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 BTFAContents
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 ContentsBOWEN 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 2In 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 3safety
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 4A 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 sCost 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 6Despite 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 7Appendix 1
Extracted chapter on the fascia- Robert Schliep Ph.D
¥ Reclactect as nob PUpiical\y aunilabte,
‘Submission on Bowen Therapy 25 January 2013
Appendix 1Appendix 2
Fascia and Myofascial Release Research
‘Submission on Bowen Therapy 25 January 2013 ‘Appendix 2Appendix 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 1mparison
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 2Low 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 3CYTOLOGY/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 4on: - z
April Neufeld, BS, LMP/LMT
http://fasci .org/2012/Abstrai pdf
vi