A home exercise program is not very effective if the patient isn't actually, you know, doing the exercises. Is self-report accurate? What about a home program diary? Does it matter? Does this have any impact on our interpretations of previous literature? Self-Reported Home Exercise Adherence: A Validity and Reliability Study Using Concealed Accelerometers. Nicolson PJA, Hinman RS, Wrigley TV, Stratford PW, Bennell KL. J Orthop Sports Phys Ther . 2018 Jul 27:1-38. doi: 10.2519/jospt.2018.8275. [E...
Jan 15, 2019•43 min
We thought we were done but THEY KEEP PULLING US BACK IN!!! We are back for a full year of weekly episodes thanks to generous sponsorship from CSMi! Brought to you by CSMi In previous episodes we have explored the controversy around the best rehabilitation after rotator cuff (RTC) repair with many papers concluding that it really doesn't matter. But when can you say that things are not going well? And if things are not going well, what can you do about it? If you have an isokinetic machine, make...
Jan 08, 2019•55 min
That's right everyone! It's that time of year again! All the PT Podcast Network voices (except for Adam) have gathered together to bring you some podcast holiday cheer! This very special episode is brought to you by My PT Insurance. Head on over to their website at myptins.com/ptinquest to be entered into a drawing for a $250 Amazon gift card (contest ends February 28, 2019). While you are there listeners can get a $20 discount off their already low price for a professional liability policy - st...
Dec 11, 2018•52 min
It's time for another season finale and we conclude with a discussion of one of the worst things in modern science, the predatory journal. These are journals that make money by publishing literally ANYTHING as long as you pay your fee. The authors of this editorial did just that, publishing a paper where they claimed that manual therapy was applied to a subject who had been dead for 5 years - and he was revived! We explore the history of demonstrations of how bad articles get into publication. H...
Nov 27, 2018•44 min
Accurate education on pain has become a popular mantra in physical therapy practice, specifically around chronic pain. A common argument is to educate at risk patients early in the process to reduce the likelihood of their pain becoming chronic. But just how effective is this? Does it really make that much of a difference? Is it addressing the driving factors related to these subjects? Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back ...
Nov 20, 2018•48 min
Here we go again, hating on physical therapy (the theme song does say "I'm my own worst enemy"...) There have been some recent pushes in the physical therapy world to promote what we do, but has this been the most honest, evidence-based approach? What is the difference between "non-evidence-based" and "evidence-based" marketing? Can we do better? Special guest Joshua Zadro from the University of Sydney School of Public Health and the Institute for Musculoskeletal Health is here to help us figure...
Nov 13, 2018•49 min
Pew! Pew! Pew! Lasers!!! What could be more high tech than that? Hold on a second...what exactly IS a laser? And how is it different than other sources of light? Knowing that, why would you use it? And can you have very high quality research on very low plausibility hypothesis? You bet you can! Incorporation of photobiomodulation therapy into a therapeutic exercise program for knee osteoarthritis: A placebo-controlled, randomized, clinical trial. de Paula Gomes CAF, Leal-Junior ECP, Dibai-Filho ...
Nov 06, 2018•53 min
Thinking your ACLR patients are using compensatory strategies when they are squatting? Simple! Just watch them do a squat and you'll see it with your own eyes...OR WILL YOU?! This week our super-special guest is study lead-author Susan Sigward , Associate Professor of Clinical Physical Therapy at the University of Southern California . Compensatory Strategies That Reduce Knee Extensor Demand During a Bilateral Squat Change From 3 to 5 Months Following Anterior Cruciate Ligament Reconstruction. S...
Oct 30, 2018•1 hr 4 min
A topic we have discussed before, early activity after rotator cuff repair, but this is a different study design. What is meant by non-inferiority? Is this the same as saying equal? What if it was better? Would such a paper tell us? No Functional Difference Between Three and Six Weeks of Immobilization After Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Non-Inferiority Trial. Jenssen KK, Lundgreen K, Madsen JE, Kvakestad R, Pripp AH, Dimmen S. Arthroscopy . 2018 Oct;34(10...
Oct 23, 2018•47 min
Anterior Cruciate Ligament Reconstruction (ACLR) is a procedure that has a lot published on it yet there are still second injury rates as high as 40% in some populations. There seems to be some consensus in the literature as to how these patients should be managed, but do physical therapists actually manage them this way? Embarrassingly the answer is no. Rehabilitation Practice Patterns Following Anterior Cruciate Ligament Reconstruction: A Survey of Physical Therapists. Greenberg EM, Greenberg ...
Oct 16, 2018•56 min
There is a lot of talk amongst medical professionals and the media about sitting being the new smoking. Is that true? How would we compare that? Even if that is not EXACTLY true, what's the harm if it scares people into moving more? This article is open access at the time this episode was released so click the link below to download! Evaluating the Evidence on Sitting, Smoking, and Health: Is Sitting Really the New Smoking? Vallance JK, Gardiner PA, Lynch BM, D'Silva A, Boyle T, Taylor LM, Johns...
Oct 09, 2018•53 min
A lot of people out there, including medical providers, believe that our understanding of chronic traumatic encephalopathy (CTE) or even concussions is complete and conclusive. As with many things, our understanding is very much just emerging. Everything from management to definitions of terms are constantly changing. Is the horse still chasing the cart here? In this episode we take a little tour of what we know and don't know with special guest Jason Hugentobler , the director of the sports phy...
Oct 02, 2018•55 min
Can psychosocial factors predict pain after rotator cuff surgery? Or could they be predictive of a poor outcome in general? Does this mean surgery shouldn't be done in these cases? Also, does hunger have an effect on the quality of a PT Inquest episode? A prospective evaluation of predictors of pain after arthroscopic rotator cuff repair: psychosocial factors have a stronger association than structural factors. Ravindra A, Barlow JD, Jones GL, Bishop JY. J Shoulder Elbow Surg . 2018 Oct;27(10):1...
Sep 25, 2018•46 min
Sometimes it seems like ACL injury can be linked to all kinds of future problems. In this example there is a correlation to future myocardial infarction, although not statistically significant. We all know that showing a correlation doesn't mean causation, but what exactly does it mean? More importantly, just how many people are murdered by steam related weapons?! Relation of Anterior Cruciate Ligament Tears to Potential Chronic Cardiovascular diseases. Meehan WP, Weisskopf MG, et al. American J...
Sep 18, 2018•47 min
This week we are discussing an editorial from Physical Therapy Journal . We get into how much we really enjoy editorials, especially from specific editors, but we also discuss the role of scientific journals. Many clinicians confuse the broad and varied missions of a professional organization and the goals of that organization's scientific journal. What is the right platform for advocacy of a profession and what role does science play? Scientific Journals Are Not Advocacy Organizations. Jette AM...
Sep 11, 2018•53 min
We are back for another season of PT Inquest with more tendinopathy talk! There are a couple studies that have shown that high load, long duration isometrics reduce pain, but would short duration be just as effective as long as time under tension was held constant? And are the effects only on pain or is there something more specific going on? Immediate and Short-Term Effects of Short- and Long-Duration Isometric Contractions in Patellar Tendinopathy. Pearson SJ, Stadler S, Menz H, Morrissey D, S...
Sep 04, 2018•50 min
Exercise and education is better than steroid injection for gluteal tendinopathy! Hooray for physical therapy! Or is it? What are the options and how great are they? We end this season with another example of an article and an intervention that we use and love, but we may want to pump the brakes a little. See you all next season!!! THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Education plus exercise versus corticosteroid injection use versus a wait and see approach on glo...
May 30, 2018•1 hr 9 min
Blow Flow Restriction (BFR) training is a topic that is often requested for us to cover, but the research has not been very impressive to us regarding rehab application. That said, we aim to please! (No we don't.) So in this episode, we are joined by Scot Morrison to discuss what we know and what we don't know around BFR and the potential rehab applications. THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Blood flow restriction training in clinical musculoskeletal rehabilita...
May 23, 2018•1 hr 9 min
We love us some pain neuroscience and exercise for the treatment of chronic pain as a very plausible approach, but there is not very much research out there that truly tests it. This article compared that approach to a more "old style" approach to physical therapy management of chronic spine pain. The conclusions were promoted as promising, but the findings may not be as impressive as advertised. Special guest Kenny Venere joins us to take an exploration of pain neuroscience as an intervention! ...
May 16, 2018•59 min
Finally a randomized controlled trial comparing physical therapy management to surgery for femoroacetabular impingement syndrome (FAIS)!!! And what were the findings? Well, not impressive on either end. Of course this generates more questions than answers but that's what good research does. Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up. Mansell NS, Rhon DI, Meyer J, Slevin JM, Marchant BG. Am ...
May 09, 2018•1 hr
Determining when to return to play after concussion requires the use of testing to make sure that the athlete has returned to baseline. But what if you don't have a baseline measurement? Can having a history of common mental illnesses like anxiety and depression have an impact in the true baseline for an individual athlete? What about other cognitive peculiarities? Erik also discusses what it is like to be on the autism spectrum. Here is the test for Autism/Asperger's that Erik was referring to:...
May 02, 2018•1 hr
Female Athlete Triad may be more common than you think, and it turns out many male athletes can have it too! We take a deep exploration of the condition, how it works, and how to screen for it with special guest, San Diego State University PT School Program Director Mitch Rauh ! Association of the Female Athlete Triad Risk Assessment Stratification to the Development of Bone Stress Injuries in Collegiate Athletes. Tenforde AS, Carlson JL, Chang A, Sainani KL, Shultz R, Kim JH, Cutti P, Golden NH...
Apr 24, 2018•55 min
Do older runners run differently than younger runners? If they do, is it A GOOD THING OR A BAD THING ?! Can this actually be used as a tool for training or useful information for return after injury? Join us with study co-author Blaise Williams from Nike! Biomechanical Implications of Training Volume and Intensity in Aging Runners. Paquette MR, Devita P, Williams DSB 3rd. Med Sci Sports Exerc . 2018 Mar;50(3):510-515. doi: 10.1249/MSS.0000000000001452. Due to copyright laws, unless the article i...
Apr 18, 2018•49 min
Many clinicians wonder is tests such as the quad index are good enough for returning an athlete to sport after ACLR. Turns out, clinicians aren't even doing that! In the episode we have special guests Allison Toole and Matt Ithurburn discussing their recent paper that looked at how athletes tested after they had already been cleared to return to play after ACLR. Spoiler - they didn't look very good. Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: ...
Apr 10, 2018•52 min
The scientific community has made some mistakes over the past couple decades, leading people to think many effects were much larger than they actually are, if they even existed at all! So what is the reason for this? How has the current process incentivized the publication of studies that may not be the best reflection of the truth? And what can we do about it? Turns out, there is a lot we can do about it! THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT! The Weak Spots in Con...
Apr 03, 2018•1 hr 15 min
Injecting tendinopathies is a popular practice; everything from PRP to steroids to saline to even sugar. But is there any efficacy? What exactly do these things do? Could there actually be a mechanical effect or is it chemical or just good ol' placebo? When is a sham not really a sham and how do we know? We explore all these questions and more with special guest, Peter Malliaras ! Effect of High-Volume Injection, Platelet-Rich Plasma, and Sham Treatment in Chronic Midportion Achilles Tendinopath...
Mar 27, 2018•1 hr 3 min
Injuries to the hamstrings are more common than just about any other muscle injury in sport. And once you do it once, you are more likely to do it again. What is the problem here? Are some people just good at injuring that muscle and simple are destined to repeat it? Or are there deficits that just aren't fully rehabilitated prior to return to sport? Also, does anyone know how to pronounce Vodafone? THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Change in knee flexor torque...
Mar 20, 2018•1 hr 1 min
When it comes to using treatments which have effects that may be nothing more than placebo, the question that is often asked is "What's the harm?" Well, according to these authors, it could be more than you realize. If it works, who cares? Does it matter that you are accidentally treating a psychosocial issue with something claiming to be treating something else? THIS ARTICLE IS CURRENTLY OPEN ACCESS SO FOLLOW THE LINK TO READ IT! 'Caution, this treatment is a placebo. It might work, but it migh...
Mar 13, 2018•1 hr 2 min
We all know that "correlation does not equal causation" but it is still counterintuitive. There are many questions in healthcare that just cannot be approached by the randomized controlled trial (RCT) requiring us to depend on observational data which is extremely susceptible to this confounding correlation problem. Are there any visual tools that we can use to help keep our thinking honest and not fall for spurious correlations? YES! Join us on an exploration of directed acyclic graphs!!! THIS ...
Mar 06, 2018•53 min
Being positive in life is usually seen as a good thing. Try to identify the silver lining and highlight it. But when it comes to research, that "spin" can have detrimental results for developing clinical guidelines and the scientific process as a whole. This is the final episode of this season - we'll see you all in a few months! 'Spin' in published biomedical literature: A methodological systematic review. Chiu K, Grundy Q, Bero L. PLoS Biol . 2017 Sep 11;15(9):e2002173. doi: 10.1371/journal.pb...
Oct 26, 2017•1 hr 6 min
