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 -----
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
