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Avoiding paralysis by analysis makes complex patients simple.



Phillips C
DMA Clinical Pilates & Physiotherapy.

Chronic patients create a unique challenge for clinicians, the presenting problem often being the tip of the iceberg. As a group they generally absorb 80% of funding and its common to see treatment of a single structure fail. Behind many chronic presentations we find a list of co-morbidities that confuse decision making. What is often missed are the patterns of these co-morbidities. Wainner describes this as regional interdependence. Clinicians often overlook such patterns and using a big picture approach for rapid decision making.Goldmans cardiac decision tree model has proven 4 key points are more effective for decision making than 40 points. We can easily apply this model within musculoskeletal settings using existing practice standards, to establish a directional process.This novel approach allows a validated sub grouping process that focuses treatment to a predominant side & direction. Directional models are common, well proven and still preferable to tissue or muscle specific models. The directional ‘filter’ also allows for inclusion / exclusion of structural & radiological findings. The system is quick & efficient and now validated as a subgrouping / intervention prediction tool with excellent inter rater reliability This session will present the steps required to apply this model in the clinical setting, the supporting evidence & outcome efficacy being achieved in a variety of settings, both published & unpublished literature and application in every day practice on the problem patients.

Craig was a professional dancer with the Australian Ballet for 10 years, before graduating from a physiotherapy degree in 1987. Having done Pilates extensively as a dancer he was awarded a highly prized “Special Projects Grant” by the Australia Council continue studies at St Francis Hospital Sports Medicine Centres, dance medicine unit in San Francisco. He introduced the first physiotherapy based Pilates clinic in Australia at Prahran Sports Medicine Centre soon after.  Due to rapid growth of interest, the first formal training process for physiotherapists, Clinical Pilates commenced in 1990.  He has presented courses for 25 years &over 150 papers at conferences & institutions globally including research & studies with bodies such as the Australian Defence Forces, Liverpool FC, English Institute of Sport,to name a few. Current focus is directed at incorporation of Clinical Pilates research into evolving primary care health reform and treatment outcome prediction tools.