Dear All
I am glad things have settled down and I now feel I can make a contribution
to the debate.
I know this is an old argument but it is yet again relevant. In physio we
have a great many techniques which we intuitively know are effective but
they have not been sufficiently evidenced. What then happens is crude and
often misleading rationale support effective treatments. In this deductive
argument 4 +- 8 often makes 4. We just need to substitute the rationale 8
with a 0.
The difficulties in evidencing whole changes in individuals, is monitoring a
myriad of variables. This is near impossible and certainly beyond the scope
of the favoured RCT. We are therefore left with (often) some good techniques
which, if we are honest or not closed minded, we are not 100+ACU- sure why they
work. The closer we get to that understanding, hopefully the better our
practice should be.
If there is a myth or false proposition it should be exposed as it is
getting in the way of a more complete and effective understanding of the
problem. Mel was simply (the explanation was not simple) doing this in his
piece and useful it was too.
I believe general exercise works generally. There are great benefits in movt
and western society is getting more sedatory. Therefore on one level Pilates
is great. Some of the techniques can be adapted to personal PT practice and
that is great. However if exercise is to work on a therapeutic level, ie
solve individual and disabling problems, I feel it must be done on an
individual level, with an experienced therpaist to stand the best chance of
success. This does not mean a Pilates class can not help individuals
therapeutically or prescribed exercise from a therapist always works. Just
that an informed, up to date, laterally thinking, open minded empathetic
therapist, on a one to one basis, is your best chance.
Hopefully this contains no personal attacks or unpleasantly personal
language, even though I am endeavouring to show restraint at some of the
personal criticsm aimed at myself . Warm Regards Kevin Reese PT UK
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