Leveraging the power of the Clinical Practice Guidelines!

Well, it has been a busy weekend! Marshall and I have been working on updating all the techniques in the apps to show a grade of evidence as shown by the clinical practice guidelines. The guidelines are so powerful because they summarize the current best evidence and make recommendations. This allows clinicians to quickly get a sense of the value of the examination or technique based on multiple studies!

See the images below of how Evidence in graded in the guidelines.

You will see in all of your apps over the next week…. These grades being built into the relevant tests, interventions, outcome measures and patient education!

What does it mean to be a Guideline Based Clinical Reasoning app?

In 1910 Villemard, a French artist, drew a picture that was a vision for education for “The Year 2000”. We were supposed to be able to pump knowledge into the young ready minds of our students…

Ok… so we are a little behind schedule… but building apps to help develop clinical reasoning might be the next best thing!

When we first set out to build the Clinical Pattern Recognition series of apps, we decided that just filming a massive list of special tests and techniques was not enough. These archives of techniques and tests did solve the problem of developing clinical reasoning or “flow” as one of our users so eloquently described. We wanted to develop a tool, that used guideline based language. We wanted to film techniques instead of read about them. We wanted to link pain patterns, to possible conditions and allow clinicians and students to see how a relevant examination should be linked to matching interventions and exercises.

We also dreamed of developing a tool that could be updated easily as the evidence changed or guidelines were revised.

To be a guideline based tool, means we can bring the world together, practicing using the best evidence. Imagine the whole world using similar rehabilitation concepts and language, allowing research to be done in a more homogenous and generalizable way! The future is here…and we are happy to lead the way!

All the guidelines… in the palm of your hands… PhysioU.com!

The whole Clinical Pattern Recognition bundle is complete.

The CPR Orthopaedic full body bundle is finally done and updated with a bunch of new things. We’ve taken the last month to organize feedback from clinicians, instructors, and students and are currently making significant updates to all the apps! (Including going through new clinical practice guideline updates and filming!)

A few key updates:

Multiple platform support:

Our CPR bundle and single apps of eight body regions are all released on Android, Web and iOS! This has been a long time coming, but we did not want to release Android until it was perfect!

 

Pain science update:

Dr. Carol Courtney suggested we add “Signs of central sensitization” to Knee OA and Patellofemoral pain (I have also added this to whiplash and some chronic elbow/wrist and hand conditions)-

Foot strengthening update:

We are adding more significant foot strengthening exercises based on Dr. Irene Davis’ recommendations from her running courses, particularly her “doming” exercises.

 

Whiplash/pain science update:

We have carefully stratified the evaluation and management of whiplash disorders with the help of Dr. Gwen Jull who graciously spent hours chatting with me over skype as we deliberated on how to simplify this complicated condition.

 

Movement science/Analysis update-

We have attempted to take key movement examination tests and treatments and re-organized them based on the daily functional movements that they are intended to mimic and improve.

This ties into the latest low back pain guideline initiative to add Movement re-education to prevent recurrence. This update will allow easier understanding and integration into clinical practice.

 

Guidelines update:

Neck pain and heel pain revisions are being processed/filmed and new guidelines are on the horizon! We have added the Carpal Tunnel Syndrome guideline based content and will update when it is officially published.

 

App logic update:

Organization of testing and interventions- based on feedback, we have attempted to stratify testing and management of key impairments, versus associated impairments. This makes it easier to understand the multi-faceted management of many of the injuries we see in the clinic and speaks to the concept of “regional interdependence”.

We have also reorganized techniques in meaningful “clumps” to give context to commonly used tests, manual therapy and exercises.

 

“Helping students learn” update:

Short fun tutorial videos have been developed and are being updated into all of the apps.

 

Newly released Apps list:

• ROM/MMT/Palpation is complete and being tested. (Available on iOS and Web)
• NeuroExam- containing all neuro examination for any neuro rehab class is now available in the iOS and Android stores
• Gait- that helps students learn the phases and critical events of gait, including slow motion video and real-time EMG. This app also contains app videos of abnormal gait in real patients to take the understanding of gait into real time movement analysis. (Available on iOS, Android, and Web)

 

In production:

• Assistive devices/Gait training/Transfers app is now completely filmed
• Lower quarter sports movement analysis app is now completely filmed
• Clinical Pattern Recognition: Wound care app is in the design phase

Just wanted to give you an update and thank you for your willingness to be a part of our dream of changing the way Physical Therapy students learn!

Please email me at care@physiou.com, we would love your insights and thoughts.

Best,

Michael