Download PDFPDF
Evidence-based physiotherapy needs evidence-based marketing
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer-reviewed
  • Once published, you will not have the right to remove or edit your response. Removal or editing of responses is at BMJ's absolute discretion
  • If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patient's written consent to publication and send them to the editorial office before submitting your response [Patient consent forms]
  • By submitting this response you are agreeing to our full [Response terms and requirements]

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Evidence based physiotherapy needs evidence based statements from researchers
    • Alan J Taylor, Physiotherapist/Assistant Lecturer University of Nottingham
    • Other Contributors:
      • Roger Kerry, Physiotherapist/Assistant Lecturer
      • Fiona Moffatt, Physiotherapist/Assistant Lecturer

    The editorial article by Zadro, O’Keefe and Maher1 entitled ‘Evidence based physiotherapy needs evidence based marketing’, highlighted both the importance of conveying clear, consistent messages and having robust data to support any statements that appear in the public domain. To use the words of the authors, statements or claims by physiotherapists or physiotherapy organisations should be grounded in ‘rock solid research data’. Their article however, appears to fall foul of the very thing they are railing against. The mid-section of the paper, which discusses the marketing of the timing and type of PT treatment, contains a misleading statement which lacks the solid evidence that the authors call for.

    The authors state “Early access to harmful or ineffective physical therapy treatments (e.g. kinesiotape and electrotherapy), irrespective of timing, is unlikely to improve patient outcomes” The claim that some physiotherapy treatments e.g. Kinesiotape and electrotherapy are ‘harmful’ to patients is unsupported by the robust data that the authors mandate. ‘Electrotherapy’ for instance is a broad umbrella definition for a range of treatments ranging from neuromuscular electrical stimulation and extracorporeal shock wave therapy, (both of which, have recent systematic reviews to support their efficacy 2, 3 ), through to therapeutic ultrasound which has little or no evidence to support its efficacy. Crucially though, none of these examples have any robust RCT data to sugg...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Response to the Need for Evidence-Based Marketing
    • Daniel I Rhon, Physiotherapist Baylor University
    • Other Contributors:
      • Chad E Cook, Physiotherapist

    The editorial by Zadro and Colleagues' calls for caution in marketing physical therapy services, and focuses on a lack of high-quality evidence to support all current claims made for PT First. Of this, we 100% agree. The purpose of our response is to highlight considerations we feel may be beyond the research-based concentration outlined in the authors’ editorial.

    First and foremost, effective marketing strategies are influenced by many factors and vary depending on targeted end users, policy makers, and payers. These factors account for variations in the delivery of medical care, payment models, and the role of enforcing organizations. In Australia, it has been reported that a majority of patients receive appropriate evidence-based care for challenging and costly conditions such as low back pain.[1] In countries such as the United States, which boasts high rates of unnecessary imaging,[2] and high percentages of opioid prescriptions as initial treatment choices for nonspecific low back pain (>50% of patients), care is less guideline based[3], and heavily influenced by direct-to-consumer marketing strategies. The United States is immersed in a situation in which many high-risk, low-value treatments are easier to obtain, with insurance policies that comprehensively cover low-value care earlier (opioid prescriptions and steroid injections[4]); whereas low-risk, high-value interventions, such as those available from physical therapy, often require more out-of-p...

    Show More
    Conflict of Interest:
    None declared.