While I totally enjoy each season in my beautiful state of Maine, the transition from winter to spring brings a special feeling of anticipation to my spirit. In late February, I begin to look forward to the arrival of the bluebirds that choose to live and raise their young in the birdhouses that I have strategically placed in my backyard. Next, I watch for the arrival of the hummingbirds. Their arrival signals the start of my preparing nectar 2 or 3 times a week to ensure a healthy diet for them, as well as entertainment for me. Then, in early May, I anxiously await the arrival of the bobolinks that come to my backyard (a hayfield) each year. They are known to migrate to Maine from as far away as South America. When they signal their arrival with the happiest songs I have ever heard, I declare to everyone I work with, “The bobolinks are back, the bobolinks are back!” They seem as happy about that as I am (or perhaps they are just polite pretenders). For the bluebirds and bobolinks, I travel to South Portland (1 hour away) to purchase live mealworms for them. Each morning before work, I put on my green wellies and trudge out to place a fresh supply in several feeders. Within a couple minutes, I can watch as the bluebirds visit the feeders to pick up the provided food and bring it to their offspring. The cardinals, gold finches, red-winged blackbirds, mourning doves, and woodpeckers are also well fed, as my dwindling budget demonstrates. I usually will bring my breakfast out on my deck so that I can enjoy the “live orchestra,” and most evenings I forgo television so that I can listen to the songs and chatters that surround me (much better for my health than the political scat of the day). When I have the time, I bring my camera with me and now I must have 1000 photographs of the birds (some with just feet or tips of wings in them).
It recently occurred to me that I hope that physical therapists (PTs) similarly look forward with anticipation toward the arrival of the new information that they receive via published manuscripts or evidence-based continuing education courses. Although I do not expect PTs to run to the mailbox (or to their computers) each day with exuberant anticipation of receiving new journals, I do hope that individuals are committed to reading the new information from peer-reviewed research that can supplement or replace the interventions they choose for the plans of care for their patients/clients. More importantly, I believe that when well-designed research results in showing that an intervention is not better than placebo, then that intervention is eliminated from the list of possibilities, just as the bluebird parents daily clean the fecal sacs from the nest (and yes, I have a picture of that for proof—they look like little diapers).
I always look forward to receiving my copies of Cooks Illustrated and Fine Cooking, as well as National Geographic, Smithsonian, Birds and Blooms, and Skeptical Inquirer (not the other Enquirer, please). I do scold myself occasionally as I thoroughly review the cooking magazines but seem to cook the same recipes week to week. I tell myself that to continue spending the money on the cooking magazines, I must actually make some of the recipes that I review. If I am not going to use the information, then what is the purpose of spending the money? If I always cook the same things, my taste buds may not become as discriminating as might be possible. I might miss the opportunity to provide to the few that dare to partake of my epicurean adventures the chance to be surprised at my success and their conclusion that they can forgo the anti-indigestion medications that fill their pockets. The writers of the recipes that are published spend hundreds of hours trying to perfect the recipes so that I can proudly say, “I made it myself.” And yes, I do look forward to the physical therapy publications because I want to use the best recipes (ie, plans of care) for my patients. The confidence derived from tested recipes or interventions calm my doubts about which ingredients will produce a successful result. Again, I continue with the analogy for physical therapy. Researchers spend hundreds of hours developing good questions and perfecting their methods to provide us with the most effective and efficient interventions so that each of us might be able to say, “I helped them (the patients) by myself.”
Many times I hear clinicians say “I don't have time to read,” or “I already know the best treatments,” or “I am an autonomous practitioner and so I don't need to know what others are doing,” or “I don't understand the statistics and so I can't tell if the research was good or not.” To each of those statements, I reply: (1) Each and every PT must make the time to read, as that is part of being a professional. (2) How does one know that she or he is providing the best treatments? How can one be 100% confident that the methods employed in the clinic are better than placebo? (3) Would you go to a medical practitioner who says that she or he is autonomous and does not believe in consulting with specialists? I offer that those who believe they have all the knowledge they need for their lifelong career need to have a conversation with their parents about the birds and the PTs. With respect to the statistics, it is the job of the editorial staff and the reviewers to determine whether the research is worthy to be published. Most journals, including this one, have a statistician on the editorial board whose job is to evaluate the strength and appropriateness of the statistical procedures used by the researchers.
I anticipate that you will receive very useful information from the manuscripts published in this issue ofJWHPT. Drs Boissonnault, Klestinski, and Pearcy have completed a systematic review on the topic of exercise in the management of pelvic girdle pain and low back pain that might occur during pregnancy. Drs Maher and Hayes examined the question of whether transvaginal electrical stimulation can elicit a pelvic floor muscle contraction. Dr Dusi and her colleagues completed research to determine the efficacy of physical therapy interventions that are commonly used to decrease coexisting pelvic symptoms at the same time as decreasing urinary incontinence. Dr Koplas and Drs Harper and Shilling investigated the effectiveness of a resistance exercise program on several psychosocial variables. I anticipate that the information provided by these authors will assist readers in becoming physical therapy gourmets. Don't be polite pretenders.
Nancy C. Donovan, PT, PhD