clinical reasoning?

[EricM]

How in the world does stuff like this (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16445339&dopt=Abstract) get published? You can access the full text there.

This case study was written by a physical therapy instructor no less, a real academic. How is reading this supposed to help me? Is Physical Therapy Journal really that desperate for articles? I could go on but will save myself from writing something I may regret. If anyone with even a remote understanding of pain is looking for an example of the irrelevancy of the clinical reasoning behind a strictly biomechanical approach, here it is.

I'd love to hear your thoughts on this one, and please, tell me if I'm wrong.

Eric

[nari]

My instinctive response at the end of the conclusion was "So what?"

Stuff like this gets published because it is full of minutiae, impressive details that go round in circles, and fluff. I don't think it is just the APTA; there are other journals which seem to be desperate to fill their pages.

My question is: Why? and also, why did it take so long (7 sessions) to fix up the poor bloke???

You're not wrong, Eric.

[Diane]

It looks like the scientific arms race has hit manual therapy, that's all. Publish or perish.

[Barrett Dorko]

I did a workshop down the street from the college in Indianapolis that this came from about a month ago. Of course, none of the faculty attended.

If asked why not I'm sure they would have explained that they were busy preparing the students for the state boards, and that unless the traditional "knowledge" established in the 50s was the primary meme in the head of each one then their job would not have been complete. Picking up new memes is detrimental.

They wouldn't have used the word "meme" though the concept should be a part of any educator's fundamental knowledge. Today if you Google the word you get 226 million hits.

I guess that isn't enough.

Maybe someone here should invite the author to Soma Simple.

[bernard]

Hi all,

I have just a weird question :
There is a table 4 in the paper showing the session content?
Is this really common in the US?

[Barrett Dorko]

Bernard,

I would say that what you see here describes elements of a common treatment regimen though as a whole it's a bit more elaborate than most patients describe.

Ask any therapist why they have their patients do all of this and they will never answer with a theoretical construct that can be defended with either supporting literature or a deep model known to be accurate and relevant.

Inevitably they will say, "It works." For them, that's where the discussion begins and ends.

[bernard]

Thanks Barrett,

I thought it was a silly session but I'm certainly mischievous.
I didn't found any "functional" exercices. Is it normal?
And some exemples show a woman with straight contracted legs with a IR component (certainly TrA...). I can't do that.