JiscMail Logo
Email discussion lists for the UK Education and Research communities

Help for PHYSIO Archives


PHYSIO Archives

PHYSIO Archives


PHYSIO@JISCMAIL.AC.UK


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

PHYSIO Home

PHYSIO Home

PHYSIO  August 2003

PHYSIO August 2003

Options

Subscribe or Unsubscribe

Subscribe or Unsubscribe

Log In

Log In

Get Password

Get Password

Subject:

Re: spondylolisthesis!

From:

nabil keshavjee <[log in to unmask]>

Reply-To:

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

Date:

Thu, 7 Aug 2003 16:01:51 -0400

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (121 lines)

Thanks for the additional info, John and Frank.

When doing repeated tests, ie extensions, I only made
her do 5 repetitions, as the pain increased, after the
second rep, and continued increasing after each
repetition.  I do not know whether I should push this
further.  I guess being somewhat cautious given the
x-ray diagnosis.
As for lumbar stabilization, my knowledge is maybe
somewhat limited.  I started with recruiting,
transverse abdominus, in supine, for teaching and
awareness of the patient.  This followed by being able
to recruit in sitting and standing.  Also doing
alternate leg lifts, in supine while contracting
transverse and maintaining a neutral spine.
Teaching multifidi, first in sidelying, or in prone.
Sidelying during this case.  Have followed that by
going on all 4s, concracting transverse, then
simultaneously lifting the arm and alternate leg,
maintaining neutral spine.  In this case I am not
allowing full leg extension.
Should I be adding anything to this regime....
Was thinking of adding some ball exercise when I am
confident in her recruitment of lumbar stabilizers.

Nabil

 --- Frank Conijn <[log in to unmask]> wrote: > John,
>
> I know that there is a difference between juvenile,
> overtraining-related spondy and adult, degenerative
> spondy. That difference may even be enormous (it is
> not even sure that the complaints in adults with
> spondies are caused by that spondy, since it is also
> seen in asymptomatic subjects). Nevertheless, in
> adults Spratt et al (1) found an extension regime to
> be more effective than a flexion. That study was one
> of the two found to be inclusion-worthy, in a recent
> systematic review (2). (The other one was the one by
> O'Sullivan et al [3], who found positive results
> with a stabilization program.)
>
> Avoiding extension would seem logical, since that is
> the painful movement. However, you cannot be sure
> until you do a repeated-movements assessment (a la
> McKenzie): response to repeated movements can be
> very different from the response to a single or just
> a few movements.
>
> My advice to have the girl (at least for the time
> being) give up gymnastics still stands, regardless
> of what kind of treatment would work. But to avoid
> extension? I'd suggest to Nabil to have a McKenzie
> assessment done first (by a credentialled McK. PT).
> Stabilization exercises can be given without a
> problem, and should have effect.
>
>
> References:
> 1. Spratt KF, Weinstein JN, Lehmann TR et al.
> Efficacy of flexion and extension treatments
> incorporating braces for low-back pain patients with
> retrodisplacement, spondylolisthesis, or normal
> sagittal translation. Spine 1993 Oct
> 1;18(13):1839-49.
> 2. McNeely ML, Torrance G, Magee DJ. A systematic
> review of physiotherapy for spondylolysis and
> spondylolisthesis. Man Ther. 2003 May;8(2):80-91.
> 3. O'Sullivan PB, Phyty GD, Twomey LT, Allison GT.
> Evaluation of specific stabilizing exercise in the
> treatment of chronic low back pain with radiologic
> diagnosis of spondylolysis or spondylolisthesis.
> Spine 1997 Dec 15;22(24):2959-67.
>
>
>
> R.,
> Frank
>
> F.J.J. Conijn, PT
> Editor, Physical Therapist's Literature Update
> The Internet Journal of Literature Updates for
> Clinicians in Primary Care Orthopaedic Medicine &
> Rehabilitation
> www.ptlitup.com
>
>
> ----- Oorspronkelijk bericht -----
> Van: John Willenbruch
> Aan: [log in to unmask]
> Verzonden: donderdag 7 augustus 2003 11:51
> Onderwerp: Re: spondylolisthesis!
>
>
> Dear all,
>
> I remember reading a study a while back about
> patients who were put in braces to prevent extension
> which seemed to have reasonably good results if it
> was over a long period of time and included
> cessation of provoking activity (diving, fast
> bowling and gymastics).
>
> As a physio all I could suggest is advice (avoiding
> extension and ? rapid deceleration) and transversus
> abdominus exercises.  I had an asymptomatic
> spondylolisetheis surgically fixed which was OK
> (although it cramped my style at uni in a hip
> spica), it was apparently to prevent degeneration in
> later life, which might be a consideration.
>
> Good luck,
>
> John Willenbruch
>
> PS Which lumbar stabilisation exs have you been
> doing?
>

______________________________________________________________________
Post your free ad now! http://personals.yahoo.ca

Top of Message | Previous Page | Permalink

JISCMail Tools


RSS Feeds and Sharing


Advanced Options


Archives

April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
October 2010
September 2010
August 2010
July 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004
September 2004
August 2004
July 2004
June 2004
May 2004
April 2004
March 2004
February 2004
January 2004
December 2003
November 2003
October 2003
September 2003
August 2003
July 2003
June 2003
May 2003
April 2003
March 2003
February 2003
January 2003
December 2002
November 2002
October 2002
September 2002
August 2002
July 2002
June 2002
May 2002
April 2002
March 2002
February 2002
January 2002
December 2001
November 2001
October 2001
September 2001
August 2001
July 2001
June 2001
May 2001
April 2001
March 2001
February 2001
January 2001
December 2000
November 2000
October 2000
September 2000
August 2000
July 2000
June 2000
May 2000
April 2000
March 2000
February 2000
January 2000
December 1999
November 1999
October 1999
September 1999
August 1999
July 1999
June 1999
May 1999
April 1999
March 1999
February 1999
January 1999
December 1998
November 1998
October 1998
September 1998
August 1998
July 1998
June 1998
May 1998
April 1998
March 1998


WWW.JISCMAIL.AC.UK

Secured by F-Secure Anti-Virus CataList Email List Search Powered by the LISTSERV Email List Manager