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