Chris Joyce

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@jdibon @AdamMeakins @behnam_liaghat Thanks, will do!

@chrisjoycept @AdamMeakins Look at work of @behnam_liaghat - he’s done great research on strengthening work.

It blows my mind that some so called evidence based physios try to say strengthening exercise doesn’t help things like hypermobility by using research that didn’t actually get any of its subjects stronger! 🤦‍♂️ Before you can claim strength doesn’t help you first have to get them stronger and then reassess! 🤫 ncbi.nlm.nih.gov/pmc/articles/P…

@AdamMeakins Okay yea thanks. I assumed you meant “help” as in help their hypermobility but understand you’re talking about outcomes secondary to the hypermobility. And yea, largely agree with your second point. Sounds like a good mediation study.

Its up to you… hypermobility causes a range of symptoms from joint pain to instability to POTS to fatigue, you could pick any of these! You cant change hypermobility directly as its a genetic disorder! But to say strengthening doesn’t help in this population you need to first get a sample stronger!

📢 Our 3rd year of the First Fridays | Physical Activity & IDD Virtual Research Network begins next Friday, Sept. 6 from 2-3pm CT! Open to students, researchers, and practicioners who want to stay in the loop about research in IDD/PA. Sign-Up Here: docs.google.com/forms/d/e/1FAI…

@GregLehman @DrSethPT @zadro_josh @PTJournal The Eugene Michels forum at CSM this year will be a discussion/debate of where we are with the movement system, diagnostic labels, and where we might head towards to create a practical and valid system for movement analysis and intervention.

@DrSethPT @zadro_josh @PTJournal I just wish there was a better way to have these public discussions. LTEs are great but they are behind a paywall and take too much time to be dynamic. I still think Twitter is the best but I think the user uptake is too low

In order to underline the diagnostic dilemmas we face, I wrote a LTE following @zadro_josh et al’s point of view in @PTJournal There are questions about what kind of labels are best/why, which also ties into the US’ efforts toward movement system dx academic.oup.com/ptj/advance-ar…

#proud of my @Aptaofma to show up and represent our profession in Boston today and of my alum @NUPTMRS who had some of their faculty stationed at the booth

@GregLehman @jacksonfyfe Yea no doubt, these tests are common functions in life and as far as properties go they do well correlating with things like overall health, QOL, and self-reported function. What caught my eye was that the exercises were the tests (if I understand the intervention correctly).

@chrisjoycept @jacksonfyfe Don't you think that these "functional tests" are the "function" we want to improve? They are the "function" they aren't just associated with it.

Can traditional resistance training improve functional task performance in older adults? Or is more “task-specific” training required? Here, 6 weeks of traditional resistance training improved dynamic (5-RM) strength, but had limited carryover to functional task performance (like gait speed or chair stands). Performing the functional tasks with a weighted vest further improved task performance, but had less impact on dynamic strength. Improvements in a non-specific (isometric) strength task and muscle size were similar with both traditional and task-specific training. An interesting lesson in specificity and the benefits of varied (both traditional and task-specific) resistance training. Nice work from @MattStockPhD and team! frontiersin.org/articles/10.33…

@jacksonfyfe @GregLehman Does this functional training improve function or does it improve scores on the tests that are associated with function? Nonetheless, specificity reigns. You get better at what you practice.

I think the evidence for "traditional" resistance training improving aspects of physical function is fairly mixed. No doubt there are benefits to improving general strength and muscle mass. But for many the goal is to improve the ability to perform activities of daily living. So a mix of both general and specific training is probably "best", but either is beneficial (depending on what the target outcome is).

The @bostonmarathon is a historic event that celebrates the grit and perseverance of the athletes every year. @WCVB and @cbsboston not highlighting the start of the Duo runners was really disappointing. Hopefully next year they are included and celebrated equally.

@JohnWarePT @AdamMeakins @CGMMaher Lost me a little there. I think @CGMMaher suggestion to use the actual terms (I.e. Hawthorne, NH, TA) instead of specific, non specific, contextual…would be helpful. I’m not even sure what is meant by “specific tx effect”. Shouldn’t that be confirmed via mediation analysis 🤷‍♂️

@chrisjoycept @AdamMeakins @CGMMaher To the extent therapeutic alliance influences confidence and trust, it’s certainly a factor in treatment effect. “Non-specific effects” should be in a separate row but also a separate column. “Tx outcome” implies a causal relationship, which isn’t the case per this definition.

What an interesting paper this is! pubmed.ncbi.nlm.nih.gov/38602164/ It shows that 70-80% all manual therapy’s effects on pain are due to contextual effects (PCE) and not the actual treatment itself! Contextual effects are things like the therapist explanations, narratives, and positive patient priming, as well as the patients beliefs, expectations, previous experiences etc It also shows that exercise rehab treatments rely on nearly 50% of these contextual effects as well! Key point is a lot of treatment effects are not due to WHAT is used, but HOW it is explained! Great work @YasEzzatvar @GiacomoRoss86 et al 👏

@JohnWarePT @AdamMeakins @CGMMaher Sure yea, as would some contextual effects (eg a therapeutic alliance). Maybe better to call it tx outcome than tx effect. I think the definitions are challenging and used inconsistently. I used to consider contextual effects as “non specific” but have tried to align with this

@chrisjoycept @AdamMeakins @CGMMaher According to this definition, “non-specific effects” would be independent of the treatment, right? So not really a “treatment effect”.

@AdamMeakins @CGMMaher If you have three groups. I love this image that explains the different components of a treatment effect. Perhaps a better interpretation of the JOSPT article is that the contextual + non specific effects are large. Still an important finding oarsijournal.com/article/S1063-…

@CGMMaher Thanks Chris!! So can we tease out a more realistic percentages of the placebo, natural history, contextual effects from this data?

The last communication in our discussion on the #MovementSystem is the original authors' of "Concerns on the Science and Practice of a Movement System" response to the letter from Shirley Sahrmann: academic.oup.com/ptj/advance-ar… @chrisjoycept @JBeneciuk @DukeMSK

Another response to our POV "Concerns on the Science and Practice of a #MovementSystem" from Shirley Sahrmann herself: academic.oup.com/ptj/advance-ar…

@PTJournal @OrthopaedicAPTA @JBeneciuk @chrisjoycept @TonyDelitto @PittSHRS Did somebody say @chrisjoycept ? Well done! Interesting findings...blaming the photo quality on the room lightning...

What happens when you get all the rockstar #BackPain researchers in one room? Come to this @OrthopaedicAPTA platform session today and find out! Featuring @PTJournal editorial board members & authors: @JBeneciuk @chrisjoycept @TonyDelitto @PittSHRS

We're back! 🙌🏼 Join us tomorrow for First Fridays - a virtual network of researchers in physical activity and health among individuals with IDD. @brendan_aylward will be presenting about AdaptX, an online adapted fitness program, & potential research collaborations. Join us!

@axelphysio Look forward to reading. Staying within the ICF makes total sense for any type of taxonomy. @ajette1 had a podcast with Pr. Sarhmann and asked her about this. I didn’t find the answer clear or compelling.

@chrisjoycept Just saw this. This is the system I've been taught at uni in Québec almost 15 years ago and have been using ever since. Simple. Uses ICD & ICF. Language any HCP in any country should understand. sciencedirect.com/science/articl…

Have people outside the US heard about the Movement System that is being developed and promoted in the American Physical Therapy Association? An aim of it is to create a classification of "Movement Diagnoses" that will be used by physical therapists. academic.oup.com/ptj/advance-ar…

Happening this Friday! This week @chrisjoycept will be leading a discussion on high intensity training for adolescents with Down syndrome. 🏋🏼‍♀️ If you'd like to join our virtual research network, please get in touch with @bchelsel who is coordinating the group while I'm on leave!