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    Bowen Therapists Federation of Australia

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    Localitatea Babadag

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    © All Rights Reserved
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    QONENTHER 4g on s Bowen Therapy An Effective, Safe Complementary Modality A submission on the scientific and clinical evidence applicable to Bowen Therapy Prepared by Dr David Paris B.Com., Grad.Dip.Ed., M.Sc., Ph.D., CPA Past President BTFA Contents Introduction by President. Bowen Therapy, Introduction for Review Panel Members... Origins of Bowen Therapy Safety... Quality Clinical Efficacy... Cost Effectiveness... Role in Complementary Health... Appendices Appendix 1 Extracted chapter on the fascia- Robert Schliep Ph.D Appendix 2. Fascia and Myofascial Release Research Part1 Bibliography Extract - International Fascia Research Congress 2012 Part2 Bibliography Extract - International Fascia Research Congress 2009 Part3 Bibliography - Fascia and Myofascial Release Research Appendix 3 Bowen Therapy Research and Articles Part1 The effects of the Bowen technique on hamstring flexibility over time Part2__ Improving the Physical Function and Activities of Daly Living of People with Adhesive Capsulits - Occupational Therapy Departments, KWH and PM, YCH, CMC & OLMH Part3 Bowen Therapy Research into treatment for back pain Part4 Bowen Therapy Research and Articles PartS Bibliography - Bowen Studies Appendix 4 Myofascial Release Research Bibliographies ‘Submission on Bowen Therapy 25 January 2013 Contents BOWEN THERAPISTS FEDERATION WENTHER 4p, OF AUSTRALIA INCORPORATED ARN: 11076128 PO Box 395 Oe 4G Leeton NSW 2705 TO og aus" Phone 1300 4 BOWEN. (1300 426 996) www bowen asn.au bifeoffie@bowen.asn.au 25" January 2013 To all who may read this submission, This submission on Bowen Therapy and the research evidence supporting it was prepared for the Review of the Australian Government Rebate on Private Health Insurance for Natural Therapies which will be overseen by Professor Chris Baggoley. ‘On behalf of the Bowen Therapists Federation of Australia Inc. (BTFA) | am very pleased to present this submission on the effectiveness of Bowen Therapy with the scientific and clinical research which is available to date, providing data supporting the clinical results achieved. This submission includes details on the topics of safety, quality, clinical efficacy and cost effectiveness as specified in the requesting document. The cross-fibre technique of Bowen Therapy has a direct relationship to the fascial structures of the body. Manipulation of the endless web-like fascial structure has been shown to assist in providing relief for a range of deficiencies in the body. This has resulted in a substantial interest and investigation into the structure, physiology and anatomy of fascia. Through the International Congresses on Fascia in recent years there has been an increase in research evidence on the effects changes to the state of fascia has on the various parts of the body. Research evidence from these Congresses is applicable to Bowen Therapy and is included in our submission. (Refer to Appendix 2) Appendix 3 contains data specific to Bowen Therapy, including randomised trials and clinical outcomes. There is also a significant body of information from clinical outcomes showing consistently repeatable benefits for given problems which are presented. The challenge is how to best verify scientifically what is occurring, with the desire that the information may enable therapists to increase their effectiveness for the benefit of th clients. | sincerely thank Dr David Paris for the preparation of this submission which hopefully will act as a catalyst for ongoing research leading to a greater understanding of how to further increase the efficacy / effectiveness and value of Bowen Therapy for the health system and within the complementary therapies arena. Sincerely Bony Yan Dip Bowen Therapy, Dip RM, FAICD President BTFA, ‘Submission on Bowen Therapy 25 January 2013, Page 1 ‘OF AUSTRALIA INCORPORATED |AREN: 110 761 281 PO Box 395 Leeton NSW 2705 Phone 1300 4 BOWEN (1300 426 936) new. bowen.asn.au bifa-office@bowen.asn.au ONENTH ER4, ae BOWEN THERAPISTS FEDERATION Fede, "oe a 25" January 2013 Professor Chris Baggoley The Natural Therapy Review Department of Health and Ageing Private Health Insurance Branch Mop 853 GPO Box 9848 ‘CANBERRA ACT 2601 Dear Professor Baggoley (for Review Panel Members) The Bowen Therapists Federation of Australia Incorporated (BTFA) is submitting the following in support of Bowen Therapy, a modality uniquely developed in Australia, that uses techniques of fascial release or manipulation. It should confirm Bowen Therapy as being a valuable complementary modality that is safe, clinically effective and cost efficient. We could provide collectively a substantial number of specific cases involving clients where Bowen Therapy resolved their presenting condition despite other treatments failing. Not only do the majority of clients achieve ready remission or resolution but the health system is saved countless thousands of dollars. Just three examples will serve to illustrate this. 1. Aclient who had been advised they required a $50,000 operation to relieve lower back pain was referred by a friend to a Bowen Therapist. After three treatments at a cost of $180 resolution of the condition obviated the need for the operation that was cancelled, 2. Aclient following admission to intensive care from an acute viral infection was subsequently diagnosed with Chronic Fatigue Syndrome. In the following twelve months of medical and psychological care there was no improvement and the client's marriage and business were on the verge of failure. Following only two $50 Bowen treatments the client no longer experienced fatigue and both marriage and business were saved. 3. The general manager of a 5 star hotel had chronic shoulder pain and severely restricted use of his arm. In a twelve month period he had spent over $6000 on medical, physiotherapy, chiropractic and acupuncture treatments without success. One Bowen treatment gave immediate relief and resolution. ‘Submission on Bowen Therapy 25 January 2013, Page 2 In all the above cases, just three of many recorded by only one therapist, remission appeared permanent from subsequent follow up extending to five years. In addition to client pain outcomes the financial savings are clearly evident both for the client and the Australian health system. While such cases are commonly reported by Bowen Therapists they unfortunately do not represent scientific studies but are the realities of practice. Importantly they substantiate the increasing recognition that the fascia is frequently both the source and means of resolution of remarkably diverse chronic pain conditions. Origins of Bowen Therapy Bowen Therapy has its origins in Geelong, Victoria when Thomas Ambrose Bowen (1916- 1982) commenced his practice. Tom Bowen had recognised an apparent common causal relationship in many seemingly unrelated painful conditions, particularly musculoskeletal but including neurological and other health problems. He identified this causal link or relationship as being the soft tissue or fascia. Fascia is the soft tissue component of the connective tissue system that permeates the human body forming a whole-body continuous three-dimensional matrix of structural support. It interpenetrates and surrounds all organs, muscles, bones and nerve fibres, creating a unique environment for body systems functioning. Bowen Therapy through fascial palpation and release can potentially influence all fibrous connective tissues, including aponeuroses, ligaments, tendons, retinaculae, joint capsules, organ and vessel tunics, the epineurium, the meninges, the periosteal, and all the endomysial and intermuscular fibres of the myofasciae Itis not surprising that fascia has been called the endless web in that it influences the whole body in myriad ways. It has now been shown to contain complex receptors that influence many of the body's functions even at the cellular level. Tom Bowen, having recognised this fascial role and using palpation and fascial release found that he could resolve a remarkable number of painful, handicapping or debilitating conditions that had not responded to other therapies. His technique which did not involve manipulation of spine, joints or other skeletal structures, was safely used on infants to the elderly. While he did not formally train others Tom had his so called “boys” who worked with him. These included chiropractors and osteopaths who effectively became his “disciples” and led to the Bowen Techniques being taken throughout Australia and to the world. These techniques, due to their effectiveness in treating such a wide range of conditions have now been widely adopted in the UK, Ireland, USA, Canada, New Zealand, Europe and more recently Russia. ‘Submission on Bowen Therapy 25 January 2013 Page 3 safety Bowen Therapy has been practiced in Australia for over fifty years. Originally by Tom Bowen, who from the Webb Inquiry in 1975 was seeing some 10,000-15,000 clients in a year. Today over 1000 registered practitioners would be seeing more than 100,000 clients a year. To the best of our knowledge in these 50 years there have been no claims by clients for any adverse events that have been the outcome of Bowen Therapy. To check this we contacted our insurance broker prior to this submission. Their underwriters advised that having run a claims history they can identify no claims from members of the Bowen Therapist Federation of Australia all of whom must hold indemnity insurance. This suggests that no other medical or complementary field of care would have a better safety record. This could be innately due to Bowen Therapy only involving palpation or release of the soft tissue of the fascia and no manipulation of the spine, joints or skeletal structures as carried out in other therapies including chiropractic and physiotherapy that do have inherent Quality Quality is a difficult concept to measure in any field of health care as it has so many elements or dimensions. One key element of quality is safety and this has been addressed above. The fact that to the best of our knowledge there have been no claims against, Bowen Therapists also strongly suggests a high level of client satisfaction that is a good indicator of quality. ‘Another is clinical efficacy. This will be addressed more specifically, but typically clients seen by Bowen Therapists have previously seen practitioners in other better known modalities, such as chiropractors or physiotherapists, without getting resolution of their problem condition. Despite this the significant improvement or long term resolution of presenting conditions from Bowen Therapy, even those experienced by clients for many years, is of a high order and normally achieved in three or less visits. As Tom Bowen stated to the Webb inquiry his success rate was some 88%. if a positive outcome, either complete remission or significant alleviation is not achieved within three treatments, for acute symptoms, the Bowen Therapist will refer the client to specialist diagnostic procedures or practitioners in whatever is considered the appropriate field. The success rate of Bowen Therapy after other modalities have not achieved the desired relief again supports its clinical efficacy. Clients presenting with chronic conditions may require more than three treatments to achieve a positive outcome. In many cases additional treatments are utilised on an as needs basis by the client to maintain relief and better quality of life. ‘Submission on Bowen Therapy 25 January 2013 Page 4 A further contributor to quality is training. All Bowen Therapists registered with the BTFA since 2007 have to hold as a minimum a Diploma of Bowen Therapy with 500 hours of clinical practice. Other registered therapists gained their therapist status prior to the existence of the nationally registered Diploma and Advanced Diploma based on extensive experience and competence. All therapists, to retain their registered status, have to maintain professional insurance, first aid qualifications and undertake ongoing professional development. Clinical Efficacy The clinical efficacy of fascial release or palpation that is the core of Bowen Therapy had been demonstrated over its early years principally by client outcomes especially where other modalities had been tried by clients without success. Tom Bowen seeing 10,000- 15,000 clients a year simply from referrals could only have been achieved by his clients getting positive clinical outcomes. This early reliance on anecdotal and experiential reports is not dissimilar to other complementary health fields including physiotherapy, chiropractic and osteopathy. In recent years however a variety of studies have been undertaken in different countries ‘on the range of techniques, including Bowen, that have fascial release or palpation at their core. These show that positive outcomes are achieved in a wide variety of common painful or disabling conditions that have failed to be alleviated by other more conventional treatments. Probably of greater clinical significance is the increasing recognition of the key role played by the fascia and its embedded receptors in a remarkable range of musculoskeletal, physiological, and neurological conditions. It has even been clinically demonstrated that fascial release or palpation can cause profound changes at the cellular level in the body. The increased awareness of the clinical significance of the fascia and the clinical potential of fascial release or palpation is exemplified by recent international congresses on the fascia. The first one was held in 2007 with subsequent ones in 2009 and 2012. We have attached references to these congresses and studies or extracts of studies that illustrate the clinical efficacy of fascial release or palpation as practiced by Bowen Therapists. The body of knowledge in fascial research is expanding greatly and what Tom Bowen originally intuited from his observations, studies and experience is now supported by extensive science based research. ‘Submission on Bowen Therapy 25 January 2013 Page s Cost Effectiveness Cost effectiveness is generally assessed using an input output model in absolute terms or in ‘comparison to alternatives. In health care of every kind from hospitals to complementary therapy the input costs can generally be measured with a reasonable degree of reliability. The problems occur in trying to measure the outcomes as these can vary significantly in nature, degree and measurability. The cost of Bowen Therapy consultations is in the range of $50-$60 in South Australia and Western Australia and most rural areas of Australia with $60-$100 in eastern state capital cities for consultations that are of 40-60 minutes in duration. On a cost/unit of time this would be at the lower end of the cost/time unit spectrum compared to other modalities seeing similar presenting conditions of a musculoskeletal or neurological nature. Published statistics suggest that Chiropractic or Physiotherapy is comparatively two to three times the cost/time unit consultation on average. It is not easy to assess the outcome side of the equation. Bowen Therapists have consistently reported achieving significant to long term remission of presenting conditions in 75-80% of cases within one to three consultations. We believe this compares very favorably to other modalities including Chiropractic and Physiotherapy. This is regularly endorsed by clients who have tried the better known modalities without success prior to seeking Bowen Therapy, often as a perceived last resort. An indicator of both clinical efficacy and cost effectiveness can reasonably be gauged from the increased role that Bowen Therapy now plays in the complementary health field and how this growth has been achieved. Physiotherapy is a well established and well known professional modality with a high level of referrals from the medical profession. Chiropractic is also a well established and well known professional modality whose Association has advertised and promoted it very effectively. Services provided by both have long been subject to service rebates from health funds that have reduced the cost to clients. Role in Complementary Health In contrast Bowen Therapy does not have the special and accepted role of Physiotherapy and historical support of the medical profession. Neither has it had a strong Association that advertises and promotes its services as has Chiropractic. In addition Bowen Therapy until recent years was not subject to rebates from health funds and even now this is not universal as with alternative modalities. ‘Submission on Bowen Therapy 25 January 2013 Page 6 Despite these comparative disadvantages Bowen Therapy has gained increased acceptance and recognition as a valued modality in the complementary health field for the treatment of musculoskeletal and associated neurological problems. This has resulted almost wholly from client referrals and could only have been achieved from an increasing client base considering it both clinically and cost effective. In the appendices to this submission we have provided hard copy references and or electronic links to over 250 research studies/articles. Some refer specifically to Bowen Therapy but most refer to the fascia, fascial release or fascial manipulation. They are in ‘most cases directly relevant to Bowen Therapy or the Bowen Technique that specifically involves fascial release or manipulation. These quite recent studies are progressively illustrating how and why Bowen Therapy is effective in such a wide range of painful or debilitating conditions. All appendices can be accessed via the “Dropbox”. Sincerely David Parix Dr David Paris B.Com, Grad.Dip.Ed, MSc, PhD, CPA ‘Submission on Bowen Therapy 25 January 2013 Page 7 Appendix 1 Extracted chapter on the fascia- Robert Schliep Ph.D ¥ Reclactect as nob PUpiical\y aunilabte, ‘Submission on Bowen Therapy 25 January 2013 Appendix 1 Appendix 2 Fascia and Myofascial Release Research ‘Submission on Bowen Therapy 25 January 2013 ‘Appendix 2 Appendix 2 Part1 Bibliography Extract - International Fascia Research Congress 2012 Website for full information is http://fasciacongress.org/ Editorial: Fascia Research 2012: Third International Fascia Research Congress wr i ijtmb /article /view! The R janipulative Tr Leon Chaitow DO University of Westminster, London UK http: 2012 /Absti MANUAL THERAPY Quantitative Approach ‘Andrea Kargel-SchwanhauBer, MA. MPH. Praxis fir Korpertherapie, Krumme St. 3 Ginerra titan, Kim Dupree Jones2, Scott Mist 2. Cheryl Wright2,Anna Art22 rracts/116 Lil th ithoak Csi o E i Amir Massoud Arab PT, PhD 2, Mohammad R. Nourbakhsh PT, PhD, OCS? hutp:/ /fasci sstracts/6 Application of Fascial Manipulation? in Pubescent Postural Hyperkyphosis, Vilma Cosict, Julie Ann Day? http: 2012 Abstract : Ammediate effect of myofascial massage for TMD with pain Setsubiro Hara http://f .org/2012/Abst Pain ina¥ 7 = pilots Paul J. Moga, D.O., Ph.D http://fasciacongress.org/2012/Abstracts/76_Moga.docx i toad (Danis Hotes ‘strength of voung sportsmen with a subacute ankle sprain, P. Roosen1*, P. Rosier2, P. Sercu2, K. Vanden Borre1, R. De Ridder1, N. Mahieu http://fasciacongress.org/2012/Abstracts/77 Roosen.pdf ‘Submission on Bowen Therapy 25 January 2013 Appendix 2 Page 1 mparison receptor massage technique on the calf muscle, Results from a Randomized Controlled Trial Oskar Berglund DN, Mathias Brunberg DN, Eva Skillgate PhD, Peter Viklund DN el Has 1s/43 Viklund.di Management of Idiopathic Scoliosis(1S) with Treatment of Myofascial Pain and Dysfunction and Fascial Restriction Lucy Whyte Ferguson, D.C. Fasclal Distortion Model (EDM) Treatment ofan Axillary Hernlated Triggerpolat Acquired 7 ith Fi a Byron Perkins http://fasciacongress.org/2012/Abstracts/113 Perkins.docx 7 facllathing iearay Mammal ; ‘Tunnel Syndrome:A Randomized, Double Blinded, Placebo Controlled Study Mohammad Reza Nourbakhsh PT, PhD, OCS *, Amir M. Arab PT, PhD? Itni//fasciacongress.org/2012/Abstracts/22. Nourbakhsh docx i a : for ilityin Duchenne muscular dystrophy - Pilot study M. Marfin-Martin, MSc", S. V. Fontes, PhD", H. Jager, PhD?, R. Schleip, PhD, A. B. Oliveira, PhD', F. Lehmann-Horn, PhD http://fasciacongress. 103 MAREIN-MAI Results of chiropractic treatment on 46 patients referred from and ear, nose and throat department, Andre Didriksen DC, Helge Hagen MD f 2012 28 Dies 1p, ion with Fascial D Todd Capistrant DO, MHA :/[fasciacongress.org/2012, docx LOW BACK re ; Mercedes BlanquetM.A Karima Boaullalene M.A Maribel Miguel Associate Professor, Cristiane Carboni MA HTTP://FASCIACONGRESS.ORG/2012/ABSTRACTS/44 CARBONLDOC ‘Myofascial Therapy For Low Back Pain: A Case Study. Renee Stenbjorn HITTP://FASCIACONGRESS.ORG/2012/ABSTRACTS/69 STENBJORN.DOCX ‘Submission on Bowen Therapy 25 January 2013, ‘Appendix 2 Page 2 Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility Paolo Tozzi, Bsc (Hons) Ost, DO, PT; Davide Bongiorno, MD, DO; Claudio Vitturint HTTP://FAS 2012, ZZLPDE ANATOMY Ei Distributi y L fSuperti 5 Body Marwan F. Abu-Hijleh, MD, PhD, MHPE hey Hil ‘a iflcatt aes feel 7 ‘Myra Kumka MD, PhD}; Jason Bonar BScKin, DC? hitp://fasciacongress.org/2012/Abstracts/90 Bonar.dacx. eae ti back. Clinical implications, Maribel Miguel! MD PhD, Juan Blasi? PhD, Tomas Domingo? MD, MarcBlasi+ MSc, Casimiro Javierre* MD PhD, Albert Perez MSc, Sergi Lépez DDS, Juan Ortiz* MD PhD. ittn://fasciacongress.org/2012/Abstracts/24 Miguel.doc Ja: in situ 0 Ming Zhang, MB, MMed, PhD asciac ti BIOMECHANICS Quantify {Non-Invasi doth to Reduce Levwit 4, Nadi Atalla!, M.S., Hans Chaudhry?, Ph.D., Thomas Findley, M.D., Ph.D. dnt: //fasciacongress.org/2012/Abstracts/83 Atalla.doc Se METP's) for E aad Pract Jocelyn W Cowie RMT httpi//fasciacongress.org/2012/Abstracts/121 Cowiepdt ‘The tensegrity of fascia ‘Saul Yudelowitz BSc(Hons) »:/ /fasciacongress. 4 Yudelowi ‘The Biomechanical and Ultrastructural Properties of Human Fascia Lata Sylwia Szotek', Joanna Czogala® congré 2. Sa ‘Submission on Bowen Therapy 25 January 2013, ‘Appendix 2 Page 3 CYTOLOGY/HISTOLOGY Effects of tensile load on cell proliferative activity of fascial connective tissue Chun Yang, Jing-peng Wu',Jun Wang2, _ Jing-xing Dai?, Lin Yuan!* hepy 012/Abstracts/7 MODELING Mechanical Stress transfer - the fundamental physical basis of all manual therapy techniques Leonid Blyum® and Mark Driscoll J. Eng, Ph.D® ress.org/2012 78 Blyurh.docx Mechanical Relationships in the Neurofascia: A Visual Schematic Mode] Michael Hamm, LMP CCST and Wilmot Li, Ph.D. iacony H NEW HYPOTHESES ‘The Fascia as the Base of our Body Image Karl-Hugo Quadflieg pee Seals 7 Tai Lin Yuan', Chun Yang?,Yong Huang?.Jun Wang®, Jin-peng Wut, Jing-xing Dait, Ou Sha’ and David Tai Wai Yew* nttp://fasciacongress.org/2012/Abstracts/71 Yuan.doc ‘New Hypotheses on the Hydration of Collagen James L. Oschman, Ph.D. .//fasciacongress.org/2. schman. RESEARCH METHODS 7 = chasi inbow? Willem J Fourie PT. MSc. nttp://fasciacongress.org/2012/Abstracts/60 Fourie,doc Anethnographic approach to describing fascia Sue Mirkin, MSc, DPH itp://fasciacongress.org/2012/Abstracts/S5 Mirkin.docx ‘Submission on Bowen Therapy 25 January 2013 Appendix 2 Page 4 on: - z April Neufeld, BS, LMP/LMT http://fasci .org/2012/Abstrai pdf vi

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