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: Non-immersive VR Immersive VR Augmented VR Mixed VR   The sense of ‘presence’ depends on the level of VR immersion. This is dependent upon the type of system used. In healthcare, VR is genera ..read more

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. 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 ef ..read more

Dr Angela Cadogan, PhD, NZRPS Frozen shoulder is still poorly understood on many levels. However the diagnostic criteria for have remained unchallenged for decades: Frozen shoulder is a clinical diagnosis characterised by: a global loss of passive ROM a ‘normal’ x-ray (to exclude other causes of joint stiffness). In my career, I have seen people diagnosed and treated for frozen shoulder for more than 2-3 years with a ‘wait and see’ approach, or with multiple injections without an x-ray to exclude other causes of stiffness.  Some of these people were subsequently diagnos ..read more

A few weeks ago I wrote a post about the level of clinical competency required at specialist levels of physiotherapy practice which generated a bit of interest. I mentioned that my experience of working at this level (compared with other levels of practice) is the expectation that the specialist physiotherapist will have a solution we are others have failed. Often we are ‘expected to know’.  In the previous post I discussed some of the factors that contribute to ‘complexity’. So how do I approach and interpret my assessment and make decisions about appropriate treatment given that many p ..read more