This article came to light when I was scrolling through Facebook. A physio colleague in the UK had posted it. I was immediately drawn to the title because it pretty much sums up what many of us have been saying for years… and I wish that more people understood the sentiment!
The article is actually an editorial piece. However, if you know anything about these two editors, you will understand that when they have something to say, it will be brilliant indeed!
I’ll attempt to paraphrase the main points of the article.
1. Physiotherapy is a profession, not a treatment technique. As such, if you are looking at a research paper where the researchers are testing ‘physiotherapy’ in the management of a certain condition, then you know right then and there that the paper is flawed!
2. Some papers will describe an intervention as “traditional physiotherapy” or “conventional physiotherapy”. These are meaningless qualifiers. Who defines what is traditional or conventional? We know that physiotherapy practice has changed over the years. It changes from country to country. It changes based on specialization, patient demographics, and area of practice.
3. For a research paper to have meaning, an intervention needs to be succinctly described. Even terms such as manual therapy or exercise are deserved of qualifications, as these are extremely broad descriptors of therapeutic interventions. Massage and manipulation are both manual therapies, and stabilization training is an exercise that is vastly different than running in water as examples.
4. The authors of the paper suggest using the Template for Intervention Description and Replication in reporting interventions tested in a clinical trial. (I found a link to the checklist: https://www.equator-network.org/wp-content/uploads/2014/03/TIDieR-Checklist-PDF.pdf
5. And the last line sums it up: “Clinical trials are arduous. Their reporting deserves clarity. Terms such as traditional and conventional should be abandoned and the word physiotherapy only be used when discussing a profession, not a treatment.”
So, I will take it further and say that this absolutely must also extend to the veterinary community and literature being generated for animal rehabilitation. Firstly, I think that rehabilitation is actually a good term, as nobody should have any preconceived notions about what it is. That being said, if on further evaluation of the paper, there is not a full descriptor of what ‘rehabilitation’ was actually consisting of in the study, then suffice to say… “Garbage-Study”.
It’s been a while now, but I have had to do battle in the past with veterinarians who tried to tell me that animal physiotherapy is not validated, or “show me the proof”. My response is that if they knew the various components of what makes up physiotherapy, then they would be able to find the proof. For example, look up laser therapy, or shockwave, or electrical stimulation and animal. You will find the research. Look up ‘manual therapy, spine, canine’ and you’ll find some research (not much… but some). Look up ‘therapeutic exercise, canine, osteoarthritis’ and again, you’ll find research. But is it a slap in the face to the profession of physiotherapy and the specialty of animal rehabilitation to not qualify and quantify the treatment interventions used!
There’s my soapbox for the week! On that note, read the research papers with a critical eye, and don’t commit the same fouls if you are to produce research yourself!
Until next time,