Hi Jason, [QUOTE]with the latest study over in the "Diagnosis and Palpation..." thread about PA mobility assessment, you may have to come off your stance a bit about using that to help guide treatment.[/QUOTE]If occasionally perceptual fantasy lines up with reality enough to produce some favorable outcome, it still doesn't make it NOT perceptual fantasy... it just makes the PF of it a little harder to discern as such. It's still just a map, not the terrain. Just about everything we learn is map, not terrain. I want cognitive terrain. :) Neuromodulation concepts give me a cognitive compass and a good set of rational night vision goggles, with which I can go anywhere I want without having to resort to an incomplete or misleading or quacky sounding map/someone's personal perceptual theory. We treat people/explore terrain, not maps.
Joined: February 15, 2008
I have a question for the people that are posting saying that visceral is a load of cr**. Have any of you had any personal experience with these or cranial techniques?
I am a PT and felt the same way as you do until I met a collegue who was getting these unbelievable outcomes with these terribly chronic pain patients who nobody else was helping. I started sitting in with him while he treated patients and asking questions and he pointed me to cranial classes at Michigan State. I'm now having better outcomes with the really chronic patients that I never had success with before.
My concern is that we as a profession are dumping techniques that have worked for many years and for many patients because our current ability to do research doesn't show that they are reliable. Are we saying that the patients who my collegue has helped that nobody else has helped are full of it? Why did they all of a sudden get better under his supervision?
Joined: December 22, 2007
With all due respect. I haven't visited the moon, but I'm fairly confident there is no oxygen. It isn't a simply matter of personal bias although it always exists. Shouldn't there be some burden of evidence an intervention should bear before we embrace it unconditionally?
I continually question some of the most fundamental and accepted aspects of our practice patterns. Why should any other assessment and intervention technique be any less scrutinized.
The "until you've walked in my shoes" argument just doesn't fly with me. Show me something...anything that begins to build objective support for the intervention and I will be all ears.
Joined: February 14, 2003
From: Madison WI USA
I for one would like to see how the outcome improvement was measured, and how the patient is doing now, down the road a month, two months, etc, before I even begin to think that there was anything more than just a few minutes of reporting "feeling better".
Joined: May 11, 2004
Your colleague needs to contribute to scientific literature. I personally have a "visceral" reaction when read or hear "cranial" in the same sentence as "success."
Forget about the reliability, take it a step further - what about effectiveness? For as long as cranial has been around, I would think that I could find that cranial is effective, but literature does not support the effectiveness of cranial therapy - let alone visceral manipulation.
Hmmmm... You believe that techniques that have worked for many years are being dumped - literature has established that the techniques are unreliable AND ineffective. Can you explain why they shouldn't be dumped? Testimonials, experience and observation isn't enough to establish effectiveness. How are you defining success and how do you define "unbelievable outcomes?"
I'm here in MI right where those cranial courses are being taught - within the same radius that my patients can go to MSU for treatments by the DO's at MSU. I can assure you that chronic pain persists and there isn't a shortage of patients with chronic pain - even ones that go to MSU for treatments. The East Lansing area is not devoid of patients with chronic pain. If cranial was so successful, I'd think that my locale would have droves of patients "cured" of their pain and there would be little chronic pain in this area. That just isn't the case...
Joined: December 3, 2007
From: MI, USA (dreaming of New Zealand)
I agree that such techniques are suspect, however these places and practitioners must be doing something to help people (or at least convince people that they are being helped) that ?all those other places? that couldn't. Doesn't work for everybody, but then neither does what any of you or I do.
I do not doubt the possibility that a chronic pain pt who has had experience with treatment at a ShakeNBake, or with a push through it bully PT, or even a very skilled practitioner seeing multiple pts at the time could be ?helped? by someone who sincerely buys into these kooky ideas, but takes time listen to these pts and put their hands on them in a way that seems purposeful. The sincerity, concern and touch are what I think are important. The connection between biopsychosocial issues and chronic pain is huge, unfortunately it seems that many ?alternative therapies? seem to have a better handle on it than the much of the mainstream.
"I have never let my schooling interfere with my education." Mark Twain
I always get a bit peeved at this type of argument:
" Are we saying that the patients who my collegue has helped that nobody else has helped are full of it? Why did they all of a sudden get better under his supervision? "
The untrained farmer's wife has been laying hands on for years and has garnered enormous support from the community around her: "She gets awesome results". Based on your argument, we should all go to her and start doing the same thing.
It may be more prudent to examine the underlying theory of WHY it works: complex constructs (movable sutures, organ malpositioning) that seem to point at "research needing to catch up" can't really trump the psycho-neurological science that is already IN PLACE. It would require dropping a lot of the elaborate construct of the "technique and its theory" and simply explore the value of considerate and careful manual therapy.
That would of course really drop the money to be made from very detailed courses with a lot of time spent on "techniques" and "diagnosis".
I think therapeutic touch and power of suggestion are largely at play with a lot of these CST type treatments (my humble opinion). I am not sure about the rest of you, but I try my hardest to make my patients independent and take some ownership in their recovery. Not that I am completely hands off, but my goal is not to foster dependence. Rather if I have done my job correctly, I will never see the patient again for the same problem and will have given the tools to manage symptoms at home shop they recurr. None of this I nee a periodic adjustment or weekly visceral mob to keep my symptoms at bay.