The 2013–2014 winter in Maine was long in duration, bone-chillingly cold, and I actually had a squirrel looking eye-to-eye at me as it was standing on the snow that had piled up in front of my kitchen window. Every day the most popular topic with the patients/clients I treated was the harshness of the winter this year. I was so often tempted to approach people to tell them to strengthen scapular muscles that appeared to be weakening as they assumed the posture of Eeyore as the winter seemed to be never-ending. However, the feet of snow finally gave way to daffodils (except for the ones my resident groundhog ate), and the peepers (a kind of frog) began their mating calls from vernal pools, and my bluebirds and tree swallows dived-bombed each other to stake their territory and take up residence in the houses I had erected. Finally, the conversations changed from snow removal to gardening. It was time for me to transition from my almost-Olympian level of crosscountry skiing to my almost–Martha Stewart level of expertise at gardening.
Because of the fact that I grew up in the second largest city in Maine (which many will smile to know that included only approximately 62 000 inhabitants) on the third floor of an apartment building, my ability to grow flowers or vegetables was not nurtured. I did occasionally help my aunt mow her 2 × 10 feet of grass and water her 12 iris plants. When I built my current home in my rural town of 5000 citizens, I decided that it was time to grow some of my own food. I bought gardening clothing and tools and a wheelbarrow and thought that so far I was having a grand and successful adventure. I went to the local nursery and saw that there were about a dozen different kinds of tomato plants, as well as several different types of cucumbers and squash seedlings. I also saw that there were different fertilizers, compost, growing mediums, and disease- and bug-preventing mixtures. I quickly began to understand that looking spiffy is not what it takes to grow flowers and food. My next stop was my local bookstore. I had to read how to be a successful gardener by reading what the experts had found from their many years of gardening. I learned that planting icicle radishes in the cucumber mounds would prevent the cucumber beetle, and that planting nasturtiums next to tomato plants would deter deer from nibbling away the fruits of my labor. I have also learned from going to workshops that expert gardeners continue to learn new things during each planting season and that if I continue to learn from them, I benefit from their research. My friends also benefit, as I just can't stop myself from purchasing too many plants each year. Already this year I was only going to buy 8 tomato plants and I now have 15. How could I refuse a new kind called “Cherokee Purple” that came in flats of 6. From my reading, I know what tomato blight looks like (unfortunately, I also now know from experience). I can identify squash bugs, cucumber beetles and the yucky tomato hornworm. But, it is because of my reading what the experts say that I know what to do about these problems so that I get to eat more of my vegetables than the bugs do.
Okay, where am I going with this commentary? You thought you would be reading an editorial about women's health physical therapy. Well, at the Combined Sections Meeting that was held in Las Vegas this year, I was sitting in Lorimer Moseley's wonderful presentation, titled “Fifteen Years of Explaining Pain: Where Are We Now and Where Are We Going.” When he reported that only 15% of research has any impact on clinical practice, I was disheartened. As I wanted to investigate that further when I returned home, a quick literature search led me to an article published in 2003 by Jette et al,1 in which they reported that 25% of the respondents to a questionnaire reported they used information garnered from the literature in their clinical decision making less than twice per month. I must admit that I just do not understand that. I think that to be successful at any endeavor (gardening or physical therapy), one should be reading everything possible to reap the fruits of the labor that researchers complete to include in plans of care interventions that have the greatest chance of being successful, whether it be to decrease the number of bugs on your crops or increase the range of motion of a shoulder. And, it is not that the information is unavailable. As of March 2014, there were 5669 journals that were indexed for Index Medicus, MEDLINE, on PubMed. Other databases include CINAHL, EMBASE, and OVID (this database includes JWHPT articles). Of course, in our field we have our Physical Therapy journal, as well as journals from the Cardiopulmonary, Health Policy and Administration, Acute Care, Aquatic, Geriatric, Neurologic, Orthopedic and Sport, Education, Pediatric and Women's Health Sections. The Internet allows every gardener and physical therapist to be just a few keyboard clicks away from information that can increase success and satisfaction with results.
When members click onto the Web site for this issue of JWHPT, they will find information about pelvic floor physical therapy assessments for individuals diagnosed with 3 types of urinary incontinence and the effectiveness of resisted hip rotation versus pelvic floor muscle training for women with the diagnosis of stress urinary incontinence. Additional information provided by the completed research that is published in this issue includes whether soft tissue mobilization or biofeedback was more successful in treating women who were diagnosed with dyspareunia, and whether progressive therapeutic exercise was successful for the treatment of severe diastasis recti abdominis. The fifth research project published in this issue examined the impact of an implanted sacral nerve stimulator on the quality of life of the recipients of that intervention.
Thanks to the diligent work completed by the peer reviewers of these published manuscripts, and the critical insights and dedication of the senior editor, Diane Borello-France, I am now able to place another check of completion for this spring issue of JWHPT. Now I am going to don my spiffy gardening clothes and, equipped with what I have learned from my gardening reading that I completed on cold winter nights, I am going to tend to my tomatoes, cucumbers, squash, potatoes, and hot pepper plants. If I correctly apply what I have learned, I shall be rewarded with the absolute joy of seeing them grow. Then I must rely on the experts who write the cookbooks I have to tell me what to do with what I have grown. Reading is never-ending but always rewarding.
Nancy C. Donovan, PT, PhD
1. Jette DU, Bacon K, Bacon K, et al. Evidence-based practice: beliefs, attitudes, knowledge and behaviors of physical therapists. Phys Ther. 2003;83:786–805.