[Editor's note: Both the letter to the editor by Belanger and colleagues and the response by White and colleages are commenting on the author manuscript version of the article that was published ahead of print September 15, 2014.]
It is with great interest that we learned of the American Physical Therapy Association's (APTA's) Choosing Wisely list of 5 things physical therapists and patients should question,1,2 as 3 of the 5 recommendations are related to the practice of therapeutic electrophysical agents. We would like to respond to the first recommendation: “Don't employ passive physical agents except when necessary to facilitate participation in an active treatment program.” In their article, White et al state, “As a partner in Choosing Wisely, APTA has a responsibility to update its list on a regular basis to ensure that the recommendations reflect the best and most current evidence…. If emerging evidence is of sufficient strength to alter conclusions on specific items, these items will be updated, amended or withdrawn.”2
Our purpose is to demonstrate that this first recommendation should be amended because the terminology and the evidence used to support its rationale are misleading, thus unfairly undermining the benefits that the evidence-based practice of therapeutic electrophysical agents can bring to the management of musculoskeletal disorders today and in the future. We believe that the arguments to follow have sufficient strength to justify our demand to amend the wording and rationale of this recommendation in a way that truly reflects the evidence used by APTA to come up with such a recommendation.
Let us first consider terminology. The APTA recommends avoiding passive physical agents …
