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Re: leg length question
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Re: leg length question - February 23, 2006 6:26:00 AM
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truthseeker
Posts: 148
Joined: June 23, 2005
Status: offline
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Shill,
I went to PT school affiliated with an Osteopathic Medical school. So, I guess you could say that maybe spine and SIJ stuff was emphasized more than other schools.
I went to two Richard Jackson Seminars and found them to be very helpful practically. He references many of his concepts and I would consider him evidence based. His courses simplify the SIJ evaluation.
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Re: leg length question - February 26, 2006 6:35:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
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Randy-
I do use the CPR, but I don't assume the findings have any sort of specific meaning beyond that. I did say that assymetry (in terms of flexibility, ROM, or strength) is correlated with injury rates. I'm not saying assymetry's unimportant. I'm saying that stating with certainty that LLD/LLI first can be truly measured with physical exam and second is a causative factor in pain states, and third can/should be resolved through therapy is not a perspective based in much evidence. I agree that it wouldn't hurt to try to look at it if other things weren't working. Like anything else in EBP, I don't argue for something's exclusion if it's biologically plausible, I just argue for it's prioritization much further down the list. When I see people putting things with small amounts of evidentiary support high up in their priority list, I sense an opportunity for a good clinical discussion. Hence this thread.
Tom R-
Please reread your explanation of the clinical/statistical significance concept. It doesn't convey what you are trying to get across.
You also said "If we do several sort of reliable tests and they all agree doesn't it increase the power and validity of our findings?"
No, Tom. No it does not.
We simply cannot have a discussion of evidence based practice and evaluation of research if you continue to throw around research terms that you clearly do not know the meaning of.
Neither reliability of a test nor the power of a study addresses validity.
Many tests can be reliable (meaning you get the same or similar results every time) but that doesn't mean they are valid. For example, I can decide that the amount of moonlight tonight will predict whether my neighbor will turn into a werewolf. If I use 4 different light sensors and they all agree, that does not have anything to do with the validity of the construct (moonlight and werewolves in this example).
The power of a study is the likelihood we will not make a Type II error. Power is increased by sample size and influenced by alpha level, among other things. It is not affected by the tests used in the research.
Look, I'm happy to have a good discussion about anything here. But you simply cannot participate on this level and make a cogent argument if you don't understand statistics and how to evaluate research literature. I don't mean to be harsh about it, but there it is.
It's nothing personal, everyone has strong and weak points, but realizing them is important. I don't post at all in the pediatric area, because I simply don't understand the practice, science, and research base enough to participate in a meaningful way. Also, I am sure there are tons of people even here who could run rings around my admittedly basic understanding of statistics and research. But I know enough to make some basic arguments and defend them. It appears you don't.
If I may, let me suggest this site to help get you started. It really helped me quite a bit:
http://www.sportsci.org/resource/stats/index.html
You're clearly a very sharp and passionate PT, so I'm sure you'll pick it up quickly.
Steve-
My Ortho instructor went into fairly good detail on SIJ stuff. We did all the usual biomechanics stuff and maitland-style mobilization as well as muscle energy, etc that I'm sure your average PT student gets. School was 9 years ago, though, so most of what I do has been informed by my postgraduate training in the Army system, my clinical experience, and appraisal of research.
Like most of us, my school education just laid a good foundation to get me in the door of clincal practice, the rest has been learned since then.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: leg length question - February 26, 2006 11:53:00 AM
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truthseeker
Posts: 148
Joined: June 23, 2005
Status: offline
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Jason,
Mea Culpa. I did not mean to use the word power in a statistical sense, and I meant the word validity in your quoted sentence to be reliability. I think I do understand the difference between reliability and validity.
Maybe it would have been better to say that multiple tests that have some reliability, improve the reliability of my conclusion. To the extent that it is valid is a matter of research to be determined. I was writing sloppily. sorry.
I think I typed that particular message twice because I included parenthesis and it was erased. It is hard to re-create a good rant.
I will check out your link and try to do better.
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Re: leg length question - February 26, 2006 1:56:00 PM
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Shill
Posts: 1092
Joined: February 13, 2003
From: Madison WI USA
Status: offline
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Jas and Tom,
My purpose with asking the question regarding schooling and the SIJ/Pelvis is that those who had it drilled into their heads at school, regardless of how long ago it was, seem to be those who have the hardest time accepting the lack of reliability. Not always, but sometimes.
So did he turn into a werewolf?
_____________________________
Steve Hill PT
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Re: leg length question - February 27, 2006 9:42:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
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Steve-
It wasn't particularly "drilled" with me, as my instructor emphasized the theoretical nature of what we were learning. Smart guy, thinking ahead of his time.
And he didn't turn into a werewolf, after all. But one leg is longer than the other, so you never can tell...
:)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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