Dear Ian & Colette,
It makes you wonder whether it really matters why it works, just that it
does and thus we should look for what is actually going to help that
individual patient in the best way. Makes you start to question the current
furore over evidence based practice and RCTs all that.
Also just a brief thought!
>From: "Ian & Colette Stevens" <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: "[log in to unmask]" <[log in to unmask]>
>Subject: Re: US Debate
>Date: Sun, 13 Feb 2000 19:52:24 -0000
>
>In answer to your question I think she is made by Mattel sponsored by Sony
>and is called Barbie or at least thats what my daughter calls her ...
>
>with regards to ultrasound there is an excellent example of the beneficial
>effects of ultrasound applicable to probably heaps of intervention
>strategies .... I will quote the example taken from p130/1 Pain the Science
>of Suffering by Patrick Wall Weidenfield and Nicholson 1999 a very
>readable book !
>
>'At the Eastman Dental Hospital in London , a team had been working on ways
>to help this troublesome
>condition ( wisdom - tooth extraction) . Ultrasound has been used for many
>years as a physiotherapy treatment for inflammation with the rationale
>that
>deep heat produced by the absorption of the sound would hasten the end
>of
>of the inflammatory process . Despite the fact that five or six trials of
>ultrasound on limbs had shown it to be no better than placebo , they
>decided to try its effect after tooth extraction. They found it to be
>highly
>effective . Then , in double blind fashion, they massaged the face w ith
>the ultrasound machine in some patients with the machine switched off and
>others with it working , unknown the doctors or patients.. There was no
>difference between the two groups . Next , they tested whether the massage
>was having the effect and trained the patients to do it themselves in the
>way the doctor moved the machine. This self administered massage had no
>effect . Up to this point they had shown a typical placebo effect in which
>a doctor in a white coat massaging the face with an impressive machine had
>a marked effect irrespective of whether the machine was switched off or
>on.
>Furthermore , there was no effect if the patient applied the machine . The
>pain was reduced by Dr applied treatment.
>They went further . The swelling of the face was markedly reduced and the
>ability to open the mouth was improved . This placebo effect was the same
>as that of a substantial dose of anti- inflammatory steroid.
>Evidently the placebo response required a doctor in a white coat with an
>impressive machine , and this combination improved not only the patients
>subjective report , but two objective signs of inflammation that are
>usually assigned to mechanical body processes . The rational explanation is
>that the brain affects hormones , which in turn affect inflammation.'
>
>I hope this is of some use and may explain why ultrasound and many other
>impressive treatments are 'just the thing' for some people. In our
>technologically/gadget orientated society I am sure these types of
>treatments will always have a role in 'the right environment' coupled with
>age old traditional rehabilitation protocols.....
>
>just a thought......
>
>
>
>
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