Dear Bruce,
You certainly seem to be on a crusade, for some reason or other. It seems
my colleagues on the EPA mail-list feels that your comments should not go
unchallenged. At the very least, your condescending and inflammatory (no
pun intended) language deserves some sort of a response.
Yes, there is a parallel mail-list on mailbase dealing solely with
electrophysical agents and evidence based practice. Believe it or not,
there is actually evidence behind those "ping" machines that you've chosen
to banish to an un-named storeroom in your department. Believe it or not,
also, most of us on the EPA list aren't "a bunch of conservative old women
who know no better". But let's not dwell on beliefs alone.... lets look at
the evidence.
If you really are interested in "finding truth", perhaps you can spend some
of the time that you've saved from abandoning a "flawed anachronistic
paradigm", do a MEDLINE or CINAHL or PEDro search and come back to the list
with something more constructive than "electrotherapy sucks".
Any self-respecting Physical Therapist in any corner of the world can tell
you that there are problems with some of the modalities that we use (but
perhaps not in the language that you've chosen to taunt us with). No one
can deny that there are many issues that needs further investigation
regarding its clinical application. Indeed, I can even agree with you that
some of the modalities currently in use (I won't be so bold as to name them)
should be similarly banished to your un-named storeroom. If you wanted to
draw attention to any of this, all you had to do was to be a bit more
specific. But like the Razor (who or what the hell is Occam??!!) that you
were so willing to brandish, your sweeping generalizations had the reverse
effect. There is no way anyone can respond to your comments without
producing a thesis. This, I am sure, would not go down well with the rest
of the members on PHYSIO or any mailing list. So, instead of giving you
counter arguments that could confine me to this chair I am sitting on for
the rest of my life, let me instead direct you to the Electrophysical Agents
Home Page at http://health.shinshu-u.ac.jp/PT/electro/index.htm . You won't
find all the answers there of course (unlike you, no one can claim to have
all the answers). But at least, you will find some of the evidence for and
some against the modalities that all of us have taken for granted.
Finally, may I just add that it is my firm belief that often it is not the
modality that is ineffective, but the inappropriate and sloppy application
of the modality that dooms the treatment from the start.
Best regards,
Goh Ah Cheng, MAppSc (Sydney), PhD candidate (Curtin)
Department of Physical Therapy
School of Allied Medical Sciences
Shinshu University, JAPAN
EPA mail-list co-owner
Webmaster, EPA Home Page
(http://health.shinshu-u.ac.jp/PT/electro/index.htm)
Webmaster, EMG Home Page (http://health.shinshu-u.ac.jp/PT/emg/index.htm)
Webmaster, Singapore Physiotherapy Association Home Page
(http://www.physiotherapy.org.sg)
> -----Original Message-----
> From: Bruce Gray [mailto:[log in to unmask]]
> Sent: 17 October 2000 09:11
> To: [log in to unmask]
> Subject: RE: evidence based practice...
>
>
> Just to get the thread back on topic, I am the sole OPD physio at a Qld
> country 90 bed hospital in Australia. I recently put all the machines that
> go "ping" into the back storage room, and there are many other hospital
> storerooms like this.
>
> So to affirm my point, electrotherapy sucks. There is no convincing
> comparative invivo studies that show it is a better treatment then the
> intelligent appn of ice/heat, rest/movement, and anti-inflamms. I am
talking
> everything from US to SWD to laser. My litmus test for the benefits of
> electrotherapy is to go and try the putated anti-inflamm properties of US
on
> an acute gout attack.......any of you out there charging good money to
treat
> inflammation with electrotherapy instead of encouraging your patients to
go
> and get a script for NSAIDs cannot call yourselves scientifically trained.
>
> If you think 30 mins of electrotherapy 2x/wk (if you are lucky) can do
> anything significant to fibroblast or leucocyte function, then you are a
> captive of the dogma of a conservative bunch of old women who know no
> better.
>
> I urge you all to come join the revolution- throw your placebo "ping"
> machines away, draw out Occam's Razor and slash the ties that bind you to
a
> flawed anachronistic paradigm.....choose instead to never compromise on
> finding truth again......
>
>
>
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