Jumping on bandwagons: taking the right clinical message from research

The prime goal of clinical research is to inform and direct practice, although a general practitioner friend of mine insists that ‘bloody academics ’ do nothing worthwhile for the world in general nor for clinicians specifically. Despite that opinion, research has consistently improved practice across all disciplines in sports medicine. There are, however, instances where clinical practice has steamed ahead of research knowledge. Experienced practitioners will recall the thousands of dollars spent on isokinetic machines in the 1980s and note that only slightly less is currently being spent on Pilates-based exercise machines. Both isokinetic training and Pilates exercise are excellent modes of rehabilitation, and the equipment can provide very positive gains. However, claims for the effectiveness of these modalities have been touted well beyond what the research has shown. There has been excellent and ongoing research into the rehabilitation of low back pain that has focused on muscle strengthening and conditioning, hence the current clinical use of Pilates-based rehabilitation. The role of transversus abdominis as a key stabiliser of the lumbar spine has been extensively reported and clinicians have taken this to heart. As a result, transversus abdominis conditioning, Pilates and ‘core stability ’ are basic tenets for the rehabilitation of low back pain, as well as for various upper and lower limb injuries. This can have clinical benefit, but recent research reported in this issue by Allison et al