Friday, June 22, 2018

Help Physiopedia through Amazon Smile

Amazon Logo

AmazonSmile – You Shop, Amazon Gives to Physiopedia. 

What is Amazon Smile?

AmazonSmile is an easy and automatic way for you to support Physiopedia for free whenever you shop on Amazon. When you buy something on AmazonSmile you will find the exact same price as with the added bonus of Amazon donating a portion on the purchase to the charity of your choice. All you have to do is select the Physiopedia  charity on your initial logon. he shopping experience is exactly the same.

The scheme was launched in the UK in November 2017 initially with only 11 major charities eligible. The great news is that now the scheme is available to all UK registered charities!

Set Physiopedia as your chosen charity!

How do I Choose Physiopedia?

The great thing is you just have to use your existing Amazon account details for AmazonSmile. The first time you login you’ll select your chosen charity. Simple!

How much do Amazon Give?

Each time customers access Amazon through, Amazon will donate 0.5% of the net purchase price of eligible products to charities of the customers’ choice.

This will be TRIPLED to 1.5% up to the 29th June 2018.

Why Donate?

Physiopedia is a charity registered in the UK run by a team of volunteers who are on a mission to improve global health by providing free access to physiotherapy knowledge to everyone! Empowering physiotherapists with knowledge means better health care and reduced disability around the world. It is about the power of individuals to do extraordinary things for the global physiotherapy profession and for the world wide population of people that will benefit from our care.

There are many ways to donate to the Physiopedia charity, including making a one time or regular donationbecoming a benefactor or making a legacy gift that will help us to plan ahead for future Physiopedia projects. We would be delighted if you joined our existing donors, benefactors and legacy gifts, ensuring Physiopedia can do much more in the future.

All money received as a donation goes towards supporting our mission where the main purpose is to:

  1. Maintain the Physiopedia website with quality information and keep it free for all for ever.
  2. Offer free online courses for physiotherapists in topics that particularly affect individuals and communities in low income and/or conflict or disaster affected settings.

This really is a great way to help the Physiopedia Charity to continue to make great content available for free on

Top 5 Fridays! 5 Facts About Digital Marketing You NEED to Know

The future is already here. Digital marketing; SEO, SEM, website design/optimization, social media, live streaming, digital footprinting. It is expansive, and, it isn’t likely to let up.

The good news is that there are specific facts about digital marketing that act as fundamental principles to which all digital platforms operate. Facts, that we can rely upon and set our compass to their true north.
Here are….!!!
5 Facts About Digital Marketing You NEED to Know!

Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. Live cases, webinars, lectures, Q&A, hundreds of techniques and more! Check out Modern Manual Therapy!

Keeping it Eclectic...

ICD-11. A Welcomed Update

The headline change is the much needed move away from considering Transgender/Gender Incongruence  as a mental health disorder.

In the 18 years between the release of ICD-10 and ICD-11, the world has changed.  Health technology has advanced, treatments have improved, people are living longer and cultural norms have shifted.  A new and updated version has been well overdue. This week that long awaited update has been released. The new version will slowly replace the ICD-10 over the next four years, coming into effect in 2022.

What is the ICD & Why is it important?

The International Statistical  Classification of Diseases and Related Health Problems is the global health information standard for mortality and morbidity statistics. More than 100 countries use the system to report mortality data, this data is then used to monitor health and disease rates worldwide.

The ICD is part of the WHO Family of International Classifications which is comprised of three core classifications which are the ICD, the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Health Interventions (ICHI). There are then smaller more specific “Related and Derived” classifications.WHO Family of International Classifications

These classifications go some way to allow standardized assessment, treatment and management across the world. This is important for a number of clear and obvious reasons. Of course this only happens if countries adopt and use the same versions of the classifications. Take ICD 10 for an example which was released in 1990. Thailand switched from using 9 to 10 in 1994 whereas the USA switched in 2015. Think about that for a few minutes, just imagine the impact of data collection, diagnosis for patients and stigmatized diagnosis for individuals.

Clearly there will always be early adopters and late laggards, but considering the benefits of using a computer integrated system, it will be easier for most if they switch early but we will wait and see.

Read the ICD-11

What is Different in Version 11?

In terms of impact for physiotherapists ICD 10 & 11 appear on the surface to be largely similar. There aren’t any key changes for physiotherapy-specific and commonly found diagnoses but this isn’t that surprising. There are some slight re-classifications that change terminology used such as stroke now being a disease of the brain, rather than the circulatory system. What has changed is the electronic infrastructure ICD-11 has been built on this means it is much more accessible for low-resource countries. It will also be more integrated with electronic health systems and records allowing more robust and continuous data collection. This will allow a more natural evolution when required.

What are the Origins of the ICD?

The history of the ICD traces back to England in the 16th century. Every week, the London Bills of Mortality would announce deaths from distinctly medieval causes: scurvy, leprosy, and the big killer – plague.

It wasn’t until the late 19th century though, when Florence Nightingale, just returned from the Crimean War, advocated for the need for gathering statistics on causes of disease and death that data began to be collected more systematically.

Around the same time French statistician Jacques Bertillon introduced the Bertillon Classification of Causes of Death, which was adopted by several countries.

In the 1940s, the World Health Organization took over Bertillon’s system and expanded it to include statistics on causes of injury and disease, producing the first version of the International Statistical Classification of Diseases, Injuries and Causes of Death (ICD). This allowed for the first time the collection of both morbidity and mortality data to map both disease trends and causes of death.

If you notice any differences between 10 & 11 you think will impact your clinical practice then let us know.

Wednesday, June 20, 2018

Visual Inputs and Motor Learning

Often times in rehabilitation, we over simplify or over complicate various topics. This can be done with or without intentions. It can have beneficial or detrimental effects on transferring this information back to our clients or on to other rehabilitation professionals. Take vision in motor learning for instance. It is taken for granted that vision play a primary role in both learning as well as adapting to our environments around us. The ability to process information classical starts with visual based inputs and in support of skill building. Did you know that two different visual systems have been documented in the literature? They are referred to as the dorsal (ambient) stream and the ventral (focal) stream (Ungerleider 1982). They are understood to have different specializations and are used in different ways during daily motor processing.
        The ventral stream is used for conscious identification of objects that lie primarily in the center of the visual field. Therefore, as you are reading these words on your smart phone, the primary input is coming from the ventral system. It is responsible for the conscious perception of objects and can be manipulated by alterations in environment lighting such as dimly lit rooms or driving as night.
          The dorsal stream is believed to be used for movement control utilizing the whole visual field. Both central and peripheral. The dorsal stream operates unconsciously contributing to the fine motor control movements we perform.

        How have we figured this out? One evidence of is from the term “blindsight”. If I may just quote this area specifically from Motor Learning and Performance 5th edition by Schmidt, “Perhaps the most startling, and most convincing, evidence came from the study of two human neurological patients, TN and DB. TN had had two successive strokes, causing major neurological damage to his visual cortex, which rendered him “blind” in both eyes. After considerable study, researchers took TN to the hallway, asking him to walk down the hallway without his usual cane. Unbeknownst to TN, researchers had placed several objects in the hall around which avoided them all, even pressing himself against the wall to avoid a trash can. Patient DB, whose occipital cortex had been removed surgically because of a tumor, was also “blind” according to the traditional measures of vision. Researcher used forced-choice tests, in which DB was asked to guess where, between two locations in front of him, an object had been placed. His guesses were significantly more accurate than chance, even though he could not see the objects.”
        Taking consideration into these extraordinary situations, it got me thinking about how we might utilize understanding of the above to enhance visual information processing during rehabilitation?
          Are we giving more consideration than just having eyes open or eyes closed during activities? Should we be more focused on introducing an open environment with foreground, background, and peripheral visual field training? Especially for our athletes? Could we maximize our vision processing by putting our clients into situations that enhance the use of both their ventral and dorsal streams of visual input to increase their reaction times, up-train their feedforward mechanisms via learning and processing, and make them LESS reliant on the ventral stream?
            A couple of recently published articles by DR Grooms seems to lead us down this path. If you aren’t aware of Grooms…search him out. In my opinion, he is doing some cutting edge research regarding visual-motor processing, see how the brain potential changes as environments change, and how the body reacts to different stimuli. In his published study found here, he makes a compelling argument establishing a link “between dynamic movement mechanics, neurocognition, and visual processing regarding anterior cruciate ligament injury adaptations and injury risk.”  
            Perhaps utilizing training tools to not just focus on “sexy” exercises on soft balls, and jumping over objects (these have their place in specific areas of rehabilitation), but also incorporate more dorsal stream neurocognitive recognition stimulation via multiple “levels” of vision processing may improve the ability to compensate for external stimuli and/or attenuate the rapid maneuvers that depend on quick visual-motor interaction. His full explanations can be found here The succinct answer is faster reaction times, possible increased visual processing via the dorsal vs ventral stream, and decreased visual reliance on motor skills in the autonomous phase may improve preparation for incoming perturbations while maintaining neuromuscular integrity.

Examples of the previous statement could range from basic recognition of flashes of different colors in the background while juggling; or more advanced utilizing strobe training glasses while catching a ball. Environments that facilitate more feedforward mechanisms than feedback andadding neurocognitive elements to injury prevention and rehabilitation programs may reduce motor control errors during sport when visual-spatial responsibilities are in high demand.

Eric Dinkins via Motion Guidance
Keeping it Eclectic...

Monday, June 18, 2018

FREE Wheelchair Service Provision Course

wheelchair training for physiotherapists and physical therapists

We are excited to announce that our FREE Physiopedia course for 2018 will be on Wheelchair Service Provision.  Starting 3 September for 4 weeks, the course will provide in depth knowledge for people interested to learn more about wheelchair provision and training. 

Register for this course

Extended knowledge of wheelchair provision and training is not seen as a core skill for all physiotherapists, rather a specialist area of training for those that require these skills in their specific work context.  Despite this there has been a call for increased training for pre-registration physiotherapists related to wheelchair provision, but with educational programmes bursting at the seams this is unlikely to happen.  To fill the gap Physiopedia and ICRC, in their annual MOOC collaboration, are happy to provide a free course that any physiotherapist can attend to extend their knowledge in this topic.

The 2018 MOOC (Massive Open Online Course) aims to provide a basic theoretical understanding of wheelchair mobility and to develop an understanding of the theoretical principles, skills and knowledge underlying the management skills and knowledge in the management of wheelchair service delivery.  Starting on 3 September and lasting for 4 weeks, it will involve around 4-6 hours of work each week (depending on your learning style).  On passing the final quiz and completion of all of the required learning activities participants will receive a completion certificate as well as CPD points and any CEUs available.

In addition to this course in English, a collaboration with Humanity and Inclusion will also provide a French version of the course.

Useful links:


Global Clubfoot Initiative Launch New Webinar Series

The Global Clubfoot Initiative (GCI) is a consortium of individuals and organisations with technical and organisational expertise in clubfoot management, using the Ponseti method and experience in establishing national clubfoot programmes in low and middle income countries. As part of their mission they provide resources and make training available to those working with people with clubfoot.

Physiopedia has worked with the GCI before in the hugely successful Managing Children with Clubfoot which was published in 2017. The course is still available now and thanks to the GCI we have some incredible content which will transform your practice.

In keeping with their aim to provide resource for the clubfoot community the GCI are launching a new webinar series with the first being on Measuring outcomes and delivering quality in clubfoot treatment. This will take place on 3 July, 14.00 – 15.30 (GMT +01). To get the link to take part you will have to sign up but don’t worry it is completely free. There is no cost involved.

Sign up to the webinar

Why this topic?

There is variation in how the result of clubfoot management is measured and reported globally. This webinar will present approaches to measure the outcomes of treatment including longer term outcome and the experience of the patient and family and their level of satisfaction with the treatment.  Participants will also hear from national clubfoot programmes in a number of different countries on how they work to improve quality in their clubfoot treatment, to support the delivery of the best outcomes possible.

Who is Speaking?

  1. Tracey Smythe, London School of Hygiene and Tropical Medicine, International Centre for Evidence in Disability, will present approaches to measuring outcomes to treatment
  2. Christie Pettitt-Schieber, Research, Evaluation and Operations Manager, MiracleFeet, will talk about supporting quality clubfoot care across national programmes
  3. Esperance Uwizeye, Regional Program Officer (Africa) & Linda Hansen, Regional Manager (Africa), CURE Clubfoot will cover supporting quality clubfoot care in a country programme
  4. Mamun Chowdhury, Director of Operations, Walk for Life, Bangladesh, will talk about supporting quality clubfoot care at a clinic level

As with all webinars there will be opportunity for questions and discussion. To make sure you don’t miss out on any future webinars run by the GCI make sure you sign up to the mailing list.

Don’t forget about the clubfoot course on PP+!

Novel Ways to Mobilize the Radial Nerve

Chronic Lateral Epicondylalgia often has neurodynamic dysfunction. The radial nerve may have some sensitivity going on due to an abnormal impulse generating site.

What's the best way to reduce sensitivity and promote nerve health? Get it moving! In this quick video, I go over different ways to mobilize the radial nerve. The full 20 min mini case for lateral epicondylalgia is on Modern Manual Therapy Premium - click Learn More below to subscribe and see it!

Novel Ways to Mobilize the Radial Nerve

Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. Live cases, webinars, lectures, Q&A, hundreds of techniques and more! Check out Modern Manual Therapy!

Keeping it Eclectic...