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Toni Talks about PT Today

Group Think Evidence

Published May 29, 2013 4:34 PM by Toni Patt

When I was at the horse show last weekend, I learned one of the show kid mothers is a PT. I learned this because she was treating another of the mothers using cranio-sacral therapy. I'm not sure what pushed more of my buttons, her treating someone on the fly or using cranio-sacral to do so. This isn't the first time I've said I don't think PTs should freely treat anyone who asks. Yes, that is against our nature but better for the profession.

I've yet to find one article supporting the efficacy of cranio-sacral therapy. I wasn't even sure it was around until I received a mailer for a course. I'm told it falls under manual therapy because it requires the therapist to place hands on the patient and cause changes to occur. The PT at the show couldn't stop telling me how wonderful it was but had no idea how it worked.

She proceeded to prove her point by telling the patient how much better she felt. Naturally she agreed. This was followed a recital of all the ways the woman looked better; less pallor, less facial swelling, rosy glow. To me this screamed placebo effect following by group think. I don't understand how holding someone's wrist improves pallor and swelling. The PT said it, so it must be so.

According to the APTA, we're movement specialists. That is our brand. We treat movement disorders. Telling me it's an effective treatment because everyone there says the patient looks better is meaningless. Of course we wanted her to feel better. Of course we're going to tell her so. PTs are always telling people they are better.

I so wanted to burst her little bubble. I do a literature review about once a year when I receive an application to approve a cranio-sacral course for Texas. I find no supporting evidence. I also deny the application, stating it would be approved when evidence is provided. That is yet to happen.

I'm not denying the effectiveness of placebo therapy. Let's just call it what it is. There's a percentage of our population who will get better no matter what we do. There's another group who will get better because of personal attention. Others never improve no matter what we do. If this therapy is so wonderful, why isn't it more mainstream?

I bit my tongue because we all need to get along and support each other at a show. I even kept quiet when she told me I should take the course. Next time I see her, I'll offer to let her sit in when I teach my course. Then we can compare notes.

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While what write in your posts do have legitimacy, I would love to see you write a post that is less negative.  You seem like a very intellectual person with thought provoking commentary.  For this reason I do enjoy reading your blog, however I do not think I have seen a single post you have written that shed's a positive light toward your opinion of the profession.  I assume with all the experience you have that there is much good that you have seen and contributed.

Shelby May 29, 2013 6:20 PM

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