Hi everyone,
Something that came out of Ben's patient with the neurological disorder that
I have been thinking. All this discussion on evidence based practice has
seen physio's present trials and studies in the literature that either show
a particular management's benefits, or show that the management is no better
than placebo or no treatment. What I have seen commonly on forums is
physiotherapists using the literature to either back or reject a particular
therapy.
I think I just like to remind everybody that evidence based practice is not
just looking at clinical trials and RCT's, but actually incorporating this
with clinical expertise and the patient. What comes out of the literature is
important, but only when the other two factors are also considered. This is
because clinical trials, RCT's, treatment guidelines presume homogeneity
with the population... it presumes that everyone with acute right sided low
back pain with radiculopathy will respond to a certain management style.
Therefore, to merely state a particular approach is the best because there
is evidence for it is not evidence based practice... rather, one must
clinically reason and decide based on each patient's situation. Too often I
see Physio's make this mistake and argue back and forth by throwing
literature at each other... in the example of Ben's patient, the Mckenzie
Physiotherapy approach was in the lime light. We must remember that there is
always individual variability and this I believe makes Physiotherapy a
challenging but fulfilling profession.
Henry***
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