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RE: Does reading my posts make you stupid?

 
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RE: Does reading my posts make you stupid? - August 7, 2008 6:17:50 PM   
TexasOrtho


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Thanks Diane.  Applied Kinesiology is a form of alt med we all love.  Click here for its link on quackwatch.  Being a um-seasoned PT, I'm surprised you hadn't heard of it.  It's been around quite a while.

I do have questions...how do you know your treatment was effective and when to discharge the patient?  I know you abhor the use of the phrase "outcome", but surely there must be something the patient displays that makes you say "hey that worked".  There must be some salient indication that you have done something positive.  In the research community this is referred to as a dependent variable.

So are you implying your outcomes are superior or simply that your theory behind your treatments is superior?  Or is it both?  We've already established you are superior BTW, I'm just trying to figure out how you've accomplished this.

Are you threatening me with the "you had better not get me confused" comment? I'm pretty sure I can take Barrett on any day of the week, but your combined powers are way to much for me to handle.  I explicitly said I am not comparing you or your treatment to AK.  You just have similar preambles. 

Yes, I still have your manual Diane. It's a decent start but still needs the attention of a good editor...

< Message edited by TexasOrtho -- August 7, 2008 6:52:14 PM >


_____________________________

Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
Movement Science Podcast and Blog

(in reply to Hpsg)
Post #: 141
RE: Does reading my posts make you stupid? - August 7, 2008 7:08:08 PM   
Hpsg

 

Posts: 32
Joined: December 26, 2007
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To TO:
quote:

quote:

Thanks Diane. Applied Kinesiology is a form of alt med we all love. Click here for its link on quackwatch. Being a um-seasoned PT, I'm surprised you hadn't heard of it. It's been around quite a while.

Thank you for the link. I had heard of the term before, but how it is used is outside my comprehension.
quote:

how do you know your treatment was effective and when to discharge the patient?

1. pain is substantially reduced or completely gone
2. function is full
3. patient can resume what they want to do.
4. All of the above at once.

Usually the patient decides, after all it's their treatment dollar - sometimes I decide for them, like a patient I've treated three times to no avail. There is just no increase in hip range. She complained of knee pain, but has full range in the knee, no strength issues there - her main complaint is inability to cross her leg on that side. She has almost no external rotation of her hip. Time to get that labrum checked medically, do you think?


quote:

I know you abhor the use of the phrase "outcome", but surely there must be something the patient displays that makes you say "hey that worked".


I don't abhor the use of the phrase "outcome." For the rest of the question, see above.

quote:

So are you implying your outcomes are superior or simply that your theory behind your treatments is superior?

No, and theory maybe..

quote:

Or is it both?

??

quote:

We've already established you are superior BTW, I'm just trying to figure out how you've accomplished this.

Snarky.

quote:

Are you threatening me with the "you had better not get me confused" comment? I'm pretty sure I can take Barrett on any day of the week, but your combined powers are way to much for me to handle.

Snarky.

quote:

Yes, I still have your manual Diane. It's a decent start but still needs the attention of a good editor...


Then why did you bother asking me what I'd do?
I agree it needs work. It's a first draft. Want to help edit?

(in reply to TexasOrtho)
Post #: 142
RE: Does reading my posts make you stupid? - August 8, 2008 2:25:00 AM   
TexasOrtho


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Joined: December 22, 2007
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quote:

ORIGINAL: Hpsg
Then why did you bother asking me what I'd do?

 
Because I can't imagine you treating each case the same way.  I would imagine there is some variation in your practice patterns based on the patient's presentation (which varies).  A smart fly on the wall would surely be able to detect some measurable consistencies in your techniques (independent variables) and the extent to which they affect the resulting outcomes (dependent variables).
 
I'm also not sure how your treatment techniques should not be subject to some form of peer reviewable data.  Again it would be no more complicated than other studies looking at specific interventions and the resulting outcome.  It would have all the credibility and drawbacks of any outcome study currently published.  Then we would be able to have a fair fight discussion on why your treatment is superior to xyz in the management of medial knee pain or other disorders.  Right now it's just your word.
 
The doorway for transparency is wide open for you Diane.  All you have to do is walk through.  I have been very clear that I will be there for you on the other side to welcome your arrival. 
 
quote:


I agree it needs work. It's a first draft. Want to help edit?



Happy to...just say the word. 

_____________________________

Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
Movement Science Podcast and Blog

(in reply to Hpsg)
Post #: 143
RE: Does reading my posts make you stupid? - August 8, 2008 2:32:10 PM   
Hpsg

 

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TO:
quote:

quote:

The doorway for transparency is wide open for you Diane. All you have to do is walk through.

I think I may have mentioned I'm doing a study. We've collected data on 8 people and are starting a 9th. It's slow, but publishing will happen.

quote:

Happy to (help edit)...just say the word.

Thank you. I'll remember.


quote:

quote:

I can't imagine you treating each case the same way. I would imagine there is some variation in your practice patterns based on the patient's presentation (which varies).

Not much variation, really. I've been a PT for almost 40 years and have eliminated all the (completely) useless stuff from my own personal hard drive by now.
quote:

A smart fly on the wall would surely be able to detect some measurable consistencies in your techniques (independent variables) and the extent to which they affect the resulting outcomes (dependent variables).

So far we are determining their effects on persistent pain of the neurogenic type.
quote:

Then we would be able to have a fair fight discussion on why your treatment is superior to xyz in the management of medial knee pain or other disorders.

Well, my theory has persistent pain at its center, for a start. And it is based squarely on verified pain theory, as opposed to "pain-is- and -must-be- tissue-based" theory. I think right there, this gives it a head start in the 'who's theory (and choice therefore of treatment) is best' department.


< Message edited by Hpsg -- August 8, 2008 2:37:29 PM >

(in reply to TexasOrtho)
Post #: 144
RE: Does reading my posts make you stupid? - August 9, 2008 2:59:11 AM   
TexasOrtho


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Have you refined your assessment process? For example, I'm sure you don't view each case of persistent pain equally (nature of the pain, chronicity, location, exacerbating/alleviating movements/positions).  Also what are the inclusion/exclusion criteria for the participants in your study? 

_____________________________

Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
Movement Science Podcast and Blog

(in reply to Hpsg)
Post #: 145
RE: Does reading my posts make you stupid? - August 9, 2008 3:40:01 AM   
Hpsg

 

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Diane says:
quote:

Subjects will have experienced persistent pain for longer than a certain length of time (I think it's longer than 2 weeks, but most of the subjects have had persistent pain for months/years.) Experienced in any zone of the body.

There is a screening interview, which I don't do, which screens out any subject who has persistent pain associated with a disease (e.g. cancer), anyone who doesn't speak English well enough to follow instructions, anyone on medications for psychosis, anyone who won't give up any other form of physical treatment for the duration of the study. There are likely more that I can't think of right now.

(in reply to TexasOrtho)
Post #: 146
RE: Does reading my posts make you stupid? - August 9, 2008 5:00:38 AM   
SJBird55

 

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From: Michigan
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Not much variation of practice?  That doesn't even sound realistic, Diane. 

Doesn't it matter if someone is very fearful and anxious?  Doesn't it matter if the person has allodynia or not?  Doesn't it matter if the person has a history of physical abuse?  Isn't there a difference in the approach for someone 2 weeks post injury versus 3 years of pain? Doesn't it matter if the person describes the pain as sharp... versus a deep dull ache... versus an electrical shock like occurrence... versus burning?  Doesn't the person's perspective matter?  What if the person has a cultural component that family or spouse should be responsible for taking care of the person AND the person's duties within the family structure?

(in reply to Hpsg)
Post #: 147
RE: Does reading my posts make you stupid? - August 9, 2008 5:07:42 AM   
ginger

 

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In fairness to diannes study Sj,  it is about neurogenic pain , so the particular types of the pain experience don't matter , they are all well explained by irritated nerves. It is the source of those irritations that matter.

(in reply to SJBird55)
Post #: 148
RE: Does reading my posts make you stupid? - August 9, 2008 5:29:05 AM   
ginger

 

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SJ, why would any of that list matter any more than wether they were cross dressing nigerian basketballers, or buddhist > or brought up on a vegan diet compared to meat eaters, you're just being picky , picky picky picky. If diannes study has something to offer we could all benefit from her efforts. Very few studies can be said to be perfect, regardless of the outcome , let's just hope the results point out interesting things that take minds and intentions to another level. 
PS the charade with dianne posting as if not herself is hilarious.

(in reply to ginger)
Post #: 149
RE: Does reading my posts make you stupid? - August 10, 2008 7:55:59 PM   
PTupdate.com


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From: Pittsburgh, PA USA
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I have been enjoying this discussion from a distance, but am losing respect for Diane for this charade as well.  The moderator's of this site would have to be goofy to not permit her to post and use her real identity for such a valuable discussion.

I would personally like to see more specific examples of the technique(s) involved.  My wife is a massage therapist, and I have to admit that the skin/tissue pulling techniques she has used on me (interscapular groups, supraorbital tissue, etc) do work quite well ON ME.   While not sure if this is the same stuff Diane uses, I'd like to see more without all those goddddamnn quote boxes that too many people are using!!!!

I'd be curious to see if there are some specific techniques that one could use for the levator/trap/interscap pain, trigger point activity, and myospasm that occur

_____________________________

John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com

(in reply to ginger)
Post #: 150
RE: Does reading my posts make you stupid? - August 10, 2008 9:02:20 PM   
Hpsg

 

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Joined: December 26, 2007
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Hello John,
Diane has read your post and asked me to send you a copy of the first edition of the manual (the one Rod has offered to help edit).

She says:
quote:

PT update, please understand I'd like to post here myself, but I must speak through Hpsg on this board because I no longer have a personal account here.


< Message edited by Hpsg -- August 10, 2008 9:07:41 PM >

(in reply to PTupdate.com)
Post #: 151
RE: Does reading my posts make you stupid? - August 10, 2008 9:07:48 PM   
PTupdate.com


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Joined: October 9, 2001
From: Pittsburgh, PA USA
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In the time it took you to go through an intermediary you could have easily created username "Hpsg-junior" and posted yourself, along with firing an email to the powers-that-be running RehabEdge indicating why you are doing this. 

I am formally asking David and all the other guys to permit Diane to post on this particular discussion herself, and I am sure all the other's feel the same way.  This is a discussion for all of us to benefit from.

< Message edited by PTupdate.com -- August 10, 2008 9:14:28 PM >


_____________________________

John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com

(in reply to Hpsg)
Post #: 152
RE: Does reading my posts make you stupid? - August 12, 2008 1:29:23 PM   
Hpsg

 

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Joined: December 26, 2007
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The site administrator has contacted me to let me know I am admitted back on the site.
I will try to reregister as Diane soon. Note the lack of quote boxes.

Diane

(in reply to PTupdate.com)
Post #: 153
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