Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews
Untold Physio Stories - Low Back Pain in a Novice Barbell Athlete - themanualtherapist.com


In the latest episode of Untold Physio Stories Podcast, we're joined again by Dr. Brett Scott of barbelltherapyandperformance.com. Brett goes over a recent case of onset of low back pain in a novice barbell athlete he has been working with on and off. It wasn't mechanical, but what was the reason? Listen and find out! 


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Time Restricted Eating and Human Health Part 2 - themanualtherapist.com


Effects of Time Restricted Eating on Human Health

SERIES (2/6)

TYPES OF TIME RESTRICTED EATING

Time-restricted feeding is an intermittent fast which consists in limiting the daily feeding period. However, the definition of the restriction is still imprecise in studies on humans and varies from 8 to 12 h, depending on the sources. First, the nomenclature used to describe the type of time-restricted feeding practiced is standardized:

TRE followed by the number of hours of feeding and fasting in a 24-h period, separated by a slash.

For example, TRE 8/16 indicates:
  • Restriction of the daily feeding period to 8 h for a 16 h fast.
  • Out of 22 studies in the review, only 1 practiced a restriction equal to 12 h or less.
  • All the others having limited daily nutrition to a window of 10 h or less.
  • The 8/16 variant is the most common form of TRE ( >50% of the trials).
  • The food window can also be varied during the day.
For example:
  • Early TRE (eTRE), in which the feeding period started earlier in the day.
  • Delayed or late TRE (dTRE) delays the intake of the first meal.
  • TRE is generally an every day water and ad libitum fast, which means that participants can eat until satiety without ay restriction on the quality or quantity of food intake.
  • However some used an iso-caloric protocols (having the same amount of calories each day).

These characteristics show that TRE could be adaptable to the participants eating habits, which may positively influence dietary adherence.

3. Adherence and Effects on Calorie Consumption
4. Metabolic Effects
5. Effects on Circadian Clock and Other.
6. Conclusions

SOURCE:
Adafer et al. 2020. Food Timing, Circadian Rhythm and Chrononutrition: A Systematic Review of Time-Restricted Eating’s Effects on Human Health. Nutrients 2020, 12, 3770; doi:10.3390/nu12123770


Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 
Want to learn more or contact him?
Reach out online:
@Grapplersperformance
 

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Top 5 Fridays! 5 Great Single Leg Strengthening Exercises - themanualtherapist.com


Single Leg Training: My Top 5 

There’s a been a great ongoing discussion in our field of unilateral (single leg) lower body training versus bilateral (double leg) lower body training.
Understanding Clinical Prediction Rules for Lumbar Manipulation - themanualtherapist.com



You learned about them. You studied them. You were tested on them. But the real question is, how important are they to use?

Understanding Clinical Prediction Rules for Lumbar Manipulation by Cameron Faller
Understanding Clinical Prediction Rules for Lumbar Manipulation

Clinical prediction rules (CPRs) were developed using multivariate statistical methods to help clinicians select particular interventions to use depending on a cluster of findings a patient presented with.

Given the black and white matter of how the CPRs were created, this allowed for the opportunity to write a lot of test questions whether it was the NPTE or the OCS exam.

However, as many practicing clinicians know, the clinic is not black and white and we cannot always shoehorn patients into classifications or rules.

So what do we do instead?

Before we release Episode 55 of our Modern Pain Podcast, we wanted to discuss some of the common limitations and pitfalls the research has shown when fully examining CPRs.

Newsflash, some patients may respond well with lumbar manipulation but we might not necessarily need a rule to tell us that.

Similarly, those same patients that satisfy the criteria to have a lumbar manipulation performed may also respond equally well with other interventions.

So how do we go about selecting what types of interventions to perform? What exactly does patient-centered care look like without using these rules?


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Time Restricted Eating and Human Health Part 1


Effects of Time Restricted Eating on Human Health

SERIES (1/6)
INTRO:
Eating behaviors are an influential factor in the development of chronic pathologies.

The daily feeding time (DFT) is the period from the start of the first meal to the end of the last meal of the day.  An American cohort of 15,000 adults showed feeding times reached 15 h for over 50%. Longer DFT may be a factor in the development of metabolic disorders.

A cohort study of 2650 adult women fasting for longer nightly intervals showed reduced:
  • Systemic inflammation.
  • Risk of breast cancer & other metabolic diseases.
Intermittent fasting (IF) alternates between a period of fasting and a period of normal eating (1–3 days per week).

Time-restricted feeding (TRF) is a form of IF that limits the daily food consumption to a period of 4–12 h, which induces a fasting window of 12–20 h per day.

TRF differs from IF in two aspects: 
  1. TRF does not require caloric restriction
  2. TRF requires a consistent daily eating window

This dietary approach has shown beneficial effects in animals.

In rodent models, TRF protected mice fed a high fat diet against obesity, hyperinsulinemia, hepatic steatosis and inflammation.

TRF attenuated onset and reversed progression of metabolic diseases in mice with pre-existing obesity and type II diabetes, hepatic steatosis and hypercholesterolemia.

The time-restricted eating (TRE) is used to refer to human models. 

TRE can benefit:
  • Cardiovascular metabolism.
  • Blood pressure.
  • Cholesterol.
  • Weight loss.
  • Reduction in fat mass.
  • Preserve Muscle

Adafer et al. (2020), systematically reviewed the international literature, exploring the effects of TRE on human health.

This series will summarize all the findings!

NEXT UP:

2. Types of Time Restricted Eating

3. Adherence and Effects on Calorie Consumption

4. Metabolic Effects

5. Effects on Circadian Clock and Other.

Conclusions


SOURCE:
Adafer et al. 2020. Food Timing, Circadian Rhythm and Chrononutrition: A Systematic Review of Time-Restricted Eating’s Effects on Human

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 
Want to learn more or contact him?
Reach out online:
@Grapplersperformance

Learn more online - new online discussion group included!


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 
  • NEW - Online Discussion Group
  • Live cases
  • webinars
  • lecture
  • Live Q&A
  • over 600 videos - hundreds of techniques and more! 
  • Check out MMT Insiders
Keeping it Eclectic...

5+1 Unilateral Kettlebell Exercises for a Full Body Workout - themanualtherapist.com


Kettlebell Workout - Unilateral Focus ⤵️

The kettlebell is one of the most versatile training tools available. I love the barbell just as much as the next fitness enthusiast, but the kettlebell is perfect for so many reasons. There's a ton of variety and versatility - and - you always get a great grip challenge since the handle is typically thicker in diameter.
Untold Physio Stories - Epic Functional Fail - themanualtherapist.com


In this episode, Erson recalls a case from earlier on in his career when he was fixing everyone with his “magic hands.” It would still be a while before he adopted active over passive strategies, but this definitely struck him as an epic fail for a long time patient.


Untold Physio Stories is sponsored by

EDGE Health and Tech Solutions - we level up your website with full SEO optimization, turn it into a referral generating machine and do full G Suite and Telehealth integrations

Modern Manual Therapy Insiders - over 650 Exclusive videos, Research Reviews, Webinars, Online Discussion - learn easy to apply Clinical Practice Patterns, integrate Pain Science with Manual Therapy and Patient Education - Join now!

Also, be sure to check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual 


Learn more online - new online discussion group included!


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 
  • NEW - Online Discussion Group
  • Live cases
  • webinars
  • lecture
  • Live Q&A
  • over 600 videos - hundreds of techniques and more! 
  • Check out MMT Insiders
Keeping it Eclectic...



By Dr. Sean M. Wells, PT, DPT, ATC/L, OCS, CSCS, CNPT, Cert-DN

Cardiac physical therapy is a rewarding area of PT practice that takes precision, complex thinking, and a team of specialists working toward a common goal. Often patients in cardiac rehabilitation present with chest pain (angina), ischemic heart disease, stents, bypass surgeries, and/or heart failure.

Doctors of physical therapy do their best to push these patients to maximize their endurance, functioning, and cardiac capability. We often do this through various interventions like treadmill exercises, stepping, strengthening, and breathing techniques.  After a recent study, nutrition may be one of those interventions that PTs need to focus more on.

New Study

Published in the British Journal of Nutrition, researchers found a correlation with plant-focused diets, like the MIND and Mediterranean diets, with left ventricular function. Specifically the researchers looked at cohort sample of 2,512 patients from the Framingham study and examined their dietary patterns relative to their cardiac function. The specific cardiac metrics included left ventricular (LV) ejection fraction, left atrial emptying fraction, LV mass (LVM), E/e’ ratio (dependent variables; primary), global longitudinal strain, global circumferential strain (GCS), mitral annular plane systolic excursion, longitudinal segmental synchrony, LV hypertrophy and aortic root diameter (secondary).

Among those with stricter adherence to the MIND diet the researchers found better cardiac functioning, specifically better LV functioning. This may prove to be very impactful for patients with congestive heart failure and other related cardiac diseases. 

Diet

What did the diet look like? The MIND diet focuses on reducing animal protein, saturated fats, while boosting intake of fruits (like berries), greens, and other whole foods like whole grains. The MIND diet has had solid evidence in the last decade or so with data connecting it to improved cognition and reduced odds of other neurodegenerative diseases. Perhaps now we can see that what is good for the brain is indeed good for the heart as well!

What does this mean for PT?

Physical therapists are doctorally prepared leaders and we can educate our patients and engage our clinics and facilities to embrace evidence-based metrics, using studies such as this one to promote healthy eating. Speaking with our patients about reducing saturated fat, increasing whole fruits and vegetables, while also pushing them physically will optimize their cardiac and health outcomes. Engaging dietitians, nurses, and physicians to promote a more whole-food, plant-based diet will help patients with CHF get better, faster!

If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60! 

Earn Your CNPT!




Photo by Liza Summer from Pexels
Learn more online - new online discussion group included!


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 
  • NEW - Online Discussion Group
  • Live cases
  • webinars
  • lecture
  • Live Q&A
  • over 600 videos - hundreds of techniques and more! 
  • Check out MMT Insiders
Keeping it Eclectic...