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Invited commentary: Evidence-based practise and physical therapy

Physical therapy is a well-accepted intervention by patients due to its multimodal and directly administered interventions. Unlike the rather anonymous pattern of drug prescription, where the medicines are dispensed by yet another party, subjects feel that their complaints are taken seriously by therapists: symptoms are seriously analysed, patient preferences are accounted for and treatments continuously refined during the course of a therapy. This tailored approach provides patient-centred attention and may result in a placebo-like effect of interventions in many cases.

Treatments are selected on the basis of availability and integrate expert opinion with research evidence. However, the evidence for effectiveness of many interventions in physical therapy is limited and often over-estimated, despite the frequent application of specific treatments. For example, Cochrane Reviews list >300 entries for “physical therapy”. Among these systematic reviews, <40 publications analyse interventions to treat low back pain such as back schools, massage, various exercises and other typical methods.

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