Alternative Medicines

Abstract

ABSTRACT Tesio L : Alternative medicines: yes; alternatives to medicine: no. Am J Phys MedRehabil 2013;92:542Y545. Key Words: Integrative Medicine, Residency Training, Alternative Medicine, Rehabilitation T he proposed program 1 of international rotation in integrative rehabilitationmedicine implemented as part of the physical medicine and rehabilitation resi-dency program (PMR) is genuinely perplexing. Three senior United States resi-dents Brotated[for some 20 working days in northern Italy (Milan and Pavia).Two half-days were spent in a pediatric intensive care unit. For the rest, theresidents were Bexposed[in outpatient clinics to Bthe clinical practice and thescientific basis for IM[(integrative medicine). More precisely, the residents wereBexposed to practitioners of traditional Chinese Medicine, acupuncture,posturology, aquatic therapy, massage, biofeedback, nutrition, yoga and a varietyof martial arts including tai chi, qigong, and kung fu.[In addition, the residentslearned about BMezie`re therapy for scoliosis[and BDeveny Hungarian harmonicexercise for back and neck pain[and all this, Bdespite any language barrier thatmay exist I.[The author’s main concern is that the program seems to follow two relatedassumptions, which are as follows:(1) that any complementary and alternative medicine (CAM) method has a sci-entific basis, making it effective and safe(2) that physical medicine and rehabilitation residents might learn to Bintegrate[all sorts of CAM with Bconventional medicine[after exposure Bto the clinicalpractice and the scientific basis for Integrated Medicine[Neither assumption holds up under scrutiny, and these make the programmisleading and counterproductive.The effectiveness of CAM, as per the accepted standards of evidence inconventional medicine, is still weak or controversial for many of the practicesusually merged into the CAM basket and, for many others, is unknown. In themeantime,evidenceforthepossibilityofseveresideeffectsispilingup.Accordingto the Cochrane Systematic Reviews, for instance, the efficacy of acupuncture(perhaps the most studied among the CAM methods according to experimentalparadigms, as per Kuhn’s