Leveraging Technology V: Beyond RSS to Engagement

This is the 5th in a series of posts investigating how to leverage technology:

  1. RSS and Web2.0
  2. Google Reader
  3. Selection of Content
  4. Blog Reviews

In the previous blog posts I have outlined how information is pushed directly to you via RSS feeds and Web 2.0. I explained how to access information from journals and blogs without searching the net. I even discussed which journals and blogs you may want to follow and why. But, to truly engage, retain, critique, and apply this information to our clinical practices and research we must move beyond just reading. We need to discuss and analyze and integrate….but…

How do we do this when we are sitting by ourselves on a computer? There are a variety of built in tools that we can utilize to accomplish this within Google Reader, in the comments sections of blogs, via Twitter and Facebook. Most of the technology presented in this post series can be linked and utilized simultaneously. All of this from you office, laptop, tablet, or smart phone. In this post, I have bolded words, phrases, or concepts that I think are important throughout this post. This includes the concept of “pushing” information, modifying a tweet, micro-blogging, and discussion via blog comments.

The exact topic of blogs and the discussions stemming from them was recently written about on the CasesBlog: Medical and Health Blog. In the post, Blogging is good for you – and for most people who read blogs it is stated:

The back-and-forth between bloggers resembles the informal chats, in university hallways and coffee rooms, that have always stimulated economic research, argues Paul Krugman, a Nobel-prize winning economist who blogs at the New York Times. But moving the conversation online means that far more people can take part.

The post links to an article from the Economist Website titled Economic Blogs: A less dismal debate. Interestingly, they assert that papers that are blogged about and/or authors who blog may be considered more respected:

Academic papers cited by bloggers are far more likely to be downloaded. Blogging economists are regarded more highly than non-bloggers with the same publishing record.

I wonder if in the future, features such as track back or blog presence will be utilized to calculate a journal’s impact factor or rate researchers and academics.

TWITTER, with it’s 140 character limit for tweets and profile descriptions, is truly a micro-blogging medium. Everyone who is on Twitter is a micro-blogger. It forces succinct communication. Twitter offers a variety of opportunities and ways to access and discuss information. Obviously, you can read the tweets and go to the links that others post. You can reply to tweets to initiate a dialogue. RE-TWEET is when you tweet someone else’s tweet with RT before their twitter handle (name).

Here I re-tweeted @BodyinMind’s link about research and blogging. The link is the article I mention earlier in the post.

Now, you can also tweet a MODIFIED TWEET (MT). Essentially, with an MT you are changing or editing the content or message of a tweet. Below is an original tweet about manual therapy from @DenverDPT regarding manual therapy effects from the 2011 AAOMPT Annual Conference:

Original Tweet
My modifications

I then modified the phrasing and content to deliver a similar, but more specific message based on my understanding of manual therapy. I preceded the tweet with MT to communicate that I had modified an original tweet by Denver Lancaster.

I view FACEBOOK as a personal mini-blog. Links, videos, and articles can be posted with ease. Similar to a blog, friends can comment and discuss. Through pages, individuals can connect on a specific topic, cause, or organization. For example, the American Academy of Orthopaedic Manual Physical Therapists has a Facebook Page: AAOMPT Facebook Page. Beyond networking and professional connection, Facebook is an also a means to access, read, and talk about information.

It is not necessary to have your own BLOG to utilize the medium to discuss and learn. You can utilize BLOG COMMENTS to write your insights and questions. If you disagree with a conclusion you can formulate a more thorough, researched response. Often, I find myself more intrigued and challenged by the discussion that happens in the comments section of a blog post. Especially if you do not publish your own blog, posting well researched and thoughtful comments is essentially blogging! You can have online discussion with links to other blogs, research articles, and online resources with the blog’s author and commentors. Professionals, researchers, and students from across the world can have in-depth, passionate debates at their convenience. Want to stay plugged into a debate? Many blogs offer the option to SUBSCRIBE TO COMMENTS via e-mail or RSS. You will automatically be alerted when a new comment is posted.

After dabbling in blog engagement, you may even desire to publish your own blog. This process is actually quite simple. There are many free resources including Blogger and WordPress. Blogger is Google’s free blog hosting service. A very professional looking blog can be started in an afternoon utilizing free templates and helpful layout designs. As I have mentioned previously, I am disappointed in the lack of blogs surrounding neurologic and acute care physical therapist practice. I remain hopeful that this segment will grow.

PUSHING is an interesting concept in the current social media landscape. All of us has experienced pushing whether we realize it or not. E-mail is a pushing service. Information is pushed to our in-box, and we push information to others. As discussed in previous posts, we utilize Google Reader to have information pushed directly to one location (our RSS Reader). Further, information chosen specifically by our Facebook friends and the tweeps we follow on Twitter is pushed automatically to our news feeds. Conversely, we can push information between our social media accounts through certain applications or linkages. For example, I have a twitter application that allows me to push any tweet to my Facebook account by putting the hashtag (#) FB at the end of my tweet > #fb.

Some pushing and linking features are automatically available. You can “like” an item on Google Reader and then make comments. Then, individuals who follow you on Google Reader can see your comments. Information can be pushed or shared directly from Google Reader to Facebook and Twitter (via the “Send To” button). A post can also be made directly to Google+. There is even a button to e-mail the link!

Most journals are now publishing content and articles online before the print version of the journal is available. E-PUB AHEAD OF PRINT simply means that article was electronically published online ahead of the print version. Journals, including Physical Therapy Journal, even have RSS feeds for E-Pub content. Now, people can blog, comment, Tweet, and Facebook about articles before the print version is published. By the time someone who subscribes to a print journal reads an article, it has probably arlready been shared, critiqued, analyzed, and discussed for weeks to MONTHS.

Interestingly, as widgets and applications evolve the line between various forms of social media and Web2.0 principles becomes more blurred. For example, Twitter feeds and tweets can be seamlessly integrated on the sidebar of a blog. Applications allow for the automatic pushing of tweets to Facebook profiles. And with tools such as HootSuite you can control both from one dashboard. Many Twitter applications allow the scheduling of Tweets into the future, so you do not overload followers with 1,249 tweets in 5.9 seconds. Facebook also allows users to create a badge, or snapshot, to have the sidebar of blogs.

Imagine networks of students, researchers, and clinicians connecting through Google Reader, Twitter, Facebook, and blogs to diseminate and discuss research, blog posts, newspaper articles, and legislation. Imagine the proliferation of professional networking, learning, and discussion. The potential exists for clinicians to collaborate remotely on patient care and research projects. If you have not already, check out PHYSIOPEDIA. Physio-pedia is the model for the future fusion of technology with education, learning, and research.

All of these tools have the ability to elevate our individual knowledge base, care delivery, and research. On a grand scale, it gives us the opportunity to improve professional growth and patient care for all regardless of geographical location. I imagine technology integration and colloboration as the basis for the future of “continuing education” and professional learning…

I envision a future where professionals from across the globe are accessing, disseminating, discussing, critiquing, and even performing research and clinical practice.

In the next post, I will illustrate these principles from a real life scenario. As a preview, I responded to a Tweet that linked to a performance and injury risk reduction program aimed at decreasing ACL injury rate AND improving performance. In that interaction, I utilized and pushed an article via Google Reader to Twitter. I was able to engage in a virtual conversation with a handful of individuals regarding the topic. After I present the interaction, I will discuss and analyze the encounter and research evidence surrounding the specific topic of ACL injury risk reduction and performance improvement.

Leveraging Technology IV: Blogs

So, this series has had a long, long hiatus between posts for which I apologize!! Time to start the new year off right. This is another dense post with a ton of resources and links. I hope you enjoy. In the previous post, I presented which research journals publish the most and highest quality clinical trials of interventions. I also discussed what research journals we should consider following. The preceding posts in this series were:

  1. Web 2.0 and RSS
  2. Google Reader
  3. Selection of Content

But, research journals are not the only way for us to engage information relating to clinical practice and scientific research. Blogs are another great online resource. With the advent of Web2.0 principles physical therapists, students, and researchers from around the world can critique research, discuss science, and debate clinical practice through the blog format (And, the micro-blog format such as Twitter, but more on that in the next post!). Disagree with a bloggers interpretation of the evidence? Comment on the post! If utilized civilly and with proper logic blogs (and social media like Facebook and Twitter) are a great platform for learning, discussing, and reviewing. And, as I have mentioned in previous posts with RSS feeds the information is pushed directly to you. Then you decide what to skip, what to skim, what to read, what to push forward through Twitter or Facebook and what to comment on!

There are many blogs relating to physical therapy, rehabilitation, training, science, exercise science, training, and research. I stumble upon new ones all the time. Some of them are great, some are bad, and some are just ugly. Below I am going to review some of the blogs that I follow.

I love the interactive nature of the blog format. You can participate in high level discussions regarding research and clinical practice from anywhere in the world. This type of crowd sourcing has the potential to elevate our knowledge dissemination, discussion, and growth. In fact, the proliferation of blogging and micro-blogging will (I believe) fundamentally change not only how information is disseminated, but how we learn, discuss, and collaborate on clinical care and research.

For each blog, I have included the title/subtitle hyperlinked to the actual blog as well as the author(s) twitter handle with a hyperlink to their twitter profile. Please comment on your thoughts of these blogs.

What blogs do you follow? Let us know in the comments section! Speaking of, follow @PTThinkTank as well as all the authors, including the creator @EricRobertson and humble contributors @MPascoe and @Dr_Ridge_DPT


I have to start off with some student blogs. As a student this is how I became exposed to and involved with leveraging technology!

AAOMPT sSIG: Blog of the Student Special Interest Group of AAOMPT

The AAOMPT sSIG Blog is where I got my start blogging about such issues as the doctor of physical therapy degree, direct access, physician owned physical therapy services, and grass roots political advocacy. The blog provides information on the happenings of the student special interest group. If you are a student, or know a student, send them to the blog for more information on getting involved in the sSIG. It is a great group of motivated, high energy students. Unfortunately, the AAOMPT sSIG is not on twitter, but you can e-mail the students directly with comments, suggestions, and questions: ssigaaompt@gmail.com

Colorado Student Physical Therapy Advocacy: Act now to protect the future of your profession

Author: @COSPTAdvocacy

I may biased since these students are from my Alma Matter, but these students are truly organized and accomplished. Not only did they WIN the APTA’s Student Advocacy Challenge they are leveraging technology through Blogger, Twitter, and Facebook to create a sustainable and visible student movement.

Below are some of the blogs that I regularly read and definitely have in my RSS Feed. Most of them deal directly with physical therapist practice, and are authored by physical therapists. Others are authored by other professionals, but still very applicable to physical therapy. Enjoy!

Better Movement: Learn to Move with More Skill and Less Pain

Author: @ToddHargrove

Todd is a Seattle based Feldenkrais Method movement instructor who used to be a lawyer. He writes about a neurocentric approach to movement, training, and pain. In Both Sides Now, he discusses research investigating the training, or treating, one side of the body and the effect on the contralateral side.

Body In Mind: Research into the role of the brain in chronic pain

Authors: @bodyinmind @NeilOConnell

This is the blog of Lorimer Mosely and crew out of Australia. They provide research summaries and discussions regarding the mechanisms of pain and the treatment of chronic. Probably one of the most robost blogs on the net regarding pain physiology and current research. Why Things Hurt is an outstanding Tedx video by Lorimer Moseley on the neurophysiology of pain. They even discuss if Chronic Pain is a Disease.

Categories: Pain Science, Chronic Pain, Neuroscience, Physiology, Research

Leaps and Bounds: Perspectives from a physical therapist

Author: @ForwardMotionPT

Corey provides unique insight into physical therapist practice, and is obviously a very deep thinker. He has produced many videos illustrating the use of novel movements of various body regions. Here is a great post about The Movement Diet.

HealthSkills: Skills for health living for health professionals working in chronic pain management

Author: @adiemusfree

Healthskills is a blog for health providers who want to read about research related to self managing chronic pain. Topics include chronic behavior therapy, measuring outcomes, patient education, and many other topics. The author was originally trained as an occupational therapist. In this post, she discusses what to do when a patient is “inconsistent” with their pain behavior or presentation.

Categories: Pain, Chronic Pain, Cognitive Behavior, Clinical Treatment of Pain

The Manual Therapist: Promoting the highest level of physical therapy practice

Author: @The_OMPT

Dr. E posts very regular providing links to other blogs (including this one, thank you!), videos on techniques he uses, clinical cases, and clinical reasoning. He has a very expansive background being both a fellow of AAOMPT and MDT diplomat. See the post What is the Mechanism Behind Rapid Change? for a discussion we had regarding mechanisms of manual therapy. (Here is the comments section)

Mike Reinold: Rehab | Sports Medicine | Performance

Author: @mikereinoldblog

The most up to date information related to evaluation and treatment of athletes, specifically overhead athletes. Good citation of clinical research for evaluation and exercise treatment. Lots of links to different courses/products. Mike is the head of athletic training for the Boston Red Sox, and is well published on issues regarding the shoulder and injuries in throwers. In the post Rotator Cuff Fatigue Increases Superior Humeral Head Migration, Mike discusses the importance of not training the cuff to fatigue.

Categories: Athletes, Shoulder, Knee, Sports, Orthopaedics

Move It: The New Professional’s Collaboration Blog

A group of young physical therapists (<5 years experience) discuss clinical practice, clinical development, and issues regarding being a new professional. It has been a while between posts, but they have some excellent content. Check out A Generation with Challenges, Vision, and Debt.

Categories: Young Professionals, Professional Development, Legislative Advocacy, Professional Issues

My Physical Therapy Space: Evidence in Motion Blog

Authors: @EIMTeam

The blog of the Evidence of Motion crew. Great information regarding private practice, legislative issues, and research pertaining to orthopaedics. Discussions regarding the overuse of imaging and surgery, as well as the how physical therapists can provide value to society and healthcare. In a Blast from the Past, John Childs illustrates how some clinicians and researchers cling to old models of pain and treatment despite evidence to the contrary. Tim Flynn discusses how access to early, cheap care (physical therapists!) for low back pain is Not Rocket Science, and could have HUGE implications for our society. Larry Benz deconstructs poor logic about Physician Owned Physical Therapy Services (POPTS) that appeared in Advance Magazine.

Categories: Professional Issues, Private Practice, Orthopaedics, Research, Professional Development

The Sports Physiotherapist: Resource for physiotherapists (or physical therapists) with a passion for assessing, diagnosing, and rehabilitating the sports injuries of the world’s athletes

Author: @TheSportsPT

Extremely well cited articles discussing the evaluation, assessment, and treatment of athletes including surgical approaches and their implications on rehabilitation. Their blog and website is maybe the most comprehensive sports physical therapy resource on the net. In this post, they review the diagnostic accuracy of tests used to identify Acetabular Labral Tears of the Hip.

Categories: Sports, Athletes, Research, Examination

Physical Therapy Diagnosis: Make Decisions Like Doctors

Author: @timrichpt

Private practice owner in Florida discusses clinical decision making as well as leveraging decision support tools/software. Lots of discussion of Medicare flaws, clinical decision making, and issues in private practice. Tim recently authored a book detailing bullet proof decision making processes to improve documentation and efficiency in outpatient practices. Tim presents The Art and Science of Physical Therapy by analyzing the Oxford Debate from the American Physical Therapy Association’s Annual Conference in 2011

Categories: Private Practice, Legislative Issues, Clinical Decision Making, Outpatient

Save Yourself: Science powered advice about your stubborn aches, pains, and injuries

Author: @painfultweets

A massage therapist by training who turned to science focused blogging regarding painful problems. Skeptical analysis of pain, pain syndromes, and treatment techniques. Great information for patients and practitioners alike. Although I very much respect Paul’s work and critiques, there is a very apparent bias towards trigger points as a significant pain complaint and treatment target. Paul talks about MRI Overuse and how MRI is too sensitive of a diagnostic tool. He also does a nice job of summarizing some of the Science Surrounding Stretching.

Categories: Pain, Chronic Pain, Manual Therapy, Science

SomaSimple: The so simple body. A place for physical & manual therapy.

@SomaSimple Contributors: @jasonsilvernail @dfjpt @BarrettDorko @wrtrohio @JohnWarePT @ForwardMotionPT among others

You will not find a more thorough or logical analysis of manual therapy, physical therapy, and their relation to people with painful problems anywhere. The folks over there are true skeptics in their thought process, and challenge all. Be ready to be challenged, even if all you do is read the forums! This site is such a density of information and discussion you could read for months. Whether you troll or join in on the discussion it will deepen your analysis and understanding of pain, pain physiology, and clinical practice. Enough is Enough is a well written piece by Jason Silvernail talking about how we need to stop looking for the magical technique or tissue and focus on deeper models of understanding pain. In Crossing the Chasm, he absolutely shines in his ability to tie current clinical research to a deeper, neurophysiologic understanding of pain as he describes his process of evaluation and treatment utilizing sub-grouping in low back pain.

Categories: Pain, Neuroscience, Discussion Board, Manual Therapy

The blogs above are more specific to physical therapy principles. But, it also useful to engage information from other disciplines or sources. For example, decision making, principles of science, behavior, and psychology are all integral parts of physical therapy practice. These topics relate to how we treat patients, but maybe more importantly how we make decisions and analyze/integrate literature.

Science Based Medicine: Exploring issues and controversies in the relationship between science and medicine

I believe this is a must read blog for all health care professionals. It discusses the application of scientific principles to improve evidence based practice. These principles include prior plausibility, physiologic plausibility, and an increased focus on the integration of basic science into the understanding and practice of medicine. Although, much of it is not related directly to physical therapy, the lessons and principles discussed are applicable to research interpretation and clinical practice of all health care professions. In fact, physical therapists receive a mention in the post Subluxation Theory: A Belief System that Continues to Define the Practice of Chiropractic.

Check out these posts:

  1. About Science Based Medicine
  2. Announcing Science Based Medicine Blog
  3. Does Evidence Based Medicine Undervalue Basic Science and Overvalue Randomized Control Trials?
  4. Is it a Good Idea to test Highly Implausible Health Claims?

Eric Cressey: Performance and health on a whole new level

A personal trainer with a masters degrees in kinesiology with a highly successful persontal training facility targeted towards baseball players. Collaborates with Mike Reinold. Although targeted for personal trainers and fitness specialists, he provides amazing information on training athletes that is very applicable to physical therapists.

Very detailed information about the training of high level athletes especially baseball players. Eric exhibits in depth understanding of kinesiology, training, and anatomy specifically as it relates to baseball players and overhead athletes. Although, he does seem to have a poor understanding to mechanisms and effects of manual therapy and at times “plays doctor” in regards to client’s pain complaints. In How Much Rotator Cuff Work is Too Much? Eric discusses the implications of training the rotator cuff in throwing athletes both in season and during the off season. He highlights the fact that many throwers overuse their cuff musculature.

Categories: Sports Training, Baseball, Shoulder


  1. Do you read any of the blogs above? If so, what is your critique?
  2. Did we miss a good resource? Please comment and enlighten us!
  3. Do you have a blog? Comment with a link and a brief summary!

Unfortunately, there seems to be a lack of physical therapist focused blogs relating to in-patient acute care, neurologic physical therapy, and in-patient rehabilitation (hint, hint, any takers??). Most focus on outpatient, orthopaedics, sports, and private practice.

I hope you have enjoyed the leveraging technology series thus far! We have covered a ton of information as these posts are are very dense. The next post will discuss the use of social media tools including Twitter, Facebook, and Blog comments to move beyond RSS into active sharing, discussion, and engagement of information! Remember, we always value your feedback and comments.

@Dr_Ridge_DPT

Leveraging Technology III: Selection of Content

In the first two posts of this series I discussed the concepts of RSS and Web 2.0 as well as detailing the set up of Google Reader.

  1. The Basics: Web 2.0 and RSS
  2. Google Reader

This post will discuss which journals we should be following and reading as physical therapists. Obviously, there is Physical Therapy Journal as well as population and practice area specific physical therapy journals published by the sections of the American Physical Therapy Association:

Click on the picture to visit the Acute Care Section’s Website!

Definitely subscribe to some (or all!) of those journals via RSS. Remember, if the journal website does not have an RSS icon or url, you can create an RSS  for a PubMed search for that specific journal. I outlined how to do this in my previous post.

Following physical therapy specific journals seems quite obvious. But, an interesting article published in Physical Therapy Journal detailed some specifics regarding journals that publish physical therapy and rehabilitation specific trials. The article, Core Journals that Publish Clinical Trials of Physical Therapy Interventions, analyzed journals that published clinical trials of physical therapy interventions. The journals were then ranked by

  1. Total Number of Trials
  2. Quality of Trials ranked via PEDro Score
  3. Impact Factor

Most Trials of Physical Therapy Interventions

  1. Archives of Physical Medicine and Rehabilitation
  2. Clinical Rehabilitation
  3. Spine
  4. British Medical Journal
  5. Chest

Highest Quality Trials Based on PEDro Score

  1. Journal of Physiotherapy
  2. Journal of American Medical Association
  3. Stroke
  4. Spine
  5. Clinical Rehabilitation

Highest Quality Trials from 2000-2009

  1. Journal of Physiotherapy
  2. Journal of American Medical Association
  3. Lancet
  4. British Medical Journal
  5. Pain

Highest Impact Factor: 2008

  1. Journal of America Medical Association
  2. Lancet
  3. British Medical Journal
  4. American Journal of Respiratory and Critical Care Medicine
  5. Thorax

The authors conclusions:

  • Physical therapists must read more broadly than physical therapy specific journals
  • High quality trials are not necessarily published in journals with the highest impact factor

Surprised? The only physical therapy specific journal is the Journal of Physiotherapy, which is published by the Australian Physiotherapy Association.

NOTE: Take into account the data is only in regards to Randomized Control Trials (RCT’s) of interventions. It does not include information regarding articles on basic sciences, physiology, or neuroscience. Further, it does not include case reports, clinical perspectives, and other manuscript types. Regardless, it provides us with guiding information on where we should be looking for research to guide our practice and understanding. In addition, I believe it reiterates the point that we need to continually look to other areas of research to deepen our mechanistic understanding of physiology especially neuroscience. I think it is absolutely imperative we stay up to date on basic science research especially as it relates to neuroscience, the physiology of pain, and exercise science.

For example, in October of 2009 Critical Care Medicine devoted an ENTIRE supplemental issue to Intensive Care Unit Acquired Weakness (ICU-AW) including clinical and physiologic studies examining neuromuscualr impairments, clinical examination, and clinical treatment. In all, there were 20 articles, reviews, and manuscripts in this supplement. That sounds like something a physical therapist practicing in acute care should follow!!

Now, although Physical Therapy Journal failed to make the Top 5 in any of the categories above a recent investigation in Journal Citation Reports gave PTJ high marks: #1 Among physical therapy specific journals. #3 Among ALL rehabilitation journals. #7 of 61 Among orthopaedic journals. Please visit this post via PT in Motion: News Now for a summary. Paul Ingraham, a massage therapist and writer covering science based pain care over at Save Yourself, compiled his own Top 10 List based on the results of the PTJ study. His list is very similar to the ones above.

Below you will see journals that I think are applicable to clinical practice and scientific understanding. I organized them by a few practice areas and topics. I also provide the RSS link next to the journal name. I did not include any of the physical therapy specific publications, but the links to those journals are earlier in the post. In the instances where the journal does not have an RSS, I have included an RSS for the PubMed search for that particular journal. If you want to follow any of the journals below all you have to do is copy and paste the RSS url into the ‘Add Subscription’ box of google reader! I have also hyperlinked to the journal websites, so please also visit the journal websites to explore other potential RSS options on content including online ahead of print and podcasts.

General Clinical Practice and Basic Sciences

Medical Journals

Acute Care

Neurologic

Orthopaedics: General

Manual Therapy

Sports

Now, this is not an exhaustive list. Depending on your practice area and the populations you work with other journals may be more applicable. For example, if you work at a rehabilitation hospital that specializes in the treatment of spinal cord injury Spinal Cord and Journal of Spinal Cord Medicine are obviously more applicable journals. Also, I did not include lists for Pediatric, Geriatric, or Women’s Health practice areas. But, if you practice in these areas or have suggestions please provide us some information by leaving a comment!

Hopefully, the information and journals listed were helpful. Spend some time over the next week analyzing which journals you subscribe to, follow, and read. Ask yourself “WHY?”

  • What journals do you read?
  • What would you add to the above lists?
  • What did I miss?

In the next post, I will provide a brief overview and evaluation of some of the blogs I follow. Do you have favorite blogs that you read? Please comment and let us know. Stay tuned!

Leveraging Technology II: Google Reader

In the last post, I introduced the basics regarding RSS and Web2.0. In this post I will go over how to set up and utilize Google Reader, a specific RSS reader. Watch the video below for a an explanation and visual demonstration of Google Reader:
Google Reader in Plain English by Google

Before you can use Google Reader, you must have a google account. If you have a gmail e-mail address or use any of the other products from the google suite including calendar or documents then you already have a google account. Once you are logged into your google account find the link to “Reader.” This link lives either on the top menu or under the “More” drop down menu.

Click the “Add a Subscription” button!

The ‘Add a Subscription‘ box of of Google Reader is where you paste RSS feed urls. Once added, the RSS feed delivers new content from the website directly to your Google Reader: Your Internet Inbox! (FYI > click on any of the images in the post and bigger version will appear in a new window)

Now, adding RSS Feeds from your favorite websites, blogs, and journals is very easy. There are 2 ways to add feeds.

  1. Click on the RSS Icon of a website
  2. Search for RSS Feeds in the ‘Add a Subscription’ box

Most websites, including blogs and major journals, will have an RSS icon. Click this icon to access the url for the website’s RSS feed url. Some websites, such as Physical Therapy Journal, have multiple RSS options.

Physical Therapy Journal has multiple RSS options. You can subscribe to current issue, ahead of print e-publication, case studies, commentaries, etc.

When you click the RSS icon it may take you to a page that looks like code and/or a preview of the RSS feed. If this is the case, copy and paste the url. Or, it may have a bunch of buttons, one of which says ‘Add to Google Homepage’ or ‘Add to Google Reader.’ If that is the case, then click the ‘Add to Google Reader’ button.

Click the Add to Google Reader button!

Clicking the button will either add the feed to your google reader and/or open the RSS feed in google reader (as if you had found it through the add a subscription search box). Do not forget to click ‘add a subscription’ button! The ‘Add a Subscription’ box doubles as a search. You can type in keywords to search for RSS feeds of websites that match your topic, and easily add them to your Google Reader line up.

Unfortunately, not all journals have RSS feeds (what?!). For example, the International Journal of Sports Physical Therapy does not have an RSS feed for new content, issues, or articles. Luckily, there is an easy fix to this. You can turn any PubMed search into an RSS feed.

Turn any PubMed Search into an RSS feed including topic specific, author, or journal. Have new results automatically pushed to Google Reader!

To construct a specific search for journal click the advanced link which will take you to a new window. Under the heading search builder there is a drop down containing such search options as author, journal, title, or abstract. Select the journal option and then type the journal name in the search box. Once the search is complete click on the RSS link, which conveniently has the orange RSS symbol to the left. This will pop out a box with some options for the RSS feed including what you want to name. Click “Create RSS” once your have picked your settings. An orange box labeled “XML” will now appear. Click on this to obtain the url for your new RSS feed. Then copy and paste this url into the add subscription box of Google Reader. Now, you the results of a PubMed search delivered right to you. Remember, you can create an RSS feed for any search including author, journal, or topic!

Click the Create RSS button, and an orange box labeled XML will appear. This is the url for the RSS feed of your PubMed search.

That’s the basics for Google Reader. Be sure to play around with the different options. You can create folders, edit feed names, and share items with people who follow you on Google. Check out the videos below for more in depth demonstrations and explanations of Google Reader. In our next post, I will discuss which Journals we should be following and why. Some of the recommendations may surprise you…

In the video below, our very own Mike Pascoe demonstrates using Google Reader including how to make an RSS feed for a specific PubMed search.

Monitoring Physical Therapy Research Using Google Reader from Mike Pascoe on Vimeo.

For a very detailed explanation of how to set up and start using Google Reader, watch the 10 minute video below.
Google Reader: Getting Started by Capture the Conversation

Leveraging Technology I: The Basics: Web 2.0 and RSS

Via The Power of Media Blog. Click image to visit.

Last week, I gave a 30 minute demonstration and lecture to students illustrating how to utilize RSS and RSS Readers, specifically Google Reader, in accessing research, information, and discussion specific to physical therapy students and clinicians. The next series of posts will explain:

  1. Basic concepts of RSS and Google Reader
  2. Selection of content: Which journals we should be reading and WHY
  3. Review and critique some of blogs that I follow
  4. Finally, discuss the use of social media and Web 2.o principles, including Twitter, to not merely access information, but engage in critique, debate, and discussion.

Web 1.0 to Web 2.0

In the beginning, Al Gore created the internet. And, that internet was very much like navigating our highway system. You merged on, with or without a map, and started exploring. You searched, found, and read relatively stagnant content published by others. If there was a website you enjoyed you added it to your bookmarks folder. Then you had to visit the website regularly to check for updated content. That is Web 1.0. With the rise of blogs, Facebook, and now Twitter, users are not just recipients of content. Now, users can edit content (i.e. commenting on a blog or news article) and create content (i.e. Facebook and Twitter). This is Web 2.0: User generated content. Engaging, critiquing, editing, adding, and publishing content in real time!

What is RSS?

RSS stands for Real Simple Syndication. RSS is a specialized URL (usually ends in .xml) that feeds information from a website to an RSS Reader. It is a way to receive information from a website without actually visiting that website. For example, a podcast is a type of RSS feed that has an audio file at the center of each new post. Research journals and blogs all usually have RSS feeds.

What is an RSS Reader?

An RSS Reader, or Aggregator, is a software program that collects and displays information pushed from RSS links/feeds. A reader is similar to an e-mail inbox, except this is an inbox for the internet! No more bookmarking or remembering [forgetting] to visit different websites, journals, blogs, and online resources. The RSS Feed pushes new information to your RSS Reader allowing YOU to stay automatically updated on any new content from a blog, research journal, website, or even a PubMed search. Journals, blogs, websites (like ESPN), and most online resources now have RSS feeds.

There are browser-based readers and desktop based readers. Many readers also feature mobile apps, allowing you to access your RSS Reader Information on your smartphone. I utilize Google Reader, but of course there are other options.

Why RSS?

RSS Feeds and Readers save time and energy by pushing information directly to you. You then decide what to skim, what to skip, what to read later, and what to read now. There is absolutely no way you could access the same amount of information by surfing the net and bookmarking. RSS allows you to organize an inbox for the internet which broadens not only the volume, but the perspective of information you engage, share, and participate in. The scope of information pushed to you is limited only by your imagination. Plus, you only have to add an RSS to your reader once!

That is the basics regarding RSS. Hopefully, if you are not already utilizing RSS this outlined some of the advantages. The next post in the series will detail how to set up Google Reader.

Resources

  1. What is RSS? on ProBlogger.net
  2. Information to YOU! RSS and RSS Readers on AAOMPT Student Special Interest Group Blog
  3. RSS Info Detailed website dedicated to RSS information and history
  4. RSS Feeds for Physiotherapy by Rachael Lowe

Videos

  1. RSS In Plain English
  2. Getting Started with Google Reader
  3. Monitoring Research using Google Reader by Mike Pascoe [includes how to make a pubmed search into an RSS feed]

Post Series: Leveraging Technology for Research, Evidence, and Discussion

Via www.problogger.net What is RSS? Click image to link to post!

This week I will be giving a lecture in the Scientific Inquiry course at the Physical Therapy Program of the University of Colorado Anschutz Medical Campus. Recently Mike Pascoe posted about Papers a Mac based application that allows for streamlined organization of PDF’s.

My talk will focus on how to utilize Real Simple Syndication (RSS) Feeds and Readers (such as Google Reader) to improve access and engagement of information. This includes information from journals, blogs, websites, and even pub-med searches pushed directly to you. I have written about this topic before at the AAOMPT Student Special Interest Group in a post entitled Information to You! RSS Feeds and RSS Readers. That post detailed how to set up Google Reader and gave a list of some blogs/journals.

Afterwards, I will also publish a series of posts about how to utilize various RSS tools. It will focus on RSS feeds and readers from set up through advanced use. I will also outline why you should be following and reading specific journals. Then, I will provide critiques of various blogs. Twitter and Physiopedia will be briefly discussed. Lastly, I will outline how we can improve our discussion and scientific debate through these tools with an eye towards the future. This is not a new topic, but I hope to bring a lot of information together to aid in how YOU leverage online tools for learning, debate, and collaboration. If you have any specific requests, please comment!

These tools allow individuals from around the world and across various disciplines/specialities to share information. Further, as Mike Pascoe mentioned in his recent talk regarding twitter, journal articles are being critiqued before the print version has even been released!

Via Flickr: Courtesy of Laurel Papworth & Gary Hayes at laurelpapworth.com and personalizemedia.com

We are truly in an exciting time. Online tools and collaboration in medicine and health are approaching a tipping point. We can leverage these tools to improve physical therapy, medicine, and the entire health care system from education to research to patient care to patient education to documentation to inter-professional communication…

The AB783 Story Continues

PT in Motion News Now now alerted me that AB783 has been re-scheduled for hearing on Monday June 27th. This bill will be heard in the California Senate Standing Committee on Business, Professions, and Economic Development.

The drama surrounding AB783 has taken some interesting turns over the past few weeks.

  • June 13th: AB783 fails to pass out of committee with 3 yes votes, 2 NO votes, and 4 abstains
  • June 20th: Mary Hayashi pulls the bill from reconsideration. Oddly, she states she would like to meet to work something out with the California Chapter of the American Physical Therapy Association [Rumor has it this never happened]
  • June 27th: AB783 is again slated for reconsideration. If it fails to pass out committee AGAIN, it can can not be re-heard until 2012 [which if history is any indication, it will be back]

Luckily, NBC LA continues to provide top notch coverage and analysis of the issues in their THIRD article entitled Caution: State Laws Hazardous to Your Health. In the comments section Johnny Chen makes a great point:

There is a reason why doctors are not allowed to own pharmacy clinics/establishments. It’s called conflict of interest. The same should apply to physical therapy clinics. Hayashi should be ashamed of herself — why would she support a bill that takes the power out of the consumer’s hand and costs taxpayers/health care system.

Unfortunately, there is a very, very easy cure to this legislation and ongoing POPTS battle:

Physical therapists need to stop working for Physician Owned Physical Therapy Clinics.

Remember the Stop POPTS Campaign has a website, Twitter, Facebook, and You Tube Channel. Read, follow, friend, and watch! Then spread the word.

Also, please take a few moments to read the 3 NBC LA Articles and leave your comments + feedback.

  1. Physician Run Physical Therapy Clinics Scrutinized
  2. Physical Therapy Bill Delayed
  3. Caution: State Laws Hazardous to Your Health

The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is.                            –Winston Churchill

The ‘continuity of care’ argument is dead. It is hard for me to get a hold of a physician when I page them in a hospital, or call them from the private physical therapy practice I practice within. They are busy. We are busy.

The issues surround physician employment, and ownership, of physical therapists are fairly simple: conflict of interest and referral for profit. What makes legislators, payors, and the public believe this will improve communication, care, and patient outcomes?

The American Physical Therapy Association doesn’t support it. The American Academy of Orthopaedic Manual Physical Therapists doesn’t support it. In fact, the American Medical Association ethics committee doesn’t support it.

The data doesn’t support it. Human behavior and psychology research don’t support it. Logic doesn’t support it. Ethics doesn’t support it.

Dear Assemblywoman Hayashi: Physical Therapists, data, logic, ethics, and human behavior all say NO! This is a bad idea!

But, physicians support it and say it is best, so it must be true…right?

AB783 and the California Campaign to STOP POPTS

On Monday, June 13th California Assembly Bill AB783 failed to pass out of committee in the California Legislature. The bill, which would explicitly allow physicians to employ physical therapists, would have been in stark contrast to current State of California Legislative Counsel opinion which states that it is illegal for physical therapists to be employed by physicians.  The bill has been pushed by Mary Hayashi, who not surprisingly receives quite a bit of campaign money from physician groups.

Recently, the issue has received increased attention as physical therapists and activists have taken to twitter and facebook to spread the word. Even more impressive, NBC LA has now run two articles critiquing the bill: Doctor Run Physical Therapy Clinics Scrutinized and Physical Therapy Bill Delayed.

Some sources have reported that supporters of AB783 have spent upwards of 2 million dollars while physical therapists and the CA Private Practice Section have spent a mere 57 thousand dollars. I think the relative success of the PT campaign illustrates the importance of viral, social medial in the form of Facebook, Twitter, and an online presence. Most notable is the Stop POPTS campaign which I have written about previously in the post Anti-POPTS Movement goes Web 2.0. But, even the California Private Practice Section has been slamming their website with information and announcements

But, in the end, I think it also illustrates the fact that the bill is grossly illogical as it promotes a huge conflict of interest in medicine: referral for profit. I wrote an extensive piece about a year ago on conflict of interest and POPTS which can be found on the AAOMPT Student Special Interest Group Blog.

Interestingly, the Medical Code of Ethics States:

“[u]nder no circumstances may physicians place their own financial interests above the welfare of their patients.”

And, what about The American Medical Association (AMA) Council on Ethics and Judicial Affairs (CEJA)?

“physicians should not refer patients to a health care facility which is outside their office practice and at which they do not directly provide care or services when they have an investment interest in that facility.”

Please, take a few minutes to read the articles. Then comment and share. Tweeps on twitter are using the hashtags #StopPOPTS  and #VoteNoOnAB783. The more physical therapists continue to articulate the many problems with referral for profit and physician employment/ownership of physical therapy the more press it will receive. Both articles have already received countless comments from individuals regarding the problem with POPTS.

What are you waiting for?

  1. Doctor Run Physical Therapy Clinics Scrutinized
  2. Physical Therapy Bill Delayed

The continued success of the anti-POPTS movement hinges on involvement from the bottom up. Every comment, like, tweet, and shared link are useful. Every mention in conversations with patients and the public add up. A big thank you to all the physical therapists who have gone to capitol to meet with legislators and testify. And of course, the importance of  the California Private Practice Section and California Section of the APTA can not be underestimated.

Continue to spread the word!

Physician Owned Physical Therapy Services (POPTS) in California. The anti-POPTS movement goes Web 2.0

Physical Therapists in California are taking to all forms of the web and utilizing Web 2.o Principles to oppose recent efforts by the California Medical Association and Legislator Mary Hayashi to LEGALIZE Physician Owned Physical Therapy Services in California through AB783. This bill would provide explicit language legalizing the employment of physical therapists by physicians. Those who have followed the POPTS debate in California are left scratching their heads because…

Interestingly, the State of California Legislative Counsel recently rendered an opinion on September 29, 2010 that it is illegal for PTs to be employed by any professional corporation except for those owned by physical therapists. The California Physical Therapy Association provides details

The opinion from Legislative Counsel confirms that, because the California Corporations Code does not specifically include physical therapists on the list of those who may be employed by a medical corporation, a physical therapist is prohibited from providing physical therapy services as an employee of a medical corporation and may be subject to discipline by the Physical Therapy Board of California for doing so.

Now in response to this new, proposed legislation the California Physical Therapy Association released an electronic memo opposing the new bill.

But, a group of concerned consumers (and I am assuming physical therapists) has leveraged technology and taken the movement to a whole new level. They have crated a campaign entitled “Stop POPTS.” So, what Web 2.0 tools are they utilizing? Well here is the list:

But, wait, that is not all! They have also created a Stop POPTS iPetition which currently has over 880 electronic signatures. They were able to amass over 500 within the first 24 hours of creation!

While it is important for our professional organizations to disseminiate opinions, information, and press releases on the national, state, and local level I am always left wondering: Are they effective? Do they even reach, and more importantly affect, the target audiences: the public, legislators, and other health care professionals? Now, the California Medical Association has been able to provide some information through news paper articles and other publicity. Unfortunately, they are able to use their clout as physicians in such outlets, and Joe Public will likely accept what they present at face value (with little questioning or skepticism). Which is a point we sometimes miss. Yes, it is important to spread this information to our PT colleagues, but we need to be reaching the public, legislators, and other health care professionals. Patients, small business owners, and legislators should be outraged! And WE need to light that fire.

Maybe the APTA, the CPTA, AAOMPT, and other organizations should take notes from the Stop POPTS Campaign in California. They are leveraging the web and technology to spread this information virally and aggressively. I believe such an approach is more effective. So, if you support the profession of physical therapy and oppose POPTS please spread the word via facebook, twitter, you tube, and even sign the petition! The Stop POPTS website has an abundance of great information.

Want more Information about POPTS?

Tim Richardson of the blog Physical Therapy Diagnosis recently wrote a post entitled Is Physical Therapy in California a Zero Sum Game?

Last year I authored a long post about POPTS and Referral for Profit on the AAOMPT Student Special Interest Group Blog detailing current rulings in Washington State as well as providing links and information about Stark Laws. The post has a TON of links to other information including APTA press releases and the American Academy of Orthopaedic Surgeons (misguided) view points.

What’s your story and opinion about POPTS? How do we spread it? Can we empower patients to tell their stories?

Fear of Re-Injury and Return to Sport Following ACL Reconstruction

Fear of Re-injury and Low Confidence 1 Year after ACL Reconstruction: High Prevalence and Altered Self-ratings: CSM2011 Sports Section Platform Presentation
Trevor Lentz, PT, CSCS

This study won the Excellence in Research Award from the Sports Section of the APTA. Trevor’s primary clinical and research interests include rehabilitation of shoulder pathology, especially of the overhead athlete, and ACL rehabilitation including advanced rehabilitation timeframes. He is part of the research group at University of Florida that includes Dr. Steven George PT, PhD. Dr. George has been involved in a large magnitude of research related to psychosocial variables in musculoskeletal conditions. His primary research interests involve the common theme of utilizing biopsychosocial models to prevent and treat chronic musculoskeletal pain and dysfunction. So, I am not the least bit surprised he is involved in this line of questioning.

Background:

34-47% of individuals do not return to prior sports participation following unilateral, isolated anterior cruciate ligament reconstruction. This number maybe up to 70% for contact sports.

Clinical Factors Associated with Disability Following ACL Recon:

  • Knee Pain Intensity
  • Knee Flexion ROM Deficit
  • Quadriceps Weakness
  • Fear of Movement and Re-Injury

**Multiple studies have supported those findings**

Differences Between Individuals Who Return to Sport and Those Who do Not:

Fear of movement and re-injury consistently associated with self-reported function. But, not routinely measured or addressed in post-operative care.

Essentially, the group wanted to study whether fear of re-injury and or fear of movement was present, and a factor, in return to sport following anterior cruciate ligament reconstruction. They included individuals in their study who had isolated, unilateral anterior cruciate ligament reconstruction. Return to sport status was measured 1 year post-operatively. Roughly 100 participants were enrolled. They gave participants a questionnaire asking if they had returned to sport. If the answer was no, they gave a list of reasons including pain, weakness, lack of ROM, lack of clearance by MD, fear of re-injury/movement, and some other variables…

Findings

  • 49% of their cohort had not returned to sport 1 year post operatively
  • 50% of those that had not returned to sport cited fear as primary reason
  • Fear was the most commonly cited primary or secondary reason for not returning to sport

A subset of the population may not only benefit from, but require, fear of re-injury interventions. Addressing psychosocial impairment may aid in function and return to sport status. But:

  • What interventions can/should be utilized?
  • At what point during rehabilitation?
  • How do confidence, self-efficacy, and pain castrophizing affect return to sport?

The speaker did a nice job of pointing out that we need to do a better job of operationally defining and measuring “return to sport.” For example, return to any sport? return to their sport? I would go one step further and say return to previous level of function (40 yard dash time, vertical leap, strength)? Previous level of performance (minutes played, game statistics, self-perceived ability)?

In my opinion, future investigations MUST specifically tease out return to sport and return to previous level of sport performance. It is useful whether measured subjectively through self-perception and self-report OR objectively through playing time, statistics, etc. Any athlete, especially high performing athletes, will tell you that there is a difference between playing/participating in their sport AND performing at their pre-injury level.

As far as intervention, it may range from graded exposure of feared activities/sport specific tasks or graded activity progression. [Many of these cognitive behavior approaches are being utilized and studied in patients with chronic and persistent pain] Some may require even further intervention (psychological or otherwise) for their biopyschosocial impairments and barriers for return to sport.

So, fear of re-injury has been identified as present following ACL surgery and a very real, patient perceived barrier for return to sport. Now, we need to figure who develops it and why? What are the risk factors? When do we intervene and how? And, what are the long term consequences of this impairment? Looks like we have some work to do!