Aquatic therapy provides numerous benefits for individuals with neurological conditions. The buoyancy of water reduces the impact on joints and muscles, allowing for increased mobility and range of motion. The resistance of the water also provides a gentle yet effective form of resistance training, helping to strengthen muscles and improve overall physical function. Additionally, the hydrostatic pressure of the water can help reduce swelling and inflammation, providing pain relief for individuals with conditions such as multiple sclerosis or Parkinson's disease. The sensory stimulation provided by the water can also help improve body awareness and proprioception, which can be particularly beneficial for individuals with conditions affecting their sensory processing.
Aquatic therapy can be used to treat a variety of neurological conditions. Some of the specific conditions that can benefit from aquatic therapy include stroke, traumatic brain injury, spinal cord injury, cerebral palsy, and peripheral neuropathy. These conditions often result in motor impairments, muscle weakness, balance and coordination issues, and sensory deficits. Aquatic therapy can help address these challenges by providing a supportive and low-impact environment for rehabilitation and exercise.
Erson follows up with the difficult lumbar lateral shift patient from this episode a few weeks back. As in the past, he's doing much better and this time Erson takes care not to flare him up! Interestingly enough using the Activforce 2 handheld dynamometer reveals some significant hip and trunk rotation strength percentage differences that could be key to better prevention. Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded IndividualCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practicesKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-05-04
Introduction SummaryLow back pain (LBP) is a prevalent and costly health problem that affects a significant portion of the global population. Pain developers (PDs) are individuals who are considered a pre-clinical LBP population at risk of developing clinical LBP, which can exact great social and economic costs. Prolonged standing has been identified as a risk factor for LBP, and it is necessary to investigate the risk factors of standing-induced LBP in PDs comprehensively. By identifying these risk factors, appropriate preventive measures can be planned, which may reduce the incidence of standing-induced LBP and its associated costs.This study1 used a systematic review and meta-analysis approach to investigate the distinctive characteristics and risk factors of standing-induced LBP in PDs. The study aimed to identify statistically significant differences between PDs and non-pain developers (NPDs) in demographics, biomechanical, and psychological outcomes and to determine the pooled effect sizes of these differences. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Characteristics of Pain Developers and Non-Pain DevelopersThe systematic review and meta-analysis identified 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) that were eligible for inclusion. The studies used a prolonged standing duration greater than 42 minutes to classify adult PDs and NPDs without a history of LBP.Significant differences were found between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables. PDs exhibited altered motor control in the anterior hip abduction (AHAbd) test and displayed higher lumbar lordosis in individuals over 25 years old. These factors were found to have a statistically significant association with standing-induced LBP.Muscular differences were also identified between PDs and NPDs. PDs had a higher level of co-activation between gluteus medius and the erector spinae muscles, which can lead to increased lumbar loading and potentially contribute to the development of LBP.In terms of postural characteristics, PDs had less trunk control and increased trunk sway during standing compared to NPDs, which may suggest a lack of postural stability.Psychological characteristics were also found to differ between PDs and NPDs. PDs had higher levels of pain catastrophizing, which is the tendency to magnify the threat value of pain and to feel helpless in the face of it, and is associated with increased pain intensity and disability.Finally, anthropometric and structural differences were found between PDs and NPDs. PDs tended to have higher body mass index (BMI) and shorter stature compared to NPDs, which may result in altered spinal loading during standing.These findings suggest that PDs have distinct biomechanical and psychological characteristics that may predispose them to standing-induced LBP. Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Risk Factors for Standing-Induced Low Back PainThe systematic review and meta-analysis identified several factors that were found to have a statistically significant association with standing-induced LBP:Lumbar fidgets – Participants with PDs displayed more lumbar fidgets, defined as small voluntary or involuntary movements of the lumbar spine, which are indicative of discomfort or pain. This factor was found to have a significant negative effect size (Hedge’s g − 0.72).Lumbar lordosis in participants over 25 years – Participants with PDs had higher lumbar lordosis, defined as the natural curvature of the lumbar spine, in individuals over 25 years old. This factor was found to have a significant positive effect size (Hedge’s g 2.75).AHAbd test – Participants with PDs displayed altered motor control in the AHAbd test, which measures the ability to control the hip and pelvis while lifting one leg. This factor was found to have a significant positive effect size (WMD 0.7).Gluteus medius co-activation – Participants with PDs had higher levels of co-activation between the gluteus medius and erector spinae muscles. This factor was found to have a significant positive effect size (Hedge’s g 4.24).Pain catastrophizing – Participants with PDs had higher levels of pain catastrophizing, which is associated with increased pain intensity and disability. This factor was found to have a significant positive effect size (WMD 2.85).These risk factors suggest that altered motor control, higher lumbar lordosis, increased gluteus medius co-activation, and pain catastrophizing may predispose individuals to standing-induced LBP. The findings may help identify individuals at risk of developing standing-induced LBP and plan appropriate preventive measures.Future research should investigate the association of the reported distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. Such interventions may include physical therapy, posture correction, and mindfulness-based stress reduction, among others. Identifying modifiable risk factors may lead to the development of effective interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP.Implications for Future ResearchThe systematic review and meta-analysis identified several distinct characteristics and risk factors for standing-induced LBP in PDs compared to NPDs. However, the study authors note that the identified risk factors do not necessarily prove causality or provide a complete understanding of the mechanisms underlying standing-induced LBP. As such, future research should investigate these factors in greater detail, and identify modifiable risk factors that can be targeted for preventive interventions.The study authors recommend that future research should investigate the following areas:Association with standing-induced LBP – Further research should investigate the association of the identified distinctive characteristics and risk factors to standing-induced LBP. Studies should investigate whether these factors are predictive of standing-induced LBP and whether they are specific to standing-induced LBP or generalizable to other types of LBP.Mechanisms underlying standing-induced LBP – Future research should also investigate the underlying mechanisms of standing-induced LBP, such as the interplay between motor control, muscle activation, and posture. Understanding the mechanisms underlying standing-induced LBP can help identify modifiable risk factors and develop effective interventions.Intervention strategies – Future research should investigate the efficacy of various interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP. Such interventions may include physical therapy, posture correction, mindfulness-based stress reduction, and other strategies aimed at reducing risk factors identified in this study.Generalizability of findings – Finally, future research should investigate the generalizability of the study findings to other populations, such as individuals with clinical LBP or those with different occupational or lifestyle factors. This will help to determine the applicability of the findings to a broader population and inform the development of preventive measures for standing-induced LBP.ConclusionIn summary, this systematic review and meta-analysis found that pain developers (PDs) – individuals with a history of low back pain (LBP) – have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing. These characteristics include altered movement patterns, muscular, postural, psychological, structural, and anthropometric variables. The study also identified several risk factors associated with standing-induced LBP, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale.These findings have important implications for preventing and managing standing-induced LBP, particularly in individuals with a history of LBP. The study suggests that altered motor control displayed in the AHAbd test and higher lumbar lordosis in individuals over 25 years old are probable risk factors for standing-induced LBP. Therefore, future interventions may focus on improving motor control and reducing excessive lumbar lordosis. Additionally, the study highlights the importance of addressing psychological factors, such as pain catastrophizing, as a potential risk factor for standing-induced LBP.Overall, the study emphasizes the need for a comprehensive approach to preventing and managing standing-induced LBP, including a focus on biomechanical, psychological, and other factors. Future research should investigate the association of these distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. By identifying and addressing these risk factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.This study emphasizes the importance of developing appropriate preventive measures for standing-induced low back pain (LBP) in pain developers (PDs). PDs are individuals with a history of LBP and are considered a pre-clinical population at risk of developing clinical LBP, which can lead to significant social and economic costs. The study found that PDs have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing, which suggests that targeted interventions may be necessary to prevent standing-induced LBP in this population.The development of appropriate preventive measures requires a thorough understanding of the risk factors associated with standing-induced LBP in PDs. This study identified several risk factors, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale. These risk factors suggest that interventions targeting motor control, lumbar lordosis, and psychological factors may be effective in preventing standing-induced LBP in PDs.In addition to identifying risk factors, the study highlights the importance of comprehensive interventions that address biomechanical, psychological, and other factors associated with standing-induced LBP. These interventions may include postural education, physical therapy, and cognitive-behavioural therapy. By addressing these factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.Overall, the study underscores the importance of developing appropriate preventive measures for standing-induced LBP in PDs. Identifying risk factors and developing targeted interventions may help reduce the burden of LBP in this population and improve their overall health and well-being.Dynamic Disc DesignsDynamic Disc Designs offers dynamic anatomical models that musculoskeletal healthcare workers (chiropractors, medical doctors, physiotherapists, osteopaths) can use to help explain how the spine is impacted when one stands, for example. The models are designed to simulate the spinal movement dynamically, allowing various spinal specialists to better illustrate to patients the impact that standing can have on the spine.Using the dynamic disc model, a healthcare worker can demonstrate how the intervertebral discs are compressed when standing due to the force of gravity on the spine. They can show how the discs lose water content and height throughout the day, resulting in reduced shock absorption and increased pressure on the spinal nerves. This can lead to various symptoms, including low back pain, stiffness, and numbness or tingling in the legs. In this particular research highlighted in this post, a practitioner can explain dynamically what excessive lordosis means and how the facets are approximated in this case. Explore.Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!Learn more online - new online discussion group included!Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion GroupLive caseswebinarslectureLive Q&Aover 600 videos - hundreds of techniques and more! Check out MMT InsidersKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
![[RESEARCH REVIEW] The High Cost of Standing: Uncovering Risk Factors for Low Back Pain](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXTsCQGpK-PEaVaLh2d-4MDJt3iZYFUMfzgmUKypDoGEjgXskP71pa-s8bMk_XOK-iWRrL8pLt-vIE6tD_i8NbsgluTbBpfCrbP80CWO3oFOoSZauwQ7U375LUV9hsBh7bwaSz6BJiYSFJfEniuRnDbSGa6swxPr0DzfpYmpWkljZ5TeS2P6031Ioh/s16000/Low%20back%20pain.png)
Posted by on 2023-04-27
The main goals of aquatic therapy for individuals with neurological conditions are to improve mobility, strength, balance, coordination, and overall functional abilities. The buoyancy of water allows individuals to move more freely and with less pain, facilitating the retraining of movement patterns and the development of muscle strength. Aquatic therapy also focuses on improving balance and coordination through exercises that challenge the individual's stability in the water. Additionally, aquatic therapy aims to enhance overall functional abilities, such as walking, transferring, and performing activities of daily living, by simulating these tasks in the water environment.
The buoyancy of water plays a crucial role in aquatic therapy for neurological conditions. The buoyant force of water counteracts the effects of gravity, reducing the weight-bearing load on the individual's body. This decreased weight-bearing allows for greater ease of movement and decreased stress on joints, making it an ideal environment for individuals with neurological conditions who may have limited mobility or muscle weakness. The buoyancy also provides a supportive environment for balance and coordination exercises, allowing individuals to practice movements without the fear of falling or injury.
Aquatic therapy for neurological conditions utilizes a variety of exercises and techniques. These may include gait training, where individuals practice walking or stepping movements in the water, often with the assistance of flotation devices or the therapist's support. Resistance exercises, such as arm and leg movements against the resistance of the water, are also commonly used to improve muscle strength. Balance and coordination exercises may involve standing or performing movements on unstable surfaces in the water, such as foam noodles or wobble boards. Additionally, sensory integration techniques, such as water temperature and pressure variations, may be incorporated to enhance sensory processing and body awareness.
Yes, aquatic therapy can help improve balance and coordination in individuals with neurological conditions. The water environment provides a safe and supportive setting for practicing balance and coordination exercises. The resistance and buoyancy of water challenge the individual's stability, forcing them to engage their core muscles and work on their proprioception. By repeatedly practicing these movements in the water, individuals can improve their balance and coordination skills, which can then translate to improved performance on land. Aquatic therapy can also help individuals regain confidence in their ability to move and balance, which can have a positive impact on their overall quality of life.
While aquatic therapy is generally safe for individuals with neurological conditions, there are some potential risks and contraindications to consider. Individuals with open wounds, infections, or uncontrolled seizures should avoid aquatic therapy until these conditions are resolved. Additionally, individuals with severe cardiovascular or respiratory conditions may need to be closely monitored during aquatic therapy sessions. It is important for individuals to be properly assessed and supervised by a qualified therapist to ensure their safety and to tailor the therapy program to their specific needs and abilities.
Proprioceptive neuromuscular facilitation (PNF) is a therapeutic technique that can improve muscle strength in older adults through various mechanisms. PNF involves stretching and contracting muscles in a specific pattern, which activates the neuromuscular system and enhances muscle recruitment. This technique utilizes proprioceptive feedback, which is the body's ability to sense its position and movement in space, to facilitate muscle activation and coordination. By incorporating repetitive and rhythmic movements, PNF can stimulate muscle fibers and promote muscle hypertrophy, leading to increased muscle strength. Additionally, PNF exercises often involve resistance, which further challenges the muscles and promotes strength gains. The combination of these factors, along with the specificity and intensity of PNF exercises, can effectively enhance muscle strength in older adults.
Therapists modify exercise programs for individuals with multiple sclerosis by tailoring the exercises to address the specific needs and limitations of each individual. They may incorporate a variety of exercises that focus on improving balance, coordination, strength, and flexibility. These exercises may include low-impact activities such as swimming or cycling, as well as exercises that target specific muscle groups affected by multiple sclerosis. Therapists may also incorporate assistive devices or adaptive equipment to ensure safety and maximize the benefits of the exercises. Additionally, therapists may adjust the intensity and duration of the exercises based on the individual's abilities and energy levels. Regular monitoring and reassessment of the exercise program are essential to ensure its effectiveness and make any necessary modifications.
Aquatic exercise programs have shown promising results in improving motor function in children with cerebral palsy. These programs involve engaging in physical activities in water, which provide a supportive and low-impact environment for children with motor impairments. The buoyancy of water reduces the effects of gravity, allowing children to move more freely and with less effort. Additionally, the resistance provided by water helps to strengthen muscles and improve coordination. Aquatic exercise programs often incorporate various exercises and activities that target specific motor skills, such as balance, coordination, and strength. Research studies have demonstrated that these programs can lead to significant improvements in motor function, including increased muscle strength, improved balance and coordination, and enhanced overall motor performance. Furthermore, the enjoyable and stimulating nature of aquatic exercise can also contribute to increased motivation and engagement in physical activity, which further supports the development of motor skills in children with cerebral palsy.
Hydro-massage therapy has been shown to effectively alleviate muscle soreness and improve recovery post-exercise. This type of therapy utilizes water pressure and massage techniques to target specific muscle groups, promoting increased blood flow and circulation. The hydro-massage therapy also helps to reduce inflammation and swelling, which are common after intense physical activity. Additionally, the combination of water and massage provides a soothing and relaxing effect, helping to relieve muscle tension and promote overall relaxation. By incorporating hydro-massage therapy into a post-exercise routine, individuals can experience faster recovery times and reduced muscle soreness, allowing them to return to their training or physical activities more quickly.
Taping techniques can be beneficial in the management of Achilles tendinopathy when certain indications are present. These indications include pain and inflammation in the Achilles tendon, limited range of motion in the ankle joint, and instability in the lower leg. Taping can help provide support and stability to the affected area, reducing stress on the tendon and allowing for proper healing. Additionally, taping can help improve proprioception and neuromuscular control, which can aid in the rehabilitation process. By using taping techniques, healthcare professionals can effectively manage Achilles tendinopathy and promote optimal recovery for their patients.
High-velocity thrust manipulation in spinal manipulation therapy carries potential risks that should be carefully considered. One of the main concerns is the risk of injury to the spinal cord or nerves, which can result in neurological complications such as paralysis or sensory deficits. Additionally, there is a risk of fractures or dislocations of the vertebrae, especially in individuals with pre-existing spinal conditions or osteoporosis. Other potential risks include muscle strains, ligament sprains, and soft tissue injuries. It is important for practitioners to have a thorough understanding of the patient's medical history and to perform a comprehensive examination before administering high-velocity thrust manipulation to minimize these risks.
The Feldenkrais Method is a somatic educational approach that aims to improve movement efficiency and coordination through increased body awareness and exploration of movement patterns. By engaging in gentle, slow, and mindful movements, individuals can develop a deeper understanding of their own movement habits and limitations. This increased self-awareness allows for the identification and release of unnecessary tension and effort, leading to more efficient movement patterns. Additionally, the Feldenkrais Method emphasizes the integration of the whole body, promoting coordination and fluidity in movement. Through the exploration of different movement possibilities and variations, individuals can expand their movement repertoire and enhance their overall coordination. By addressing the underlying neuromuscular patterns that contribute to inefficient movement, the Feldenkrais Method offers a holistic approach to improving movement efficiency and coordination.
Taping techniques can be used as part of the management of patellofemoral pain syndrome in individuals who experience anterior knee pain during activities such as running, jumping, or squatting. These techniques may be indicated for patients who have been diagnosed with patellofemoral pain syndrome and are looking for non-invasive treatment options. Taping can help provide immediate pain relief by altering the alignment and tracking of the patella, reducing excessive lateral patellar tilt and glide. It can also help improve patellar stability and proprioception, allowing for better control of the knee joint during movement. Additionally, taping techniques can be beneficial for individuals with patellofemoral pain syndrome who are undergoing rehabilitation exercises, as it can provide additional support and stability to the knee joint, allowing for more effective strengthening and conditioning. Overall, taping techniques can be a valuable adjunct to the management of patellofemoral pain syndrome, providing pain relief and improving functional outcomes for individuals with this condition.