Research and Evidence Based Medicine

 Definition: "the integration of best research evidence with clinical expertise and patient values"

Hierarchy of Evidence:

Level 1a:  Systematic Reviews of Randomized Control Trials

• Comprehensive survey of a topic in which all primary studies of the highest level have been identified, analyzed and appraised
• Assessed by individual reviewers
• Cochrane systematic review is a type of review specifically used in health care.

 

Level 1b:  Individual Randomized Control Trials

• Type of research design in which participants are randomly split between 2 groups
• One group is the intervention group, one is the control group
• The control group receives either no treatment or a default treatment
• Random assigning reduces risk of bias

 

Level 2: Cohort Study

• Observational study of subjects with a specific condition and/or who are receiving a specific treatment
• Followed over a period of time
• Comparisons are made from the 2 groups, the cohort and possibly the gerneral population
• Limitations include lack of control of variables
• Not as reliable as RTC's

 

Level 3: Case Control Study

• A study that involves identifying subjects who have the outcome of interest and control subjects without the same outcome, and looking back to see if they had an exposure of interest
• Typically done retrospectively, looking back over time, example is smoking as a link to lung cancer

 

Level 4: Case Report or Case Series

• Describes the medical history of one participant
• Used to record and alert other health care professionals to occurrences 
• No control group
• Not statistically valid

Level 5: Expert Opinion

Other Things to Consider:

Ethical Considerations:

• Informed consent, confidentiality, Protection from harm or danger, Knowledge of the outcome

Variables:

• Independent Variable: the factors manipulated by the researcher
• Dependent Variable: the factors used to measure the effect of the independent variable (the "effect" or outcome of interest)

Statistics:

• Descriptive statistics: Summarize or describe important characteristics of a known set of data
• used to determine whether there are significant differences between groups

Product Review: Disruptive Strong Bag

 Product Details:

• Included Shotbells were custom designed to allow one DisruptiveStrong Bag to vary in weight, and can also be used like a dumbbell, kettlebell, barbell, medicine ball, and slam ball without bursting or damaging floor surfaces. 
• Life happens in multiple planes of direction, but traditional fitness has led us to train in only two directions. Training in only two planes of motion creates muscular imbalances and puts us at risk for injury and poor function. 
• With DisruptiveStrong, you can incorporate real world movement patterns with each workout, and start to look better, feel better and perform better. 

Your Choice: (Beginner OR Intermediate OR Advanced)

Beginner Includes:
— 10 Pound Shotbell
— 20 Pound Shotbell

Intermediate Includes:
— 10 Pound Shotbell
— 20 Pound Shotbell
— 30 Pound Shotbell

Advanced Includes:
— 10 Pound Shotbell
— 20 Pound Shotbell
— 30 Pound Shotbell
— 40 Pound Shotbell

• CHANGE THE WEIGHT: The DisruptiveStrong Bag is incredibly versatile. The workout bag itself weighs 10 pounds and you can add our Shotbells to add weight. Each Shotbell weighs 10, 20, 30, or 40 pounds. That means you can add up to 100 pounds for the training bag to weigh up to 110 pounds. The Shotbells can also be used like a dumbbell, kettlebell, barbell, medicine ball, and slam ball. Our bag is perfect as a heavy punching or striking bag and great for weighted workouts and MMA training. 
• DURABLE AND STURDY: Our fitness bag is sturdy enough to slam, drag, strike, swing, and lift while holding all of the steel shot bags inside. A durable vinyl material makes the outer shell and a flexible neoprene cylinder makes up the inside. The reinforced handle stitching helps make it resistant to tremendous intensity. It makes for great youth fitness equipment and boxing and MMA equipment. 
• 5 GRIP OPTIONS: The DisruptiveStrong Bag is great with its 5 different hand grips. For a wide grip, grab the handles on the edges of the bag. To get a neutral grip, use the handles perpendicular to the bag. To get a suitcase-like grip, hold the center handle. For an overhand or underhand grip, use the handles parallel to the bag. Add the DisruptiveStrong Bag to your home exercise equipment. 
• APP WORKOUT BONUS: You don’t just get an amazing weightlifting bag. You also get a DisruptiveStrong workout app, which includes over 1,000 unique exercises and over 350 always different workouts that get updated every month to help you so you’re always gaining muscle and burning fat with your Strong Bag. Up your weightlifting workout routine with the DisruptiveStrong Bag and our workout app. 
• 3-YEAR WARRANTY: Each purchase of workout equipment comes with a “7 Guidelines to Shed More Fat” PDF and a 3-year warranty in the unlikely event of defects in the product's materials or manufacturing. Dragging or slamming the Shotbells and Strong Bags on abrasive and sharp surfaces such as gravel, rocks, grass with sticks, etc. will void the warranty. 

Product Review:
Meet the DisruptiveStrong Bag: a training bag that you can strike, slam, lift, or drag to burn calories and build strength in your body. You will be able to change its weight from 10 to 110 pounds. The bag supports over 700 exercises, many of which simulate functional everyday movements. You can use the Shortbell filler weights like a dumbbell, kettlebell, or barbell.

As a complete training system, the DisruptiveStrong Bag is soft enough to strike, but strong enough to take abuse.  It is a padded cylinder that can be filled with small, weighted bags to create a weight from 10 to 110 pounds. The cylinder can be used for a martial arts workout or it can be used like a dumbbell or kettle bell for weight training.You can use the Shortbell filler weights like a dumbbell, kettlebell, or barbell. The solid yet flexible inner core and the soft, shock-absorbing outer shell are two key qualities that allow you to lift, strike, slam, and drag this remarkable tool. From military grade vinyl to double and triple stitching to soft, resilient silicone handles, the DisruptiveStrong Bag was built for comfort, sleekness, and longevity.

The most impressive piece of equipment on the market by far! It is very easy to use and can be used in the comfort of your house and easy to travel with. Literally hundreds of exercises can be done with the equipment, so your workouts are versatile and not repetitive. You will gain strength and muscle while losing fat and inches. Anyone despite their current fitness level can utilize this equipment because weight is easily added! Well worth the investment. I regularly work out at a CrossFit Gym and every time I workout with the Disruptive Strong Bag I am completely sore all over again. It hits muscle groups that no other method of working out can due to the weight shifting and sand movement. The design and durability makes it a great long term investment and a great workout tool and easily portable for workouts on the go.

It arrived at my door and the first thing I noticed was the quality as it was pieced in about 6 different packages.  For most people its going to take a while to get used to the weights. It's unconventional and I can tell this thing is going to make you work. The shotbells are either heavier or I'm just not as strong as I think. The handle is a huge plus. The workouts you can perform are endless.  The bag is durable and versatile. You get multiple grip options and an easy weight changing mechanism.

In conclusion, this product is strong, versatile, and extremely convenient. The bag and shot bells allow me to perform the functional fitness workouts I am accustomed too. I no longer have to go to the gym to use different weighted sandbags, Bulgarian bags, and different kettle bells.  I was looking for something that did it all in one complete package and allowed for me to travel with it. That's when I found the Distruptive Strong Bag, the Swiss Army knife for fitness training. This product is legit and will push you to the next level in training.

https://disruptivestrong.com/

Product Review: Titan Fitness Heavy Foam Plyo Box (30/24/20in)

 Product Details

The Titan Fitness pro-duty Foam Plyometric Box is perfect to start doing box jumps, box push-ups, dips, step ups, and other creative exercises. Are your workouts too easy on the 20" side? Simply rotate the box to add 4"-10", forcing you to jump higher and burn more calories! These boxes are constructed from high density foam and built to last. With up to a 350 lb weight limit, you can be confident that when you land your jump, this box will support you. An added bonus is that the edges and sides won’t hurt your shins!

Features: 
- Pro-duty firm foam construction
- Soft material helps prevent injury
- Slip free surface
- No assembly required
- Save money and space with 3 box sizes in 1
- Solid foam platform supports heavy weight athletes
- Rotate the box for more challenging heights

67lb Specifications:
- Material: Foam
- Height: 20"
- Width: 24"
- Length: 30"
- Weight: 67 LB

Product Review:
I am a huge crossfitter, doing 2-3 sessions a day. I wanted a foam plyo at home but did not want to spend a fortune on some of the other brands with less utility. I did a good amount of research and found this one to be very sturdy and high quality. Foam plyos are great, though can be deceiving. They are soft but they cannot be too soft or you do not get the right feel and landing on them can be difficult. This one seemed to have a good stiffness to it as well as it weighed enough to know that when I use it at 30" (which is most of the time) it will not tip or be unstable. It has performed well, seems like it will hold up for the long haul, just wish the foam was a hair stiffer. Great quality none the less for a very reasonable price. Perfect for a home garage box.

There are alot of wooden ones out there but this one is great, knowing that it is foam makes that jump easier for those that have never tried it before. The ladies I am working out with had never Attempted box jumps, it was great to see.  It came put together already (unlike my wood box) which was a plus. I've bit it and landed my shins on it, and only bruised my ego (versus splitting open my shin like on my wood plyo box).

This is HEAVY. I have to either sled push or tire flip it across my garage. I've had 0 issues with tipping, and there is plenty of surface area for box jumps/jump overs. Cover unzips, although I just wipe clean with a Lysol wipe. Colors are great to easily find the height I need.  Already had a couple members save their shins on this box.  The only down side is that and the fact it has to be flipped all the way to where you want to use it (no handles obviously).

Each jump box features an ultra dense foam core with softer foam on all six sides—making them firm and secure enough to perform plyometric movements, but soft enough that you won’t tear up your shins on the edges if you misstep. The box can be quickly positioned at three different height settings—20", 24", and 30"—and an 18 ounce vinyl is included with printed indications of which height you’re jumping at.  This plyo box is an absolute steal. It’s everything that the first offering was not. Heavy, sturdy and safe. The Black Friday sale price was insane for this piece of equipment.

In conclusion, by removing much of the fear factor and injury risks from high-intensity box jumps, and by allowing multiple athletes to set their own preferred height, the Titan Fitness Heavy Foam Box offers huge benefits for any size training facility.  The durable vinyl cover resists wear and tear while remaining firm even after heavy use. Never worry about footprints or dirt again, as the vinyl covering allows for easy cleanup.   This 3-in-1 Ballast Plyo Box is a staple item of any fitness studio or box. It allows you to design your workout & adjust on the fly. This unmatched versatility removes clutter from a workout space.

https://www.titan.fitness/3-in-1-heavy-foam-plyometric-box-20-24-30.html

DIY Plyo Box

How much do you DIY?
When I started my garage gym, I had very little cash, so I built almost everything.

10+ years later, and economies of scale have prevailed. It's cheaper to buy most things than it is to build these days. But we still have many people in our community who have made racks, boxes, etc.

Today, I present the DIY Plyometric Box - One of my first DIY projects. It's one project that will still save a fair amount of money over having one shipped to your house. And, this thing is ROCK SOLID!

This is one of the easiest DIY Garage Gym builds I have completed and one of the most important.

I know many guys like to build their boxes in a slant (kind of like a pyramid with a flat top), but I prefer to keep my DIY projects easy.

People build it that way, so you don't catch your shins on the box, and for plyometric purposes. That does make sense, but I jump higher than the box and land on top. I do not jump at an angle forward and barely make it to the top…and neither should you. A rectangular box is a good practice for keeping good form for a box jump.

Jump. Land. Full hip extension. Land.

Building it my way not only saves you a geometric-math-problem headache but also gives you a 3 in 1 box!

Building a rectangular prism will give you three different sides to jump on that will be three different heights. This is great for different workouts and overall functionality.

Materials Needed:
1 Piece of Plywood (I got the cheap plywood for flooring because it is tough. Get any plywood you want, so long as it is 3/4″ x 4ft x 8ft)
1 box of screws
1 Bottle of Gorilla Wood Glue

First, you must answer this question:

What kind of box do YOU want/need?? I built mine with these dimensions:

L= 30″
W=20″
H=24″

I wish I made the length more like 40″ because I like to do high box jumps sometimes. That is why you need to determine what you can handle and what you would want. You can make it as tall or as short as you want.

How to Build a Plyometric Box, Step 1: Let's start Cutting

You will need the following dimensions cut2x 30″ x 22.5″
2x 30″ x 20″
The trickiest part of the project2x 18.5″ x 22.5″ (this cut will be the sides and will fit within the other pieces to make a streamlined box.)

How to Build a Plyometric Box, Step 2: Gluing and Screwing, what all DIY Projects need.

Now, you have all your pieces, just put them together. (Refer to the pic of the box above, it is pretty self-explanatory.)

Anywhere wood will be touching wood, put a thin line of Gorilla Wood Glue.

I recommend starting with the base and two sides, all touching. This will give it immediate stability, and you can let it dry as needed.

I would put a screw spaced about every 2-3 inches around the entire box while putting it together. I tend to overkill things when building, but hey, if it falls apart, you can only blame yourself, so make it STURDY. Mine has withstood a lot of jumping, and I have even used it as an apparatus for floor press with 250lbs. resting on it. Now you have built an item to add to your garage arsenal.

RECIPE: Greek Stir-Fry + Meal Prep Haven Containers

 Greek Stir-Fry

Prep Time: 8-10 min

Serves: 4-5

Ingredients	Calories	Fat (g)	Carbs (g)	Protein (g)
• 1 lb. ground beef	1152	90	0	78
• 1 lb. frozen green beans	140	0	28	6
• 1 large onion	60	0	14	4
• 2 tbsp. coconut oil	234	28	0	0
• 1 15-oz. can of diced tomatoes	85	0	21	2
• 1 tsp. basil • 1 tsp. salt • 1 tsp. oregano • 1 tsp. garlic powder
Totals	1671	118	63	90
Per Serving	334	23.5	12.5	18

Instructions
• Melt oil in a large skillet and add diced onion.
• Cook three minutes or until starting to become translucent.
• Add ground meat and cook until well browned.
• While cooking, add spices.
• Once meat is browned, add the diced tomatoes (drain off liquid first!), green beans and any additional spices if needed.
• Cover pan and simmer 15+ minutes or until all vegetables have softened.
• Check after ten minutes and add a couple tablespoons of water or chicken broth if needed.
• Serve warm and enjoy!


Meal Prep Haven 1, 2, and 3 compartment containers:

• DESIGNED FOR MEAL PREP: Easily store food while prepping in advance. Pop your pre-made meals in the freezer for storage and thaw them in the fridge overnight for the next days meal. 
• EXCELLENT FOR PORTION CONTROL: Each container stores up to 17 oz of food, making it a great tool for keeping your diet in check. 
• BPA FREE: All our containers are certified BPA free to ensure that youre not exposed to chemicals typically found in containers. 
• MICROWAVE & DISHWASHER SAFE: These containers can withstand the freezer, fridge, microwave & dishwasher (top rack). Use them again and again so that you can save time & money.

Built for meal preppers, by meal preppers, that's our motto. At Meal Prep Haven, we know that preparation is the key to meeting your fitness goals. With the right tools and mindset we're here to empower all of our customer to stay happy, fit and healthy.

Weight loss isn't easy. In fact, it's damn hard. That's why we built our containers to help our customers plan their meals for the week ahead. Our 1 compartment containers help you stick your diet plan. Simply cook for the week ahead, portion them out evenly across a week's worth of containers and voila! your weekly nutritional needs are set ahead.

Order yours here: 
http://www.mealprephaven.com/store/
Meal Prep Haven on Amazon

Simple product that arrives quickly and does it's job perfectly. As a college student, meal prep has become crucial to managing my time wisely while still eating well. This product has aided me greatly in that endeavor. The containers survive the microwave no problem, even though they are quite thin and light. The seal is good all the way around the container and have yet to experience any leaks in my backpack when they are full of chicken breast and beans on my walks to class. These are also far more affordable than other leading brands. Highly recommend.

OpEd: Does Your Doctor Even Lift Bro??

 What’s your experience with dealing with doctors/PTs/chiros who treat like this?

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I’m not here to call in to question pain medication, or passive treatments (like soft tissue work or electrical stimulation or even joint manipulation) ... but I am here to challenge the use of those as the ONLY treatment in dealing with an injury. The medical system today is largely broken because we so heavily rely on what professionals do or give to those dealing with injuries. This creates a dependency on those treatments and doesn’t empower the injured person to take control and actively participate in the rehab process.
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Too many doctors ONLY prescribe pain meds & tell you to take time off. Too many physical therapists, physios & chiropractors rely on passive treatments instead of taking a step back & treating the person in front of them and how they move! Are there good professionals in all of these fields? YES & I applaud those who are taking a stand to change things but I think we can all agree we have more work to do!🙌🏼
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Now this is also a two way street because as athletes, WE need to quit searching out the quick fix.Sometimes the right approach is a longer process. BUT with the right team in place & the right approach that does not rely ONLY on passive treatments we can hope to find lasting results that keep you lifting and participating in whatever fitness aspirations you have for life.🏋🏼‍♀️

Product Review: XPO Trainer

 Product Details:

Multi-Purpose and All Surface!
The XPO Trainer® is not only the very first exercise sled on wheels but a training device so versatile that it serves multiple purposes:

Athletes
For the athlete it is simply the most effective push sled on the market today. With its revolutionary patent-pending exponential resistance curve, it delivers the ultimate workout in the shortest time possible! The XPO Trainer's automatically adjusting power demands will humble the most elite athletes from any sport.

Rehab and Physical TherapyFor the trainer, physical therapist, or individual working on rehab or recovery from injury, the same exponential resistance curve provides a safe method to work natural movements that will adjust to the needs of the user. Instead of pushing against a static object such as a wall, or pushing against a traditional sled that can quickly slide away and lead to further injury, the XPO Trainer provides a very low rolling resistance at low speeds with an immediate and automatic increase in resistance that will provide an opportunity for the user to regain equilibrium safely.

XPO Trainer Features

• Nearly silent operation. 
• Removable handles for easy transport, portability, and storage. 
• Safe for use on almost any surface, even indoors. 
• Suitable for any level from rehab to training elite athletes. 
• The only trainer or sled ever made that gets eXPOnentially harder to push the faster you go.
• Assembled Sled Weight: 60lbs

My Review:

Developed by Bill Strahan, co founder of Armored Fitness Equipment,  the "XPO" stands for Exponential Power Output. The XPO Trainer meets force with force, with all the resistance coming from a damper like motor. There is no friction, skidding or tearing up the surface since it is on wheels. Its smooth and quiet. One plate is all you need for some traction, no more loading up a few hundred pounds for a sled workout, or having to constantly change the weights due to variance in athlete What I love about it, is a you fatigue you slow down but you don't grind to a stop.

The faster you push it, the harder it gets. The XPO Sled is designed to bolster explosive functional power for any class of athlete from the most elite to your grandmother, on all types of different surfaces. Unlike traditional push sleds and pull sleds that are abrasive on most flooring surfaces,The XPOs durable inflated rubber wheels are easy on indoor surfaces such as carpet and rugged enough for outdoor training on grass, turf, concrete or asphalt and even slightly uneven surfaces. This makes the XPO the perfect training tool for sports performance centers, sports teams, crossfit gyms and even physical therapy clinics!  

When rehabbing individuals in the therapy setting, implementing sled pushes allows your body to naturally work the core muscles and those of the hips and legs simultaneously without having to instruct someone to do multiple exercises for activation or isolation single muscles.  Once an individual is able, this can help save a lot of time and teach more practical applications of muscle engagement.  The XPO sled resistance progresses along as the patient recovers increased work capacity, which means no more guessing if the weight is appropriate for their plan of care.  As their capacity to push this sled increases the individual is forced to place their trunk in  good position and create appropriate stiffness to continue pushing at force, thus this sled is extremely helpful in reinforcing proper positioning while also being the perfect progressive resistance tool.

My Rating: 9/10
An XPO workout is easy to get into, feels great, and takes less time than existing aerobic and strength exercise to deliver more of the results you desire. A few critiques to justify my rating include price point, and attachments.  I know this sled is not the cheapest on the market ($700) but one sled can be used for any number of individuals and serve all their needs equally.  Another thing I was a little disappointed in was that it was missing different attachments or hand holds for different pushing or pulling grips.  Looking similar to your standard prowler sled I was wishing it had a high and low bars, as well as  carabiner loop in the front for sled pulls and drags (or atleast options for such features).  However, the standard sled push is what the XPO does best, and is by far my top ranked piece of equipment for the movement.  In summary, training advantages I noticed include: safe acceleration/deceleration, full body engagement, convenience for groups, and being surface friendly.

Nothing is more functional than feet on the ground training your body in real world, not simulated, athletic movements. Increase speed, acceleration, and explosive power on the surface you play on.

You can get your own XPO Trainer sled on their website using this link:
https://www.armoredfitness.com/products/xpo-trainer