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PHYSIO  August 2002

PHYSIO August 2002

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Subject:

Re: A Question of Posture

From:

John Spencer <[log in to unmask]>

Reply-To:

- for physiotherapists in education and practice <[log in to unmask]>

Date:

Fri, 16 Aug 2002 16:38:44 +0100

Content-Type:

text/plain

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text/plain (145 lines)

> OK John
>
> The first refernce (which I think you are aware of) is
>
> (O'Sullivan PB, Twomey LT, Allison GT 1997 Evaluation of specific
> stabilising exercise in treatment of chronic low back pain with radiologic
> diagnosis of or spondlolisthesis. Spine 22: 2259 2267) This showed
> improvement in function and pain levels and function even at 30 months
> post-intervention compared to control.
>
> You could also look at: Hides JA, Richardson JA and Jull GA (1996),
> Multifidus muscle rehabilitation decreases recurrence of symptoms
following
> first episode of LBP. In Proceedings of the National Congress of the
> Australian Physiotherapy Association, Brisbane).
>
>  and ...  Hides JA 1996 Multifidus recovery in acute LBP patients. Phd
> thesis, Dept of Physiotherapy, Univ of Queensland (might be hard to get
hold
> of!)
>
> This research ( a randomised, controlled clinical trial) showed that in
> people with first onset LBP the Multifidus muscle had reduced in
> cross-sectional area on the side of the LBP and at the same level at the
> dysfunction (as determined by palpation). The reduction in cross section
was
> determined by an experienced radiaographer using U/S scan and 'blinded' as
> to the results by palpation.
>
> TrAb and MTf training over a 4 week period restored the x-sectional area
of
> MTf and had a significantly lower recurrence rate of LBP in the 12 months
> following treatment.
>
> The 1 and 3 year outcomes for LBP recurrence with TrAb training are
reported
> in Spine (One of the authors was P Hodges) and I will chase up the
refernces
> over the weekend (papers at home).
>
>
>
>
>
>
>
>
> John Spencer
> ----- Original Message -----
> From: "John Dufton" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, August 16, 2002 2:59 AM
> Subject: Re: A Question of Posture
>
>
> hello john,
> sorry to trouble you, particularly because i am entering this thread late.
> But perhaps you could provide the references to your points (paricularly
> point 2)below so i could take a look at the original works.
>
> I have read the paper regarding spondylo and stabilization, but i am not
> aware of the other ones you refer to.  Personally i have not found these
> techniques have out performed other techniques that i have used. However i
> do find them more time consuming to teach to patients.  They not yet been
> endoresed by any national guidelines quite yet either as far as i know
(i.e
> AHCPR, UK, Denmark, etc). Nonetheless, if stabilization has been shown to
> reduce recurrent bouts of lbp compared to other interventions that would
be
> a quite an interesting read.
>
> Thanks,
> John Dufton DC
> Vancouver, BC
>
>
>
>
>
>
> _________________________________________________________________
> Join the world's largest e-mail service with MSN Hotmail.
> http://www.hotmail.com
>
>
>
>
John Spencer
----- Original Message -----
From: "John Dufton" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, August 16, 2002 2:59 AM
Subject: Re: A Question of Posture


hello john,
sorry to trouble you, particularly because i am entering this thread late.
But perhaps you could provide the references to your points (paricularly
point 2)below so i could take a look at the original works.

I have read the paper regarding spondylo and stabilization, but i am not
aware of the other ones you refer to.  Personally i have not found these
techniques have out performed other techniques that i have used. However i
do find them more time consuming to teach to patients.  They not yet been
endoresed by any national guidelines quite yet either as far as i know (i.e
AHCPR, UK, Denmark, etc). Nonetheless, if stabilization has been shown to
reduce recurrent bouts of lbp compared to other interventions that would be
a quite an interesting read.

Thanks,
John Dufton DC
Vancouver, BC


>
>
>1) there is a very strong correlation between people with a measurable
>(scientifically measurable that is) dysfunction in TrAb timing and
>recurrent low back pain
>
>2) that addressing this dysfunction by using techniques available to us all
>in our clinics the researchers (physiotherapists) have been able to show
>the largest single reduction in recurrence rates of low back pain ever
>demonstrated in an intervention initially over a 12 month and now a 36
>month period.
>
>3) this research, having been repeated in various fashions by clinicians
>around the Western world, has been shown to be positive in clinical
>outcomes for a whole range of patients ith low back pain from ballet
>dancers to post-partum women with SI joint dysfunction.
>
>Why do you feel that a clincal model that is convincing in its ability to
>reduce recurrence rates of low back pain irrelevant to your patients?
>
>
>
>
>John Spencer




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