Podcasts about oarsi

In this episode of PTs Snacks podcast, host Kasey delves into osteoarthritis (OA), clearing up common misconceptions and explaining its impact on physical therapy. Kasey emphasizes the importance of addressing patients' self-limiting beliefs about OA and highlights the necessity of educating them about the true nature of the condition. The episode covers the basics of osteoarthritis, including its degenerative nature, contributing factors, and commonly affected joints. Kasey stresses that OA is not solely about cartilage loss and isn't always progressive, with exercise and physical therapy playing crucial roles in managing symptoms and improving patients' quality of life. The episode also touches on situations where patients may need to be referred for surgical consultations or further medical evaluation. Kasey wraps up by providing resources and recommendations for further learning, including guidelines from OARSI, ACR, and NICE, as well as courses available on MedBridge.00:00 Introduction and Podcast Overview00:55 Understanding Osteoarthritis03:30 Common Misconceptions About Osteoarthritis04:13 Physical Therapy for Osteoarthritis05:45 Empowering Patients and Setting Goals07:45 When to Consider Surgical Consults09:15 Conclusion and Additional ResourcesRelevant MedBridge Courses1. Management of Knee Osteoarthritis – Megan Mitchell, PT, DPT 2. Osteoarthritis: Clinical Pathways – Eric Robertson, PT, DPT, PhDSupport the showWhy PT Snacks Podcast?This podcast is your go-to for bite-sized, practical info designed for busy, overwhelmed Physical Therapists and students who want to build confidence in their foundational knowledge without sacrificing life's other priorities. Stay Connected! Never miss an episode—hit follow now! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. Join the email list HERE On Instagram? Find unique content at @dr.kasey.hankins! Need CEUs Fast?Time and resources short? Medbridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: Medbridge Students: Save $75 off a student subscription with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less!(These are affiliate links, but I only recommend Medbridge because it's genuinely valuable.) Optimize Your Patient Care with Tindeq Looking for a reliable dynamometer to enhance your clinical measurements? Tindeq ...

Ikke den mest mundrette titel, men nu fik undertegnede lov at besøge Robin Christensen, og så skulle vi hele vejen rundt. Gæst: Robin Christensen, Biostatistiker, Professor mm.Robin er interessant at tale med, både fordi han er skarp og underholdende, men for mig primært fordi han er meget vidende udi reumatologi, dog med et helt andet syn på tingene end en læges.Jeg lagde op til en snak om antiinflammatorisk kost; en spændende trend, der har verseret i vel nok en decade som etablere fænomen. I den forbindelse kommer vi også omkring blandt andet kosttilskud og carnivor diæt samt kød og evidensen for sundhedsricisi herved.Efter kostdelen står den på en snak om placebo, for at blive klogere på den størrelse. Robin får chancen for at forklare sit syn på placebo, og hvorfor placebo burde omdøbes.Til sidst står den på statistik, nærmere en diskussion omkring p-værdier - noget man forhåbentligt kan få gavn af, skulle man selv sysle med noget forskning, forskningslæsning, fortolkning, reviewing og hvad har vi.LINKS:ASA's statement on p-values:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187603/Faste + vegetar:https://www.tandfonline.com/doi/abs/10.1080/030097401750065256Kød og sundhed: https://pubmed.ncbi.nlm.nih.gov/31569217/https://pubmed.ncbi.nlm.nih.gov/31569219/https://pubmed.ncbi.nlm.nih.gov/31569235/Placebo bøger af Ian Harris:https://www.plusbog.dk/surgery-the-ultimate-placebo-professor-ian-harris-ian-harris-9781742234571?affiliate=6433&gad_source=291197&gad_source=1&gclid=CjwKCAjwvvmzBhA2EiwAtHVrb-OK_qoKGuHB2dj8dTz3L57coTLfKEeOolkUqfKwcmob0vRrK5E-xxoCr20QAvD_BwEhttps://www.saxo.com/dk/hippocrasy-how-doctors-are-betraying-their-oath-how-doctors-are-betraying-their-oath-rachelle-buchbinder-ian-harris_haeftet_9781742237350?gad_source=1&gclid=CjwKCAjwvvmzBhA2EiwAtHVrb0YjV9rOFVYkepfVOpfb-calCIQVcl80VH_fhIJ8HPJpwEJXNT9xthoC5FkQAvD_BwE

Hvor jeg de forgange år har været ene om at opsummere, hvad året har budt på indenfor artroseforskning, har jeg denne gang være heldig at få selskab.Anna Døssing er, ligesom jeg, læge og PhD og mindst lige så interesseret i artrose.Vi kommer omkring forskellige emner og herunder kan du finde tidskoder, så du kan springe rundt i afsnittet efter behov:04.17: Placebo - abstract 257 og 12019.54: Radiologi - abstract 10024.43: Søvnproblemer og smerter - abstract 13032.58: D vitamin - abstract 42338.10: Tarmmikrobiomets rolle i artrose - abstract LB00344.39: SGLT2 vs GLP-1 i artrose - abstract 5149.17: Relativ betydning af struktur vs smerte - abstract 5755.34: Vejrfølsomhed - abstract 11058.15: Forudsiger tidlige artrosetegn manifest sygdom? - abstract 360Abstracts kan findes i OARSI appen

BioSenic, a Belgian clinical-stage company specializing in serious autoimmune and inflammatory diseases and cell therapy, will share data on its late-clinical asset JTA-004 at the Osteoarthritis Research Society International (OARSI) World Congress 2024 in Vienna, Austria. The post hoc analysis of a phase 3 study found that a single injection of JTA-004 was safe and efficacious for patients with a newly characterized severe inflammatory subtype of knee osteoarthritis (OA). This week on the podcast, we talk about the treatment with BioSenic chief scientific officer and chief operating officer, Dr Carole Nicco.  00:52-03:19: About BioSenic03:19-07:34: What is osteoarthritis?07:34-11:45: What is ALLOB?11:45-15:03: What is JTA-004?15:04-17:14: What will you be presenting at the OARSI event? 17:14-20:20: How useful is attending events for BioSenic?20:20-21:04: How often will JTA-004 need to be administered?21:04-24:08: Are other companies working on osteoarthritis?24:08-26:26: What stage are your arsenic trioxide trails at?26:26-29:50: Will this be useful in treating other autoimmune diseases?29:50-31:08: What are the next steps?Interested in being a sponsor of an episode of our podcast? Discover how you can get involved here! Stay updated by subscribing to our newsletter

I denne episode indledes med lidt Q&A, så kommer lidt highlights fra verdenskongressen i artrose (OARSI 2023) og til sidst fortæller jeg om nogle nye studier indenfor hhv. artrose og photobiomodulation.REFERENCERMODIChttps://pubmed.ncbi.nlm.nih.gov/23404353/ https://pubmed.ncbi.nlm.nih.gov/33037486/ https://ugeskriftet.dk/videnskab/antibiotika-bor-ikke-anvendes-til-behandling-af-rygsmerterhttps://ugeskriftet.dk/videnskab/antibiotika-til-patienter-med-kroniske-rygsmerter-efter-diskusprolapshttps://pubmed.ncbi.nlm.nih.gov/31619437/ (Open access)Ashwaganahttps://foedevarestyrelsen.dk/kost-og-foedevarer/alt-om-mad/kemi-i-maden/mad-med-uoensket-kemi-/ashwagandha https://pubmed.ncbi.nlm.nih.gov/36900932/ Melatoninhttps://pubmed.ncbi.nlm.nih.gov/9062869/ Perikon
https://min.medicin.dk/Artikler/Artikel/232 Søvnhttps://hjernerystelsesforeningen.dk/insomni/ https://ugeskriftet.dk/videnskab/effekt-af-psykofarmaka-pa-sovnkontinuitet-og-sovnarkitektur OARSI 2023 abstractshttps://www.oarsijournal.com/issue/S1063-4584(23)X0004-1 Artrose og photobiomodulation papershttps://pubmed.ncbi.nlm.nih.gov/36171024/https://pubmed.ncbi.nlm.nih.gov/36991094/ https://ard.bmj.com/content/82/6/866

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.06.30.547216v1?rss=1 Authors: Obeidat, A. M., Ishihara, S., Li, J., Lammlin, L., Junginger, L., Maerz, T., Miller, R. J., Miller, R., Malfait, A.-M. Abstract: Objective: Knee joints are densely innervated by nociceptors. Sprouting of nociceptors has been reported in late-stage osteoarthritis (OA), both in human knees and in rodent models. Here, we sought to describe progressive nociceptor remodeling in four mouse models of knee OA, capturing early and late-stage disease. Methods: Sham surgery, destabilization of the medial meniscus (DMM), partial meniscectomy (PMX), or non-invasive anterior cruciate ligament rupture (ACLR) was performed in the right knee of 10-12-week old male C57BL/6 NaV1.8-tdTomato mice. Mice were euthanized (1) 4, 8 or 16 weeks after DMM or sham surgery; (2) 4 or 12 weeks after PMX or sham; (3) 1 or 4 weeks after ACLR injury or sham. Additionally, a cohort of naive male wildtype mice was evaluated at 6 and 24 months. Twenty-m thick mid-joint cryosections were assessed qualitatively and quantitatively for NaV1.8+ and PGP9.5+ innervation. Cartilage damage (using a modified OARSI score), synovitis, and osteophytes were assessed blindly. Results: Progressive OA developed in the medial compartment after DMM, PMX, and ACLR. Synovitis and associated neo-innervation by nociceptors peaked in early-stage OA. In the subchondral bone, channels containing sprouting nociceptors appeared early, and progressed with worsening joint damage. Two-year old mice developed primary OA in both the medial and the lateral compartment, accompanied with neuroplasticity in the synovium and the subchondral bone. All 4 models had an increased nerve signal in osteophytes. Conclusion: Anatomical neuroplasticity of nociceptors was observed in association with joint damage in 4 distinct mouse models, suggesting that it is intrinsic to OA pathology. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Digital interventions include mobile apps, virtual reality, and the internet and telephones. They have been recommended by the World Health Organization to complement traditional care. There has been a shift towards digital interventions especially during the COVID-19 pandemic. On this week's episode we are joined by Andrea Dell'Isola to discuss digital interventions for osteoarthritis.Andrea Dell'Isola is a research associate at the Clinical Epidemiology Unit Lund University in Sweden and a member of the OARSI early career investigators committee. His research interests include multimorbidity and the impact that other disease have on osteoarthritis development and management and first-line interventions for OA.RESOURCESJournal ArticlesComparison of Face-to-Face vs Digital Delivery of an Osteoarthritis Treatment Program for Hip or Knee OsteoarthritisTechnology-assisted rehabilitation following total knee or hip replacement for people with osteoarthritis: a systematic review and meta-analysisParticipatory health through behavioural engagement and disruptive digital technology for postoperative rehabilitation: protocol of the PATHway trialWebsitesMyJointPainMindSpot ClinicCONNECT WITH USTwitter: @ProfDavidHunter @jointactionorgEmail: hello@jointaction.infoWebsite: www.jointaction.info/podcast Hosted on Acast. See acast.com/privacy for more information.

Credits: 0.25 AMA PRA Category 1 Credit™     CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-301   Overview: In this episode, we will discuss a simple and inexpensive yet effective strategy for slowing the loss of knee joint cartilage in a patient with osteoarthritis: walking. Hear how recent evidence suggests that including a walking regimen into treatment plans may confer numerous benefits in this patient population.   Episode resource links: Busse, JW, Sadeghirad, B., Oparin, Y. et al; Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med.2020;173:730-738. [Epub 18 August 2020]. doi:10.7326/M19-3601 Kolasinski, S.L., Neogi, T., Hochberg, M.C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W.F., Hawker, G., Herzig, E., Kwoh, C.K., Nelson, A.E., Samuels, J., Scanzello, C., White, D., Wise, B., Altman, R.D., DiRenzo, D., Fontanarosa, J., Giradi, G., Ishimori, M., Misra, D., Shah, A.A., Shmagel, A.K., Thoma, L.M., Turgunbaev, M., Turner, A.S. and Reston, J. (2020), 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res, 72: 149-162. https://doi.org/10.1002/acr.24131 Lo GH, Vinod S, Richard MJ, et al. Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals with Knee Osteoarthritis: Data from the Osteoarthritis Initiative Cohort [published online ahead of print, 2022 Jun 8]. Arthritis Rheumatol. 2022;10.1002/art.42241. doi:10.1002/art.42241 Thudium C. Markers of synovial inflammation matrix turnover and symptoms. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Ooman JMH. Babs on a mission: An experimental study on the effects of message framing and exemplification on treatment intentions of osteoarthritis patients. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Zeng C, Doherty M, Persson MSM, et al. Comparative efficacy and safety of acetaminophen, topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis: evidence from a network meta-analysis of randomized controlled trials and real-world data. Osteoarthritis Cartilage. 2021;29(9):1242-1251. doi:10.1016/j.joca.2021.06.004   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato  

Credits: 0.25 AMA PRA Category 1 Credit™     CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-301   Overview: In this episode, we will discuss a simple and inexpensive yet effective strategy for slowing the loss of knee joint cartilage in a patient with osteoarthritis: walking. Hear how recent evidence suggests that including a walking regimen into treatment plans may confer numerous benefits in this patient population.   Episode resource links: Busse, JW, Sadeghirad, B., Oparin, Y. et al; Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries: A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med.2020;173:730-738. [Epub 18 August 2020]. doi:10.7326/M19-3601 Kolasinski, S.L., Neogi, T., Hochberg, M.C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W.F., Hawker, G., Herzig, E., Kwoh, C.K., Nelson, A.E., Samuels, J., Scanzello, C., White, D., Wise, B., Altman, R.D., DiRenzo, D., Fontanarosa, J., Giradi, G., Ishimori, M., Misra, D., Shah, A.A., Shmagel, A.K., Thoma, L.M., Turgunbaev, M., Turner, A.S. and Reston, J. (2020), 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res, 72: 149-162. https://doi.org/10.1002/acr.24131 Lo GH, Vinod S, Richard MJ, et al. Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals with Knee Osteoarthritis: Data from the Osteoarthritis Initiative Cohort [published online ahead of print, 2022 Jun 8]. Arthritis Rheumatol. 2022;10.1002/art.42241. doi:10.1002/art.42241 Thudium C. Markers of synovial inflammation matrix turnover and symptoms. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Ooman JMH. Babs on a mission: An experimental study on the effects of message framing and exemplification on treatment intentions of osteoarthritis patients. Presented at: OARSI 2022 World Congress on Osteoarthritis; April 7-10; Berlin, Germany (virtual meeting). Zeng C, Doherty M, Persson MSM, et al. Comparative efficacy and safety of acetaminophen, topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis: evidence from a network meta-analysis of randomized controlled trials and real-world data. Osteoarthritis Cartilage. 2021;29(9):1242-1251. doi:10.1016/j.joca.2021.06.004   Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato  

Physical Activity with Osteoarthritis - Prof David Hunter (Pt2) Professor Hunter is a rheumatology clinician researcher whose main research focus has been clinical and translational research in osteoarthritis (OA). He is the Florance and Cope Chair of Rheumatology and Professor of Medicine at University of Sydney and the Royal North Shore Hospital. He is ranked as the worlds leading expert in osteoarthritis on Expertscape.com since 2014. He is on the editorial board for Arthritis and Rheumatology, Osteoarthritis and Cartilage, Arthritis Care and Research and part of the review committee for OA for the American College of Rheumatology, EULAR and OARSI scientific meetings. Dr Hunter has over 500 peer reviewed publications in international journals, numerous book chapters, is the section editor for UpToDate Osteoarthritis and has co-authored a number of books, including books on self management strategies for the lay public. --- This podcast episode is sponsored by Fibion Inc. | The New Gold Standard for Sedentary Behaviour and Physical Activity Monitoring Learn more about Fibion: fibion.com/research --- Collect, store and manage SB and PA data easily and remotely - Discover new Fibion SENS Motion: https://sens.fibion.com/

Professor Hunter is a rheumatology clinician researcher whose main research focus has been clinical and translational research in osteoarthritis (OA). He is the Florance and Cope Chair of Rheumatology and Professor of Medicine at University of Sydney and the Royal North Shore Hospital. He is ranked as the worlds leading expert in osteoarthritis on Expertscape.com since 2014. He is on the editorial board for Arthritis and Rheumatology, Osteoarthritis and Cartilage, Arthritis Care and Research and part of the review committee for OA for the American College of Rheumatology, EULAR and OARSI scientific meetings. Dr Hunter has over 500 peer reviewed publications in international journals, numerous book chapters, is the section editor for UpToDate Osteoarthritis and has co-authored a number of books, including books on self management strategies for the lay public. --- This podcast episode is sponsored by Fibion Inc. | The New Gold Standard for Sedentary Behaviour and Physical Activity Monitoring Learn more about Fibion: fibion.com/research --- Collect, store and manage SB and PA data easily and remotely - Discover new Fibion SENS Motion: https://sens.fibion.com/

Undertegnede har igen i år været til OARSI kongressen og traditionen tro rapporteres den nyeste artrose forskning fra året.

▪好獸醫來讀書單元由台灣禮藍動保公司ELANCO獨家贊助 ▪ 第五季每週一中午12點播出，十個主題新知說給你聽 簡介： 犬骨關節炎 (OA) 的盛行率在 1 歲以上狗佔 20% 而在 8 歲以上狗則達 80%，疾病控制和預防中心估計 25% 的美國人患有骨關節炎和80% 的 55 歲以上的人患有出現症狀的骨關節炎。人和狗的另一個相似之處是髖關節和膝關節骨關節炎的發病率很高。國際骨關節炎研究協會 (OARSI) 定義的膝關節骨關節炎核心治療包括陸地上運動、強化訓練、體重管理、水中運動、自我管理和教育。強化訓練定義為在提高力量和耐力的體能訓練。 重點整理：骨關節炎的患病率很高，預計還會繼續增加。骨關節炎被認為是一種嚴重的疾病，因為它會嚴重影響生活品質。骨關節炎疼痛會限制活動程度，導致力量進一步喪失。運動在骨關節炎的治療中，扮演非常重要的角色。透過加強骨關節炎的強度鍛煉，可以看到中等至較大的治療效果。在完成強度鍛煉計劃後，可以在短期（3 個月）和長期（12 個月）內，看到加強鍛煉的好處，但需要幾週到幾個月的鍛煉，才能使成效變得明顯。由於對疼痛的敏感性增加，骨關節炎可能使運動變得困難。在專業的監督下，患者的改善程度更大。 ▪官方網址 https://www.wondervet.com.tw ▪請主持人喝杯咖啡 https://pay.firstory.me/user/ck4fgb04n698h0804wzdkaycj Powered by Firstory Hosting

¿Qué vendrá después y hacia dónde se dirige la gestión y el tratamiento de la OA? El Dr. Anthony Criquet, Director Médico Global en los Laboratorios Expanscience, compartirá la información científica clave en relación a los aspectos más destacados sobre la Osteoartritis de los Congresos OARSI y EULAR de 2021. Los comentarios y opiniones expresados por los ponentes son propios. Esta serie de podcasts está dirigido a profesionales de la salud exclusivamente. Los podcasts tienen un fin educativo para los profesionales de la salud. Laboratorios Expanscience como patrocinadores no se hacen responsables de las opiniones de los profesionales sanitarios expresados en esta serie de podcast.

What's next and where is OA management and treatment headed? Join Dr. Anthony Criquet, Medical Doctor in charge of Global Medical Affairs at Laboratories Expanscience, as he shares the key scientific information regarding the highlights on Osteoarthritis from the OARSI & EULAR Congresses in 2021. The comments of the speakers are their own. The podcast is for HCPs (Healthcare Professionals) only. The podcast have a HCPs educational purpose. Laboratories Expanscience as sponsors are not responsible for the healthcare professional's positions.

Qu'est-ce qu'il se passera dans le futur et quelle direction prend la gestion et le traitement de l'arthrose? Le docteur Anthony Criquet en charge de la gestion des affaires médicales pour le global au sein des Laboratoires Expanscience partagera l'information scientifique clé en relation avec les aspects mis en avant lors des congrès OARSI et EULAR de 2021. Les commentaires et opinions des intervenants sont les leurs. Le podcast est réservé aux professionnels de santé. Le podcast a un but éducatif pour les professionnels de santé. Les Laboratoires Expanscience en tant que sponsors ne sont pas responsables des opinions du professionnel de santé.

What is a serious disease and why is Osteoarthritis a serious disease? Prof. Ali Mobasheri, President of OARSI walks us through the OARSI White Paper submission, the key and future steps to find ways to make this serious disease that is chronic feel more acute. But, why was OA not considered a serious disease before? What impact does this new classification have in the way we treat patients and more in this episode! The comments of the speakers are their own. The podcast is for HCPs (Healthcare Professionals) only. The podcast have a HCPs educational purpose. Laboratories Expanscience as sponsors are not responsible for the healthcare professional's positions.

¿Qué es una enfermedad grave y por qué la Osteoartritis es una enfermedad grave? El Profesor Ali Mobasheri, presidente de OARSI, nos guía a través de la presentación del Libro Blanco de OARSI, que muestra los puntos claves y los pasos a tomar en el futuro para encontrar formas de hacer que esta enfermedad grave, que es crónica, sea más manejable. Pero, ¿por qué la OA no se consideraba una enfermedad grave antes? ¿Qué impactos tiene esta nueva clasificación en la forma en la forma en la que tratamos a los pacientes? ¡Esto y más en este episodio! Los comentarios y opiniones expresados por los ponentes son propios. Esta serie de podcasts está dirigido a profesionales de la salud exclusivamente. Los podcasts tienen un fin educativo para los profesionales de la salud. Laboratorios Expanscience como patrocinadores no se hacen responsables de las opiniones de los profesionales sanitarios expresados en esta serie de podcast.

Key stakeholders discuss the motivation for the OARSI Clinical Trials Symposium and what to expect for this year's event in October 2021. Learn more and register at: https://oarsi.org/2021-clinical-trials-symposium

En la segunda entrega de OAFI radio de la nueva temporada nos visita el Dr. Enrique R. Soriano, Presidente de PANLAR, la Liga Panamericana de Asociaciones de Reumatología, una de las asociaciones de médicos más importante del mundo. Nos habla del Panlar 2020 que se celebrará en los próximos días, y en el cual OAFI va a estar muy presente con la celebración de dos simposios; uno de ellos muy importante, elaborado conjuntamente con el mismo PANLAR y con OARSI, la Osteoartritis Research Society International, que es la principal organización internacional de científicos y profesionales de la salud enfocados en la prevención y el tratamiento de artrosis.

Ali Mobasheri is Professor of Musculoskeletal Biology in the Research Unit of Medical Imaging, Physics and Technology within the Faculty of Medicine at the University of Oulu in Finland. He is also Professor and Chief Researcher in the Department of Regenerative Medicine at the State Research Institute Centre for Innovative Medicine in Vilnius, Lithuania and Associate Professor in the departments of Orthopaedics, Rheumatology and Clinical Immunology at University Medical Center Utrecht, the Netherlands. Since May 2019 he has served as President of the Osteoarthritis Research Society International (OARSI).On this episode we discuss: the mission, vision and promise of the Osteoarthritis Research Society International, goals for the future and much moreConnect with Ali on LinkedInLike what you hear? Donate to our research here. See acast.com/privacy for privacy and opt-out information.

Following the cancellation of the 2020 World Congress on Osteoarthritis, OARSI president Dr. Ali Mobasheri discusses how OARSI is adapting to the COVID-19 pandemic, including the introduction of new initiatives and programs and planning for the future. Find out more at oarsi.org.

REFERENCER:1)https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/yjoca/OARSI_2020_Oral_Abstracts.pdf2)https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/yjoca/OARSI_2020_Poster_Presentations.pdf3)Hunter & Felson, BMJ, 20064)Hochberg, JAMA, 2019

Ira Pastor, ideaXme longevity and aging ambassador and founder of Bioquark, interviews Dr. Virginia Byers Kraus, Professor of Medicine, Pathology, and Orthopaedic Surgery, and a faculty member of the Duke Molecular Physiology Institute in the Duke University School of Medicine. Ira Pastor Comments: Arthritis is a term often used to mean any disorder that affects joints (the most common forms being osteoarthritis (OA) and rheumatoid arthritis (RA)), where symptoms generally include joint pain, stiffness, redness, warmth, swelling, and decreased range of motion. In some types of arthritis (on the auto-immune side of things) other organs can be affected, and onset of arthritis can be gradual or sudden. There is no known cure for either rheumatoid or osteoarthritis. Joint replacement surgery may be required in eroding forms of arthritis. Treatment options vary depending on the type of arthritis and can include physical therapy, lifestyle changes (including exercise and weight control), orthopedic bracing, and various medications which can help reduce inflammation in the joint (and immune responses in case of auto-immune forms of arthritis) which can help decrease pain and potentially slow the rate of joint damage, hopefully to "zero", which is the nature of the current class of “holy grail-ish” type drugs in the Rheumatoid Arthritis space known as Disease Modifying Anti-Rheumatic Drugs (DMARDs). No drug fulfilling the criteria for a "Disease Modifying Osteoarthritis Drug " (or DMOAD) is approved by the regulatory agencies such as the FDA or EMEA. But whether one is looking for a DMOAD, or looking beyond the current state of the art of the DMARDs to the next RA holy grail type intervention, many thought leaders would agree that it would be a form of intervention that stimulates Chondrogenesis, or the process by which new fresh cartilage is created in the joint, literally reversing the pathogenesis of such diseases, as opposed to just slowing or stopping them. Once damaged in humans, cartilage has very limited repair capabilities. Because chondrocytes are bound in lacunae, they cannot migrate to damaged areas. Also, because hyaline cartilage does not have a blood supply, the deposition of new matrix is slow. Damaged hyaline cartilage is usually replaced by fibrocartilage scar tissue instead. But this is not the case in other species such as newts and zebrafish, where fresh cartilage is regrown and regenerates perfectly over a lifetime. Today’s guest who is going to take us further into all these themes is Dr. Virginia Byers Kraus. With an MD and PhD from Duke University, Dr. Kraus is Professor of Medicine, Pathology, and Orthopaedic Surgery, and a faculty member of the Duke Molecular Physiology Institute in the Duke University School of Medicine. She is a practicing Rheumatologist with 20 years’ experience in Osteoarthritis research. Dr. Kraus is past president of the Osteoarthritis Research Society International (OARSI), the premier organization focused on the prevention and treatment of osteoarthritis through the promotion and presentation of research, education, and the worldwide dissemination of new knowledge. In 2019, she was elected to the Association of American Physicians and awarded the Lifetime Achievement Award from OARSI. She is co-principal investigator of the OARSI/Foundation for NIH Osteoarthritis Biomarkers Consortium Project, which advances the validation and qualification of biomarkers for OA diagnosis, prognosis, and clinical trials. She also directs the Duke Biomarkers Shared Resource which is a facility that assists investigators with the design and implementation of molecular and protein assays to evaluate biochemical and inflammatory markers. Dr. Kraus is also the Director of the Molecular Measures Core in the Center for the Study of Aging and Human Development. On this show we will hear from Dr. Kraus: How she developed an interest in science, medicine, and rheumatology. The importance of appropriate biomarker development, validation and qualification in the diagnosis, prognosis, and development of effective interventions in arthritis. Her recent paper entitled Analysis of “Old” Proteins Unmasks Dynamic Gradient of Cartilage Turnover in Human Limbs, in which she highlights the discovery of interesting protein / microRNA constituency differences of various joints of the body, leading to clues for different regenerative medicine interventional possibilities. Finally, we’ll discuss her work in the Molecular Measures Core in the Center for the Study of Aging and Human Development where her group is focused on "understanding the means to optimize whole person reserve and resilience through analyses of molecular factors indicative of cellular and tissue level ability to withstand and recover from stressors.” ideaXme is a global podcast, creator series and mentor programme. Mission: Move the human story forward!™ ideaXme Ltd.

On this episode, we review the treatment options of osteoarthritis. We discuss the various joints and comorbidities that can guide treatment selection. We also compare and contrast three different sets of guidelines currently available.  The link for the OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis can be found at the following link:  https://www.ncbi.nlm.nih.gov/pubmed/31278997   The guidelines from the ACR can be found at the following link: http://mqic.org/pdf/2012_ACR_OA_Guidelines_FINAL.PDF If you have any questions, reach out to us on any of the following: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx This podcast reviews current evidence-based medicine and pharmacy treatment options. This podcast is intended to be used for educational purposes only and is intended for healthcare professionals and students. This podcast is not for patients and not intended as advice or treatment.

Dr. Ali Mobasheri, current OARSI president and Professor, Project Leader, and Senior Research Scientist in the Department of Regenerative Medicine at the State Research Institute Centre for Innovative Medicine in Vilnius, Lithuania, discusses his research in Lithuania, Finland, and the UK, how his experiences as an OA patient, journal editor, reviewer, and instructor fit into his career, and his plans for the further internationalization of OARSI. More information can be at the following websites: https://www.oarsi.org/about/board-directors https://www.linkedin.com/in/ali-mobasheri-68009712/ http://www.imcentras.lt/research-council/department-of-regenerative-medicine/ http://www.approachproject.eu/about/governance http://www.sportsarthritisresearchuk.org/centre-staff/partners.aspx

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dan White on the show to discuss evidence-based practice.  Daniel K. White is an assistant professor at the University of Delaware in the Department of Physical Therapy.  Dr. White’s research focuses on physical activity and physical functioning in older adults, people with knee osteoarthritis, and people after Total Joint Replacement.  In this episode, we discuss: -What is implementation science? -Evidence Based Practice and how to use Clinical Practice Guidelines -The latest research findings from the Physical Activity Lab at the University of Delaware -Limitations of physical therapy branding and how we can step into the physical activity space -And so much more!   Resources: Email: dkw@udel.edu Academy of Orthopedic Physical Therapy University of Delaware Physical Activity Lab Published CPGs   For more information on Dan: Dr. Daniel K. White is an assistant professor at the University of Delaware in the Department of Physical Therapy. Dr. White received his Bachelor’s degree in Health Sciences, M.S. in Physical Therapy, and Sc.D. in Rehabilitation Sciences, all from Boston University.  He completed a post-doctoral fellow at the Boston University School of Public Health and earned a Masters in Science in Epidemiology from the BU School of Public Health 2013. Dr. White’s research focuses on physical activity and physical functioning in older adults, people with knee osteoarthritis, and people after Total Joint Replacement.  Dr. White is an Associate Editor for Arthritis Care and Research, and an active member in the American Physical Therapy Association.  His research is funded by the National Institutes of Health, and the Rheumatology Research Foundation.  Dr. White can be reached at dkw@udel.edu Daniel K. White is an assistant professor at the University of Delaware in the Department of Physical Therapy. Dan’s research focuses on physical activity and physical functioning in older adults, people with knee osteoarthritis, and people after joint replacement.  His research uses large existing datasets to answer questions related to physical functioning and physical activity.  As well, he is also conducting clinical trials to lead ways to better promote and increase physical activity in people with knee osteoarthritis and after joint replacement.  Dan is an Associate Editor for Arthritis Care and Research, and an active member in the American Physical Therapy Association, the American College of Rheumatology, and OARSI.    Read the full transcript below: Karen Litzy:                   00:01                Hey Dan, welcome to the podcast. I'm happy to have you on. Dan White:                   00:05                Thanks. Great to be here. Karen Litzy:                   00:07                And now today we're going to be talking amongst other things, implementation science. So before we go any further, can you give a definition of what implementation science is? Dan White:                   00:19                Absolutely. So implementation science, that definition is the scientific study of methods to promote the systematic uptake of research findings and other evidence based practice into routine practice and hence to improve the quality and effectiveness of health services. So essentially it is bridging the gap between science and practice, and it is taking things that we find in laboratories and in clinical studies and literally implementing them into real world, clinics where most physical therapists work. Karen Litzy:                   01:00                Right. So then my other question was why should the average PT care, which I think you just explained that, so we need to care about implementation science because this is how we're getting what researchers do in the lab to our real world situations and our real patients. Dan White:                   01:16                Yeah. I think practicing as a physical therapist, you know, you can look around and a lot of people do a lot of different things and a lot of things seem to work. Snd I think, if we want a game changer in our practice, that is going to come from a systematically studying people and understanding what are the underlying critical ingredients of our practice that really work and the best thing we have made up today to answer that sort of question of, you know, what is it that really works our clinical practice guidelines that is the, essentially the best body of evidence that has been reviewed by a panel and vetted and made to be digested by the everyday clinician. And implementing these clinical practice guidelines are really the key element that is going to lead to a game changing opportunity for us as a profession. Karen Litzy:                   02:34                And when you talk about clinical practice guidelines, I know sometimes people think that you're doing sort of it's cookie cutter and what do I need to follow a cookie cutter recipe for because all of my patients are different. So can you speak to that? Dan White:                   02:52                Yeah, no that is a great point. So on the one hand, there is definitely an art to physical therapy and the clinical practice guidelines and evidence based practice is by no means trying to take that away. It's evidenced based practice in general is not cookbook medicine. It is combining the three things and one is what the evidence says, but two it also combines what the therapist's experiences are and then finally it's what patient's preferences and what their feelings are on the whole thing. And it's a combination of all three. It is literally the definition of evidence based practice and these clinical practice guidelines are definitely consistent with that EBP models. So they are not directions or they're not instructions, they're guidelines. They're ways of helping people make informed decisions. And at a minimum, if you consider yourself an expert clinician and knowing what the clinical practice guidelines are, is a big leg up. And definitely key to helping our profession. It doesn't necessarily mean you ascribe them to every single patient. No, that's not what evidence based practices, but being aware of them is by definition, in my opinion, being a good clinician. Karen Litzy:                   08:02                So can you give us an example of one of these clinical practice guidelines? Dan White:                   08:21                Sure, absolutely. So one of the common patient populations that people treat is low back pain. And Tony Toledo and his colleagues at the University of Pittsburgh and elsewhere developed a clinical practice guidelines for low back pain, and published this and JOSPT in 2012, their paper described that the purposes of these CPGs, our first to what EBP is for a physical therapy practice. And then also to classify and define common musculoskeletal conditions from this classification criteria specific interventions are devised. So for an example, so I don't treat low back pain. This is not my area. So just forgive me for giving a guess here. Dan White:                   09:32                One example, is a lumbosacral segmental somatic dysfunction. And this is associated with the ICF diagnosis of acute low back pain with mobility deficits. And, Tony goes on to saying that there's, certain clinical findings with this, including acute low back pain, a buttock or thigh pain restricted lumbar range of motion and lower back pain and lower extremity related symptoms with provocation. And then from that, there are specific interventions that I'm not going to get into that is unique from a different classification. So a different classification, a low back pain is sub acute, low back pain with mobility deficits, which is basically not acute but subacute patient and the symptoms are produced with ingrained spinal motions and there's a presence of a thoracic lumbar pelvic girdle mobility deficits. Dan White:                   10:41                And then he goes on and there's these different classification criteria from which there are very specific interventions you're supposed to do. So it's classification and then intervention based on that. And essentially, that is in an ideal world of what a CPG should do. However you’re always gonna have the patient that really doesn't fit into one or the other. Let's have somebody who is not quite acute, but they're not quite subacute. So what do you do? And I think being able to first even make that distinction, you have to be aware of the clinical practice guidelines. So knowing that, okay maybe it's going to be a combination of these two interventions because of this person doesn't fit into either one, but see how that approach is already a leg up from not knowing what CPGs are to begin with and what our common classifications is. Does that make sense? Karen Litzy:                   11:38                Yeah, that makes a lot of sense. Thanks so much for using that as a really great example for people. And when you're talking about different CPGs, I know that the Academy of Orthopedics, which used to be the orthopedic section of the American physical therapy association, they have all these different names now. It's just made it all so, so much more confusing. But now obviously big proponents of the clinical practice guidelines, but if I wanted to find the average clinician and I want to find some of these guidelines, where do I go? How do I find them? Dan White:                   12:14                Sure. So all the published clinical practice guidelines for orthopedics are on the Academy of Orthopedic Physical Therapy’s main webpage, which is Orthopt.org. There's a banner that says CPGs and you just click on that and you can get right to all the published CPGs. Karen Litzy:                   12:41                Awesome. And we'll have a link to that in the show notes at podcasts.Healthywealthysmart.com under this episode so that if people need it one click and we'll take you right there. So there's no excuse to not know these CPGs after listening to this podcast then because we're going to make it really easy for you. And now you just gave us a good example of how CPGs can work in clinical practice. Are there times where maybe they don't work so well or is there a downside I guess is what I'm trying to say? Dan White:                   13:16                Yeah. I mean, again, going back to your original question of, you know, is this cookie cutter medicine and it's not and again, since EBP is a combination of patient preference, the provider know how, and what the evidence is. I mean, there's going to be situations where, you know, a situation's weighted much more towards a patient's preference. Like they don't want you to do manipulation or maybe they want something specific and you're like, well, that's really not called for in this case. And so you don't do the intervention that's prescribed or that the CPG recommends. And that's okay. We're not here to tell people, to command them what to do. They're coming to us for help. And, patient preference is a large part of evidence based practice. I think that’s the best example I can think of. Karen Litzy:                   14:16                Yeah. And, and I think another, if you're looking at your clinical experience as one of the legs of that stool, if you will, and the patient doesn't have a preference yet, you're sensing as a clinician that there's some trepidation on the patient's part. There's some fear if you were to, like you said, we'll take a manipulation as an example, then using your provider know how you would say, you know, this is not the right time or place for this. And so I think you've got all of that in. So the CPGs is not a cookie cutter oath just because A B C is present you have to do treatment B or treatment a or B. But instead it's giving you a way to maybe differentially diagnose and a way to, you know, be able to maybe give your patient an explanation as to what's going on and then use your judgment, use the patient preference and the evidence to then guide your treatment. Dan White:                   15:21                Yeah, exactly. It's just like, you know, when you just meet somebody, you try to figure out who they are, right. And you try to figure out what kind of personality they are. And there's some sort of structure or rubric people use. Like let's say there's introverts and extroverts, is this person an introvert or extrovert in the CPG the first thing that it does is provide you a framework of saying, well, what kind of types of people are there with this type of pathology? How are they a type of person that has, I don't know, this type of this type of disorder or this type or another type of disorder. And from that diagnosis of providing a classification, you can, there are clear treatments associated, with that so back to the party analogy, you know, if you're dealing with an introvert, you know, you, you know that they're not going to be super bubbly and all over. Dan White:                   16:10                You have to kind of bring things out of them and maybe take it easy and you know, take it on the slow road. Versus if someone's an extrovert, maybe are going to be doing all the talking. And, you can just be an active listener and be very interested in what they're saying, because they're the extrovert and perhaps, you know, that that's Kinda how it goes. And the CPGs is essentially just it is in the party analogy, a way of just navigating through our clinical practice, to provide best care. And, you know, I think another, medical example that really, stays fresh in my mind is a sort of lifesaving approaches to acute MIs. And, it wasn't the sort of protocol for or clinical practice guidelines for myocardial infarction, weren't developed, when necessarily, right after science discovered that, you know, look, if you do x, Y and z can actually save someone's life. Dan White:                   17:20                It kinda came much, much later. And it wasn't until, the university hospital in Chicago, implemented these sort of CPGs for lifesaving approaches to MI that the death rate for acute MI’s went way down. And all the medical residents followed, this CPG for treating acute MIs. And, that systematic approach is what made care better. Obviously in physical therapy we're not talking about life or death, but these CPGs have been vetted and are an approach that is systematically used, will produce a better outcomes. So yes, it's, you know, EBP, I'm not changing my story here. EBP is obviously patient preference, provider experience as well as the evidence, but when applied systematically, which means you'd be at minimum aware of what the CPGs are, they should produce better outcomes system wide. Karen Litzy:                   18:27                Yeah. And thank you. I love the party analogy and comparing it to that medical example really kind of makes the CPGs a little bit clearer and hopefully people will now not look at them as some sort of cookie cutter program, but instead, as a way to help inform you of your practice, which I think is, yeah, I think it's great. And now, all right, so let's move on from CPGs. Let's talk about, I'm kind of interested in what you're doing next. So you are the director of the physical activity lab at the University of Delaware. So let us in on some of the things that you guys are working on. If you can, you know, I understand you can't say everything, but what are some things that you're working on that you feel like will be part of future implementation science for the average physical therapists treating patients like myself? Dan White:                   19:23                Yeah. Thank you for the opportunity. You know my whole goal is just to get patients better. And, I worked in inpatient, acute, acute Rehab for several years. And I always wondered, you know, after I got people independent with bed mobility, transfers and ambulation, you know, would they actually take those, you know, new found independence, and actually resume their daily activities and be active in the home. And that led me to really thinking a lot about this notion of physical activity or, you know, how much do people do. And so, in the area I study, it's osteoarthritis and osteoarthritis is a serious disease that is associated with higher rates of mortality. Dan White:                   20:21                And only definitive treatment for osteoarthritis is a total knee replacement. Now, after total knee replacement, people do great with improving their pain, and increasing their function. But there's many systematic studies that show in terms of physical activity, people aren't doing more, they're doing just as little as they did before. And I think that's a real missed opportunity for physical therapists. And I think there's a great opportunity to talk about, you know, being more active and helping patients and it really doesn't take that much. It's just a, hey, so, you know, how much are you doing every day? With smart phones and the use of fitbits, counting steps per day is actually an  incredibly effective, a way to increase or one to see where people are at in terms of physical activity and to increase how much activity people are doing. Dan White:                   21:19                So just like if you're trying to, you know, lose weight, you usually have a scale and you want to see how much you know, where you're at and what progress you've made. Using a pedometer or using a fitbit monitor to count your steps is an analogy and analogous way of doing the exact same thing. So at the University of Delaware, we are studying what are the best ways, physical therapists and practical ways physical therapists can increase activity in people with knee replacement. And what we've done is we recently published a study that basically found that, it's very feasible to talk about physical activity and do a really quick intervention for people after knee replacement by simply giving them a fitbit monitor. And seeing how many steps per day they're walking, and then increasing that number of steps today. Dan White:                   22:19                Our target goal of 6,000 steps per day in a study we did several years ago, we found people with knee osteoarthritis who want at least 6,000 steps per day we're much less likely to develop financial limitation than people who walked less than 6,000. So that's where we use the 6,000 steps per day. That's where we have the goal set up. And, since there is a health outcome associated with 6,000 steps that's our goal. And we see where people are walking and then we start to increase their steps by five to 10% per week. So if you're walking 2000 steps, we increase it by 100 to 200 steps per day more. Dan White:                   23:25                And then the next week we see where they're at and we increase it again by another five to 10%. And what we found, doing this intervention and physical therapy is that a one year after discharge from physical therapy. So they've had no physical therapy and no intervention. People pretty much maintain the gains they made in physical activity and their gains are pretty substantial. There was a high percentage of people that met the 6,000 steps per day goal, and maintain that one year out in a preliminary study. And we are currently collecting more data to look at a larger sample to have a little more robust results. In talking with the theme of Implementation Science, what our next step is to do is to implement this intervention in real world physical therapy clinics. Dan White:                   24:24                We recognize, you know, at the University of Delaware, we have a fantastic physical therapy clinic. But you know, our clinicians, and the type of people, patients that come here don't represent a cross section of the entire country. We want to see whether this intervention will work in real world clinics. And we've partnered, with a clinic in Lancaster, PA called hearts physical therapy. And we're looking at developing a implementation of our intervention at that clinic, to see, you know, what's the uptake with clinicians, what are the barriers, what are the uptake with patients, where the barriers and how can we make this evidence based practice approach actually work. Karen Litzy:                   25:13                Yeah. And you know, as you're saying that I'm thinking, well, hmm, does it matter like these people know that they're in a study. So is that their incentive to, you know, continue on with getting these 6,000 plus steps in a day because you know, we all want to show the teacher that we're good at what we do. Yeah. Right. And then the question is that enough? Like you said, you followed them for a year to really make that a lifestyle change and maybe after a year it is. Dan White:                   25:43                Yup. No, those are good questions. So in terms of sort of in terms of like a Hawthorne effect or where you were, you know, you're just doing this because you know you're in this study. First we do have a control group that wears the Monitor. And they did not have the intervention, but we are monitoring their physical activity and know it and the intervention group, in our previously published study, in arthritis care and research, that the intervention group still is walking almost double of what the control group does a one year out. So that's, you know, that's notable. Karen Litzy:                   26:36                Oh, one year is a long time and at that point, do you feel like it has shifted to a lifestyle change? Dan White:                   26:47                Yes and that's the encouraging part. Like one year out that's a pretty good outcome, for not having any contact with, you know, well not having your original physical therapy for you. And, that's incredibly encouraging for a longterm outcome and actually thinking that there might be large behavioral change. Another interesting thing with our preliminary studies that we looked at adherence or the fidelity of a treatment in the physical therapy clinic. And what that means is how often did physical therapists tell the patient about, you know, ask them about their step goals and ask them about you know, how they're doing. And it actually wasn't that great. It was around 50%. So, it wasn't that this intervention was, you know, so well taken, in my mind, it was more that the patients really grabbed onto this and saw that, you know, look, this monitor tells me exactly where I'm at. And in qualitative studies we've done, or interviews we've done after the intervention, the patients, by and large, they say, look, I know where I'm at, that this monitor tells me, and I know when I have a good day and I know I have a bad day and what I need to do to make a difference between the two. Karen Litzy:                   28:05                That's great. And if you can get that from the monitor or the fitbit or the pedometer or whatever it is that you're using, then I think that's a huge win, not just for mobility, which obviously we know we need as we get older and especially after knee replacements, but for a whole host of other health reasons as well. Dan White:                   28:27                Yup. Yup. Exactly that. I was just lecturing yesterday to newly-minted rheumatology fellows at u Penn in Philly. And talking about physical activity first, it was interesting to know that none of them knew what the physical activity guidelines are, which maybe, you know, most people don't know what they are, but it's a 150 minutes of moderate intensity activity per week or 75 minutes a week of vigorous intensity. And the reason why these guidelines are so important is that the benefits of health of being physically active are far reaching. They range from not only improved strength and flexibility, but you also have cardiovascular benefits. You have a mental health benefits. There's less the chance of depression, there's less chance of weight gain. Dan White:                   29:28                There are a lot of far reaching effects even so that the American College of Sports Medicine Jokes that if you could put the benefits of exercise into a pill, you'd have a blockbuster pill. I mean, it’s definitely a huge benefit to be active. And then the second thing is that, you know, for physical therapists, you know, is that something we should address? I mean, that could be something that, yes, typically, yeah. Typically therapists you think with a patient comes in, you know, they have their complaints and, you know, let's talk about, you know, reducing your pain and increasing your range and then getting you back to, you know, where you were at. But our recently published study in physical therapy actually surveyed patients and said, you know, what do you feel physical therapists should talk about? Dan White:                   30:24                And they were asked a range of things including weight and Diet and physical activity. And by and large, it was 90 plus percent of patients said, I want my physical therapist to talk about this collectivity. That is what they're there for. You know, that that is a major reason I am here and I want them to ask me about it and to counsel me on it. So I think that's something we should, you know, to embrace and understand, you know, what our guidelines are this 150 minutes a week, understand that. And understand, you know, what our steps per day, what are sort of major benchmarks for steps today. You know, we oftentimes say 10,000, but you know, we found earlier that 6,000 for people, you know, osteoarthritis is a meaningful benchmark. Dan White:                   31:15                And then, the last thing I'll say about the physical activity thing is that, American College of sports medicine and the physical activity guidelines from the Department of Health and Human Services, you know, their major recommendation and before the timeline is that it's the saying that some is good but more, it's better that there is a dose response relationship between how much activity people do and their health benefits. So even getting somebody who is completely sedentary to doing at least walking for five to 10 minutes a day, can have a huge change in their health outlook and risk for future poor health outcomes. So, that is a major thing that, you know, PTs need to keep in mind is if I can get this person who I know is sedentary just to do something in adopt that I think is huge win for this patient. Karen Litzy:                   32:12                Yeah. And, I think that the physical therapy profession needs to really step up and be the people to step into this space. I mean, this is what we do. This is our space. You know, we should be grabbing those patients who maybe have knee OA, but don't need a knee replacement yet. We should be stepping in. That's our jobs. That's what we should be doing. We should be working with obese or sedentary people of any age before they have to come and see us for an injury. Dan White:                   32:46                Yup. Yup. Exactly. My doctoral student Meredith Christianson who worked with Gillian Hawker at the University of Toronto to do this qualitative study on primary care physicians. And essentially the question was why don't primary care physicians recommend exercise and physical activity to patients with knee osteoarthritis. Although despite the fact that every single clinical practice guideline recommends, you know, exercise by and large, the primary care physicians or that we're saying, well, we don't know what to recommend. We're not the experts. And, they would like to refer their patients to PT, but it's not reimbursed up in Canada. So, you know, I think this further underscores the notion that as physical therapists, we should own the physical activity sphere. We should be the ones that people think of, like, you know, well, I want to be active but I have some problems. What do I do? Go see a physical therapist. You are highly educated individuals who know more about biomechanics, more about kinesiology than anybody else in the clinical sphere. And we are the best place to make exercise and physical activity recommendations to people of all types, more so than any other health provider. Karen Litzy:                   34:13                Yes. I couldn't agree more. I could not agree more with that. And, in my opinion, and my hope is that physical therapy really starts to move toward that in the very, very near future because boy could we make a big impact in the lives of people around the world if we're that sort of first line of defense, if you will. And isn't it amazing that like, I love that you brought up this not covered by insurance, but people will go and pay for a trainer or a massage therapist, not knocking any of those professions at all because I think they're all very valuable. But people will pay for that and not say, well, can you turn it into my insurance? And then when it comes to physical therapy where, you know we know all this stuff, we have the guidelines, we have the clinical prediction rules. We have the education and it's just not something that people are willing to put money down for. Dan White:                   35:27                Yeah, I think there's two things. One I think people will pay if they see value in it. And yes, I think that it's not that we don't have value, but I don't think we're marketing ourselves well as specifically to the larger community. Going back to the implementation science, Workshop Implementation Science Conference and workshop in Providence, Rhode Island this past march and the president of the APTA came and spoke there and he said that, you know, for us as physical therapists, we're really lacking in the sales and marketing sphere. And one of the reasons why is because, well, one of the things is we all call ourselves physical therapists. But what that means is very different depending on where you work. Dan White:                   36:33                So for instance, you know, a patient is going to have an eye, a view of what a physical therapist is. In this context. So if they see a physical therapist working in a school, well they'll think all PTs work in a school, and in acute care after a major MI then they think they only worked at acute care, but you know, marketing that we actually are versed in many areas is a challenge we have. And I don't know if that means we start to call ourselves a sports specialist or you know, cardiac specialists or what, but, you know, something along the lines of marketing our idea or marketing our expertise better is a key area of need. And then the second thing is, you know, I think it's okay to ask people to pay for things. Dan White:                   37:24                In knee osteoarthritis as people will pay five to $10,000 for stem cells or PRP injections, and, you know, the evidence behind that is, well, let's say it politely, much lower than what the evidence is for exercise is. And, it's just incredible that, you know, if someone's gonna lay down that sort of cash, you know, I think there is a definite market out there for services that are viewed as valuable and having a physical activity or exercise prescription that's tailored to, you know, individual needs, you know, is a clear area of opportunity for our profession, for people with chronic diseases. And, you know, I think a space that we should definitely pick up. Karen Litzy:                   38:16                Yeah, there's no question I could not have said it better myself. And I think I'm going to make nice quote on that because you're absolutely right. And now before we wrap things up here, it's the same question I ask everyone, and that is knowing where you are now in your life and in your career, what advice would you give to yourself fresh out of school? Dan White:                   38:54                Yeah, that's a good question. The advice I'd give myself is, just do your best to make your patients better. I think that's all it is. And you know, at the University of Delaware, we have people here that work in very different outputs. So we have our clinical faculty that are working, doing a bulk of the teaching for the students. And then we have research faculty or tenure track that teach the PT students, but all have our own research lines. And then we have clinicians that are working in the clinic so very different outputs. But our goal is all unified and that is just to help patients get better. That, you know, and from the clinical side, we are focused on excellence in research or excellence in teaching students the best and latest up to date things and the most effective ways to teaching them. Dan White:                   40:05                So they remember not only to pass the test, but to have successful careers. And then from a research perspective, we're trying to look for, you know, what are game changing discoveries to help treat people and help them get better. And then the clinicians are implementing that on a daily basis at the University of Delaware. And you know, again, what makes us, I think, what I think of as a prideful point is that we're all aligned in our goals with trying to get people better. And so that's something that I guess, you know, I've always ascribed to as both a therapist, as a doctoral student and now as a clinical scientist is trying to, you know, my major goal is just to help people get better. Karen Litzy:                   40:54                That's a wonderful answer. Thank you so much. And where can people get in touch with you if they have questions? Dan White:                   40:59                My email address is dkw@udel.edu. Feel free to email me anytime. Karen Litzy:                   41:16                Awesome. Well, thank you so much. Thanks for breaking down the clinical practice guidelines and implementation science, and I love the stuff you're doing in your lab, so thanks for sharing. Dan White:                   41:25                Great. Thanks so much for having me Karen Litzy:                   41:27                And everyone else, thanks so much for tuning in. Have a great couple of days and stay healthy, wealthy, and smart.   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

Welcome to Sports Med Res’ this week in review podcast where we highlight the news in sports medicine research from the week ending on July 19, 2019. * OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis * Who Gets Chronic Traumatic Encephalopathy? RSS Feed or iTunes or Google Play Evidence-Based CEU […] The post CTE: It’s Not Just in Athletes (July 19, 2019) appeared first on Sports Medicine Research.

Prof. Dr. Henning Madry, an MD, tenured professor, and Director of the Center of Experimental Orthopaedics at Saarland University in Germany, describes the new OARSI-affiliated journal Osteoarthritis and Cartilage Open and how his background in both basic science research and as a clinician prepared him to serve as the journal’s editor. More information about Prof. Madry’s research can be found at www.uks.eu/ieo and about the journal (including contact information) at www.journals.elsevier.com/osteoarthritis-and-cartilage-open.

Dr. Tuhina Neogi, program chair for the 2019 OARSI World Congress on Osteoarthritis, previews the upcoming conference.

Professor David Hunter is a rheumatology clinician-researcher whose main research focus has been clinical and translational research in osteoarthritis (OA). He is the Florance and Cope Chair of Rheumatology and Professor of Medicine at the University of Sydney and the Royal North Shore Hospital and Consultant Rheumatologist at North Sydney Orthopaedic and Sports Medicine Centre. He is ranked as the world's leading expert in osteoarthritis on Expertscape.com since 2014. He is on the editorial board for Arthritis and Rheumatology, Osteoarthritis and Cartilage, Arthritis Care and Research and part of the review committee for OA for the American College of Rheumatology, EULAR and OARSI scientific meetings. Dr Hunter has over 400 peer-reviewed publications in international journals, numerous book chapters, is the section editor for UpToDate Osteoarthritis and has co-authored a number of books.  He is also Co-Chair of the recent RACGP Osteoarthritis guidelines.  This was a thoroughly enjoyable and informative discussion around osteoarthritis pathophysiology, imaging, prevention and treatment.  There was a bit of mic rustling when David speaks but this stops at ~11:25mins (to be exact!). Resources mentioned: Patient program - https://www.myjointpain.org.au/ RACGP guidelines = 2018 Royal Australian College of GPs Guidelines: https://www.racgp.org.au/your-practice/guidelines/musculoskeletal/hipandkneeosteoarthritis/ Warm up programs to prevent injuries: PEP: https://www.aclstudygroup.com/pdf/pep-program.pdf FIFA 11 training: Shorter version - https://www.tmphysio.com/wp-content/uploads/2017/08/FIFA-11-_Poster_EN_Druck_2015.compressed.pdf Longer version - https://www.kort.com/uploadedFiles/KORT/Content/Services/Sports_Medicine/Concussion_Management/FIFA-the-11-Booklet.pdf   Other resources: Some published references: Clinical algorithms to aid osteoarthritis guideline dissemination. Osteoarthritis Cartilage. 2016 Sep;24(9):1487-99. Osteoarthritis: Models for appropriate care across the disease continuum. Best Pract Res Clin Rheumatol. 2016 Jun;30(3):503-535. Therapy: Are you managing osteoarthritis appropriately? Nat Rev Rheumatol. 2017 Dec;13(12):703-704. Lower extremity osteoarthritis: optimising musculoskeletal health is a growing global concern: a narrative review. Br J Sports Med. 2018 Jul 20.   Multimedia options: Annual Florey Public Lecture: https://www.youtube.com/watch?v=vY__ApcQOOc Article author Professor David Hunterdiscussed appropriate osteoarthritis management. Short video:https://vimeo.com/108976519 Podcast from Radio National Health Report: Everything you ever wanted to know about osteoarthritis:https://www.abc.net.au/radionational/programs/healthreport/everything-you-ever-wanted-to-know-about-osteoarthritis/8664218   An online electronic educations module for RACGP for CPD points: https://www.racgp.org.au/education/courses/activitylist/activity/?id=54640&q=keywords%3dosteoarthritis%26triennium%3d17-19   As always – rating this podcast 5 stars and leaving a review in iTunes is great help. Enjoy Friends  

Dr. Jill Halstead, a clinical academic podiatrist who works in the National Health Service and is a visiting research fellow affiliated to the University of Leeds in the UK, talks everything you want to know about osteoarthritis of the foot. If you are interested in more about foot OA, you can follow Jill on twitter @HalsteadDr and check out the International Foot and Ankle OA Consortium discussion group meeting at OARSI 2019.

Dr. Jamie MacKay, a musculoskeletal radiologist and clinical research fellow (and 3rd year PhD student!) in the Department of Radiology at the University of Cambridge, discusses career decisions, musculoskeletal imaging, and preparing for his upcoming OARSI collaborative scholarship at Stanford University. You can find out more about Dr. MacKay and his research on twitter (@dr_jamie_mackay) or at http://radiology.medschl.cam.ac.uk/about-us/departmental-staff/phd-students/jamie-mackay. The systematic review and meta-analysis paper that was mentioned can be found at: https://www.oarsijournal.com/article/S1063-4584(18)31069-0/abstract

Dr. Gillian Hawker, a clinician scientist, professor, and chair of medicine at the University of Toronto, discusses why we need to classify OA as a serious disease, the need for consistent definitions of OA, and remaining sources of bias in the treatment of women with OA. Find more about the OARSI white paper at: https://www.oarsi.org/research/oa-serious-disease This podcast is made possible with funding from Flexion. 

Dr. Amanda Nelson, an assistant professor of medicine at the University of North Carolina at Chapel Hill in the United States, discusses imaging, the Walk with a Doc program, developing OARSI guidelines, and barriers preventing clinician scientists from staying in research. More information can be found at: Faculty website: https://www.med.unc.edu/tarc/people/amanda-e-nelson-md-mscr Walk With a Doc: http://walkwithadoc.org/ OA Action Alliance: http://oaaction.unc.edu/

Dr. Tom Appleton, a clinician-scientist and assistant professor of rheumatology and medicine at Western University in London, Ontario, Canada talks about having both a clinical career and a research career, OA phenotypes and the potential for patient-specific treatments, and his experience being part of the OARSI year in review for 2017. More information about Dr. Appleton’s research can be found at his website (coming soon): www.appletonlab.com or on twitter: @ctgappleton. The paper mentioned by Dr. Appleton on cell senescence and post-traumatic OA can be found at https://www.nature.com/nm/journal/v23/n6/full/nm.4324.html Remember to check out the new OARSI video at the bottom of the OARSI.org home page! You can also find OARSI on Facebook and Twitter: @OARSInews @OARSI_YI

Dr. Katz tells us about OARSI’s roles in promoting and facilitating OA research, his vision for the future of OARSI, and how his own research on treatment of meniscal tears fits into the broader goals of the organization. This episode was recorded at the 2017 OARSI World Congress on Osteoarthritis in Las Vegas! The OARSI guidelines mentioned by Dr. Katz can be found here https://www.oarsi.org/education/oarsi-guidelines The patient section of the OARSI website mentioned by Kerry can be found here https://www.oarsi.org/patients You can find out more about Dr. Katz’s research at http://www.oracore.org Lastly, the Osteoarthritis and Cartilage journal, which publishes abstracts from the annual OARSI conference, can be found at http://www.oarsijournal.com/

In this very first episode of Hey OA, host Kerry Costello gives an introduction to the podcast and a preview of what's to come. We have some great guests lined up for the next few episodes so get excited! For more OA research news, check out OARSI.org and follow us on social media @OARSInews, @OARSI_YI, and @heyoapodcast. If you have any questions or comments, tag us and use the hashtag #heyoapodcast. Thanks for listening!