Support us on Patreon! How do patients engage with pain medications? How much of this is influenced by their medical providers? How do we make sure that patients are in more control of their pain? Does this article really provide a good faith exploration of these issues? Can We Eliminate Opioid Medications for Postoperative Pain Control? A Prospective, Surgeon-Blinded, Randomized Controlled Trial in Knee Arthroscopic Surgery. Matthew J. Hartwell, Ryan S. Selley, Michael A. Terry, Vehniah K. Tjon...
Oct 06, 2020•1 hr 17 min
Support us on Patreon! The literature around dry needling has some...issues...to say the least. But is it just dry needling? Or is this common around other PT interventions? How should we investigate some of these ideas? Should some of them be investigated at all? Join us along with study author Giovanni Ferreira to find out more! Dry Needling Combined With Guideline-Based Physical Therapy Provides No Added Benefit in the Management of Chronic Neck Pain: A Randomized Controlled Trial. Fábio Fran...
Sep 01, 2020•1 hr 14 min
Support us on Patreon! What does it take for an athlete to change direction? Does it matter how fast they are going? What about the angle of cut? What implications does this have for athletes who are returning to sport after injury? Listen in to our discussion on all things change of direction with special guest Richard Clarke! Richard Clarke can be found on Twitter: @RICH_AgilityLab Role of the Penultimate Foot Contact During Change of Direction: Implications on Performance and Risk of Injury. ...
Aug 04, 2020•1 hr 26 min
In this Extrasode, Erik reads his post Muscle Interventions After ACLR . It explores what the true goals may be for interventions around restoring the quad in these subjects. With special guest voice from @LauraOpstedal Intro music for PT Inquest Extrasode is Take a Chance by Kevin MacLeod - incompetech.com
Jul 28, 2020•15 min
Support us on Patreon! Systemic racism is a topic that we have covered before on PT Inquest, but it has recently become the focus of worldwide attention. In this episode, we talked with Tim Vidale and Deidra Debnam from the American Academy of Sports Physical Therapy's (AASPT) Diversity, Equity, and Inclusion (DEI) Committee to discuss some of the current conversations around race. We hope that this discussion can help give some insight and initial guidance for individuals and PT organizations t...
Jul 02, 2020•1 hr 21 min
We are bringing back the "Extrasodes"! They were a thing we used to do in 2014... In this Extrasode, Erik reads his post Brave New Profession that he wrote right after the COVID-19 lockdowns. It lays out a reimagining of who we are and how we should be reimbursed as professionals. Intro music for PT Inquest Extrasode is Take a Chance by Kevin MacLeod - incompetech.com...
Jun 19, 2020•13 min
In this episode we discuss the possible effects of exercise for knee osteoarthritis (OA). Are there non-specific effects but also specific effects? Can intensity of the workout change this? Which direction do the causation arrows point? Check our website: ptinquest.com Support us on Patreon: patreon.com/ptinquest Erik's courses and blog: thesciencept.com Enter "ptinquest" at checkout for 10% off Erik's courses The Role of Muscle Strengthening in Exercise Therapy for Knee Osteoarthritis: A System...
Jun 04, 2020•47 min
In this episode we go back to reviewing articles. We discuss the differences in therapist perceptions and patient perceptions of care, specifically in regards to telehealth. Are we more dissatisfied than our patients? Therapeutic Alliance Between Physical Therapists and Patients With Knee Osteoarthritis Consulting Via Telephone: A Longitudinal Study. Lawford BJ, Bennell KL, Campbell PK, Kasza J, Hinman RS. Arthritis Care Res (Hoboken) . 2020 May;72(5):652-660. doi: 10.1002/acr.23890. Due to copy...
May 06, 2020•59 min
Support us on Patreon! In this episode JW and Erik talk about what it means to be a PT practicing, or not practicing, during this COVID-19 pandemic. There is discussion about social responsibility, immunity, disease spread, and the luxury of quarantining yourself in a submarine at the bottom of Lake Michigan. This episode is NOT available for continuing education credit. Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission Give us money by buying stu...
Mar 31, 2020•1 hr 1 min
Available for CEU credit!!! Click here! The concepts of Envelope of Function and Physical Stress Theory are very useful in rehabilitation applications. We review these constructs and give ideas for use in the clinic. Reference List Dye SF. The Knee as a Biologic Transmission With an Envelope of Function: A Theory. Clinical Orthopaedics and Related Research . 1996;325:10-18. doi:10.1097/00003086-199604000-00003 Dye SF. The Pathophysiology of Patellofemoral Pain: A Tissue Homeostasis Perspective. ...
Mar 03, 2020•1 hr 7 min
Available for CEU credit!!! Click here! Our understanding of the ACL, it's related pathophysiology, surgical strategies, and postoperative rehabilitation has an interesting history. We take a tour of the history and interview a couple guests who lived it. Reference List Chambat P, Guier C, Sonnery-Cottet B, Fayard JM, Thaunat M. The evolution of ACL reconstruction over the last fifty years. Int Orthop . 2013;37(2):181-186. doi:10.1007/s00264-012-1759-3 Davarinos N, O’Neill BJ, Curtin W. A Brief ...
Feb 05, 2020•1 hr 17 min
Brought to you by CSMi In this episode we review an article about causal fallacies but, more importantly, changes are coming in 2020 to PT Inquest! Tune in to hear all about it. Also, PATREON!!! Core stability and low-back pain: a causal fallacy. Open Science Collaboration. J Exerc Rehabil . 2019 Jun 30;15(3):493-495. doi: 10.12965/jer.1938198.099. eCollection 2019 Jun. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to downloa...
Dec 24, 2019•55 min
Brought to you by CSMi. In this episode we are joined by Dan Quintana from the Everything Hertz podcast to discuss reproducibility and improving science. We even talk a little about the "love hormone"! PSYCHOLOGY. Estimating the reproducibility of psychological science. Open Science Collaboration. Science . 2015 Aug 28;349(6251):aac4716. doi: 10.1126/science.aac4716. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download a...
Dec 10, 2019•1 hr 17 min
Brought to you by CSMi So we're not the best with chronic nonspecific low back pain. We also tend to underload our patients in general. Maybe if we increased the intensity of our exercises, we would be more effective with chronic nonspecific low back pain. Well, at least we can test it! Exercise Intensity Matters in Chronic Nonspecific Low Back Pain Rehabilitation. Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, O Eijnde B, Vandenabeele F, Timmermans A. Med Sci Sports Exerc . 2019 Dec;51...
Dec 03, 2019•55 min
Brought to you by CSMi Clinical depression is a very real part of many of our patients' lives. As a matter of fact, our current understanding of many commonly treated PT diagnoses suggests that clinical depression may be a huge driver of symptoms. How do we identify it in our patients? Assuming we can do that, what do we do about it once we identify it? Using the 9-Item Patient Health Questionnaire to Screen for and Monitor Depression. Zimmerman M. JAMA Insights . Published online October 18, 20...
Nov 26, 2019•51 min
Brought to you by CSMi Everyone wants to succeed and no one wants to fail. Is failure so bad? Can we even have success without failure? How can we learn to embrace failure to get the greatest knowledge? A celebration of failure. Loscalzo J. Circulation . 2014 Mar 4;129(9):953-5. doi: 10.1161/CIRCULATIONAHA.114.009220. The other article that Erik mentioned: On the (f)utility of pain. Stonington SD. Lancet . 2015 Apr 11;385(9976):1388-9. doi: 10.1016/S0140-6736(15)60708-5. Due to copyright laws, u...
Nov 19, 2019•1 hr 1 min
Brought to you by CSMi One of the most important components of ethical healthcare is patient education. A fully informed patient makes everything easier later during the care. But that includes educated on the good and the bad. Sometimes "being hopeful" can actually be a disservice. "Doctor, What Happens After My Meniscectomy?" Smith JH, Houck DA, Kraeutler MJ, McCarty EC, Frank RM, Vidal AF. J Bone Joint Surg Am . 2019 Nov 6;101(21):1965-1973. doi: 10.2106/JBJS.19.00082. Due to copyright laws, ...
Nov 12, 2019•1 hr 6 min
Brought to you by CSMi Cognitive Functional Therapy for the win! Or is it? Are these differences in effect sizes from a simple group program big enough to get excited about? What else could be at play here? Chronic low back pain is hard... Cognitive functional therapy compared with a group-based exercise and education intervention for chronic low back pain: a multicentre randomised controlled trial (RCT). O'Keeffe M, O'Sullivan P, Purtill H, Bargary N, O'Sullivan K. Br J Sports Med . 2019 Oct 19...
Nov 05, 2019•59 min
Brought to you by CSMi What does it mean to have self-efficacy? How does that differ from one's perceived locus of control? Are they situation dependent? Can we changed them or just measure them? How does this affect our patients. The Self-Efficacy for Home Exercise Programs Scale: Development and Psychometric Properties. Picha KJ, Lester M, Heebner NR, Abt JP, Usher EL, Capilouto G, Uhl TL. J Orthop Sports Phys Ther . 2019 Sep;49(9):647-655. doi: 10.2519/jospt.2019.8779. Epub 2019 Jul 10. Due t...
Oct 29, 2019•1 hr 1 min
Brought to you by CSMi Physicians often will offer a corticosteroid injection for those with osteoarthritis. Patients feel better in the short term, but is there long term harm? If the joint is shot anyway, does it matter? Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought? Kompel AJ, Roemer FW, Murakami AM, Diaz LE, Crema MD, Guermazi A. J Radiology . Published Online:Oct 15 2019. doi: 10.1148/radiol.2019190341. Due to copyright laws, unless the art...
Oct 22, 2019•54 min
Brought to you by CSMi Shared decision making is the greatest thing! Ethical, honest, engaging. But do patients give a crap? Would they rather the provider just tell them what to do? Can we find a happy ground? Semistructured interviews regarding patients' perceptions of Choosing Wisely and shared decision-making: an Australian study. Allen J, King R, Goergen SK, Melder A, Neeman N, Hadley A, Hutchinson AM. BMJ Open . 2019 Aug 28;9(8):e031831. doi: 10.1136/bmjopen-2019-031831. Due to copyright l...
Oct 15, 2019•1 hr 6 min
Brought to you by CMSi There has been some great work done regarding guidelines for many different musculoskeletal diagnoses, but do physical therapists follow them? How do they do compare to other medical professionals? We can always be better, but what stops us? Is it stubbornness, lack of knowledge, or might market forces and patient/professional cultures drive some of this? We discuss all of this and more with one of the authors, Josh Zadro ! Do physical therapists follow evidence-based guid...
Oct 08, 2019•1 hr 16 min
Brought to you by CSMi If you have listened to more than one episode of PT Inquest you will know that Erik thinks that quadriceps dysfunction is a major problem after ACLR. Assuming that you agree with that, are there interventions to address that issue? Do they work? What about just waiting? How would we know what works? Progressive strength training restores quadriceps and hamstring muscle strength within 7 months after ACL reconstruction in amateur male soccer players. Welling W, Benjaminse A...
Oct 01, 2019•1 hr 20 min
Brought to you by CSMi Providing accurate information on back pain seems to build confidence in the provider but doesn't seem to have a huge effect on outcomes. Is this really an improvement? In this episode, Erik and JW explore the role of the provider is these difficult cases. The Fear Reduction Exercised Early (FREE) approach to management of low back pain in general practice: A pragmatic cluster-randomised controlled trial. Darlow B, Stanley J, Dean S, Abbott JH, Garrett S, Wilson R, Mathies...
Sep 24, 2019•53 min
Brought to you by CSMi Patients have unique personalities, values, and circumstances but what about providers? Can the specific personality traits of the provider have an effect on outcomes? Is that a good thing? Or a bad thing? And what should we do about it? Do therapist effects determine outcome in patients with shoulder pain in a primary care physiotherapy setting? Kooijman MK, Buininga EM, Swinkels ICS, Koes BW, Veenhof C. Physiotherapy . Available online 2019 Aug 13. doi: 10.1016/j.physio....
Sep 17, 2019•1 hr 9 min
Brought to you by CSMi We can prevent ACL injuries!!! Or are we just reducing risk? Or both? How do these programs work? Does it matter what you do or do you just need to do something ? A Majority of Anterior Cruciate Ligament Injuries Can Be Prevented by Injury Prevention Programs: A Systematic Review of Randomized Controlled Trials and Cluster-Randomized Controlled Trials With Meta-analysis. Huang YL, Jung J, Mulligan CMS, Oh J, Norcross MF. Am J Sports Med . 2019 Aug 30:363546519870175. doi: ...
Sep 10, 2019•1 hr 1 min
Brought to you by CSMi We are all aware of financial conflicts of interest. Their mechanisms for incentivizing towards inaccurate beliefs are known but can still be easy to fall for. But what about intellectual conflicts of interest? What if you job, or even worse your profession, depends on it? Conflict of Interest Wojtys EM. Sports Health . 2019 Aug 26;11(5):395-396. doi: 10.2106/JBJS.18.01160. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the websi...
Sep 03, 2019•1 hr 4 min
Brought to you by CSMi Is more better? Would additional tests improve outcomes? How often do we look for things that may not actually make a difference? We explore these questions as we review this non-inferiority study on managing wrist fractures. Omitting Routine Radiography of Traumatic Distal Radial Fractures After Initial 2-Week Follow-up Does Not Affect Outcomes. van Gerven P, El Moumni M, Zuidema WP, Rubinstein SM, Krijnen P, van Tulder MW, Schipper IB, Termaat MF. J Bone Joint Surg Am . ...
Aug 27, 2019•54 min
Brought to you by CSMi You have an athlete with want appears to be FAIS and you want to know if they would be able to return to full sport after surgery. How would you know? Are there predictors before surgery? Are predictors for failure after surgery also just predictors of failure in general? Preoperative Predictors of Achieving Clinically Significant Athletic Functional Status After Hip Arthroscopy for Femoroacetabular Impingement at Minimum 2-Year Follow-Up. Stone AV, Beck EC, Malloy P, Chah...
Aug 20, 2019•51 min
Brought to you by CSMi When you look at someone with a torn meniscus and some osteoarthritis, can you tell who would benefit from arthroscopy and who wouldn't? What about whether or not they would benefit from rehab? Would you be better than a coin flip? Can even experienced orthopaedic surgeons predict who will benefit from surgery when patients present with degenerative meniscal tears? A survey of 194 orthopaedic surgeons who made 3880 predictions. van de Graaf V, Bloembergen CH MD, Willigenbu...
Aug 13, 2019•53 min
