This scoping review explored knowledge (from 10 academic databases, 7 grey literature databases, reference searches & expert consultations) on the use of telerehab (PT, OT, SLP) for Indigenous children. These services are particularly important in addressing the challenges in accessing rehab services for Indigenous children, particularly those living in rural & remote locations and experiencing inadequate infrastructure, shortages in the healthcare workforce, disparities in funding and resources, and systemic racism. Although some studies explicitly acknowledged cultural responsiveness within both the research process and the intervention, most were not designed for Indigenous children and their caregivers. The authors advocate for (1) addressing technological limitations, (2) understanding and respecting diverse worldviews acknowledging the strengths of indigenous families and indigenous knowledge, and (3) co-developing services to meet the unique needs of Indigenous families.

This study reported the results of an online survey of international healthcare clinicians to determine if, and why or why not, they use electrophysical modalities to treat paediatric lower limb conditions. Interestingly, of the 445 practitioners who responded, 68% stated they used electrotherapy with the most common reason being the effectiveness of the modality while the remaining 32% reported not using electrotherapy with the most common reason being the lack of evidence of evidence. This finding exposes that how we perceive the evidence influences our clinical practice and that people can have conflicting interpretations of the same evidence.

This small study (7 males with previous or current AT & 7 healthy males) used 3D gait analysis to explore whether the biomechanics of those with current or previous AT were characteristic of either of the 2 proposed biomechanical mechanisms for development of AT in runners: (1) a whipping mechanism characterized by prolonged and excessive rearfoot eversion and (2) a tearing mechanism characterized by high eccentric plantar flexor forces. Analysis revealed that there weren’t differences in any rearfoot eversion, inversion or dorsiflexion variables or waveforms during running in the AT group compared to the controls. Although it was too small a study to convincingly influence practice, it is great to see empirical studies like this testing hypotheses.

Do you see patients with a diverse array of symptoms that raise your suspicions that long COVID may be present? Watch this video recording of PT Jessica DeMars from a presentation she gave at a recent rehab grand rounds for the Rehab Covid Network in which she reviews the symptoms and pathophysiology of Long COVID, shares screening tools and patient reported outcomes for people with Long COVID and discusses safe rehabilitation principles for this population.

PT know that there are many barriers to patients doing their strengthening exercises. This article from the American College of Sports Medicine identifies which barriers are modifiable (e.g. inadequate knowledge, low self-efficacy, misperceptions, accessibility, affordability). More importantly it provides guidance in how to help patients overcome them using the “STRONG approach”: S =social support; T=talk to others, R=regulate motivation; O=optimize attitudes; N=nurture ability; and G=gentle persistence (examples are provided 😊).

This study evaluated the diagnostic value of 7 injury history variables, 9 clinical tests (with different combinations) and overall clinical suspicion for complete tears of the lateral ankle ligaments in acute (0–2 days post-injury) and delayed timeframes (5–8 days post-injury). In the first 2 days, lateral swelling had 100% sensitivity, haematoma had 85% specificity, and the anterior drawer test had 100% specificity. When assessed in days 5-8, sensitivity for the presence of haematoma improved from 43% to 91% and the sensitivity of the anterior drawer test improved from 21% to 61%. The overall clinical suspicion had a positive likelihood ratio (LR) of 4.35 in the acute timeframe and a positive LR of 6.09 during days 5-8. The take home messages are: in the first 2 days clinical exam can exclude complete tears (e.g., absent lateral swelling) and identify high probability of complete tears (e.g., positive anterior drawer test) but the ability to accurately diagnosis injury improves 5-8 days after injury.This study evaluated the diagnostic value of 7 injury history variables, 9 clinical tests (with different combinations) and overall clinical suspicion for complete tears of the lateral ankle ligaments in acute (0–2 days post-injury) and delayed timeframes (5–8 days post-injury). In the first 2 days, lateral swelling had 100% sensitivity, haematoma had 85% specificity, and the anterior drawer test had 100% specificity. When assessed in days 5-8, sensitivity for the presence of haematoma improved from 43% to 91% and the sensitivity of the anterior drawer test improved from 21% to 61%. The overall clinical suspicion had a positive likelihood ratio (LR) of 4.35 in the acute timeframe and a positive LR of 6.09 during days 5-8. The take home messages are: in the first 2 days clinical exam can exclude complete tears (e.g., absent lateral swelling) and identify high probability of complete tears (e.g., positive anterior drawer test) but the ability to accurately diagnosis injury improves 5-8 days after injury.

This trial compared some of commonly used treatments (corticosteroid injections, heavy-slow resistance training, advice re activity, and heel cups) for patients with plantar fasciopathy. 180 patients were randomized to 1) Patient Advice and a heel cup (PA), 2) PA and heavy-slow resistance training (PAX), or 3) PAX and a single corticosteroid injection (PAXI) and followed them for 1 year. The exercise was a heel raise (as many sets as possible every other day until they felt they had reached a self-evaluated acceptable symptom level and then for 4 more weeks). The analysis (Foot Health Status Questionnaire) revealed no clinically relevant difference in the pain domain between PA and PAXI after 12 weeks despite a statistically significant difference. There were no differences between either PA and PAX or PAXI and PAX. The take home message is that simple advice on staying active, minimizing pain-aggravating activities and using heel cups is sufficient for most people.

This pilot study of fatigue management for 60 patients living with Long COVID reported an analysis of self-reported measures of fatigue, well-being, and health status were taken at baseline and repeated at 2 wks after the intervention. At baseline, 93% of participants reported moderate to severe fatigue impacting on everyday activity – particularly impacting leisure and work activity. There was statistically significant improvement in fatigue (P < 0.001), well-being (P < 0.001), and health status (P < 0.001). Although encouraging, it is important to recognize that this was a retrospective analysis and there was no control group. 

This well designed RCT of 36 patients with axillary web syndrome post mastectomy compared the effects of 5 sessions/week for 5 weeks of manual lymphatic drainage versus soft tissue mobilization (in combination with stretching, strengthening, & ROM exercises). Pain threshold, shoulder mobility and QOL were evaluated at baseline and 5 wk were assessed using the breast-cancer specific QOL questionnaires, Disabilities of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NPRS) and Patient Specific Functional Scale (PSFS), dynamometer and goniometer. Analysis revealed manual lymphatic drainage and soft tissue mobilization were clinically equally effective yet manual lymphatic drainage showed more improvement in functional movements.

This recently updated Cochrane systematic review of the effect of exercise-based cardiac rehab (ExCR) on mortality, hospital admission and health-related quality of life, was designed to address the limitations of the previous review i.e. (1) most trials were undertaken in patients with heart failure with reduced (<45%) ejection fraction and women, older people, and those with heart failure with preserved (>=45%) ejection fraction were under-represented; and (2) most trials were undertaken in a hospital or centre-based setting. A total of 60 trials (8728 participants) included 16 new trials (2945 new participants). Analysis supported the conclusions of the previous 2018 version – compared to a no exercise control, ExCR participation likely reduces the risk of all-cause hospital admissions and heart failure-related hospital admissions, and may result in important improvements in HRQoL(although there was no evidence of a difference in all-cause mortality). Perhaps most importantly, this updated review provided additional evidence supporting the use of alternative modes of ExCR delivery, including home-based and digitally-supported programmes.