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John, You said: "I don't really understand why you would advocate [...] extension in treatment epecially when it is painful." *FC: I don't. I only do if repeated extension proves to significantly reduce the complaints. Chances are not great that that will happen, in *juvenile* spondies, but you wrote that extension should be avoided, without making any exception. And you seem to have based that statement on a study that showed the opposite. You asked: "I may have got the wrong end of the sticvk from the abstract but isn't the extension treatment they talk about in Spratt et al a brace to prevent that movement rather than exercises to promote it?" * FC: You indeed have got the wrong end of the stick. From the full text: "The Extension Treatment was designed to maintain lumbar extension or lordosis. Each patient was fitted with a Camp hyperextension brace (Camp International, Inc. Jackson, MI) with a pelvic basin, instructed by a physical therapist in the proper techniques for performing a series of McKenzie-type exercises [ref.], and viewed an audio/slide presentation emphasizing the value and necessity of maintaining lordotic postures and presenting various coping strategies to maintain lordotic postures." So, would I advise the above treatment? No. That is, not without an assessment proving that that is the way to go. R., Frank ----- Oorspronkelijk bericht ----- Van: John Willenbruch Aan: [log in to unmask] Verzonden: vrijdag 8 augustus 2003 8:08 Onderwerp: Re: spondylolisthesis! I would agree that in a case where it appeared that if a person had a symptomatic discogenic problem and an asymptomatic spondylolisethesis limiting there extension would be unnecessary, and encouraging extension may even be advisable, but Nabil describes a situation with a symptomatic spondylolisethesis and no other pathology. I don't really understand why you would advocate either a McKenzie assessment or promoting extension in treatment epecially when it is painful. I may have got the wrong end of the sticvk from the abstract but isn't the extension treatment they talk about in Spratt et al a brace to prevent that movement rather than exercises to promote it? Cheers, John