On 12/22/98 19:26:48 you wrote:
>
>In a message dated 12/22/98, "Peter Gladwell" <[log in to unmask]>
>wrote:
>
>>Whilst it is possible to develop polarised debates about whether
>>back pain is biological or psychological or social, these debates
>>are timewasting at best, and do not help the flesh-and-blood-and
>>feeling-and-thinking patients who we see clinically.
>
>***A simple equation answers this comment:
>
>No debate - no perceived problems with existing methods and theories - no need
>for research - no progress - patients still suffer.
>
>The answer? Plenty more debate - plenty of research - research and clinical
>interaction - more hope for patients!
>
>Dr Mel C Siff
>Colorado, USA
>[log in to unmask]
>
>
>
Certainly Dr Siff most of us agree more discussion needs to occur. I sense the frustration
of the clinician to that of yours which seems to primarily academic. (Not meant to insult)
Frequently when I read your P & P's they seem to belittle a current creed, belief or set of
research or lack of research findings. I don't know if it is possible for you to change the
questioning in your P&P's to develop more discussion.
In your last P&P in regards to physical findings in LBP that research does not support. I
would beg you to look closer at methodology. For example: just because some X measurement
does not correspond with another Y measurement does not mean there is no correlation. If
you look to see if those measurements have even been documented to be measured reliabling is
highly questionable and is much the fault for poor physical therapy research. And even if
they were reliably measured how do you know that by changing X you will get a change in Y.
I'm thinking of X being a muscle length and Y being posture. I have numerous times had some
one stretch a hip flexor,hamstring or glute and the pain disappears, function improves and I
cannot detect a postural change why is that? Perhaps my paradigm needs to be changed in the
fashion of what is to be measured in order to say X is affecting Z, Z being the new found
factor that is really being changed.
Again, I would like to criticize your cause and effect thinking in your last note on
strength training as proof for periodization. You didn't give any info on the status of the
population being studied. Most strength training athletes (advanced) are in some type of
competition and that could account for the lack of findings. They could be in a maintenance
phase, perhaps they had already reached their potential, there are many things that could
effect the outcomes that weren't discussed. This is always going to be the challenge with
physical performance when trying to isolate a cause and effect. Don't you agree?
Pat
Patrick Zerr P.T.
Advanced PT Concepts http://www2.netcom.com/~pezerr/physicaltherapy.html
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