I went to Dublin the other day. I like Dublin. I like the Irish actually. One Irishman who seems particularly likeable is a fellow called David Fitzgerald. He offered to take me to the airport. We got there and then, out of his dubious looking backpack he produced a big fat microphone! Anyway, he said ‘Listen, I am not unlocking the door on this tank until you answer a few questions’. Clearly I was trapped. I was thinking quickly, however, and said, ‘sure – let me just fetch my radio voice interlocuter from my suitcase…in the back’. So I got out and did a runner. Actually, I didn’t because David left out the questions, alluringly, on the seat. I couldn’t resist. So, David runs this blog Physio Digest . He does it out of his enthusiasm to spread the good word and I reckon he is doing a good thing. He has recorded our conversation, complete with occasional ‘move along please gents’ from the Airport security man in the faint background. Listen carefully for the grunt. Anyway, go here to listen. For your info – the questions he asked me are these:
1 I’ve heard you previously discuss your early dis-illusionment with physiotherapy in the formative years and subsequent rejuvenation on discovery of the neurosciences. Can you tell us a little bit about that transition and the path you have subsequently taken?
2. You frequently use examples of visual illusions to illustrate discrepancies between sensation and perception. It would appear that neuroscientists are increasingly interested in the summation of sensory input from multiple sources and how this is processed within the brain. He written extensively on the use of mirror therapy to challenge perceptual distortions of painful body regions – are there other clinical approaches involving the utilization / challenges of on the sensory inputs to alter pain perception?
3. There have been a number of calls for classification of pain based on mechanisms rather than structure or symptoms. Given that this type of approach is not appear to have received widespread recognition in clinical practice how you see the integration of perceptual components of the pain experience being incorporated into a practical framework?
4. Improvements in technology have greatly facilitated neuroscience research. Can you give are listeners some idea of the types of technologies and research methodologies that I used to conduct this type of work?
5. I see in some of your recent publications work documenting proprioceptive deficiencies in low back pain patients and also perceptual impairments of painful body parts. Would you see this type of information being applicable as a clinical screening tool which could direct treatment strategies or are we in a position to determine the neurological basis of such impairments yet?
6. Some of our listeners would be aware of the clinical tools you have produced in conjunction with David Butler of the NOI. “Explain pain” is a text adorns most physiotherapy libraries and waiting rooms but tell us a little more about the “Recognize” program which is available for purchase also?
7. I’ve asked this question of 2 other professors of physiotherapy in recent weeks regarding the balance between scientific research and clinical practice. We hear so much about evidence-based practice and yet the reality is that the therapeutic relationship and outcome measures are intimately connected to perceptual components of human interaction – which neuroscience is unraveling. Where do you think this leaves the double-blind clinical trial and such like in the context of physiotherapy interventions?
To listen to the interview click here