In episode 16 of season 8 of Inside the Science we’re highlighting the study, “Classification approaches for treating lower back pain have small effects that are not clinically meaningful: a systematic review with meta-analysis” with Mr Scott Tagliaferri.. You’ll hear him explain what the literature on classification systems was suggesting before which prompted this study, exactly what was assessed in this review, how effectiveness was measured from the included studies, which systems showed any superiority in effectiveness compared to others, possible interpretation regarding the use of classification systems for complaints like low back pain, the clinical implications and big takeaways.
Season 8, Episode 5 with Stephen May; An international survey of the comprehensiveness of the McKenzie classification system and the proportions in spinal pain
In episode 5 of season 8 of Inside the Science we’re highlighting the study, “An international survey of the comprehensiveness of the McKenzie classification system and the proportions of classifications and directional preferences in patients with spinal pain” with Dr. Stephen May. You’ll hear him share the background of what prompted the paper, specifics as to what classification syndromes were found and to what percentage, what was found for the “OTHER” subgroup, what direction was generally preferred, how often the provisional classification remained the same from initial to discharge, the clinical implications and big takeaways.
Season 6, Episode 13 with Lori Michener: Observational Scapular Dyskinesis: Known-Groups Validity in Patients With and Without Shoulder Pain
In episode 13 of season 6 of Inside the Science we’re highlighting the study, “Observational Scapular Dyskinesis: Known-Groups Validity in Patients With and Without Shoulder Pain” with Dr. Lori Michener. She explains specific on the methods, some limitations in the design, the conclusions she encourages the reader to takeaway related to scapular movement, how she’s use this study to educate her patients, additional clinical implications and big takeaways, the clinical implications and the big takeaways.
Season 5, Episode 4 with Joseph Hathcock: Shoulder Pain of Spinal Source in the Military: A Case Series
In episode 4 of season 5 of Inside the Science we’re highlighting the study, “Shoulder Pain of Spinal Source in the Military: A Case Series” with Dr Joseph Hathcock. He shares the selection process of these three patients with shoulder complaints included in this case series, the unique loading strategies which yielded a reduction of each subject’s pain and the restoration of movement and function, the subject’s response and utilization of care and timeframe needed to recover, the clinical implications and the big takeaways.
Season 5, Episode 2 with Monica Chan: Inter-rater Reliability of MDT for the Provisional Classification of LBP in Adolescents and Young Adults
In episode 2 of season 5 we’re highlighting the study, “Inter-rater Reliability of the McKenzie Method of Mechanical Diagnosis and Therapy for the Provisional Classification of Low Back Pain in Adolescents and Young Adults ” with Ms. Monica Chan. In the full discussion you’ll hear Ms. Chan further explain the limitations of this study, the most important data to draw from this paper including the agreement between the examiners, possible reasons why younger subjects were classified less reliably, the specific implications and the big takeaways.
Season 5, Episode 1 with Joe Maccio: Directional preference of the wrist: a preliminary investigation
In episode 1 of season 5, we’re highlighting the study, “Directional preference of the wrist: a preliminary investigation” with Dr. Joe Maccio. In the full discussion, you’ll hear Dr. Maccio further explain the characteristics of these 19 patients, the predictive observations of those patients showing directional preference, how this has influenced his assessment of extremities in general and especially patients with wrist complaints, the specific implications and the big takeaways.
Season 4, Episode 12 with Joe Maccio: Directional preference of the wrist: a preliminary investigation
In episode 12 of season 4, we’re highlighting the study, “Directional preference of the extremity: a preliminary investigation” with Dr Joe Maccio. In the full discussion, you’ll hear Dr Maccio further explain what data was measured and gathered, what were the most associated findings linked to those with a directional preference and therefore classified as derangement, some data regarding movement targeted at the thoracic spine, the specific implications and the big takeaways. You can subscribe to the premium version at www.mechanicalcareforum.com
Season 4, Episode 2 with Sinikka Kilpikoski: Comparison of Prevalence of Degenerative Findings in Lumbar Magnetic Resonance Imaging among Sciatica Patients classified using the McKenzie Method
In episode 2 of season 4 of Inside the Science we’re highlighting the pre-published study, “Comparison of Prevalence of Degenerative Findings in Lumbar Magnetic Resonance Imaging among Sciatica Patients classified using the McKenzie Method ” with Dr. Sinikka Kilpikoski. She explains the differences in MRI findings in those who classified as derangement versus mechanically unresponsive radicular syndrome or MURS, the details of how this study was conducted, how she uses this information to educate others and with whom she shares it, the clinical implications and the big takeaways.
Season 3, Episode 10 with Melissa Kolski: Validation of a pain mechanism classification system (PMCS) in physical therapy practice
In episode 10 of season 3 of Inside the Science, we’re highlighting the study, “Validation of a pain mechanism classification system (PMCS) in physical therapy practice” with Ms. Melissa Kolski. She shares specifics on this classification system including each subgroups’ distinct characteristics, the sensitivity, and specificity of each classification, the clinical implications, and the big takeaways.
Season 2, Episode 7 with Mark Laslett: Clinical Classification in LBP
In episode 7 of season 2 of Inside the Science, we’re highlighting the study, “Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews” with the author, Dr. Mark Laslett. He shares a look at this case and his view as to why we should classify related to pathoanatomy. He elaborates, tissue by tissue, as to if the literature points toward our being able to classify according to each, how he’d suggest using it to impact our clinical behavior and the big takeaways.
Season 1, Episode 14 with Hans van Helvoirt: Reliability of the Delitto Classification System
In episode 14 of season 1 of Inside the Science, we’re highlighting the study, Inter-rater reliability of a modified version of Delitto et al.’s classification-based system for low back pain: a pilot study and discussing it with one of its authors Hans van Helvoirt. He shares a look at this paper looking at the reliability of a popular classification system within physical therapy. He explains the appropriate interpretation of this data, how he allows these findings to influence his clinical thinking, the big takeaways, and recommended other work that would shed further light on this topic.
Season 1, Episode 13 with Hans van Helvoirt: Epidural injection followed by MDT to prevent disc surgery
In episode 13 of season 1 of Inside the Science, we’re highlighting the study, Transforaminal Epidural Steroid Injections Followed by Mechanical Diagnosis and Therapy to Prevent Surgery for Lumbar Disc Herniation and discussing it with one of its authors Hans van Helvoirt. He shares a look at this popular paper analyzing the effects of epidural steroid injections on non-responders per MDT assessment. He explains what prompted this work, its clinical implications, how he uses it with patient education, the big takeaways, and recommended other work that would shed further light on this topic.
Season 1, Episode 5 with Audrey Long: An RCT of exercise for LBP
In Season 1 Episode 5 of Inside the Science I’m joined by Ms. Audrey Long, author of Does it matter which exercise? A randomized controlled trial of exercise for low back pain which was published in Spine in 2004. Although it’s over 15 years old it is a fundamental study for any clinician who evaluates and treats patients with low back pain. Being how common comparative effectiveness studies which show results where all the groups are improved but none more than the others, this study shows a different result. Comparing groups with a matched program to their directional preference, a non-matched program and a control group who received “evidence based” nondirectionally-specific exercises this trial revealed stark differences in patient responses. Hear Audrey acknowledge its limitations, how she uses this study with her patient education and how she’d encourage clinicians to be careful to not exaggerate its findings.