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Then she decided to treat my right supraspinatus tendon with what I understand are called Cyriax’s frictions. For example, after my general practitioner referred me for physiotherapy for a very painful right shoulder injury, the experienced physiotherapist tried a number of technological approaches using some impressive-looking kit nothing seemed to be helping. Sometimes the effects of treatments are dramatic, as they had been for my wife. By contrast, although I was delighted that her longstanding symptoms had subsided, I noted that I would begin to believe in the benefits of chiropractic when a systematic review of the relevant controlled trials suggested that it could be helpful. I illustrated the issue by noting that, after about five treatments from a chiropractor to whom she had been referred by her general practitioner, my wife believed that she had reliable evidence that chiropractic could help relieve her chronic shoulder and back pain. I can’t imagine that many patients or health professionals would suggest that this is an unreasonable wish, but they might well vary quite a lot in what they regard as ‘reliable evidence’.

I tried to make clear that I want decisions about my care to be based on reliable evidence about the effects of treatments. The Publisher's policy is to use paper manufactured from sustainable forestsįoreword A few years ago, I wrote an article about what I want from health research when I am a patient (Chalmers 1995). To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications.

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In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. First edition 2005 Second edition 2011 ISBN 9780702042706 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Notices Knowledge and best practice in this field are constantly changing.

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Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Sir Iain Chalmers Editor, James Lind Library, Oxford, UKĮdinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2011 MCSP Formerly Head of Research and Clinical Effectiveness, Chartered Society of Physiotherapy, London, UK Foreword by PT PhD Professor, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway PT MPH PhD Executive Director, Norwegian Knowledge Centre for the Health Services, Oslo, Norway Practical Evidence-Based Physiotherapy SECOND EDITIONīAppSc MAppSc PhD Professor, The George Institute for Global Health and Sydney Medical School, The University of Sydney, Sydney, Australia Commissioning Editor: Rita Demetriou-Swanwick Development Editor: Ailsa Laing Project Manager: Annie Victor Designer: Charles Gray Illustration Manager: Bruce Hogarth