Anyone have any failry simple ideas on measuring proprioception of the
shoulder without too much expense?
Thanks in advance,
J.Moran
> ----------
> From: alistair grant[SMTP:[log in to unmask]]
> Reply To: [log in to unmask]
> Sent: Friday, March 10, 2000 11:13PM
> To: [log in to unmask]
> Subject: Re: spinal psychology
>
> Surely not Kevin Reese infamous at 1990-1993 University of Northumbria at
> Newcastle???
>
> Anyhow I have been fascinated by this ongoing debate concerning manual
> therapy approaches and the pro's and con's of differing models in the
> management of low back pain. I wonder if all this energy could be
> harnessed
> in helping me (as a non-specialist respiratory physio!) answer two
> questions
> for a proposed research trial of opioids in chronic pain:
>
> The specific questions are:-
>
> 1)What might be the anticipated average reduction in the patients
> analgesic
> consumption when physiotherapy is "effective" (i.e. any favourable
> response)
> in the management of chronic back pain?
>
> 2)How would this be measured and interpreted clinically (if at all)?
>
> Hope somebody might have a measure on this.
>
> In anticipation!
>
> Alistair Grant
>
>
> >From: "kevin reese" <[log in to unmask]>
> >Reply-To: [log in to unmask]
> >To: <[log in to unmask]>
> >Subject: Re: spinal psychology
> >Date: Tue, 7 Mar 2000 18:56:24 -0000
> >
> >Dear Ian
> >
> >By far the most sensible answer on this topic to date. You neither imply
> >that these points have been proven (philosophically is this possible) or
> we
> >ditch our traditional skills after 3/52.
> >
> >Giffords 10 minute, 1999 CSP Conference presentation was head and
> shoulders
> >the best. The layered analagies for genetisist to politician is exactly
> the
> >the right conceptualisation of pain in my view. We can all alter a window
>
> >in
> >the greater picture, should have a good awareness of the other factors
> >influencing pain, but realise our strengths.
> >
> >I feel we can present lots of evidence for and against most issues and I
> >think previous fads in physio like MET and MB are being replaced by the
> >psychosocial approach; perhaps the most recent fad.
> >
> >Nice reply and I'll shut up for a bit. Regards Kevin
> >
> >
> >-----Original Message-----
> >From: Ian & Colette Stevens <[log in to unmask]>
> >To: [log in to unmask] <[log in to unmask]>
> >Date: 07 March 2000 14:05
> >Subject: Re: spinal psychology
> >
> >
> > >Kevin,
> > >
> > >I have replied to this on two occasions but owing to little hands my
> >replies
> > >got deleted !
> > >
> > >However briefly to an altogether complex multifaceted problem Kevin I
> >will
> > >offer some thoughts ......
> > >
> > >Using a different model for the assessment of psychological V's
> physical
> > >dysfunction may be worthwhile and make one aware of the complexities
> and
> > >multifaceted nature of the person before you. Wherever possible I try
> to
> >use
> > >Louis MOM approach, analysed from this perspective the model may serve
> to
> > >minimise dualistic interpretations of facet/imbalance or whatever else
>
> >is
> > >in vogue in physio circles V's supratentorial ...
> > >
> > >However with this in mind it is certainly advisable for a person
> >interested
> > >in manual therapy to be aware of the issues outside their
> interpretation
> >of
> > >physical dysfunction .... It is so easy to search endlessly for a
> tissue
> > >based solution to explain benign low back or for that matter
> >cervicobrachial
> > >pain before the patient trundles off somewhere else or ends up at a
> pain
> > >management clinic .
> > >If the literature is to be believed and my clinical practice certainly
> > >reflected this, Kendalls work on yellow flags for poor outcome should
> be
> > >widely disseminated .
> > >Simple questions on presentation should be what do you think is wrong
> >with
> > >you ? If you give a purely mechanical structural answer or solution
> many
> > >people will become disabled .... which is exactly what has happened
> read
> > >Zussmanns excellent essay, Waddells back pain revolution or ask
> patients
> > >what they were told ......
> > >However this again is a complex issue as many people obviously respond
> to
> > >the analogies of things being pushed in and out and some therapists
> make
> >a
> > >fortune doing and telling people this ( depends who is doing the
> probing/
> > >how expensive/ distance travelled and impressiveness etc etc)....
> > >Additionally as a culture the usual response is to treat ones body like
> a
> > >car and the intervention is usually analysed in this fashion too ---
> in
> > >grey areas like musculoskeletal pain the intervention certainly is not
> > >simplistic as we all know ....but people like simple solutions to
> complex
> > >problems therapists/patients alike...
> > >
> > >We should as a profession be much more aware of the complex interaction
>
> >as
> > >people becoming disabled with benign 'mechanical' problems are
> increasing
> > >not reducing in number ?
> > >However this requires in many instances a shift to happen in therapists
> > >education and the issues associated with musuloskeletal pain to be
> >better
> > >understood or at least be valued ......This doesn't mean being a
> > >psychologist but often a subtle shift in intention during treatment not
> > >slotting people into boxes because they fit into categories who may or
> >may
> > >not become chronically disabled.....
> > >If the epiemiology statistics were to be believed no patient in my
> last
> > >place of employment would have got better at all ( poorest health in
> UK,
> > >massive unemployment, little if any place of leisure , and family
> > >dysfunction++ typical of many nhs deepest in inner cities I am sure).
> > >
> > >It does have to be said that depts as above do need multidisciplinary
> >teams
> > >to have a chance with this common group . In order to be therapeutic
> and
> >to
> > >have a successful outcome with more patients it is necessary for
> >therapists
> > >themselves to be healthy . Knowledge is one way forward but it has to
> be
> > >said that treating people who have been around the houses, given
> >erroneous
> > >information and who are often at their wits end is a thankless task
> > >.........
> > >
> > >all the best to you
> > >
> > >Ian p.s I am looking for a new job!
> > >
> >
>
> ______________________________________________________
> Get Your Private, Free Email at http://www.hotmail.com
>
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|