PT Inquest

Brought to you by CSMi Historically is has been typical to expect to return from an ACL reconstruction around 6 months after surgery. We know know that such suggestions are not very well founded. What can a study with over 3500 subjects tell us about how these athletes typically look at this time point? Only one patient out of five achieves symmetrical knee function 6 months after primary anterior...

Brought to you by CSMi When we say that a patient is "strong", what does that mean exactly? Can a single muscle do well on one strength test but poorly on another? Are some tests more "functional"? Sometimes it is less about IF they are strong and more about WHEN they are strong... Deficits in rate of torque development are accompanied by activation failure in patients with knee osteoarthritis. Ve...

In this episode we swap podcast feeds in order to confuse the crap out of you and see if anyone reads the show notes. Hint: Take a look at the release date. For real, listen to the episode though. More info at  https://www.ptpintcast.com/  

Brought to you by CSMi This episode explores the application of exercises starting 2 months after total knee replacement. Is working with a PT better than just joining a community program? If there are performance improvements, is there much of an effect on perceived function? How difficult is it to answer these questions? Effectiveness of Later-Stage Exercise Programs vs Usual Medical Care on Phy...

Brought to you by CSMi This episode explores the nature of fixating an injury in a place that normally allows a little movement. Should the fixation also allow some movement? Would this allow faster return to function? Can breaking a screw actually lead to better outcomes? We also explore the need for services like PRISMA. Suture Button Versus Syndesmotic Screw for Syndesmosis Injuries: A Meta-ana...

Brought to you by CSMi This article ruffled some PT feathers. In a head to head match up, many interpreted this RCT to show that surgery beats physical therapy, but is there more to it? Would Erik and JW have been able to put together a better rehab program than what was studied in this paper? Perhaps...perhaps not. This article gives a great opportunity to contrast the quality of research in the...

Brought to you by CSMi Epidemiology studies are a fascinating snapshot of injuries in a population, but they also provide insight on how we interpret data. How common are lumbar spine injuries amongst elite athletes? How are they defined? How limiting are they? Is there a group we should address and another group we should leave alone? Lumbar Spine Injuries in National Collegiate Athletic Associat...

Brought to you by CSMi Low value healthcare (like ordering imaging for patients with nonspecific low back pain) is a known issue for healthcare providers. But how big of an issue is it? Are the best providers doing that much better than the worst offenders? Why do they do this? Is there anything we can do about medical overuse and all the problems that come with it? Analysis of Physician Variation...

Brought to you by CSMi Pain catastrophizing has been shown to have an affect on outcomes specifically after total knee arthroplasty. This article took a good look at the problem and many people interpreted the findings to say that cognitive behavioral therapy (CBT) wasn't effective. Turns out it's much more interesting than that... Pain Coping Skills Training for Patients Who Catastrophize About P...

Brought to you by CSMi Returning to sport after ACL reconstruction is kind of a complex mess. Strength issues, coordination, soreness, not to mention the psychological factors. How do these things interact? What matters? What should we measure and how? Join us with special guest Ryan Zarzycki from Arcadia University ! Psychological Readiness to Return to Sport Is Associated With Knee Kinematic Asy...

Therapeutic ultrasound has been relegated to the physical therapy trash heap as "ultraplacebo". But is there an application where it might work? What can we learn about other physical therapy interventions from research on ultrasound? Effect of low-intensity long-duration ultrasound on the symptomatic relief of knee osteoarthritis: a randomized, placebo-controlled double-blind study. Draper DO, Kl...

It would be great if we could provide regular, personal follow up communications with our patients but the time commitment becomes huge. But what if you just had a bot send generic patient education text messages? Would that give a sense of connection? Will that improve patient compliance? A Novel, Automated Text-Messaging System Is Effective in Patients Undergoing Total Joint Arthroplasty. Campbe...

Some people have cams in their hips, some don't. Some cams are a problem, some aren't. What effects can a cam have on a hip joint? Are these good or bad? What happens after a cam is surgically removed? Hip Joint Torsional Loading Before and After Cam Femoroacetabular Impingement Surgery. Ng KCG, El Daou H, Bankes MJK, Rodriguez Y Baena F, Jeffers JRT. Am J Sports Med . 2018 Dec 31:363546518815159....

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, Stra...

  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 wel...

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...

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...

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 I...

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 S...

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:...

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 Durin...

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 Tria...

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...

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 Sitt...

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...