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The Modernisation of Manipulative Therapy

PainSci » bibliography » Zusman 2011
Tags: biomechanics, physical therapy, politics, etiology, pro, manual therapy, treatment

Three pages on PainSci cite Zusman 2011: 1. The Complete Guide to Low Back Pain2. Your Back Is Not Out of Alignment3. Pseudo-Quackery in Physical Therapy

PainSci notes on Zusman 2011:

This paper strongly criticizes the persistent use of “passive movement” in physiotherapy — doing things to patients bodies — and the disappointing reasons for it: a “now obsolete, structure-based ‘bio-medical’ model” which has “been shown flawed or at least irrelevant.” Unfortunately, the language of the paper is tortuous, and the bizarre overuse of scare quotes and parentheticals is particularly odd. But I agree entirely with its substance, and share the Max Zusman’s frustration with the state of physical therapy: “The profession needs to be seen to be taking the mature stance afforded by its modern science-based training.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Research indicates that, despite physiotherapists’ comprehensive training in the basic sciences, manipulative therapy is still dominated in the clinical setting by its original, now obsolete, structure-based “bio-medical” model. This is further inexplicable in the light of evidence that not only the underlying “philosophy” but also several of the fundamental requirements of the clinical process itself which has the structural-mechanical model as its basis, have been shown to be flawed or at least irrelevant. The apparent inability of the profession to fully abandon outmoded “concepts” (and embrace the acknowledged science-based “best practice” biopsychosocial model) may have potentially undesirable consequences for both patients and therapists engaged in the management of (chronic) musculoskeletal pain and disability.

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