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Letters - 20 March 2013

Get involved now by sending your contributions by email to or write to Letters, Frontline, 14 Bedford Row London WC1R 4ED. Letters should be no more than 250 words. Frontline reserves the right to edit letters. Please ensure you include your name, address and a daytime telephone number.

Straight Talking

I was saddened to read that the Association of Chartered Physiotherapists in Women’s Health has reservations about my Twitter account – @gussiegrips – to promote pelvic floor awareness (Talkback, 20 February).

I’d like to reassure the association that my tweets are entirely evidence-based.

The feedback I have from patients is that me tweeting them to prompt them to do their exercises is very helpful.

So I have to disagree with Ms Lough when she says that Twitter is not a place to take pelvic floor muscle exercise advice. Elaine Miller

Timely advice

I must respond to the letter from the Association of Chartered Physiotherapists in Women’s Health, commenting on the article about a physio who is a stand-up comedian and who tweets.

As a retired physio who also tweets I am heartened by the notion that there is someone out there reminding me to do my exercises so that I don’t have to visit a specialist continence adviser in the future.
Judy Dalton

Them and U.S.

I read your article about overseas qualified physiotherapists with great interest (page 34, 23 January).

I qualified in the UK and am trying to work towards a licence in the US.

The US has a very rigorous approach to foreign-trained therapists.

I had to get my credentials checked which took six months and cost $800 (about £530), then had to find a facility who would take me for a six-month, full-time internship, working with a supervisor.

Now I have to study for a huge exam.

Please don’t make it too easy for overseas therapists coming to the UK. Some countries certainly do not make it easy for UK-trained therapists trying to gain employment abroad.Ruth Paterson, Alaska

Best practice

We were pleased to see that you included an article on our recent publication in The Lancet in Frontline (page 9, 20 February).

There were, however, a couple of inaccuracies.

First, the physiotherapy package included exercises – an important aspect of the package along with manual therapy and advice.

This package was best practice physiotherapy based on the current evidence and reflected the recommendations of the CSP’s guidelines for the management of whiplash associated disorders.

Second, the control intervention was an advice session only – there was no telephone follow-up as indicated in the article. Dr Esther Williamson, University of Warwick

Added benefit

Janet Wright’s summary of the comparative benefits of treatment for acute whiplash in people presenting to A&E departments (page 9, 20 February) gives the impression that there is no added benefit in a course of physiotherapy treatment over one physiotherapy session of advice with a telephone follow up.

This is not the case.

Although there is no difference in outcome at the eight and 12-month stage, there is a reduction in the amount of time people spend off work in the enhanced treatment group.

Rightly, Ms Wright states, as do the study’s authors, that the six treatments are not cost-effective to the NHS.

The study’s authors add, however, that the reduced time off work has a societal benefit. This is an important advantage to both the individual and, financially, to society.

People in paid employment and, indeed, unpaid carers, are given priority when triaged for musculoskeletal outpatient appointments. This recognises the effect on both the individual and society of lost work days.

It would be a pity if this important study was taken to show that no added benefit accrued with the six physiotherapy treatments.

Next we have to persuade those that hold the purse-strings that beneficial effects cannot be shown merely on the NHS balance sheet. Cathy Gill

Art therapy

I was disappointed to see the use of the term ‘cage fighting’ (‘Talkback’, 20 February).

Physiotherapy should expand to meet these needs of mixed martial arts athletes in a non-judgemental way. David Angove, Physiotherapy student

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20 March 2013

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