Evidence for the effectiveness of physical therapy modalities to improve mobility functional performances, muscle characteristics and pain management become more important, particularly when social security institutions discovered Evidence Based Medicine (EBM) as a policy for financial co mpensation of therapies and therap y guidelines. In believe o f EBM social security institutions more often use scientific "external evidence" neglecting "individual clinical expertise" and "patient values" as Sackett et al. and the Cochrane Collaboration proposed. Sackett, a founder of EBM published in 1996 how three pillars are building the value of therapies, but that use of EBM may raise rather than lower the cost s. However, even if no strong evidence exists from randomized controlled trials for a treatment/method, the next levels should be considered too . In no case, however, the clinical experience and the patient's value should be forgotten as key decision criteria! Finally, referring to Sackett, it is the treating physician who rates the importance of scientific literature for the individualized treatment of a patient
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