Paincast

Ep33: The Common Sense in Physiotherapy That’s Not So Common in Practice: Deep Dive with Dr. Dave Walton

In this episode, we talked about
Using the Assess, Predict, Treat framework to direct our patient care
The radar plot, triangulation, arms-length approach, and phenotyping
Correlation and causation; confounders, moderators, and mediators
The significance and practical tips of practicing trauma-assumed care
 
Professor Walton is a clinical researcher who focuses on the intersection between trauma, pain, physical and mental health. He uses both quantitative and qualitative approaches to explore these phenomena, and engage in critical theory around measurement of pain, wellness, and other clinical outcomes to enrich the rehabilitation and life experiences of people living with pain. He was one of the pioneers in Canada in the area of Pain Science in Physiotherapy, and was one of the co-founding members of the Pain Science Division of the Canadian Physiotherapy Association. He co-authored Musculoskeletal Pain---Assessment, Prediction, and Treatment, A Pragmatic Approach with Dr. James Elliott, which is the textbook we will be discussing in the episode.
 
Resources
Walton, D., & Elliott, J. (2020). Musculoskeletal Pain-Assessment, Prediction and Treatment. Jessica Kingsley Publishers.
Lee, J. Y., et al. (2020). Defining pain and interference recovery trajectories after acute non-catastrophic musculoskeletal trauma through growth mixture modeling. BMC Musculoskeletal Disorders, 21, 1-11.
Walton, D. M., Tremblay, P., Seo, W., Elliott, J. M., Ghodrati, M., May, C., & MacDermid, J. C. (2021). Effects of childhood trauma on pain‐related distress in adults. European Journal of Pain, 25(10), 2166-2176.
Elliott, J. M. et al. (2023). Biopsychosocial sequelae and recovery trajectories from whiplash injury following a motor vehicle collision. The Spine Journal, 23(7), 1028-1036
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Ep32: All about ACL with Dr. Linda Truong (Part 2): Evidence-based, biopsychosocial ACL rehabilitation

In this episode, we talked about
What is good ACL rehab?
What are the psychological, social, and contextual factors influencing ACL rehab outcomes, and what can we do about them?
What about ACL healing and Cross Bracing Protocol?
 
Clinician-Scientist | Physical Therapist | Post-doctoral Fellow
Expertise and research focus:
Qualitative research
Mixed methods research
Musculoskeletal (MSK) and sports rehabilitation 
Digital health implementation
Models of care in rehabilitation
Current Focus: Postdoctoral research on innovative care models and the integration of digital health solutions for MSK pain management.
My work bridges the gap between clinical practice and digital health technology, aiming to improve patient outcomes through evidence-informed strategies. My clinical expertise lies in management and treatment of traumatic knee injuries (e.g., ACL injuries). I currently work part time at a local physiotherapy clinic and teach within the Master of Physical Therapy program at the University of British Columbia in Vancouver Canada. 
 
Resources
Kotsifaki, R., Korakakis, V., King, E., Barbosa, O., Maree, D., Pantouveris, M., ... & Whiteley, R. (2023). Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. British journal of sports medicine, 57(9), 500-514.
Whittaker, J. L., Culvenor, A. G., Juhl, C. B., Berg, B., Bricca, A., Filbay, S. R., ... & Crossley, K. M. (2022). OPTIKNEE 2022: consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis. British journal of sports medicine, 56(24), 1393-1405.
Article on non-surgical ACL rehab: https://www.physio-network.com/blog/growing-evidence-non-surgical-acl/
Podcast on group rehab ACL https://podcasts.apple.com/dk/podcast/ep-41-life-in-the-fast-lane-with-linda-truong-christina-le/id1522929437?i=1000526250993
Podcast on social and contextual factors https://bjsmbmj.podbean.com/e/taking-the-social-and-contextual-seriously-in-sports-medicine-with-linda-truong-ep-469/
ACL rehab criteria: https://www.melbourneaclguide.com/docs/ACL_Guide.pdf
 
Social media connection
X @LKTphysio
Instagram @lint.fit IG 
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Ep31: All about ACL with Dr. Linda Truong (Part 1): Surgery or Not?

In this episode, we talked about
Different options after an ACL tear
What the current body of evidence say about the outcomes of different options
Clarifying research terminologies: statistical vs clinical significance, levels of certainty, what constitute good research
 
Clinician-Scientist | Physical Therapist | Post-doctoral Fellow
Expertise and research focus:
Qualitative research
Mixed methods research
Musculoskeletal (MSK) and sports rehabilitation 
Digital health implementation
Models of care in rehabilitation
Current Focus: Postdoctoral research on innovative care models and the integration of digital health solutions for MSK pain management. My work bridges the gap between clinical practice and digital health technology, aiming to improve patient outcomes through evidence-informed strategies. My clinical expertise lies in management and treatment of traumatic knee injuries (e.g., ACL injuries). I currently work part time at a local physiotherapy clinic and teach within the Master of Physical Therapy program at the University of British Columbia in Vancouver Canada. 
 
Resources
Owen, P., et al. (2023). Infographic. Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries. British Journal of Sports Medicine, 57(13), 882-883.
Saueressig, T., et al. (2022). Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries: a living systematic review and meta-analysis. British journal of sports medicine, 56(21), 1241-1251.
Beard, D. J., et al. & ACL SNNAP Study Group. (2024). Comparison of surgical or non-surgical management for non-acute anterior cruciate ligament injury: the ACL SNNAP RCT. Health technology assessment (Winchester, England), 28(27), 1.
Culvenor, A. G.,et al. (2022). Rehabilitation after anterior cruciate ligament and meniscal injuries: a best-evidence synthesis of systematic reviews for the OPTIKNEE consensus. British journal of sports medicine, 56(24), 1445-1453.
Beard, D. J., et al. (2022). Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial. The Lancet, 400(10352), 605-615.
Frobell, R. B., et al. (2010). A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine, 363(4), 331-342.
Reijman, M., et al. (2021). Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial. Bmj, 372.
Whittaker, J. L., et al. (2022). OPTIKNEE 2022: consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis. British journal of sports medicine, 56(24), 1393-1405.
Kamper, S. J. (2019). Interpreting outcomes 2—statistical significance and clinical meaningfulness: linking evidence to practice. journal of orthopaedic & sports physical therapy, 49(7), 559-560.
Kamper, S. J. (2019). Interpreting outcomes 3—clinical meaningfulness: linking evidence to practice. journal of orthopaedic & sports physical therapy, 49(9), 677-678.
 
Social media connection
X @LKTphysio
Instagram @lint.fit
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8
 
Episode's transcript: https://drive.google.com/file/d/1ifU8bzVpXReOWx3ZYTEgvWehFs1ixnHF/view?usp=sharing
 

Ep30: Music for Pain with Dr. Amy Clements-Cortés

In this episode, we talked about
What Music Therapy is and how it can immensely benefit patients
The affect of music on the biological, psychological, and social aspects to improve pain and overall health and wellness?
Recent research evidence for Music Therapy in dementia and palliative care populations
Important future developments of Music Therapy
 
Dr. Amy Clements-Cortés PhD, RP, MTA, MT-BC
Dr. Amy Clements-Cortés is an Associate Professor, Faculty of Music, University of Toronto; Credentialed Music Therapist, Registered Psychotherapist and a Fellow in the Bonny Method of Guided Imagery and Music, and Neurologic Music Therapy. Amy has extensive clinical experience working with clients across the life span, with a specialty in mental health, dementia and palliative care. Her research contributions have had a significant impact in the understanding of understudied phenomenon, resulting in excelled treatments provided by professionals in music and medicine. She has authored 70+ peer reviewed journal articles, multiple book chapters, co-edited 2 books, and provided 300 conference and/or invited academic presentations. Her work has been cited by over 1300 scholars. In 2020, she received the World Federation of Music Therapy Clinical Impact Award honoring a music therapist who has had a long-term impact on advancing the knowledge and practice of music therapy within a specific clinical area or population through the publication or presentation of his or her work.
 
Resources:
Xiao, X., Chen, W., & Zhang, X. (2023). The effect and mechanisms of music therapy on the autonomic nervous system and brain networks of patients of minimal conscious states: a randomized controlled trial. Frontiers in Neuroscience, 17, 1182181.
Loewy, J. (2022). Underlying music mechanisms influencing the neurology of pain: an integrative model. Brain Sciences, 12(10), 1317.
Lee, J. H. (2016). The effects of music on pain: a meta-analysis. The Journal of Music Therapy, 53(4), 430-477.
Kulinski, J., Ofori, E. K., Visotcky, A., Smith, A., Sparapani, R., & Fleg, J. L. (2022). Effects of music on the cardiovascular system. Trends in cardiovascular medicine, 32(6), 390-398.
https://www.notesbyamy.com/
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Ep29: It Doesn't Have to Hurt; Better Paediatric Pain Care with Dr. Christine Chambers

In this episode, we talked about
The consequences of poorly managed paediatric pain
Evidence-based practical suggestions for managing acute, transitional, and chronic pain
How we can advocate for better paediatric pain management in our healthcare encounters and in hospitals
 
Dr. Christine Chambers, PhD RPsych FRSC FCAHS is an international leader in children’s pain research and a national voice for children’s health. Named one of Canada’s Top 100 Most Powerful Women, she creates connections and partners with patients to advance research, mobilize knowledge and improve the lives of children, youth and families. She is a Professor and Tier 1 Canada Research Chair in Children’s Pain at Dalhousie University, a faculty member of the Centre for Pediatric Pain Research at IWK Health Centre, Director of The Chambers Lab, and Scientific Director of Solutions for Kids in Pain and the CIHR Institute of Human Development, Child and Youth Health.
 
Resources:
1. Solution for Kids Pain: https://kidsinpain.ca/  A national knowledge mobilization network whose mission is to improve children’s pain  management by mobilizing evidence-based solutions through coordination and collaboration.
2. It Doesn't Have to Hurt: https://itdoesnthavetohurt.ca  A patient-oriented research program in children’s pain management.
3. Paediatric Pain Management Health StandardDownload from: https://store.healthstandards.org/products/pediatric-pain-management-can-hso-13200-2023-e Executive summary at: https://kidsinpain.ca/wp-content/uploads/2023/04/Exec-Summary_Pediatric-Pain-Management-standard.pdf
4. Follow Dr. Chambers on social media @DrCChambers
5. Follow SKIP @kidsinpain
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Ep28: Fireside Chat with the World Physiotherapy President (Part 2): Physiotherapy around the World

In this episode, we talked about:
What World Physiotherapy does
What physiotherapy looks like around the world
How the profession can help each other globally
 
Michel D. Landry is a Professor in the Departments of Physiotherapy and Global Health at the Western Norway University of Applied Sciences (Bergen, Norway).  He was the Chair of the Department of Physical Therapy and Associate Dean for Global Health in the College of Health Professions at Virginia Commonwealth University (VCU) in Richmond, Virginia, from 2021-23, and was a Professor and Division Chief of Duke University’s Doctor of Physical Therapy Division in Durham, North Carolina from 2011-2021.  At Duke, he successfully led an essential rebuild of the program that is now one of the top physical therapy programs in the United States.  Before arriving at Duke University, he was a tenure-track Assistant Professor at the University of Toronto (2007-2011), where he was also a Career Scientist at the Ontario Ministry of Health and Long-Term Care.  He has held senior clinical management positions within the private rehabilitation sector in Ontario (Canada) and leadership positions within international humanitarian aid and development agencies in conflict, emergency, and disaster settings.  Dr. Landry is a past president of the Canadian Physiotherapy Association and the current President of World Physiotherapy, the global body that represents 700,000 physiotherapists around the world.  He delivered the 2020 Enid Graham Memorial Lecture, and in 2023, he received the Dean’s Award of Excellence from the University of Ottawa’s Alumni of the Faculty of Health Sciences for his commitment to global health and physiotherapy. 
 
Connect with Dr. Mike Landry
X: @drmikelandry                                                                 
www.drmikelandry.ca
insta: mikelandryphysio
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Ep27: Fireside Chat with the World Physiotherapy President (Part 1): Necessary Innovations in Physiotherapy

In this episode, we talked about:
The value of hard work for physiotherapists
The necessity of innovating the future of physiotherapy
Important mindset changes for physiotherapists
 
Michel D. Landry is a Professor in the Departments of Physiotherapy and Global Health at the Western Norway University of Applied Sciences (Bergen, Norway).  He was the Chair of the Department of Physical Therapy and Associate Dean for Global Health in the College of Health Professions at Virginia Commonwealth University (VCU) in Richmond, Virginia, from 2021-23, and was a Professor and Division Chief of Duke University’s Doctor of Physical Therapy Division in Durham, North Carolina from 2011-2021.  At Duke, he successfully led an essential rebuild of the program that is now one of the top physical therapy programs in the United States.  Before arriving at Duke University, he was a tenure-track Assistant Professor at the University of Toronto (2007-2011), where he was also a Career Scientist at the Ontario Ministry of Health and Long-Term Care.  He has held senior clinical management positions within the private rehabilitation sector in Ontario (Canada) and leadership positions within international humanitarian aid and development agencies in conflict, emergency, and disaster settings.  Dr. Landry is a past president of the Canadian Physiotherapy Association and the current President of World Physiotherapy, the global body that represents 700,000 physiotherapists around the world.  He delivered the 2020 Enid Graham Memorial Lecture, and in 2023, he received the Dean’s Award of Excellence from the University of Ottawa’s Alumni of the Faculty of Health Sciences for his commitment to global health and physiotherapy. 
 
Connect with Dr. Mike Landry
X: @drmikelandry                                                                 
www.drmikelandry.ca
insta: mikelandryphysio
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Ep26: What You Need to Know About Preventing Knee Post-Traumatic Osteoarthritis with Dr. Jackie Whittaker

In this episode, we talked about:1. What preventing post-traumatic knee osteoarthritis (PTOA) means;2. Risk factors for developing PTOA and how to mitigate/manage;3. Practical tips in clinical care around preventing PTOA.
Dr. Whittaker is an Associate Professor in the Faculty of Medicine at the University of British Columbia (UBC), Senior Research Scientist at Arthritis Research Canada, and recognized as a Clinical Specialist in Musculoskeletal Physiotherapy by the Canadian Physiotherapy Association. Dr. Whittaker’s research focuses on long-term athlete welfare with a specific focus on musculoskeletal health after sport-related injuries. This includes research to improve injury care pathways, understand the consequences of injuries, and develop approaches to optimize function and healthy behaviours after injury. Two themes that cross cut Jackie’s research are exposing and overcoming gendered environments that disadvantage female athletes, and partnering with people on the front lines including athletes, family members, coaches, trainers, and health care providers to ensure her research produces solutions that are acceptable, relevant, and empowering.
Resources: OPTIKNEE: https://msklab.med.ubc.ca/optiknee/SOAR clinical trial information: https://www.arthritisresearch.ca/research/soar-clinicial-trial/Dashboard for ACL Reconstruction Testing (DART): https://acldashboard.com/Anyone interested in doing a PhD with Jackie: https://bit.ly/3rtmGQbTwitter handles: @jwhittak_physio and @OPTIKNEE
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 

Ep25: Interviewing Physiotherapists about Pain at the CPA Congress 2024

I had the pleasure and privilege of attending the annual Canadian Physiotherapy Association Congress in Beautiful Vancouver in April. This episode compiles 8 interviews I conducted during the congress with clinicians. I think this is one of the best ways to involve more clinicians in the discussion of pain and physiotherapy. Last year, I asked about their views on and approaches to pain. This year, I asked them about their feelings about treating pain, what they wish to learn more about, and a memorable experience as a clinician. I also have a student interview at the end.
Timestamp(00:01:31) Lawrence - MSK PT (00:09:20) Emilee - MSK PT, clinic owner @emiwhitt(00:18:35) Cheng, MSK PT, clinic owner @OTPerformanceRehab(00:27:14) Onkar, MSK PT, clinic owner @pfp_physio(00:34:03) Florence, MSK PT, clinic owner @northburnabyphysio(00:45:05) Patrick, MSK PT, clinic owner @thrivenowphysio(00:52:20) Amy, Ontario Physiotherapy Association staff, former primary care chronic pain group provider @chroniclesofhondronicols(01:03:28) Iris, first year PT student @irisw_pt
 
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 

Ep24: Utilizing Virtual Reality to Transform Pain Education, Management, and Research

This episode showcases how Virtual Reality, VR in short, can be used to facilitate, advance, and even transform pain education, management, and research. You'll hear about a few different applications of VR in physiotherapy, including using VR as a tool for pain neuroscience education, VR for phantom limb pain, and VR for research. We also highlight the current literature related to these applications. Note that this episode is a limited demonstration of how VR can be used in different aspects of pain care and there are a lot more out there. Interested listeners can refer to the review papers I have cited in the episode description.
Timestamps:(00:01:14) Reality Health: VR as a tool for Pain Neuroscience Education (00:27:48) VR as a tool to prevent or manage Phantom Limb Pain (00:43:52) SilicoLabs: VR as a versatile research and clinical tool 
Relevant resources:
VR for pain overview:
Ahmadpour, N., et al. (2019). Virtual Reality interventions for acute and chronic pain management. The international journal of biochemistry & cell biology, 114, 105568.
Trost, Z., et al. (2021). Virtual reality approaches to pain: toward a state of the science. Pain, 162(2), 325-331.
VR for phantom limb pain:
Limakatso, K., et al. (2020). The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial. Physiotherapy, 109, 65-74.
Purushothaman, S., et al. (2023). Assessment of efficiency of mirror therapy in preventing phantom limb pain in patients undergoing below-knee amputation surgery—a randomized clinical trial. Journal of Anesthesia, 1-7.
Cheung, J. C. W., et al. (2023). X-reality for phantom limb management for amputees: a systematic review and meta-analysis. Engineered Regeneration, 4(2), 134-151.
SilicoLabs: www.silicolabs.ca
Reality Health: https://reality.health/home/
Skidmore, N., et al. (2024). Acceptability and Feasibility of Virtual Reality to Promote Health Literacy in Primary Care from the Health Professional’s view: A Qualitative Study. Patient Education and Counseling, 108179.
Making pain education better: historical underpinnings & recent innovations – a discussion paper: https://www.petalcollaboration.org/uploads/1/4/4/1/144169171/moseley__ryan_petal_discussion_paper_making_pain_education_better_120923.pdf
Video introduction to the platform:  https://vimeo.com/915832727/e6572e2a5c?share=copy
Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8