Saturday, March 29, 2008

Encyclopedia of Dynamical Systems, in Scholarpedia

Scholarpedia is a work in progress, of course, but it is a publically accessible site where anyone can go and get an explanation of a concept or overview of a field of study from the scholars themselves. In the little menu on the left, one finds "dynamical systems". Clicking on it takes you directly to Encyclopedia of dynamical systems, which is a very good resource for anyone mystified by how brains "work", and who would like to de-mystify themselves a little. The very first article in the "applications" list is Binding by Synchrony, by Wolf Singer at Max Planck Institute in Germany.

At the moment I'm working on Mechanoreceptors and stochastic resonance. It's well worth a read just for basic review of sensory organs in skin, if nothing else, but if you're a manual therapist who has always been curious about the meaning of 'stochastic resonance' and want to know more, this article might enlighten considerably.

Monday, March 24, 2008

Ten-part post series on brain oscillations

I want to put a link up to a blogpost series I just completed at humanantigravitysuit, on brain oscillations, based on the Ginger Cambell brainsciencepodcast interview with Dr. György Buzsáki in Feb/08, based on his book Rhythms of the Brain.

The link to everything is called Brain Oscillations: Ten part series. I'll be posting it in the menu to the right, as well.

Friday, March 14, 2008

Something in Swiss water?

I am starting to wonder what it is about Switzerland. In the past few months, three separate science projects jumped out at me, all Swiss and all brainy:


These are described in the blog post Virtual Body Experience. The third was by Bigna Lenggenhager:
"Swiss scientist Bigna Lenggenhager induced virtual body illusions in her subjects, then had them move themselves out of position, then back into positions where they thought they had previously been, but which were in fact where their "virtual" bodies had been.

Her paper “Video Ergo Sum: Manipulating Bodily Self-Consciousness” was also published in the August 24, 2007, issue of Science."
Here is a related video.


This is a Swiss project headed by Henry Markram, in which an artificial "brain" is being painstakingly built. Jonah Lehrer writes,
"In the basement of a university in Lausanne, Switzerland sit four black boxes, each about the size of a refrigerator, and filled with 2,000 IBM microchips stacked in repeating rows. Together they form the processing core of a machine that can handle 22.8 trillion operations per second. It contains no moving parts and is eerily silent. When the computer is turned on, the only thing you can hear is the continuous sigh of the massive air conditioner. This is Blue Brain."
So far the project has managed to accurately simulate a single cortical column from a two-week old rat brain, only... but is still an amazing achievement. Here are media links.


A systematic review in press for Manual Therapy:
Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation

Annina Schmid, Florian Brunner, Anthony Wright and Lucas M. Bachmannd
a Uniklinik Balgrist, Department of Physiotherapy, Forchstrasse 340, 8008 Zurich, Switzerland
b Uniklinik Balgrist, Department of Rheumatology, Forchstrasse 340, 8008 Zurich, Switzerland
c School of Physiotherapy, Curtin University of Technology, Perth, Australia
d Horten Center for patient-oriented research, University of Zurich, Switzerland
Received 28 February 2007; revised 30 November 2007; accepted 18 December 2007. Available online3 March 2008.


Segmental neurological modulation, neural hysteresis and biomechanical effects have been proposed as mechanisms underpinning the effects of manual therapy. An increasing number of studies hypothesise activation of the central nervous system resulting in a non-segmental hypoalgesic effect with concurrent activation of other neural pathways as a potential mechanism of action. Whether this model is consistent with the current literature is unknown.

This systematic review aims to assess the consistency of evidence supporting an involvement of supraspinal systems in mediating the effects of passive cervical joint mobilisation.

We searched randomised trials in three electronic databases from inception to November 2007, without language restriction, and checked reference lists of included studies. We assessed study validity and extracted salient features in duplicate.

Fifteen studies met our inclusion criteria. The overall quality was high. We found consistency for concurrent hypoalgesia, sympathetic nervous system excitation and changes in motor function. Pooling of data suggested that joint mobilisation improved outcomes by approximately 20% relative to controls. This specific pattern suggests that descending pathways might play a key role in manual therapy induced hypoalgesia.

Our review supports the existence of an alternative neurophysiological model, in which passive joint mobilisation stimulates areas within the central nervous system.

Keywords: Treatment outcome; Cervical pain; Neck; Manipulation spinal; Joint mobilisation techniques; Physical therapy (speciality)"

Whatever the Swiss have going on there, I hope it doesn't lose any momentum, especially in view of the fact that it would appear brain consideration is making it all the way into Swiss PT culture, and out into the world of manual therapy. (Big smile)

Tuesday, March 4, 2008

Cultural Relativism and Postmodernism, what a team.

"In the final session of the conference, Paul Shankman, associate professor of anthropology at UC Boulder, spoke about cultural relativism and its evolution from a powerful anthropological research tool, which asked researchers to temporarily suspend moral judgment in order to understand cultures on their own terms, to its "lapse into moral relativism and epistemological relativism." If each culture has its own way of knowing and its own completely unique set of values that others cannot understand, cross-cultural understanding is rendered impossible, said Shankman. Also, extreme relativism overly romanticizes culture and assumes that all cultural practices deserve respect simply because they are "out there."

"Used properly," concluded Shankman, "relativism can lead to better understanding and possibly greater objectivity. Misused, it can lead to moral paralysis and an end to a rational approach to cultural differences and similarities.""

The above is an excerpt from this aricle in the Skeptical Enquirer about cultural relativism.

I think you are quite right, Diane. Also, this helps make sense of why many of those demonstrating post modern thinking to justify adoption of pseudoscientific thinking demonstrate a peculiar phenomenon. No ideas are to be rejected because they are that particular person's "truth" while at the same time they will attack vigorously any who question the validity of the pseudoscience. If you assume that cultures cannot understand each other or make any objective observations of eachother then the person attempting to do so must be acting in an immoral manner.

Sunday, March 2, 2008

Engulfed: To be or not to be

In reference to What's in a Name:

Cory, you said,
"I stumbled upon a blog this week that has engulfed me. It is the science based medicine blog."

I find that site a good port in a storm. I linked it to my own blog awhile ago. It looks like an wonderfully informative effort by medical skeptics to uncover and examine pseudoscientific thinking in general and in their own profession specifically. I think the world, especially the internet world, needs all the help it can get in that regard.

Cory, you said,
"I wanted to explore the name Science based medicine. What is the difference between this and Evidence Based Medicine?"
It looks like the authors at Science-Based Medicine blog are burrowing straight into a similar topic at the moment.

Could some of the problem defining the boundary of what is and what isn't strictly "evidence-based" include issues stemming from cultural relativism?

Lynn Payer wrote a book that impressed me greatly at the time, called Medicine and Culture:
"A classic comparative study of medicine and national culture, Medicine and Culture shows us that while doctors regard themselves as servants of science, they are often prisoners of custom. The United States, England, Germany, and France have equivalent life expectancy rates, yet medical treatment differs enormously from country to country. A new foreword by the author examines the trend toward evidence-based medicine and addresses the substantial changes in medical culture since 1988, including the proliferation of alternative medicine and the changing face of medicine in the European Community since the fall of Communism."
It was from the perspective of a writer who noted that the treatment of one's medical "diagnosis" could change just by crossing a border.

All we can do, I think, from inside a designated profession, is ultimately rely on basic science to settle the arguments. About PT, we certainly have our own fires to put out, don't we? In the absence of a generally recognized theory of our work, lots of strange fluff can creep in, which may need close scrutiny on a regular basis.

If I could choose a way to conceptually unite PT globally, I think I'd pick Cott's Movement Continuum Theory, based on Hislop's pathokinesiology theory. It's stretchy enough to include movement from cellular through to social. From an article by Michael A. O'Hearn:
"Building on Hislop's pathokinesiology theory is the MCT as proposed by Cott et al.3 It was described with the purpose of being unique and central to physical therapy, as well as being broad and applicable to research and education while "subsuming" current middle-range theories. It is similar to pathokinesiology, being established on the principle that movement is essential for human life, taking place on a continuum from a cellular level to an individual's interaction with society. Physical therapy intervention can take place at one or several places along the interdependent continuum similar to Hislop's.1"

I've just finished a lengthy look at Buzsáki, learning a bit about his research on brain oscillations. Even they qualify as "movement", inherent in neurons. Seems to me that neuroscience has opened up vast new territory for PT to explore, adapt to, consolidate itself into.

Most of this post is straying off topic though, isn't it? In the end, in the clinic, when we are working with the patients, regardless of who we are, medical doctors or physiotherapists, we are people in a culture who have adopted a designation, a path that is trying to make scientific sense of the world. As an individual we can choose to just ride along, or else we can put a bit of personal thought and energy into looking at where that path is actually heading, help to steer it a bit. One of my favorite essays of all time is James Willis' The Sea Monster and the Whirlpool. In this essay Willis argues that in a profession where one finds oneself looking after others medically (and dare I say, physiotherapeutically), one must retain one's humanity, steering carefully between "Scylla", for Willis a two-headed sea monster, whose heads are Antiscience and Pseudoscience, on one side, and on the other, "Charybdis" the whirlpool of "Scientific Fundamentalism."

There, I think I've finally managed to get back on track with Sackett.