Here's my response to a reader who is interested in "Measuring the Effects of various Manual Therapy Interventions".
People typically get Manual Therapy to
* Increase mobility/flexibility and/or to
* Reduce Pain.
The reader pointed out - The Effects of various Manual Therapy Interventions typically cannot be tested/measured using cadavers or computer modeling, and often there is no valid “sham” therapy to measure against.
Let's look into this....
First let's start with a few references....
* Standardized Outcome Measures in Manual Therapy
* Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial - Commentary: Bootstrapping simplifies appreciation of statistical inferences
* Assessment tools for OT
* Guide to Outcomes Measurement for Patients With Low Back
* The effectiveness of manual therapy, physiotherapy and treatment by the general practitioner for chronic non-specific back and neck complaints
* Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial
* Patient-Reported Outcome (PRO) questionnaires for people with pain in any spine region. A systematic review
* Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care
* Physical Therapy Evaluation and Management of the Shoulder Complex
* Effectiveness of Manual Physical Therapy for Painful Shoulder Conditions: A Systematic Review
* Efficacy of Manual Therapy
* The Science and Practice of Manual Therapy - body language
* Immediate Changes Following Manual Therapy in Resting State Functional Connectivity As Measured By Magnetic Resonance Imaging (fMRI) In Subjects With Induced Low Back Pain
* Placebo response to manual therapy: something out of nothing?
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Based on the above...."Measuring the Effects of various Manual Therapy Interventions" might be accomplished by....
* Ask the patient whether the manual therapy is effective or not. Listen to their story/narrative. Observe body language. Perhaps, use questionnaires.
* You can use more sophisticated efficacy measurement tools like fMRI, but these are usually out of the reach of most practitioners. Stress/Pain Measurement Tools like those used in Biofeedback can be used to test relaxation level (skin conductance and/or heart rate variability). Since stress/tension increases muscle tightness and increases pain, probably anything to reduce stress/anxiety will help therapy effectiveness
* The Therapist could increase the perceived effectiveness of the therapy by words/actions. This is due to enhancing the inherent Placebo Effect, which is a part of any health intervention.
* Lastly, if the perceived or measured effectiveness is slow going or non-existant, please consider psychological/emotional reasons for the chronic patient - "Are You “Sick and Tired” of Being “Sick and Tired”?" - Especially see questions therein.
* I'm sure there are more ways to measure efficacy of Manual Therapy. Perhaps the Measurement/Testing Modalities of related Health/Medical Interventions might be useful to measure the efficacy of Manual Therapy, too. Please add your comments to add to this discussion.
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Article is for information only and is not medical advice. See full disclaimers at TG Ideas LLC.
