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The Relevance of Contextual Factors for Hands-on Treatment in Musculoskeletal Pain and Manual Therapy
By: Giacomo Rossettini PT, PhD ‘I definitely feel less pain in my back after the manipulation’. ‘My shoulder has better mobility after the massage’. Phrases such as these, uttered daily by patients in rehabilitative settings, lead clinicians to think that their hands-on treatments are so powerful that they are sometimes miraculous. Although the literature supports […]
Why do our Interventions Result in Similar Outcomes?
By: Chad Cook PT, PhD, FAPTA; Derek Clewley PT, PhD, FAAOMPT If you’ve seen the movie, Oppenheimer, you may remember him discussing the paradoxical wave-particle duality. This revolved around the finding that light exhibits both wave-like and particle-like properties. In fact, in certain experiments, light behaves more like a wave, whereas in others, it behaves […]
The Placebo Effect
By: Chad E Cook PT, PhD, FAPTA Definitions Matter In healthcare, the use of appropriate definitions is imperative. I was recently part of an international nominal group technique (a qualitative study that is used to build consensus) that harmonized a definition for contextual factors [1]. Within the literature, contextual factors have been variably described as […]
Shared Decision Making for Musculoskeletal Disorders: Help or Hype?
By Chad E Cook PT, PhD, FAPTA; Yannick Tousignant-Laflamme PT, PhD Background In 2010, the Affordable Care Act (ACA) was passed with a goal to expand access to insurance, increase consumer protections, emphasize prevention and wellness, improve quality and system performance, expand the health workforce, and curb rising health care costs [1]. Principle to the […]
It’s the Dose, Stupid
By: Seth Peterson, PT, DPT, OCS, FAAOMPT The Motive Physical Therapy Specialists Oro Valley, AZ We learn from our failures more than our success. In other times, we learn from our “almost failures.” These close-calls are the best events to learn from, really, because they can carry almost the same weight as a failure without […]
Compared to What?
By: Chad Cook PT, PhD, FAPTA Physical therapists commonly compare two or more things to one another. For example, I’ve frequently heard the comparison of the diagnostic accuracy of one test to another, when defending or rejecting the use of a special test. I’ve also heard the reporting that one intervention is more effective compared […]
Manual Therapy for Shoulder Pain: Trick or Treat(ment)?
By: Dr Angela Cadogan, PhD, NZRPS, Specialist Physiotherapist (MSK) Musculoskeletal physiotherapists have a therapeutic ‘bag of tricks’ that includes a range of interventions such as advice, pain science education, acupuncture, exercise and manual therapy to name a few. What turns a ‘trick’ into an effective ‘treatment’ is its application within a biopsychosocial framework, guided by […]
I Hate Systematic Reviews
Chad E Cook PT, PhD, FAPTA Preface I have grown to despise systematic reviews/meta-analyses. I do not like writing them, I do not enjoy reading them (any more than I enjoy reading an instructional manual), and I especially hate explaining to people why they have so many limitations. I feel lazy and uninspired when […]
Are Diagnostic Paradigms Based on Scientific Thought and Procedure?
By: Sean P. Riley, PT, DPT, ScD In an editorial titled “Science or Cult?” published in PTJ in 1963, Hislop stated, “Observations are the principal data of clinical science. Sometimes observations are inaccurate and faulty. Inferences and concepts can arise from such observations which also may be indefinite and confused. For persons not well grounded […]
Zoom In: Is It Time to Review How We Teach Manual Therapy?
Dr Kesava Kovanur Sampath, PhD, M.Ost, BPT Learners of manual therapy (MT) are required to develop complex hands-on clinical skills underpinned by clinical reasoning, manual/physical assessments and palpation [1]. While much of focus in MT has been either on its effectiveness and/or mechanisms, not much attention has been given to how MT is being taught. […]
