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 Permiss

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 s

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

It is a landmark episode for PT Inquest - the century mark! No article to review but the guys look back on some of our listeners' favorite episodes and topics from over the years. Full list of episodes can be found on the PT Inquest Home Page. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission "Balkan in the City" by rocavacoLicensed under a Attribution (3.0) "café connection" by morgantjLicensed under a Attribution (3.0) "Otra Vez (sight mix)" by gmzLicensed under a Attribution (3.0)

We got 99 episodes but a bad one ain't...one! That didn't work. Dammit. Anyway, this episode takes another look at whether or not early range of motion after rotator cuff repair makes a difference during recovery. Also there are balloons... The Effect of Early Range of Motion on Quality of Life, Clinical Outcome, and Repair Integrity After Arthroscopic Rotator Cuff Repair. Mazzocca AD, Arciero RA, Shea KP, Apostolakos JM, Solovyova O, Gomlinski G, Wojcik KE, Tafuto V, Stock H, Cote MP. Arthroscopy. 2017 Jan 19. pii: S0749-8063(16)30889-1. doi: 10.1016/j.arthro.2016.10.017. [Epub ahead of print] Here is the supplemental material page. Here is the pre-trial registration. 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  

In this first for PT Inquest, the guys review a letter to the editor. No paper is perfect. When looking in hindsight, papers that seemed to be originally accurate reveal themselves to be flawed. How do we steer clear of those mistakes in the present? What is the responsibility of a journal to catch these issues before publishing a paper? Would any of our listeners like to buy JW a '60s era Oldsmobile 98? High Risk of Bias and Low Transparency in "How Effective are F-MARC Injury Prevention Programs for Soccer Players? A Systematic Review and Meta-Analysis". Thorborg K, Krommes K, Esteve E, Clausen MB, Bartels EM, Rathleff MS. Sports Med. 2016 Feb;46(2):293-4. doi: 10.1007/s40279-015-0458-9. Here is the original article. Here is the authors' reply. The video from Veritasium that Erik references: https://youtu.be/42QuXLucH3Q 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

What do you believe about the treatments, screenings, and tests that you use as a clinician? What are the potential benefits? What are the potential harms? How accurate are your beliefs? Does anyone know what a Proth prime is? Clinicians’ Expectations of the Benefits and Harms of Treatments, Screening, and Tests: A Systematic Review. Hoffmann TC, Del Mar C. JAMA Intern Med. Published online January 9, 2017. doi:10.1001/jamainternmed.2016.8254 Open Access at the time of release The similar article on patient expectations that was referenced in the podcast. Open Access at the time of release 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

On this episode the guys review a clinical commentary on patellofemoral pain (PFP) written by Rich Willy and some moron (Erik and his dumb face). How should we best conceptualize PFP? Is Scott Dye's "envelope of function" accurate or even useful? Does this understanding change the way we treat this enigmatic diagnosis for the better? We break out the shorts and t-shirts as the temperature in Minnesota gets above 0°F! Current concepts in biomechanical interventions for patellofemoral pain. Willy RW, Meira EP. Int J Sports Phys Ther. 2016 Dec;11(6):877-890. Open Access at the time of release 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

It's time for another season of PT Inquest! This first paper does not bode well for the idea of seeing a PT early making much of a difference in long term costs and outcomes for acute low back pain in older patients. How was this study conducted? What does this mean for physical therapists? As a profession, are we promoting ourselves in spite of the research? Are there ethical implications? Is there a roadmap forward? Is JW becoming the weakest member of his family?! Subsequent healthcare utilization associated with early physical therapy for new episodes of low back pain in older adults. Karvelas DA, Rundell SD, Friedly JL, Gellhorn AC, Gold LS, Comstock BA, Heagerty PJ, Bresnahan BW, Nerenz DR, Jarvik JG. Spine J. 2016 Oct 17. pii: S1529-9430(16)31013-0. doi: 10.1016/j.spinee.2016.10.007. [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,

The PT Podcast Network crew are here to spread some holiday cheer with the annual PT Podcast Network Extravaganza! They talk Jedis, rectums, Festivus, and horrible jet lag - all the holiday standards. Some say it's unlistenable...but you get to judge for yourself! Music for The PT Podcast Holiday Extravaganza: Kevin MacLeod - incompetech.com  

As the fellas wrap up this season of PT Inquest, they discuss the newly released Warwick Agreement on FAI Syndrome. What do we know about this condition? What differentiates "FAI" from "FAI syndrome"? What is the best way to diagnose and then manage this? WHY CAN'T WE ALL GET ALONG?! (We can and do.) What is your favorite crappy action movie? SEE YOU ALL IN 12 WEEKS!!! The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M, Clohisy JC, Dijkstra HP, Falvey E, Gimpel M, Hinman RS, Hölmich P, Kassarjian A, Martin HD, Martin R, Mather RC, Philippon MJ, Reiman MP, Takla A, Thorborg K, Walker S, Weir A, Bennell KL. Br J Sports Med. 2016 Oct;50(19):1169-76. doi: 10.1136/bjsports-2016-096743. Open Access at the time of release You can also download Supplementary File A which is a simple summary of the agreement. Due to copyright laws, unless the article is open source we cannot legally post

Early evidence suggests that heavy load isometrics may be effective for acute reduction in patellar tendon pain in a laboratory setting, but is it effective for managing patellar tendon pain for athletes during their competitive season? How does it compare to isotonics (heavy slow resistance)? Does the type of contraction matter more than the total time that the heavy load is applied? Is Erik too tired to think straight? Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial. van Ark M, Cook JL, Docking SI, Zwerver J, Gaida JE, van den Akker-Scheek I, Rio E. J Sci Med Sport. 2016 Sep;19(9):702-6. doi: 10.1016/j.jsams.2015.11.006. Epub 2015 Dec 7. Open Access at the time of release Check out Peter Malliaras' blog post on this paper! 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, co

Can we predict which shoulder patients will get better with physical therapy? How much does the psychology of the patient play into their response? Does it have anything to do with the actual treatment provided by the therapist or were these patients going to get better no matter what? Is JW actually DYNOMIIIITE!!!!! Hip Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: a multicentre longitudinal cohort study. Chester R, Jerosch-Herold C, Lewis J, Shepstone L. Br J Sports Med. 2016 Jul 21. pii: bjsports-2016-096084. doi: 10.1136/bjsports-2016-096084. [Epub ahead of print] Open Access at the time of release 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