Musings, Evidence Based Practice, Etc

Dear Blog,

Sorry for my neglectful behavior. I have not forgotten about you, but I had a lot to figure out in my professional life recently. The experience has led to a lot of clarification as to my goals and although the details continue to be a bit hazy, they are gradually revealing themselves.

Prior to my recent professional journey I have to admit that I was struggling as well. I’m new to blogging and found it challenging to find my “voice.” I want to post current, evidence based, but practical information. However, in real life those things can be a bit of an oxymoron! A recent article written by Marcia Stamer, PT, C/NDT on the NDT Association  Network on the Net  newsletter expressed the discomfort I feel with evidence-based practice better than I ever could have. The medical community has adopted the evidence-based practice mandate with gusto. Accountability for treatment efficacy is important, but at the same time we must realize that in the area of pediatric re/habilitation we don’t have all the answers right now. It is likely we never will. If we waited for solid evidence to determine every detail in how we re/habilitate children, we wouldn’t be providing ANY treatment. Reading some of the overviews that have been written on this topic one would conclude that nothing we do in current pediatric physical therapy practice works, or that one strategy is just as good as another, but that is certainly NOT what we see in our practices. We see results, some faster and some slower. We see kids learning new skills and going out in the world and using those new skills. We design individual treatments that encompass so many variables (personality, learning style, sensory needs…) that it is difficult to compare one child’s treatment to the another. What we do is constantly evolving. As long as we are committed to continuing to learn then we need to continue helping children and their families day in and day out to maximize their skills based on our current clinical knowledge and experience. So off we go…

1 reply
  1. Barbara
    Barbara says:

    Hey, Friend. I feel your pain. But I have found some answers for myself. I no longer agree that each particular modality needs to be randomizedcontrolledblindstudied IF it is a piece of equipment that supports *exercise*.

    See my post: http://www.therextras.com/therextras/2008/12/the-big-one.html

    Keep in mind that results that physiologically known – like increased blood flow from a heat application – do not need studies for ‘evidence’. Modalities are tools of therapists – thinking individuals who do not follow protocols but creatively and individually apply tools during treatment. I hope this sounds as encouraging as I intend it, Joni.

    And, I recommend the post dated August 30 – now on top.

    Reply

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