Rowan Paul, M.D.

The American College of Sports Medicine published scientific and practical guidelines for #medical doctors to incorporate exercise in chronic disease and disability. The following information is published by the ACSM: “What physicians usually want to know is when things are not going according to expectations, because that is a situation in which the physician needs to figure out why the patient is not responding as expected. Another isssue is the multidisciplinary nature of exercise management. Experts who have worked in this field a long time know that physicians and allied health care staff have very different professional cultures in training and don’t think in the same fashion. At first, it’s a little shocking to learn this, because one might think that all of health care would be based on the same “textbook”. But, in fact, that is often not the case, and it’s common to find various healthcare staff having very different takes on a situation.” Our reply to this from experience in the real world: THE PERSPECTIVE FROM PHYSICIANS: Physicians often focus on the macro clinical and diagnostic aspects of health. Following an exercise test they are primarily interested in the MACRO clinical data points: a) was maximal exertion reached? b) was sufficient oxygen provided / sufficient oxygen extracted? c) was ECG normal? The culture (according to their training) from physicians are to assume medical clearance can be provided as there are no macro clinical diagnostic evidence if macro data points are normal. THE PERSPECTIVE FROM ALLIED HEALTHCARE PROVIDERS Allied health care professionals are looking at this a bit differently. Obviously the macro data points need to be cleared first and addressed accordingly during exercise when required, but once the macro data points are normal, their culture (according to their training) focus more on the finer details exposed during exercise that are underlying weaknesses that are not clinical but rather sub-clinical which could improve the overall quality of life. EXAMPLE A classic example is a fit individual who will undergo a physical exam, showing normal macro data points. However only during exercise training intensities (according to CPET outcomes) are these underlying sub-clinical weaknesses exposed. If not addressed, these underlying sub-clinical weaknesses can become “the little foxes that destroy the outcome” that can fast track the development of macro acute events. Healthcare environments need to marry the macro and micro data points to ensure superior clinical outcomes. The future need is to create practical solutions how to manage the macro and micro data points, and allow an environment where the different cultures of physicians and allied healthcare providers to work together as a team. At the end, this is the bottom line for the patient, as this approach will assist the patient to proactively understand what is required to manage their lifestyle. This is the essence of Medicise.

5

1 Comment

Shout out to Noraxon USA !! 📣 New published research. 🔔 Trend change analysis in the assessment of body balance during posture adjustment in reaction to anterior-posterior ground perturbation. Postural adjustments (PA) occur to counteract predictable perturbations and can be impaired as a result of musculoskeletal and neurological dysfunctions. The most common way to detect PA is through electromyography measurements or center of pressure (COP) position measurements, where analysis in time domain and frequency domain are the most common. Aim of the research was to determine whether a new method of analyzing stabilographic measurements—the COP trend change analysis (TCI) of temporary posture corrections- can expand understanding of changes in balance strategy connected with PA. https://lnkd.in/gWgsbmHZ

16

2 Comments

The impact of physical therapy on nociceptive processing. Impact on directional pain processing based on the method and type of intervention provided. Manual Therapy and personalized care provide comprehensive pain modulation in adverse sensory experience processing. To hurt is a mammalian phenomenon, and to experience pain carries human dimensions—informative read.

16

This study investigated the efficacy of using Dynasplint LPS® (low, prolonged-stretch) devices for restoring range of motion in cases where either immobilization stiffness or an established contracture had developed at the elbow or knee. Patients treated with Dynasplint, a force adjustable device for use in clinic and at home and capable of providing low levels of force over prolonged periods of time, resulted in a 61% additional increase in range of motion at the elbow or knee in 13 case studies in spite of the fact that 9 of the 13 subjects had already undergone previous and, oftentimes, intensive physical therapy programs designed for the same purpose of restoring range of motion. Dynasplint knee and elbow devices were found to be highly effective and efficient tools for speeding recovery from immobilization stiffness and to correct established contractures in 13 subjects who had suffered elbow fractures (8), knee fractures (2), surgeries (2), and a stroke (1). #dynasplint #LLPS #knee #elbow #rehabilitation #orthopedic #rangeofmotion #physicaltherapy #improveoutcome #stretching #hometherapy

2

Interesting to see an Orthopedic Surgery journal promote Physical Therapy care and associated clinical outcomes. Domain specific knowledge and domain specific performance, we can evaluate clinical outcomes adjusted to the risk of bias with traditional recovery trajectory. Physical Therapy interventions lead to clinically significant improvements in reduction of pain, promotion of function, and other important barometers of health.

4

2 Comments

Normalizing the non-linear progress and recovery trajectory for most MSK problems. Long-term planning and forecasting future recovery through a better understanding of non-linear recovery and variability in symptom intensity and behavior. Normalizing flare-ups.

10

This comprehensive analysis on changing trends in hand injuries from 2007 to 2022 sheds light on the significant impact of demographic shifts on the landscape of hand trauma. As our population ages and our work environments evolve, it is crucial to understand these trends in order to effectively address and prevent hand injuries. This study provides valuable insights for healthcare professionals and policymakers in developing targeted strategies to improve hand injury prevention and treatment. #handtrauma #demographics #injuryprevention #healthcareanalysis

20

🚨 New Study Alert! 🚨 We’re thrilled to share groundbreaking findings from a recent study on knee stability, authored by Baptiste Guegan, Michel Drouineau, Harold Common, and Henri Robert. This research focuses on the critical roles of the ACL and medial plane structures. 🦵🔍 Using the Dyneelax® laximeter/arthrometer, this study provides valuable insights into knee biomechanics, specifically highlighting rotation and translation movements, offering potential advancements in diagnosis and treatment. 📈🧠 Study Highlights: • Objective: Determine the roles of the ACL and medial plane components in controlling anterior tibial translation (ATT), internal rotation (IR), and external rotation (ER). • Methodology: Analysis of 29 cadaveric knees using the Dyneelax® laximeter/arthrometer. • Key Findings: • The ACL is the primary restraint for ATT. • The deep medial collateral ligament (dMCL) is crucial for ER control. 🔄 • The posterior medial capsule (PMC) significantly contributes to IR stability. Clinical Implications: • Enhanced understanding of knee biomechanics can improve surgical and rehabilitation protocols. 🏥💪 • Early and accurate detection of partial ruptures, which are often missed by MRI. 🩺🔬 • Post-operative monitoring of ACL grafts for better patient outcomes. 📊🏃‍♂️ Why It Matters: These insights can transform how we approach knee injury diagnosis and treatment, particularly in complex cases involving multiple ligament tears. 🌟 🔗 Read the full article here: https://lnkd.in/eCCSr3j9 🔗 Stay tuned for more updates and advancements in orthopedic research. 💡📚 #KneeStability #ACL #MedialPlane #Orthopedics #Dyneelax #Laximeter #Arthrometer #Biomechanics #MedicalResearch #HealthInnovation Thank you for being a part of our journey to better knee health! 🦵❤️

12

Return to Sport Testing After ACL Reconstruction How do you assure that our return to sport testing after ACL reconstruction can assess the functional capabilities of the athlete?

11

Sympathetic Chain Pathology & Sympathetic Autonomic Hyperactivity: The Importance of Spinal Manipulation in Optimizing Autonomic Nervous System Homeostasis https://lnkd.in/eV-c4pW8

2

An important article on resistance training. Standardizing care to optimize delivery and optimize clinical output. Because exercise prescription and exercise delivery are the primary products associated with MSK PT intervention, we, as a community, should invest some time in learning ways to optimize output from resistance training.

8

PRP vs PPP for muscle injuries. New paper published by Robby Bowers, DO, PhD from Emory, highlights the utility of PPP (platelet poor plasma) for muscle injuries. This paper echoes the presentation from jason dragoo many years ago TOBI: The Orthobiologic Institute emphasizing that PPP may be more effective for muscle tears vs traditional PRP preparations. It just spotlights the nuisances to stay informed in the advancing understanding of PRP. Personally, treating muscle tears w/ hematomas ranks among my top 3 favorite PRP indications. I aspirate the hematoma & inj it with PRGF. Then I inject healthy surrounding tissue w/ PPP to stimulate satellite cells & healing based on Mikel Sanchez's work. It makes sense taking out the bad (RBC) & replacing with the good (plasma w/ Growth factors to speed the body's natural healing capacity). More awareness & studies are needed to focus on this application which has been very successful in my practice https://lnkd.in/g3w89ZZq #prp

74

2 Comments

Low-back pain & spine health in general have become a huge issue in modern lifestyle composed of unhealthy sitting postures, whether at work or home. Pulsed Electromagnetic Field Therapy is a safe, non-invasive therapy and has been shown to reduce back pain and improve the regeneration of cartilages, bones and muscles. Here is an in-depth article that discusses the published clinical research: https://lnkd.in/dp_4jPBe #spinehealth #backpain #wellness #physiotherapy #chiropractic #neurology #painscience #orthopedic #neurology

2

3 Comments