Interview: Dr James Elliot & Whiplash

This interview was recorded as part of the cervical spine course on Physiopedia Plus

Dr James Elliott is a Physiotherapist who currently undertakes some incredibly interesting research at the Northwestern University, Chicago. His years of experience and passion will empower you to think differently about neck pain.

During this interview with Rachael, James provides extensive advice on appropriate clinical predictions rules, outcome measures and subsequent approaches to treatment based on the latest published research. There are great clinical tips here which are relevant to clinicians looking to improve their practice and patient outcomes.

In this interview Dr Elliott talks about clinical prediction rules, risk assessment tools, fear avoidance beliefs, kinesophobia, emotional impact of events, pain thresholds and MRI scanning.

Make sure you keep up to date with James’s research via twitter, his University Profile, LinkedIn and his research group.

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Resistance Training in Youth: Laying the Foundation for Injury Prevention and Physical Literacy.

The rising incidence of physical activity- and sports-related injuries has prompted the present-day investigation of resistance training as a potential means of injury prevention and physical literacy development among youth. Relevant studies on the topics of athlete development, physical literacy, resistance training, and injury prevention in children and adolescents were reviewed (PubMed and Sports Discus, 1982-2016). Recommendations from consensus guidelines and position statements applicable to resistance training and injury prevention in youth, in addition to young athlete development, were reviewed. Additionally, hand searches, expert requests, article reference lists, and gray literature were utilized and reviewed for pertinent content.

Youth throughout the physical activity spectrum are at risk for physical activity- and sports-related injury. Of highest priority are early specializers, physically inactive youth, and young girls, owing to increased injury rates. Resistance training among these at-risk populations has been shown to reduce injury risk by up to 68% and improve sports performance and health measures, in addition to accelerating the development of physical literacy. Recent recommendations, position statements, and national initiatives advocate for the incorporation of resistance training with qualified instruction among these groups.

Resistance training in addition to free play and other structured physical activity training can serve as a protective means against injury and a positive catalyst for the development of physical literacy to offset the impact of diminishing physical activity and early sport specialization in today’s youth.

[FREE WEBINAR] ACL Rehab, Motor Control, and Return to Sport

The latest MMT Webinar Registration is now live!

This webinar reviews the concepts of Motor Controls, Motor learning and retention, and return to play considerations for the ACL injury population.

What You’re Going To Learn
  • Introduction in to Motor Control and systems involved
  • Review of the literature regarding learning and retention strategies
  • Review of the literature on Return to Play testing
  • Introduction into use of visual feedback and the Motion Guidance Clinician Kit during performance training and testing
  • Recommendations for return to play

 

Keeping it Eclectic…

Activity Demands During Multi-Directional Team Sports: A Systematic Review.

Late-stage rehabilitation programs often incorporate ‘sport-specific’ demands, but may not optimally simulate the in-game volume or intensity of such activities as sprinting, cutting, jumping, and lateral movement. The aim of this review was to characterize, quantify, and compare straight-line running and multi-directional demands during sport competition.

A systematic review of PubMed, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials databases was conducted. Studies that reported time-motion analysis data on straight-line running, accelerations/decelerations, activity changes, jumping, cutting, or lateral movement over the course of an entire competition in a multi-directional sport (soccer, basketball, lacrosse, handball, field hockey, futsal, volleyball) were included. Data was organized based on sport, age level, and sex and descriptive statistics of the frequency, intensity, time, and volume of the characteristics of running and multi-directional demands were extracted from each study.

Eighty-one studies were included in the review (n = 47 soccer, n = 11 basketball, n = 9 handball, n = 7 field hockey, n = 3 futsal, n = 4 volleyball). Variability of sport demand data was found across sports, sexes, and age levels. Specifically, soccer and field hockey demanded the most volume of running, while basketball required the highest ratio of high-intensity running to sprinting. Athletes change activity between 500 and 3000 times over the course of a competition, or once every 2-4 s. Studies of soccer reported the most frequent cutting (up to 800 per game), while studies of basketball reported the highest frequency of lateral movement (up to 450 per game). Basketball (42-56 per game), handball (up to 90 per game), and volleyball (up to 35 per game) were found to require the most jumping. These data may provide an incomplete view of an athlete’s straight-line running load, considering that only competition and not practice data was provided.

Considerable variability exists in the demands of straight-line running and multi-directional demands across sports, competition levels, and sexes, indicating the need for sports medicine clinicians to design future rehabilitation programs with improved specificity (including the type of activity and dosage) to these demands.

Treatment effectiveness and fidelity of manual therapy to the knee: A systematic review and meta-analysis.

Manual therapy (MT) is a commonly used treatment for knee osteoarthritis (OA) but to date only one systematic review has explored its effectiveness. The purpos e of the present study was to perform a systematic review and meta-analysis of the literature, to determine the effectiveness and fidelity of studies using MT techniques in individuals with knee OA. Relevant studies were assessed for inclusion. Effectiveness was measured using effect sizes, and methodological bias and treatment fidelity were both explored. Effect sizes were calculated using standardized mean differences (SMD) based on pooled data depending on statistical and clinical heterogeneity, as well as risk of bias.

The search captured 2,969 studies; after screening, 12 were included. Four had a low risk of bias and high treatment fidelity. For self-reported function, comparing MT with no treatment resulted in a large effect size (standardized mean difference [SMD] 0.84), as did adding MT to a comparator treatment (SMD 0.78). A significant difference was found for pain when adding MT to a comparator treatment (SMD 0.73). The findings in the present meta-analytical review support the use of MT versus a number of different comparators for improvement in self-reported knee function. Lesser support is present for pain reduction, and no endorsement of functional performance can be made at this time.

Untold Physio Stories S6:E6 – The Strongest Rotator Cuff Tear in the World

Download file | Play in new window | Duration: 7:11
Listen in to one of Erson’s patients from way back before pain science and Modern Manual Therapy. How do you assess a world record holding power lifter with a confirmed rotator cuff tear? Previous PTs tested him as 5/5 with some minor pain.

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Untold Physio Stories is sponsored by the EDGE Mobility System, featuring the EDGE Mobility Tool for IASTM, EDGE Mobility Bands, webinars, ebooks, Pain Science Education products and more! Check it out at edgemobilitysystem.com .  Be sure to also connect with Dr. Erson Religioso at Modern Manual Therapy and Jason Shane at Shane Physiotherapy.

Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. Live cases, webinars, lectures, Q&A, hundreds of techniques and more! Check out Modern Manual Therapy!

Keeping it Eclectic…

Mobilization of Mechanically Ventilated Patients in Switzerland.

Growing evidence suggests that early mobilization benefits intensive care unit (ICU) patients. However, national practices and the culture of individual ICUs influence mobilization activities. In a 1-day, Swiss point prevalence study conducted in 35 ICUs (representing 45% of all ICUs), the highest level of mobilization for mechanically ventilated patients was characterized using the validated ICU Mobility Scale, along with data collection for potential safety events and mobilization barriers.

Among 161 mechanically ventilated patients, a total of 33% (n = 53) had active mobilization, with walking achieved by only 2% (n = 4). More severe organ failure was associated with lower mobilization (respiratory Sequential Organ Failure Assessment score: P = .037, cardiac: P = .008, neurology: P < .001). Barriers to mobilization were reported in 71% (n = 115), with deep sedation significantly higher among patients receiving passive versus active mobilization (14% vs 0%, P = .005). Potential safety events occurred in 20% (n = 33) of patients without significant differences between passive and active mobilization. Availability of physiotherapists and appropriate equipment were not reported barriers.

Mobilization during mechanical ventilation occurred infrequently with greater organ failure associated with lower mobilization. Addressing the identified modifiable barriers via structured efforts to achieve multidisciplinary culture change is essential to decrease the common use of bed rest in Swiss ICUs.