- Email: [email protected]
Mrs Cotton and the Bobaths
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Bobath Topics MADAM -The Manchester Branch would like to explain the cancellation of a recent Branch course (October journal). This was due to the Bobath Centre being unhappy with the wording used. As is normal in these cases the advertisement was placed in the Journal making the course ‘national’ as opposed to ‘regional’ and the Centre felt this to be poaching on its ground. We were not aware that certain terminology such as ‘postural sets’ and ‘key-point control’ were protected material to be used solely by the Bobath Centre. This course was organised by the Branch in order to recoup funding to attend Centre courses given to Manchester physiotherapists from our education fund - it was designed to promote interest and introduce treatment ideas. The whole affair has resulted in a considerable loss of money for the Branch, putting in jeopardy our education fund, and we feel that it should be brought to the notice of the membership and other Branches. On behalf of the Manchester Branch committee: Julia Herbert MCSP Chairman Jo Hunter MCSP Hon Secretary Editorial note: The Bobath Centre was invited to comment on this letter and the response is published below. Howevel; we should emphasise that it is not accepted that any one group within the profession can claim exclusive use of certain terms.
Mrs Jennifer Bryce, principal of the Bobath Centre, writes: In their letter Julia Herbert and Jo Hunter of the Manchester Branch of the CSP attempt to explain the cancellation of their recent Branch course in terms which are unacceptable to the Bobath Centre. The Centre appreciates the tremendous efforts made by CSP Branches to support the education of their members. It also recognises that course participants should give of their new knowledge through inservice training and informal talks to their Branch colleagues. Is it fair, however, to expect members to give nationally advertised courses on the strength of attending a course? The Centre validates and controls Bobath tutors to safeguard the reputation of its courses. The Centre felt that to advertise a course, with terminology well known to be used exclusively in the teaching of the Bobath approach, without a Bobath tutor, could be seen as misrepresenting that course. Manchester Branch was made aware of the Centre’s objections to the wording of its advertisement. The Centre did not request the cancellation of the advertised course but suggested that a qualified Bobath tutor be invited to lecture. This would have ensured maintenance of the standards associated with Bobath
introductory courses, and at the same time have provided revenue for the Branch education fund.
we consider that there is value in studying for an examination since the process of physiotherapists having to investigate their equipment, quiz their supplier, and think about why they give the treatment Mrs Cotton and the Bobaths they do, can be more valuable than solely MADAM - In the December issue of attending a couise. Physiotherapy there was a news note We are concerned that practitioners about Mrs Ester Cotton FCSP receiving an are not sufficiently knowledgeable in this honorary doctorate from Queen Margaret subject and have in the past been misled College, Edinburgh. by theories contrived by some salesmen I was very glad to read about the for the purposes of selling laser equipment. recognition of her work and the life she We wish practitioners lo make informed has devoted to improving the management decisions regarding treatment of patients and treatment of cerebral palsy. and choice of equipment, and we want However, I was amazed that it did not them to use their lasers more effectively mention her time at the Western Cerebral and for a wider range of conditions. This Palsy Centre, where she worked with Dr would be good for our industry and it and Mrs Bobath for more than seven years. complements our range of services and our In their early years, the Bobaths and commitment to being the best possible Dr Pet0 met many times, sharing ideas suppliers of laser therapy equipment, and experiences. We see now that the words ‘examination’ In the future when someone’s life is and ‘certificate’ do imply some kind of mentioned 1 would like to know more about formally approved professional assessthe people and approaches that influenced ment. We apologise and have withdrawn their careers. Readers should know! our advertisement and will reconsider how to present it. Paul Beelen Belgian Bobath Society Mrs Cotton is now 79 and has been active in many spheres. It is impossible to mention every aspect of a long and full life in a brief news note about a specific event.-Ed.
Unrecognised Examination MADAM -The January Journal carried an advertisement for the courses run by the Laser Exchange and also advertised a laser therapy safety and competence postal examination. I would like to point out that this examination has not been recognised by any of the bodies dealing with laser therapy - such as the British Medical Laser Association and The International Laser Therapy Association. It does not have validation by the CSP The standard of this paper is set by James and Karen Carroll of the Laser Exchange, who have been involved in the promotion, education and selling of lasers. I would not like anyone to be misled into thinking that this examination has any recognised professional merit. It may be that there is a need for a competence assessment in this modality but this should come from within the profession in discussion with the appropriate bodies.
Physiotherapy, February 1992, vol78, n o 2
Sue England
GradDipPhys MCSP Stratford upon Avon Mr James Carroll of The laser Exchange replies:
Mrs England rightly states that our laser therapy safety and competence examination is not an approved examination and has no professional merit. We support her recommendation that such a course should come from within the profession. We placed the advertisement because
Unnecessary Evil? MADAM - In response to the correspondence on post-operative percussion and vibration (Physiotherapy,December 1991). I would question the use of such techniques in the study by Jones and Hutchinson (1991) for two reasons: Percussion and vibration are both uncomfortable and rarely necessary after surgery, so was it ethical to use them routinely in this study in order to ’allow comparison of the efficacy of the analgesic modalities’? Lengthy treatments of 15 to 20 minutes were based on the unreferenced statement that this is ‘normally required’. Further justification was found by citing the notorious 67-minute treatment sessions of MacKenzie and Shin (1985), whose study not only subjected their hapless patients to the ordeal of over an hour of ‘postural drainage, percussion, chest wall vibration and suctioning’, but resulted in no significant improvement in arterial oxygenation, and an admission that the long-term clinical effect was ‘unknown’. All physiotherapy treatments should be subject to critical scrutiny, but none more so than those which can cause discomfort.
Alexandra Hough BA MCSP DipTP London N19 References
Jones, A Y M and Hutchinson, R C (1991). ‘A comparison of the analgesic effects of transcutaneous electrical nerve stimulation and Entonox’, Physiotherapy, 77, 8, 526 - 530. MacKenzie, C F and Shin, B (1985). ‘Cardiorespiratory function before and after chest physiotherapy in mechanically ventilated patients’, Critical Care Medicine, 13, 483-486.
Bobath Topics MADAM -The Manchester Branch would like to explain the cancellation of a recent Branch course (October journal). This was due to the Bobath Centre being unhappy with the wording used. As is normal in these cases the advertisement was placed in the Journal making the course ‘national’ as opposed to ‘regional’ and the Centre felt this to be poaching on its ground. We were not aware that certain terminology such as ‘postural sets’ and ‘key-point control’ were protected material to be used solely by the Bobath Centre. This course was organised by the Branch in order to recoup funding to attend Centre courses given to Manchester physiotherapists from our education fund - it was designed to promote interest and introduce treatment ideas. The whole affair has resulted in a considerable loss of money for the Branch, putting in jeopardy our education fund, and we feel that it should be brought to the notice of the membership and other Branches. On behalf of the Manchester Branch committee: Julia Herbert MCSP Chairman Jo Hunter MCSP Hon Secretary Editorial note: The Bobath Centre was invited to comment on this letter and the response is published below. Howevel; we should emphasise that it is not accepted that any one group within the profession can claim exclusive use of certain terms.
Mrs Jennifer Bryce, principal of the Bobath Centre, writes: In their letter Julia Herbert and Jo Hunter of the Manchester Branch of the CSP attempt to explain the cancellation of their recent Branch course in terms which are unacceptable to the Bobath Centre. The Centre appreciates the tremendous efforts made by CSP Branches to support the education of their members. It also recognises that course participants should give of their new knowledge through inservice training and informal talks to their Branch colleagues. Is it fair, however, to expect members to give nationally advertised courses on the strength of attending a course? The Centre validates and controls Bobath tutors to safeguard the reputation of its courses. The Centre felt that to advertise a course, with terminology well known to be used exclusively in the teaching of the Bobath approach, without a Bobath tutor, could be seen as misrepresenting that course. Manchester Branch was made aware of the Centre’s objections to the wording of its advertisement. The Centre did not request the cancellation of the advertised course but suggested that a qualified Bobath tutor be invited to lecture. This would have ensured maintenance of the standards associated with Bobath
introductory courses, and at the same time have provided revenue for the Branch education fund.
we consider that there is value in studying for an examination since the process of physiotherapists having to investigate their equipment, quiz their supplier, and think about why they give the treatment Mrs Cotton and the Bobaths they do, can be more valuable than solely MADAM - In the December issue of attending a couise. Physiotherapy there was a news note We are concerned that practitioners about Mrs Ester Cotton FCSP receiving an are not sufficiently knowledgeable in this honorary doctorate from Queen Margaret subject and have in the past been misled College, Edinburgh. by theories contrived by some salesmen I was very glad to read about the for the purposes of selling laser equipment. recognition of her work and the life she We wish practitioners lo make informed has devoted to improving the management decisions regarding treatment of patients and treatment of cerebral palsy. and choice of equipment, and we want However, I was amazed that it did not them to use their lasers more effectively mention her time at the Western Cerebral and for a wider range of conditions. This Palsy Centre, where she worked with Dr would be good for our industry and it and Mrs Bobath for more than seven years. complements our range of services and our In their early years, the Bobaths and commitment to being the best possible Dr Pet0 met many times, sharing ideas suppliers of laser therapy equipment, and experiences. We see now that the words ‘examination’ In the future when someone’s life is and ‘certificate’ do imply some kind of mentioned 1 would like to know more about formally approved professional assessthe people and approaches that influenced ment. We apologise and have withdrawn their careers. Readers should know! our advertisement and will reconsider how to present it. Paul Beelen Belgian Bobath Society Mrs Cotton is now 79 and has been active in many spheres. It is impossible to mention every aspect of a long and full life in a brief news note about a specific event.-Ed.
Unrecognised Examination MADAM -The January Journal carried an advertisement for the courses run by the Laser Exchange and also advertised a laser therapy safety and competence postal examination. I would like to point out that this examination has not been recognised by any of the bodies dealing with laser therapy - such as the British Medical Laser Association and The International Laser Therapy Association. It does not have validation by the CSP The standard of this paper is set by James and Karen Carroll of the Laser Exchange, who have been involved in the promotion, education and selling of lasers. I would not like anyone to be misled into thinking that this examination has any recognised professional merit. It may be that there is a need for a competence assessment in this modality but this should come from within the profession in discussion with the appropriate bodies.
Physiotherapy, February 1992, vol78, n o 2
Sue England
GradDipPhys MCSP Stratford upon Avon Mr James Carroll of The laser Exchange replies:
Mrs England rightly states that our laser therapy safety and competence examination is not an approved examination and has no professional merit. We support her recommendation that such a course should come from within the profession. We placed the advertisement because
Unnecessary Evil? MADAM - In response to the correspondence on post-operative percussion and vibration (Physiotherapy,December 1991). I would question the use of such techniques in the study by Jones and Hutchinson (1991) for two reasons: Percussion and vibration are both uncomfortable and rarely necessary after surgery, so was it ethical to use them routinely in this study in order to ’allow comparison of the efficacy of the analgesic modalities’? Lengthy treatments of 15 to 20 minutes were based on the unreferenced statement that this is ‘normally required’. Further justification was found by citing the notorious 67-minute treatment sessions of MacKenzie and Shin (1985), whose study not only subjected their hapless patients to the ordeal of over an hour of ‘postural drainage, percussion, chest wall vibration and suctioning’, but resulted in no significant improvement in arterial oxygenation, and an admission that the long-term clinical effect was ‘unknown’. All physiotherapy treatments should be subject to critical scrutiny, but none more so than those which can cause discomfort.
Alexandra Hough BA MCSP DipTP London N19 References
Jones, A Y M and Hutchinson, R C (1991). ‘A comparison of the analgesic effects of transcutaneous electrical nerve stimulation and Entonox’, Physiotherapy, 77, 8, 526 - 530. MacKenzie, C F and Shin, B (1985). ‘Cardiorespiratory function before and after chest physiotherapy in mechanically ventilated patients’, Critical Care Medicine, 13, 483-486.