The issue of evidence - parachutes and movement

[Barrett Dorko]

I thought that this was an important article and after being prompted I linked it to my Facebook page I wrote the following:

In the presence of a painful complaint altered with position or use aren’t we looking for a movement that reduces the mechanical deformation responsible for the nociceptive drive? I know that doing this motion might not be sufficient or necessary, but, as they say, it couldn’t hurt.

Those focused on evidence alone often ask the wrong question, and, this can lead to a premature dismissal of an empirical finding and an ignorance of plausibility.

Does your technique work according to the literature? Have there been studies done? What’s the evidence supporting its use?

Every one of these is superficial in the sense that an answer either way would result in silence.

And we should never be silent – not in this case.

[Barrett Dorko]

Another way of putting this:

What evidence can you cite that proves parachutes save lives?

What evidence can you cite that movement in the right direction might relieve pain?

It’s the same question, and both imply a remarkable ignorance of reality. Both are non-starters.

[amacs]

Hi Barrett

but uncertain as to what you quite mean when you say

Those focused on evidence alone

What would be looking for if not evidence of one kind or another?

regards

ANdy

[Barrett Dorko]

The important word is alone. We need to first and foremost consider plausibility.

This is the essence of sciencebased medicine.

[Randy Dixon]

I don't follow the analogy. It is clear why we don't have a control in a parachute study, (although it could be done in limited ways) but I can't see any reason not to have a control in the example of movement.

Plausibility is important but if it can be tested, empirical evidence is more important and more reliable.

[Barrett Dorko]

I don't think you understand movement as modern science has informed us it actually exists.

Plausibility is important but if it can be tested, empirical evidence is more important and more reliable.

No, not the case. See this.

[Randy Dixon]

I take back my last sentence. Science is a process, to say that one part of it is more important than the other is denying the process. All of the different parts are necessary.

Having a plausible hypothesis is part of the scientific process but it is not the culmination of it. There are many plausible hypotheses which turn out to be false and many things which seem implausible that turn out to be true. Here are a couple, and to those who have questioned my diligence in watching TV, this should help dispel the notion that I have been lax in that department.
http://www.youtube.com/watch?v=uKXMTzMQWjo

and another one:
http://www.skepticblog.org/2010/05/2...than-the-wind/

The physics on the first one seem implausible but it actually worked. The second one continues to generate argument about whether it is plausible or not even after it has actually been done. This is the way science advances. A plausible hypothesis is formed, it is tested, the results either confirm or reject the plausibility of the hypothesis, and then a new hypothesis is formed. Plausibility often serves no other purpose than to expose our ignorance, allowing us to reform what we believe to be true. It is insufficient by itself.
While empirical testing alone doesn't explain why something happened it does answer IF it happens, something plausibility does not answer.

[Randy Dixon]

Originally Posted by Barrett Dorko

I don't think you understand movement as modern science has informed us it actually exists.



No, not the case. See this.

I read the article but I don't see how movement is a different case, particularly if we are looking at a specific type of movement or technique to elicit that movement. I agree that empirical observation can't be divorced from knowledge we have already tested and confirmed, but the opposite is true as well, you can't divorce plausibility, which may or may not be true, from empirical observation.

[Barrett Dorko]

Randy says:

...you can't divorce plausibility, which may or may not be true, from empirical observation

This is both difficult to understand and redundent. I mean, what sort of observation isn't empirical?

These are two different things, and we cannot trust what we sense. Magicians and conmen exploit this continuously. Because plausibility, like everything else in science, contains conjecture that will forever be provisional, it needs tweaking every once in a while. The law of gravitation (involved quite often when dealing with parachutes), not so much.

Is movement of a certain sort likely to alter the amout of mechanical deformation, nociception and ischemia present in the nerve? Well, yes, of course.

Is that easily measured? No.

Would the patient feel it? Probably.

Would we instinctively move in a corrective direction? Of course.

Why don't we just do that? We do, but sometimes not enough. We need help in the form of context and caring, often from another human being - a human who understands.