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Raising the Bar in Rehab

The Dangers of Bad Research

Published December 1, 2011 12:13 PM by Lisa Mueller

There was as article posted on the Forbes website last week about another article (are you following me?) published in a chiropractic magazine. The chiropractic article theorizes that certain interventions (provided by chiropractors) could be linked to repair at the DNA level. According to Forbes (I have not yet read the entire article), the chiropractic article never measured DNA repair and did not randomize or blind any of the study subjects. And yet, many chiropractor websites are using the study as evidence of their interventions.

Now, I'm not going to regurgitate the entire Forbes article. And, take what you will from the original chiropractor study (Titled: "Surrogate Indication of DNA Repair in Serum After Long-Term Chiropractic Intervention - A Retrospective Study." I am sure we could all dig and find many poorly designed physical therapy articles. What I will propose is this - how dangerous is poor research? What are the consequences of chiropractors using this study to promote their interventions, and the general public basing their opinion on those marketing efforts?

It's very easy to get caught up with exciting information. As clinicians, we may see improvements in function and in our interventions, and with that excitement may start connecting pieces of information that result in only one plausible explanation: Because I helped this patient, I must be influencing all of his improvements. We start taking more detailed notes, start making conclusions with the evidence we have - our treatment skills. We write a few pages of our work, and boom! It's published! ...Before we even had a chance to iron out the details.

Technology is a blessing and a curse, as my dad says. It's incredibly easy to post new information online, to connect with potential patients with eye-grabbing news updates. We have a new nutritionist! Come to our free health screenings! But we have to be careful about what we post. Our research must remain at the highest of standards, because the smallest mistake could cost years to rebuild a reputation. While we may get caught up in having the latest research, the newest information, don't let the "keeping-up-with-the-Joneses" attitude prevent us from being responsible clinicians.

3 comments

Hi Kristen-

Thanks for the comment, and thanks for reading the article!  What an interesting case- spasticity caused by gluten reaction.  Wow.  

My disclaimer is this- I don't work with pediatrics nor do I consider myself a spasticity expert.  From the research I've done, my advice would be to talk with the patient's parents and primary physician to see if the family would be interested in a baclofen trial, and to hear the physicians recommendations on a physiatrist to consult.  If the patient already has a neurologist, they may also be able to lead you towards the right practitioner for a trial.  I know they do make pediatric-sized baclofen pumps if your patient responded well to the trials.  

I'm not sure if I've been very helpful, but I think if you start asking some questions to both the family (willingness to trial) and the physician (appropriateness to trial) you may be able to find a good solution to reduce the patient's spasticity.  

Thanks again.

Lisa Mueller December 8, 2011 10:30 AM

Hi Lisa,

    I actually had a question kind of off subject....I just read your article about intrathecal baclofen pumps in the Nov 28th edition of the Advance.  I was wondering if you have ever heard of this type of treatment being used on a child who has neurological damage post enchephalitis caused by an extreme sensitivity and reactivity to gluten.  This little girl has lots of spasticity in her lower extremities (scissor gait) and though she is getting stronger everyday, the tone is greatly impairing her ability to walk.  I have no idea how the parents would feel about the idea but I just wanted to know if you had any further information regarding who would be a good candidate for, as well as the effectiveness of, this form of treatment.  Thanks so much for your time....Sincerely, Kristen PT

Kristen, school PT December 7, 2011 1:56 PM
NJ

Just today I had a discussion with a nurse who stated a "fact". I questioned her about this "fact" and she replied, "It is a new piece of research!" She automatically gave it credibility because it came under the heading of research.

I requested the article so I could have a look (and a critical one at that) to see how reliable this research is.

Even among some professionals, it is easy to fall under the spell of "research".

Dean Metz December 2, 2011 12:22 PM

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