Hi Kevin
Well I was having trouble accepting your excellent points of contention until
I read that you hypothesize and appear to treat on the principles of
uncertainty. I was getting of the opinion that you were implying that you
were inplyingwe dont really know WHAT we are doing. I dare say it is
extremely dangerous to treat in that manner and the scientific among us would
not TREAT unless they knew what results they were planning to achieve from a
specific manuever.
I myself have very little faith in the research evidence that has been shown
in manual therapy treament. I think there are too many variables that we are
unable to measure at this point. In addtiont what we DO measure is much
more GROSS in function than what we actually are doing. ( e.g, after
mobiliaztion we would measure RANGE OF MOTION. ) On the other hand, as
therapists in the U.S. these days the standards our treatment is measured by
is even GROSSER. " does the patient " ' feel better' , can they return to
their previous level of function?"
I guess I had the feeling that since you felt that there were so many
variaibles in our treatment techniques and in the results, you were not
assessing your patients. I think that when we approach a specific injury with
a specific type of treatment (eg a "muscle strain" with a counterstrain
type of approach that we ARE treating Tender points. If this hypothesis does
not work, then we must try a differnt approach with a different system and
be, as I was once taught "more than a one horse dog and pony show" . I do
strongly feel that we MUST approach the body through a system and that if we
treat the problem with the correct system we as therapistscan begin to
correctly CLASSIFY symptoms ( rather than diagnose or assess) that are
found in specific systems. We can then more effectively treat with the
correct system.
Is this what you have been saying?
Julie
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|