Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews
[RESEARCH] Safety of Blood Flow Restriction Therapy/Training - themanualtherapist.com


Blood Flow Restriction Training Safety

Background:
Blood flow restriction training (BFRT) is defined as the partial restriction of arterial blood flow into the muscle while venous outflow is occluded during a bout of exercise.

BFRT is used for physical training and performance in healthy individuals, as well as an adjunct to physical rehabilitation in injured individuals.

Current understanding of the physiological mechanisms of BFRT and related performance includes:
Acute muscle cell swelling.
Increased fiber-type recruitment
Decreased myostatin.
Decreased atrogenes.
Satellite cell proliferation.

With the increasing use of BFRT in clinical populations, Minniti et al. (2020) systematically reviewed the research to assess the potential adverse events associated with BFRT when used clinically in the treatment of patients with musculoskeletal disorders.

RESULTS:
  • 19 studies with 322 pooled participants
  • 9 studies reported no adverse events
  • 3 reported rare adverse events, including an upper extremity deep vein thrombosis and rhabdomyolysis
  • 3 case studies reported common adverse events, including acute muscle pain and acute muscle fatigue
Individuals exposed to BFRT were not more likely to have an adverse event than individuals exposed to exercise alone.

Adverse Events Overall:
  • Overall (14 of 322)
  • Rare Overall (3 of 322)
  • Rare BFRT (3 of 168)
  • Rare Control Group (0 of 154)
  • Any adverse BFRT (10 of 168)
  • Any adverse control (4 of 154)

CONCLUSIONS:
BFRT appears to be a safe intervention and even more so when used according to evidence-based guidelines and in patients with knee-related musculoskeletal disorders.

Further research is needed to make definitive conclusions about the absolute safety in all patient populations.
WANT RESEARCH SENT TO YOU?

šŸ”»Rapid Review MembershipšŸ”»

SOURCE:
Minniti et al. 2020. AmJ Sprt Med 2020;48(7):1773–1785 DOI: 10.1177/0363546519882652

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





Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

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...

Untold Physio Stories - A Double Derangement - themanualtherapist.com

It's great to challenge your biases. Bias when leading to great outcomes in a shorter time period normally equals experience. However, thinking outside of the box and trying things different can get you results on patients you struggling with. Mentee Dr. Malik Parker goes over a recent case of double derangement syndrome and how he came about the unique directional preference for hips versus lumbar spine.


Untold Physio Stories is sponsored by


Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started.


Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual


My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link.


Keeping it Eclectic...

[RESEARCH] Ice for Ankle Sprains? - theManualTherapist.com


Should you ice ankle sprains?

INTRO:
Some documented treatment options after an acute ankle sprains include:
  • Cryotherapy.
  • Surgical treatment.
  • Joint mobilization.
  • Kinesiotherapy.
  • Bracing.
  • Acupuncture.
  • And many others. 
Cryotherapy has often been recommended by clinical practice guidelines and used by health professionals in acute ankle sprain management because it has low cost, easy application, and is considered potentially effective in clinical practice settings.

However, current evidence supporting cryotherapy is still unclear. 

Previous systematic reviews (1,2,3 sources below):
Included trials without appropriate comparators (i.e., placebo, sham, waiting list or no intervention).
Failed to investigate whether cryotherapy enhances effects of other treatments (i.e. cryo + exercise). Thus, a new systematic review is necessary to investigate effectiveness of cryotherapy in the management of acute ankle sprains. 

Miranda et al. (2021) investigated the effectiveness of cryotherapy for acute ankle sprains on:
  • Pain intensity.
  • Swelling.
  • Range of motion.
  • Function.
  • Recurrence.

RESULTS:
  • 377 articles were found.
  • 134 duplicates were removed.
  • 19 potential full texts were assessed.
2 RCTs with high risk of bias met inclusion criteria. 

Neither evaluated the effectiveness of cryotherapy compared with placebo, sham, waiting list or no intervention.

Uncertain evidence showed cryotherapy does not enhance effects of other interventions on:
  • Swelling.
  • Pain intensity.
  • Range of motion.
CONCLUSIONS:
Current literature lacks evidence supporting the use of cryotherapy on management of acute ankle sprain. 

High-quality RCTs are needed. 

Get Research reviewed for you, just $1 a week

SOURCE:
Miranda et al. 2021. Effectiveness of cryotherapy…Pt in Sport. (49), pp. 243-249.

Noted Systematic Reviews
1: Bleakley, McDonough, & MacAuley, 2004
2:Van den Bekerom et al., 2012
3: Doherty et al., 2017


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
Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

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...

Untold Physio Stories - You're Doing it All Wrong - themanualtherapist.com


Have you ever been corrected or called out by an instructor in front of the class? It's not a great feeling and not a good way to learn. Listen to this story where a course participant gets corrected by the instructor which makes him realize techniques and assessments are probably non-specific.




Untold Physio Stories is sponsored by


Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started.


Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual


My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link.


Keeping it Eclectic...

Best Nutrition Guide for PTs - themanualtherapist.com

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

Physical therapists (PTs) are direct care providers who help people across many settings and with various pathologies and functional losses. From cardiac issues, metabolic dysfunction, cancer, neurological deficits, and musculoskeletal disorders, PTs can help a variety of patients get stronger, move with more confidence, and feel better. One key tool that can help with PT's treatments is nutrition.

Nutrition is in the scope of practice of Doctors of PT (DPTs), according to the American Physical Therapy Association (APTA). Nutrition is linked with inflammation, recovery, pain, psychological well being, and quality of life. Plus, most of our clients are taking supplements or simply want to get better, faster with any approach possible -- as such, PTs need more quality dietary info.

One of the best evidenced-based resources for nutrition is Examine.com. Examine offers copious research, great summaries, and even plain-language explanation for patients. The website offers a very useful supplement guide section, which will help many PTs navigate those awkward questions patients have (like does glucosamine help my knees arthritis?). DPTs can also search specific diseases or diagnoses to pull up current nutrition and supplement guides, based on solid peer-reviewed evidence.

Check them out today: https://examine.com/ We receive no funding or reimburse for clicks or memberships -- we simply are recommending this site based on their quality and presentation of data.

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 and save big on the 3 course bundle! 

Earn your CNPT Online!



 
Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

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...



Untold Physio Stories - Dry Needling Adverse Event? - themanualtherapist.com


At a recent seminar, a PT told a case of a possible dry needling adverse event. After consultation with a specialist, scans, and better history from the patient, it seems more like a spontaneous or patient caused injury rather than iatrogenic. What do you think? Have you ever heard of anything similar? 


Untold Physio Stories is sponsored by


Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started.


Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual


My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link.


Keeping it Eclectic...

[RESEARCH] Strength and Balance Training for Chronic Ankle Instability - themanualtherapist.com


Balance & Strength Training to Improve Chronic Ankle Instability


INTRO:
Lateral ankle sprains most prevalent musculoskeletal injuries in sport.

Without appropriate rehab, risk increases for chronic ankle instability (CAI), and osteoarthritis (OA).

Prolonged symptoms of CAI include pain, weakness, or instability, which can lead to range-of-motion (ROM), strength, balance, and functional performance deficits.

Hall et al. (2018) determined if balance- and strength-training protocols would improve the strength, balance, and functional performance deficits associated with CAI.

METHODS:
  • 39 volunteers with CAI, 3 groups, all completed 20-minute sessions, 3x/week, for 6 weeks:
  • Balance-training protocol
  • Strength-training protocol
  • Control

KEY FINDINGS:
  • Time-by-group interactions were found in:
  • Concentric & eccentric inversion
  • Eccentric eversion
  • Concentric & eccentric plantar flexion
  • Balance Error Scoring System (BESS)
  • Star Excusrion Balance Test (SEBT)
  • Side hops

Improvements in the balance- and strength-training protocol groups in concentric and eccentric inversion and concentric and eccentric plantar flexion and the BESS, SEBT, and side hop. Only the strength-training protocol group improved in eccentric eversion. The control group did not improve in any dependent variable

MAIN TAKEAWAYS:

  • The balance- and strength-training groups improved their strength, balance, and functional performance.
  • The control group did not improve, suggesting that bicycling alone or increasing passive motion did not improve strength, balance, and functional performance.
  • Combining resistance-band and proprioceptive neuromuscular facilitation strength training was an effective intervention.
  • More clinicians should incorporate hop-to-stabilization exercises into their rehabilitation protocols to improve the deficits associated with chronic ankle instability.

SOURCE:
Hall et al. 2018. Balance- and Strength-Training Protocols to Improve CAI. Journal of Athletic Training 2018;53(6):568–577


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
Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

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...