Each year I look forward to the Combined Sections Meeting. It is the one time I get to see friends from around the country and to attend educational sessions (mostly - but, unfortunately, not all research based) on topics that interest me. As a bonus, CSM is usually in a place that is fun to visit. Having been to Las Vegas in the 80s, I had decided back then that I did not need to visit again. Given the fact that my gambling is limited to the occasional $1.00 that I lay on the counter for my State of Maine lottery ticket (when it gets up to double digit millions as it is difficult to live on less than that), I am reluctant to participate in the most publicized activity in Las Vegas. However, encouraged by some of my patients, I allocated $2.00 to partake in the activity. While I do enjoy taking chances with new hikes, or new lakes on which to spend a day kayaking, I am a bit conservative when it comes to taking chances with my money. My very limited stock portfolio demonstrates that as I have absolutely nothing in the high risk category (lately, I have less in every category - but[horizontal ellipsis] I won't go there!!). Upon entering the casino in the hotel in which I was staying, well[horizontal ellipsis]. I was overwhelmed. How does one make a decision regarding at which machine to sit? There were rows upon rows of noisy and lighted machines (so much for energy efficiency) with pictures of animals, scantily dressed males and females, or heroes and villains on them. How does one make a choice? There was no one there to help me decide. There were no guidelines. I was looking for a machine with an arrow over it that said something like "This one has the best results." Anyway, the casino was "information overload," so I chose to not make a decision. On the very last day, so as not to disappoint the folks back home, I sat down at a penny machine that was named "Lobster-Mania" and put in $1.00. I had no idea what to do. There must have been a dozen buttons that I could choose and no instructions. Anyway, I pushed one that said "bet" on it (I think) and after approximately 30 seconds I had increased my $1.00 to $2.48. So[horizontal ellipsis]I collected my winnings and decided to leave the smoke-filled, glitzy and noisy place behind.

I am comforted by the fact that many things in life are not a gamble. I go to presentations each year at CSM in order to increase the odds that what I choose as interventions for plans of care of patients/clients that come for physical therapy are going to have winning results. I simply don't believe in blind betting or bluffing my way through my work days as I have patients/clients that are trusting me for my skills.

Overall, I was not disappointed at CSM this year. While there are still some presenters who have very short reference lists for their talks, it does seem to be getting better each year. The research that was presented will assist each clinician in honing in on the most effective interventions versus hedging their bets by trying a little bit of everything from the treatment wheel. I believe that as you read the platform and poster abstracts that are included in this issue, you will see the evidence on which I base that statement. It is my hope that what happened in Vegas, does not stay in Vegas. The information from the completed and presented research must make its way into clinics.

In this spring 2009 issue, Dr. Jill Boissonnault has provided another in the invited series of reviews of outcome measures that should be used not only in research, but also as a way to evaluate the effectiveness and efficiency of the interventions performed each day by physical therapists. Evaluation employing validated outcome measures increases the odds that patients will improve not by chance, but by precise selection, and that their co-pays are not gambling dollars.

While my outcome at the penny slot machine was just pure luck, interventions that are based upon data obtained from valid and reliable measurements will hopefully ensure that all patients will "hit the jackpot" of decreased pain and increased function because of the skills of a physical therapist's hands.