Lynda

Yes, its interesting that Pilates and yoga also work on what seem to be
'core stability' principles too.

However, I am still unconvinced by Anna's assertion that there is a
"significant body of evidence on other exercise having good
outcomes in LBP rehab as well" - though I am prepared to stand corrected.

John Spencer

----- Original Message -----
From: "Lynda Bennett" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, August 22, 2002 12:04 PM
Subject: Re: Movements not Muscles?


> 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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