Stewart,
Gwendolyn Jull has produced excellent research on the effects of low back
pain on the spinal stabilizers and that specific exercises do in fact "turn
them back on". Follow-up research using her exercise regimen demonstrated
reduction in pain and improvement in function.
Quite a few studies do indicate (and some don't) that manual treatment does
work.
The AHCPR guidelines on low back pain, flawed as it was, did conclude after
a analysis of available literature, that manual treatment and exercise is
the best conservative management for acute low back pain episodes in
adults.
I've also come across literature that shows that post ACL and post ankle
sprain patients can and do decrease muscle firing latency in hams and
peroneals with balance training/perturbation training.
I studied literature while in school that demonstrated that stroke patients
who were 5 years and I think a few were 10 years post (if memory serves)
did make functional gains with task-oriented/functional training (walking
on treadmill with a hoist, gait training and balance/perturbation
training).
So, there is a lot of positive literature out there, you just have to seek
it out. There is more out there justifying what we do, than one may think
at first. In the states, the buzz is that we need better outcomes
research, and I don't dispute that, but I personally don't think that we
are lacking as much as people seem to be describing.
Regards and hang in there!
-------------------------------------------
Jason Steffe, PT, MS, MTC
Physiotherapy Associates
1089 Red Bud Rd, NE
Calhoun, GA. 30701
706-602-0027:W
706-625-3910:F
----------
> From: Lorraine Flaherty <[log in to unmask]>
> To: [log in to unmask]
> Subject: Re: Despair and Despondency
> Date: Friday, August 18, 2000 1:33 PM
>
> Stewart-
> I have been there myself, and my sympathies are with you. As a matter of
> fact, it seems a spend a few days there every few months, but I always
come
> out of it again and realize how much I love my profession.
> I often seem to feel negative when I feel unsuccessful or unappreciated.
> You may want to ask yourself if your feelings could have anything to do
> with where you work, the kind of patients you see and the people you
work
> with. Is it a positive environment, are most of your patients motivated
to
> get better?
> Sometimes I also find that I get bogged down in thinking about a
particular
> patient who is not improving.What helps me then is to go back over their
> case, think about new perspectives or new ideas, and if I have none, try
to
> refer them to someone who might. It also helps me to stay grounded in a
> particular perspective. I'm not talking here about a school of thought,
but
> a way of working. What do I generally try to address first, although I
may
> use different techniques to address it with each patient, what are my
plans
> and how do those work with the patient's goals for rehab. Sometimes, they
> just don't work well together, and the patient can't benefit from
therapy,
> or can't benefit from therapy from me. It definitely has something to do
> with knowing yourself and how you think and what you value.
> And finally, keep reading the literature. You may find it challenging and
> energizing. There is so much out there we keep discovering, (that's a
good
> thing!)
> Good luck.
> Lorraine Flaherty P.T.
> At 09:29 AM 8/18/00 -0400, you wrote:
> >After 5 years as a physio I have hit a wall! It appears that little, if
> any,
> >of what we practise is proven to work. It feels that I am selling
something
> >which I no longer believe in. Before I embark on an alternative career
does
> >anyone have any words of comfort [with references please :o) ]
> >
> >Stewart Harrison
> >Physiotherapist
> >UK
> >
> Lorraine M. Flaherty, P.T.
> Staff Physical Therapist
> The Pennsylvania State University
> Room 3 Ritenour Building
> University Park, PA 16802
> (814) 865-7381
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|