Hi Steve,
>For example, on a regular basis I get a small number of patients
>(probably my lowest percentage), especially with chronic or >reoccurring
>problems that do not respond to any type of exercise or >manual therapy
>(they do respond, but badly). This could obviously be >due to inadequacies
>on my part, although I would hope not, and
>the fact that amazes me is what they do respond to... e.g. a combination of
>interferential (that really shouldnt work) gentle >massage and a lot of
>encouragement of progressive movements in (generally) all directions. And
>shock horror, this small group of >patients respond unbelievably well.
chronic lbp patients would be expected to respond well to encouragement and
manual therapy that addresses their fear of movement and pain focussed
behaviour. no? the attention and caring that you give them and the number
of therapies you offer would also likely add to the non specific effects of
the treatment encounter(notwithstanding any specific effects they may also
have).
cheers
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