Podcasts about arch phys med rehabil

One and Done? The Effectiveness of a Single Session of Physiotherapy Compared With Multiple Sessions to Reduce Pain and Improve Function and Quality of Life in Patients With a Musculoskeletal Disorder: A Systematic Review With Meta-analyses Dubé MO, Dillon S, Gallagher K, et al. Arch Phys Med Rehabil. 2024;105(6):1171-1180. doi:10.1016/j.apmr.2023.09.017 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik/Jason/Chris's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

Dr. Jennifer Penrose interviews Dr. Elizabeth Piper on many myths around pelvic health.  Such as people think it is normal to leak urine as they age or after having multiple kids.  Another one is that the only thing for pelvic health is “Kegel's.”  And so much more!  This is a great episode on pelvic health and when you should seek out a pelvic health physical therapist and what you can do to help those sensitive topics.   -------------------------- Other resources:  This podcast discusses the importance of Fiber: https://open.spotify.com/episode/6LTakbZLM0pcFgRqEU3lIW?si=sxYAWtl2QayTGEnGC41kjQ Also some links about hip strength and pelvic floor:  Tuttle LJ, DeLozier ER, Harter KA et al. The Role of the Obturator Internus Muscle in Pelvic Floor Function. Journal of Women's Health Physical Therapy. 2016; 40, 1 pg 15-19 Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther 2004;9(1):31-42 Sapsford RR, Hodges PW, Ricahrdson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neruourol Urodyn 2001;20(1):3-12 Sapsord RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med REhabil. 2001;82(8):1081-1088  -------------------------- Guest: Dr. Elizabeth Piper, Doctor of Physcial Therapy that specializes in pelvic health for women and men.   Find her on instagram: elizabeth.piper.dpt Currently works at Providence  Host: Name: Jennifer Penrose, DPT, OCS, MTC Company: Penrose Physical Therapy  Author of “Run Forever: The secrets to common running & walking injuries.”  https://www.facebook.com/PenrosePhysicalTherapy/ www.penrosept.com. Phone: 360-456-1444 Address: 1445 Galaxy Dr. Suite 301 Lacey, WA 98516

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.Originally released: December 17, 2020I shouldn't have to tell you that traumatic brain injury is a major cause of morbidity and mortality. I shouldn't have to. But I will. And it is. In severe cases of head injury, there can be delayed and irreversible deterioration in the nervous system for which there is no treatment, and the prognosis is grim. This week on the program, Dr. Monisha Kumar (University of Pennsylvania) discusses the worst of the worst of these scenarios, what to look out for, and expert recommendations on what to do when it happens.Produced by James E Siegler and Monisha Kumar. Music courtesy of Rui, Swelling, Unheard Music Concepts, Jahzzar, Ian Southerland, and TRG Banks. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.REFERENCESAdams JH, Graham DI, Murray LS, Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Ann Neurol 1982;12(6):557-63. PMID 7159059Arfanakis K, Haughton VM, Carew JD, Rogers BP, Dempsey RJ, Meyerand ME. Diffusion tensor MR imaging in diffuse axonal injury. AJNR Am J Neuroradiol 2002;23(5):794-802. PMID 12006280DeKosky ST, Ikonomovic MD, Gandy S. Traumatic brain injury--football, warfare, and long-term effects. N Engl J Med 2010;363(14):1293-6. PMID 20879875Gentry LR. Imaging of closed head injury. Radiology 1994;191(1):1-17. PMID 8134551Haghbayan H, Boutin A, Laflamme M, et al. The prognostic value of MRI in moderate and severe traumatic brain injury: a systematic review and meta-analysis. Crit Care Med 2017;45(12):e1280-8. PMID 29028764Izzy S, Mazwi NL, Martinez S, et al. Revisiting grade 3 diffuse axonal injury: not all brainstem microbleeds are prognostically equal. Neurocrit Care 2017;27(2):199-207. PMID 28477152Johnson VE, Stewart W, Smith DH. Widespread τ and amyloid-β pathology many years after a single traumatic brain injury in humans. Brain Pathol 2012;22(2):142-9. PMID 21714827Meythaler JM, Peduzzi JD, Eleftheriou E, Novack TA. Current concepts: diffuse axonal injury-associated traumatic brain injury. Arch Phys Med Rehabil 2001;82(10):1461-71. PMID 11588754Povlishock JT, Becker DP, Cheng CL, Vaughan GW. Axonal change in minor head injury. J Neuropathol Exp Neurol 1983;42(3):225-42. PMID 6188807Scheid R, Preul C, Gruber O, Wiggins C, von Cramon DY. Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T. AJNR Am J Neuroradiol 2003;24(6):1049-56. PMID 12812926Schrag M, Greer DM. Clinical associations of cerebral microbleeds on magnetic resonance neu

Many athletes pick a season for a solid 12 week long training cycle -- wintertime being a particularly popular time of year to train. In this episode, we're give you our top 6 tips for getting the most out of a training cycle - nutrition advice included.  If you're looking to make the most out of your training, this episode is for you. ... and speaking of optimizing your training, don't forget that Breakthrough Group Coaching is open for enrollment. If you apply by February 9th you can get $400 off!  Go to www.breakthroughclimbing.com to learn more. Support us on Patreon. The Average Climber Podcast is a part of the Plug Tone Audio Collective. Go to plugtoneaudio.com to learn more. Sources for this weeks' episode: Arch Phys Med Rehabil. 1954 Jul;35(7):420-6. A study of production and evaluation of muscular hypertrophy. McMORRIS RO, ELKINS EC. [adaptation persistence study in 6 week vs. 12 week training programs]

Join Sally as she talks with Suzanne Koucheravy about dancers with scoliosis. Learn tools to best handle working with these beautiful bodies in your dance studio. Dancers with Scoliosis NotesSuzanne Koucheravyskoucheravy56@gmail.comWebsite: www.benemotus.comInstagram: benemotus_scolio_pilatesskoucheravy@bodydynamicsinc.comScolio-Pilates website: www.osteopilates.comFounder Karena ThekIADMS: International Association of Dance Medicine and Sciencewww.iadms.org 2022 Conference October 27-31 Limerick Ireland Scoliosis Research Society: www.srs.org International Society on Scoliosis Orthopaedic and Rehabilitation Treatment(SOSORT): www.sorsort.orgSchroth Method:www.schrothmethod.com Stephanie Sorota: “Dancing with Scoliosis”https://www.washingtonballet.org/a-dancers-diary-stephanie-sorota-and-dancing-with-scoliosis/ ReferencesLongworth B, Fary R, Hopper D. Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers. Arch Phys Med Rehabil. 2014 Sept;95(9): 1725-30. Stienberg N, Herskovitz I, Peleg S, dar G, Masharawi Y, Zeev A, Siev-Ner I. Morphological characteristics of the young scoliotic dancer. Phys Ther in Sport 2013 Nov;14(4). www.sciencedirect.com/science/article/abs/pii/S1466853.Steinburg N, Tenenbaum S, Zeev A, Pantanowitz M, Waddington G, Dar G, Siev-Ner I, Generalized joint hypermobility, scoliosis, patella femoral pain and physical abilities in your dancers. BMC Musculoskeletal Disorders (2021) 22:161. Https://doi.org/10.1186/s12891-021-04023-z.Stienberg N, Siev-Ner I, Peleg S, dar G, Masharawi Y, Zeev A, Hershkovitz I. Injuries in female dancers aged 8 to 16 years. J Athl train 2013 Jan-Feb;48(1):118-23.Czaprowski D, Kotwicki T, Pawlowska P, Stolinski L.  Joint Hypermobility in Children with Idiopathic Scoliosis: SOSORT award 2011 winner. Scoliosis. 2011;6: 22. PubMedPMC3204294.. Air M, Grierson M, Davenport K, Krabak B, Dissecting the doctor-dancer relationship: health care decision making among American collegiate dancers  PM R 2014 Mar;6(3): 241-9. Doe:10.1016/j.pmrj.2013.09.001 Pub 2013 Sept 10.Wong A, Chan C, Hiller,C, Yung P, Lau K, Samartzis, Surgenor,B  Is scoliosis associated with dance injury in young recreational dancers?  A large-scale cross -sectional epidemiological study J Dance Med Sci 2022 Mar 15:26 (1);41-49.doi: 10.12678/1089-313X.031522f. Epub 2021 Dec 5.Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S. Active self-correction and task oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomized controlled trail. Eur Spine J (2014) 23:1204-1214 doi: 10.007/s00586-014-3241-y.Have an idea or suggestion for a future podcast? Call our voicemail:703-981-0718How to rate and review this podcast.Step by Step Instructions on Leaving a Review on AppleStep OneOpen the Podcasts app on your iPhone, iPad, or Mac.Step TwoNavigate to the page of the podcast you want to leave a review for. You can find it by searching for The Dance Studio Podcast or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.Step ThreeScroll down to find the subhead titled “Ratings & Reviews.”Step FourUnder the highlighted reviews, sOriginal music and audio production provided by Jarrett Nicolay at Mixtape Studios. www.mynewmixtape.com

En episodios anteriores sobre los desórdenes de conciencia, hablábamos de la conciencia desde la filosofía y la neurociencia. También en otro episodio, introdujimos los diferentes desórdenes de conciencia, sus características y diferencias fundamentales. Sin lugar a dudas, la clave dentro de la valoración de estos desórdenes de conciencia está en la capacidad de dar un pronóstico de recuperación y, embebido en ello, la capacidad de detectar cambios de transición entre la vigilia sin respuesta y el estado de mínima conciencia. Es importante conocer ciertas escalas y pruebas que se realizan para valorar distintos aspectos que están relacionados con la conciencia y con la transición entre, por ejemplo, una vigilia sin respuesta a una mínima conciencia. Podemos distinguir dos tipos de valoraciones: las valoraciones clínicas, que se pueden realizar a pie de cama, que básicamente sistematizan las respuestas a distintos estímulos o respuestas espontáneas; y por otro lado las valoraciones neurofisiológicas que tratan de valorar el sustrato de la conciencia que permite comprender las respuestas comportamentales de los pacientes. Referencias del episodio: 1. Cuadernos FEDACE sobre daño cerebral adquirido: síndrome de vigilia sin respuesta y de mínima conciencia (2011) (https://fedace.org/files/MSCFEDACE/2016-10/17-19-28-40.admin.13_vigilia_conciencia.pdf). 2. Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004 (https://pubmed.ncbi.nlm.nih.gov/15605342/). 3. Manual de la CRS-R (Coma Recovery Scale-Revised) (https://www.tbims.org/combi/crs/CRS%20Syllabus.pdf). 4. Noé E, Olaya J, Navarro MD, Noguera P, Colomer C, García-Panach J, Rivero S, Moliner B, Ferri J. Behavioral recovery in disorders of consciousness: a prospective study with the Spanish version of the Coma Recovery Scale-Revised. Arch Phys Med Rehabil. 2012 (https://pubmed.ncbi.nlm.nih.gov/22277244/). 5. Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S, Moonen G, Laureys S. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol. 2009 (https://pubmed.ncbi.nlm.nih.gov/19622138/). 6. Shiel A, Horn SA, Wilson BA, Watson MJ, Campbell MJ, McLellan DL. The Wessex Head Injury Matrix (WHIM) main scale: a preliminary report on a scale to assess and monitor patient recovery after severe head injury. Clin Rehabil. 2000 (https://pubmed.ncbi.nlm.nih.gov/10945425/). 7. Turner-Stokes L, Bassett P, Rose H, Ashford S, Thu A. Serial measurement of Wessex Head Injury Matrix in the diagnosis of patients in vegetative and minimally conscious states: a cohort analysis. BMJ Open. 2015 (https://pubmed.ncbi.nlm.nih.gov/25900459/). 8. Zasler ND, Formisano R, Aloisi M. Pain in Persons with Disorders of Consciousness. Brain Sci. 2022 (https://pubmed.ncbi.nlm.nih.gov/35326257/). 9. Rossi Sebastiano D, Varotto G, Sattin D, Franceschetti S. EEG Assessment in Patients With Disorders of Consciousness: Aims, Advantages, Limits, and Pitfalls. Front Neurol. 2021 (https://pubmed.ncbi.nlm.nih.gov/33868153/). 10. Pruvost-Robieux E, Marchi A, Martinelli I, Bouchereau E, Gavaret M. Evoked and Event-Related Potentials as Biomarkers of Consciousness State and Recovery. J Clin Neurophysiol. 2022 (https://pubmed.ncbi.nlm.nih.gov/34474424/). 11. Kondziella D y cols. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness. Eur J Neurol. 2020 (https://pubmed.ncbi.nlm.nih.gov/32090418/). 12. Formisano R, Contrada M, Aloisi M, Ferri G, Schiattone S, Iosa M, Buzzi MG. Nociception Coma Scale with personalized painful stimulation versus standard stimulus in non-communicative patients with disorders of consciousness. Neuropsychol Rehabil. 2020 (https://pubmed.ncbi.nlm.nih.gov/31088203/). 13. Formisano R, Aloisi M, Iosa M, Contrada M, Rizza F, Sattin D, Leonardi M, D'Ippolito M. A new tool to assess responsiveness in disorders of consciousness (DoC): a preliminary study on the Brief Post-Coma Scale (BPCS). Neurol Sci. 2018 (https://pubmed.ncbi.nlm.nih.gov/29948469/). 14. Cortese MD, Arcuri F, Nemirovsky IE, Lucca LF, Tonin P, Soddu A, Riganello F. Nociceptive Response Is a Possible Marker of Evolution in the Level of Consciousness in Unresponsive Wakefulness Syndrome Patients. Front Neurosci. 2021 (https://pubmed.ncbi.nlm.nih.gov/34975378/). 15. Chatelle C, Thibaut A, Bruno MA, Boly M, Bernard C, Hustinx R, Schnakers C, Laureys S. Nociception coma scale-revised scores correlate with metabolism in the anterior cingulate cortex. Neurorehabil Neural Repair. 2014 (https://pubmed.ncbi.nlm.nih.gov/24065132/). 16. Chatelle C, Thibaut A, Whyte J, De Val MD, Laureys S, Schnakers C. Pain issues in disorders of consciousness. Brain Inj. 2014 (https://pubmed.ncbi.nlm.nih.gov/25099024/). 17. Lin K, Wroten M. Ranchos Los Amigos. 2021 (https://pubmed.ncbi.nlm.nih.gov/28846341/). 18. American Congress of Rehabilitation Medicine, Brain Injury-Interdisciplinary Special Interest Group, Disorders of Consciousness Task Force, Seel RT y cols. Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research. Arch Phys Med Rehabil. 2010 (https://pubmed.ncbi.nlm.nih.gov/21112421/). 19. Disorder of Consciousness & Cognitive Recovery Following TBI Levels 1-10 with Dr. Alan Weintraub (Craig Hospital) (https://www.youtube.com/watch?v=ZWJUfSWYppM&t=2516s&ab_channel=CraigHospital).

En el episodio de hoy, hablo de la lesión medular y el entrenamiento con sistemas de soporte de peso corporal, una modalidad de tratamiento que cada vez está más en boga y que parece realmente que tiene su lugar asentado dentro de la rehabilitación de la lesión medular. Normalmente colocamos un arnés al paciente, que se une a una máquina que descarga el peso en un cierto porcentaje. Esa idea se cumple a la perfección en el caso de las grúas pero si pensamos en un paciente que quiere caminar, parece que quitarle peso, no es suficiente. ¿Hay algo más en estos sistemas de soporte de peso? ¿Qué hay de interacción humano-máquina? En este episodio, vemos estudios en sujetos sanos y en lesionados medulares, describimos sistemas de soporte de peso y aportamos ideas prácticas para terapia. Bibliografía: (1)Alexeeva N, Sames C, Jacobs PL, Hobday L, Distasio MM, Mitchell SA, Calancie B. Comparison of training methods to improve walking in persons with chronic spinal cord injury: a randomized clinical trial. J Spinal Cord Med. 2011;34(4):362-79. doi: 10.1179/2045772311Y.0000000018. PMID: 21903010; PMCID: PMC3152808 (https://pubmed.ncbi.nlm.nih.gov/21903010/). (2)Apte S, Plooij M, Vallery H. Influence of body weight unloading on human gait characteristics: a systematic review. J Neuroeng Rehabil. 2018 Jun 20;15(1):53. doi: 10.1186/s12984-018-0380-0. Erratum in: J Neuroeng Rehabil. 2018 Aug 8;15(1):73. PMID: 29925400; PMCID: PMC6011391 (https://pubmed.ncbi.nlm.nih.gov/29925400/). (3)Apte S, Plooij M, Vallery H. Simulation of human gait with body weight support: benchmarking models and unloading strategies. J Neuroeng Rehabil. 2020 Jun 25;17(1):81. doi: 10.1186/s12984-020-00697-z. PMID: 32586398; PMCID: PMC7318415 (https://pubmed.ncbi.nlm.nih.gov/32586398/). (4)Easthope CS, Traini LR, Awai L, Franz M, Rauter G, Curt A, Bolliger M. Overground walking patterns after chronic incomplete spinal cord injury show distinct response patterns to unloading. J Neuroeng Rehabil. 2018 Nov 12;15(1):102. doi: 10.1186/s12984-018-0436-1. PMID: 30419945; PMCID: PMC6233558 (https://pubmed.ncbi.nlm.nih.gov/30419945/). (5)Escribano-Ardura S, Cuesta-Gómez A, Fernández-González P, Carratalá-Tejada M, Molina-Rueda F. Entrenamiento en cinta rodante con soporte parcial del peso corporal en pacientes con lesión medular incompleta: revisión sistemática [Treadmill training with partial body weight support in subjects with incomplete spinal cord injury: a systematic review]. Rev Neurol. 2020 Aug 1;71(3):85-92. Spanish. doi: 10.33588/rn.7103.2020054. PMID: 32672346 (https://pubmed.ncbi.nlm.nih.gov/32672346/). (6)Fenuta AM, Hicks AL. Metabolic demand and muscle activation during different forms of bodyweight supported locomotion in men with incomplete SCI. Biomed Res Int. 2014;2014:632765. doi: 10.1155/2014/632765. Epub 2014 May 21. PMID: 24971340; PMCID: PMC4055602 (https://pubmed.ncbi.nlm.nih.gov/24971340/). (7)Fenuta AM, Hicks AL. Muscle activation during body weight-supported locomotion while using the ZeroG. J Rehabil Res Dev. 2014;51(1):51-8. doi: 10.1682/JRRD.2013.01.0005. PMID: 24805893 (https://pubmed.ncbi.nlm.nih.gov/24805893/9. (8)Fischer AG, Debbi EM, Wolf A. Effects of body weight unloading on electromyographic activity during overground walking. J Electromyogr Kinesiol. 2015 Aug;25(4):709-14. doi: 10.1016/j.jelekin.2015.05.001. Epub 2015 May 16. PMID: 26025610 (https://pubmed.ncbi.nlm.nih.gov/26025610/). (9)Hidler J, Brennan D, Black I, Nichols D, Brady K, Nef T. ZeroG: overground gait and balance training system. J Rehabil Res Dev. 2011;48(4):287-98. doi: 10.1682/jrrd.2010.05.0098. PMID: 21674384 (https://pubmed.ncbi.nlm.nih.gov/21674384/). (10)Huber JP, Sawaki L. Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study. J Neuroeng Rehabil. 2020 Nov 30;17(1):157. doi: 10.1186/s12984-020-00791-2. PMID: 33256797; PMCID: PMC7706039 (https://pubmed.ncbi.nlm.nih.gov/33256797/). (11)Lewek MD. The influence of body weight support on ankle mechanics during treadmill walking. J Biomech. 2011 Jan 4;44(1):128-33. doi: 10.1016/j.jbiomech.2010.08.037. Epub 2010 Sep 19. PMID: 20855074 (https://pubmed.ncbi.nlm.nih.gov/20855074/). (12)Mignardot JB, Le Goff CG, van den Brand R, Capogrosso M, Fumeaux N, Vallery H, Anil S, Lanini J, Fodor I, Eberle G, Ijspeert A, Schurch B, Curt A, Carda S, Bloch J, von Zitzewitz J, Courtine G. A multidirectional gravity-assist algorithm that enhances locomotor control in patients with stroke or spinal cord injury. Sci Transl Med. 2017 Jul 19;9(399):eaah3621. doi: 10.1126/scitranslmed.aah3621. PMID: 28724575 (https://pubmed.ncbi.nlm.nih.gov/28724575/). (13)Morawietz C, Moffat F. Effects of locomotor training after incomplete spinal cord injury: a systematic review. Arch Phys Med Rehabil. 2013 Nov;94(11):2297-308. doi: 10.1016/j.apmr.2013.06.023. Epub 2013 Jul 9. PMID: 23850614 (https://pubmed.ncbi.nlm.nih.gov/23850614/). (14)Nooijen CF, Ter Hoeve N, Field-Fote EC. Gait quality is improved by locomotor training in individuals with SCI regardless of training approach. J Neuroeng Rehabil. 2009 Oct 2;6:36. doi: 10.1186/1743-0003-6-36. PMID: 19799783; PMCID: PMC2764722 (https://pubmed.ncbi.nlm.nih.gov/19799783/). (15)M. Plooij, U. Keller, B. Sterke, S. Komi, H. Vallery and J. von Zitzewitz, "Design of RYSEN: An Intrinsically Safe and Low-Power Three-Dimensional Overground Body Weight Support," in IEEE Robotics and Automation Letters, vol. 3, no. 3, pp. 2253-2260, July 2018, doi: 10.1109/LRA.2018.2812913 (https://ieeexplore.ieee.org/document/8307350). (16)Plooij M, Apte S, Keller U, Baines P, Sterke B, Asboth L, Courtine G, von Zitzewitz J, Vallery H. Neglected physical human-robot interaction may explain variable outcomes in gait neurorehabilitation research. Sci Robot. 2021 Sep 22;6(58):eabf1888. doi: 10.1126/scirobotics.abf1888. Epub 2021 Sep 22. PMID: 34550719 (https://pubmed.ncbi.nlm.nih.gov/34550719/). (17)Wessels M, Lucas C, Eriks I, de Groot S. Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury: a systematic review. J Rehabil Med. 2010 Jun;42(6):513-9. doi: 10.2340/16501977-0525. PMID: 20549154 (https://pubmed.ncbi.nlm.nih.gov/20549154/).

Classic texts say that tai chi will help you become “Strong as an oak, flexible as a willow, and [mentally] clear as still water.”It's often called meditation in motion. Scientific studies are showing more and more health benefits that you can get from this practice. Dianne Bailey, CSCS, FAS, CTCIAs a fitness professional, martial artist, and owner of a successful personal training studio in Denver, Dianne is passionate about creating the best opportunities for the mature adult to enjoy health and fitness. This passion has led her to create a system for learning Tai Chi which will empower fitness professionals to be able to offer this amazing form of exercise to their clientele and help others learn this wonderful form of “movement meditation.”  Dianne is the author of three books: Eating Simply  Open the Door to Tai Chi . . . Tai Chi for the Everyday PersonHealthy, Happy and Fit – Ageless Exercise to enjoy Your Best Years YetDianne is a CSCS, a Functional Aging Specialist and a Certified Tai Chi Instructor. She has presented the benefits of Tai Chi at the Functional Aging Summit, ICAA Conference and Fitness Fest. In her engaging, easy-going yet commanding style, she hopes to encourage people to include Tai Chi in their offerings.Here are some Tai Chi resources.New 30 Days of Tai Chi.  Here is the link to Day 1.A link to Diane's presentation, 'Who can use Tai Chi'  Tai Chi for Balance - VeDA (vestibular.org)Articles: (So many choices)Wang LC, Ye MZ, Xiong J, Wang XQ, Wu JW, Zheng GH. Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis. J Am Geriatr Soc. 2021 Jul;69(7):2000-2010. doi: 10.1111/jgs.17094. Epub 2021 Mar 26. PMID: 33769556.Hu C, Qin X, Jiang M, Tan M, Liu S, Lu Y, Lin C, Ye R. Effects of Tai Chi Exercise on Balance Function in Stroke Patients: An Overview of Systematic Review. Neural Plast. 2022 Mar 9;2022:3895514. doi: 10.1155/2022/3895514. PMID: 35309256; PMCID: PMC8926482.Zhang T, Lv Z, Gao S. Tai Chi Training as a Primary Daily Care Plan for Better Balance Ability in People With Parkinson's Disease: An Opinion and Positioning Article. Front Neurol. 2021 Dec 24;12:812342. doi: 10.3389/fneur.2021.812342. PMID: 35002945; PMCID: PMC8739955.Li G, Huang P, Cui SS, et al. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson's disease patients. Transl Neurodegener. 2022;11(1):6. Published 2022 Feb 7. doi:10.1186/s40035-022-00280-7Guo G, Wu B, Xie S, et al. Effectiveness and safety of Tai Chi for chronic pain of knee osteoarthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022;101(2):e28497. doi:10.1097/MD.0000000000028497Winser SJ, Tsang WW, Krishnamurthy K, Kannan P. Does Tai Chi improve balance and reduce falls incidence in neurological disorders? a systematic review and meta-analysis. Clin Rehabil. (2018) 32:1157–68. 10.1177Zou L, Han J, Li C, Yeung AS, Hui SS-C, Tsang WWN, et al. . Effects of tai chi on lower limb proprioception in adults aged over 55: a systematic review and meta-analysis. Arch Phys Med Rehabil. (2019) 100:1102–13. 10.1016/j.apmr.2018.07.425 

I shouldn’t have to tell you that traumatic brain injury is a major cause of morbidity and mortality. I shouldn’t have to. But I will. And it is. In severe cases of head injury, there can be delayed and irreversible deterioration in the nervous system for which there is no treatment and the prognosis is grim. This week on the program, Dr. Monisha Kumar (University of Pennsylvania) discusses the worst of the worst of these scenarios, what to look out for, and expert recommendations on what to do when it happens. Produced by James E. Siegler and Monisha Kumar. Music courtesy of Rui, Swelling, Unheard Music Concepts, Jahzzar, Ian Southerland, and TRG Banks. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Strich SJ. Diffuse degeneration of the cerebral white matter in severe dementia following head injury. Journal of neurology, neurosurgery, and psychiatry. 1956;19:163-85. Adams JH, Graham DI, Murray LS and Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Annals of neurology. 1982;12:557-63. Povlishock JT, Becker DP, Cheng CL and Vaughan GW. Axonal change in minor head injury. J Neuropathol Exp Neurol. 1983;42:225-42. Gentry LR. Imaging of closed head injury. Radiology. 1994;191:1-17. Meythaler JM, Peduzzi JD, Eleftheriou E and Novack TA. Current concepts: diffuse axonal injury-associated traumatic brain injury. Arch Phys Med Rehabil. 2001;82:1461-71. Arfanakis K, Haughton VM, Carew JD, Rogers BP, Dempsey RJ and Meyerand ME. Diffusion tensor MR imaging in diffuse axonal injury. AJNR American journal of neuroradiology. 2002;23:794-802. Scheid R, Preul C, Gruber O, Wiggins C and von Cramon DY. Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T. AJNR American journal of neuroradiology. 2003;24:1049-56. DeKosky ST, Ikonomovic MD and Gandy S. Traumatic brain injury--football, warfare, and long-term effects. The New England journal of medicine. 2010;363:1293-6. Johnson VE, Stewart W and Smith DH. Widespread tau and amyloid-beta pathology many years after a single traumatic brain injury in humans. Brain Pathol. 2012;22:142-9. Schrag M and Greer DM. Clinical associations of cerebral microbleeds on magnetic resonance neuroimaging. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2014;23:2489-2497. Haghbayan H, Boutin A, Laflamme M, Lauzier F, Shemilt M, Moore L, Zarychanski R, Douville V, Fergusson D and Turgeon AF. The Prognostic Value of MRI in Moderate and Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Critical care medicine. 2017;45:e1280-e1288. Izzy S, Mazwi NL, Martinez S, Spencer CA, Klein JP, Parikh G, Glenn MB, Greenberg SM, Greer DM, Wu O and Edlow BL. Revisiting Grade 3 Diffuse Axonal Injury: Not All Brainstem Microbleeds are Prognostically Equal. Neurocritical care. 2017;27:199-207. van Eijck MM, Schoonman GG, van der Naalt J, de Vries J and Roks G. Diffuse axonal injury after traumatic brain injury is a prognostic factor for functional outcome: a systematic review and meta-analysis. Brain Inj. 2018;32:395-402.

Listen as chiropractor and founder of the Cox Technic, Dr. James Cox explains what Cox Technic is and why it is so effective for treating back pain. James M. Cox, DC, DACBR, FICC, Hon.D.Litt., FACO(H) Dr. Cox is the developer of Cox® Technic Flexion Distraction Manipulation and the proud participant in the on-going federal research projects involving the Keiser University, National University of Health Sciences, Palmer College of Chiropractic Research Center, Loyola Stritch School of Medicine, University of Illinois, University of Iowa, Auburn University, etc. He is a member of the postgraduate faculty of the National University of Health Sciences and has been privileged to speak throughout the world. Resources: About Dr. Cox curriculum vitae  More about Cox Technic Find a Back Doctor The Cox 8 Table by Haven Medical References: Chesterton P, Evans W, Wright M, Lolli L, Richardson M, Atkinson G. Influence of Lumbar Mobilizations During the Nordic Hamstring Exercise on Hamstring Measures of Knee Flexor Strength, Failure Point, and Muscle Activity: A Randomized Crossover Trial. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30201-3. doi: 10.1016/j.jmpt.2020.09.005. Epub ahead of print. PMID: 33248746. INFLUENCE OF LUMBAR MOBILIZATIONS DURING THE NORDIC HAMSTRING EXERCISE ON HAMSTRING MEASURES OF KNEE FLEXOR STRENGTH, FAILURE POINT, AND MUSCLE ACTIVITY: A RANDOMIZED CROSSOVER TRIAL. AFTER SPINAL MOBILIZATION, IMMEDIATE CHANGES IN BILATERAL HAMSTRING FORCE PRODUCTION AND PEAK TORQUE OCCURRED DURING THE NHE. THE EFFECT ON THE NHE FAILURE POINT WAS UNCLEAR. ELECTROMYOGRAPHIC ACTIVITY INCREASED ON THE IPSILATERAL SIDE. Meet the Nordic hamstring exercise, also known as the Nordic hamstring curl—your potential new favorite go-to that can help keep you healthy while boosting your performance.  me 19 Lead researcher Nicol van Dyk, Ph.D., of Aspetar Orthopaedic and Sports Medicine Hospital in Qatar, told Runner's World the move is simple: Begin in a kneeling position with both ankles secured—tucking your feet under a bar, for example, or having a running buddy hold them down—and then progressively lean forward as slowly as possible while keeping your back straight. When you can't resist anymore, just fall forward, catching yourself with your hands against the floor. Check out the video below for how to do it properly.   Ekşi MŞ, Özcan-Ekşi EE, Özmen BB, Turgut VU, Huet SE, Dinç T, Kara M, Özgen S, Özek MM, Pamir MN. Lumbar intervertebral disc degeneration, end-plates and paraspinal muscle changes in children and adolescents with low-back pain. J Pediatr Orthop B. 2020 Nov 27. doi: 10.1097/BPB.0000000000000833. Epub ahead of print. PMID: 33252539. FATTY INFILTRATION IN THE PARASPINAL MUSCLES AND IVDD WERE CLOSELY ASSOCIATED WITH MODIC CHANGES IN CHILDREN AND ADOLESCENTS WITH LBP. LUMBAR IVDD IN CHILDREN AND ADOLESCENTS COULD BE THE RESULT OF A MECHANICAL PATHOLOGY   Karartı C, Özüdoğru A, Basat HÇ, Özsoy İ, Özsoy G, Kodak Mİ, Sezgin H, Uçar İ. Determination of Biodex Balance System Cutoff Scores in Older People With Nonspecific Back Pain: A Cross-sectional Study. J Manipulative Physiol Ther. 2020 Nov 25:S0161-4754(20)30153-6. doi: 10.1016/j.jmpt.2020.07.006. Epub ahead of print. PMID: 33248744. DETERMINATION OF BIODEX BALANCE SYSTEM CUTOFF SCORES IN OLDER PEOPLE WITH NONSPECIFIC BACK PAIN: A CROSS-SECTIONAL STUDY BBS CUTOFF SCORES ARE SENSITIVE AND SPECIFIC IN DISTINGUISHING BETWEEN POOR AND GOOD POSTURAL PERFORMANCE IN OLDER PEOPLE WITH NSLBP.   TRACTION EFFECTS: TRACTION AND DISTRACTION STUDIES ON WHICH OUR WORK IS BASED. Luigi Albano, DC introduced the first paper on which I built the remaining studies. This gives us foundational understanding as to the benefits of placing a spine into distraction prior to producing ranges of motion – IT FIRST REDUCES STENOTIC EFFECTS THAT COULD CAUSE GREATER NERVE AND DRG COMPRESSION AND CHEMICAL INFLAMMATORY IRRITATION. - JMC   Gaowgzeh RAM, Chevidikunnan MF, BinMulayh EA, Khan F. Effect of spinal decompression therapy and core stabilization exercises in management of lumbar disc prolapse: A single blind randomized controlled trial. J Back Musculoskelet Rehabil. 2020;33(2):225-231. doi: 10.3233/BMR-171099. PMID: 31282394. A COMBINATION OF SPINAL DECOMPRESSION THERAPY WITH CORE STABILIZATION EXERCISE HAS PROVEN TO BE MORE SIGNIFICANT WHEN COMPARED WITH CSE ALONE TO REDUCE PAIN AND DISABILITY IN SUBJECTS WITH CHRONIC LDP.   Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):1015-1022. doi: 10.3233/BMR-169581. PMID: 28505956. THIS STUDY SHOWED THAT PATIENTS WITH LHNP RECEIVED PHYSIOTHERAPY HAD IMPROVEMENT BASED ON CLINICAL AND RADIOLOGIC EVIDENCE. NON-INVASIVE SPINAL DECOMPRESSION THERAPY (NSDT) CAN BE USED AS ASSISTIVE AGENT FOR OTHER PHYSIOTHERAPY METHODS IN TREATMENT OF LUMBAR DISC HERNIATION.   Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial. J Back Musculoskelet Rehabil. 2017;30(2):247-253. doi: 10.3233/BMR-160741. PMID: 27636836. SEGMENTAL TRACTION THERAPY MIGHT PLAY AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LBP STIMULATED BY LDH.   Kamanli A1, Karaca-Acet G, Kaya A, Koc M, Yildirim H Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 2, pp. 247-253, 2017 CONVENTIONAL PHYSICAL THERAPIES WITH LUMBAR TRACTION WERE EFFECTIVE IN THE TREATMENT OF PATIENT WITH SUBACUTE LDH. THESE RESULTS SUGGEST THAT CLINICAL IMPROVEMENT IS NOT CORRELATED WITH THE FINDING OF MRI. PATIENTS WITH LDH SHOULD BE MONITORED CLINICALLY   Choi J, Lee S, Hwangbo G. Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. J Phys Ther Sci. 2015 Feb;27(2):481-3. doi: 10.1589/jpts.27.481. Epub 2015 Feb 17. PMID: 25729196; PMCID: PMC4339166. SPINAL DECOMPRESSION THERAPY AND GENERAL TRACTION THERAPY ARE EFFECTIVE AT IMPROVING THE PAIN, DISABILITY, AND SLR OF PATIENTS WITH INTERVERTEBRAL DISC HERNIATION. THUS, SELECTIVE TREATMENT MAY BE REQUIRED   JUDOVICH BD. Herniated cervical disc; a new form of traction therapy. Am J Surg. 1952 Dec;84(6):646-56. doi: 10.1016/0002-9610(52)90127-x. PMID: 12986095. CLINICAL STUDIES INDICATE THAT IN THE AVERAGE INTRACTABLE CASE THE CERVICAL SPINE SHOULD BE STRETCHED BY FORCE RANGING FROM 25 TO 45 POUNDS. ALMOST HALF THE PATIENTS IN A SERIES OF SIXTY CASES EXPERIENCED PARTIAL OR COMPLETE MOMENTARY RELIEF WHEN THIS FORCE WAS APPLIED. ROENTGEN STUDIES REVEAL THAT IN THE AVERAGE PATIENT THE INTERVERTEBRAL SPACES OF THE CERVICAL SPINE BEGIN TO SHOW MEASURABLE WIDENING WITH TRACTION FORCE RANGING FROM 25 TO 50 POUNDS. THE NECESSARY FORCE TO RELIEVE PAIN CANNOT BE TOLERATED BY THE AVERAGE PATIENT WHEN IT IS ADMINISTERED AS A CONSTANT PULL. IF ADMINISTERED INTERMITTENTLY, ADEQUATE AND MUCH GREATER TRACTION LOAD CAN BE TOLERATED WITHOUT THE DISCOMFORT WHICH WOULD NORMALLY ACCOMPANY SUCH FORCE. A NEW METHOD OF MOTORIZED INTERMITTENT TRACTION IS PRESENTED. THE CLINICAL RESULTS OF INTERMITTENT TRACTION, BECAUSE OF ADEQUATE FORCE, HAVE BEEN EXCELLENT AS COMPARED TO CONVENTIONAL TRACTION METHODS.   Burton AK, Tillotson KM, Cleary J. Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation. Eur Spine J. 2000 Jun;9(3):202-7. doi: 10.1007/s005869900113. PMID: 10905437; PMCID: PMC3611397. BECAUSE OSTEOPATHIC MANIPULATION PRODUCED A 12-MONTH OUTCOME THAT WAS EQUIVALENT TO CHEMONUCLEOLYSIS, IT CAN BE CONSIDERED AS AN OPTION FOR THE TREATMENT OF SYMPTOMATIC LUMBAR DISC HERNIATION, AT LEAST IN THE ABSENCE OF CLEAR INDICATIONS FOR SURGERY. Further study into the value of manipulation at a more acute stage is warranted.   Kirkaldy-Willis WH, Cassidy JD. Spinal manipulation in the treatment of low-back pain. Can Fam Physician. 1985 Mar;31:535-40. PMID: 21274223; PMCID: PMC2327983. RESULTS OF SPINAL MANIPULATION IN 283 PATIENTS WITH LOW BACK PAIN ARE PRESENTED. THE PHYSICIAN WHO MAKES USE OF THIS RESOURCE WILL PROVIDE RELIEF FOR MANY PATIENTS.   Oliphant D. Safety of spinal manipulation in the treatment of lumbar disk herniations: a systematic review and risk assessment. J Manipulative Physiol Ther. 2004 Mar-Apr;27(3):197-210. doi: 10.1016/j.jmpt.2003.12.023. PMID: 15129202. THE APPARENT SAFETY OF SPINAL MANIPULATION, ESPECIALLY WHEN COMPARED WITH OTHER “MEDICALLY ACCEPTED” TREATMENTS FOR LDH, SHOULD STIMULATE ITS USE IN THE CONSERVATIVE TREATMENT PLAN OF LDH.   Kane MD, Karl RD, Swain JH. Effects of Gravity-Facilitated Traction on lntervertebral Dimensions of the Lumbar Spine*. J Orthop Sports Phys Ther. 1985;6(5):281-8. doi: 10.2519/jospt.1985.6.5.281. PMID: 18802302. MEAN POSTERIOR SEPARATION WAS SIGNIFICANT AT ALL LEVELS EXCEPT L1-L2 AND L5-S1. MEAN INTERVERTEBRAL FORAMINAL SEPARATION WAS SIGNIFICANT AT ALL LEVELS BUT L5-S1. IF INCREASES IN INTERVERTEBRAL DIMENSIONS PLAY A ROLE IN THE RELIEF OF LOW BACK SYNDROME, THEN GRAVITY-FACILITATED TRACTION MAY BE AN EFFECTIVE MODALITY IN THE TREATMENT OF THIS CONDITION.   Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther. 2008 Mar;31(3):191-8. doi: 10.1016/j.jmpt.2008.02.001. PMID: 18394495. TRACTION, ULTRASOUND, AND LOW POWER LASER THERAPIES WERE ALL EFFECTIVE IN THE TREATMENT OF THIS GROUP OF PATIENTS WITH ACUTE LDH. THESE RESULTS SUGGEST THAT CONSERVATIVE MEASURES SUCH AS TRACTION, LASER, AND ULTRASOUND TREATMENTS MIGHT HAVE AN IMPORTANT ROLE IN THE TREATMENT OF ACUTE LDH   Chung TS, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology. 2015 Jun;275(3):755-62. doi: 10.1148/radiol.14141400. Epub 2015 Jan 22. Erratum in: Radiology. 2015 Jun;275(3):934-5. PMID: 25611735. HERNIATED LUMBAR DISKS: REAL-TIME MR IMAGING EVALUATION DURING CONTINUOUS TRACTION CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.   Isner-Horobeti ME, Dufour SP, Schaeffer M, Sauleau E, Vautravers P, Lecocq J, Dupeyron A. High-Force Versus Low-Force Lumbar Traction in Acute Lumbar Sciatica Due to Disc Herniation: A Preliminary Randomized Trial. J Manipulative Physiol Ther. 2016 Nov-Dec;39(9):645-654. doi: 10.1016/j.jmpt.2016.09.006. Epub 2016 Nov 9. PMID: 27838140. HIGH-FORCE VERSUS LOW-FORCE LUMBAR TRACTION IN ACUTE LUMBAR SCIATICA DUE TO DISC HERNIATION: A PRELIMINARY RANDOMIZED TRIAL PATIENTS WITH ACUTE LUMBAR SCIATICA SECONDARY TO DISC HERNIATION WHO RECEIVED 2 WEEKS OF LUMBAR TRACTION REPORTED REDUCED RADICULAR PAIN AND FUNCTIONAL IMPAIRMENT AND IMPROVED WELL-BEING REGARDLESS OF THE TRACTION FORCE GROUP TO WHICH THEY WERE ASSIGNED. THE EFFECTS OF THE TRACTION TREATMENT WERE INDEPENDENT OF THE INITIAL LEVEL OF MEDICATION AND APPEARED TO BE MAINTAINED AT THE 2-WEEK FOLLOW-UP. DURING THE 2-WEEK FOLLOW-UP AT DAY 28, ONLY THE LT10 GROUP IMPROVED (P < .05) IN VAS (–52%) AND EIFEL SCORES (–46%).   Onel D, Tuzlaci M, Sari H, Demir K. Computed tomographic investigation of the effect of traction on lumbar disc herniations. Spine (Phila Pa 1976). 1989 Jan;14(1):82-90. doi: 10.1097/00007632-198901000-00017. PMID: 2913674. COMPUTED TOMOGRAPHIC INVESTIGATION OF THE EFFECT OF TRACTION ON LUMBAR DISC HERNIATIONS. CHANGES OCCURRING UNDER THE EFFECT OF A TRACTION LOAD OF 45 KG HAVE BEEN EVALUATED IN 30 PATIENTS WITH LUMBAR DISC HERNIATION WITH CT INVESTIGATION. THE HERNIATED NUCLEAR MATERIAL (HNM) HAS RETRACTED IN 11 (78.5%) OF MEDIAN, SIX (66.6%) OF POSTEROLATERAL, AND FOUR (57.1%) OF LATERAL HERNIATIONS.   Clarke J, van Tulder M, Blomberg S, de Vet H, van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. Spine (Phila Pa 1976). 2006 Jun 15;31(14):1591-9. doi: 10.1097/01.brs.0000222043.09835.72. PMID: 16778694. INTERMITTENT OR CONTINUOUS TRACTION AS A SINGLE TREATMENT FOR LBP CANNOT BE RECOMMENDED FOR MIXED GROUPS OF PATIENTS WITH LBP WITH AND WITHOUT SCIATICA. NEITHER CAN TRACTION BE RECOMMENDED FOR PATIENTS WITH SCIATICA BECAUSE OF INCONSISTENT RESULTS AND METHODOLOGICAL PROBLEMS IN MOST OF THE STUDIES INVOLVED. HOWEVER, BECAUSE HIGH-QUALITY STUDIES WITHIN THE FIELD ARE SCARCE, BECAUSE MANY ARE UNDERPOWERED, AND BECAUSE TRACTION OFTEN IS SUPPLIED IN COMBINATION WITH OTHER TREATMENT MODALITIES, THE LITERATURE ALLOWS NO FIRM NEGATIVE CONCLUSION THAT TRACTION, IN A GENERALIZED SENSE, IS NOT AN EFFECTIVE TREATMENT FOR PATIENTS WITH LBP   Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective case series study. Arch Phys Med Rehabil. 2008 Feb;89(2):269-74. doi: 10.1016/j.apmr.2007.06.778. PMID: 18226650. TRACTION APPLIED IN THE PRONE POSITION USING THE VAX-D FOR 8 WEEKS WAS ASSOCIATED WITH IMPROVEMENTS IN PAIN INTENSITY AND RMDQ SCORES AT DISCHARGE, AND AT 30 AND 180 DAYS AFTER DISCHARGE IN A SAMPLE OF PATIENTS WITH ACTIVITY-LIMITING LBP. CAUSAL RELATIONSHIPS BETWEEN THESE OUTCOMES AND THE INTERVENTION SHOULD NOT BE MADE UNTIL FURTHER STUDY IS PERFORMED USING RANDOMIZED COMPARISON GROUPS.   REAL-TIME MR IMAGING WHILE PERFORMING TRACTION IS POSSIBLE. Mitchell UH, Beattie PF, Bowden J, Larson R, Wang H. Age-related differences in the response of the L5-S1 intervertebral disc to spinal traction. Musculoskelet Sci Pract. 2017 Oct;31:1-8. doi: 10.1016/j.msksp.2017.06.004. Epub 2017 Jun 9. PMID: 28624722. TO DETERMINE DIFFERENCES IN THE APPARENT DIFFUSION COEFFICIENT (ADC) OBTAINED WITH LUMBAR DIFFUSION-WEIGHTED IMAGING (DWI) OF THE L5-S1 IVD BEFORE, AND DURING, THE APPLICATION OF LUMBAR TRACTION STATIC TRACTION WAS ASSOCIATED WITH AN INCREASE IN DIFFUSION OF WATER WITHIN THE L5-S1 IVDS OF MIDDLE-AGE INDIVIDUALS, BUT NOT IN YOUNG ADULTS, SUGGESTING AGE-RELATED DIFFERENCES IN THE DIFFUSION RESPONSE. FURTHER STUDY IS NEEDED TO ASSESS THE RELATIONSHIP BETWEEN THESE FINDINGS AND THE SYMPTOMS OF BACK PAIN. HIGHLIGHTS: STATIC TRACTION IS ASSOCIATED WITH AN INCREASE IN ADC IN OLDER DISCS, NOT YOUNGER. INVERSE RELATIONSHIP BETWEEN BASELINE ADC AND PERCENT INCREASE WITH TRACTION. FINDINGS SUGGEST PRESENCE OF AGE-RELATED CHANGES IN THE RATE OF DIFFUSION RESPONSE.   SAAL, JEFFREY A., MD; SAAL, JOEL S., MD Nonoperative Treatment of Herniated Lumbar Intervertebral Disc with Radiculopathy: An Outcome Study, Spine: April 1989 - Volume 14 - Issue 4 - p 431-437 64 PATIENTS WITH LUMBAR HERNIATED NUCLEUS PULPOSUS WITHOUT SIGNIFICANT STENOSIS WERE TREATED NON SURGICALLY. 90% GOOD OR EXCELLENT OUTCOME WITH A 92% RETURN TO WORK RATE. FOR THE SUBGROUPS WITH EXTRUDED DISCS AND SECOND OPINIONS, 87% AND 83% HAD GOOD OR EXCELLENT OUTCOMES, RESPECTIVELY, ALL (100%) OF WHOM RETURNED TO WORK. SICK LEAVE TIME FOR THESE SUBGROUPS WAS 2.9 MONTHS (+/- 1.4 MONTHS) AND 3.4 MONTHS (+/- 1.7 MONTHS), RESPECTIVELY. THESE RESULTS COMPARED FAVORABLY WITH PREVIOUSLY PUBLISHED SURGICAL STUDIES. FOUR OF SIX PATIENTS WHO REQUIRED SURGERY WERE FOUND TO HAVE STENOSIS AT OPERATION.   Sari H, Akarirmak U, Karacan I, Akman H. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-Mar;21(1):3-11. PMID: 16385939. DURING TRACTION OF INDIVIDUALS WITH ACUTE LDH THERE WAS A REDUCTION OF THE SIZE OF THE HERNIATION, INCREASED SPACE WITHIN THE SPINAL CANAL, WIDENING OF THE NEURAL FORAMINA, AND DECREASED THICKNESS OF THE PSOAS MUSCLE.   Park WM, Kim K, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. Man Ther. 2014 Dec;19(6):527-33. doi: 10.1016/j.math.2014.05.004. Epub 2014 May 22. PMID: 24913413. A COMBINATION OF GLOBAL AXIAL TRACTION AND LOCAL DECOMPRESSION WOULD BE HELPFUL FOR REDUCING TENSILE STRESS ON THE FIBERS OF THE ANNULUS FIBROSUS AND LIGAMENTS, AND INTRADISCAL PRESSURE IN TRACTION THERAPY. THIS STUDY COULD BE USED TO DEVELOP A SAFER AND MORE EFFECTIVE TYPE OF TRACTION THERAPY   Chow DHK, Yuen EMK, Xiao L, Leung MCP. Mechanical effects of traction on lumbar intervertebral discs: A magnetic resonance imaging study. Musculoskelet Sci Pract. 2017 Jun;29:78-83. doi: 10.1016/j.msksp.2017.03.007. Epub 2017 Mar 20. PMID: 28347933. HORIZONTAL TRACTION WAS EVIDENTLY EFFECTIVE IN INCREASING THE DISC HEIGHT OF LOWER LUMBAR LEVELS, PARTICULARLY IN THE POSTERIOR REGIONS OF THE DISCS. FURTHER EVIDENCE OF THE EFFECTS OF TRACTION OF DIFFERENT MODES, MAGNITUDES, AND DURATIONS ON THE CHANGE IN DISC HEIGHT IS REQUIRED FOR PROPER CONTROL OF TRACTION APPLIED TO SPECIFIC DISC LEVELS. HIGHLIGHTS: MECHANICAL EFFECTS OF TRACTION ON LUMBAR DISCS WAS EVALUATED USING MRI. HORIZONTAL TRACTION USING 42% OF BODY WEIGHT WAS ASSOCIATED WITH AN INCREASED DISC HEIGHT OF LOWER LUMBAR DISCS. HORIZONTAL TRACTION ALSO RESULTED IN REDUCED LORDOSIS AND CHANGE IN TILT ANGLE. THE EFFECTS WERE MORE PROMINENT AT THE POSTERIOR DISCAL REGIONS.   Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14. PMID: 28192789. a  systematic  review  of  randomized, controlled  trials  and  systematic  reviews  published  through  April 2015  on  noninvasive  pharmacologic  and  nonpharmacologic treatments  for  low  back  pain.  Updated  searches  were  performed through  November  2016. Recommendation  1: Given  that  most  patients  with  acute  or subacute  low  back  pain  improve  over  time  regardless  of  treat-ment,  clinicians  and  patients  should  select  nonpharmacologic treatment  with  superficial  heat  (moderate-quality  evidence),  massage,  acupuncture,  or  spinal  manipulation  (low-quality  evidence). If  pharmacologic  treatment  is  desired,  clinicians  and  patients should  select  nonsteroidal  anti-inflammatory  drugs  or  skeletal muscle  relaxants  (moderate-quality  evidence).  (Grade:  strong recommendation) Recommendation  2: For  patients  with  chronic  low  back  pain, clinicians  and  patients  should  initially  select  nonpharmacologic treatment  with  exercise,  multidisciplinary  rehabilitation,  acupuncture,  mindfulness-based  stress  reduction  (moderate-quality  evidence),  tai  chi,  yoga,  motor  control  exercise,  progressive relaxation,  electromyography  biofeedback,  low-level  laser therapy,  operant  therapy,  cognitive  behavioral  therapy,  or  spinal manipulation  (low-quality  evidence).  (Grade:  strong recommendation) Recommendation  3: In  patients  with  chronic  low  back  pain  who have  had  an  inadequate  response  to  nonpharmacologic  therapy, clinicians  and  patients  should  consider  pharmacologic  treatment with  nonsteroidal  anti-inflammatory  drugs  as  first-line  therapy,  or tramadol  or  duloxetine  as  second-line  therapy.  Clinicians  should only  consider  opioids  as  an  option  in  patients  who  have  failed  the aforementioned  treatments  and  only  if  the  potential  benefits  out-weigh  the  risks  for  individual  patients  and  after  a  discussion  of known  risks  and  realistic  benefits  with  patients.  (Grade:  weak  recommendation,  moderate-quality  evidence) Low  back  pain  is  one  of  the  most  common  reasons for  physician  visits  in  the  United  States.  Most  Americans  have  experienced  low  back  pain,  and  approximately  one  quarter  of  U.S.  adults  reported  having  low back  pain  lasting  at  least  1  day  in  the  past  3  months  (1).Low  back  pain  is  associated  with  high  costs,  including those  related  to  health  care  and  indirect  costs  from missed  work  or  reduced  productivity  (2).  The  total  costs attributable  to  low  back  pain  in  the  United  States  were estimated  at  $100  billion  in  2006,  two  thirds  of  which were  indirect  costs  of  lost  wages  and  productivity  (3).Low  back  pain  is  frequently  classified  and  treated on  the  basis  of  symptom  duration,  potential  cause, presence  or  absence  of  radicular  symptoms,  and  corresponding  anatomical  or  radiographic  abnormalities. Acute  back  pain  is  defined  as  lasting  less  than  4  week   Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt ED. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017 Apr 4;166(7):493-505. doi: 10.7326/M16-2459. Epub 2017 Feb 14. PMID: 28192793. Background: A  2007  American  College  of  Physicians  guideline addressed  nonpharmacologic  treatment  options  for  low  back pain. The  current  evidence  on  non-pharmacologic  therapies  for  acute  or  chronic  nonradicular  or  ra-dicular  low  back  pain from  MEDLINE  (January  2008  through  February 2016),  Cochrane  Central  Register  of  Controlled  Trials,  CochraneDatabase  of  Systematic  Reviews,  and  reference  lists. Evidence  continues  to  support  the  effectiveness  of  exercise,  psychological  therapies,  multidisciplinary  rehabilitation,  spinal  manipulation,  massage,  and  acupuncture  for  chronic  low  back  pain. Funding  Source:Agency  for  Healthcare  Research  and Quality.  (PROSPERO:  CRD42014014735)Ann  Intern  Med.2017;166:xxx-xxx.  doi:10.7326/M16-2459Annals.org the  American  College  of  Physicians  (ACP)and  American  Pain  Society  (APS)  recommended  spinal manipulation  as  a  treatment  option  for  acute  low  back pain  and  several  nonpharmacologic  therapies  for  sub-acute  or  chronic  low  back  pain.    Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MØ, Fournier G, Højgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20. PMID: 28429142. Purpose: To summarise recommendations about 20 non-surgical interventions for recent onset ( If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.   Krekoukias G1, Gelalis ID1,2, Xenakis T1, Gioftsos G3, Dimitriadis Z4, Sakellari V3. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther. 2017 May;25(2):66-73. doi: 10.1080/10669817.2016.1184435. Epub 2016 Jun 23. MANUAL THERAPY SPINAL MOBILIZATION IS PREFERABLE TO CONVENTIONAL PHYSIOTHERAPY IN ORDER TO REDUCE THE PAIN INTENSITY AND DISABILITY IN SUBJECTS WITH CHRONIC LBP AND ASSOCIATED DISK DEGENERATION. THE FINDINGS OF THIS STUDY MAY LEAD TO THE ESTABLISHMENT OF SPINAL MOBILIZATION AS ONE OF THE MOST PREFERABLE APPROACHES FOR THE MANAGEMENT OF LBP DUE TO DISK DEGENERATION.   REFERENCES FOR 25% RELIEF PAPER BY WIRTH ET AL Wirth B1, Riner F1, Peterson C1, Humphreys BK1, Farshad M2, Becker S3, Schweinhardt P1. An observational study on trajectories and outcomes of chronic low back pain patients referred from a spine surgery division for chiropractic treatment. Chiropr Man Therap. 2019 Feb 5;27:6. doi: 10.1186/s12998-018-0225-8. eCollection 2019. Refs on minimal clinical improvement determination: Farrar JT, Young JP, Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94:149–158. doi: 10.1016/S0304-3959(01)00349-9. [PubMed] [CrossRef] Kovacs FM, Abraira V, Royuela A, Corcoll J, Alegre L, Cano A, et al. Minimal clinically important change for pain intensity and disability in patients with nonspecific low back pain. Spine (Phila Pa 1976) 2007;32:2915–2920. doi: 10.1097/BRS.0b013e31815b75ae. [PubMed] [CrossRef] Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8:283–291. doi: 10.1016/j.ejpain.2003.09.004. [PubMed] [CrossRef] Robinson-Papp J, George MC, Dorfman D, Simpson DM. Barriers to chronic pain measurement: a qualitative study of patient perspectives.Pain Med. 2015;16:1256–1264. doi: 10.1111/pme.12717. [PMC free article] [PubMed] [CrossRef] Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 2008;33:90–94. doi: 10.1097/BRS.0b013e31815e3a10. [PubMed] [CrossRef]   Chung TS1, Yang HE, Ahn SJ, Park JH. Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction. Radiology 2015 Jan 22:141400. CONTINUOUS TRACTION ON HERNIATED LUMBAR DISKS AND SURROUNDING STRUCTURES RESULTED IN CHANGE IN DISK SHAPE, DISK REDUCTION WITH OPENING IN THE INTERVERTEBRAL DISK, REDUCTION OF HERNIATED DISK VOLUME, SEPARATION OF THE DISK AND ADJOINING NERVE ROOT, AND WIDENING OF THE FACET JOINT.    Wong A, Parent E, Dhillon S, Prasad N, Kawchuk G: Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically From Nonresponders, Untreated Controls or Asymptomatic Controls? Spine: 01 September 2015 - Volume 40 - Issue 17 - p 1329–1337  doi: 10.1097/BRS.0000000000000981 PARTICIPANTS WITH LBP AND ASYMPTOMATIC CONTROLS ATTENDED 3 SESSIONS FOR 7 DAYS. ON SESSIONS 1 AND 2, PARTICIPANTS WITH LBP RECEIVED SMT (+LBP/+SMT, N = 32) WHEREAS ASYMPTOMATIC CONTROLS DID NOT (−LBP/−SMT, N = 57). IN THESE SESSIONS, SPINAL STIFFNESS AND MULTIFIDUS THICKNESS RATIOS WERE OBTAINED BEFORE AND AFTER SMT AND ON DAY 7. RESULTS. AFTER THE FIRST SMT, SMT RESPONDERS DISPLAYED STATISTICALLY SIGNIFICANT DECREASES IN SPINAL STIFFNESS AND INCREASES IN MULTIFIDUS THICKNESS RATIO SUSTAINED FOR MORE THAN 7 DAYS; THESE FINDINGS WERE NOT OBSERVED IN OTHER GROUPS. SIMILARLY, ONLY SMT RESPONDERS DISPLAYED SIGNIFICANT POST-SMT IMPROVEMENT IN APPARENT DIFFUSION COEFFICIENTS.     Wong AYL1,2, Parent EC3, Dhillon SS4, Prasad N5, Samartzis D6, Kawchuk GN3. Differential patient responses to spinal manipulative therapy and their relation to spinal degeneration and post-treatment changes in disc diffusion. Eur  Spine J. 2019 Jan 2. doi: 10.1007/s00586-018-5851-2. NON-SPECIFIC LOW BACK PAIN PATIENTS WHO RESPOND WITH >30% RELIEF SHOW HIGHER APPARENT DIFFUSION COEFFICIENT DISC DIFFUSION OF WATER THAN NON POSITIVE RESPONDERS. MRI WAS PERFORMED BEFORE AND AFTER SMT ON DAY 1 OF CARE. OSWESTRY DISABILITY TEST WAS ALSO USED.     Beattie PF, Butts R, Donley JW, Liuzzo DM. The Within-Session Change in Low Back Pain Intensity Following Spinal Manipulative Therapy is Related to Differences in Diffusion of Water in the Intervertebral Discs of the Upper Lumbar Spine and L5-S1. Orthop Sports Phys Ther. 2013 Nov 21. Doctoral Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC. STUDY TO DETERMINE DIFFERENCES IN THE CHANGES IN DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS BETWEEN THOSE SUBJECTS WITH LOW BACK PAIN (LBP) WHO DID, AND DID NOT, REPORT A WITHIN-SESSION REDUCTION IN PAIN INTENSITY FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY (SMT) WAS DONE. CHANGES IN THE DIFFUSION OF WATER WITHIN THE LUMBAR INTERVERTEBRAL DISCS AT THE L1-2, L2-3, AND L5-1 LEVELS APPEAR TO BE RELATED TO DIFFERENCES IN WITHIN-SESSION PAIN REPORTS FOLLOWING A SINGLE TREATMENT OF SPINAL MANIPULATIVE THERAPY. PARTICIPANTS UNDERWENT T2- AND DIFFUSION-WEIGHTED LUMBAR MAGNETIC RESONANCE IMAGING SCANS IMMEDIATELY BEFORE, AND AFTER, RECEIVING A SINGLE TREATMENT OF SMTJ     Kuo, Ya-Wen PhD; Hsu, Yu-Chun MS; Chuang, I-Ting MS; Chao, Pen-Hsiu Grace PhD; Wang, Jaw-Lin PhD Spinal Traction Promotes Molecular Transportation in a Simulated Degenerative Intervertebral Disc Model. Spine: April 20th, 2014 - Volume 39 - Issue 9 - p E550 Traction biomechanics studied in the porcine model biomechanical benefits include disc height recovery, foramen enlargement, and intradiscal pressure reduction. 48 thoracic discs were dissected from 8 porcine spines and then divided into 3 groups: intact, degraded without traction, and degraded with traction. From Day 4 to Day 6, half of the degraded discs received a 30 min traction treatment per day (traction force: 20 kg, loading: unloading = 30 sec: 10 sec). Traction treatment is effective in enhancing nutrition supply and promoting disc cell proliferation of the degraded discs.  

So how exactly does physical therapy fit into the management and understanding of pain? Join Erin and Michelle as they describe some ways a physical therapist can help you manage and understand pain. As we like to say, physical therapy is body knowledge for life! Questions or comments?? Email Erin and Michelle at bodybrainpain@gmail.com! References: - Louw, Adriaan. Why Do I Hurt?: A Patient Book about the Neuroscience of Pain. Orthopedic Physical Therapy & Rehabilitation Products, 2013. - Louw, A., et al. (2011). “The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain”. Arch Phys Med Rehabil. 92:2041-56. - TEDxAdelaide - Lorimer Moseley - Why Things Hurt: https://www.youtube.com/watch?v=gwd-wLdIHjs Disclaimer: This podcast contains general information for educational purposes only, and is not intended to serve as medical advice. Please seek advice from your individual healthcare provider for any injury, illness or medical condition you may have.

What is pain and what are the largest misconceptions people have right away pertaining to pain? Why have we been confused for so long? Join Erin and Michelle as they dive into what pain neuroscience is and how knowing more helps us feel better and have less pain overall. Questions or comments?? Email Erin and Michelle at bodybrainpain@gmail.com! References: - Louw, Adriaan. Why Do I Hurt?: A Patient Book about the Neuroscience of Pain. Orthopedic Physical Therapy & Rehabilitation Products, 2013 - Louw, A., et al. (2011). “The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain”. Arch Phys Med Rehabil. 92:2041-56. - TEDxAdelaide - Lorimer Moseley - Why Things Hurt: https://www.youtube.com/watch?v=gwd-wLdIHjs Disclaimer: This podcast contains general information for educational purposes only, and is not intended to serve as medical advice. Please seek advice from your individual healthcare provider for any injury, illness or medical condition you may have.

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 Pain Prior to Knee Arthroplasty: A Multisite Randomized Clinical Trial. Riddle DL, Keefe FJ, Ang DC, Slover J, Jensen MP, Bair MJ, Kroenke K, Perera RA, Reed SD, McKee D, Dumenci L. JBJS. February 6, 2019 - Volume 101 - Issue 3 - p 218-227 doi: 10.2106/JBJS.18.00621. The effectiveness trial. Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study. Riddle DL, Keefe FJ, Nay WT, McKee D, Attarian DE, Jensen MP. Arch Phys Med Rehabil. 2011 Jun;92(6):859-65. doi: 10.1016/j.apmr.2011.01.003. Epub 2011 Apr 29. The efficacy trial. OPEN ACCESS! Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Riddle DL, Wade JB, Jiranek WA, Kong X. Clin Orthop Relat Res. 2010 Mar;468(3):798-806. doi: 10.1007/s11999-009-0963-y. Epub 2009 Jul 8. The validation of the metric. OPEN ACCESS! Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission

Michelle Nelson in an interview with Ross Upshur discusses the importance of intra- and inter-sectoral collaboration in healthcare and explains how the voluntary sector could be engaged to support improved patient and family experiences and the outcomes. In a recent interview with Ross Upshur, Michelle Nelson, a Research Scientist at Research Collaboratory, Lunenfeld-Tanenbaum Research Institute, explained about her research, the importance of intra- and inter-sectoral collaboration in health care, engagement of the voluntary sector to support improved patient and family experience and the patient outcomes. Michelle has been actively pursuing development of a complexity and stroke rehabilitation research network. Her tireless efforts recently led to holding a meeting attended by 43 researchers, policy-makers and clinicians. The meeting initially generated 120 potential research questions, from which 16 high-priority questions were identified focusing on complexity characteristics including multimorbidity, social determinants, patient characteristics, social support and system factors (1). In this recent work, Michelle and her colleagues put the emphasis on expanding the kind of research that focuses beyond the single disease approach, and try to help understand complex patients and their care needs. This approach, as they put it, will not only help stakeholders to better understand and provide integrated stroke rehab care for complex patients but it will also help improve patient outcomes that would ultimately lead to a more developed and advanced health care system. Dr. Nelson is a Research Scientist within the Lunenfeld-Tanenbaum Research Institute in Toronto, Canada. She also holds academic appointments in the Institute of Health Policy, Management and Evaluation at the University of Toronto, and Ryerson University in the School of Nursing. Her research is concentrated on patient complexity (the intersection of health conditions and social determinants); specifically examining issues related to the management of patient complexity, health profession education/collaborative practice, and community reintegration. From 2005 – 2009 she was the Research Director for a Health Canada funded Interprofessional Education program within geriatrics. She was the Principal Investigator for two Canadian Institutes of Health Research grants focused on patient complexity and rehabilitation. As a result, she convened national rehabilitation experts and stakeholders to develop a multidisciplinary, multisectoral research agenda specific to patient complexity in stroke rehabilitation. In 2014, Dr. Nelson received a $600,000 grant to examine how the voluntary sector could be engaged to support improved patient/family experiences and outcomes. So far, she has published over 40 articles and reports specific to issues of complexity, clinical practice, rehabilitation, collaboration, and the role of the voluntary sector in meeting patient needs. She is a sought after committee member for rehabilitation strategic planning, clinical guideline development and knowledge translation. In 2017, she was a visiting professor at the Queensland University of Technology, engaging colleagues in collaborative work related to patient complexity. Michelle was elected to the Board of Governors for the World Stroke Organization and nominated to the Executive in August 2018. Some of Michelle’s papers indexed in Google Scholar by September 2018. Reference: Nelson ML, McKellar KA, Munce S, Kelloway L, Hans PK, Fortin M, et al. Addressing the Evidence Gap in Stroke Rehabilitation for Complex Patients: A Preliminary Research Agenda. Arch Phys Med Rehabil. 2018;99(6):1232-41.

Quais as melhores opções para infiltrações em pacientes com tendinopatia do manguito rotador? Nesse episódio eu analiso a Meta-Análise em Rede publicado por Lin et al no Arch Phys Med Rehabil, e discuto sobre metodologia... O conteúdo Episódio #3 – Infiltrações para Tendinopatia do Manguito Rotador aparece primeiro em Fisiacast.

An interview with Ernest W. Johnson, MD author of Pathokinesiology of Duchenne muscular dystrophy: implications for management. Arch Phys Med Rehabil 1977;58:1-4. Interviewed by Ted Burns, MD and Greg Carter, MD, MS.

An interview with Ernest W. Johnson, MD author of Pathokinesiology of Duchenne muscular dystrophy: implications for management. Arch Phys Med Rehabil 1977;58:1-4. Interviewed by Ted Burns, MD and Greg Carter, MD, MS.

An interview with Ernest W. Johnson, MD author of Pathokinesiology of Duchenne muscular dystrophy: implications for management. Arch Phys Med Rehabil 1977;58:1-4. Interviewed by Ted Burns, MD and Greg Carter, MD, MS.

An interview with Ernest W. Johnson, MD author of Pathokinesiology of Duchenne muscular dystrophy: implications for management. Arch Phys Med Rehabil 1977;58:1-4. Interviewed by Ted Burns, MD and Greg Carter, MD, MS.

An Interview with Andrew J. Haig, MD, author of Haig AJ, et al. Electromyographic and magnetic resonance imaging to predict lumbar stenosis, low-back pain, and no back symptoms. J Bone and Joint Suregy 2007;89:358-366. Haig AJ, et al. Spinal stenosis, back pain, or no symptoms at all? A masked study comparing radiologic and electrodiagnostic diagnoses to the clinical impression. Arch Phys Med Rehabil 2006;87:897-903. Haig AJ, et al. The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis. Spine 2005;30:2667-2676.0. Interviewed by Ted Burns, MD and Gregory T. Carter, MD, MS The participants in this Podcast had nothing to disclose.

An Interview with Andrew J. Haig, MD, author of Haig AJ, et al. Electromyographic and magnetic resonance imaging to predict lumbar stenosis, low-back pain, and no back symptoms. J Bone and Joint Suregy 2007;89:358-366. Haig AJ, et al. Spinal stenosis, back pain, or no symptoms at all? A masked study comparing radiologic and electrodiagnostic diagnoses to the clinical impression. Arch Phys Med Rehabil 2006;87:897-903. Haig AJ, et al. The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis. Spine 2005;30:2667-2676.0. Interviewed by Ted Burns, MD and Gregory T. Carter, MD, MS The participants in this Podcast had nothing to disclose.

An Interview with Andrew J. Haig, MD, author of Haig AJ, et al. Electromyographic and magnetic resonance imaging to predict lumbar stenosis, low-back pain, and no back symptoms. J Bone and Joint Suregy 2007;89:358-366. Haig AJ, et al. Spinal stenosis, back pain, or no symptoms at all? A masked study comparing radiologic and electrodiagnostic diagnoses to the clinical impression. Arch Phys Med Rehabil 2006;87:897-903. Haig AJ, et al. The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis. Spine 2005;30:2667-2676.0. Interviewed by Ted Burns, MD and Gregory T. Carter, MD, MS The participants in this Podcast had nothing to disclose.