In Touch – Journal of the Organisation of Chartered Physiotherapists
Autumn Issue 2004 No. 108
The Bowen Technique – Treatment of shoulders
By Julian Baker
Helen Kinnear and European College of Bowen Studies
Results of the European College of Bowen Studies/Helen Kinnear Frozen Shoulder Research Programme published in February 2000.
Outline of the Protocol
From amongst volunteers for the study 100 patients were accepted, each of whom was currently suffering from chronic shoulder pain with considerably reduced -range of shoulder motion. Patients were initially assessed for function, pain and range of motion and all patients completed a case history questionnaire which was signed and sealed away from the therapist’s view.
Patients were paired with experienced Bowen therapists and each therapist was assigned equal numbers of treatment and placebo patients. Patients were randomly assigned to either a treatment or blind placebo group.
Treatment patients received four sessions of the normal Bowen shoulder protocol, no extra moves. Placebo patients received a previously tested procedure that was known to have no affect. All therapists followed the protocol strictly and there was no deviation from the set moves.
Therapists were told not to give too much information about Bowen and to give the some aftercare advice for all patients, whether treatment or placebo. The initial assessment tested range of motion for a number of glenohumeral shoulder movements.
The patient also conducted a subjective self-assessment of their pain level during each movement. All assessments were then repeated before each treatment session.
The results of the research show that The Bowen Technique significantly improves the ‘frozen shoulder’ condition. Improvements were seen in shoulder range of motion, function and pain levels. Although all therapists were already aware of this, it is good to now be able to show objective findings and the clinical trials will enable provision of firm evidence on the affect of Bowen as a treatment.
Results are presented in two parts: Overall Results and Specific Results.
These show the overall average range of motion improvement for all shoulder movements. The results show that overall 67% of treatment patients improved. This was compared to 50% of placebo patients. However, the placebo patients only showed an improvement of 8 degrees and this is not significant. In other words, this is just what would be expected by chance alone. In contrast the treatment patients improved by 23 degrees. This was found to be highly significant (p<0.05%). This was the average improvement over all the shoulder movements and is indicative of some movements improving considerably and others not responding much at all.
Patients with a chronically stiff and painful shoulder most often complain about loss of function, especially with regard to lifting the affected arm overhead. We were therefore particularly interested in the off ect of Bowen on two shoulder movements – forward flexion (lifting the arm overhead forwards) and shoulder abduction (lifting the arm overhead sideways). These results were particularly exciting and provide enormous potential for the introduction of Bowen into nation-wide treatment programmes for this condition.
Shoulder abduction improved in 78% of patients compared to the placebo improvement of just 22% of patients. Again, although the numbers of placebo patients improving was higher than expected, the actual improvement was not significant and was no more than could be expected by chance alone. However, the actual improvement for the treatment group was 40* compared to just 90 for the placebo group. Again, this is highly significant (p<0.05%). Similarly, forward flexion improved by 281 in the trial group and only 7′ in the placebo group. These results are again highly significant (p<0.05%).
Pain levels were also significantly improved by Bowen treatment and although these measures are only subjective they do underline the importance of Bowen in reducing pain and discomfort. It is also interesting to note that placebo patients who went on to receive actual Bowen improved significantly where they had shown no significant improvement with the placebo moves.
I trust these results will be found to be both interesting and thought-provoking. Practitioners have always known that Bowen works – now it can be shown.
See Also: Treatment of Shoulders by Julian Baker