Treating Chronic Pain with Clinical Hypnosis| Ali Navidi
PT Elevated
EIM’s Dr. Ali Navidi is a licensed clinical psychologist and one of the founders of GI Psychology, a private practice focused on helping patients with GI disorders and chronic pain. He has been helping patients with GI disorders, chronic pain and complex medical issues for over ten years. He has comprehensive training in the use of clinical hypnosis and cognitive behavior therapy. Listen and learn more about clinical hypnosis and how he uses it to treat chronic pain. Helpful research and training: GI Psychology Website - Ad Info: If you want to keep learning beyond what you hear today,...
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Faculty Development | Angela MacCabe
PT Elevated
EIM’s Angela MacCabe is a physical therapist with over 33 years of experience. Through faculty development, she helps not only new faculty members transition but also clinicians transition from the clinic into academia. She developed the Faculty Certification in Academic Excellence, which is now available at Evidence In Motion. This online 6-month program takes anyone that is interested in academia through step by step increasing their knowledge and skills so that they are ready either to apply for a position or conquer the classroom. Listen to find out more! Helpful research and training: ...
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Override Health | Jennie Shulkin
PT Elevated
Jennie Shulkin is a lawyer, co-founder and CEO of Override Health, a multi-specialty chronic pain program. She was a division one athlete in college that suffered two traumatic brain injuries. Soon after she developed a complex chronic pain syndrome affecting multiple parts of her body. As best she could, Jennie continued living her life – pushing through Harvard Law School and building a career in law. All the while, she carried the burden of the agonizing, time-consuming, expensive, and both physically and emotionally painful journey of seeking pain relief. When each medication,...
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Is Residency Right for You? l Stephanie Pascoe
PT Elevated
EIM faculty Stephanie Pascoe talks about her current roles at EIM, her journey as a physical therapist and her current interest. She shares about her different experiences in residency programs, mentorship and gives more information about the Orthopaedic Physical Therapy Residency Program at EIM where she is the program director. Listen and learn more about residency programs and how one may be the right path for you. Helpful research and training: Orthopaedic Physical Therapy Residency Ad Info: Since you’re listening to this podcast, there’s a pretty good chance you’re the...
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Post-Professional Training Options | Mark Shepherd
PT Elevated
Mark Shepherd the director of the fellowship at Bellin College and faculty in the DPT program joins to discuss fellowship, research, lifestyle medicine and how to become an overall higher level practitioner. Listen and find out why Mark says fellowship changed his world when he started practicing and more. Helpful research and training: Ad Info: If you want to keep learning beyond what you hear today, EIM offers certifications that elevate your clinical decision making and take you to the next level of patient care and subject matter expertise. I encourage you to check out their website...
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Integrating Functional Dry Needling | Edo Zylstra
PT Elevated
EIM functional dry needling expert Edo Zylstra joins to share some of his expert FDN knowledge. He gives a history of how his FDN passion and expertise evolved, how FDN application and education has developed over the years, discusses integrating FDN as a clinician and more! Helpful research and training: Ad Info: If you want to keep learning beyond what you hear today, EIM offers certifications that elevate your clinical decision making and take you to the next level of patient care and subject matter expertise. I encourage you to check out their website and explore your different...
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Occupational Therapy and Chronic Pain | Megan Doyle
PT Elevated
EIM faculty Megan Doyle a practicing occupational therapist discusses occupational therapy’s role in chronic pain and how occupational therapists can be involved with patients to provide intricate care to help. She talks about when clinics can bring in an occupational therapist to help with a patient. Listen and find out more about occupational therapy and how it works together with physical therapy to help a patient. *Correction from Megan: I state in the interview that Lifestyle Redesign does not require additional training, but I have since confirmed that it actually does. I myself...
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Building Clinical Reasoning Skills | Zachary Walston
PT Elevated
Dr. Zachary Walston the director of quality and research and the orthopaedic residency coordinator at PT Solutions Physical Therapy discusses their orthopaedic residency program, what they do to build their clinicians clinical reasoning skills and how those things have evolved over time. Listen and find out how he has built his clinical reasoning skills and how PTs can build theirs. Helpful research and training: Ad Info: If you want to keep learning beyond what you hear today, EIM offers certifications that elevate your clinical decision making and take you to the next level of patient...
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Behavioral Health with Rehab Providers | A.J. Steele
PT Elevated
EIM faculty A.J. Steele a licensed psychologist discusses behavioral health and how both the physiological and social factors are impacting functioning clinicians. How does our behavior represent what we are thinking or feeling? How might the behavior be impacted by those things? Behavioral health is a piece of overall health and if looked at that way A.J. says it is easier to keep altogether instead of separated and look at as whole health. Listen to find out more about behavior health in the clinic. A.J.’s Clinical Pearl: Be patient with yourself in learning new things. Once we get a...
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Topics in The PT Profession Today | Tom Denninger
PT Elevated
EIM faculty Tom Denninger discusses topics that are top of mind for many physical therapists today like, patient choice, good physical therapy, burnout, and clinical decision making. Why are these topics relevant with PTs today? Listen and learn more. Helpful research and training: update Ad Info: Since you’re listening to this podcast, there’s a pretty good chance you’re the type of clinician who is always learning. One great way to learn more and earn CEUs is Evidence In Motion’s huge selection of courses. Choose from topics ranging from MSK management and pelvic health, to dry...
info_outlineWelcome back to season 2 of PT Elevated where we are broadening our topics to include more researchers but still focusing on topics that you can use in your clinic every day.
Our eighth episode of season 2 welcomes Dr. Steve George who is in the department of Duke University’s Orthopaedic Surgery and a member of their Clinical Research Institute. His primary charge is research where his focused has been in musculoskeletal pain conditions, cohort studies, clinical trials with low back pain and more! This week he discusses acute and chronic lower back pain as it is related to recent changes to the newest clinical practice guidelines that were recently released.
Here are some of the highlights:
Clinical practice guidelines are guidelines provided to assist in clinical decision making, not to take the place of clinician judgment. The new Clinical Practice Guidelines for back pain are a revision to the 2012 release focused primarily on intervention updates. Things to remind your students and learners are these are guidelines they do not necessarily override the 2012 guidelines.
“I still think there is value in structuring your decision making around things and it’s great when there is a lot of evidence to support them, you just have to temper it to support them when there isn’t as much evidence. I think the exercise in structuring your thinking is still super valuable especially for those people just getting started in the area. Clinicians need to understand that you have to have flexibility in decision making because nothing in their findings were clearly superior and they know that happens with back pain studies. There isn’t a huge difference in results in exercise or manual therapy trials for back pain in some areas of medicine if they saw these small differences, they would wonder what we were studying but we live in small to moderate effects and that makes decision making a little bit more challenging.”
Steve shared the search Process for updating the Clinical Practice Guidelines:
Process
1. Research Questions
-They decided to keep the questions for the clinical practice guideline update broader because they are covering a lot of area.
2. Gathering search terms
-They had the original search terms from the 2012 clinical practice guidelines and updated where needed.
-Focused on randomized trials
-Only looked at studies with PEDro scores 6 or higher
-Focused on trials where a PT was either delivering the treatment or they were in a PT environment.
3. First Draft
-Put together and sent out for external reviews
4. Submit final version
-Designed an Infographic and the summary of recommendations
Our hope is that people can use this as fuel to get an idea of what they want to do in their local health systems, in trying a new approach.
It was good to see some new themes popping up in this update like pain neuroscience education, cognitive functional therapy, and the prognostic risk stratification. A lot of this is moving away from the diagnostic model of treating back pain and moving into this management model that can be informed by prognosis.
Steve's Clinical Pearl – “I think remaining curious is so important. Asking good question and if you do not get good answers to your questions keep asking them. That is what drove me from moving from a clinical career to a research career. I was not the smartest person in the clinic. I was never voted most likely to do research, but I think when I got out and practiced, I think what bothered some of the people I worked with is just being curious and wondering why we were doing things one way. The focused curiosity. Secondly, I grew up in the non-patient centered era, but I learned so much from listening to my patients and viewing it as a bridge of my expertise with what their experiences were. Listening to your patients. Be curious not only about the patients that got better but the patients that did not.”
Helpful research and training:
Management of Lumbopelvic Disorders
Management of Lower Extremity Disorders
PTA Orthopaedic Skills Weekend Intensive
Ad Info: If you want to keep learning past what you hear today, Evidence In Motion offers certifications that elevate your clinical decision making and take you to the next level of patient care and subject matter expertise. I encourage you to check out their website and explore your different options. What’s cool is that you can get 5% off by letting your enrollment advisor know you’re a PT Elevated Podcast listener. Details and links to find the certification for you are in the show notes. I encourage you to check it out.
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