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We always are looking at ways to exit our own echo chamber and get an idea of what others' opinions and views on things are.  When it comes to research this is no different.  We all tend to interpret and apply research differently.  

So we put out a post on social media to ask for what people felt were the most impactful papers of 2019 for them.  Take a look at the list below with the linked papers.  There are definitely some great papers to help make an immediate impact in your practice!

 Vincent Gutierrez, PT, Cert. MDT

Vincent has been using Mechanical Diagnosis and Therapy (MDT) in his practice for some time successfully and he shares the following articles regarding use of MDT 

Here are his most impactful articles of 2019:

A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS).

This exploratory study looked at applying the MDT screening process to determine if extremity symptoms responded to spinal movement or loading strategies.  It found 40% of the 369 patients in the study had a positive response to spinal movement and loading strategies and they declared it a spinal source of symtpoms

The cost impact of a quality-assured mechanical assessment in primary low back pain care

This study looked at claims data for 5036 people and compared what they termed community care to care involving a mechanical assessment per the MDT model.  A 51.5% cost-savings was found in those receiving a mechanical assessment per the MDT model versus community care.  Community care was bascially defined as care provided by physical therapists not trained in the MDT assessment methods. 

Check out Vincent Gutierrez, PT, DPT at where he shares his expertise around various topics surrounding physical therapy.


Seth Peterson, PT, DPT, OCS, CSCS, FAAOMPT

Seth is owner of The Motive Physical Therapy Specialists in Oro Valley, Arizona.  He also is highly trained in orthopedic and manual physical therapy.  He offers the following article as his most impactful for 2019

Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain.  A Randomized Clinical Trial

Seth states, “t challenges a lot of the assumptions people were making about whether we can predict chronicity and whether pain neuroscience education can influence this. Is it still beneficial in people with acute pain? Should we look at different types of education and framing? We’re left with more questions than answers, yet again!”

 Follow Seth on Facebook and Twitter


 John Ware, PT, MS, FAAOMPT

John is the owner of Move to Improve Physical Thedrapy in the Greater New Orleans area.  He has been an active social media voice on topics surrounding physical therapy practice especially as it pertains to best understanding and applying the modern science of pain to practice.  He offers the following article:

Are within and/or between session improvements in pain and function prognostic of medium and long-term improvements in musculoskeletal problems? A systematic review

John states, “This one should be a game-changer, but given the perverse nature of how we're paid, I doubt it will significantly influence clinical practice any time soon. The most frequent argument by far that I hear from those who continue to promote passive interventions to treat pain, including MT and DN, is that they create a “window of opportunity” to progress to more active interventions, namely, exercise. The findings from this SR challenge this view by showing that there's no evidence to support it. Granted the studies are of low/moderate quality, and absence of evidence is not evidence of absence, but isn't the onus on those making the argument that these interventions produce clinically meaningful outcomes for patients?”

John is a great follow on Facebook and Twitter



John has been a vocal critique of some of our theories and view around trigger points, fibromyalgia, the biopsychosocial model as a whole.  He shares an article he co-authored this year that challenges the term congenital insensitivity to pain.

Congenital Insensitivity to Pain: A Misnomer.

Follow John on Facebook or Twitter


Elan Schneider, PT

Elan is the co-founder of the Re-train Pain Foundation where free pain education is offered to clinicians all across the world.  Elan found the following article most impactful in 2019:

Individual differences in sensory sensitivity: A synthesizing framework and evidence from normal variation and developmental conditions.

This paper critically evaluates the concept of individual differences in sensory sensitivity, explores its possible underlying neurobiological basis, and presents a roadmap for future research in this area. 


 Sigurd Mikkelsen, MSc

Sigurd is an impressive physiotherapist and manual therapist based out of Norway.  You can count on him with respectful and intelligent responses to complex and often emotional topics around the care of those in pain.  He offers the following article for 2019:

The Future of Intervention Science: Process-Based Therapy

This is a fascinating paper that discusses some limitations of the current scientific process in intervention science and proposes a processed-based therapy approach and discusses the implications such an approach may have. 

Sigurd is another must-follow on Facebook and Twitter.


  Andrew Vigotsky

Andrew is a Graduate Research Fellow at Northwestern University and has expertise in biomedical engineering.  He has published extensively around topics such as biomechanics, rehabilitation, sports science, exercise science, neuroscience, and more.  Andrew offers the following article for his best of 2019:

Scientists rise up against statistical significance

He states, “The most salient article on the dichotomization used to declare an effect or—especially wrongly—no effect. Has implications for clinical decision making, how SR’s are written, how individual studies are interpreted, etc.”

Follow Andrew on Facebook and Twitter

 Lars Avemarie, Physiotherapist

Lars is a treasure trove of great content at his site .  He is a active voice in social media and specializes in better understanding of those in pain.   Lars offers the following two articles:

Social Determinants of Health: If You Aren't Measuring Them, You Aren't Seeing the Big Picture

In this Viewpoint, the authors discuss the SDH and argue that recognizing the impact of SDHs on health behavior is vital to seeing the whole picture related to musculoskeletal recovery.

Shifting beliefs across society would lay the foundation for truly biopsychosocial care.

This is a great editorial discussing societal beliefs and how they have and will continue to impact adopting truly biopsychosocial driven care.  Public education campaigns and face-to-face interactions are posed as two ways to shift these beliefs.


 Matt Erb, PT

Matt Erb, integrative physical therapist, owner of Embody Your Mind, and faculty member for the Center for Mind-Body Medicine, has a passion for helping the world understand the science of mind-body medicine, stress, and integrative wellness.  Matt offers the following two articles as his best of 2019

A Qualitative Systematic Review of Effects of Provider Characteristics and Nonverbal Behavior on Pain, and Placebo and Nocebo Effects.

Previous research has indicated that the sex, status, and nonverbal behaviors of experimenters or clinicians can contribute to reported pain, and placebo and nocebo effects in patients or research participants. However, no systematic review has been published.  This article concludes that characteristics and behaviors of clinicians/experimenters contribute the the elicitation and modulation of pain, placebo, and nocebo effects.

Coupled whole-body rhythmic entrainment between two chimpanzees

An interested article on dance.  The authors conclude, “Our analyses show a first case of spontaneous whole-body entrainment between two ape peers, thus providing tentative empirical evidence for phylogenies of human dance. Human proto-dance, we argue, may have been rooted in mechanisms of social cohesion among small groups that might have granted stress-releasing benefits via gait-synchrony and mutual-touch. An external sound/musical beat may have been initially uninvolved. We discuss dance evolution as driven by ecologically-, socially- and/or culturally-imposed “captivity”.”

Follow Matt on Facebook

Hsieh Hsing Wu (Vincent), Physiotherapist

Vincent is a practicing physiotherapist in Taiwan and has had extensive experience and mentoring by some top names in our field.  Check out his practice here.   He offers the following article for his best of 2019.

Evidence and recommendations for the use of segmental motion testing for patients with LBP – A systematic review

This systematic review looks at the use of segmental motion testing for patients with low back pain.  The authors conclude, “The evidence regarding validity and reliability of segmental motion testing is poor and clinical use of stand-alone tests cannot be recommended. Superiority of the combination of tests as a test battery or with other clinical information needs further investigation.”

Follow Vincent on Facebook and Twitter

 Shelly Prosko, PT, C-IAYT, CPI

Shelly is a physiotherapist and yoga therapist who has done an amazing job bridging the two in her Physio Yoga practice and teachings.  Check out Physio Yoga here.  Shelly offered the following paper for her paper of 2019 and stated, ” appreciated Stilwell & Harman’s paper on the shortcomings of BPS model, offering a model that includes language more inclusive of non-dualism and the complexities of human experience including the ‘relational and emergent process of sense-making’”

Follow Shelly on FacebookInstagram, and Twitter


 Michael Ray, DC

Dr. Ray is a chiropractor based out of Harrisonburg, VA. He owns and operate Shenandoah Valley Performance Clinic and specializes in the rehabilitation of neuromusculoskeletal issues,associated pain, and dysfunction.  He also is a part of the Barbell Medicine team and is a great follow on social media – Facebook and Instagram

“I will second Peter Stilwell and Katherine Harman’s paper on an enactive approach to pain. For me it broadened my lens with which to consider the human experience through a phenomenological and 5E approach.”

An enactive approach to pain: beyond the biopsychosocial model

Michael also recommended the following paper stating, ” I also highly recommend Sullivan et al’s recent piece on selling chronic pain narrative regarding low back pain. It elucidated a paradox I’ve personally felt in clinical practice of being patient centered but also trying to aid with sense-making about pain without unnecessarily imposing my world view on the individual.”

“Selling” chronic pain: physiotherapists' lived experiences of communicating the diagnosis of chronic nonspecific lower back pain to their patients.

We couldn't leave the Modern Pain Care crew out of this awesome list!

 Mark Kargela, PT, DPT, OCS, FAAOMPT

Mark also recommended the Stilwell and Harman article linked above as it shed light on a philosophical perspective we can take to better understand the person in pain and all that surrounds their experience.  John Launer had said that we see a person as a single frame in a long movie with a complex cast.  The 5E approach is a helpful one to better understand the movie plot and cast that surrounds each person we interact with. 


 Jarod Hall, PT, DPT, OCS, CSCS

Jarod chose an article he feels everyone should read.  It goes over a challenging topic of over medicalization of pain by some of our fields top minds.  

“This is a short and really good read everyone should see”

Musculoskeletal healthcare: Have we over‐egged the pudding?



We hope this list helped you get exposed to some papers that can have a positive impact in your practice.  Feel free to message us on social media with any questions you may have – FacebookInstagram, Twitter

We hope everyone has had an awesome holiday season!

Mark Kargela

Mark Kargela

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