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Letters

Let’s Learn to Criticise IN her lead article in the February issue of I’hysiothrrapy Jane Salvage clearly shows

Ni~v:sing Times by expressing her angst and angtiish over the scant attention given to it by academics and researchers.

Ms Salvage’s argument is clear: Since most readers find articles in scholarly ,joiiriials dull and thejargon esoteric, why not direct them to magazines with a large rexlcrship ( e g Nu.r.s&g ?’im.cs) to be edited to make them ‘easier to understand and

g to read’ and more widely

I have no qualms about this logic or the qnality of thr Nursing Tli’me,t But if we arc not prepared t o become critical consumers, no amount of editing or Pancifd juxtaposition of photographs or graphics will bring us nearer to evidence- based practice.

What is perhaps truly pseudo-scientific will be the habitual and uncritical acccptancc of scientific information from a( tractive packages and questionable soIIl‘crs.

It is iiiteresting to note that Ms Salvage

Stick Safety from Top to Bottom

I READ with interest the article ‘Drsignctl for walking’ (lihodes, I 999). I ~voiild like to promote the awareness and iisc of thc Slipnott ferrule, which ciin turn ;i walkiiig stick or crutch from being a

balancc, to an ergonomic piece of &pipinent, which proinotes fluency of piit pattern. I became aware of this type of frrrulc when I saw a young man who had cerebral palsy walking with elbow crutches arid Slipnott ferrules. IIe had a lunging gait pattcmi, using a wide base of support with his crutches, which meant that these werc not at right angles when he was taking weight through them. The Slipnott fertules made 100% contact with the

ting Wright bearing and

chose a scholdrlyjourndl like Phyczotherapy (rather than FrontlznP or lhprapy Weekly) to make her point. But at least she can draw comfort from the Fact that her article has managed to ‘expand debate and stimulate practitioners’ thinking’.

Yong Hao Pau Final Year Student Manchester School of Physiotherapy

Reference

Salvage, J (1999). ‘Nursing perspective, coinmon problrms’, I’/zy.siolhmuf)y, 85, 2, 58-60,

Ms Salvage did not ‘choose’ Physiotherapy; she iiias inviled lo rum’te,[or the, Journal. - Editor

more ‘plain speak’, but even so I would appreciate clarification as to how exercise can ‘contribute to a reduction in morbidity and morality’ (Kerr, 1999).

My imagination goes into overdrive visualising Dr Kerr’s patients performing exercises that would reduce morality - in the gym itself or behind a curtain?

In the amoral climate of this country, perhaps we should be encouraging exercises that begin: ‘Kneel, hands together and eyes shut. . . .’

Seriously, I would agree that exercise can promote a healthier life, but the mortality rate is and always will be 100%.

Ann 5 Wooldridge MCSP

. . . .

Billericav

Morality in the Gym PKEVIOUSLY I scanned theJournal with some bewilderment at the ‘academic speak’ of the articles, wondering how the authors communicated with Mr and Mrs Average MCSl’.

Recently there has been a tendency to

Reference

Kerr, K (1990). ‘Exercise: No easy option’, Physiothwapy, 85, 3, 114-115.

We regret the misspelling of (mortality’. lh Kerrs lead article was not inlended to conwy detailed statistics. I<xercisp ha.$ been shown to reduce the mortality rates in conjunction with age bands - ie exerrism can exprct to die later than sluggards. - liditor

ground, whatever the position of the crutch, and the crutch rotated round the ferrule to allow a fluent, albeit abnormal gait pattern.

Since then I have used the ferrules with great success with two people. One had widespread arthritis, and the ferrules reduced the pain in her shoulders which was aggravated by using elbow crutches all the time, and was particularly cllrctive when she negotiated stairs, plus it increased her feeling of safety when walking outside. The second was someone who had severe arthritis of her hips and spine, and was awaiting surgery. The ferrules reduced the effort and increased her fluency when she was walking.

I prit forward the hypothesis that the Slipnott ferrules could be used therapeutically in people who are dependent on walking sticks or elbow crutches and who have pain which is

aggravated by using the equipment, or those who have a disturbance in their gait pattern which means they cannot place the stick or crutch so that they are able to use it effectively without effort.

I would be interested to hear from anyone who has used Slipnott ferrules as I have not seen evidence of them being used. Is this because my hypothesis is wrong, or are we accepting that the sticks and crutches we have are effective, so there is no need to think of improving them t o meet patients’ needs more effectively?

Janet Cross MCSP

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Oxford

Reference Rhodes, H (1999). ‘Designed for walking’, Physiothm@y, 85, 3, 173-1 76.

Physiotherapy May 1998/vol85/no. 5