therapeutic ultrasound has been relegated to the physical therapy trash heap as "ultraplacebo". But is there an application where it might work? What can we learn about other physical therapy interventions from research on ultrasound? Effect of low-intensity long-duration ultrasound on the symptomatic relief of knee osteoarthritis: a randomized, placebo-controlled double-blind study. Draper DO, Klyve D, Ortiz R, Best TM. J Orthop Surg Res. 2018 Oct 16;13(1):257. doi: 10.1186/s13018-018-0965-0. 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. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission