Originally Posted by
Canuck Physio
Evolve or devolve:
We don't just sit back on our asses waiting for answers to be presented.
BEFORE EVEIDENCE BASED PRACTICE NO ONE EITHER SAT ON THEIR BACKS.
Progressive rehabilitation research is all about seeking out and piecing together recent advances in rehabilitation, muscular biochemistry/endocrinology, muscular physiology to form a substantiated logic that supports a hypothesis.
THIS ALL WAS ALSO DONE BEFORE EVIDENCE BASED PRACTICE.
Then you apply it, either in real life or a clinical setting. It is not about making assumptions from one research paper. Anyone can recite research findings.
ASWELL DONE PRIOR TO EVIDENCE BASED PRACTICE, AT LEAST THE ENVIRONEMT I GREW UP IN.
Analyzing research data, examining the effectiveness of a study, and applying its results to real world training situations is an entirely different matter.
EVEN WITHIN MATHEMATICS NOT EVERYTHING CAN BE PROVEN, E.G DEFINITION OF A POINT, A STRAIGHT LINE, A FLAT SURFACE CANNOT BE PROVEN BUT IS EXPECTED TO BE TRUE.
Research studies are continuing to show that what we thought or perceived work (Ultrasound, massage, acupuncture, electrotherapies, etc.) may not work in specific settings or cases. Lack of evidence does not mean they do not work, but perhaps we need to utilize our CLINICAL Knowledge, examine specific physiological variables or outcome measures, and apply a hypothesis to determine in which setting/situation each modality is important. If we can specifically cite research to back this up, it will only add to the clinical reasoning/justification that is available unto us.
HOW FAR DO WE WANT TO GO WHEN IS ENOUGH ENOUGH. WHEN CAN WE SAY WE DO NOT KNOW BUT AFTER OUR EXPERIENCE IT DOES WORK?
Wake up people, chiropractic is not going to survive forever considering the onslaught it has been taking from the medical/scientific community in the past few decades. I EXPECT IT SIMPLY TO GO ON, IT MIGHT CHANGE NAMES OR GOING UNDERGROUND AS HAS HAPPENED WITH OTHER MODALITIES. MEDICAL WORLD IS UNABLE TO JUSTIFY ALWAYS WHAT THEY ARE DOING, WE GOT ENTANGLED IN THEIR WAY OF REASONING AS THE ONLY WAY. WHY DO WE ACCEPT A REFERRAL OF LBP OR OA OF THE LOWER BACK ( MAYBE 90% OF PEOPLE OVER 40 HAVE SOME OA OF THE LOWER BACK)
Physiotherapy must adapt to ensure it's survival. Maybe this way professors at college will stop blurting to students that 'oh we don't know how it works, but we think it does', or 'it just works'.
LIKE IN MATHEMATICS WE HAVE ACCEPTED A STRAIGHT LINE IS THE SHORTEST DISTANCES BETWEEN 2 POINTS, IT JUST IS SO.
The need for evidence is important, but let us also bridge the gap between clinical reasoning and clinical research, let's use the hypothesis as the basis to conduct good, no High quality research that can make sure we stay a strong profession for years to come.