4th International Mulligan Conference – Copenhagen, Denmark 20-21 May 2017

The Easter break was well welcomed at Sheffield Shoulder Physio, with an ever growing client list and busy clinic ensuring that the last few weeks have been not only busy, but challenging and productive – it’s been great seeing so many people improve and achieve their goals.

In addition to guiding people through their rehabilitation to recovery, 2017 has been a hectic year with increasing teaching commitments, presentations and research publications. In addition to my recent ‘Letter to the Editor’, I was proud to see a paper that I was co-author on be published earlier this month. The lead author on this was Joe Palmer, not only a colleague who I’ve had the pleasure of teaching with in Delhi earlier this year, but also a great friend of mine. This paper investigated whether the ‘Functional Movement Screen’ (FMS) was a reliable outcome measure to be used in UK Physiotherapy practice; particularly within clinicians i.e. intra-rater reliability.

The FMS is a series of seven component movements that are scored from 0 (Lowest) to 3 (Highest) before being totaled to give a composite score out of 21 with the aim of predicting injury in the asymptomatic population. The validity of the FMS has been questioned by a really nice study due to each of the seven component movements measuring a different ‘thing’ (construct being the technical term); i.e. two people can score 14/21 with a completely different make up of points score – does this mean that they are both at equal injury risk? As such, it has been suggested that the component movement scores should be utilised in isolation rather than tallied up to a composite score.

Whilst the validity of the FMS has been questioned, the saving grace is often ‘yeah, well at least it’s reliable’; reliable refers to it being reproducible i.e. if I complete the FMS twice on the same person at two separate time points do I get the same score? Indeed, our paper showed that the composite score demonstrated excellent reliability. However, with this composite score being invalid and not really measuring one or the same ‘thing’ and the suggestion to use the component movement scores for greater clinical utility, are these component scores reliable? For a measure to demonstrate acceptable reliability, it is suggested that it must demonstrate a reliability co-efficient greater than 0.7. Of the seven component movements, only two demonstrated acceptable reliability and thus questions the wider clinical utility of the FMS within this population. Want to know which two? Read the paper, it’s open access!

I know what you’re thinking, what about inter-rater reliability? Watch this space, this data is currently going through peer review and may be even more damning..

Copenhagen, Denmark

Copenhagen, Denmark

To the title of the blog, it is an honour to be provided with the opportunity to deliver two presentations at the 4th International Mulligan Conference in Denmark.

We will be discussing some work that we have completed at the clinic which looks at the clinical reasoning, approaches and opinions of contemporary Musculoskeletal clinicians with regard to the use, role, mechanisms and indications for Manual Therapy. We hope to combine this insight, with our own analysis of current UK practice to discuss, critique and hopefully reconceptualise the use and application of Manual Therapy. Following our presentation, we intend to make both the slides and the data accessible for you all to enjoy!

Manual Therapy: Is there a generational shift in practice?

Manual Therapy: Is there a generational shift in practice?

Excitingly due to the interest shown in my course in Exeter next month, the organiser emailed me today informing me that he was opening up two additional places. If you wish to attend please see here – it would be great to meet you.

Thanks for reading this post and I welcome all comments, queries and critique below!


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