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. […]
Thorough Research Questions should have Layers
By: Chad E Cook PT, PhD, FAPTA Order Questions Most of our musculoskeletal treatments fall within a ‘gray zone’ of effectiveness1. Nearly none of our treatments are strongly effective all of the time and few have no benefit all of the time. This is one of the reasons we see outcomes that are consistently similar […]
The Hip Barely Moves During Joint Mobilization: What does that mean for clinicians?
Seth Peterson, PT, DPT, OCS, FAAOMPT In a popular video, a clinician demonstrates the vacuum phenomenon of the hip joint in a cadaver, moving the femoral head around to create suction and then pulling (clearly very hard) to demonstrate how strong that suction force can be. It prompts the question – if someone can apply […]
The Truth? Whose Truth?
By: Chad E Cook PT, PhD, FAPTA; Sean P. Riley, PT, DPT, ScD The Truth? Whose Truth? Our impetus for writing this blog is our disappointment with modern United States news media outlets, how they report information, and how it impacts the public. Their extremist style of reporting has led to a division of thought […]
What is Orthopaedic Manual Therapy anyway?
By: Jason Silvernail DPT, DSc, FAAOMPT Patient: “That feels a lot better” he said. “What were you doing there?”Me” “Some hands-on treatment for your neck – I suspected some of your shoulder pain might have been coming from your neck, and I think we just found the main source of your problem,” I said.Patient: “I […]
Mechanisms are Not Clinical Outcomes but Both Are Very Important
By: Chad E Cook PT, PhD, FAPTA What are Mechanisms? The term “mechanism” reflects the theoretical steps or processes through which an intervention (or some independent variable) unfolds and produces a change in a patient. For example, a cortisone injection for a frozen shoulder works by stopping the release of regional molecules that cause inflammation […]
Null statistical hypothesis testing, confirmation bias, and statistical significance
By: Sean P. Riley, PT, DPT, ScD Null statistical hypothesis testing aims to prevent confirmation bias [1]. The researcher creates the null hypothesis by converting the research question to a research hypothesis and then converting the research hypothesis to the null hypothesis. This should happen before starting data collection starts. The researcher should use statistical […]
