The past few months have seen a lot of great clinical resources come out for physiotherapists, most of which are open access to read or listen to.
This month I’ve put together links to a systematic review looking at the effectiveness of isometric exercise in tendinopathy management, as well as a research paper (FIDELITY study) looking at the 5-year follow up for arthroscopic partial meniscectomy compared to placebo surgery for degenerative meniscus tears.
We’ve also got a great new podcast to share, showcasing the new ‘Physio Explained’ by the crew at Physio Network. This is episode two of their podcast, looking at the management of femoroacetabular impingement (FAI) syndrome with Dr Jo Kemp.
This month’s Outside the Box is an article from one of my favourite sites to read, Gates Notes. This is a short 3-minute review by Bill Gates of the book ‘Why We Sleep‘ by Professor Matthew Walker.
Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials1
This is a recent systematic review that confirms what has been often discussed by experts over the past few years that there is no ‘silver bullet’ for exercise prescription in the management of tendinopathy.
There aren’t a great number of studies that made the inclusion criteria, but the overall takeaway is that isometrics are not superior to concentric or eccentric exercises in the management of chronic tendinopathy.1
The authors also importantly highlight that the response to isometric exercise varies between individuals with tendinopathy, but that it can be used at part of an overall progressive exercise loading program for relevant patients.1
Arthroscopic partial meniscectomy (APM) for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial2
This trial explored the effect of APM, compared to placebo-surgery at 5-year follow up on radiographic knee osteoarthritis, as well as knee symptoms and function.2
The results show that APM is associated with a slight increase in the risk of developing radiographic knee osteoarthritis and has no concurrent benefit in patient-relevant outcomes.2
Managing FAI syndrome with Dr Jo Kemp – Physio Explained by Physio Network3
(Duration: ~18 minutes)
This is a great new initiative from Physio Network. Here they are releasing short podcast episodes (less than 20-minutes) with clear takeaways for help in our clinical practice.
Key takeaways from this episode:3
- Exercise programs of greater duration (12-weeks) have demonstrated greater improvements statistically in the management of FAI compared to shorter rehabilitation programs of 6-weeks or less
- We should discuss the importance of specific exercise dosage in clinical practice. A comparison to being prescribed 500mg of a certain medication by a doctor, but the patient only taking 100mg. The ineffectiveness of this is easy to visualise and can highlight the importance of exercise dosage in clinical practice
- Research is supporting the use of strength training for larger muscle groups around the hip and trunk such as gluteus maximus and gluteus medius (and the functions they perform) in the management of FAI, as opposed to smaller, intrinsic neuromuscular muscle retraining as often prescribed in other areas such as the rotator cuff in shoulder rehabilitation
Outside the Box
This book put me to sleep4
– By Bill Gates (19th December 2019)
This is a short book review by Bill Gates of ‘Why We Sleep‘ by Professor Matthew Walker.
Sleep hygiene is a topic that I’m planning to write more about and will continue to share in my clinical practice as well as here at Physio Development as I feel it is such an important topic.
It’s great to see Bill Gates share this important book and his thoughts on it to his many readers and followers around the world.
Please feel free to share these physiotherapy clinical resources with anyone that would find them helpful in their clinical practice.
1. Clifford C, Challoumas D, Paul L, et al. Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials. BMJ Open Sport & Exercise Medicine 2020;6:e000760. doi: 10.1136/bmjsem-2020-000760. https://creativecommons.org/licenses/by/4.0/ [link]
2. Sihvonen R, Paavola M, Malmivaara A for the FIDELITY (Finnish Degenerative Meniscus Lesion Study) Investigators, et al. Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial. British Journal of Sports Medicine 2020;54:1332-1339. https://creativecommons.org/licenses/by/4.0/ [link]
3. Podcast: #2 Managing FAI syndrome with Dr Jo Kemp. Physio Explained by Physio Network – 11th October 2020 [link]
4. Blog post: This book put me to sleep. An expert explains the benefits of a good night’s rest. By Bill Gates – 19th December 2019 [link]