pediatric orthotic efficacy research

pediatric orthotic efficacy research

Beverly Cusick

1/2/1998

Hello, Colleagues -

You might be interested in either reading or participating in an on-line
discussion on orthotic efficacy research for children with CP. Shortly
after reading the research report by Sandra A. Radtka and others in the
April, 1997 issue of Physical Therapy (Volume 77(4):395-408 ), I wrote a
detailed critique which has been revised and reduced by half, and still
will apparently not be published by the Physical Therapy journal in any
form. I've decided not to cut it down further.

The latest version of the critique (10 web pages including 15 references)
is posted on my web site (double click on the URL posted below). I've
invited the authors to reply to this critique, and will add their replies
to my paper. If you wish to check back later on this winter, you might find
their comments at the same web site.

Please double click on this URL:

    <URL Redacted>


If you want more explanation as to it's existence, and as to my diligence
in putting it out to my colleagues in pediatric rehabilitation, read on...

I wrote the response paper to alert the researchers involved in this
project, and future researchers addressing similar topics, to:

* some new developments in orthotic management and gait analysis for this
population (particularly kinetics), which might influence the selection of
variables and data collection methods

* the complexity of variables inherent in such projects, given the
selected diagnosis of cerebral palsy, as well as the plethora of new
orthotic designs and equinus deformity management strategies now available

* some problems I had with the original Physical Therapy article -
particularly the premise, literature review, presentation of information,
and the authors' decision not to use their own statistical evidence, but
rather, the individual data, for individual clinical decision-making

* some limitations on the scope of information the authors brought to
their conclusions.

I also wrote it to try to inspire the editorial review team at Physical
Therapy to apply more rigorous academic standards to their review of such
projects in the future. By way of example, this paper not only features
inaccurate data (a discovery made by Judy Carmick, PT and her husband, Al
Shepherd, as the numbers did not compute logically in their highly
analytical minds - the data will be corrected in the March issue of
Physical Therapy, I am told.) Furthermore, it contains an illustration of
only 1 of the 2 orthoses studied, cites different body landmarks of
reference to compare the shaft lengths of the two devices, and lacks any
detail regarding the clinical evaluation that prompted the authors to
prescribe one orthosis over the other in a clinical setting.

I think we can expect better than this.

If, having read the research paper, you, too, have concerns, I hope you
will voice them in a letter to the editor of Physical Therapy, Jules
Rothstein, PhD, PT, at < <Email Address Redacted> >, and that he will consent
to print it.

My thanks for your attention to this message, and my apologies in advance
for any inconvenience it's arrival might have caused those of you who do
not work clinically with children with CP.



Beverly Cusick, MS, PT
970/728-0270 FAX: 970/728-3304
PO Box 600
Placerville, CO 81430

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>>> Beverly Cusick, MS, PT <Email Address Redacted>
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Beverly Cusick, MS, PT <Email Address Redacted>
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