Evidence Based Practice

[alophysio]

Hi - Why is this under Paediatric Physiotherapy??

Anyway, hi.

The absence of evidence is not proof enough that something does not work.

Where possible, we use RCTs and Systematic reviews to support our work.

We may not understand why what we do works. But we know that what we do works (Level 4 evidence).

What we need are researchers who are prepared to change their study designs to show we can do.

We need to try to do research where the results are not diluted because of poor classification of patients (e.g. Chronic LBP).

There are those doing that now in the States (Childs, Cleland, Fritz etc). We need to keep up!

[Tommy77]

Hi and welcome to the world of paeds physio!! :-)

Well basically I put this post under paediatric physiotherapy because I am primarily interested in the views of other peadiatric therapists... none of whom I could see had any input into the other evidence based therapy approaches. (Although I must admit to not having read all of them).

I consider what I do as a paeds physio so astronomically removed from what most people understand physiotherapy to be that most of those other threads are completely irrelevant to my particular situation.

I also noticed a particularly long evidence-based thread under musculo-skeletal physiotherapy, but didn't see anyone asking why that thread wasn't under general physiotherapy discussion. Interesting....

Anyhoo, back to the subject at hand... Yes I am aware that no evidence doesn't mean something doesn't work. I haven't seen any evidence supporting the fact that tying your shoes up decreases your risk of falling over, yet I know it to be so! However, if I was providing the funding for charitable organisations or government departments (where most paediatric services hail from) the fact that there is no proof something doesn't work would hardly be enough reason for me to think paying for it was justified.

However, as a clinician and a researcher I am more than aware of the difficulties of doing legitimate research with the tiny numbers and the vastly heterogenous populations within the one "diagnosis". I have also seen some horendously generalised conclusions drawn from tiny studies that make me wonder how these things get published in the first place.

Anyway, the purpose of this thread was not for me to espouse EBP, but more to find out whats going on in other parts of the world. More specifically, other parts of the paediatric physiotherapy world.

Hope this cleared things up a little.