The Curious Case of Paresthesia in the Legs

 

Today I had the opportunity to present to the OSU DPT students on a case that I’m passionate about. This was the 3rd year I’ve presented the case to OSU DPT. Also I’ve presented it at the OPTA annual conference, AAOMPT annual conference, and to our OSU ortho/sports PT residents and OMPT fellows in training.

The case report in question is available to read in the journal Physiotherapy Theory & Practice. 

 

Even though I’ve presented this case report at the local, state, and national levels. I still needed to do a run thru of the lecture and tune it up a bit. I’ve always found that providing a little pressure during practice sessions helps with the performance the day of. So, I recorded my practice session for the blog to create that added pressure. It is rough to say the least, but doing this helped me knock the presentation out of the park this morning. Also, I was reminded of how crucial having an audience for a presentation is. You feed off the audience a lot as a presenter (even when it’s on Zoom). The discussions we had this morning and questions the students asked were excellent.

So, if you’re interested, here is my practice session of the presentation I gave today, on my couch in my basement: https://osu.box.com/s/105ds8b9qfby36g4r8wk29kp0w5gyzk3

If you want to save time, just download and read the case report instead 🙂

Predictive Factors for Patients’ Failure to Show for Initial Outpatient Physical Therapist Evaluation

Check out our team’s latest publication in PTJ!

https://academic.oup.com/ptj/advance-article-abstract/doi/10.1093/ptj/pzab047/6124132 

The current version of the manuscript is the uncorrected version. It is a must read when trying to better understand why people no show their evaluation PT appointment.

 

PUBLICATION ALERT: Paresthesia Post Total Knee Arthroplasty Secondary to Severe Thoracic Spinal Cord Compression

Still waiting on my December JOSPT issue to be delivered to the house, but I’m excited I can view our MSK imaging article online for now.

“This case demonstrates the importance of differential reasoning by a physical therapist in a post-operative patient and timely communication to the referring surgeon.”

-Cody James Mansfield, Ryan Harrison, Matthew Briggs

 

 

 

Favorite response online to the article so far:

Must Read Dry Needling Articles

My Favorite References: Dry Needling Edition

One of my favorite presentations on dry needling that I’ve given for the Ohio Physical Therapy Association and our orthopaedic manual physical therapy fellowship is titled The Wild West of Dry Needling: Why Research Needs to Catch Up to Clinical Practice. Often times I’m asked for my references from this presentation.

Below is a curated list of my favorite dry needling articles to read.

History of Dry Needling: Of these articles my favorite is the Zhou and Brogan paper. I think it gives an excellent look at the history of dry needling and acupuncture, and has a measured view of the debate between acupuncture and dry needling. Dunning et al. and Unverzagt et al. give great perspectives as well.

Classic Paper: After performing a systematic review on the effects of needle therapies on muscle force produciton in JOSPT, when it came to dossage of trigger point dry needling, almost every study cited this article from Hong.

Safety of Dry Needling: When it comes to safety of dry needling as performed by physical therapist, this Brady et al. paper is probably the most mentioned, and classic paper to read. I’m a fan of the latest research from Boyce et al. which gives an updated perspective on adverse events with dry needling by physical therapists and does an excellent job comparing their results to the Brady et al. paper. The Hall et al. part one and part two papers are excellent in regard to practical safety considerations with dry needling, and papers I wish I would have read sooner.

Accuracy of Dry Needling and Safety: There needs to be more research investigating the accuracy and safety of various dry needling procedures. For our paper on the safety of dry needling to the lumbar spine we were inspired by the paucity of evidence in the scientific literature and the work from Dr. Kearns and Dr. Fernández-de-Las-Peñas.

Effects of Dry Needling: I think both of these papers are good introductions to the effects of dry needling.

Dry Needling for Tendinopathy: AW McDevitt and PE Mintken presented an excellent talk at APTA CSM in New Orleans and packed two ball rooms wall to wall on the topic of dry needling and tendinopathy. Hands down one of the best talks I’ve seen at CSM and a great summation of the evidence.

Systematic Reviews: There have been numerous systematic reviews on the topic of dry needling. Below are some of our favorites. Majority of the reviews assessed the effects of dry needling on pain, which is what motivated us to analyze the effects of needling therapies on muscle force production.

Placebo Mechanisms: Our systematic review identified many methodological flaws in dry needling studies, however a major concern was that few studies actually controlled for the placebo effect. The study by Mayoral et al. is one of my favorite examples of a dry needling study controlling for the placebo effect and a very unique example of the participants actually being blinded to which treatment group they were in. A super rare find and worth a read. In regard to placebo mechanisms, my favorite viewpoint article from JOSPT on the topic was written by Bialosky et al. This articles scores extra points with me because they reference Indiana Jones in Raiders of the Lost Ark.

Interesting Case Reports: Journal of Manual and Manipulative Therapy had a special issue on dry needling where they published a case report by Snyder. My jaw dropped when I read this case,  from the first word to the last.

Those are my favorites. Hope you found one to add to your own reading list.

Best wishes,