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Another article seeking to develop a clinical prediction rule (CPR) has been accepted for publication in the Journal of Orthopaedic and Sports Physical Therapy (JOSPT). Iverson et al found five predictors of success with lumbopelvic manipulation:
1. Difference in hip internal rotation (> 14 degrees)
2. Ankle dorsiflexion with knee flexed (>16 degrees)
3. Navicular drop > 3mm
4. No stiffness with sitting > 20 minutes
5. Squatting is the most painful activity
Pre-test probability of success with manipulation was 45%.
If a hip internal rotation difference of greater than 14 degrees was present, the likelihood of success with manipulation increased to 80%!
If any three of the five factors above were present, likelihood of success improved to 94%.
Keep in mind this is a study performed on 50 subjects with detailed criteria for inclusion. Validation studies will have to be performed, but think of this…
If I told you that from your clinical exam, the likelihood that you would experience a 50% decrease in your knee pain if I performed a lumbopelvic manipulation was 94% – would you want that treatment?
Practice standardization is the future of our profession – get on board.
The folks over at EvidenceinMotion.com hit on an important topic in a January 22nd blog post. In case you don’t know, EIM was developed by a group of Physical Therapists to promote and protect the profession of Physical Therapy. These folks are leaders in the profession and are as passionate as any you will find. Check out their site, the blog, and their networking site — MyPhysicalTherapySpace.com!
A huge problem today (remember my discussions about PT’s identity crisis) is that fact that researchers and clients/patients often throw the term around incorrectly. It’s important that everyone knows that “Physical Therapy” is not a specific treatment. Articles like the one discussed at the EIM blog is a good example of why it’s important to appropriately say PT is a profession.
Oh yeah — it also highlights the importance of subgrouping/classifying patients with LBP for matched interventions that lead to better outcomes.
I’ve created a new page here at the PTDoc blog to share files and links for EBP. I hope to make this a collection of article summaries so the visitors of this blog can have quick and easy access to current medical evidence surrounding Physical Therapy interventions.
Check it out.