Evidence based massage therapy group

Comment

Comment by Carl W. Brown on July 18, 2009 at 10:28am

Bodhi the Sicily statement was excellent. It provided a different perspective that it is primarily an attitude of positive skepticism that leads to a pursuit of knowledge and skills. It also teaches us to accept and work with uncertainty. I think that is where it deferrers from science based therapy in that you can actually provide a more beneficial results with less potential downside. I see that all the time in my hospice work where the focus is on the patient and what is best for them rather than the exact pursuit of the best medicine. It is not about ego. It is about questioning your sources as well as your past experience. It is knowing that you have limitations and that sometimes your strengths are also your weaknesses.
Thanks for being patient with me. Entering the bodywork field really upset my faith that everything could be explained by science. That does not mean that I accept things on blind faith, but instead I question everything. I think that many other MTs have had similar experience but have instead embraced fanciful explanations and superstitions. I think EBP training could do wonders for the entire professions because these ideas are so far out that they reflect on the credibility of the profession.

Comment by Carl W. Brown on July 17, 2009 at 4:51pm

Paul we all rub shoulders with people who believe and practice real quackery. It makes me shiver but the other extreme is just as bad. Maybe EBM is not what I am looking for if it precludes non-research based work but SBM is denies people real alternatives. For example if a person comes to me with carpal tunnel I can often fix the problem by getting the carpal bones to articulate allowing the retinaculum to reform the tunnel taking pressure off the median nerve. The alternatives are steroid injections or surgery. The steroids are at best temporary and the surgery is not always successful so what not try a less invasive procedure which works most times but if it doesn’t there are no negative drawbacks?
I also find that that most of us experience things that fall outside of what can be explained scientifically. We need to use good science it insure that we do no harm but beyond that we need guidelines to handle things that repeatedly show positive result even though we don’t fully understand them.
BTW Thanks Jennifer for the wiki link.

Comment by Carl W. Brown on July 17, 2009 at 1:46pm

“This group was set up to advance and encourage EBP, not debate its merits or the merits of science.” Before you advance and encourage you need to establish a clear concept of what EBP is. I have searched the web and cannot find any such clear explanation. If example I think people understand what medical massage is. But how does EBP differ? What do you mean by “Research Evidence” this will imply scientific studies. Is EBT limited to what can be scientifically proven? Are other forms of evidence acceptable and if so what are they?

Comment by Whitney Lowe on July 16, 2009 at 3:27pm

I may be missing something, but can we post things in the articles section or is that only something that you (the group founder) can do? I don't immediately see how to post things in this section.

Comment by Whitney Lowe on July 16, 2009 at 10:59am

Thanks for reminding us of this group's purpose so we can get back on track!

Comment by Carl W. Brown on July 16, 2009 at 10:21am

Whitney, I think that if we limit evidence to scientifically obtained research evidence we are limiting our observations to that which can be measured using tools that are analytical in nature. By doing so we are limiting the scope of what we do and the ways we can help others. On the other hand to work totally without structure is not right.
Expanding EBT from the atomistic to holistic is a serious challenge. I think is can be done I am not sure how. Are there forms of research that go beyond the limits of science? This was the problem I had with psychology. What was taught was limited to science but it left one unable to be fully effective unless you acquired your skills outside of school.

Comment by Whitney Lowe on July 16, 2009 at 12:49am

Carl:
It sounds as if you are misunderstanding what evidence-based practice is actually about. The diagram that Bodhi has used for this group’s icon on the site is a great example of what EBP encompasses. When you speak of evidence, it sounds as if you are just relying on the observations of what you have found from your own clinical work and from the results you have produced. This perspective is represented by the circle down below and labeled “own expertise and experience”. That is certainly a component of EBP, but this is not research evidence unless you have specific research studies that back up the claims you are making. What seems to be missing from what you describe is research evidence (represented by the upper right hand circle).

Comment by Carl W. Brown on July 15, 2009 at 11:41pm

Dodhi "We need to get therapists at least to start questioning theories and approaches." I agree 100%. I also think we need to teach people to use both halves of their brain. I tell people that one can easily recognize a face but if one analyzes it they are less able to recognize the face because they remember the analysis. Evidence based work that relies on right brain activity is just as valid. It is just that it is more difficult to tie to outcomes.
My last client today had a migraine. I find that I have use bodywork to help people with migraines. Understanding the nature of migraines only helps a bit. For example I can tell with better than 90% accuracy which side the headache is on. I don’t know how it works but I have the evidence to support my feeling and use science to insure that if I am wrong that I do no damage.
Intuition by itself is nothing but when you can start combining it with a monitoring of objective evidence it can be powerful but you must always keep a skeptical eye on the whole process.
I decided at one time to major in psychology. However in school something was missing. If I wanted to work in a rat lab or be a pure behaviorist then the schooling was fine but there was something major missing. I did not know exactly what it was unit I read “Blink” which explains right-brained evidence based thinking. I think this book is a must for all bodyworkers.

Comment by Jan Schwartz on July 15, 2009 at 5:05pm

I understand that Jennifer. I was responding to another comment.

To move on, the biggest obstacle is education, in my opinion. If we don't at least teach research literacy in the schools so that students can begin to read and discern valid and reliable research, then we will not get massage therapists actually doing the research and collecting the data in our own field. There was a great study done several years ago on the effects of massage therapy on arthritis of the knee. It was published in the Journal of Internal Medicine. Fortunately the study was run by Adam Perlman, MD who insisted on using professional massage therapists, but he had a hard time finding therapists who wanted to be involved. Why? I think it's partly because research is not included in our education. The least we can do is introduce the word, use it in our classrooms, and tell students how we know massage is efficacious. That means teachers have to be trained. yadda, yadda, yadda.

Comment by Jan Schwartz on July 15, 2009 at 3:56pm

Robin, I agree with Bodhi. I think a literacy/attitude survey comes first.

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