AAOMPT Conference Wrap
I got the chance to spend this past weekend at the annual conference of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). The event was excellent and my hat is off the the planners from AAOMPT who put together a seamless conference packed with incredibly useful programming, leaders in the field, pleasant receptions, and some awesome research platforms.
One of the more interesting moments occurred during the business meeting when a motion pass a position statement against referral-for-profit arrangements was passed without so much as a quip of debate. This, from a group who then proceeded to debate the appropriate use of the word "Evidence" vs. "Research" for more than 20 minutes! To me, this speaks to the ethical and rigorous standards the AAOMPT and its members are known to hold itself to.
This year’s conference marked the addition of a Student Association into the AAOMPT family (AAOMPT-SA). The
students who attended were well received and played a very significant role in the conference. Congratulations to them and to those students interested…join up! The networking and career growth that can occur from a conference like this is great.
Next year, we’re off to Seattle, Oct 29 – Nov 2. Convention center and all, it will be big time!
Images from Liz Sonnenberg
This story isn't so hip!
Some days it seems I need to search high and low for good blog fodder. On other days, the story seems to write itself.
Yesterday became one of those days when I clicked on the NEJM RSS feed in my reader. An article about the care and treatment of hip OA by Dr. Nancy Lane, was one of the new articles in this month’s issue of the New England Journal of Medicine. The editors obviously thought highly of the piece, because they attached continuing education credits for reading it if you were to take the following quiz. I was excited to see the medical community take a step toward reconciling their lack of musculoskeletal competence, however small, with this article.
The piece started off normally, with examination and interpretation of findings, but as the article progressed to treatment I found something sorely lacking. The physician writing the piece kind of skipped right over any details about a physical therapy intervention for this patient. Recommended were meds, an education program, and an aquatic exercise program. It wasn’t until the final conclusions that the term "physical therapy" actually makes an appearance and the term "joint mobilizations" was absent altogether. Dr. Lane did include acupuncture and "periodic telephone-support interventions by lay personnel" as treatments with supportive evidence, however.
A recent editorial in JOSPT (Journal of Orthopaedic and Sports Physical Therapy) thinks quite differently about how to treat an arthritic hip. In "First-Line Interventions for Hip Pain: Is It Surgery, Drugs, or Us?" Wainner and Whitman discuss exactly the patient population which the NEJM article presents. Their editorial outlines a variety of compelling evidence about the under-utilized, yet effective role physical therapists play with this patient population.
I’m not surprised that the Dr. Lane presumably had not read their editorial. After all, what motivation does a physician have to keep up with PT literature? Especially when they are so busy working as a consultant:
"Dr. Lane reports receiving consulting and lecture fees from Eli Lilly,
Merck, Procter & Gamble, Wyeth, and Roche and grant support from
Procter & Gamble, Amgen, and Rinat Neuroscience."
Which is another story in itself!
Hey, everyone’s got to make a living right? Regardless of who pays who and for what, the bottom line is that there is a standing lack of respect for Physical Therapy literature. Perhaps we speak "gibberish" to the docs, perhaps they don’t have the construct to understand manual therapy interventions, perhaps it is more of an institutionalized opinion among physicians that contributes to this oversight. Whatever the cause, I can only presume that more good evidence, from our group to theirs, can only help our cause.
Until then, I’m thinking of sending Dr. Lane an e-mail to let her know about how effective physical therapists can be with this patient population.
ERIC
Chicago Marathon Disaster
Yesterday, the Chicago Marathon turned deadly, killing one and sending hundreds to the hospital. The race was run in record heat and quite possibly without enough beverages for runners. The race was halted after 3 1/2 hours for safety.
Some quotes from the race:
"I had no water until Mile 8," said Blayne Rickles, 57, of Denver.
"There were people falling all over the place," said Rob Smith, 40, of Naperville, who was running his first marathon."
A hot fall is obviously problematic when it comes to the dangers of heat. In most cases, your body has adjusted to several weeks of cooler weather during training and is simply in a poor position to cope.
As terrible as this run turned out to be, there is one theory that suggests the fatigued runners simply had to stop and put up their feet. I’m not so sure about that.
There was actually some grumbling about the need to call the race from some runners. I can appreciate their disappointment, but as someone who has completed a mountain bike race with a stick impaled through my hand, I also understand that competitive people in a competitive environment often need some help making the right decisions.
Perhaps that is the most important and dangerous part of the effects of heat and fatigue: a reduced ability to make the right decisions. This piece suggests the reason is that fatigue causes you to re-route more of your cognitive functions towards the movement and less away from your decision making. Perhaps not quite that simple…
ERIC
USC Ranked #1 Against the Bugs!
Sometimes you just meet a winner. The impressive collection of on-field success over the past several years by the USC football team certainly earns them the right to be considered winners. How far does that culture of winning extend? USC has accomplished a victory over antibiotic resistant (MRSA) bacteria which most hospitals could only hope to pull off in their dreams.
"…the Trojans defeated crafty drug-resistant staph bacteria that landed
two players in the hospital in 2002 and led to 11 confirmed infections
and six suspected cases in 2003."
A little hygiene is sometimes credited as one of the factors integral to the success of our species on this planet. In this case, the good sanitary habits might be responsible for saving the locker room and helping to earn the national championship!
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