Physiotherapy November 2000/vol 86/no 11

Letters 613

Breathing and Relaxation: Flexibility needed

MAY I add my opinion to the issue of howuseful is Physiotherapy journal? I live inIndia and therefore look forward toreceiving the journal as a way of keepingin touch with current trends and clinicalpractice in the UK. Unfortunately, withthe current emphasis on research,Physiotherapy does not fulfil this purpose.

I find the research papers long and‘heavy going’, and wonder how manyreaders actually plough through them all.I suspect for most it is a case of theemperor’s new clothes: few understandthem but no one wants to admit to it.

Each paper’s subject is by necessityextremely focused and I therefore wonderwhat the benefit is to the majority ofreaders. I am not saying research is notnecessary, but I would like the journal tobe more useful.

Abstracts are much more digestible,take up less space and are informative. I also enjoy the book reviews.

I agree with the suggestion by JoannaPowell (July 2000) of a section dedicatedto ‘accessible educational material’ andwould appreciate a section for CSPmembers to air and discuss currenttreatment trends in the various specialties.

Let’s make Physiotherapy more excitingto receive and read!

Janet WalshMCSP Chandigarh, India

I WOULD like to echo Peggy-Anne Pye’s(September 2000) call for more digestibleprofessional articles to be available. I also returned to physiotherapy after a prolonged break and survived theexperience due to the unfailing support of my colleagues.

In view of the reported shortfall of 1,000physiotherapists in the NHS (Chadda,2000), I am sure it would encourage manymore like me to return to the profession ifthis kind of material were produced.

I have always found the journal articlesvirtually impenetrable -- at least untilChristine Bithell brought some changes.However, in the main they are stillacademically weighty and clinically light.

What I need is many people immersedin the clinical field who can share theirpractice – successes and failures – so thatwe can all learn.

Am I alone?

Helen LawrenceMCSPFleet, Hampshire

ReferencesChadda, D (2000). ‘PRB told pay key toshortage’, Physiotherapy Frontline, 6, 18, 9.

Powell, J (2000). ‘Short and simple wayforward’ (letter) Physiotherapy, 86, 7, 389.

Pye, P-A (2000). ‘Short and simple is theway forward’ (letter) Physiotherapy, 86, 9,494-496.

How Can We Use the Journal?The scientific and clinical editor,Michele Harms, replies:I am grateful to Mrs Walsh and Mrs Lawrence for their comments about the usefulness of the journal intwo different situations. The primarypurpose of Physiotherapy is todisseminate high quality originalresearch and to facilitate continuingeducation. In selection of material, the journal aims to balance the styles of writing to achieve this purpose.

Abstracts are indeed publishedregularly – as it happens there are 25 inthis very issue! Several pages of bookreviews are always included. Treatmentnotes, case reports, opinions andscholarly papers are all encouraged,alongside research reports.

Each professional article is prefacedby an abstract, but the importance ofproviding the full paper for those whowish a deeper understanding cannot be underestimated. The diversity ofphysiotherapy means that for any onesubject, a degree of tenacity is requiredto accumulate the necessary evidence to inform treatment decisions.

As individuals, it is important to seek knowledge from various sources;textbooks provide the basics andresearch articles keep readers abreast ofdevelopments or controversies to enrichthe argument. Clinical Interest Groups,courses, conferences (see this month’slead article) and peer exchange are alluseful vehicles for divining knowledge.

IN response to the article on the efficacyof teaching Mitchell’s relaxation (Bell andSaltikov, 2000) I would like to make a fewcomments.

I teach both breathing and relaxation tostressed and anxious patients, and withthem decide, after practice, what suitsthem best. This might be using eithertechnique or a combination of both.

I am concerned that in the conclusion itwas suggested that breathing alone shouldbe taught even though both methods areequally effective. Some patients, for

instance, are unable to cope with thebreathing exercises, as they canexperience an increase in anxiety whenpractising, and a less direct approachusing relaxation works better for them.

I feel it is misleading to suggest thatteaching breathing exercises alone couldbe quicker and more cost effective, asstressed patients cannot be treated eitherbriefly or swiftly.

I aim to meet the patients’ needs, andthe financial restrictions of the service, byteaching the breathing individually and

the relaxation in small groups. I think thisflexibility allows the optimum response tobe achieved by each patient.

Anne Stephens MCSPLondon N1

Reference

Bell, J A and Saltikov, J B (2000).‘Mitchell’s relaxation technique: Is iteffective?’ Physiotherapy, 86, 9, 473-478.