Physical Therapy: Technology Update

This is my presentation given at Evidence In Motion's Manipalooza 2013 Symposium held in Aurora, CO.

I was traveling at the time but the organizers graciously allowed me to submit my talk as a recorded video. Therefore, you will be experiencing the talk just as the symposium participants did!



#CSM2013 is here! PT Think Tank and it’s contributors are all in attendance. We plan to provide highlights, quick summaries of sessions, and other insights right here on PT Think Tank as well as through the conference hashtag #CSM2013. If you are tweeting do not forget about the other hashtags curated and discussed in the #Physicaltherapy Hash Tag Project 2.0 . Not attending? Follow the hashtags at home and join the conversation.

Official CSM 2013 iOS App Available

CSM 2013 is quickly approaching, is your itinerary planned? (I know you’ve been networking before the conference)

Here in time to help is the APTA CSM 2013 App. Basically, the app contains most of the information about the schedule, speakers, exhibitors, venues, and San Diego you find be lugging around in the bulky paper directories you get at the registration table.

In lieu of yammering on more about the specific features, I recorded a quick demo of the app using my favorite app of 2012 – Reflector. Enjoy:

Demo of the APTA CSM 2013 Mobile App from Mike Pascoe on Vimeo.

Here is a quick video showing a few things you can do with the APTA CSM 2013 app, which was released on Dec 20, 2012.

Here is the link to the app:


#DPTStudent Tweetchat Analytics

The inaugural #DPTStudent tweetchat took place this past Wednesday, Nov 28.

It was a huge success! How do you measure success? With these analytics of course, taken from the hour that the chat occurred:

66 twitter accounts participated

Most of these accounts were that of PT students of course, but we also saw PT faculty and PT programs participating.

486 tweets issued

This new hashtag stacks up well compared with other established PT hashtags, as illustrated by this fancy chart (note: the number on the chart is > 486 because this chart shows total tweets for the entire day):

 389 tweets per hour, 7.36 tweets per participant

We expect to see these numbers jump once the word gets out about the tweetchat. A figure of 7.36 tweets per participant indicates that although there was a small group, they were all very engaged with one another.

155,083 impressions made

“Impressions” is a metric for how many impressions a healthcare hashtag has made in users’ tweet streams. Symplur computes total impressions by taking the number of tweets per participant and multiplying it with the number of followers that participant currently has. This is done for all participants in this time period and then finally the numbers are added up.

 The influencers

Being atop the mentions column means your tweets were interesting enough for others to respond back to you, the tweets column explains itself, the impressions column shows the heavy hitters whose tweets were viewed by the massive number of followers they have.

The transcript

The topic of the first DPTStudent tweetchat was “Why PT?”. It was a great discussion, one that we suggest you relive by looking at the chat transcript.:

#DPTStudent – Healthcare Social Media Transcript


Tweetchats are a great forum to connect users with a common interest. #DPTStudent is bringing PT students from across the country together the exchange thoughts and ideas in a meaningful way. This is just another example of the power the PT profession can leverage by using emerging media. Let’s keep an eye on this and see how big it can get.

#IFOMPT12 – Day 1 Summary


Just sitting lying here in the hotel room reflecting on an excellent day of programming. I was able to attend and live blog from these seven sessions, take home messages summarized here:

“Management of cervical spine disorders: Where to now?” by Gwen Jull

  • Creating classification schemes for treating patients with neck pain is a slippery slope
  • Using one patient example we can easily construct over a million subgroups
  • Teaching entry-level DPTs may require black and white concepts, but clinical reasoning resides in the gray

“Knowledge Transfer in the Age of Information Technology” by Stuart Gowland

  • Telemedicine is revolutionizing renal surgeries in remote locations in the south pacific
  • Operating rooms can be mobilized in buses that can reach remote areas of NZ
  • The quality of video is very important when it comes to broadcasting

“Motor Control of the Knee”

  • Manual therapy did not modulate spinal excitability in patients with knee pain
  • Resting knee pain was reduced in patients with knee OA following manipulation
  • To maintain the gains in knee ROM following 6 weeks of stretching, the patient must continue stretching 3 X per week

“Understanding Cervical Muscle”

  • Patients with whiplash assoc disorder (WAD) have impairments in lengthening and shortening of deep neck flexor muscles as quantified using ultrasonography
  • Detailed dissection of cadaver neck flexors revealed strong adherence of the muscles to the bones, not like drawings in Gray’s Anatomy

“Physiotherapists/ Physical therapists’ role in exercise prescription & “Exercise is medicine”” by Karim Khan

  • More people die in the USA as a result of low exercise than smoking, diabetes, and obesity – COMBINED
  • You must appeal first to the emotions of your patient, then use simple statements to effect changes in their behavior

“Tendinopathy task force – guideline development” by Alex Scott

  • It takes 17 years to get 14% of research findings adopted into clinical practice
  • CPG are viewed as too restrictive by clinicians

“Biological mechanisms of dizziness” by J Treleaven, E MajMalmstrom, R Landel

  • The neck is very unique, not just a muscular joint but a major sensory organ
  • Multimodal therapy is a great approach for treating these patients
  • Postural stability is impaired in patients with neck pain
  • Put frickin’ lasers on the heads of your patients! (Dr. Evil Voice)
  • Treat the neck like you would a sprained ankle

Off to bed, catch you all at 8AM with live blogging of Joy MacMacDermid!

#IFOMPT12, here we come!

Quebec City Aerial | flickr user Andos_pics


The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT <- say it, it’s fun!) will be happening very soon (Oct 1-5) in Quebec City, Canada. Specific details on the Conference Website.

The conference will showcase some of the most up-to-date information by the leaders in manual therapy. It is an opportunity not to be missed. You may not be able to attend, but fortunately the 21st century offers many ways for you to learn and to engage with those attending:

Live Blogging

Live-blogging is live coverage of an event as it happens. The correspondent sitting in the lecture hall can share quotes from the speaker, links to relevant websites, photos, and more. The service we will use is called CoverItLive. You can check out their current event listings and view a live event right now to get a flavor of what this is like. You can also scroll through a transcript of the coverage of an event after it has concluded, here is an example from CSM2012. The best part of watching a live blogged session is your ability to contribute to the discussion remotely!

Replay Transcript
Replay Transcript


PTTT contributor Mike Pascoe had a successful pilot experience live-blogging five sessions from CSM2012 and is ready to step up his game for IFOMPT2012! We have dedicated a special page of PT Think Tank to IFOMPT Live Coverage. Mike Pascoe will be live-blogging all day, every day! Head over to the page and look at the sessions Mike Pascoe is planning on live-blogging. You can even sign up to receive email reminders a specified amount of time ahead of the event:

Setup an event reminder
Setup an event reminder



Official conference handle: @IFOMPT2012

Conference hashtag: #IFOMPT12

Are you using twitter to network before arriving at IFOMPT?



Official conference blog

PT Think Tank, of course!


Au revoir!

Looking forward to meeting you in Canada and interacting with you on the web…

Thought of the Week: The Garden of Your Mind

The following video was posted by PBS yesterday. Turn up the volume, click play, and enjoy:

Amazing. This video struck a nerve with me instantaneously. I was a young boy at the peak of popularity of Mister Rogers’ Neighborhood in the late 1980s and my grandparents allowed me to watch the show just about every time we stayed with them. Although I was entertained by the characters at that time, watching this remixed video now gives a deeper appreciation of the lessons taught by that great educator Fred McFeely Rogers (1928-2003).

These are those lessons:

You can grow ideas in the garden of your mind.

It is good to be curious about many things.

Every person you see is someone different from every other person in the world.

There are so many people that can help us learn in this world.

Did you ever think of all the many things you can do?

All you have to do is think and they’ll grow.

You should have noticed that Mister Rogers’ voice sounds different in the video compared with what you remember from a kid. That is because the audio has been remixed using an “auto-tuned” style. I am so impressed that an aging network like PBS is reinventing itself by remixing and breathing new life into this iconic shows. Make sure you subscribe to their new pbsdigitalstudios YouTube channel to see what they roll out with next!

What other lessons did you hear in the video? @mpascoe

P.S. – Here is another video of Fred Rogers (1997) giving the best award acceptance speech in the history of mankind –

CSM 2012 | The Pauline Cerasoli Lecture

from APTA

Being an educator of PTs, I always look forward to the Pauline Cerasoli Lecture. I had planned to relay the action through live blogging, but lack of free WiFi or 3G coverage left me in the digital dark. I did manage to take several notes during the lecture, summarized below.

This year marked the 15th installation of the Cerasoli Lecture, which is now in memory of Pauline “Polly” Cerasoli (1939-2010). Polly Cerasoli was the director of my physical therapy program, a fact I and many of my colleagues are proud of. The lecture was given by Christine Baker, PT, EdD, a faculty member at the Univ of Texas Medical Branch.

Christine had two primary objectives of her lecture. She proudly listed them to begin her talk “as any good instructor would”:

  1. Recognize benefits and challenges presented by technology
  2. Appreciate current technology in the way it changes things

Having been in the game for many years, it was a treat to listen to Christine reflect back on the old workflows students, clinicians, and faculty members used to take care of daily tasks. Students went to class in a building, went to the library to do research, used card catalogues to locate papers, and typed out the bibliography citation by citation. Clinicians hand wrote charts and documentation. Faculty posted exam grades on a cork-board in the hallway, arranged by social security number to preserve anonymity. The ways we complete these tasks today have completely changed due to the introduction of new technologies. Although you could still read a summary of the lecture in Chicago on a printed page.

flickr | McCain Library

Christine then presented a wordle word cloud taken from what I believe was a document on educational technology (please keep in mind that you need to explain the source if you are going to use the ubiquitous wordle cloud). Key phrases that stood out included laptops, podcasts, and blogs; all new tools in this digital age. Those comfortable using these emerging digital tools fall into the category of digital “immigrant” or digital “native”. The digital immigrant speaks an outdated language and can be identified by their accent (e.g., I dialed a phone, I wrote an email). To connect effectively with the digital native, the immigrant must make an effort to adapt to the changing technological landscape and also know about the eligibility to file adjustment of status (AOS).

I’d never though of this before, but Federal policies have actually facilitated digital literacy. Looking at the policy “A Nation at Risk” (1983), we find proficiency in computer science as a goal to be achieved by the completion of high school. You might be more familiar with George W. Bush’s “No Child Left Behind” (2001), which stated that all 8th grade students have the ability to use computers to communicate with others. Digital literacy is becoming acquired at younger and younger ages. Christine actually knows of several kindergarten students presenting slide presentations to their classmates! Show-and-tell as we now it has changed. | arfblat

What are the outcomes of this digital literacy? It seems that difference in student achievement between in-class lectures and online distance learning are shrinking. Students learn equally well in both formats. A review of the literature of technology use in the education of health care professionals shows that many tools are being utilized to facilitate learning, including:

  • Video modules for independent study of specific materials (Sanford et al 1996)
  • Hybrid/distance courses (English, 1998; Maring et al 2008; Bayliss & Wardon, 2011)
  • Web-based interactive tutorials (Perlman et al 2005)
  • Blogs (Goldman et al 2008)
  • Audience response systems (Wait et al 2009)
  • Computerized testing (Caudle et al 2011)
  • Podcasts and lecture recording (Allen & Katz 2011)

Christine did establish a mantra during her lecture “do not just use these toys, you need to know how to use them right.” Your students will not magically benefit from the fact you are using podcasts, you need to consider why you should use them and provide outcome measures to show how the students are benefitting from them. There are also intangible qualities of the education process that are hard to measure. It seems that students need to be part of a community to develop professional skills and would would argue that this can only comes from being in a classroom and socializing.

Christine offered some tips to faculty who choose to teach online:

  • Think about how to present material online
  • Do more than simply post PPT slides on the LMS (learning management system)
  • Consider how the materials will be consumed by the learners
  • Prepare the instructional environment, you are now the guy on the side instead of the guru in the front of the class
  • Monitor discussion boards, make yourself a presence in the course by providing feedback
  • Utilize departmental technology support
  • Consider establishing a distance education coordinator
  • Allow time to become familiar with technology before launching into content
  • Provide an orientation to the course and expectations

Christine also offered some tips from a student perspective in order to be successful learners online:

  • Be organized, carve out time, do not procrastinate
  • Participate, you will get out what they put into it
  • Be comfortable with technology, complete a technology readiness survey
  • Technology needs to be reliable, let faculty know when it isn’t
  • Utilize student support services

Christine also reviewed the types of interactions learners can expect to have in online courses:

  • Learner to content, occurs when the students reads and article or watches a podcast
  • Learner to learner, occurs during discussion forums, chats, study sessions over Skype
  • Learner to instructor, occurs when instructor provides feedback on assignments
  • Learning to interface, refers to the delivery of content, this often stressful to digital immigrants

Christine offered several benefits to computer-assisted instruction:

  • Students have more responsibility in participating and contributing information
  • Attracts student attention
  • Increases access to a variety of courses, scheduling ease
  • It is cost effective for the institution
  • Allows for the provision of immediate feedback

What about the PT clinic? Would you believe I have actually heard clinicians argue that they became PTs in order to avoid using technology? Guess what, technology is findings its way into the clinic. Computerized documentations through the use of EMR is the prime example. Several PT clinics also offer customized video clips of prescribed exercises for patients to take home and refer to. She mentioned the example of medical students using PDAs in the clinic to look up reference information. Christine encouraged those in the audience using technology to educate in the clinic to submit their studies to the Journal of PT Education.

flickr | ismnet

Technology also has a role in EBP (evidence-based practice). New content delivery platforms are providing a myriad options for continuing education courses. No more travel to a distance facility (manual techniques are another story). Speaking of continuing education, technology can help clinicians stay on top of relevant literature by leveraging RSS feeds.

Christine then moved onto a summary of the ways technology has penetrated into physical therapy. Today’s PT student is expected to attend class, but can review video recordings of the class later. They also order their textbooks online (and in some cases download them) and pay their tuition online. Today’s physical therapist does not wear a white jacket with an APTA patch on the sleeve, use EMR for treatment documentation, attend continuing education online at their own pace and use RSS feeds to be alerted of new research. Today’s PT faculty use clickers to poll students and group sessions to facilitate problem solving, post grades online to LMS, use DVDs and YouTube to demonstrate techniques, email handouts, use smart boards for diagrams and save hundreds of article PDFs to flash drive.

Christine offered her visions of a future that will include electronic textbooks with rich media and embedded videos, social media use, and advents in tele-health for the delivery of health care especially for those in rural serving communities.

Christine energetically concluded her lecture by stating “I cannot wait to see what is ahead!”