Therapeutic Lies

Recently a study was brought to my attention which led me to question the information we give to our clients. I have included the abstract below:

'In a study testing whether the relationship between exercise and health is moderated by one's mindset, 84 female room attendants working in seven different hotels were measured on physiological health variables affected by exercise. Those in the informed condition were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General's recommendations for an active lifestyle. Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.'

Interesting hey? It would appear that changing beliefs, not only lead to positive effects through behavioural change, but also through other psycho-physiological processes, or placebo if you like.

So what impact might such knowledge have on therapy? Well rather than bringing people in with one problem (e.g. low back pain), and sending them away with 10 (tight muscles, weak 'core', bad posture, lack of exercise, bad dietary habits etc etc), we might want to accentuate the positives with a slight spin. Lack of exercise but your walk to work is good, tight muscles but this has been shown to be useful for energy efficiency (in endurance athletes), poor 'core' but pregnant ladies seem to do just fine without this one aspect of spinal stability etc etc. We must not neglect the importance of trying to influence behaviour when promoting health and well-being. But when negotiating this notoriously difficult area, is there really any harm in maximising more readily achievable improvements during that lengthy, often never achieved move to change? As somebody else so succinctly put it, every little helps.

The full article can be viewed here:
http://pss.sagepub.com/content/18/2/165

Danny Armitage, Clinical Lead Physiotherapist, Chancery Lane

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