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A podcast by Exercise Physiologists, specifically for Exercise Physiologists. These casual chats cover all things EP - drawing from the experience and expertise of the Bodytrack Exercise Physiology team and a variety of guests. There's clinical discussions, business and marketing chats, and lots of opportunity for personal and professional growth. From uni students and new grads, to business owners and Senior EPs, the Bodytrack Academy podcast has something for everyone.
Episodes
7 days ago
7 days ago
In this podcast, Gage sits down with Caitlin Scott (APA Sports and Exercise Physiotherapist/ Musculoskeletal Physiotherapist.), a Physiotherapist at Milton Physio and a close allied health colleague of ours.
Caitlin has had extesnsive experience in the physiotherapy world and discusses all things knee OA, specifically on physiotherapy principles and how and EP can integrate effectively into the care of the patient. A great multidisciplinary discussion!
Show notes:
- What is Knee OA?
o Knee OA is a progressive multifactorial degenerative joint disease involving the articular surface of the joint
§ progressive loss of articular cartilage
o There are 4 stages
§ early, mild, moderate, severe
o 3 key areas in the knee
§ tibiofemoral medial compartment
§ lateral compartment
§ patellofemoral compartment
- Prevalence:
o 653.1 million >40 y.o with knee OA worldwide (2020).
o 73% of those with OA >55 y.o, 60% female
o Knee most frequently affected, followed by hands and hip
o 16% >15 year old
o 22.9 %> 40 y.o
- Risk factors:
o Previous trauma/Surgery
o Obesity
o Female gender
o Laxity
- Diagnosis:
o Individualised subjective and objective assessment
§ Consideration of history, symptoms, other health conditions, physical assessment, functional levels
o Symptoms
§ Persistent knee pain, limited morning stiffness and reduced function
o Signs
§ Crepitus, restricted movement and bone enlargement
o When all 6 signs/symptoms present – 99% accuracy in diagnosis
o No imaging required – diagnosis can occur on assessment alone
o Imaging considered for other alternate diagnosis as clinically indicated
§ Considering insufficiency fracture, avascular necrosis, inflammatory
o Impact on function
§ WOMAC, KOOS o Osteoarthritis Knee clinical care standard
- Treatment pathways for knee OA – Surakanti et al 2023
o Conservative
§ Education
· Including pain management (Lesmond et al 2023)
§ Weight loss and exercise
§ Medication
· Research supports Exercise> NSAIDS
o However need to consider if patient having an acute painful flair – is medication required to maintain exercise levels Thorlund et al 2022
§ Individualised program
· Considering other comorbidities. Activity levels, goals
§ Physiotherapy/EP
· Promoting restoration/maintaining movement
· Identification of contributing factors
o Adding hip strengthening to quads exercises improves patient reported pain and function: Ref: Hislop et al 2020
o Unilateral OA: hip add is lower affected side, hip strength is lower bilaterally, dynamic balance lower bilaterally, patient reported pain associated with knee ext strength but not hip strength/dynamic balance: Ref: Hislop et al 2022 § GLAD program - Good Life with OsteoArthritis: Denmark Ewa Roos
· 2-3 patient education sessions and 12 supervised exercise sessions over 8 weeks
o Improved pain and objective outcome measures
§ Roos et al 2021
· Need to consider this is a group exercise program – it is better than nothing but we need to have individualised programs ideally
o Injections
§ Cortisone, hyaluronic acid, platelet-rich plasma
· Need to consider limitations – chondrotoxicity resulting in increased cartilage damage, increased risk of infection if injection 3/12 prior to surgery (Wernecke et al 2015)
o Surgical
§ Total knee arthroplasty
§ Uni-compartmental: unicompartment knee arthroplasty, High tibial osteotomy · McCormack et al 2021
§ Less likely to see arthroscopy’s
- Criteria for Surgery – Hawker et al 2023
o Considers the need, readiness/willingness, expectations and health status.
§ Do not want to wait until extended period of being inactive with reduced quads and gluteal function.
o Need
§ Evidence of knee OA on clinical and radiographic examination
§ Reports knee OA symptoms impacting on quality of life
· WOMAC, KOOS, 4 item arthritis coping efficacy Scale
§ Adequate trial of non-surgical OA treatment
· Exercise, physiotherapy, weight loss, medications, injections
o Readiness/willingness
o Patient expectations – Quote Quentin.
o Health status
- Realistic improvements – Quote Dr Quentin Scott – Specialist MSK Physiotherapist
o 3 months before you are starting to do well
o 6 months before you are pleased you did it
o 9-12 months before you have forgotten about it
o Key is individual – everyone will respond differently depending on reason for surgery, prehab
o Post operative response can be affected by prehab: ROM, quads fn, understanding of initial rehab process
- How long should we approach conservative treatment
o No hard and fast rule
§ Individualised
§ Targeting limitations
§ Understanding comorbidities
o Surgical techniques and replacement technology has improved § 82% TKR last >25 years (Evans et al 2019) § 3.9% require revision within 10 years, 10.3 within 20 years (Bayliss et al 2017)
§ Age matter: >70 y.o 5% likely to require second replacement, 50 y.o men – 35% require second replacement (Bayliss et al 2017)
- What assessments should we do, measures, goals
o Baseline strengthening and loading
§ VALD
o Balance
o Range of Movement o Consider regarding exercise – Lawford et al 2022
§ Easily accessible
§ High quality
§ Develop by and for consumers
§ Different ways to deliver information
§ Different types of resources for self management
§ Resources on exercises and how to perform them/progress
§ Support motivation and track progress
§ Include options
§ Facilitate access to support
- What's a physio's and EPs role in rehab
o Physiotherapist:
§ Diagnosis, movement impairment identification, specific exercise prescription, manual therapy, education
o EP
§ Exercise prescription and modification, education, o Therapeutic exercise recommendations (Holden et al 2022)
§ Use evidence based approach
§ Consider exercise in context of living with OA and pain
§ Comprehensive baseline assessment with follow up
· Reported difficulties, physical limitations, functional restrictions, impact on participation, psychosocial factors
· Red flags, contraindication to exercise
· Overall health (comorbidities) and exercise precautions
· Baseline measurements and targets
§ Set goals
§ Consider type of exercise, dose, modification and progression
§ Individualise exercise
§ Optimise delivery of exercise and adherence
§ Education OA and role of exercise
Myth:
- Osteoarthritis is painful
o Not all osteoarthritis is painful – many show changes on imaging without pain or significant movement limitations
- Weights and running will make it worse
o Evidence indicates otherwise – positive outcome
§ Consideration regarding training into pain – exercises should not be painful and increase symptoms associated with OA
- I need an X-ray to confirm osteoarthritis
o Consider signs and symptoms as a diagnosis
References:
Australian Commission on Safety and Quality in health Care 2017 – Osteoarthritis of the knee clinical care standard.
Cieza et al 2021, Global estimates of the need for rehabilitation based on the global burden of Disease study in 2019: a systematic analysis for the global burden of disease study 2019
Cui et al 2020, Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population based studies
Dong et al 2023 Evidence on risk factor for knee osteoarthritis in middle-older aged: a systematic review and meta-analysis
Evans et al 2019 How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years follow up
GLA:D Australia https://gladaustralia.com.au/
Hawker et al 2023 Patient appropriateness of total knee arthroplasty and predicted probability of a good outcome
Hislop et al 2020 Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis: A Systematic review and meta-analysis
Hislop et al 2022 Hip strength, quadriceps strength, dynamic balance are lower in people with unilateral knee osteoarthritis compared to their non-affected limb and asymptomatic controls
Holden et al 2022 Recommendations for the delivery of therapeutic exercise for people with hip and/or knee OA. An international consensus stydy from OARSI Rehabilitation discussion group
Lanois et al 2024 Associations between anterior knee pain and 2-year patellofemoral cartilage worsening: the MOST study
Lawford et al 2022 What should a toolkit to aid the delivery of therapeutic exercise for hip and knee osteoarthritis look like? Qualitative analysis of an international survey of 318 researchers, clinicians and consumers by the OARSI Rehabilitation Discussion
Lesmond et al 2023 Neurophysiological pain education for patients with symptomatic knee osteoarthritis: a Systematic review and Meta-analysis
Roos et al 2021 Immediate outcomes following the GLA:D program in Denmark, Canada and Australia. A longitudinal analysis including 28370 patients with symptomatic knee or hip osteoarthritis
Surakanti et al 2023 Surgical vs Non-surgical treatments for the knee: Which is more effective?
Thorlund et al 2022 Similar effects of Exercise therapy, nonsteroidal Anti-inflammatory drugs and opiods of the management of osteoarthritis pain: A Systematic Review with Network Meta-analysis
Wernecke et al 2015 The effect of intra-articular corticosteroids on articular cartilage: A Systematic review
Zhang et al 2010 EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis
Tuesday Apr 30, 2024
Chronic Pain | Case Study Research to Practice
Tuesday Apr 30, 2024
Tuesday Apr 30, 2024
Have you checked out the range of educational webinars we have available to access 24/7? Head over to access our educational Webinars HERE:
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Use code FIRST10 to receive $10 off your order
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In this podcast, the seats have changed! Josh interviews Dan H about a client he has been seeing who is experiencing chronic lower back and neck pain. Dan explores how he introduced the Biopsychosocial model to explain the pain his client was experiencing and how all of these factors can influence the severity of pain. Listen in for a real life case study bringing research to practice!
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Apr 04, 2024
Metabolic | Practical Application of Blood Flow Restriction
Thursday Apr 04, 2024
Thursday Apr 04, 2024
Have you checked out the range of educational webinars we have available to access 24/7? Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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In recent years, Blood Flow Restriction (BFR) Training has been a popular research topic, especially in hypertrophy. This is due to the theory that mechanically occluding blood flow can induce similar physiological outcomes to traditional strength training whilst only requiring low weights.
In this podcast Dan and Cam talk about the theory and mechanisms of BFR training and how we can adapt the use to different populations. In particular, the populations who are restricted in their capacity to load due to specific joints due to pain.
Cam talks through how he used blood flood flow restriction with a client that was unable to complete heavier style strength training due to osteoarthritic changes in his knee. We delve into the rationale, application, considerations and outcomes that Cam and his client faced through their rehabilitation journey.
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Mar 21, 2024
Thursday Mar 21, 2024
Final week of our March Webinar sale. Each webinar is only $30 and once purchased are available to access 24/7
Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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What is endometriosis, and what are the most common symptoms
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The stigma associated with endometriosis and how we as health practitioners can ensure our clients feel heard
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Ideas around subjective and objective assessment markers and how to apply this to a treatment plan
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Discussion around the importance of meeting your client where they are at, as well as examples of what this may look like in practice
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How exercise can be utilised to manage the symptoms associated with endometriosis and some ideas for exercise selection
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Mar 14, 2024
Cardiology | POTs Management and Exercise Prescription
Thursday Mar 14, 2024
Thursday Mar 14, 2024
Our educational webinars are now just $30!
Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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Diagnostic Criteria
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Understanding Symptoms
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Knowing where to start with exercise prescription
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Non-exercise recommendations
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Co-morbidities
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Navigating through the fluctuations of symptoms
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Education strategies
This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Feb 29, 2024
Oncology | Evidence Based Prehab for Oncology Treatment
Thursday Feb 29, 2024
Thursday Feb 29, 2024
Have you checked out the range of educational webinars we have available to access 24/7? Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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Access to the webinars mentioned in the podcast:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Feb 15, 2024
Things I wish I knew as a New Graduate Exercise Physiologist
Thursday Feb 15, 2024
Thursday Feb 15, 2024
Have you checked out the range of educational webinars we have available to access 24/7? Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
_________________________________________________________________________________
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Feb 01, 2024
Case Study | Practical applications for Osteoporosis Management
Thursday Feb 01, 2024
Thursday Feb 01, 2024
Kick off 2024 with a PD bang! Check out the range of educational webinars we have available to access 24/7 HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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In this podcast, the very experienced AEP Campbell chats with Dan about a long term client of his who has Osteoporosis. Cam delves into:
- how he initially assessed this client,
- the importance of education and listening to the client's beliefs, attitudes and goals
- the keys to safe progression for Osteoporosis management
- top tips as a practitioner to best manage clients with Osteoporosis
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Jan 18, 2024
Welcome to 2024 | The Bodytrack Academy - What’s available and what’s ahead?
Thursday Jan 18, 2024
Thursday Jan 18, 2024
Have you checked out the range of educational webinars we have available to access 24/7? Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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Dan is joined by Caitlin, Exercise Oncology Specialist, to discuss all things happening in 2024 with the podcast, educational webinars and a selection of some of our favourite podcasts and webinars from 2023!
If you want to make a good start to your education in 2024, this podcast will set you up for what we have available and what is to come for the Bodytrack Academy. As always, we value your input! Please reach out to us with any topics you would like us to discuss/create a webinar on at caitlin@bodytrack.com.au
Enjoy!
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE
Thursday Jan 11, 2024
Ehlers-Danlos syndrome | An EP’s Practical Approach
Thursday Jan 11, 2024
Thursday Jan 11, 2024
Have you checked out the range of educational webinars we have available to access 24/7? Head over to access our educational Webinars HERE:
https://www.eventbrite.com/cc/bodytrack-academy-educational-webinars-2146819
Use code FIRST10 to receive $10 off your order
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- What is Ehlers Danlos Syndrome, and a brief overview of it's subtypes
- The importance of letting your clients tell their story, especially in the context of more complex conditions
- Considerations for subjective and objective assessment of clients living with EDS and how this may impact exercise prescription
- Tips and tricks around conditions such as POTS, that are associated with EDS and how to adjust exercise for this
- Key takeaway messages around managing clients with complex histories and the importance of our job as an EP in validating their experiences
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This podcast is proudly sponsored by HGG Performance. As a valued Bodytrack Academy Associate, you are entitled to a discount on their great products! Use the code BODYTRACK10 at the checkout to receive 10% off! Access HERE:
https://hggperformance.com/?gclid=EAIaIQobChMIsKL4xNmAggMVdKtmAh1ZoQOREAAYASAAEgLVW_D_BwE