Jason Steffe<[log in to unmask]> writes:
<< Those studies are all good and well, but I feel that they are aside from
the topic of discussion. Those are primarily balance studies that are
investigating COG and BOS in response to perturbations; not the effects and
results of trunk training/rehabilitation of patients. You seem to be drawing
conclusions that are different from the original intent of the research in
order to make a point about core training/Pilates.
I totally agree that the limbs and the trunk are interdependent functionally,
but when a physical therapist treats a patient who has low back pain, he/she
cannot simply throw the pt into exercises that incorporate the L-spine to the
ankle from the get-go. There has to be a starting point which addresses the
dysfunction locally first and then a progression. Usually, we don't see the
pt long enough to be able to begin incorporating the whole kinematic chain.
Sometimes we do, but most of the time we don't. That is why we do have to
focus on one body part in the beginning...the pt in most cases won't be able
to tolerate advanced rehabilitation early on. >>
*** None of those claims and research articles which specifically focus on
the practical aspects of trunk training/rehabilitation has yet provided
definitive evidence that an isolationist approach to the problem of "core"
health and functionality is superior to a more integrated approach that
relies on the graded use of whole kinetic chain activities. Thus, it is
highly relevant to understand the nature and use of balance and allied motor
processes that are addressed in those articles. The use of whole body
methods is not necessarily advanced - it is perfectly possible to progress
from some very basic undemanding whole body regimes to far more challenging
methods. We can focus on one body part or motor quality (e.g. strength,
power, speed, endurance) at any stage of the rehabilitation prcess, be it
advanced or rudimentary - no evidence has shown that it is a 'sine qua non'
that one has to begin with only one body part.
Where is the evidence that one "cannot simply throw the patient into
exercises that incorporate the L-spine to the ankle from the get-go" ? It
simply does not exist. In fact, if one analyses the evidence in those
studies which I cited, it will be seen that they offer the foundations for
creating even more effective and logical ways of rehabilitating the spine and
movement associated with its involvement. That, essentially, is a major
reason why I provided those references - it is desirable and sometimes even
essential that we re-examine the traditional methods that tend to become
dogma with the passage of time.
Dr Mel C Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/
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