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Probleme des klinischen Wiederbefunds

Problems of clinical retesting

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Zusammenfassung

Hintergrund

Die Wirkung jeder Therapieform wird durch spezifische und/oder unspezifische Wirkfaktoren vermittelt. Kliniker behaupten, sie könnten mithilfe des Konzepts des klinischen Wiederbefunds beurteilen, ob ihre Intervention gewirkt hat. Dabei wird fälschlicherweise oft angenommen, dass die postulierten spezifischen Wirkmechanismen für das Behandlungsergebnis verantwortlich sind.

Material und Methoden

Basierend auf einer Zusammenstellung an ausgewählter Primär- und Sekundärliteratur wird im vorliegenden Beitrag argumentiert, dass der klinische Wiederbefund per se kein geeignetes Instrument ist, um zu beurteilen, welcher Teil der Intervention (spezifisch und/oder unspezifisch) in einer konkreten Therapiesituation gewirkt hat. Davon ausgehend werden unspezifische Wirkfaktoren diskutiert und in den Vordergrund der therapeutischen Aufmerksamkeit gebracht. Damit sollen Manualtherapeuten und -mediziner darauf aufmerksam gemacht werden, dass sie in ihrer therapeutischen Praxis auch diese Faktoren bewusst manipulieren können, um so den Therapieerfolg zu vergrößern.

Schlussfolgerung

Klinische Studien sind die einzige Möglichkeit, um durchschnittliche Therapieeffekte in der manuellen Medizin systematisch vorherzusagen.

Abstract

Background

The effect of every form of therapy is mediated by specific and/or unspecific effective factors. Clinicians claim that they can assess whether an intervention has been successful using the concept of clinical retesting. Under these circumstances it is often falsely assumed that the postulated specific effective mechanisms are responsible for the results of treatment.

Material and methods

Based on a compilation of selected primary and secondary literature sources this article provides argumentation that clinical retesting per se is not a suitable instrument to assess which component of the intervention (specific and/or unspecific) was effective in a concrete therapy situation. From these aspects unspecific effective factors are discussed and brought to the forefront of attention for therapy. The aim is to make manual therapists and physicians aware of the fact that in the therapeutic practice these factors can also be consciously manipulated in order to increase the success of therapy.

Conclusion

Clinical studies are the only possibility to systematically predict the average effect of therapy in manual medicine.

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Authors and Affiliations

  1. Premreinergasse 19/3/3, 1130, Wien, Österreich

    C. Thalhamer BSc

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  1. C. Thalhamer BSc
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Correspondence to C. Thalhamer BSc.

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C. Thalhamer gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Thalhamer, C. Probleme des klinischen Wiederbefunds. Manuelle Medizin 55, 29–33 (2017). https://doi.org/10.1007/s00337-016-0221-9

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