At SPACE we take great pride on following the latest developments in the fields of physiotherapy, sports science, and surgery. Keeping up to date with the evidence base means we can make clinical decisions with confidence which we can then pass on to patients through education.
Through this page, we share research papers with fellow clinicians which we have found useful and which may help guide others clinical decision making. In addition to this open access, we may also link to other relevant blog pieces or press releases.
10th January 2017
To start the New year we have provided a link to some superb free resources from La Trobe University in Australia in the build up to the next Patella-Femoral Retreat 2017 which is being held in Melbourne. There are some great free presentations you can download on the deficits in patients with PFP and also on the treatment of this sometimes challenging patient group.
27th October 2016
This month saw the relsease of the Warwick Consensus Statement on Femeroacetabular Impingement Syndrome. The term ‘FAI syndrome’ emphasises the fact that the patients in discussion are symptomatic, suffering from a clinical disorder that is characterised by a triad of symptoms, clinical signs and radiological ﬁndings. The statement looks at factors such as the clinical signs, radiology, treatment recommendations and prognosis for patients presenting with possible FAI and presents the information alongside an infographic. The paper is open access. Alongside there are two free podcasts discussing the paper and its recommendations.
29th September 2016
The Running Physio Tom Goom released an excellent paper this year in JOSPT looking at Proximal Hamstring Tendonopathy. The full paper can be accessed here and a post containing videos of the rehab exercises is also included.
22nd September 2016
This month saw the release of The Copenhagen Consensus Statement looking at children, youth, and physical activity in schools and during leisure time. As physiotherapists we should be one of the main professions advocating sport and exercise to children so this statement is a very welcome piece of work
10th August 2016
This week saw the release of two very good overview papers in Physical Therapy in Sport looking at the Female Triathlete. Firstly looking at the Masters Athlete and secondly at the post partum Triathlete. Both paper provide a good overview of biology and the aging process as well as physiological considerations and training programs. These are two populations we see a lot of at SPACE and both would benfit from good evidence based management.
The master female triathlete
The postpartum triathlete
01st August 2016
Running as a means of exercise is popular for both recreation and competition. Injury rates reported vary between 19% to 78% and a number of intrinsic and extrinsic factors have been highlighted as potential risk factors. Multiple interventions have therefore been developed to address these factors. Despite extensive research a lack of long term treatment strategies remains a frustration for runners and clinicians.
Alteration and manipulation of running technique may help to reduce load in certain muscles or tissues. The field of run re-training is gathering interest and a number of publications are now available to help the clinician advise patients. While a number of the tools suggested in theses papers may not be available in the average clinic it does not mean that a good working knowledge or ingenious use of a mobile phone may not lead to positive changes for your patients.
Running Re-training to treat lower limb injuries: a mixed methods study of current evidence synthesised with expert opinion
- Paucity of current evidence in injured populations but substantial evidence for immediate changes to biomechanics in healthy populations
- Limited evidence to support run retraining in exertional lower leg pain and PFP
- Retraining options that clinicians may consider include strategies to reduce over-stride and increase step rate, altering strike pattern, reducing impact loading, increasing step width and altering proximal kinematics
Runners with PFP have altered biomechanics which interventions can alter: a systematic review and meta-analysis
- Limited evidence of reduced hip adduction post gait re-training
- No evidence of of any favourable kinematic change post “strengthening” exercise
- Both interventions lead to significant reductions in pain and improvements in function
Gait Re-training for healthy and injured runners using augmented feedback: A systematic literature review
- Real time visual and auditory feedback is effective in modifying running mechanics in treating runners with with PFP and exertional compartment syndrome
- Superior results may be achieved with multiple feedback sessions with ever decreasing cues given
The International Patello-Femoral Pain Research Retreat took place in Manchester in 2015 where a number of the leading researchers in the topic met to produce a consensus statement based on evidence from January 2010 to June 2015. Despite its high prevalence among active individuals and frequent presentations there are few published guidelines to help clinicians choose the appropriate evidenced based treatment. The first part of the statement looks at the Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient reported outcome measures.
The second part of the consensus statement addresses exercise, taping, bracing, foot orthoses and combined interventions.
This paper from Physical Therapy in Sport looks at Electrical stimulation as a treatment intervention to improve function, edema or pain following acute lateral ankle sprains: A systematic review. Ankle sprains are one of the most common MSK injuries we will see and managing edema can have a large impact on pain and dysfunction. Excitable tissues are targeted with therapeutic electrical stimulation in an attempt to reduce pain and/or muscle spasm, facilitate muscle re-education, strengthen muscles, minimize disuse atrophy, and aid in the resolution of edema.
This paper from the Journal of Foot and Ankle Research looks at Effects of soft bracing or taping on a lateral ankle sprain: a non-randomised controlled trail evaluating recurrence rates and residual symptoms at one year. While this is a non-randomised trial, taping is a highly used intervention in ankle sprains and recurrence rates are also very high. The decision to use bracing or taping with our patients can sometimes be down to our own bias but it is always useful to see what the evidence has to say.