Evidence Based Practice

‘The conscientious, explicit and judicious use of current best evidence about the care of individual patients’
Sackett et al (1997)

Massage techniques have been developed and passed on as part of an oral tradition for millennia. But it is only in the last few decades that research, using sophisticated methods of scientific analysis, has been used to test this collective wisdom.

Evidence-based practice requires healthcare providers to use research inquiry and evidence in their clinical work and many are nervous or suspicious of what they see as the cold, methodical dissection of the custom and practice of their profession. Massage therapy is both an art and a science and the fear is that this eclectic mixture of instinct, common sense, experience and technical skills would be replaced with a limited and uncompromising set of ‘cookbook’ treatments that have been validated by the scientific method. Should we only use techniques that have been thoroughly tested and researched?

This was addressed by Smith and Pell(2003) in an amusing but apposite paper on ‘Parachute use to prevent death and major trauma related to gravitational challenge’. Their argument is that there is very little research evidence on the effectiveness of parachutes. The evidence is almost exclusively anecdotal and single case reports. Bearing this in mind, should the use of parachutes be banned until high quality trials have been completed utilising control groups and placebos? Fortunately we don’t need research, involving randomised trials, to know that parachutes are a very good idea and I for one wouldn’t want to be in the placebo group!

It is important to distinguish between ‘Research’ and ‘Evidence’, they are not necessarily the same thing. Evidence can come from more than research findings. Clinical experience, patient feedback and the local context in which therapist works are all recognised as important factors and sources of evidence.
Evidence-based practice is about using the best evidence available to you, to promote the effective care of patients to the best of your ability.

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