Efficacy of physiotherapy treatments in children and adolescents with somatic symptom disorder and other related disorders, 2022, Sartori et al

Full title: Efficacy of physiotherapy treatments in children and adolescents with somatic symptom disorder and other related disorders: systematic review of the literature

Abstract

According to the latest version of the Diagnostic and Statistical Manual of Mental Disorders, somatic symptom and related disorders (SSRDs) are defined as psychopathological manifestations characterized by physical signs not attributable to organic pathology. Their incidence has grown dramatically over the past few decades, and treatment is challenging. Besides other interventions on the child and the family, physiotherapy is considered an integral part of the treatment, although there is no evidence for its efficacy.

The study aimed to review the available proof on the effectiveness of physiotherapy in children and adolescents with SSRDs. A systematic literature search was conducted on MEDLINE/PubMed, CINAHL, Cochrane Library, PsycINFO, and PEDro, including 1999 to 2021. The methodological quality of the publications was assessed by applying the guidelines proposed by the Equator network, according to the different study designs. The scientific bibliography on the subject was minimal and had poor methodological quality. The choice of outcome indicators and the scales to measure them varied from study to study and were not standardized, making comparison and meta-analysis challenging.

Conclusion: According to the available evidence, it is impossible to answer the review question regarding the effectiveness of physiotherapy in children and adolescents with SSRDs. It is necessary to improve the methodological quality of the studies. Definition of standard rehabilitation treatments, identification of appropriate result indicators, and adoption of standardized evaluation scales are needed.

Open access, https://ijponline.biomedcentral.com/articles/10.1186/s13052-022-01317-3

 

"In some studies, reference was made to a physiotherapy intervention model called "Restrained rehabilitation" [8, 10, 11, 16] based on a hierarchical scheme of the proposed activities and on the constraint of achieving the objectives shared with the patient for the discharge from the hospital. This approach was inspired by the therapeutic guidelines adopted for chronic fatigue syndrome patients at King's College Hospital [16]. The patient's favourite and most enjoyable activities became a motivating tool, a sort of reward and compensation [8, 16]. The maintenance of results over time was critical in evaluating the effectiveness of the treatment of SSRDs, since it could also relapse months later. Nevertheless, only three authors analyzed a follow-up time of more than three months [9, 10, 15], while others did not consider it [11, 14, 17]."

 

This paradigm is called evidence-based medicine. For real.

It's not the second half that is problematic, it's the first: "considered an integral part". Despite the fact that there is no evidence, which is sometimes acknowledged, sometimes mocked as not understanding what the evidence says or even forcefully argued against: of course there is evidence, you just don't understand it, trust us we're experts.

The one thing that medicine has achieved with the biopsychosocial ideology is creating the most perfect form of pseudoscience ever. It explicitly exploits beliefs in the general population, explicitly because they are commonly believed.

There will never be a more perfect pseudoscience than this, an entire profession of experts actually fully believes in and promotes it, endlessly, and completely on faith, without any evidence whatsoever, while insisting variously that 1) there is evidence and 2) more evidence is needed because none exist yet but also that 3) evidence is not needed here, they know it works and evidence is just a formality.