The double bundle ACL reconstruction is better! Kinda. Sorta. Maybe. But maybe it's not for you. Or maybe it is! Does this squirrel look fat? Does anyone read these descriptions? Does anyone else smell toast? I smell toast... Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study With 10-Year Results. Järvelä S, Kiekara T, Suomalainen P, Järvelä T. Am J Sports Med . 2017 Sep;45(11):2578-2585. doi: 10.1177/0363546517712231. Epub 2017 Jun 29. D...
Oct 17, 2017•52 min
There is a lot that we can throw at musculoskeletal pain, but what actually has evidence behind it? We do we actually know and what directions should the research be headed? THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. PLoS One . 2017 Jun 22;12(6):e0178621. doi: 10.1371/journal.pone.0178621. eCol...
Oct 10, 2017•1 hr
Medical research as a whole can be a mess of low quality studies. This has significant downstream effects of misinformation, confusion, and large variation of practice, not to mention the abundance of low value healthcare being provided. So how do we survive this mess? THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! How to survive the medical misinformation mess. Ioannidis JPA, Stuart ME, Brownlee S, Strite SA. Eur J Clin Invest . 2017 Sep 7. doi: 10.1111/eci.12834. [Epub ahead of pri...
Oct 04, 2017•1 hr 2 min
QUICK! Cams in the hip: Good thing or bad thing?! Where do they come from? How do they develop? Does playing sports during adolescence cause them? How should you advise your patients? THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Physical activity during adolescence and the development of cam morphology: a cross-sectional cohort study of 210 individuals. Palmer A, Fernquest S, Gimpel M, Birchall R, Judge A, Broomfield J, Newton J, Wotherspoon M, Carr A, Glyn-Jones S. BJSM . 2017 Aug...
Sep 26, 2017•46 min
Why is there so much research waste? Why are there lots of redundancies and studies that show effects but don't actually move our understanding forward? Can anything be done to prevent this for happening before data collection even begins? THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Preparing for what the reporting checklists will not tell you: the PREPARE Trial guide for planning clinical research to avoid research waste. Bandholm T, Christensen R, Thorborg K, Treweek S, Henrikse...
Sep 19, 2017•50 min
If all patients get formal rehab right after lumbar disc surgery that would result in better outcomes and reduced overall costs right? Well, that makes sense but it turns out that such a question is very difficult to answer objectively. Turns out that cost-effectiveness studies require a very particular design and a lot of forethought. Keep in mind that papers like this provide our profession honest guidance, not hurtful criticism. THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Early...
Sep 12, 2017•52 min
Psychological interventions are becoming popular for treating pain but what is the evidence base for this? Can these interventions stand alone or are they just are part of a bigger picture? Is pain what should be measured as a benchmark for success? THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! An umbrella review of the literature on the effectiveness of psychological interventions for pain reduction. Markozannes G, Aretouli E, Rintou E, Dragioti E, Damigos D, Ntzani E, Evangelou E,...
Sep 05, 2017•47 min
Is research like a language? The data being the words, studies being the sentences, and systematic reviews being paragraphs. But what gives all of this the required structure? You know, the grammar? Statistics! But how is all of this supposed to work? THIS ARTICLE IS OPEN ACCESS SO FOLLOW THE LINK TO READ IT! Statistical science: a grammar for research. Cox DR. Eur J Epidemiol . 2017 Jul 29. doi: 10.1007/s10654-017-0288-1. [Epub ahead of print] Due to copyright laws, unless the article is open s...
Aug 29, 2017•1 hr
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 m...
Aug 22, 2017•47 min
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...
Jul 25, 2017•2 min
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...
Jul 18, 2017•58 min
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 Biologi...
Jul 12, 2017•42 min
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,...
Mar 21, 2017•1 hr 25 min
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...
Mar 14, 2017•50 min
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 J...
Mar 07, 2017•1 hr 1 min
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/s00402-016-2...
Feb 28, 2017•39 min
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, Trepa...
Feb 21, 2017•58 min
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 Orth...
Feb 14, 2017•56 min
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 rocavaco Licensed under a Attribution (3.0) "café connection" by morgantj Licensed under a Attribution (3.0) "Otra Vez (sight mix)" ...
Feb 07, 2017•1 hr 15 min
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. Arthrosco...
Jan 31, 2017•47 min
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 Progra...
Jan 24, 2017•1 hr 4 min
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 artic...
Jan 17, 2017•50 min
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. Will...
Jan 10, 2017•56 min
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 utiliz...
Jan 03, 2017•1 hr 9 min
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
Dec 11, 2016•57 min
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,...
Sep 20, 2016•1 hr 13 min
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 pa...
Sep 13, 2016•54 min
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...
Sep 06, 2016•54 min
Running on a treadmill is not the same as running over ground!!! Or is it? It appears that in most respects it's a wash. But what about regarding loads to the patellofemoral joint and the Achilles tendon? Find out as Rich Willy (the author of the paper) joins Erik and JW to discuss this and more! Hip Patellofemoral Joint and Achilles Tendon Loads During Overground and Treadmill Running. Willy RW, Halsey L, Hayek A, Johnson H, Willson JD. J Orthop Sports Phys Ther . 2016 Aug;46(8):664-72. doi: 10...
Aug 30, 2016•1 hr 1 min
Clinical depression has a known correlation with chronic pain. Can exercise be an effective treatment for these patients by using it to "treat the depression"? Well, before we can explore that, we need to get a better understanding of the psychological effects of exercise on subjects with clinical depression who DO NOT have pain. Also, JW now has an IQ higher than a sea cucumber! Hip Strength in "Crawling Out of the Cocoon": Patients' Experiences of a Physical Therapy Exercise Intervention in th...
Aug 23, 2016•50 min
