Hump Day Hustling – Weekly Research Summary – April 12, 2023

Does post-op TKA require skilled PT? What is causing all the burnout in our profession? Answers to those questions and more in this week’s Hump Day Hustling! Enjoy, and if you want to dive deeper with ICE Physio check out our Upcoming Course Dates and Locations.


Do patients need PT post-op?

It’s a tough pill to swallow, but it appears maybe not all of them. While the title of this recently published open access systematic review is a bit of an overstatement of the findings (Patient reported outcomes actually DID have a statistically significant improvement in favor of supervised vs not), there is still a bit of a gut check here that indeed many folks do fine with unsupervised exercise. Looks like it’s time to take on the bigger challenge of identifying ahead of time who would get added benefit from supervised exercise vs who could be safely sent the unsupervised route.

ADL & Aerobic Demands

A new twist on #1RepMaxLiving

We often speak to 1RM Living, where one’s max capacity is near the demands of an activity in relation to strength, but what about endurance? This study from January’s PTJ looked at relative aerobic load of daily activities after stroke. We know physical activity typically plummets after stroke which can lead to reduced endurance capacity. This paper showed that these changes can result in a higher relative aerobic load despite a SLOWER movement pace. Results speak to the need to build aerobic capacity WHILE teaching pacing strategies for ADL’s. Great read!


Status & causes in outpatient PT

The topic certainly gets its share press, but what do we know about where burnout actually comes from in our specific population? Quoting directly from this qualitative analysis published in March’s edition of Musculoskeletal Care: “Participants interpreted an increased workload with no increase in wages, loss of control, and a mismatch between organizational culture and values as the main drivers of organizational stress. Professional issues such as high debt burden, low salaries, and declining reimbursement emerged as stressors”. The paper goes on to put some actual numbers to the amount that altering workload and control effect stress/burnout and they are certainly sufficient to consider both viable targets.

Daily Steps and Mortality

Every little bit counts!

One of our sayings with patients is “pitch perfect, negotiate acceptable”, and that pertains to these recent findings published in JAMA. Over 3,000 adults had their steps tracked and the data evaluated in light of mortality rates. From the paper: “The study’s findings suggest that for adults who face difficulties in exercising regularly, achieving the recommended daily steps only a couple days a week may have meaningful health benefits.”. Clinical take home: Yes, of course we want our patients committed to a daily formal fitness/gym routine, but we can’t lose focus on the fact that imperfect effort goes a long ways to bumping the needle in the right direction. Sometimes doing anything besides nothing is exactly what needs to be celebrated!

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PTonICE Rewind

Did you miss any of our ICE Physio podcasts last week? Well here you go!

Monday: “Marketing for the cash based pelvic PT: Part 2” (April Dominick)
Tuesday: “Reviewing the game film: Part 2” (Zac Morgan)
Wednesday: “The hardest transition in healthcare” (Dustin Jones)
Thursday: “There is no end to justify your means” (Jeff Moore)
Friday: “Stop ****ing getting surgery” (Alan Fredendall)

Thank You! – ICE Faculty

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📢 On Virtual ICE next week we’ll be chatting “Hip Mobility” with ICE faculty Guillermo Contreras! Not in our virtual mentorship program? Find out how to enroll and learn more HERE