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Re: "special skills"
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Re: "special skills" - September 19, 2006 2:41:00 AM
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MPT
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Here is the link to the article I mentioned above.
[URL=http://www.medscape.com/viewarticle/508148]Frequency and Clinical Predictors of Adverse Reactions to Chiropractic Care in the UCLA Neck Pain Study[/URL]
_____________________________
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Re: "special skills" - September 19, 2006 2:52:00 AM
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proud
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I think some key points are being missed:
1. The topic "special skills" started by myself, was actually meant to be a commentary on the Canadian Orthopeadic Division's curriculum to become proficient in manipulation( as this is primarily a PT board). For some reason, some of the chiropractors feel this is akin to an attack on them.
2. Clearly jbird007 still feels he has "special skills" as outlined in his above post about all the suppossed training he has. It's okay jbird007 or any PT out there who feels they have "special skills", go ahead and ignore the research. However, I do not feel that is in the best interest of the public.
3. Ar15 has re-enforced my points about "what defines a skilled manipulator". If we continue to view this topic as some kind of turf war, we will delay our ability to advance the care we can deliver.
4. My posts have been about the research concerning specificity and safety( relevent to both PT and chiropractic). Can we do away with the name calling? This is not chiroweb.
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Re: "special skills" - September 19, 2006 2:57:00 AM
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Jeep
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From: USA
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You make a very good point ARI5-
The studies make a minip, a manip, = a manip. Personally, I(and most DCs), know at least a dozen different ways of Cervical manipulation. None of the studies take the specificity of the manip into the criteria.
The studies Proud touts,------ only one manip procedure was performed. What different results would have been, had different manipulative procedures been employed? The much touted CPR, used only one manip move. What different results would be observed with different manips? Manips are not a "one size fits all". Knowing which to employ, when, why,...... for each given patient is essential. However this concept is entirely lost on some posters here.
Proud- It is comforting, I am glad to know, that you do not try to perform cervical manipulations in the application of your physio trade-------
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Re: "special skills" - September 19, 2006 3:05:00 AM
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proud
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Jeep.
Again with the insults. The preferred method. Present some research to debate and instead of discussing it, just insult the person. Geesh.
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Re: "special skills" - September 19, 2006 3:19:00 AM
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Jeep
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Proud there are no insults------Please identify any you consider such.
BTW- I am still waiting on your cite(per prior repeated request)............Can I anticipate that you will provide that?
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Re: "special skills" - September 19, 2006 3:30:00 AM
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proud
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Jeep,
Really? By implying that it is comforting to know that I do not perform manipulation. I can perform manipulation. Did for 3 years. I discontinued on my own accord based on the research. Seemingly with no ill effects on my patients outcomes.
And no, I do not want to go any further into the turf war thing. My apologies for throwing the recruitment/retention thing into the mix. I am sure if you wanted to, you could locate the source.
My point stands. Read the research and apply it to practice. And that apply's to both PT and chiropractic.
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Re: "special skills" - September 19, 2006 3:49:00 AM
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Jeep
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So...... you have no cite/support for your assertion????? If so- please provide. It incumbent upon you to provide support for your claims.
Or shall we consider your claim to be only smoke and mirrors/without credibility.............or just not consider it at all?
Surely you would not make such a claim without solid/citable support.........would you?
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Re: "special skills" - September 19, 2006 4:19:00 AM
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jbird007
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I suggest anyone to get manipulated by someone with 25 years experience (who has been schooled, trained and attended 50-60 seminars) and then get manipulated by a monkey (as proud put it).
Then tell me the difference.
BTW, a skilled manipulation does not have be aggressive nor does it need to cavitate.
JBird
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Re: "special skills" - September 19, 2006 4:21:00 AM
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jbird007
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[QUOTE]"My point stands. Read the research and apply it to practice."
[/QUOTE]..another classic Alan Botnick quote! funny guy!
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Re: "special skills" - September 19, 2006 5:03:00 AM
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jbird007
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[QUOTE]"Manips are not a "one size fits all". Knowing which to employ, when, why,...... for each given patient is essential. However this concept is entirely lost on some posters here."
[/QUOTE]I think Jeep sums it up well.
JBird
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Re: "special skills" - September 19, 2006 5:13:00 AM
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dfjpt
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[QUOTE]a skilled manipulation does not have be aggressive nor does it need to cavitate.[/QUOTE]Jeep and jbird, do you consider slow handling of the neck at superficial levels, handling that results in improved range and decreased pain, "skilled manipulation"?
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Re: "special skills" - September 19, 2006 5:29:00 AM
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Jeep
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From: USA
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I consider it one of many tools, that I, (not gurued into a one technique, one size fits all mentality), can clinically choose if indicated. I fit my treatment to the patient. I do not fit my patients to a "technique" paradigm. And I may also use many different techniques, as clinically indicated, along the path of patient progression.
There is no cookbook "recipe", that I "squeeze" my patients into......... "Recipes" are for those that either- can't think/reason/use clinical judgement/clinical experience to arrive at the optimal patient application, or are just too lazy, or too,appathetic, or too brainwashed by a "theory" guru.
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Re: "special skills" - September 19, 2006 5:41:00 AM
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dfjpt
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So, Jeep, to you, and jbird probably, any sort of hands-on is "manipulation", be it skilled or unskilled? Not trying to be a provacateur here, just trying to sort out what manipulation means to you, and what you think it is, how it is defined by chiros.
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Re: "special skills" - September 19, 2006 5:52:00 AM
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Jeep
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From: USA
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What does it mean to you? THAT may be a more enlightening topic.
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Re: "special skills" - September 19, 2006 6:03:00 AM
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dfjpt
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To PT in general (I think) and to me, "manipulation" means HVLA, thrust, cavitation.
Everything else applied to joints is mobilization, and anything to soft tissues in general is "soft tissue" manual therapy. Other PTs might slice it a bit differently, but those are the main broad categories. One thing we all have in common I should think, is that we all can use our hands to treat effectively. So that is not the issue.
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Re: "special skills" - September 19, 2006 6:22:00 AM
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proud
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Jeep,
Ever heard of Christopher Kent?
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Re: "special skills" - September 19, 2006 7:46:00 AM
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Jeep
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There are some that like to promote "manipulation=HVLA". While HVLA is manipulation, it is not the ONLY form of "manipulation". For those who have been led to believe this, let me introduce you to another widely used DC manipulation....see: http://coxtechnique.com/
I would like to add the latest study here on lumbar stenosis. As you well know, this is a very problematic condition, often yielding less than acceptable outcomes. I would urge all PTs here to look at this study, and refer these patients to a DC employing this protocol.
http://www.medscape.com/viewarticle/528906
A Non-Surgical Approach to the Management of Lumbar Spinal Stenosis
And for those who insist on promoting chiropractic=HVLA manipulation-----you now know that is not accurate. Although I've linked to only ONE(1) non-HVLA manipulation approach, there are many others also.
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Re: "special skills" - September 19, 2006 8:03:00 AM
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proud
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Jeep,
The medscape link does not work. Can you post again?
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Re: "special skills" - September 19, 2006 8:41:00 AM
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Jeep
Posts: 353
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From: USA
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Proud-
I just clicked on it------it works just fine.
Again:
From BMC Musculoskeletal Disorders
A Non-Surgical Approach to the Management of Lumbar Spinal Stenosis: A Prospective Observational Cohort Study
Posted 04/13/2006
http://www.medscape.com/viewarticle/528906
Hey- How about getting that cite(from the other thread) up?? I am looking forward to reviewing it.
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Re: "special skills" - September 19, 2006 8:55:00 AM
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jbird007
Posts: 297
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There may be many variations amongst DC's as to the definition of manipulation. Heres mine:
A hands-on procedure that induces a specific range of force to muscles, joint structures and bone with the goal of restoring normal joint motion.
I agree with Jeep, Cox F&D is a form of manip. I also believe using a (metal mallet) or "activator" is a from of manip.
You could use a 2x4 and a hammer to manipulate a cow, and you could use a pen cap (with hardly any force) to manipulate a mouse.
I agree with Diane that most people associate manipulation with a heavy thrust and cavitation. Patient education cures that, and discussion forums :)
And yes, this all involves SKILL which is gained through education and put into trial and error testing then doing it over and over to attain perfection.
More importantly,(and I stated this on my very first post) is having the knowledge and clinical wisdom to know when NOT to manipulate.
In closing, a manipulator needs many SKILLS. SKILLED in clinical thinking, assessment, work-up and ddx and SKILLED in the art of manipulation.
No monkey can do that.(although they would be fun to have around a clinic) :)
JBird
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