Louis Gifford

Louis Gifford (1953ko urtarrilaren 1a - 2014ko otsailaren 9a) fisioterapeuta ingelesa izan zen, min kronikoaren tratamenduari heltzeko ikuspegi-berrikuntzarengatik nabarmendu zena.

Fisioterapian hastapenak 

Gifforden guraso biak fisioterapeutak ziren; 1971ean Falmouth Physiotherapy Clinic zentrua ireki zuten, Falmouth herriko Swanpool auzoan. Louisek, baina, zoologia ikasi zuen. 1980ko hamarkada hasieran hasi zen fisioterapia ikasten. Bere aita -1940-50 hamarkadetan formatua, osteopatia eta bonesetter giroetan- oso ona omen zen esku terapian eta pazientearekiko komunikazioan, baina Louisek karrera amaitu baino lehen hil zen, 59 urterekin.

Louisen lehen lana Londreseko St Stephen's ospitalean izan zen. Muskulu-eskeletu arazoetan interesaturik, Robin McKenzie Zeelanda Berriko fisioterapeutarekin formazioak egin zituen, eta 1985ean Philippa Tindle emaztearekin -hau ere fisioterapeuta- Australiara jo zuen: Adelaiden Graduate Diploma in Advanced Manipulative Therapy atera zuen, Geoffrey Maitland, Patricia Trott eta Mary Magarey-rekin. 1988an itzuli zirenean, Gifforden gurasoen klinikan sartu ziren eta zenbait urte eman zituen Maitlanden teknikekin lanean. Halere, lan egiteko modu honetan pasibotasun gehiegi, eta pazientearen inplikazio aktibo gutxiegi aurkituko zuen.

Ikuspegi berriaren garapena 
Australian 1985ean ezagututako zenbait lankiderekin konexio ona lortuko zuen, eta kontaktua mantendu zuen: David Butlerrek lan handia egin zuen nerbioen biologia, fisiologia eta mekanika fisioterapiarekin integratzen; eta Mark Jonesek, berriz, arrazonamendu klinikoaren arloan. Haiekin kolaborazioan aritu zen Gifford, gai hauekin lotutako kurtso asko emanez Erresuma Batuan eta Europan.

1993an berriz Australiara jo zuen Zientzia Aplikatuetan Masterra egitera, Hego Australiako Unibertsitatean. Bertan, sei hilabetez, minari buruzko literaturan sakondu zuen. 1990ko hamarkadan, Giffordek estresa, psikoneuroimmunologia eta psikoneuroendokrinologia arloak asko landu zituen, gorputzaren eta gogoaren arteko konexioena alegia; hauek gorputzaren fisiologian izan zitzaketen eraginak interesatzen zitzaizkion. Garai honetan hasi zen lankide eszeptikoei Aches and Pains izeneko lehen hitzaldiak ematen, eta ideia probokatzaileak erabiliz: "kontuz haurra bainatu ostean, ura botatzen duzunean haurra ere ez botatzeko", "min kronikoa Bogey Koronelaren Martxa bezalakoa da: behin musika buruan sartzen zaizunean, oso zaila da hortik ateratzea". Hitzaldiokin 2007ra arte jarraitu zuen.

1994an, CSP-ren baitan (Chartered Society of Physiotherapy, EBko elkarte profesional eta sindikal nagusia) Gifford Physiotherapy Pain Association azpielkartearen sortzaileetako bat ere izan zen.

1997an organismo helduaren eredua (mature organism model) garatu zuen, fisioterapia arloan eragin handia izan duen kontzeptua, neurobiologia eta fisioterapia uztartuz.

1998an Topical Issues in Pain liburu sorta atera zuen, min kronikoaren tratamenduari buruz idatzi zuten autore askoren idazkien editore bezala.

2005 urtean fisioterapian erabilitako ikurrin sisteman kolore arrosakoaren erabilpena proposatu zuen, pazientearen sendatze prozesuan positiboki eragin dezaketen faktoreak seinalatzeko.

Gaixotasuna eta azken urteak 

2007an prostata-minbizia diagnostikatu zioten; lanean, forma fisikoa mantenduz eta ikuspegi positiboarekin jarraituz, iragarri baino biziraupen nabarmen luzeagoa lortu zuen. 2013 inguruan, bere bizitzako azken sei hileak idazketan murgildua pasatu zituen, eta bere hiru kurtsoren edukiarekin hiru testu liburu prestatu zituen: Aches and Pains, The Nerve Root eta Graded Exposure. Bera hil ostean argitaratu ziren, saldutako liburu bakoitzeko EB-ko prostata-minbizi elkarteari dohaintza bat emateko konpromisoarekin.

Bere paziente gehienek ez zuten Giffordek mundu mailako fisioterapian izandako garrantziaren berririk izan; haientzat Swanpooleko fisioterapeuta zen, besterik gabe. Bera hil eta gero fisioterapia zentruak martxan jarraitu du, Filipa emaztearen eta Louise Nicholettos lankidearen ardurapean, eta prostata-minbiziaren ikerketarako dirua biltzen jarraitzeko kanpainak sustatuz.

Bestelako jakingarriak 
Gifford ezagutu zutenek azpimarratzen dute paziente bakoitzari soluziorik egokiena bilatzen zuela, horretarako haien sinesmenak eta itxaropenak bereziki kontuan hartuz. Oro har, Giffordek eredu biopsikosozialean eta ebidentzia zientifikoan oinarritutako fisioterapia eredua bultzatu zuen, kolektiboa eraldaketa sakon baten atarian jarriz.

Bere interesak fisioterapiatik harantzago zituen, jakintzaren beste adarretatik ere irakaspenak jasota: genetika, entomologia, poesia, arrantza, kirola (bela, korrika, txirrindularitza, golfa, snowboard...), perretxikoak, arotzeria edo ogia egitea bezalako afizioetara emana bizi izan zen.

Louisek eta Filipak bi seme izan zituzten, Jake eta Ralph. Louisen heriotzarengatik ez zuten hiletarik egin; horren ordez, gorpua pribatuan erraustu zuten, eta gero Swanpooleko hondartzako kafetegian lagun arteko festa jendetsua egin zuten, arropa beltzik gabe.

Ekoizpen bibliografikoa

Artikuluak: 

 Gifford, L S  (1987). “Circadian variation in human flexibility and grip strength”, Australian Journal of Physiotherapy, 33, 1, 3-9.
 Butler, D S and Gifford, L S   (1989)  “Adverse Mechanical Tension in the Nervous System – Part 1, Testing for dural tension”, Physiotherapy  75, 622-629
 Butler, D S and Gifford, L S   (1989)  “Adverse Mechanical Tension in the Nervous System – Part 2, Examination and Treatment”, Physiotherapy  75, 629-636
 Gifford, L S  (1993)  Examining and treating signs of neural tension.  In Touch: The Journal of the Organisation of Chartered Physiotherapists in Private Practice, 68: 16-24
 Gifford L S and Gifford M J  1994  Connective Tissue Massage, In Pain Management in Physiotherapy 2nd Ed , Bowsher Frampton and Wells (Eds). Blackwell Scientific London
 Gifford, L S (1995). “The influence of circadian variation on spinal examination”, In: Boyling, J and Palastanga, N (eds) Grieve’sModern Manual Therapy, Churchill Livingstone, Edinburgh
 Gifford, L S  1995  Pain mechanisms and their recognition for physiotherapy – a new approach for the late 1990’s.  Swiss Journal of Physiotherapy: June 1995: 4-16.
 Gifford, L S 1995  Fluid movement may partially account for the behaviour of symptoms associated with nociception in disc injury and disease.  In: Shacklock, M O (ed) Moving in on Pain.  Butterworth-Heinemann, Australia.
 Gifford L S 1997 Neurodynamics. In: Pitt-Brooke (ed) Rehabilitation of Movement:  Theoretical bases of clinical practice  Saunders, London 159-195
 Gifford L S 1997 Pain. In: Pitt-Brooke (ed) Rehabilitation of Movement:  Theoretical bases of clinical practice  Saunders, London 196-232
 Gifford L S, Butler D S 1997 The integration of pain sciences into clinical practice. Hand Therapy 10(2): 86-95
 Gifford L S, Butler D B 1998 Integrering av smertevitenskap i klinisk praksis. Fysioterapeuten nr 9 August: 10-20
 Gifford L S 1998 Pain, the tissues and the nervous system: A conceptual model. Physiotherapy 84(1): 27-36
 Gifford L S 1998 Acute low cervical nerve root conditions: Symptoms, symptom behaviour and physical screening. In Touch  The Journal of the Organisation of Chartered Physiotherapists in Private Practice Winter issue No. 85: 4-19
 Gifford L S 1998 The mature organism model. In: Gifford L S (ed) Topical Issues in Pain.  Whiplash – science and management.  Fear-avoidance beliefs and behaviour.  CNS Press, Falmouth 45-56
 Gifford L S 1998 Central mechanisms. In: Gifford L S (ed) Topical Issues in Pain 1.  Whiplash – science and management.  Fear-avoidance beliefs and behaviour.  CNS Press, Falmouth 67-80
 Gifford L S 1998 Output mechanisms. In: Gifford L S (ed) Topical Issues in Pain 1.  Whiplash – science and management.  Fear-avoidance beliefs and behaviour.  CNS Press, Falmouth 81-91
 Gifford L S 1998 Tissue and input related mechanisms. In: Gifford L S (ed) Topical Issues in Pain 1.  Whiplash – science and management.  Fear-avoidance beliefs and behaviour.  CNS Press, Falmouth 57-65
 Gifford L S 1998 ‘Pain memory’ In Touch  The Journal of the Organisation of Chartered Physiotherapists in Private Practice Autumn issue.
 Gifford L S 1999 A medico-legal report to a solicitor. Manual Therapy 4(4): 229-235
 Gifford, LS 2000  Schmerzphysiologie. In: Van den Berg, F (Ed) Angewandte Physiologie 2, Organsysteme verstehen und beeinflussen. Georg Thieme Verlag, Stuttgart 467-518
 Gifford L S 2000 The patient in front of us: from genes to environment. In: Gifford L S (ed) Topical Issues in Pain 2.  Biopsychosocial assessment and management. Relationships and pain  CNS Press, Falmouth
 Gifford LS 2001 Editorial: Criticism, is it destructive or productive?  Physiotherapy Pain Association News: Issue 11, May, p3-5.
 Gifford LS 2001 Editorial: A plea for descriptive research – part 1  Physiotherapy Pain Association News: Issue 12, December, p3-5.
 Gifford L S 2001 Acute low cervical nerve root conditions –  symptom presentations and pathobiological reasoning.  Manual Therapy 6 (2) 106-115
 Gifford LS 2002 Editorial: Quite a pill eh?  Physiotherapy Pain Association News: Issue 13, May, p3-4.
 Gifford L S 2001 Perspectives on the biopsychosocial model – part 1:  Some issues that need to be accepted?  In Touch, The Journal of the Organisation of Chartered Physiotherapists in Private Practice.  Autumn, No 97
 Gifford L S 2002 Perspectives on the biopsychosocial model part 2:  The shopping basket approach. In Touch, The Journal of the Organisation of Chartered Physiotherapists in Private Practice Spring issue No 99: 11-22
 Gifford LS 2002 Editorial: Therapist and patient fear of bending:  Does the McKenzie approach – need a shift?  Physiotherapy Pain Association News: Issue 14, May, p3-8.
 Gifford LS 2002   Memes, dreams and dualism… the flexion-extension debate and beyond.   Physiotherapy Pain Association News: Issue 15, May, p14-20.
 Gifford L S 2003 Perspectives on the biopsychosocial model part 3:  Patient example – using the shopping basket approach and graded exposure. In Touch, The Journal of the Organisation of Chartered Physiotherapists in Private Practice Spring issue No 102: 3-15
 Jones M A,  Edwards I, Gifford L S 2002 Conceptual models for implementing biopsychosocial theory in Clinical Practice. Manual Therapy 7(1): 2-9
 Gifford L S 2002 An Introduction to evolutionary reasoning: –  Diet, discs and the placebo. In: Gifford L S (ed) Topical Issues in Pain 4.  Placebo and nocebo. Pain management. Muscles and pain.  CNS Press, Falmouth
 Gifford L S, Thacker M 2002 A clinical overview of the autonomic nervous system, the supply to the gut and mind-body pathways. In: Gifford L S (ed) Topical Issues in Pain 3.  Sympathetic nervous system and pain. Pain management. Clinical effectiveness  CNS Press, Falmouth 21-52
 Gifford L S, Thacker M 2002 Complex regional pain syndrome: Part 1. In: Gifford L S (ed) Topical Issues in Pain 3.  Sympathetic nervous system and pain. Pain management. Clinical effectiveness  CNS Press, Falmouth 53-74
 Thacker M, Gifford L S 2002 Complex regional pain syndrome: Part 2. In: Gifford L S (ed) Topical Issues in Pain 3.  Sympathetic nervous system and pain. Pain management. Clinical effectiveness  CNS Press, Falmouth 75-102
 Thacker M, Gifford L S 2002 A review of the physiotherapy management of complex regional pain syndrome. In: Gifford L S (ed) Topical Issues in Pain 3.  Sympathetic nervous system and pain. Pain management. Clinical effectiveness  CNS Press, Falmouth 119-142
 Thacker M, Gifford L S 2002 Sympathetically maintained pain: myth or reality? In: Gifford L S (ed) Topical Issues in Pain 3.  Sympathetic nervous system and pain. Pain management. Clinical effectiveness  CNS Press, Falmouth 103-118
 Gifford L S 2003 Behov for helhedstaenkning. Fysioterapeuten Nr 20/November/ 85.argang   (Danish translation of Gifford L S 2000 The patient in front of us: from genes to environment. In: Gifford L S (ed) Topical Issues in Pain 2.  Biopsychosocial assessment and management. Relationships and pain  CNS Press, Falmouth)
 Gifford L S 2004 Unnecessary fear avoidance and physical incapacity in a 55-year-old housewife. In: Jones M & Rivett D (Eds) Clinical Reasoning for Manual Therapists.  Butterworth-Heineman, Edinburgh 61-86
 Gifford L S 2004 Laast sich chronischer Schmerz vergessen?  Manuelletherapie. 8:181-182
 Robson S, Gifford LS 2005  Pain and brain – a revolutionary approach to chronic injury. Peak Performance Issue 221: 1-4
 Robson S, Gifford LS 2005  Pain And Brain –  The Biopsychosocial Method Of Chronic Injury Rehabilitation. Peak Performance, Issue 222:8-11.
 Gifford, LS 2005  Schmerzphysiologie. In: Van den Berg, F (Ed) Angewandte Physiologie 2, Organsysteme verstehen (2nd edn). Georg Thieme Verlag, Stuttgart 481-535
 Gifford L S Thacker M and Jones M 2006 Physiotherapy and pain. In: McMahon S, Koltzenburg M.  Wall and Melzack’s Textbook of Pain, 5th Edn pp:603-617
 Robson S, Gifford L S 2006 Manual Therapy in the 21st Century.  In: Gifford L S (Ed), Topical Issues in Pain vol 5, CNS Press, Falmouth 3-34
 Gifford L S 2006  Red and yellow flags and improving treatment outcomes, or: ‘Top down before bottom up!”.  In Touch, Summer 2006 issue no: 115:18-24
 Robson S, Gifford LS 2008  Manual medicine.  In: Breivik H, Campbell WI, Nicholas MK (Eds): Clinical Pain Management (2nd Edn) : Practice and Procedures. Hodder Arnold, London 230-239.

Liburuak: 

 Gifford L S (ed) 1998 Topical Issues in Pain 1.  Whiplash – science and management.  Fear-avoidance beliefs and behaviour. CNS Press, Falmouth
 Gifford L S (ed) 2000 Topical Issues in Pain 2.  Biopsychosocial assessment. Relationships and pain. CNS Press, Falmouth
 Gifford L S (Ed) 2002 Topical Issues in Pain 3.  Sympathetic nervous system and pain. Pain management. Clinical effectiveness. CNS Press, Falmouth.
 Gifford L S (Ed) 2002 Topical Issues in Pain 4.  Placebo and nocebo.  Pain management. Muscles and pain. CNS Press, Falmouth.
 Gifford L S (Ed) 2006 Topical Issues in Pain 5.  Treatment. Communication. Return to Work. Cognitive-behavioural. Pathophysiology.  CNS Press, Falmouth.
 Gifford, Louis. 2014. Aches and Pains. Autoedizioa.
 Gifford, Louis. 2014. The Nerve Root. Autoedizioa.
 Gifford, Louis. 2014. Graded Exposure. Autoedizioa.

Omenaldiak 
2001 urtean, Giffordek CSP-aren aipamen bat jaso zuen profesioari egindako ekarpenengatik, eta bere hezkuntza lanarengatik.

2018tik aurrera, European Pain Federation elkarteak bere kongresuan ematen duen sari nagusiak Louis Gifford izena darama.

Erreferentziak

Kanpo estekak 

Fisioterapia
Ingalaterra
Kornuallesko kultura