Barrett,
I never implied that pt's suffer in the absence of a thorough postural
screen. Rather, it is my opinion that utilizing it adds some valuable
information and helps to guide my approach (as does all of the other
subjective and objective data). I agree that there is limited research
supporting it usage and yes, that is a problem with our profession.
However, there is much to say for intuition and clinical experience that I
feel warrant its application with patient care.
Thanks for your reply. I really enjoy the responses of the posted
questions and comments on the list serve.
James H. McMahon MPT, ATC
Physical Therapist
Fort Howard VA Medical Center
-----Original Message-----
From: Barrett Dorko [mailto:[log in to unmask]]
Sent: Tuesday, August 06, 2002 3:25 PM
To: [log in to unmask]
Subject: Re: A Question of Posture
James McMahon writes:
"How can you say that intersegmental relationships/positions have no
influence on symptomatology? I think that traditionally, therapists
utilized the "postural assessment/screen" as a way to collect additional
objective information, however I found that therapists would make great
leaps in correlating their findings with a specific PT diagnosis.
Barrett Dorko: Well, I can say this without much trouble because there is no
evidence I'm wrong. In fact, the absence of evidence for symptoms arising
from intersegmental relationships is precisely what worries Dr. Sahrmann.
Having conceded that general postural assessment reveals nothing reliable,
she wants the research community to find something predictably painful about
intersgmental relationships so that traditional (and not so traditional)
assessment methods are justified. As I said, the chiropractors never managed
this and neither have the osteopaths. I'm not talking about clinical
results, I'm talking about the theories that support our methods of
assessment and care. Nor did I say that postural assessment was anyone's
sole means of diagnosis.
James Mc Mahon writes: " ... from an osteopathic standpoint, certain lesions
(Type
I) are often initially recognized through a postural screen. It isn't that
a diagnosis is made based solely upon the visual inspection, but rather it
helps to guide the clinician in identifying underlying pathology (ex. sacral
base dysfunction, LE length discrepancy, myofascial dysfunction, etc)"
Barrett Dorko: This is a matter of opinion and you're certainly entitled. I
did the same type of screening for years, taught other therapists how to do
it and treated patients accordingly. The research community never supported
the theory and I abandoned the tradition, simple as that. If my patients
have suffered for its absence, that's news to me.
Barrett L. Dorko, P.T.
http://barrettdorko.com <http://barrettdorko.com/>
