PT Inquest

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 M...

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...

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 c...

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 hone...

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 fo...

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:...

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 ar...

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 Sel...

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...

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...

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...

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: 10.1177/03635465166675...

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 broad...

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,...

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 Suppor...

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 Quadri...

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 Attrib...

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,...

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 Oldsmob...

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 Janua...

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 Minne...

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 the...

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 fem...

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...