Recent Research Articles
2011
October 2011
No downsides found in skipping the physician referral and seeing a physical therapist on your own accord
For most people who go to a physical therapist for treatment, the process usually entails an initial visit to a physician, who will review the patient's condition and refer them to a physical therapist if they see fit. While this is often the standard protocol, some suggest that the referral from the physician is unnecessary and more costly, and that patients can instead use what's called "direct access" in certain cases and refer themselves to a physical therapist. Opponents cite potential backlashes from this system, and in select states, as well as under certain insurance policies, it's not allowed; however, a study that compared a group of patients who were self-referred with a group that was physician-referred found no significant differences between groups when assessing cost and overall improvement of patients. These findings suggest that physician referrals may oftentimes not be required, and that patients can instead take matters into their own hands and refer themselves whenever possible.
Most marathon runners are inexperienced and unaware of dangers of not hydrating properly
The popularity of marathon running has skyrocketed in recent history, and what was once an event reserved for the elite competitors throughout the world has come to include all walks of life and a wide variety of skill levels. Due to this process, a large percentage of marathon runners are first-timers, and many are inexperienced in running and the precautions that should be taken while competing in a marathon. To get a clearer sense of this breakdown, surveys were distributed to a large sample of marathon runners to evaluate their perceptions on the race. Unsurprisingly, many of these runners were inexperienced, with only about half having run at least two marathons in the past, but more importantly, the majority of runners displayed a lack of knowledge regarding hydration techniques and how to avoid injuries that arise from improper hydration. This calls for more education on this topic for newcomers to the sport who might not know all the risks involved.
Patients and care providers have different perceptions of pain from exercise and mobilization
For patients with chronic, painful conditions such as neck pain, back pain, or osteoarthritis, there may be instances of pain from either the diagnosis or in the treatment itself. While this is completely normal, helping care providers to diagnose a condition and necessary to make exercise and mobilization techniques effective, some patients may not be aware of this, and instead take it as malicious and fail to comply with their therapy as a result. To get a better impression of how feel about pain experienced during therapy, a series of interviews was conducted with both patients and care providers. Results showed that most patients viewed the pain as a necessary part of therapy, but a select few reacted negatively and were driven away from therapy due to it if their therapist didn't explain it properly. This highlights the importance of communication from care providers, especially physical therapists, when it comes to thoroughly explaining the role and necessity of pain in the treatment of certain conditions.
September 2010
Exercise for elders can lead to improvements in mental health, too
Reaching old age comes with a multitude of associated ailments, particularly in the physical realm with issues like weakening joints and muscles, but also in the mental realm with possible memory loss, depression and anxiety. Getting regular exercise has always been recommended to elders for the plethora of physical benefits it can provide, but in addition to that, it's been suggested that exercise can lead to improvements for the mind as well. To look into this matter in greater detail, a review was conducted that analyzed all available information on the topic, and results supported this notion with a number of significant figures. This led researchers to suggest a minimum of two 45-minute sessions of light-to-moderate intensity exercise each week for those over 65 to help improve mental wellbeing.
Protocols for determining when an injured athlete is ready to return to sports need to be improved
For any injured athlete of any level of competition, the most pressing question following an injury is always, "how long until I can return?" Answering this question and returning an athlete to competition as quickly as possible while also ensuring their safety is a difficult matter for physicians, and evaluating these cases requires consideration of a number of important factors. While there are certain common denominators across the board when it comes to making these decisions, there's also a great amount of variation from one physician to another, which calls for the need of more definitive guidelines to help medical professionals navigate this process. Taking note of this, two physicians highlighted all current guidelines on the topic and pointed out the gaps that need to be improved upon, including in these reviews some useful tests that can gauge an athlete's readiness to return and some vital categorizations that divide athletes into appropriate groupings.
Adding a creatine supplement to a strengthening exercise program can be beneficial for patients with knee osteoarthritis
Osteoarthritis (OA), a result of the wearing away of a protective substance known as articular cartilage, is a prevalent and burdensome condition, and it tends to occur frequently in the knees and in more women than men. Already disabling on its own, those with knee OA who also have weak quadriceps (thigh muscles) are at an additional disadvantage, as it leads to further functional impairments and difficulties in everyday life. On the other hand, a stronger quadriceps could halt the progression of knee OA, which would in turn reduce pain and improve function. For this reason, programs that strengthen the knee have been recommended for OA patients, and one recent development has been supplementing these programs with creatine, a natural organic compound that encourages rapid muscle growth. Based on these components, a study investigated if adding creatine to a strengthening exercise program could lead to additional benefits than the program alone, and results showed the supplement to be extremely helpful in a number of ways.
August 2011
Exercise therapy program can help lift the burden of neck pain for office workers
Following low back pain, the most prevalent musculoskeletal condition in the U.S., neck pain also ranks highly on the list of common, debilitating disorders out there. For those who work in an office and sit at a desk on a regular basis, neck pain occurs even more regularly, with roughly 43-69% of all office workers experiencing pain in the past year. To attempt to curb this trend, measures have been made to reduce neck pain for office workers, and exercise therapy is one intervention growing in popularity. Investigating all available literature on the topic, it was found that muscle strengthening and muscle endurance exercises can help reduce the intensity, duration and discomfort of neck pain. Therefore, instilling a program such as this for office workers suffering from neck pain can relieve employees and improve productivity in the workplace.
Temporarily stopping participation and starting a rehab program effective for young soccer players experiencing back pain
Though soccer doesn't experience the same popularity levels in the U.S. that it does internationally, it's still the most widely played sport in the world, with participation numbers that only continue to grow. Consequently, the rate of injuries sustained by soccer players also continues to increase, especially in the spine. Spondylolysis, which results from a stress fracture to a vertebra, is the most common condition that leads to low back pain (LBP) for soccer players under 18, making it an important disorder for young players. In an effort to determine an effective strategy for dealing with this condition, a study found that temporarily halting participation in sports and beginning a conservative rehab program (free of surgery) was extremely beneficial for young soccer players and greatly facilitated their return to sports.
Attempting to prevent injuries before they occur by using a neuromuscular training program
What if, rather than crossing fingers and hoping for the best, athletes were better equipped to avoid injuries by a training program that teaches their bodies and brains how to react in a situation that might cause injury? Effective use of such a program could significantly reduce the rate of sports-related injuries and save the health-care system huge amounts from the second most common source of injuries behind domestic accidents. Proprioceptive and neuromuscular training programs (PT/NT) are designed to prevent injuries by improving the body’s stability and balance, but they’re not used universally due to conflicting views on their effectiveness. To clear up this matter, a review was conducted on pertinent literature, which found these types of training exercises to be effective at reducing the rate of a number of injuries in certain sports. Ample consideration should therefore be given to using these programs in sports where they can better prepare athletes in competition and lower their chances of sustaining injury.
July 2011
Regular smokers shown to improve less following back surgery than nonsmokers
The negative impact of being a habitual smoker has never been underplayed, particularly when it comes to lung health and cancer. In addition to those risks, however, smoking can also lead to more complications and slower recovery following certain types of surgery. To determine how great these risks are, a study evaluated the recovery of a number of patients following lumbar spinal surgery, and found smokers to improve less, with more pain and a lower quality of life than nonsmokers, adding more reasons to the laundry list of potential pitfalls of smoking regularly.
The amount of physical activity kids are getting at school and in PE is alarmingly low
It's no longer a mystery that kids in general these days are not getting sufficient amounts of physical activity in their daily lives, which is both a result and a cause of high obesity rates. One component of a child's life that has strong potential to curb these trends is at school, where a good portion of kids' time is spent almost every day, and where programs can encourage kids to become more active regularly. Despite this opportunity, many schools fail to fulfill their part, and consequently, kids are not getting proper doses of exercise. To get a better gauge of just how much physical activity kids are actually getting daily, a study analyzed a large group of elementary students throughout the day and found physical activity rates to be shockingly low, especially during physical education class.
For those going to physical therapy for hip osteoarthritis, certain factors predict a better recovery
Osteoarthritis (OA) is a common condition that becomes more likely to occur with age, and of which there is still no definitive treatment that completely rids patients of pain. One approach to OA that has been garnering attention is to identify certain factors that predict which patients are more likely to respond well to treatments like physical therapy (PT), and taking note of this, a study sought to discover these factors for hip OA. Results from the study identified being aged 58 or younger and suffering from hip OA for one year or less to be amongst five predictive factors that should be used by physical therapists and known by patients to help facilitate recovery from hip OA.
June 2011
Physical therapists need to treat psychosocial factors in addition to physical ones
Most patients enter a physical therapist's office with a physical ailment of some sort, and intend to be treated primarily for that particular ailment. While this is the major concern for physical therapists (PTs) and should remain as such, a recent issue of Physical Therapy magazine stresses the importance of treating the "whole" patient, and the necessity of addressing their psychosocial issues associated with their condition to ensure the best possible outcome. Treating an injury or condition is a process that triggers a number of emotional responses, and, according to the issue, PTs need to keep them in mind and tend to them while treating patients. This sort of shift can mean better overall results and more patient satisfaction, both of which are sought after by all PTs.
Caffeine use can be either beneficial or detrimental, depending on how it's used
Caffeine is far and away the most widely consumed drug in the world, with an estimated 85-95% of Americans using it on a regular basis. While most people drink it for a morning or mid-day pick-me-up in coffee, tea or soda, it can also be used in conjunction with pain medications to increase effectiveness. On the downside, regular caffeine intake can also be detrimental to some when use is stopped after a long period of habitual consumption, possibly leading to withdrawal and headaches. The effects of caffeine such as these and others, on both the positive and negative end of the spectrum, are given sufficient in this review, with the intention of better educating those who use caffeine so regularly.
Knuckle crackers can breathe easily: no associations found to osteoarthritis
When you think about knuckle cracking, whether you do it yourself or not, chances are more than likely that the rumor of it causing arthritis will also pop up in your head in some form or another. Most people are at least aware of this urban legend, but some are uncertain of its validity and if there's any actual medical backing to it. Responding to this prevailing sentiment, a study looked into the relationship between knuckle cracking and hand osteoarthritis in depth, trying to determine if there was in fact any connection. Fortunately for knuckle crackers, no evidence was found of any association between the two, which doesn't guarantee it's safe, but does plenty to dispel the common rumor with great support.
April 2011
Abdominal obesity associated with chronic pain and depression in the elderly
Chronic pain, defined as pain lasting for more than three months, occurs in the elder population more than any other age group, as some figures report more than half of seniors experience chronic pain regularly. Dealing with chronic pain on a regular basis can be an extreme burden and have a negative impact on elders' health-related quality of life (HRQoL), and it unfortunately only gets worse with age. The exact reasons why this pain plagues older people, however, are not clearly defined, leading some researchers to investigate the matter in greater detail. Results showed that greater abdominal obesity and associated osteoarthritis were high indicators of chronic pain and depression based on HRQoL, and that exercise programs catered towards elders should therefore be implemented to address this issue.
Thinking about seeing a chiropractor for your low back pain? Read this report and think again.
The high occurrence rates of low back pain (LBP) and the hindrances it causes on peoples' lives continue to be well documented, and those who suffer from it continue to seek any form of treatment that may be effective in alleviating their pain. One of the most popular interventions Americans use is to see a chiropractor, who will use manipulation and a number of other methods to treat LBP. Yet despite their common usage in the U.S., the evidence of a chiropractor's effectiveness is limited. Looking into this matter further with the intent of drawing more definitive conclusions, a review of available information on the subject actually found no meaningful effects of chiropractic interventions on LBP in the long-term, leading to more questions than answers on the usefulness of chiropractics.
Doing away with the concept of 'diagnosis' could be the key in optimizing treatment for axial neck pain
Axial neck pain, one of the three major types of neck pain, is a musculoskeletal disorder (affecting both the muscles and bones) that's limited to pain in the neck only. Unfortunately, when it comes to diagnosing axial neck pain and determining how to treat it, many spine specialists differ in their approach, using only the types of tests they know will confirm the treatment they wish to recommend. As a result, patients are put through a number of expensive and sometimes unnecessary tests that may or may not even help in better defining their condition. The problems with this system lie primarily in the lack of uniformity of spine clinicians, who continue to do things their own way even if they're not proven to be effective. Many researches believe the flawed system needs to be overhauled entirely, and one possible change that's been gaining some popularity is to nix the term “diagnosis” altogether, and instead use a series of clinical prediction rules that will highlight specific characteristics in patients that will determine which treatments will lead to the best possible outcome for each subject.
March 2011
Balance training program helps reduce the likelihood of repeated ankle injuries
One ankle sprain is usually bad enough for the person who experiences it, but for some, if the proper moves aren't made, it could mean the start of an ongoing and bothersome condition known as chronic ankle instability (CAI). CAI is the tendency towards repeated ankle sprains and recurrent symptoms (pain, weakness, giving way), and occurs in about 40-70% of patients who suffer from an initial lateral ankle sprain. One suggested method to prevent CAI from occurring is by improving balance and proprioception (the sense of your joint's position in your body) after the first ankle sprain. To investigate this theory, a study evaluated the effect of a balance training on study subjects and found it to significantly improve balance and proprioception, meaning such a program has the potential to reduce the occurrence of CAI if administered after the initial injury is sustained.
Insider's perspective from those with low back pain claim it never fully goes away
Low back pain (LBP) continues to affect the lives of millions of Americans on a regular basis, preventing many from engaging in everyday activities and leading a normal lifestyle. Efforts have been made to be better understand LBP and the reason it reoccurs so often, but there is still not a universal system for measuring its recurrence rates. Some measurements take into account time off work and health-care utilization, but questions exist as to if those figures accurately depict the bigger picture of LBP. A group of researchers noted this and thought it would be beneficial to hear from LBP sufferers in an open-forum discussion to get a sense of how it impacts their lives. The overall consensus showed that most with LBP felt it was an ongoing condition that comes and goes in varying degrees, but never fully goes away. Health care use was minimal since participants felt it never actually helped their pain, and work was only missed in extreme situations. These findings suggest that time off work and health-care use aren't effective measurement statistics, and that treatment strategies need to be improved significantly.
Losing weight, engaging in prevention programs among ways to avoid knee osteoarthritis
Osteoarthritis (OA), which is defined by the breakdown of protective articular cartilage in a joint and leads to pain and limitation of movement, is the most common musculoskeletal disease and occurs most frequently in the knee. Though knee OA usually affects athletes involved in high-risk sports, it may also claim the knees of those over the age of 60. In an attempt to reduce its occurrence rates, a review was organized with some helpful tips for athletes and others at risk. Aside from the increasing risk for knee OA that comes as age increases, the review named the three most important risk factors high body mass index (BMI), excessive stress to the knee and previous knee injury. Based on those risk factors, the review suggested weight loss and prevention programs targeted at patients with previous knee injuries as effective strategies to reduce knee OA occurrence. The review also suggested that athletes involved in high-risk sports (soccer, football, basketball) take extra care and educate themselves on how to avoid OA.
February 2011
The approach towards osteoarthritis treatment in the medical world needs to change drastically
Osteoarthritis (OA) is a growing problem on an international scale that is receiving growing recognition for the potential dangers and costs it presents if not dealt with properly, but for some reason there are still no significant improvements in the management of the disease. One of the most important issues with current treatment is that it only seeks to alleviate symptoms and reduce the severity of the disease rather than actually cure it. In a call to action, an article was written that urges medical professionals to come together and establish a definitive model for treating OA that doesn't stop short at mere symptom reduction, but actually focuses on completely eliminating symptoms and halting the progression of the disease. With a new paradigm and unified approach to the disease, OA rates can be reduced significantly and provide millions with safer and healthier lives.
NSNSAIDs proven to be much safer than opioids for older adults with arthritis
Analgesics such as opioids, nonselective non-steroidal anti-inflammatory drugs (NSNSAIDs) and coxibs are popular prescriptions these days for older adults, especially those with arthritis. Yet despite their common usage, the comparative safety of these drugs, particularly opioids, is not well understood. Prescribers of these medications should have access to better information regarding these important safety levels in order to make the best decisions for choosing which drugs to prescribe. In order to rectify this problem, data pertaining to each medication group was compared side-by-side, and opioids were proven to be the most dangerous of the three, while NSNSAIDs were shown to be the safest. Opioid use should therefore be approached with caution and NSNSAIDs should be prescribed more often.
Early physical therapy treatment for low back pain can prevent future complications
Low back pain (LBP) is one of the most common disorders found throughout the world, with about 65-80% of adults experiencing the condition at some point in their lifetime, making it an urgent and pressing matter to address with the best possible treatment. Physical therapy administered early on is regarded by most as the leading treatment method available, but there are some medical professionals who question its effectiveness and choose to treat it by other means. Seeking definitive answers, a study was conducted that compared early PT to a number of other interventions and found it to be effective in reducing the likelihood of receiving costly procedures like injections and surgery later on in the course of LPB.
January 2011
Family history shown to be major predictor of hallux valgus, while high-heeled shoes are deemed safer than believed
Hallux valgus is a chronic condition in which the big toe deviates inward towards the smaller toes, eventually leading to the development of a bump on the side of the foot called a bunion. If the condition isnŐt treated properly and the bunion grows, pain and discomfort will result and lead to disability in every day life. The specific causes of hallux valgus are not known, but many believe improper footwear such as high heels can lead to its occurrence due to excessive pressure on the feet. To test this theory, a study was performed on a population of females in China, and found family history of the condition, and not high heel usage, to be the most indicative predictor of hallux valgus. With this, high heel use should not be encouraged, but those who do wear them should feel secure in knowing they donŐt contribute to the condition.
Ankle sprain prevention program dramatically saves money for health-care system
Acute ankle injuries are far and away the most common musculoskeletal injuries throughout the world, with lateral ankle sprains occurring more often than any other. To combat this issue, a number of preventative intervention programs have emerged as of late, and many of them have proven to be effective in reducing ankle sprain recurrence. The only thing lacking is a full-scale analysis on the cost-effectiveness of such a program on the health-care system. Therefore, researchers tested a particular program and calculated the savings of a reduction in ankle sprains, finding it to beneficial and economically advantageous to those who implement it.
Most patients are incredibly satisfied with musculoskeletal physical therapy
Today, more than ever, health-care providers are concerned with implementing patient-centered care, the goal of which is to provide the highest quality and most cost-effective treatment for every patient. Following this trend, one of the main indicators for evaluating quality care is patient satisfaction, which is doubly important because satisfied patients are also more likely to adhere to treatments and benefit from their health care. With a desire to evaluate patient satisfaction in the physical therapy setting, a team of researchers conducted a review of all available literature on the topic. Results showed that patients are predominantly satisfied with the musculoskeletal physical therapy they were receiving, with an overall satisfaction estimate for all patients of 4.44 out of 5 (with 1 being very dissatisfied and 5 being very satisfied.)
2010
December 2010
Evaluating the effectiveness of exercise therapy for groin pain in athletes
Groin pain is a common ailment for many athletes, particularly those involved in sports like football and soccer, where running and sudden changes in direction make the risk of developing this pain more likely. Diagnosing these injuries is difficult, and treating it is even harder due to the fact that only minimal research exists on treatments that have been proven to be effective. A review of all available literature on the topic was therefore conducted, and it found exercise therapy to be an incredibly helpful intervention, as it led to favorable outcomes in helping athletes return to sport in all research found, with two studies even reporting it significantly reduced symptoms.
How healthcare professionals' word choice affects patients' perceptions on low back pain
Low back pain (LBP) continues to affect countless individuals throughout the globe with distress and discomfort, and remains a major concern of health-care professionals. In addition to the physical aspects that are largely responsible for LBP, there are also some psychosocial factors that can contribute to it and create negative beliefs about the condition. For this reason, the word choice used by physicians to deliver news to patients is of utmost importance, as it can shape patients' views and potentially lead to the condition worsening. A study investigated the role of word choice in a clinical setting and found direct correlations between certain words and inappropriately negative outlooks, which means physicians should be much more cognizant about the manner in which they deliver messages to patients.
Surgical vs. non-surgical treatment for Achilles tendon rupture
The course of treatment for Achilles tendon rupture is one that continues to change on a regular basis, and a general consensus on the best way to approach it is yet to be reached. While re-rupture rates are slightly lower with surgery compared to rehab, the complications and costs associated with surgical intervention are much higher, and some meet it with caution. The recent development of a functional brace that allows movement, however, has given more credence to the possibility of a non-surgical intervention. To determine the effectiveness of this new brace, a study compared it to patients who underwent surgery, and found only minimal differences in re-rupture rates, boosting the stock of rehab over surgery.
November 2010
Knee bracing proven to be ineffective in preventing knee injuries for football players
Knee injuries and football players have a direct and unfortunate relationship, accounting for the most common injuries in the sport and plaguing athletes at all levels of competition. Most knee injuries occur in the medial collateral ligament (MCL) since it’s the first ligament to be ruptured upon impact, making it a major matter of concern for health-care professionals and those involved in football. Knee bracing is one method that’s been used for MCL and other knee injuries, yet the specific benefits of bracing are yet to be proven. Noting this, a study investigated the use of prophylactic knee braces further and did not find sufficient evidence to recommend them for the prevention of MCL injuries.
Stretching shown to have benefits associated with looseness and soreness, but not in preventing injury
For quite some time, stretching before and after physical activity has been a popular course of action performed by many and underscored with the belief that it reduces the risk of injury while engaged in activity. Surprisingly enough, despite its widespread usage across the gamut, the specific benefits of stretching to prevent injury are not well established, and many studies have shown them to be questionable. To evaluate this matter in greater detail, a powerful study was conducted and found stretching to be effective in increasing the feeling of looseness and reducing some soreness, but debatable in terms of preventing injury.
Understanding possible causes and prevention methods for cramps induced by exercise
Exercise-associated muscle cramps (EAMC) consist of acute pain, stiffness and muscle knotting, and usually occur during or shortly after exercise and last for several days. These types of cramps can be extremely debilitating for athletes and can prevent them from participating at full capacity. Medical professionals believe that by understanding the cause of EAMC, better treatment and prevention methods can be established. Two main schools of thought exist on the subject, one that believes the cramps are due to dehydration imbalances, and another that claims they're a result of deeper-rooted neuromuscular changes. Both theories have some strong points, as well as flaws, and are examined in greater detail here.
September 2010
Full-scale evaluation of various treatments for knee osteoarthritis
Osteoarthritis (OA) is an extremely prevalent and hampering condition defined by the breakdown of joint articular cartilage that causes pain and discomfort and occurs in the knee more than any other bodily location. It's estimated that more than 30% of adults over the age of 60 experience functional limitations due to knee OA today, which detracts majorly from their quality of life (QoL) and costs the health care system billions of dollars annually. For this reason and more, it's essential that all available treatments are analyzed for their effectiveness and that physical therapists stay current on how to administer optimal care for the droves who suffer from knee OA. Noting this, a systematic review was created that evaluated various interventions for knee OA with the intention of determining which is most effective and if there are any other variables that need to be considered in constructing a treatment plan for knee OA.
Identifying which pitchers are at risk for injury in minor and major league baseball
Assessing injury risk for professional athletes is an incredibly important duty that has the potential to save sports franchises large sums of money if performed correctly. When it comes to major and minor league pitchers, the task is weighted even greater, since so much rides on pitchers' health as it is, and because they're more likely to sustain injuries than any other players. For this reason, it's essential to attempt to determine which pitchers are more likely to experience a throwing-related injury during the season by indicators they show during the preseason. Therefore, a study was created that sought to define risk factors that could lead to injury, and found weaknesses in particular shoulder muscles to be a likely cause for future injury.
The role of habitual physical activity in overall health for the elderly
It's well understood and recommended that regular moderate-intensity physical activity for the elderly population (aged 65 and older) is one of the most important components of a healthy lifestyle, as it enhances life, prolongs independent living and reduces the risk of numerous chronic health disorders. Despite this widely publicized concept, many elders fail to exercise as regularly as they should, leaving them at a higher risk for health complications. To get a better understanding of exactly what types of physical activity patterns elders should be engaging in, and to evaluate what factors influence whether or not elders exercise regularly, a study was performed in an average-sized town not far from Tokyo, Japan. Gender, physical and mental health, and weather were all shown to be important factors that affect the likelihood of exercise for those in the elderly community.
August 2010
Progressive resistance exercises and glycemic control for type 2 diabetes patients
Diabetes is a metabolic disorder that results from complications with insulin, which creates elevated plasma glucose levels and disturbances in metabolism that lead to further complications. Therefore, in order to manage diabetes, patients try to maintain appropriate plasma glucose levels, which can be done with medication, dietary intervention and exercise. Progressive resistance exercise is one form of exercise that has been suggested to improve glycemic control, but there is minimal research to confirm this theory. To better evaluate the effectiveness of this type of exercise on glycemic control, a systematic review was conducted and found it to be both beneficial and safe for type 2 diabetics compared to aerobic exercise and no exercise at all.
How characteristics of swinging mechanics can lead to low back pain for golfers
Golf is a sport that enjoys wide-ranging popularity on an international scale due to its casual nature and mild intensity level. Despite the fact that golf doesn't require much energy exertion and is fairly safe compared to most other sports, injuries still do occur, with lower back pain (LBP) being the most common complaint for both professional and amateur golfers. Consequently, physical therapists have been investigating which characteristics, if any, in a golf swing could contribute to a more likely chance of a golfer experiencing low back pain and why. One study compared golfers with LBP to those without it, and found a number of indicators that may lead to LBP that can be avoided if addressed properly.
Moderate exercise proven to be safe for fetus in last trimester of pregnancy
Exercise of any sort throughout the course of a pregnancy has long been a debated topic that continues to attract varying viewpoints. Of the greatest concern is the final trimester of a pregnancy, a time vital to the development of fetal lungs and other organs, which leads to questions regarding the effect of exercise on the homeostasis of the maternal-fetal unit. To better understand the connection between moderate exercise and the safety of fetuses in the final trimester of a pregnancy, a study was conducted on pregnant women and found no noticeable effects that were negative to the development of the fetus resulting from exercise.
July 2010
Treating ACL tears with physical therapy can eliminate need for surgery
Tears of the anterior cruciate ligament (ACL) occur often in young athletes who are active in sports, and tend to result in extended absences from performance. Reconstructive surgery is considered the preferred method of treatment for tears, despite the fact that surgery is extremely expensive and there is a lack of evidence confirming its effectiveness, while treatment with rehab alone is rarely seen. To compare the two, a study was conducted and found no significant advantages of going into surgery right away, recommending to begin with rehab and only have surgery in cases where it's unsuccessful.
Many patients with low back pain fail to follow recommendations for improvement
Low back pain (LBP) is an extremely common condition and major source of discomfort that affects a large percentage of people throughout the world at some point in their lives. When not treated correctly, cases of LBP can go on to turn more extreme and pose future problems that could've been avoided if guidelines were followed properly by patients. Noting this, an Australian study surveyed patients with LBP and found that many of those suffering from the condition didn't seek advice, and of those that did, a significant amount didn't actually follow the recommendations given to them. This figure points out much of what's wrong with the overall face of LBP rehab and should be considered in moving forward.
Non-operative treatment for labrum tears proven to be just as effective as surgery
Superior labrum anterior posterior (SLAP) tears, which can be extremely painful and debilitating injuries, occur most frequently in athletes who participate in overhead sports such as baseball, tennis and swimming. Treatment options are typically reserved to surgical intervention or the non-operative route of physical therapy and medication, though research is minimal on the latter. To better establish an understanding of the non-surgical option, a case series was performed and the results showed that treatment without surgery provided outcomes that were very similar to those from surgical intervention, suggesting that surgery is not always necessary.
June 2010
A close look at hyperkyphosis: how it develops, how to manage it
Age-related hyperkyphosis, which is defined by an exaggerated curvature of the thoracic spine, is a common condition in the elderly population that impairs the ability to function properly and increases the risk of falls and fractures. Though it effects somewhere between 20-40% of senior citizens, the natural history of hyperkyphosis is not completely understood, and it’s thought to come about from a variety of processes. Fortunately, if hyperkyphosis is identified and treated early in its onset, the chances of recovering from it are much more likely. Take a look at what can cause it and the best ways to treat hyperkyphosis if it occurs.
How hip-strengthening exercises can help reduce knee pain in runners
Patellofemoral pain (PFP) is an extremely common issue encountered by runners in that usually occurs when the kneecap (patella) and thighbone (femur) rub against each other, causing pain in and around the kneecap area. The condition tends to only come about while in the course of running, but can intensify to the point where running becomes nearly impossible. One theory suggests that strengthening the hips will alleviate PFP since stronger hips can mean an improvement in running-form flaws that cause the pain in the first place, and a small trial of collegiate female runners provided outcomes that were favorable in supporting this theory.
Shoulder muscles with pendulum exercises and light activities during rotator cuff rehab
Tears and other injuries to the rotator cuff are seen in a variety of sports and usually occur due to the stress that repetitive throwing motion puts on the shoulder. Some studies claim that 75% of patients who repair large rotator cuff tears will go on to re-tear their rotator cuff in the future, meaning proper rehab is extremely important. One study sought to get a better understanding of activities that could be harmful to a healing shoulder, and found that the commonly prescribed pendulum exercises, when done incorrectly, as well as drinking out of a water bottle, could have a detrimental effect on shoulder rehab and should be performed with caution.
May 2010
Full-scale evaluation of lumbar spinal stenosis surgery for older adults
Spinal stenosis, a condition in which the narrowing of the spinal cord causes nerve pinching and subsequent pain in the buttocks, is the most common indicator for spine surgery in older adults, which itself is extremely prevalent. Despite the popularity of the surgery, however, a general consensus on the best surgical method has yet to be reached, as many surgeons still take their own individualized approach. To investigate these various methods and to clarify which is the best option, a study was conducted that evaluated Medicare trends to determine the optimal surgical style.
The effects of exercise intervention on elite swimmers' posture
Swimmers who compete at a competitive level rotate their shoulders an average of 16,000 times a week, a motion that over time can have serious complications and lead to sidelining injuries. Consequently, some studies show that as many as 47% of collegiate swimmers report pain, or swimmer's shoulder, for three weeks or more at some point in their career. Exercise interventions aimed at strengthening weak muscles and stretching tight ones are believed to alleviate pain and reduce the risk for injury, and to better understand the potential benefits of such an intervention, a study was performed on a group of Division I collegiate swimmers.
Resistance training for young athletes: possible benefits, risks and safety precautions
A new form of exercise that has been experiencing a significant upswing in popularity for young athletes over the past few years has been resistance training, a form of conditioning that uses resistive loads and a variety of exercises to improve strength and overall health. Not quite weightlifting or bodybuilding, which are more focused on increasing muscle size exclusively, resistance training s designed to help young athletes in a number of sports improve their overall performance with a carefully-constructed regimen. Responses to its usefulness and level of necessity have varied, with some deeming it too dangerous for young athletes. On the contrary, though, research has shown it to be a valuable form of conditioning that can be extremely effective if carried out properly and safely.
April 2010
A choice of words: what to use, what to avoid when delivering news to patients
When it comes to hearing news regarding an important, possibly life-altering condition, patients are at an increased level of susceptibility and vulnerability. For this reason, the manner in which news is delivered to patients is of extreme importance, and it can go on to have a major impact on how they come to deal with their diagnosis. Some medical professionals still manage to err in this sensitive process, but this pamphlet should elucidate on the most common mistakes and how to properly deliver these pieces of news.
Differences between running-related injury predictors for male and female novice runners
Running is far and away the most popular form of physical activity throughout the world, primarily due to the fact that just about any able-bodied person in just about any location can do it. With its popularity, however, also comes a high risk of injury, as some studies report numbers as high as 79% of all runners sustaining a running-related injury (RRI) at some point in their career. To evaluate the inherent risks associated with running and to determine the differences in risk factors for male and female novice runners, a randomized control trial was performed with these objectives in mind.
Why obese and overweight young athletes are more likely to sustain injuries
Figures for obesity and overweight in children and adolescents in the U.S. remain some of the highest in the world, and despite major attempts to counter the trend, the numbers don't seem to be getting any smaller. In addition to the general drawbacks of being overweight or obese, experts are now pointing out that there is also an additional risk of injury resulting from excessive weight that must be acknowledged and dealt with. Fortunately, awareness and some minor modifications in both lifestyle and sports participation can help overweight young athletes be less likely to suffer an injury.
March 2010
Vitamin C considered effective in reducing CRPS associated with distal radius fractures
Vitamin C, a water-soluble compound that's found in a wide array of fruits and vegetables, is essential for a number of important bodily functions and is recommended to improve general health. Some physicians also prescribe vitamin C to patients who've recently suffered a wrist fracture to prevent a condition known as complex regional pain syndrome (CRPS), but debate exists as to whether or not it's effective in doing so. To evaluate vitamin C's specific role in preventing CRPS, two randomized control trials were analyzed.
Evidence-based medicine: the importance of understanding varying levels of evidence
With the overwhelming slew of information on the Internet regarding just about any subject imaginable, including medical research and advice, it's difficult for the common man to determine what to believe and what to dismiss. Evidence-based medicine (EBM) uses a system that assigns a number to each medical study according to its strength of evidence, and as a result, makes the process of deciding what to trust as credible much easier.
Common training mistakes for marathon and half marathon runners
Making the decision to participate in a marathon (26.2 miles) or half marathon (13.1 miles) usually means one will be spending a sizable period of time prior to the race involved in a serious training program. For many who follow these programs, however, a number of minor but common mistakes in the course of training or on the day of the race can have negative effects on performance, but can easily be avoided by following these guidelines.
Feburary 2010
How injuries affect adolescent athletes' quality of life
Participation in sports for adolescents remains high, with an estimated 30 million being active in some organized form. Along with it, injuries are common and affect close to half of all young athletes. Aside from the natural impact on physical abilities and functioning, injuries can also have a negative effect on overall quality of life and wellbeing. In order to better understand these secondary implications of injury and the best ways to handle them, a study was performed on a small group of adolescent athletes.
An investigation of physical therapy intervention for adhesive capsulitis (frozen shoulder)
Adhesive capsulitis, also known as frozen shoulder, is a condition defined by pain, stiffness and a reduced range of motion and can have long-term implications if left untreated. The amount of research on nonsurgical treatments such as physical therapy for the disorder is extremely small, prompting a group to conduct an extensive randomized control trial that evaluated the effectiveness of specific therapy interventions. Certain interventions were shown to be beneficial while others proved more likely to impede rehabilitation rather than help it.
Evaluation of osteoporosis risk factors and recommendations for prevention
It's estimated that 1 in 4 women and 1 in 8 men in Canada have osteoporosis, a skeletal condition that occurs as a result of low bone mineral density. Osteoporosis particularly affects those over the age of 65 and has significant implications for those who suffer from it and on the entire health care system due to its prevalence. By understanding who's at risk and by following some simple preventative measures given by the organization Osteoporosis Canada, the rate of osteoporosis can be lowered, saving money and reducing complications for all those affiliated with the condition.
January 2010
Stem cells used in new treatment for damaged cartilage to prevent osteoarthritis
Osteoarthritis, the wearing away of cartilage in a joint, is the most common form of arthritis in the country, and is often caused by weakened or damaged cartilage as a result of injury. Damaged cartilage is usually treated with a procedure known as microfracture, which is only semi-effective and of which the long-term benefits are not known. With a new approach in mind, Dr. Constance Chu of the University of Pittsburgh has been working for the past 20 years on new forms of treatment that use stem cells to regenerate new, improved cartilage.
Hip impingement: recognizing, understanding and treating a common cause of hip pain
Based off the recent progress in diagnosing and treating nonarthritic hip injuries, hip impingement has become increasingly recognized as one of the more common causes of hip pain for athletes, adolescents and adults. Caused by a bone in the hip and the thighbone rubbing against each other, hip impingement can lead to the wearing away of cartilage and eventually osteoarthritis if not treated properly. The debilitating disease can have serious implications for both physical and daily life activities, but physical therapy has been strongly recommended as a method to treat it.
The effect of Pilates on adult fitness characteristics
Pilates have seen a major upswing in popularity in recent years, with more than five million Americans regularly using the exercise system today. The Pilates method, as its formally known, employs a series of resistance exercises performed with various apparatuses and a Pilates mat, and its goal is to improve body composition, flexibility and muscular endurance. Despite its prominence, evidence on the specific benefits of Pilates is scarce. To better analyze the actual effects of Pilates, a small study was performed using a group of physically active adults.2009
December 2009
The benefits of dealing with obesity in patients with knee osteoarthritis
People who suffer from obesity are at an increased risk of obtaining knee osteoarthritis (OA) due to excessive pressure on joints in the knee, and for obese patients who already have the condition, not doing anything about it can lead to further complications. Increased physical activity and dietary modifications with the purpose of losing weight are therefore considered productive methods to prevent knee OA and lessen the severity of pain in those who have it. To highlight these benefits and prompt physicians to encourage weight-loss treatment programs, a study was conducted and published in The Journal of Musculoskeletal Medicine.
Hip arthroscopy for athletes in the long term: a 10-year follow up
Arthroscopy is a minimally invasive procedure preferred by some for its shorter recovery time and smaller scar, and it has been a popular method to treat sports-related hip problems for years. Despite the popularity of hip arthroscopy, there is a lack of data on the long-term effects of the surgery, spurring a study in which athletes who underwent the procedure were monitored over the course of 10 years to determine its effectiveness or lack thereof.
Obesity accounts for nearly 10% of all medical spending in the United States
Recent research released by the U.S. Center for Disease Control and Prevention (CDC) claims that obesity-related diseases account for 9.1% of all medical spending in the U.S., or about $147 billion annually. With this in mind, the CDC emphasizes the importance of reducing the national obesity rate in order to lower health care costs, and suggests certain ways in which this can be accomplished.
November 2009
Evaluating postconcussive outcomes after return to play in Australian Football
Concussions are prevalent in any sport in which contact is involved, and the rule of thumb usually says the higher the level of contact, the higher the frequency of concussions. One matter of debate amongst physicians is the amount of time that should be spent recovering from a concussion before returning to competition. A study was therefore conducted on players in the Australian Football League (AFL), a sport with one of the highest rates of concussion, to determine the ideal amount of sitting out time following a concussive injury.
How ACL reconstruction and/or meniscectomies can affect NFL players' careers
Two of the most common injuries in football are those related to the meniscus and anterior cruciate ligament (ACL), and as a result, procedures done to repair those areas are extremely prevalent with NFL players. Due to the frequency of these procedures, a study was performed using data from the NFL Scouting Combine to determine how the procedures impact the length and quality of players' careers.
Thrown a curve: a new take on youths, curveballs and overuse injuries
Since the early days of sports medicine, parents and coaches of young pitchers have been under the belief that curveballs are dangerous for developing arms, and should not be thrown at least until the age of 14. Two separate studies investigated the validity of this concept and discovered that fastballs are in fact more stressful on the elbow than curveballs, but a high volume of any pitch will be detrimental to the pitcher's arm despite the type.
What a knee arthroplasty could mean for one's golf game
The popularity of golf in the U.S. is due in part to the fact that its low-impact nature makes it a sport for all ages to participate in, especially elders. Many elders suffering from degenerative arthritis, however, experience problems with their knees during play and go on to have a total knee arthroplasty (TKA) to resolve the issue. In order to better understand the usefulness of TKA on golfers, a study was conducted that evaluated pain and enjoyment levels before and after the procedure.
February 2009
Getting on the ball for diabetes prevention
High rates of diabetes are far from limited to the United States, as the International Diabetes Federation estimates there to currently be 246 million adults worldwide with diabetes, a figure expected to only continue to increase. Mainly due to the paralleled ascension of obesity and overweight, the diabetes problem has reached a global level, and requires dedicated efforts in education, research and development, and forms treatment on grand scale.
Type 2 diabetes patients should be given option of self-monitoring
The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Center for Chronic Conditions surveyed nearly 900 type 2 diabetics to garner a clearer understanding of their perception towards the disease and how best to treat their condition. An updated set of guidelines was subsequently released that emphasized the need for more educational information for diabetics, and recommended diabetics monitor their own glycosylated hemoglobin target barring that it doesn't affect their quality of life.
How high-force eccentric resistance exercise can improve glucose control for diabetics
With the numerous forms of treatment available for diabetics, one of the easiest and cheapest remains basic aerobic exercise. In addition to everyday aerobic exercises like walking, running and biking, a new study found that an eccentric resistance exercise program designed to increase strength and muscle size could also help type 2 diabetics.
2008
December 2008
What studies have more validity and why: The importance of clinical trials
With such an abundance of medical reports being released by the media, it has become a difficult task to determine whether a source or study is trustworthy. Clinical trials, due to a number of powerful factors, are proven to be the most accurate of studies, even when their conclusions contradict popular belief.
Chasing the enigma of female ACL injuries and the gender differences that cause them
A research retreat was held in Greensboro, NC, to further examine why females suffer from ACL injuries easier than males. The group came up with three important themes that need to be aggressively pursued in order to better understand the mysterious disparity.
How menstrual cycle phase and anatomy may have an impact on ACL injuries in females
One major consensus emerging in medical literature is the possibility that the menstrual cycle phase of females affects their vulnerability to ACL injuries. According to a number of studies, females are much more likely to experience an ACL injury in the preovulatory phase of their cycle than the postovulatory phase. Female anatomical makeup is also investigated.
Wrist guards' impact on wrist and elbow injury in snowboarders
An Australian study investigated the effect of wrist guards on both wrist and elbow injuries, as it has been suggested by some that wrist guards can actually lead to elbow injury as a result of redistributing the impact of the force. The study found the claim to be false and the guards to be extremely effective for their purpose.
October 2008
An investigation into damaged menisci in the average middle-aged and elderly reveals a shockingly high number of incidences of damage, many of which occurred in patients who did not have symptoms of injury
Tears to the meniscus, a pair of fibrocartilaginous discs in the knee that provide support and protection, are one of the most common injuries and surgeries to repair this region are recognized as the most common surgery performed by orthopedic surgeons. In addition, many middle aged and elderly persons suffer from damaged menisci without being aware of it. One study investigated the number of people with the injuries and whether MRI usage was effective in diagnosing them.
Evaluating arthroscopic surgery vs. physical therapy for treatment of Osteoarthritis of the knee: the minimally invasive procedure rising in popularity may not be any more effective in rehabilitating OA knee than therapy, but will veritably cost more money and time than the latter
Osteoarthritis of the knee (OA knee) is a condition that can be treated with extensive physical and medical therapy or with arthroscopic surgery in other situations. While arthroscopy has risen in popularity, whether or not it is actually more effective than therapy alone is a matter of debate. An investigation sent nearly 200 eligible patients to both forms of treatment and evaluated which was a more beneficial means of alleviating pain.
Dairy intake, particularly milk and yogurt, is a proven weapon used for combating weight issues and type 2 diabetes due to dietary calcium in all dairy and a number of weight loss properties found in milk
One new dietary method for preventing obesity and type 2 diabetes is based on higher amounts of dairy due to its high concentration of dietary calcium, which is known to burn fat rather than store it. In addition, milk's bioactive peptides provide additional weight loss capabilities, due to their multiform composition with elements that reduce blood pressure, regulate food intake and cause a number of other reactions that contribute to weight loss.
Cod liver oil supplements capable of reducing Non-steroidal anti-inflammatory drugs for patients with rheumatoid arthritis who are forced to limit their usage of NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) are essential for patients with rheumatoid arthritis, yet certain people have to limit their usage of NSAIDs due to unwanted gastrointestinal and cardiovascular side effects. A Scottish study found that cod liver oil supplements were able to lower the amount of NSAIDs taken on a regular basis by a significant degree.
