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Colleagues, I have enjoyed the conversations - hope it can stay civil! Frank, let me pose the following. I do some consultant work for a clinic that does a wide variety of alternative approaches to PT (cranio, muscle energy, etc, etc). The majority of the patients they see have failed traditional PT approaches (EBP). The therapists are excellent manual therapists and have tremendous patient care relationship skills. They often perform mobility testing of the SI joint, find dysfunction, select their approach to treatment and the patients get better. I personally can't ignore this, regardless what the literature states. However, that does not stop me from asking the question - Why? Knowing the number of patients that are referred to this clinic, and evaluating the wonderful care they receive should we encourage them to stop using their approach? I hope not. What about the phenomenology of the patient - therapist relationship that is so important in the "ethics of care." What about the phenomenology of the therapist him/herself, and what role does that play in positive outcomes? There are many questions to ask, and many answers yet to come.Honestly, I hope we don't find all of them - life would be to boring. Just my thoughts. Rege At 05:16 PM 2/1/2003 +0100, you wrote: >Patrick, > >You: "There are some techniques that I can >gaurantee you don't come close to moving L5/S" >Me: Evidence? If I would have to believe you, I would also have to believe >a therapist who claims that s/he can palpate the position of mobility of >the SIJ, while whole series of studies have shown that that is unreliable. >You're claiming something that, in the light of the studies done and the >claims still made by therapists, is at least unlikely. > >R., >Frank > > >----- Oorspronkelijk bericht ----- >Van: <mailto:[log in to unmask]>Patrick Zerr >Aan: <mailto:[log in to unmask]>[log in to unmask] >Verzonden: zaterdag 1 februari 2003 16:50 >Onderwerp: Re: Sacroiliac Dysfunction and Treatment? (David] > >Frank: >I'd have to agree with your last statement but there is a flaw in it. Your >statement ":They're darn close >together, so judging that by sound or feel seems extremely unreliable." >Judging whether or not the manip to the sij was successfull also requires >knowing how the joint was manipulated. There are some techniques that I can >gaurantee you don't come close to moving L5/S1 and others that are less >specific and could be moving L5/S1 so I think without knowing the mechanics >of the manip it is difficult to evaluate it's effectiveness. > >Patrick Zerr ><http://www.apluspt.com>www.apluspt.com >The easiest way to prepare for the National PT Exam! ><http://www.summitpt.com>www.summitpt.com >Summit Physical Therapy; Tempe, Arizona