In the same vein of thinking, the only thing that the Deyo study showed in
my opinion (McKenzie vs. Manip vs. control group) was that not every
patient that walks in the door will benefit from McKenzie ex's or manip.
No one ever purports that McKenzie will work on every patient nor manual
therapy, so why are those approaches constantly held to that standard? Of
course they will fall short under those circumstances. When choosen
selectively, McKenzie works well as does manual treament. The studies that
are attempting to categorize patients into treatment groups and then given
the intervention accordingly are a step in the right direction. At least
those designs are perserving clinical decision making and allowing for
flexibility in choosing which treatment to give based on the evaluation.
Jason
----------
> From: Owen Allen <[log in to unmask]>
> To: [log in to unmask]
> Subject: Re: BACK CARE BIAS?
> Date: Wednesday, February 24, 1999 4:42 AM
>
> At 22:58 22/02/99 -0500, you wrote:
> >..." But this is really not exactly fair. If I had a tumor, a
> >kidney infection, etc, that caused back pain, I am sure I would be more
> >satisfied with an MD. If I had a herniated disk unresponsive to
> >chiropractic care or physical therapy, I would be more satified with a
> >ortho or neuro surgeon. If I had "garden variety" low back pain, I
would
> >be most satisfied with doing some home exercises and walking either with
> >instruction by a PT or a DC or an MD".
> ---------------------------------
> In similar vein, last year I read a brief of a research report from a
> professor of General Practice in Canada who purported to have studied the
> effect of physiotherapy on low back pain, and found the efficacy to be
low.
> I was baffled by the suggestion in this report that 'physiotherapy' is a
> treatment technique or protocol, and that low back pain is a specific
> pathology. It is of great concern that leaders of health sciences either
> fail to be rigorous in the definition of their research variables, or
their
> communication of that research. Whichever the case, in this era of
> information it is a failure of duty of care for scientists to be that
> sloppy. Although I would go so far as to suggest that some researchers
might
> be downright mischievous, for their own gain.
>
>
> Owen Allen
> Atherton Hospital
> P.O. Box 183
> Atherton 4883
> Queensland, Australia.
> Ph: 07 40910261
> F: 07 40913502
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