Postural Stability And Spinal Movement In Chronic Low Back Pain

For the first time, international scientific and clinical leaders have collaborated to present this exclusive book which integrates state-of-the art engineering concepts of spine control into clinically relevant approaches for the rehabilitation of low back pain. Spinal Control identifies the scope of the problem around motor control of the spine and pelvis while defining key terminology and methods as well as placing experimental findings into context. Spinal Control also includes contributions that put forward different sides of critical arguments (e.g. whether or not to focus on training the deep muscles of the trunk) and then bring these arguments together to help both scientists and clinicians better understand the convergences and divergences within this field. On the one hand, this book seeks to resolve many of the issues that are debated in existing literature, while on the other, its contributing opinion leaders present current best practice on how to study the questions facing the field of spine control, and then go on to outline the key directions for future research. Spinal Control – the only expert resource which provides a trusted, consensus approach to low back pain rehabilitation for both clinicians and scientists alike! Covers the most important issues in spine control research Illustrates the clinical relevance of research and how this is or can be applied in clinical practice Edited and written by world leading experts, contributing first class content on different aspects of spine control Chapters that bring together the expertise of these world leaders on topics such as neuromotor mechanisms of spine control, proprioception, subgrouping in back pain and modelling spine stability An extensive and illustrated clinical consensus chapter that brings together the philosophies of clinical opinion leaders for the first time

Extensively illustrated and evidence based, Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines helps you effectively diagnose and manage musculoskeletal pain. It discusses diagnostic categories and their associated muscle and movement imbalances, and makes recommendations for treatment. Also covered is the examination itself, plus exercise principles, specific corrective exercises, and the modification of functional activities. Case studies provide examples of clinical reasoning, and a companion Evolve website includes video clips of tests and procedures. Written and edited by the leading experts on muscle and movement, Shirley Sahrmann and associates, this book is a companion to the popular Diagnosis and Treatment of Movement Impairment Syndromes. An organized and structured method helps you make sound decisions in analyzing the mechanical cause of movement impairment syndromes, determining the contributing factors, and planning a strategy for management. Detailed, yet clear explanations of examination, exercise principles, specific corrective exercises, and modification of functional activities for case management provide the tools you need to identify movement imbalances, establish the relevant diagnosis, and develop the corrective exercise prescription. Case studies illustrate the clinical reasoning used in managing musculoskeletal pain. Evidence-based research supports the procedures covered in the text. Over 360 full-color illustrations -- plus tables and summary boxes -- highlight essential concepts and procedures. A companion Evolve website includes video clips demonstrating the tests and procedures and printable grids from the book.

This volume provides a review of the definition, biomechanics, physiopathology, clinical presentation, diagnosis and treatment of lumbar segmental instability. The contributors address the controversies surrounding this condition and offer clinicians guidance in choosing appropriate and cost-effective therapy.

In this volume, world authorities on spinal surgery from the fields of Neurosurgery, Orthopaedic Surgery, and Neuroscience present current data on the basic science and clinical management of the unstable spine. Unique to this book: a frank presentation of controversies in the field.

The human pelvis, in particular movement at the pelvic joints, has recently become the focus of a number of major research programmes. The outcomes of this research are giving rise to a new set of questions with important clinical implications. These questions include: Is the consideration of the lumbar spine and pelvis as separate entities an obstacle to the effective treatment of back pain? What are the similarities between lumbopelvic pain and peripartum pain? Does the latest anatomical and biomechanical research provide the missing links? How is the stability of the pelvis maintained? What effect does lumbar spine surgery have on pelvic stability? What is the relevance of the latest kinematic findings to the prevention and treatment of low back pain? Movement, Stability and Low Back Pain brings together the latest findings which help to provide the answers to these questions. Back pain is one of the most common clinical problems in modern society. Its safe and effective management concerns many professional groups from gynaecologists and midwives to physiotherapists, osteopaths, chiropractors and orthopaedic surgeons.

This book presents the latest information and research on the prevention and management of musculoskeletal pain and dysfunction. It introduces the reader to an approach to clinical management and prevention based on that research. This text's impressively thorough coverage makes it an indispensable text for both researchers and clinicians in the field of musculoskeletal pain and dysfunction.

Abstract: Low back pain (LBP) is one of the most common medical problems, afflicting around 80% of the world's population at one time or other in their lifetime. The LBP episodes usually resolve quickly but a high number of individuals often relapse and suffer repeated episodes of LBP. This leads to a loss in work productivity and a decrease in their quality of life. Hence, it becomes imperative to understand and possibly correct the underlying factors responsible for recurrent LBP. Alterations in trunk muscle response patterns such as delays in muscle onset times, increased agonist/antagonist co-activation levels, and loss of anticipatory control have been observed in subjects with LBP. Altered muscle responses contribute to impaired postural control and instability which may be a contributing factor to the recurrence of LBP. Stabilization exercise programs have been shown to decrease the risk of LBP recurrence in a select group of patients with acute, first episode LBP. However, there is little evidence to demonstrate if the stabilization exercise program influences the underlying neuromuscular control of the spine and postural stability. Hence, the purpose of this study was to determine whether a 10-week stabilization exercise program improved postural stability or altered the neuromuscular control in subjects with LBP. Two experiments were designed for that purpose: 1) A sudden perturbation test to assess the trunk muscle reflex responses, and 2) A seated postural control task to assess postural stability and trunk equilibrium control. 30 subjects (15 subjects with sub acute recurrent LBP, 15 healthy) aged between 18-55 years participated in the study. The LBP group was tested before (PRE) and after (POST) the 10-week physical therapy intervention program. The healthy control (CNTL) group was tested on one occasion. In the sudden perturbation test it was observed that the subjects with LBP at PRE therapy had delayed and dampened trunk muscle reflexes compared to the CNTL group subjects. Postural stability assessed using a fractional Brownian motion analysis of the force plate data from the wobble chair revealed that the subjects with LBP at PRE therapy had increased postural sway and large trunk displacements. In addition, the subjects with LBP displayed compensatory flexor activation during the seated postural task compared to the CNTL group subjects. At POST therapy in the subjects with LBP, the reflex responses remained delayed but there was a significant increase in the reflex amplitudes. In the seated postural task, there was a decrease in the postural sway and a reduction in the compensatory trunk flexor activity. In addition compared to the CNTL group, the LBP group at POST therapy demonstrated increased extensor activity. In conclusion, a 10-week stabilization program improved the neuromuscular control of the spine and postural stability in subjects with LBP.