Sunday, January 31, 2010

PC Tablet Survey

I received an e-mail about a survey regarding the new iPad - if you have a few minutes I extend the invite to participate:

I've created a short survey (8 multiple choice questions) about what tablet PC features are important to healthcare professionals. I'll use the results from the survey to determine which tablet PC is best positioned to rule the halls of healthcare. Even if you've never used a tablet PC, I'd love to get your opinion on what features are important.

Here is the link to the survey:

Tuesday, January 26, 2010

Collagen-Platelet Composite

A colleague of mine requested I blog about this article so here it is. A very interesting article about enhancing healing of the Anterior Cruciate Ligament.

Joshi et al. Collagen-Platelet Composite Enhances Biomechanical and Histologic Healing of the Porcine ACL. AJSM 37 (12), 2401-2410.

Important to note the sample here was 18 pigs (27 knees), all 4 months old and female. The immature population is a good one to study because these injuries do happen in youth quite often and they are the most likely to develop OA down the line. The authors do cite that pig knees are similar to those in humans with subtle differences not yet clearly appreciated.

They did find that the addition of a CPC injection enhanced primary ACL repair in that structural properties of CPC-treated ligaments increase. The big takeaway for rehabilitation is the need to respect the healing stages after such a surgical procedure. This study only looked from 4 weeks through 3 months which does lose out on the very important post-operative inflammatory stage and the full remodeling up to 1 year.

I have seen a few ACL repairs, but have not seen the addition of CPC or PRP to assist the operation. It is important to note that in ACL surgery, a repair and a reconstruction are two different procedures that should be approached with respect to the expected healing process and times.

PS, I apologize to the JETS for posting a pic which seems to jinx (like that darn sports illustrated cover) them every time... there is always next year... :(

Sunday, January 17, 2010

International Injuries

Quick thoughts about Paris:
Way overpriced! Food was subpar, weather was terrible, a few museums and the top of the Eiffel tower were closed for repairs (Picasso museum has apparently been closed since mid-2008 with no sign of opening back up any time soon). My two days in Ireland were much more enjoyable.

While I was in Argentina it seemed the majority of injuries I saw in the streets had some kind of arm or wrist brace and then in Paris it seemed the shift was to lofstrand crutches.

Here is an interesting article about the difference in assistive devices available.

For anyone from Paris or Buenos Aires can you confirm for me if there is an increased incidence of lower or upper extremity injuries based on some kind of cultural difference or is it the focus of the healthcare system, a different philosophy in treatment? Anyone from other cities of the world notice any major trends that may be shifted towards one body part? In America Low Back Pain seems to be the most common trend which is seen through obesity on the streets, not that we can draw a clear line between the two.

Now to plan my next international exploration... stay healthy out there!

Thursday, January 7, 2010

NY Times and PT

The NY Times has been fairly kind to physical therapy in the past and now I have an issue with what comes across as slightly negative towards PT.

Check out the article here.

This statement is what throws me off:
When I asked Dr. Irrgang for studies showing what worked, I was a bit surprised. To put it kindly, they left much to be desired.

The authors review of the research presented makes it difficult to believe these are the articles Dr. Irrgang would show him. Poor intention to treat and drop out rates along with a study that had a sample of 4 seem like items that would not be presented by the President of the Ortho section of the APTA.

Also regarding the guidelines, the author only brings up the currently published heel pain and the ones currently in production. But they also published neck pain and hip pain guidelines.

Why go to a physical therapist for as many as 20 sessions, though, in order to do strengthening exercises? Why not just go to a gym?

Overutilization does seem to be a huge issue with the state of the economy and insurance money getting tight. I always tell patients that "I am not here to cure you, I am here to help you cure yourself." Even if they come in 3 times a week, that is 3-5 hours out of the entire 168 hours of the week. I am confident in the ability to provide someone with the tools necessary to begin/expedite the healing process and it is up to them to carry out and take care of their bodies.

The evidence seems like it is beginning to catch up with what we are capable of. I think the article does bring out the ugly side of PT that is "voodoo PT". I have seen too many patients who have had bad experiences at other therapy offices and I have been offered jobs at a clinic or two that made me report them to the state board for what to me seemed like highly unethical practice. Another subject for another day perhaps... I have to go pack for Paris, ciao!

(This guy probably needed some PT after this French headbutt - hope I can avoid Zedane)

Sunday, January 3, 2010

Happy New Year/Decade!

Wanted to wish everyone all the best for the new year/decade, hope it brings new and prosperous opportunities. I resolve (as I have many a time) to focus this blog on what its original intent was... PT and the decisions that go with being a New Professional.

Here is a seemingly fun way to get out and exercise with your friends: A relay run from Woodstock, NY to NYC.
One thing I can say from reflecting on 2009 is these group activities are very fun to do and exercise is fairly important. I read a lot of the latest evidence/research coming out and I consistently see support for exercise helping almost every aspect of life. The people I meet who exercise a lot on an anecdotal level, they just seem to be very pleased with life (not say those who don't exercise aren't happy, but for most finding the right exercise seems to make things better).

I am going to the JETS game tonight where the forecast is calling for "Freezing your toes off" weather. Then next Saturday I leave for 5 days in Paris, a day in Dublin, a day in Belfast (my excuse for the likely lack of posts over the next few weeks, but I will try :). Hope you guys are resolving to be healthier for 2010 and stick with it--> don't forget to set attainable goals and take necessary steps towards making it happen. Everyone is motivated differently, find yours and "get 'r done".