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Rapid Responses to:
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Electronic letters published:
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif){kind=icon}
Physical Therapy In Australia Differs Widely From the US
Physiotherapist-Directed Exercise
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Daniel G. Arkfeld, MD USC Keck School of Medicine
Send rapid response to journal:
arkfeld{at}usc.edu Daniel G. Arkfeld
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It is with great interest that I read the article entitled "Physiotherapist-Directed Exercise, Advice, or Both for Subacute Low Back Pain: A Randomized Trial" by Pengal et al. I commend the attempt to show the benefit of physical therapy in treating the enigmatic area of back pain. However, I am concerned about the cotherapies used by patients in this study.They state that at baseline, nearly two thirds (64%) of the participants had received some form of treatment for their current episode of low back pain. Additionally between 5% to 13% of patients received co- interventions including massage and spinal manipulation during the treatment phase. These 2 facts cloud the issue of benefit with physiotherapy alone especially since physical therapists in Australia are able to perform spinal manipulation and therapeutic massage is a covered benefit. An advantage of physical therapists in Australia and New Zealand has been their ability to incorporate multiple modalities in managing back pain. This area does not appear to have been fully studied to it's full benefit. Perhaps further studies could explore the role of multidisciplinary therapy in helping suffers of low back pain. Conflict of Interest:None declared |
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Brian R. Duncan, MS Harris County Hospital District, H. M. Pengel, Kathryn M. Reshauge, Christopher G. Maher
Send rapid response to journal:
brian_duncan{at}hchd.tmc.edu Brian R. Duncan, et al.
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After a quick read of your article I am confused about the choice of physiotherapist-directed exercise. The treatment regimen does not seem to represent current best evidence. The lack of sub-grouping/classification of the low back pain patients seems to be a strong limitation in the study as is the assumption that the patients simply need exercise. However, I do appreciate your efforts and am happy to see that no longer do we simply tell patients to go home and heal thyself. Thanks Brian Conflict of Interest:None declared |
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