Joan, thanks for the excellent recommendation. I agree with you 100% about brain neuroplasticity potential, which is why I encourage all of us to search the literature and not become dependent on isolated techniques or old learning--I have been theorizing since I started in rehab 15 years ago that short stays have forced OT into a compensatory approach at the expense of neuro recovery--and as always, I can't emphasize enough that when it comes to the brain, "occupation is 'organizing'".
Terrianne Joan Riches <[EMAIL PROTECTED]> wrote: On the whole question of 'good enough evidence' I recommend to all of you The Brain that Changes Itself by Norman Doidge M.D. It makes far more sense to me based on my experience and observations than the neuroscientific orthodoxy we were all brought up on, especially the belief that once a post stroke patient 'plateaus' the rehab window is closed. Comments, anecdotes anyone. Despite my commitment to a 'compensation' model I think neuroplastcity will be the future of rehab and we ignore these developments at our peril. Joan -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Terrianne Jones Sent: Monday, August 13, 2007 7:30 PM To: [email protected] Subject: Re: [OTlist] Neurofacilitation Hello, evidence based practice is more than finding randomized control trials in the literature to support an intervention--yes, critically appraising the currently available literature is a large part of EBP, but so is critical thinking and clinical experience. Together these should guide our practice. In the case of NDT, it is true that much has not been "proven", but perhaps a lit search for weight bearing and some of the techniques NDT may yield some studies. I am not NDT certified myself -- never will be-- and am about as far into the occupation camp as an OT can get (as those who have seen my previous posts will attest), yet even I believe that a working knowledge of motor learning and neuro theories serves an OT well. I encourage you to find the literature that you can and appraise it critically and present it to your supervisor. Mc Master University (see below) has a great website to walk you through this--good luck. Terrianne www.srs-mcmaster.ca/nbspnbspResearchResourcesnbspnbsp/EvidenceBasedPractice/ EvidenceBasedPracticeResearchGroup/tabid/630/Default.aspx "Johnson, Arley" wrote: Since I didn't get a response, then I shall assume that no one else has any other strategies. That's good because I was close to engaging in a drawn out debate with a PT with an APTA neuro specialty cert that felt an OT did not need a practical understanding of NDT principles to deliver comprehensive care in the acute rehab environment. I believe that her point of view was NDT did not have much, if any, supportive literature proving its' effectiveness. Therefore, NDT had failed the evidence based practice test and I should not require an OT working on a Stroke unit to complete a competency on NDT principles and application. Evidence based practice makes sense, but to exclude a treatment option because limited research exists, does not mean that it does not work. As always, the research itself needs to be reviewed to determine if it measured relevant areas. I'll get off my soapbox now ... Please, I welcome any comments, because my debate isn't officially over. Arley Johnson MS, OTR/L The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. 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