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Заголовок сообщения: Physical Therapy articles

СообщениеДобавлено: 13 авг 2012, 08:20

Chiropractic Philosophy & Technique

The Story of the Sacral Base: Evidence-Informed Technique Rumination

By Robert Cooperstein, MA, DC


A Sacral Conundrum
Years ago, I was browsing through a selfpublished chiropractic technique book written by an instructor at one of the colleges. I unexpectedly came across a passage in which the author expressed his existential despair over the mysteries of the subluxated sacrum. He wrote:

It is a Gonstead premise that the sacrum will always rotate posteriorly on the inferiorly tipped side. I have not been able to locate the biomechanical explanation underlying this premise within the Gonstead literature . . . Logan Basic Technic is based on the foundation of an anterior-inferior sacrum. Janse, Illi, and other chiropractic researchers consider sacral misalignments other than posterior-inferior.

This author, your very own truly humble narrator, can shed no new light on this issue. That’s an interesting question. Often enough, we can see that the sacral base has dipped inferiorly on one side, as seen on a radiograph or surmised from the obvious observation of pelvic obliquity in a standing patient. I agree with the cited instructor that in the Gonstead system, this inferior sacrum would be judged to have also subluxated posteriorly, whereas in most other technique systems (and not merely in Logan technique, as the instructor suggests), the inferior sacrum would be judged anterior, as well. We see this particularly well described in Thompson Technique.

Well, which is it: posterior-inferior or anterior-inferior? Can we shed any new light on the issue?

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Заголовок сообщения: Re: Physical Therapy articles

СообщениеДобавлено: 13 авг 2012, 08:26

The painful dysfunctional shoulder. A new treatment approach using ‘Mobilisation with Movement’

Brian Mulligan FNZSP (Hon). Dip MT

The literature that describes the concept of ‘Mobilisation with Movement’ (‘MWM’) does not include specific ‘MWM’ techniques for the shoulder girdle. These techniques, which have only been developed over the last two years, appear to be clinically effective and are therefore an important addition to the existing repertoire of ‘MWM’ techniques.
Brian Mulligan. The Painful Dysfunctional Shoulder. A New Treatment Approach Using ‘Mobilisation with Movement’. New Zealand Journal of Physiotherapy 31(3): 140-142.

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СообщениеДобавлено: 13 авг 2012, 08:29

Mulligan’s MWM for soft tissue injuries like tennis elbow: Its application & the evidence

Bill Vicenzino
Professor in Sports Physiotherapy
Head of Division of Physiotherapy


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СообщениеДобавлено: 27 авг 2012, 11:35

Fascial Fitness: Training in the Neuromyofascial Web

by Thomas Myers

Research shows why taking a different approach to exercise and the movement brain is the wave of the future.

If you are interested in the role of fascia in fitness training, the following questions lead to new takeaways:
• Most injuries are connective-tissue (fascial) injuries, not muscular injuries—so how do we best train to prevent and repair damage and build elasticity and resilience into the system?
• There are 10 times more sensory nerve endings in your fascia than in your muscles; therefore, how do we aim proprioceptive stimulation at the fascia as well as the muscles?
• Traditional anatomy texts of the muscles and fascia are inaccurate, based on a fundamental misunderstanding of our movement function—so how can we work with fascia as a whole, as the “organ system of stability”?

Consciously or unconsciously, you have been working with fascia for your whole movement career—it is unavoidable. Now, however, new research is reinforcing the importance of fascia and other connective tissue in functional training (Fascia Congress 2009). Fascia is much more than “plastic wrap around the muscles.” Fascia is the organ system of stability and mechano-regulation (Varela & Frenk 1987).

Understanding this may revolutionize our ideas of “fitness.” Research into the fascial net upsets both our traditional beliefs and some of our new favorites as well. The evidence all points to a new consideration within overall fitness for life—hence the term fascial fitness. This article lays out the emerging picture of the fascial net as a whole and explores three of the many aspects of recent research that give us a better understanding of how best to train the fascial net.

The Neuromyofascial Web
Fascia is the Cinderella of body tissues—systematically ignored, dissected out and thrown away in bits (Schleip 2003). However, fascia forms the biological container and connector for every organ (including muscles). In dissection, fascia is literally a greasy mess (not at all like what the books show you) and so variable among individuals that its actual architecture is hard to delineate. For many reasons, fascia has not been seen as a whole system; therefore we have been ignorant of fascia’s overall role in biomechanics.
Thankfully, the integrating mechano-biological nature of the fascial web is becoming clearer. It turns out that it really is all one net with no separation from top to toe, from skin to core or from birth to death (Shultz & Feitis 1996). Every cell in your body is hooked into—and responds to—the tensional environment of the fascia (Ingber 1998). Alter your mechanics, and cells can change their function (Horwitz 1997). This is a radical new way of seeing personal training—stretching, strengthening and shape-shifting—as part of “spatial medicine” (Myers 1998).
Given the facts, many would prefer the term neuromyofascial web to the fascia-dissing musculoskeletal system (Schleip 2003). As accustomed as we are to identifying individual structures within the fascial web—plantar fascia, Achilles tendon, iliotibial band, thoracolumbar aponeurosis, nuchal ligament and so on—these are just convenient labels for areas within the singular fascial web. They might qualify as ZIP codes, but they are not separate structures (see the sidebar “Muscle Isolation vs. Fascial Integration”).
You can talk about the Atlantic, the Pacific and the Mediterranean oceans, but there is really only one interconnected ocean in the world. Fascia is the same. We talk about individual nerves, but we know the nervous system reacts as a whole. How does fascia webbing function as a system?

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Заголовок сообщения: Re: Physical Therapy articles

СообщениеДобавлено: 28 авг 2012, 02:36

Layperson писал(а):
Fascial Fitness: Training in the Neuromyofascial Web by Thomas Myers

Ссылки на оригинальную публикацию статьи на сайте журнала:
и на авторском сайте:

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Заголовок сообщения: Re: Physical Therapy articles

СообщениеДобавлено: 12 сен 2012, 14:02

Masgutova NeuroMotor Reflex Integration Foot Imprinting

Brian Esty

Examination of potential for change of the load bearing properties of feet as a result of global NeuroMotor Reflex Integration therapy.

I imaged the feet of five children at the MNRI Buena Park Camp 1/19/10 – 1/28/10. Verbal permission was given for each set of prints with a brief explanation that the images were to be used for research. An ink based Bauerfierld Foot Imprinter was used. Due to the challenges the subjects faced (Autism / CP / SPD) it was extremely difficult to make clean prints. I recommend that if a larger study is taken, a digital imprinter be used as an instantaneous snapshot will be much more accurate.
Prints were made as close to the beginning and end of the camp as possible. Every child had at least 36 hours of therapy between prints. No special attention was made to work on the feet of any child. Four of the five print sets showed identifiable change toward more efficient load bearing. However, due to the challenges in making the images, much of this change is in the range of variance. The images shown here are demonstrate the most dramatic differences. For this report, the images were photocopied, physically cut and taped together to maintain scale and then scanned.

The MNRI camp environment changes the neuromotor dynamics of stance. Stance is a good indicator for lower level active neuromotor control. Therefore these images indicate the MNRI camp changes activity in the Brain Stem / Cerebrum region.

Foot dynamics are notoriously difficult to change, and it is normal to resort to
surgical interventions to achieve the type of result presented with these images.
Therefore, I believe that imprinting feet is strong evidence for the efficacy of the MNRI camp protocol. Given that Reflex Integration focuses on lower level brain function, I postulate that this may provide a clearer picture than the use of EEG to demonstrate positive change.

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Заголовок сообщения: Re: Physical Therapy articles

СообщениеДобавлено: 22 сен 2012, 05:41

For PTs

- The 5-Step Functional Approach
- Evaluation and Treatment of Unilateral Sacrums with Concurrent Ilial and Coccygeal Dysfunctions
- Function and Pain Inventory (FAPI)
- Navicular "Up-Down-Up" Tape Job
- Soft Tissue Mobilization (STM)
- Proprioceptive Neuromuscular Facilitation (PNF)
- Lumbar Protective Mechanism (LPM)
- Pre-Affiliation Instructions (PDF)


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Заголовок сообщения: Re: Physical Therapy articles

СообщениеДобавлено: 06 окт 2012, 14:26

Arthur Akhmetsafin - Craniosacral technique and Chinese Medicine
Артур Ахметсафин - Краниосакральная техника и Китайская медицина

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СообщениеДобавлено: 02 дек 2012, 02:07


Workshop Presented at the Second International Research Congress
Vrije Universiteit, Amsterdam

October 31, 2009

Steven Finando Ph.D., L.Ac.
Donna Finando, M.S., L.Ac., L.M.T.


The idea that there is a relationship between the fascia and acupuncture is not a new one. The earliest reference to the fascia can be found in centuries-old Oriental medical literature. One of the oldest known classics on acupuncture, the Nei Ching (The Yellow Emporer’s Canon of Internal Medicine), circa 200 BC, consisted of two fundamental sections,
the Su Wen, (Fundamental Questions) and the Ling Shu, (Spiritual Axis). As was common at that time, language couched in metaphor and metaphysics was used to describe anatomical structures and functions. However, it is important to recognize that medical thinkers of the time had a clearer understanding of human anatomy than is generally recognized. The classical texts contain information that indicates that the ancient Chinese physicians had considerable awareness of the body’s inner structure. Tissues and fasciae were known to have an important role in human function, such as forming enclosures for each of the organs and connecting the organs to one another. The size, shape and functions of the organs and blood vessels were identified, as well as the pathways between organs and membranes (Matsumoto and Birch, 1988). The Ling Shu describes ‘fatty, greasy’ tissues and connecting membranes. Channels are described as keeping the bones and sinews moistened and the joints lubricated (Matsumoto and Birch, 1988, p. 133). In the Su Wen we find a statement indicating that the channels are located within the ‘body lining.’ Early physicians were locating the theoretical channels within the fascia. Thus, we can see that there is an ancient notion that channels are located within the fascia. We can also say that while the locus of treatment, the fascia, was clearly identified, it appears that a belief was held that a separate system was being affected: the channel system1.

In a later classic, the Nan Jing (Classic of Difficult Issues), circa 20 AD, we see that the channel system had evolved into one that included fourteen interconnected channels. A significant phrase taken from the Nan Jing describes the ‘fat, greasy membranes’ as the ‘space between the organs, bones and flesh…..through which the yang qi streams’ (Matsumoto and
Birch, 1988, p 136). Channels had taken on definition and purpose. Acupuncture points were defined and the notion of the circulation of qi via the channels had been developed (Birch and Felt, p 19). Acupuncture points were chosen for use by skilled palpation of the body and were treated with the aim of balancing the flow of qi throughout the channel system.

Some modern acupuncturists have suggested that acupuncture might be referred to as connective tissue therapy (Nagahama, 1958). Yet, with some exceptions, very few acupuncturists have embraced such ideas, although the research community is coming close to achieving the critical mass of scientific evidence to make definitive statements regarding the mechanisms underlying acupuncture therapy. The following discussion is an effort to integrate recent fascia research with ancient acupuncture philosophy and principles.

One of the great difficulties of acupuncture research is that the practice of acupuncture is far from homogeneous. Acupuncture has undergone numerous transformations over the centuries, and the sources of such transformation have been varied. Chinese thinkers were immensely practical and capable of absorbing apparently opposing ideas without replacing or negating earlier ones. They integrated whatever worked, hence the coexistence and influence on the practice of acupuncture of each of the Three Pillars of Chinese thought: Confucianism, Taoism and Buddhism. Not only has it been influenced by religious philosophy, but by political, economic and social circumstances as well. The result is a vast array of practices and principles that are all called ‘acupuncture.’

Paul Unschuld (1986) states: “A third major distortion encountered in nearly all European and American attempts to characterize traditional Chinese medicine is related to the issue of terminology; it results from efforts to squeeze an enormous array of concepts and schools of thought in traditional Chinese medicine (which are sometimes mutually contradictory, antagonistic or exclusive) into the kind of homogeneous, logically coherent system of ideas and practices that is so attractive to the Western mind.” (p. 5)

The most common conception of acupuncture today refers to an approach to treatment that was created in the middle of the twentieth century. Today, many practitioners and the lay public commonly refer to acupuncture as Traditional Chinese Medicine (TCM). TCM includes the use of traditional herbal medicines. Few realize this specific term and associated practice was a creation of the Cultural Revolution, a product of the People’s Republic of China (PRC). It was, in some sense, the effort of a reluctant Mao, who was skeptical about acupuncture, to retain the identity of Chinese medicine in a rapidly evolving trend toward modern Western medicine. The PRC established standards for the development of TCM. The first requirement was the integration of acupuncture and herbal medicine under a single set of fundamental principles. At that time, herbalists were more politically powerful than acupuncturists. The result was an acupuncture practice that was grounded upon principles that had previously been applied to the application of herbal medicines, focused on organ function rather than channel/qi disruption, and strongly connected to modern biomedicine. This approach was more conducive to large classroom instruction than apprenticeship training. It connected pattern pathology to modern disease diagnosis, and textbooks were produced that described treatments for asthma, gastritis, arthritis and a host of Western-defined diseases. In many ways this shift helped to promote and make acupuncture understandable in the West. Moreover, other forms or styles of acupuncture were banned in the PRC. Schools taught only TCM and practitioners were only allowed to practice TCM. In the West, there were very few acupuncture texts written in English, so by the 1970’s, when English translations of TCM texts were published, they quickly became the basis of many newly forming schools of acupuncture.

TCM is clearly the predominant approach to acupuncture for the PRC and much of the West. This is important, because TCM marks a major departure from the classical emphasis on palpation. It is less connected to the skill and sensitivity of the practitioner and the evaluation of channels and constriction through touch, and more reliant on the conceptualization of symptom patterns. Because it is so pervasive, many Western researchers use TCM acupuncture as the independent variable in acupuncture studies. As we will see later, the construct validity of the independent variable (acupuncture) could be greatly improved if researchers chose a more classical approach of treatment utilizing meridian-based styles as their independent variable.

A new theory must provide better explanation of phenomena and improved prediction of outcomes. For the clinician, better prediction refers to treatment outcomes. For the researcher, it is established through testable hypotheses. A theory that provides better explanation may provide new or modified clinical approaches, and can imply future directions for research. A theory, therefore, must confine itself to observable phenomena that may be explained or predicted.

While the connection between acupuncture and the fascia has been suggested for a long time, it is only in recent years, with the explosion of new research on the structure and physiology of the fascia, that a new theory, one that does not replace, but modifies the qi paradigm, can become a source of explanation and prediction regarding acupuncture practice. Extraordinary new conceptions of the fascia lend powerful evidence to the theory that the fascia is the mediating system of acupuncture. However, we must first address the issue of defining what we mean by acupuncture if we are to propose new explanations regarding its mechanism of action.

49 pages, PDF, 335 kb - Online


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