Hump Day Hustling – Weekly Research Summary – October 11, 2023

Shoulder instability, intermittent fasting, and much more in this episode of Hump Day Hustling! Enjoy, and if you want to dive deeper with ICE Physio content make sure to check out our Upcoming Course Dates and Locations!

Atraumatic Shoulder Instability

Capsular shift fails to outperform placebo surgery

It’s another dire report for the surgical option in this bit from BMJ over the summer. “Mean reductions in pain and functional impairment for both groups were similar” where “both groups” means arthroscopic capsular shift vs diagnostic arthroscopy alone (e.g. placebo surgery).

Now before physical therapists get up on their high horse it should be noted that both groups got PT and yet had quite modest improvement. Importantly the “PT” was a supervised HEP using an algorithm approach.

Atrial Fibrillation

Experience of endurance athletes

Interesting qualitative study on Endurance Athlete Experience with A-Fib.

The authors identified 3 main themes:

  • Tensions with Training (fear of needing to train but worried about worsening AF)
  • Tensions with Treatment Plans (b/t AF and an active lifestyle, medication use being highly disliked since they feel like it impacts ex. performance)
  • Tensions with Clinicians (lack of guidance, clinicians not recognizing importance of their athletic needs)

Almost all participants settled on a clinician who better understood their lifestyle!!!

ICE Hot Take: We could be the providers to bridge these gaps! Having an understanding of Afib, knowing what to look for in identifying it, understanding the treatment options + how to modify training seems to be very important to this population.

Alzheimers

Creatine to the rescue??

Talk about the supplement that just keeps delivering pleasant surprises! Before we get ahead of ourselves let’s make it clear that the link being discussed between Alzheimer’s and creatine in this open access paper is based on animal models, but the possible neuroprotective potential is incredibly encouraging none the less! 

Diabetes & Mortality

A shocking and urgent conversation

A linear dose-response relationship is emerging between diagnosable type 2 diabetes (T2DM) and life expectancy.

Lancet – OCT2023

N = 515,718 subjects

The sooner your onset of type 2 diabetes, the sooner you are likely to die, with those individuals diagnosed at age 40 or younger dying 14 years earlier than peers without T2DM, those diagnosed between 40-49 dying 10 years earlier, and those diagnosed at age 50+ dying 6 years earlier.

This dose-response relationship appears very similar to lung cancer trends in smokers. Earlier detection & cessation allows individuals diagnosed at a young age the time for their body to heal to limit the long-term effects, while those going undiagnosed and/or who do not change their lifestyle experiencing the worst of outcomes.

Intermittent Fasting

Benefits of 36 hour “water only”

While the evidence on intermittent fasting is not particularly strong especially in cases where daily calorie consumption is relatively equal between fasters & non-fasters, evidence is continuing to emerge on the benefits of infrequent, but longer fasts.

This study of 20 individuals had subjects perform a 36-hour fast (only drinking water) with outcome measures focused on tracking effects on the plasma lipidome. Findings revealed that an infrequent, but longer fast significantly remodeled the plasma lipidome of the body, vastly altering the way that the body utilized fat stores following the fast. Fat mass was more readily available for metabolism & used preferentially for energy following the fast.

Limitations: small study size with healthy active folks who often aren’t the most important target of such lifestyle modification interventions.

    PTonICE Rewind

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

    Monday: “Breath manipulation and the pelvic floor” (Jess Gingerich)
    Tuesday: “Frozen shoulder: Helping patients navigate no (hu)mans land” (Lindsey Hughey)
    Wednesday: “Dynamic gait training: Obstacle course 2.0” (Julie Brauer)
    Thursday: “The needle is in, now what?” (Paul Killoren)

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    📢 On Virtual ICE next week we’ll be chatting “Non-operative ACL management” with special guest Dr. Amy Pakula! Not in our virtual mentorship program? Find out how to enroll and learn more HERE