• Poor rehabilitation adherence may lead to sub-optimal treatment outcomes, reduced clinic efficiency and increased cost of care. But despite this knowledge, research indicates that attendance at physiotherapy departments is within 54%-94%and can be as low as 40%. Several studies confirm that adherence to a clinic-based exercise protocol is often around the 50% markand may be particularly poor for unsupervised home exercise programs.

  • Rehabilitation adherence is an outcome of a complex interaction of physical, social, therapeutic and psychological elements. This second article, based on the findings of my doctoral research, highlights the role of social support and other social influences as a determinant of rehabilitation adherence.

  • While objective clinical testing is important and is given a lot of focus within clincal training programs, subjective assessment and history taking is one of the key aspects of the clinical reasoning process. A detailed subjective assessment will help a physiotherapist form provisional hypotheses as to the potential causes of the patient's presentation and therefore form the basis of the subsequent objective assessment.

  • Parkinson Canada presents the role of physiotherapy in management of parkinson's disease

  • Recently Independent.ie published an article about low back pain which talked about some of the most common triggers. Frankly, it was one of the most outrageous articles written on the causes of low back pain. It was as if research doesn't count for anything. One of the assertions was uterus can push back on the spine causing inflammation of spine.... just utter rubbish.... with no consideration of evidence or anything.. Twitterati went into hyperactivity in challenging the basis of assertions.. calling out the biased facts.... and finally the article was removed from their website.. 

    But the positive news is that The Lancet and their Low Back Pain Series Working Group has come up with a series of articles on low back pain which summarise the state of the art. The articles have been authored by the best in the business of researching low back pain and clearly present the evidence for this most common low back clinical presentation. 

    The first article is titled 'what is low back pain and why we need to pay attention.' This article presents the global burden of low back pain as the leading cause of disability worldwide. But more importantly it highlights that only a small proportion of people have a well understood pathological cause—eg, a vertebral fracture, malignancy, or infection. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. It goes on to discuss that that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain.

    The second article focusses on the prevention and treatment of low back pain. The key focus is on utilisation of education and self management as the key interventions as opposed to inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. I was shocked recently when having a conversation with one of the colleagues who is starting some work in Australia and mentioned that it has been recommended that all patients will undergo an initial MRI scan... not sure who devises such recommendations... but anyway, back to the topic.. the key focus is on moving away from therapies which have little evidence for benefit but surely work to move the locus of control from the patient to the therapist and therefore ensure that the patient keeps turning up in private practice. While researchers have said that for a while now, unfortunately, both the patients and physiotherapists continue to utilise the same passive therapies to manage low back pain. The authors have also highlighted the role of psychological therapies in managing chronic persistent low back pain. If you work with low back pain patients, this article is well worth a read. 

    Finally, as a call to action, the Low Back Pain Series Working Group has recommended focused strategies to implement best practice, the redesign of clinical pathways, integrated health and occupational interventions to reduce work disability, changes in compensation and disability claims policies, and public health and prevention strategies.

    All these articles are available free

  • This video describes shoulder joint differential diagnosis, examination of shoulder joint according to pain and chief complains.
    difference between tendinitis, tendinopathy, tendinosis, paratenonitis.
    biceps tendinitis, Rotator cuff tendinitis, Rotator cuff tear, shoulder impingement types and its stages, differential diagnosis of Rotator cuff tear ans shoulder impingement. subacromial bursitis, differential diagnosis of tendinitis and bursitis . TOS and type of TOS, difference of vascular and neural TOS, differential diagnosis of TOS and pronator Teres syndrome. scapular dyskinesia, special test for dyskinesia and sick scapula, Laberal tear : SLAP lesion, Bankart's tear , Hill-sach's tear.shoulder instability: anterior, posterior and inferior instability . Adhesive capsulitis, AC sprain and fracture of shoulder joint.

    if you want to approach the exams with clinical view point, please visit this . https://therapyexamprep.com

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