Split brains and causation

There’s gotta be a reason. You can’t have an event pass by you without knowing why, right? Right.

“Well, you know, the weather made it hurt. It’s all that rain…”

“My back is hurting today, I was at a family BBQ and I stood for an hour yesterday, so…”

“The knee feels much better, I think it was the tape you put on there.”

Post Hoc Ergo Proctor Hoc. After that, therefor because of that.

Making a reason for things is not conscious, often. We always see cause and effect as a truth. If we’re wrong, it’s confabulation, not a lie. It’s “only human.” See a quote below from some of the Split Brain research:

Experience and the Experiment

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“Dad, let’s do an experience” my 6.5 year old said to me this morning. “Let’s see how far away these walkie-talkies can go and we can still hear each other.”

“Do you mean experiment?” I ask. “Yes, ex-per-i-ment” she says. We go over its pronunciation a few times. It’s a mix between my daughter having no front teeth and that she just gets her word choices mixed up now and then. Experience. Experiment. It’s an easy one to slip up on, plus they could be viewed in the same category in her head. “I will have an experience and learn something.” “I will do an experiment and learn something.” Same thing, basically, to a 1st grader.

So, you can see this question coming: Do you get Experience and Experiment mixed up?

Cervical Artery Dissection: Implications for the Physical Therapist A Case Report from a Direct Access Environment

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Intro:

You receive a call from your friend and fellow DPT classmate to evaluate her neck… the patient herself is a physical therapist by occupation. A healthy and fit 29 year old female, 5’0″, 115lbs. She reports she is having some cervical musculoskeletal issues going on. She has an achy pain in the bilateral upper traps., levator scapula, and peri-cervical muscles. She is limited by pain with the following cervical motions: right side-bend, right rotation and extension. No signs of central or peripheral neurological issues.

You are an experienced PT and have completed many cervical manipulations on a patient like this and it’s the end of your day. So you are going to do a quick favor for a friend and manipulate her neck, complete some STM, and maybe some PROM/SNAGs/isometrics/METs or whatever your favorite manual therapy technique is. What could go wrong? She’s a therapist herself so she wouldn’t miss anything serious. Being that you are friends you want to do some “magic” giving her some relief of symptoms. So… snap, crackle, manip. You move into some PROM and she reports severe vertigo, nausea, double vision, and you notice hemi-facial asymmetries as she talks about her onset of symptoms. Now what?  Your table, your hands, your patient.

Five Days of Fallacies: Day 2, Complex Question

Five Days of Fallacies: Day 1 here, Day 3 here, Day 4 here, Day 5 here. I am discussing some common mistakes we humans make in reasoning, in the hope that you can 1) Understand what they are 2) Recognize them when others speak 3) Recognize them when you think this way 4) Attempt to correct your thinking on old, current and future ideas.

The Complex Question Fallacy is in the family of Fallacies of Presumption. It makes assumptions, thereby defining the conversation and the result of the outcome, when asking a question.

An easy example of this is seen here: “When are you going to admit that you lied?” You cannot say “Right now” because that is an admittance of lying. If you say “Never!” you uphold the assumption that you lied, and that you are just not admitting it. Lose lose.

How does this show up in the clinic?

Five Days of Fallacies: Day 1, Post Hoc

Five Days of Fallacies, Day 2 here, Day 3 here, Day 4 here, Day 5 here. I am going to share some common mistakes we humans make in reasoning, in the hope that you can 1) Understand what they are 2) Recognize them when others speak 3) Recognize them when you think this way 4) Attempt to correct your thinking on old, current and future ideas.

Let’s start with one of the biggest logical fallacies: Post Hoc, Ergo Proctor Hoc.  “After this, therefore, because of this.” Affectionately known as Post Hoc, for short.

We make a mistake in seeing a causal connection between things when one action/event follows another certain action or event. This is where you get the “rain dance” from.

You did a rain dance, the next day it rained. Boom! Therefore, your dance caused the rain. Oops…Post Hoc! This is where chiropractic

How to start a Journal Club

I had the awesome experience of starting and coordinating the ODU DPT Journal Club over the past year.  I started it wanting to know what was being put out there in research (the First Pillar), and that was certainly valuable.  I found out, however, that the most valuable aspect of Journal Club is the conversation.  Everyone has different perspectives, reads the same line in a different way, asks different questions and can see what you don’t see.  I learned a ton from participating in this process and you certainly will too.

So, without further ado, here are my tips on how to start a PT Journal Club (J-Club):

How to use Special Tests

Image Credit: http://img.medscape.com

In studying for final comps/orals/boards we have come across many special tests that need knowing. We learn how to do them, where to place hands, what indicates a positive, tissues involved, etc.  If we have enough brain capacity after that, we try to remember gold standards in a pathology and how the special tests correlate.  And finally… we attempt to know whether a test is Sensitive or Specific for a certain pathology or impairment. Whew!

The last item is what I would like to focus on because it relates to clinical reasoning an differential diagnosis. Sensitivity and Specificity. 

Argument. You’re doing it wrong.

Image Credit: Bill Watterson

Hello from pre-DPT curriculum land,

The #PTBT has been working hard back at the academics this semester and is attempting to maintain posts on-the-regular.  Stephen is busy as a Graduate Teaching Assistant in the program, and Spencer and I are just messing around reading articles about Dry Needling, Manual Therapy, Acupuncture and Chiropractic… while we’re supposed to be studying.

We have been discussing the future of the field, the future of our own practices and a bunch of things that I’m sure dominated every student’s thoughts towards the end of school, namely: comps, boards, money, residency, setting, etc.  That being said, if left to our own devices, we eventually gravitate back to talking about the more divisive topics that exist out there.  We have read many discussions, editorials and expert opinions.  We have looked on social media, listened to podcasts, read blogs and listened in on conversations around the halls here in school.   We often observe (and participate in?!) arguments.  Some good, some bad.

Clinical Practice Algorithm: Motor Control Series

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More of this Motor Control business.  See the previous Background and Learning post to get caught up.

“Science is built up of facts, as a house is built of stone; but an accumulation of facts is no more a science than a heap of stones is a house.”-Jules Henri Poincare

Practice is built upon theories, as a house is built of stone… Let’s put these theories into practice. Time to build a house…..

Background and Learning: Motor Control Series

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Working the late-shift at the Nerdery- more research based musings…