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tomdalonzobaker -> RE: Total Motion Release (April 17, 2008 10:05:37 AM)
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SJbird - I would be happy for some meat and potato discussion. I know pretty much anything I say will be up for dissection. I would like to break up the discussion between evidence and research. As for research - we have three DPT grads doing case study research in Tennessee. I have lots of projects that I want researched and I am working on the local Universities for doing some of this. SJBird, I would love it if with your research interests you would do some research on TMR. It would be great to hear from someone who goes into the research with high skepticism to come out and let other therapists know their findings. In fact, I would prefer it this way. As for evidence, we are very scientific in both data collecting and recording of this data. In fact, our forms collect data in a very detailed format so that the data allows the therapist and patient to determine what to do from the numbers. I have not seen any other techniques that use as detailed forms as we have, Mckenzie is probably the closest in comparison. Because of this obsessive data collecting that is done after EVERY set of exercises or EACH time one technique cycle is performed, we can determine whether to continue with the technique/exercise or if it is more important to move forward. The evidence is displayed in the numbers. The evidence is either positive, negative, or inconclusive. Based on this info decisions are made. I don't like to be led by my gut I like to be lead by my findings. With this said, most of the time when I ask therapists in the seminars to tell me how they collect data it is very spotty at best. When I ask them how they know to determine if their technique is working or whether it is better to move forward, again there response is often vague into their own understanding and rarely is any of this written down. Most rack it up to experience, or I just know, or they get worse, or it feels like it is as good as it gets. When I ask them how do you know this, by what are you comparing it to they have a hard time asking. They don't collect data. It is all stored in their heads and decisions are being made by their "intuition, gut, response of patient, or experience." And there isn't necessarily anything wrong with this, but so much more can be learned. Patterns can start being established both for that patient as an individual and patient conditions in general. The concept I talk about rib cage and thoracic spine related to ankle injuries or hip external rotation restriction causing shoulder problems is all due to a tremendous effort on my part to use data to find patterns. The recording on my forms is kind of like doing those experiments you did in 7th grade where they made you write in that black bound graph paper note book and every step you took was recorded. Fortunately, we have developed a form that makes the data collecting quick and easy and patterns causing the patients pain can be seen using it. The TMR Video Package on the website this entire process is outlined. I know I am going to hear it now that this line is in their to push my products and make money. SJbird - I would be happy to send you a copy for free if you would review it, perform it on at least 10 patients, give it an unbiased effort and report back to us your findings. I really love the underlying principles of evidence and research - data collecting and then using those numbers to determine what to do next. I believe if one person can achieve results then the process should be that anyone should be able to achieve those results. Including the patient. My education with Mckenzie, Maitland, and Ola Grimbsy trained me to do a technique until you no longer are seeing a result. Continue until . . . . Collect data until it tells you something . . . . then do it until it no longer is improving, and then collect more data. With this said - I would bet that I probably collect more data and record more of my findings than most therapists. If I read one of your daily notes would I be able to extrapolate from what I see and determine the patterns that are causing their pain? And will this data let me know what to do next? Will it let me know when you just did the last technique 5 minutes ago if it was better than the set you did before it or the ones you do after it? Are you organized in your record keeping? Can you show patients your forms and they can tell you the patterns that cause their problems? I think you can tell by now - I like data and all of what I do lends itself nicely to research. The research part, as it does lags behind the clinical evidence. There is a wonderful book called Probst - the NeuroScientist. He talks about how the Art of a Science often times takes years even centuries before the proof of why it works is known. I began the videos to allow others to see the possibilities of what TREATING THE NON-INJURED AREAS of the body does to the INJURED AREAS. This is phenomenon that you have to witness to begin to wrap your mind around it. Lets face it, the concept of treating the good side leads to a lot of skepticism seeing that most of us have been treating the area of pain our entire career. Because this pattern of treating the injured side is so ingrained in our profession, I feel videos is a quick way to begin showing the opposite approach. If you told me 7 years ago to treat the opposite side of pain, I too would look at you as if you had two head. If you then showed me it working on several patients, it would force me to perhaps reconsider the possibilities. That is what I want the videos to do. To perhaps make people reconsider the possibilities. And yes it "appears" to go against so many of the ingrained techniques we use as therapists, yet what it actually does is complements other technique very well. It offers another dimension. You can do joint mobs to the good side, exercise to the good side, manipulate to the good side, do Mckenzie Extensions to the good side, help a stroke patient by doing more of the good side, and even reduce lymphodema at a faster pace. As with anything - Total Motion Release needs to be practiced to be good at and to master, but the simplicity of it allows itself to even be practiced by patients and have great results. OK - I have rambled on considerably. Take a look at the videos. Do they make you wonder even just a little bit as to if this concept might have some importance in what we do? Tom Dalonzo-Baker, MPT Founder of TMR
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