One Million Visits – Thank You!

from on to one million

We did it!  In October this year Physiopedia had over 1 million page views!!

Everyone here in the office has been waiting for this day for some time now.  Earlier this year when I gave a keynote presentation at the Canadian Physiotherapy Conference my story was based on the rise of Physiopedia from it’s birth to over one million visits in one month.  We didn’t quite manage it in time for my presentation but now we have.  How amazing is that!!

One million page views for Physiopedia

The popularity of Physiopedia really highlights the thirst for physiotherapy related information. Physiopedia is just one of many places that we can provide that information.  What is great about Physiopedia though is that it is a community built resource, any physiotherapist or physical therapist around the world can make edits at anytime.  The more we, you, contribute the better the resource gets.  So join us, if you have expertise in a particular topic or if you simply see something that needs updating or correcting, login and make your contribution.

Today in the United States is Thanksgiving so we’d like to take this opportunity to say a huge thank you to each and every one of you that has contributed to the rise of Physiopedia.  You are all awesome!

michael jordan making it happen

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Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence.

arm

The burden of disabling musculoskeletal pain and injuries (musculoskeletal disorders, MSDs) arising from work-related causes in many workplaces remains substantial. There is little consensus on the most appropriate interventions for MSDs. Our objective was to update a systematic review of workplace-based interventions for preventing and managing upper extremity MSD (UEMSD). We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis. 6 electronic databases were searched (January 2008 until April 2013 inclusive) yielding 9909 non-duplicate references. 26 high-quality and medium-quality studies relevant to our research question were combined with 35 from the original review to synthesise the evidence on 30 different intervention categories.

There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms. The synthesis also revealed moderate evidence for stretching programmes, mouse use feedback and forearm supports in preventing UEMSD or symptoms. There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for UEMSD and symptoms. Messages are proposed for both these and other intervention categories.

The influence of chronic pain on post-operative pain and function after hip surgery: a prospective observational cohort study

Neuropathic Pain

Pre-existing or chronic pain is an established risk factor for severe post-operative pain. In this prospective observational cohort-study, we investigate whether a history of chronic pain, beyond the presence of hip-related pain, affects other post-operative factors including early mobilization, function, and psychological distress following hip surgery.

Patients undergoing total hip replacement surgery were observed from the pre-operative day until the seventh post-operative day. Prior to surgery, they were characterized by their pain history, pain intensity, function and psychological characteristics. Post-operatively, pain intensity was evaluated on day 1, 3, 5 and 7 and the analgesic consumption was recorded for each of these days. Measures of function (functional questionnaire, ability to mobilize and to climb stairs and range of hip motion) and psychological distress were re-evaluated on day 7. A history of chronic pain was associated with slower postoperative mobilization, poorer physical function and higher psychological distress in addition to increased post-operative pain intensity. The co-morbidity of a chronic pain disorder results in higher pain intensity post-surgery, and also impedes postoperative rehabilitation. Identifying patients with a chronic pain disorder is necessary pre-operatively so that appropriate pain management and rehabilitation can be planned to facilitate recovery.

Chronic pain, beyond the presence of hip-related pain, is associated with slower postoperative mobilization, poorer physical function and higher psychological distress following total hip replacement surgery. Identifying patients with chronic pain and establishing multiprofessional perioperative management might improve postoperative rehabilitation of patients with chronic pain.

Happy Thanksgiving and Huge Sale Announcement!

I hope those of you in the US are enjoying some well deserved time off this week. Thanks to all my readers and followers on The Manual Therapist, Modern Manual Therapy, youtube, facebook, and twitter!

If you haven’t seen it yet, make sure to check out this classic head to toe resets video that was shot at an Eclectic Approach Course a few years back.

Head to Toe Resets for Rapidly Increased Mobility and Decreased Pain
 

As a special thank you to my supporters, there are several sales going on…
Act now and save and everyone have a safe and happy holiday week!  Regular posts will start again Monday!

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic…

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The efficacy of movement representation techniques for treating limb pain – a systematic review and metaanalysis

1. HERO.Phantom-Pain-2014-Cambodia-0355

Relatively new evidence suggests that movement representation techniques, i.e. therapies that use the observation and/or imagination of normal pain-free movements, such as Mirror Therapy, Motor Imagery or Movement/ Action Observation may be effective in reducing some types of limb pain. To summarize the evidence regarding the efficacy of those techniques, a systematic review with metaanalysis was performed. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, PEDro and OT-seeker up to August 2014 and handsearched further relevant resources for randomised controlled trials that studied the efficacy of movement representation techniques in reducing limb pain. The outcomes of interest were pain, disability, and quality of life. Study selection and data extraction were performed by 2 reviewers independently. We included 15 trials on the effects of Mirror Therapy, (Graded) Motor Imagery, and Action Observation in patients with Complex Regional Pain Syndrome, Phantom Limb Pain, post-stroke pain, and non-pathological (acute) pain. Overall, movement representation techniques were found to be effective in reducing pain (SMD=-0.82, 95%CI [-1.32…-0.31] p=0.001) and disability (SMD=0.72, 95%CI [0.22…1.22], p=0.004) and showed a positive but non-significant effect on quality of life (SMD=2.61, 85%CI [-3.32…8.54], p=0.39). Especially Mirror Therapy and Graded Motor Imagery should be considered for the treatment of patients with Complex Regional Pain Syndrome.

Furthermore, the results indicate that Motor Imagery could be considered as a potential effective treatment in patients with acute pain after trauma and surgery. To date, there is no evidence for a pain reducing effects of movement representation techniques in patients with Phantom Limb Pain and Post Stroke Pain other than Complex Regional Pain Syndrome.

Proximal muscle rehabilitation is effective for patellofemoral pain: a systematic review with meta-analysis.

Knee-rehab-exercises-patellar-mobilization

Proximal muscle rehabilitation is commonly prescribed to address muscle strength and function deficits in individuals with patellofemoral pain (PFP). This review (1) evaluates the efficacy of proximal musculature rehabilitation for patients with PFP; (2) compares the efficacy of various rehabilitation protocols; and (3) identifies potential biomechanical mechanisms of effect in order to optimise outcomes from proximal rehabilitation in this problematic patient group. Web of Knowledge, CINAHL, EMBASE and Medline databases were searched in December 2014 for randomised clinical trials and cohort studies evaluating proximal rehabilitation for PFP. Quality assessment was performed by two independent reviewers. Effect size calculations using standard mean differences and 95% CIs were calculated for each comparison. 14 studies were identified, seven of high quality. Strong evidence indicated proximal combined with quadriceps rehabilitation decreased pain and improved function in the short term, with moderate evidence for medium-term outcomes. Moderate evidence indicated that proximal when compared with quadriceps rehabilitation decreased pain in the short-term and medium-term, and improved function in the medium term. Limited evidence indicated proximal combined with quadriceps rehabilitation decreased pain more than quadriceps rehabilitation in the long term. Very limited short-term mechanistic evidence indicated proximal rehabilitation compared with no intervention decreased pain, improved function, increased isometric hip strength and decreased knee valgum variability while running.

A robust body of work shows proximal rehabilitation for PFP should be included in conservative management. Importantly, greater pain reduction and improved function at 1 year highlight the long-term value of proximal combined with quadriceps rehabilitation for PFP.

Podcast Update! Strength Doc Podcast Ep 11 – Charlie Weingroff

Charlie is a Doctor of Physical Therapy, a Certified Athletic Trainer, and a Certified Strength and Conditioning Specialist.  He is currently a Physical Therapist and Strength & Conditioning Coach at Drive 495 in Manhattan, NY and Fit For Life in Marlboro, NJ.  He also is a member of the Nike Executive Performance Council and serves as the Physical Performance Lead and Head Strength & Conditioning Coach for the Canadian Men’s National Basketball Team.  Prior to returning to his home of NJ, he was the Director of Physical Performance and Resiliency and Lead Physical Therapist for the United States Marines Corps Special Operations Command in Camp Lejeune, NC.    He graduated from Ursinus College with a degree in Exercise and Sports Science in 1996, and went on to earn an MSPT in 1999 and DPT in 2010 from the University of Medicine and Dentistry of New Jersey.
Beginning in 1998, Charlie spent 12 seasons of professional basketball, highlighted by his time as the Head Strength & Conditioning Coach and Assistant Athletic Trainer for the Philadelphia 76ers in the NBA.   Among the highlights of his tenure in Philadelphia was being part of the medical staff that ranked 1st in the NBA in Player Missed Games in the 2005-06 season.
Through rehabbing patients, he subscribes to a movement-based approach popularized by the works of Gray Cook, Mike Boyle, Val Nsedkin, Dr. Pavel Kolar, and Louie Simmons.  In training athletes and clients, he champions the principles of the Functional Movement Screen and sound, evidence-based training principles.  Some of the methodologies Charlie is formally trained in include DNS, ART, Dry Needling, Graston, FMS/SFMA, TPI, and StrongFirst.
Aside from working with patients, athletes and clients, he is also under the bar himself.  In 2007, he achieved AAPF Elite status in the 220 weight class with a total of 1915 pounds. His best powerlifting competition total is 800 squat, 510 bench press and 605 deadlift.
Currently Charlie is available to treat, train, and consult at Drive495 in Manhattan, NYC and Fit For Life in Marlboro, NJ.  Charlie often teaches and speaks internationally and consults regularly with Nike, the Roddick-Grunberg Tennis Academy, Perform Better, and Equinox Fitness Clubs.
Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic…

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