Dr Angela Cadogan
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Measuring Up: Do Hand-Held Dynamometers and Force Plates Add Value to Shoulder Rehab?

17/11/2024

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Dr Angela Cadogan, PhD, NZRPS
​Specialist Physiotherapist (MSK)

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Force measuring technology has been around for decades but has only recently become more affordable and accessible to the mass physiotherapy market. The ability to objectively measure force and track changes over time provides the patient with a source of motivation, takes the guess work out of manual strength testing, provides us with deeper insights into force production and provides funders with objective measures of progress.

​With increasing amounts of time and money being spent on equipment and collecting force data, maybe it’s a good time to pause and consider what value we are getting from these devices in our shoulder rehabilitation?

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From Referrals to Results: The Many Faces of Orthopaedic Triage

31/8/2024

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Dr Angela Cadogan, PhD, NZRPS
​Specialist Physiotherapist (MSK)
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"Orthopaedic triage" is becoming a common term in the world of physiotherapy and musculoskeletal care. As healthcare systems evolve to meet the rising demand for elective musculoskeletal and orthopaedic services, orthopaedic triage has found itself in the spotlight.

An increasing number of physiotherapists are working in “orthopaedic triage” roles in elective (non-acute) settings in both the private and public sector. Elective services include anything that is not urgent or emergent. In New Zealand, examples of elective orthopaedic services include community-based ACC funded ICP/ECP pathways, referrals to private orthopaedic services and referrals by GPs to elective orthopaedic services in the public hospital.
​But here’s the issue – the term “orthopaedic triage” doesn’t mean the same thing to everyone. Depending on where you work or who you talk to, "orthopaedic triage" can take on different meanings, leading to confusion and inconsistent practices. A shared understanding of what “orthopaedic triage” is in the elective setting is needed to help us prepare for these roles as they emerge.

In this post, we’ll take a look at what orthopaedic triage is (and isn’t), we’ll explore definitions and why these matter, and review the purpose of triage and some of the factors that shape it. 

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Is Virtual Reality a Useful Rehabilitation Tool for Shoulder Instability?

19/11/2022

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Virtual reality (VR) is an emerging technology that involves the interaction between a user and a computer with real time simulation of environments, functional activities, exercises and games. (Rutkowski et al., 2020). The definition of VR is based on the concept of “presence” which relates to the sense or feeling of being in an all-surrounding environment. There are currently 4 main types of VR:
  1. Non-immersive VR
  2. Immersive VR
  3. Augmented VR
  4. Mixed VR

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Manual Therapy for Shoulder Pain: Trick or Treat(ment)?

19/9/2022

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Musculoskeletal physiotherapists have a therapeutic ‘bag of tricks’ that includes a range of interventions such as advice, pain science education, acupuncture, exercise and manual therapy to name a few. What turns a ‘trick’ into an effective ‘treatment’ is its application within a biopsychosocial framework, guided by clinical reasoning, informed by evidence within a person-centered, shared decision-making model of care.
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Manual therapy as a “low-value” treatment
Manual therapy has been the subject of mounting criticism for being a passive, low value intervention that has potentially nocebic effects, that can create dependency, foster maladaptive beliefs and create unrealistic expectations of treatment. This assumes that manual therapy is applied indiscriminately, in isolation, without clinical reasoning or context. If that is the case, I would be the first to agree that manual therapy, and any other treatment applied in this way, literally becomes another ‘trick’ of the trade.

So what turns our manual therapy ‘tricks’ into an effective treatment for shoulder pain?

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    Dr Angela Cadogan

    Passionate about learning and helping others to think critically about their practice. I hope these posts stimulate your thinking.

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  • Home
  • About
  • Clinical
    • Outcome Questionnaires
    • Clinical Guidelines
  • Research
  • Education
    • Courses >
      • Shoulder Academy
      • Online Courses
      • Practical Courses
    • Inservice Education
    • eBooks
  • Leadership
    • Mentoring
  • Blog