Dear Bruce
I applaud your healthy sceptism and hold the majority of the same opinions,
with a few exceptions.
We know ultrasound does something as when you introduce an energy to a
substance it changes it. I know you have not said this but I have heard
people say US does nothing and this is clearly untrue. Its therapeutic
benefits are the debating issue.
Your call for a psychosocial approach is commendable, but you must realise
that these academic disciplines have championed other research methods other
than the flawed RCT, when dealing with human research. Therefore your use of
the word significant must be defined. Are you meaning the 5%
statisical or clinical significance?. As I have said many times I would
never discard a treatment with only a 94% efficacy and of course this would
not be statistically significant.
Current EBM is driven by the medics and I feel their clinical reasoning is
inferior to our own. In these incidences lets not jump on their bandwagon
and make RCT God. They will catch up eventually
I am not a lover of US but while the issue remains so cloudy we must not
dismiss so easily other valuable sources of evidence, ie clinical
experience. After all one persons clinical experience and having the bravery
to voice it has topplied large RCT's and saved many thousands from deformity
and pain. Phalidamide (I can never spell that word)
As a final point Barretts comment with regard to the incidental nature of US
and recovery is true of every modality we use. I am more certain of the
power of a treatment when it elicits a beneficial change in the more
chronic. Ie the more acute an injury the more likely the recovery is despite
PT.
Just some thoughts Kevin Reese PT UK
ps in the cricket the Aussies may have the weather god, but we have the
groin strain god. Slater appears to have done a Steve Waugh. If US is an
uneffective treatment lets hope both are getting it from the team physio.
----- Original Message -----
From: Bruce- Australia <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, August 17, 2001 6:55 AM
Subject: still no evidence for therapeutic ultrasound
> Some of you might remember an emotive attack last year upon me by
> proponents of therapeutic ultrasound.
>
> I have just completed a lit review via cinahl, medline, and current
> contents. And the consensus is still, as I stated last year, that
> therapeutic ultrasound has no significant invivo evidence via RCTs.
>
> Further, dosage levels, frequencies, and durations are still being plucked
> out of thin air.
>
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