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Desperately seeking evidence

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Back exercisesA very interesting thing has been happening with the CPN blog in recent weeks.

After publishing two relatively controversial blogposts – one on Six useless treatments and the other titled There are no new treatments in physiotherapy, we saw a big spike in members and enquiries through our email service.

The post There are no new treatments in physiotherapy has been accessed more than 15,000 times on Facebook, and Six useless treatments nearly 13,000 times.

These might not be particularly big numbers for Justin Bieber, but they are for most groups in physiotherapy.

What is it about these posts that made them so popular?

Based on some of the emails we received after they went online, some of it comes from people’s desperate desire to have the latest evidence to support their treatments.

For others its the fact that they talked about subjects that people recognised as physiotherapy ‘specific’; things about assessment and treatment; practical things; things that people can use in their clinical practice tomorrow morning.

This is interesting for a group like the Critical Physiotherapy Network, because our core philosophy states that we were ‘formed from a desire to challenge & reform physiotherapy practice & thinking.’

You can find the Objectives of the CPN on our website here, but they are worth repeating here because they are our founding principles, and if you are in any doubt as to whether the CPN is for you, you could do worse that look at these:

‘A lesson learned from the philosophy of science is that evidence is not self-apparent or ‘‘given’’ when gathered from even the most idealised and controlled observational setting. The critiques launched against positivist philosophy by feminist and phenomenological epistemologies of science contest the seemingly unproblematic nature of ‘‘evidence’’ that underlies EBM by emphasising different features of the social nature of science. The appeal to the authority of evidence that characterises evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry’ (Goldenberg, 2006: 2630-1).
The Critical Physiotherapy Network will strive to challenge contemporary physiotherapy theory and practice by:

  1. Actively exploring the world beyond the current boundaries of physiotherapy practice & thought
  2. Challenging physiotherapy to critically examine its position on alterity & otherness, abnormality, deviance, difference & disability
  3. Recognising & problematising power asymmetries inherent in physiotherapy practice, particularly where they marginalize some groups at the expense of others
  4. Developing a culture & appreciation for the exploration of all views that deviate from conventional thought & practice in physiotherapy
  5. Actively embracing ideas that promote thinking against the grain/challenging in physiotherapy
  6. Being open to a plurality of ideas, practices, objects, systems & structures that challenge contemporary physiotherapy practice & thought
  7. Promoting critically-informed thinking, encouraging ideas from diverse disciplines uncommon in mainstream physiotherapy, including anthropology, the arts, cultural studies, critical theory, education, geography, historiography, humanities, linguistics, philosophy, politics, sociology & others
  8. Providing a space for ideas that promote a more positive, diverse & inclusive future for the profession.

I’ve highlighted a specific phrase in Objective 4 because it’s particularly important in the context of those two blogposts.  Members of the CPN actively explore ‘all views that deviate from conventional thought & practice in physiotherapy.’

So you are more likely to find us arguing against the whole idea of evidence-based practice than providing any more support for it.

The blogposts don’t advocate for more EBP, but challenge the very idea that EBP is necessarily good for the profession.  This seems to many of us to be a far more significant issue than the latest trial on laser therapy or manual therapy.

If you too find yourself thinking these things and looking for a safe place to explore ‘the world beyond the current boundaries of physiotherapy practice & thought’ (Objective 1), then welcome to the Network.  You’re amongst friends.

Reference

Goldenberg, M. J. (2006). On evidence and evidence-based medicine: Lessons from the philosophy of science. Social Science & Medicine (1982), 62(11), 2621-2632. doi:10.1016/j.socscimed.2005.11.031.

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