I agree. Tai Chi has been great for me. One of the main postural
considerations is Trans Ab, although that is not what they call it.
Lynda
>
>Hello,
>
>there is a significant body of evidence on other exercise having good
>outcomes in LBP rehab as well.
>
>
>Cheers,
>
> Anna.
>
>
>Anna Lee
>Principal,
>Work Ready Industrial Athlete Centre
>
>Write to me at: [log in to unmask]
>
>Visit me at: www.workready.com.au
>
>Snail mail:
>Suite 3, 82 Enmore Road,
>Newtown NSW Australia 2042
>Australia
>
>Phone: (612) 95197436
>Fax: (612) 95197439
>Mob: 0412 33 43 98
>
> ----- Original Message -----
> From: Jason Steffe
> To: [log in to unmask]
> Sent: Sunday, August 18, 2002 2:52 AM
> Subject: Re: Movements not Muscles?
>
>
> John,
>
> Nice rant! Well put. I agree that the evidence is overwhelming. It's
>very clear, when you group the evidence (studies) into 3 stages (Normal
>function, dysfunction after back pain, and rehabilitation outcomes), that
>the TVA and MF are intimately related to each other and go down the drain
>with back pain. Retraining these muscles has strongly supported in the
>literature thus far. I did a ROL academic paper a few months ago in this
>area and I found the approach to be very solid. No other approach to
>spinal rehab, that I'm aware of, has as much supporting literature as
>segmental stabilization does.
>
> The researchers in this area have identified the function, dysfunction
>and rehabilitation of these muscle groups in well-controlled clinical
>trials. More work remains to be done such as alternative/better more
>efficient ways to target the muscle groups, refinements with the PBU, stab
>of the SIJ, investigations into the deep fibers of the MF vs. the
>superficial fibers and investigating the cervical musculature.
>
> Jason
> ----- Original Message -----
> From: John Spencer
> To: [log in to unmask]
> Sent: Saturday, August 17, 2002 8:29 AM
> Subject: Re: Movements not Muscles?
>
>
> Thanks Jason
>
> I will try and be patient.
>
> My frustration is that some list members seem to pay great lip service
>to high-quality evidence in terms of well-controlled research - except when
>it contradicts their own belief systems.
>
> In response to accusations of Dynamic Stability being 'basically
>flawed' and "a fashionable fad" I have provided considerable lists of high
>quality research ('extraordinary evidence' to use Mels's phrase), performed
>by whole departments of well-qualified academics with Doctorates and
>post-graduate degrees, research that has been published in some of the most
>heavily peer-reviewed journal in the world (eg 'Spine'), research that has
>won awards from professional bodies that specialise in this area, research
>that has been funded by some of the most pedantic funding bodies in the
>world (eg The European Space Agency), research that has been repeated by
>academics around the world, supporting the initial researchers conclusions.
>
> In return I have received NOT A SINGLE REFERENCE (ie a reference with
>author's names, title of article, Journal name, volume number and page
>numbers) that contradicts this research. Nor has the list seen even a
>single attempt to intelligently criticise the basic premise of Dynamic
>Stability and I must be honest in saying that some contributors are
>betraying a profound ignorance of the actual research - when I ask (as I
>have done on several occasions) for an explanation of why they see a flaw
>in the basic premise it all goes very quiet.
>
> I would be so delighted if some of the academics on this list that
>disagree with my conclusions would quote this research directly and
>criticise it with an acute eye for contradictions. I would be happy if they
>would just supply me with references for a few articles that counter these
>researcher's conclusions. Unfortunately the response seems to be one of "I
>disagree with their basic premise" - or "I have tried this techniques and
>it doesn't work for me and other colleagues have reported difficulties with
>it - so the reseach must be flawed", or "I'll believe it when I see the
>evidence" - or "I have other techniques that work better" -
>
> So far we have had (some months ago now) articles quoted that related
>to people being unstable on their feet - (the person who referred these
>articles to the list thought that Dynamic Instability was about people
>being unable to stay upright) and lots of anectdotal stories. Frank has
>been good enough to refer to articles that he says contradict my
>contentions but unfortunately we have to pay to read them - (but at least
>he referred to research). Apart from that - nothing of substance. I am
>totally sympathetic to practitioners writing in like Emilie who find
>outcomes are dissapointing (though she admits to the convincing outcomes
>that other seem to have had). My frustration is with academics who are
>unable to use basic principles of academia to counter an argument.
>
> I have news for this list - the techniques that physiotherapy have
>used for the last 100 years ARE FAILING TO DEAL WITH THE EPIDEMIC OF LOW
>BACK PAIN.
>
> I suggest you read books such as that by Gordon Waddell "The Back Pain
>Revolution" (an ex-surgeon who, distressed by the ineffectiveness of
>surgery to stem the back-pain tide looked at the epidemiology of LBP). His
>assessment (based on researched evidence not the self-important claims of
>so many of us therapists) shows that we are failing our patients profoundly
>in this area. There is no evidence that our techniques have anything but
>short-term effects - we fail to deal with recurrent or persistent back pain
>- if you have an 'altenative' method you use that reduces long-term
>recurrence in LBP lets hear about it - and lets read the evidence!
>
> Anectdotal evidence that your techniques for persistent LBP 'really
>work' just DONT CUT THE MUSTARD. Vague assertions that you "really don't
>agree with these dynamic stability ideas" are unimpressive and unconvincing
>in the face of (I believe) overwhelming evidence that Dynamic Stability
>techniques work - in the hands of competent, skilled practitioners.
>
> If, as some of you say, you don't believe that there is any
>association between LBP and Trb or MTf dysfunction - FINE! But PLEASE come
>up with some explanation as to why the published research has shown strong
>associations between first-onset back pain and loss of x-sectional area of
>Multifidus. Explain why, in a population with LBP TrAb has such MEASURABLE
>significant changes in Timing and Quality of contraction. Offer an
>alternative explanation as to how 'blinded' practitioners using a pressure
>biofeedback unit were able to clearly distinguish between people with a
>history of LBP and people who had no such history (despite the fact they
>had no other evidence for these individual's LBP history other than their
>ability or inability to perform a TrAb contraction).
>
> What I am trying to say to the academics on this list is fight
>evidence with evidence, not with personal predjudices and anectdotal
>stories.
>
> My feeling Jason is this. I think that some people's first experience
>of Dynamic Stability work has been via the health and fitness industry
>where silly claims, unsupported by research are being made and (as Mel
>rightly says) it is being made into a money making 'fad'. However, having
>bought that prejudice to the list I think that it has now been effectively
>challenged by plenty of extraordinary evidence that some people have been
>previously unaware of - and they are finding it hard to digest this
>evidence that contradicts their previously held assumptions. This is what
>Mel has previously referred to as 'congnitive dissonance' - the
>contradication between what somebody believes to be true (an emotional
>attachment to a truth) and what the evidence suggests is true (an
>intellectual, more 'objective' truth). I think we are seeing some exapmles
>of cognitive dissonance on the list (people find having their emotional
>'truths' questioned quite threatening).
>
> Now this might all seem pretty confrontational and perhaps it is . All
>I am asking is that those who should know better 'put up or shut up' so to
>speak. I mean it when I say that, on a personal level, I have considerable
>respect for any colleague who is willing to enter such a public arena with
>their views. However, on a professional level it concerns me that there is
>an unwillingnmess to admit that the evidence contradicts one's previously
>held beliefs and so (courageously change those beliefs).
>
> This isn't about personal reputation or pride - its about the future
>direction of our profession. Either it is going to have the courage to
>address the fact that it is failing to address the crippling epidemic of
>LBP affecting the Western World (The World Health Organisation points to
>LBP along with cardiac problems and AIDS as the most concerning health
>issues of the coming decade) and turn towards Evidence Based Medicine and
>Research that can direct the profession's efforts towards clinical
>techniques that are proven to be effective or it will stay in the 'safe'
>shadows of personal anectdotal opinion, unwilling to intelligently assess
>the researched evidence, uncomfortable with the unsettling accusing finger
>of scientific evidence that asks we constantly re-address our 'traditional'
>views about clinical practice we are familiar and comfortable with.
>
>
> John Spencer
> ----- Original Message -----
> From: Jason Steffe
> To: [log in to unmask]
> Sent: Friday, August 16, 2002 11:07 PM
> Subject: Re: Movements not Muscles?
>
>
> John
>
> I went down this road with Mel about 8 months ago. It won't do you
>any good. It will only frustrate you more.
>
> Jason
> ----- Original Message -----
> From: [log in to unmask]
> To: [log in to unmask]
> Sent: Friday, August 16, 2002 6:07 PM
> Subject: Movements not Muscles?
>
>
> John Spencer <[log in to unmask]> writes:
>
> << Perhaps if you were more familiar with this 'apparent fact' you
>would be
> aware that the research doesn't just indicate TrAb activation "in
>a given
> limited situation" but in both upper and lower limb movements, at
>varying
>
> speeds, as well as during trunk perturbation (expected and
>unexpected),
> independent of direction of movement. >>
>
> *** I have seen many of those studies and each one has been
>carried out
> according to a certain protocol with specific scope and
>limitations, as is
> the case with all scientific studies. Their findings still do not
>imply
> universality under all non-pathological conditions. Have you
>read any
> studies which have examined the differences in TrAb involvement
>during
> cocontractive vs ballistic conditions (for more details of these
>different
> types of movement, see Basmajian, "Muscles Alive")? For example,
>please
> cite any references where TrAb monitoring has been carried out
>under the
> complex ballistic and explosive conditions which are typical in
>many sports.
> Some of the free standing floor exercises, saltos and manoeuvres
>in Olympic
> gymnastics or the high jump might be interesting starting points.
>
> Dr Mel C Siff
> Denver, USA
> http://groups.yahoo.com/group/Supertraining/
>
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