Considerations for Effectiveness

Different considerations or mechanisms have been suggested and documented for the improvement of a disorder which may occur as a result of the effectiveness of physical treatment.

There are two common considerations.  Each has its own advocators seeking support for a mechanism for effectiveness of physical treatment.  These considerations or mechanisms can be summarised as:

1.  Treatment is administered to alleviate or control pain and as a result movement is increased or restored.

2.  Treatment is administered to control, normalise or increase movement or to control, normalise or increase function and as a result, pain will be alleviated.

The principles of treatment for the first consideration are mostly based upon the theory of peripheral modulation of pain by the stimulation of articular nocioceptors with the use of appropriately applied passive movement techniques.  The principles for the second consideration are based on biomechanics.

There may be strong clinical bias towards the adoption of one mechanism while other opinions may advocate a mix of the two mechanisms at different stages of the treatment.  The administration of the treatment in both cases may be passive therapist intervention or active patient participation, or a combination of both.

The tendency for the apparent bias in one mechanism over the other appears to lie in its differing conceptual approach and emphasis.  However both mechanisms appear to be based on signs and symptoms of a disorder and do not appear to take into account a diagnosis, other than when it precludes the use of physical treatment.

Therefore it is with this in mind that the most important consideration now acknowledged is the choice of physical treatment according to disorder selection/diagnosis.

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