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Hi Tasha
Thanks again for taking the time to discuss your research with our members. It has been very useful and interesting discussion. Keep us posted on your research.
To all participants
Thank for your input and sharing your thoughts on this important topic. We are planning more exciting sessions with researchers in the coming months.
Your certificate of attendance can be downloaded from the link pasted in the introduction at the beginning of forum..
Kind regards,
Dr. Eyal LedermanI use the terms stretch sensitivity or ROM sensitisation.. but open to suggestions. Patients seem to understand stretch sensitivity..
Technical note: you may have to press the refresh button on your server to get the latest posted messages
It is the button on the right of the address bar on the top..
Perhaps we can start with the first question, is there a way of differentiating between the two “stiff” states?
Since there has been no further activity on the forum I will now bow out..
Thank you for attending the forum. Another one is planned for Feb 2017.
Your certificates can be downloaded from here:
http://www.cpdoathome.com/courses/certificate
Seasons’ greetings
EyalThe bottom line is that proprioception might be the least of your elderly patients problems.. I wouldn’t worry about it..
Or more correctly, get them to look at their limb while they are attempting to execute the task
A stroke patient can recover movement by replacing proprioception with vision. Get them to look at the movement
Unwilling to be active can be multidimensional but less likely to be proprioceptive, e.g. cognitive loss, movement related anxieties, depression, lack of life goals, lack of social support, loss of other sensory modalities such as hearing, sight. + Co-morbidities – cardiovascular etc. and they are more fatigable..
Yes, this is the right way. Do you have any areas you would like to discuss?
Some thoughts about proprioception:
Are there any exercises which are not proprioceptive, and along these lines is there any human activity which is not proprioceptive?Hi All
Welcome to the forum exploring the role proprioception in therapy and sports.
Please free to raise questions in this area
At the end of the session don’t forget to download your attendance certificate which will account for your learning with others activities. The certificate can be downloaded from here:
http://www.cpdoathome.com/courses/certificate
EyalOK dinner is waiting
Thank you all for your contribution.
Don’t forget to download your Learning-With-Others certificate from here:http://www.cpdoathome.com/courses/certificate
If needed I also do Skype supervision
Looking forward to meeting you on future forums (How to Manage Frozen Shoulder coming soon).
Kind regards,
EyalProprioception from the remaining muscle tend to capture cortical territory of the missing proprioceptors. Yes, a lot of it is internal CNS, probably related to the sense of effort..
Just press the refresh button on the address bar..Proprioception from the remaining muscle tend to capture cortical territory of the missing proprioceptors. Yes, a lot of it is internal CNS, probably related to the sense of effort..
Just press the refresh button on the address bar..Apparently there is negative transfer when they move from one activity to the other + fatigue would be their greatest enemy. Furthermore, during exertion athletes revert to internal focus of attention (thinking about their body rather than the goal – external focus of attention). This tend to degrade their performance to the level of a novice = more prone to error and injury
any further Qs?
great read:
Neuromuscular Rehabilitation in MTyes they are
here is the A:
Absolutely. In particular, active movement that resembles normal daily tasks.
Have a look at my book Neuromuscular Rehabilitation in MThaha, you’ll need to buy the book..!
The correctness of movement is a fascinating topic and not as obvious has we may think..
Overuse are not necessarily due to “incorrect movement”. It often happens to athletes with very good technique. It is due to overuse as the name implies. Have a look kat my book about Behavioural Spheres. This type of condition has to be managed within the organisational behaviour and peer behaviour of the individual, i.e. how often they have breaks, training schedule etc..
This topic was my doctorate research… 1991-1998!
Absolutely. In particular, active movement that resembles normal daily tasks.
Have a look at my book Neuromuscular Rehabilitation in MTAgree..
So proprio recovery is by peripheral regeneration and central reorganisation. It is not by direct augmentation of proprioception as is often thought
The 3 months I had in mind is related to bottox injections. Basically it kills off the muscle including the spindle’s intrafusal fibres. However, the whole lot regenerates after about 3 months..
Yes, in most MSK injury there may be very minor proprio loss. The body seems to have proprio reserves, i.e. there are still many intact tissues that can provide sensory feedback… The relation to sports has been hyped. It sells courses and books on propriocptive exercise..
Yes, there is a pain-proprioception competition for CNS attention. The perceived most important one tends to win. For example, painful subacromial bursitis tends to negatively influence proprioception from the shoulder. However, 9 months after the op to remove it (the competition), proprioception seems to normalise
If the peripheral proprioceptive apparatus is damaged, such as in studies, receptor and axonal regeneration seems to take several weeks to regenerate (I have 3 month in mind for some reason). Whether it regenerates depends on the magnitude of damage to the receptors and their axons. Central related proprioceptive loss and recovery is an unknown entity. Again depends on the extent of damage and emergency medical care, etc.
If the peripheral proprioceptive apparatus is damaged, such as in research, receptor and axonal regeneration seems to take several weeks to regenerate (I have 3 month in mind for some reason). Whether it regenerates depends on the magnitude of damage to the receptors and their axons. Central related proprioceptive loss and recovery is an unknown entity. Again depends on the extent of damage and emergency medical care, etc.
…i.e. you can still feel your back but it is represented in a different location in your cortex
No, there are 3 of us… any Q regading the lecture?
Surprisingly, proprioception in the spine is not affected by CLBP. When it is affected it is of very low magnitude, often something like 1-2 degrees of error. Such minor losses do not lead to further LB injury.
The change in the cortex is to demonstrate the profound sensory adaptation that results from CLBP. However it does not seem to affect proprioception directly…welcome!
Hi All
Warm welcome (from a cold London to) [email protected] online live forum.
Please feel free to ask any question regarding the proprioception workshop. I would also value your comments, thoughts or ideas about this topic.
Remember that at the end of the session you can claim 1 CPD credit learning with other (I will provide you with the link to download it).
Spleing msitkaes R aloud
Dr. Eyal LedermanBen
In a recent talk you mentioned that core stability training is still the most popular treatment modality for LBP by physiotherapists in the UK. This is despite your study and all previous systematic reviews showing that such training is no better than any other exercise:
1. Lomond KV et al Altered postural responses persist following physical therapy of general versus specific trunk exercises in people with low back pain. Man Ther. 2014 Apr 24. pii: S1356-689X(14)00068-X. doi: 10.1016/j.math.2014.04.007. [Epub ahead of print]
2. Wang XQ et al A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082. doi: 10.1371/journal.pone.0052082. Epub 2012 Dec 17.
3. Kriese M et al Segmental stabilization in low back pain: a systematic review. Sportverletz Sportschaden. 2010 Mar;24(1):17-25. Epub 2010 Mar 16.
4. Macedo LG, Maher CG, Latimer J et al 2009 Motor Control Exercise for Persistent, Nonspecific Low Back Pain: A Systematic Review PHYS THER Vol. 89, No. 1, January, pp. 9-25
5. Rackwitz B et al Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials. Clin Rehabil. 2006 Jul;20(7):553-67.
6. May S, Johnson R. Stabilisation exercises for low back pain: a systematic review. Physiotherapy.2008;94(3):179-189
7. Ferreira PH, Ferreira ML, Maher CG, et al. Specific stabilisation exercise for spinal and pelvic pain: a systematic review. Aust J Physiother 2006;52:79–88.Is it possible that this information has not filtered down to clinical practice? Does it reflect outdated education or simply practitioners choose to ignore it?
We are approaching the end of this session. Thanks you for your contribution.
Don’t forget to download your Learning with Others certificate from here:There will another forum about this topic later this year, will inform you in advance.
Please let your colleagues know about this website.
Looking forward to meeting you future forums.
Regards
EyalSELF-REGULATION – ABILITY FOR SELF-CALMING / SOOTHING WITH ALL THE PHYSIOLOGICAL-BEHAVIOURAL-PSYCHOLOGICAL PROCESSES ASSOCIATED WITH IT. HAVE A LOOK AT SECTION 3 OF SCIENCE AND PRACTICE OF MT…
As I have so much respect for your opinion, I would love to know if you think there is any value internal focus type work, with the aim of affecting ‘cortical body maps’? Could it not be seen as part of a Process Approach, if the goal is to promote adaptation and/or alleviation of symptoms? WHY NOT USE THE PERSON OWN MOVEMENT REPERTOIRE FOR THAT?
For example for patients with fear behaviour? Or do you consider all exploration of movement which is not pedestrian or part of the individuals functional movement repertoire to be redundant? AS A RECERATIONAL ACTIVITY IT IS FINE BUT FOR RECOVERY OF MOVEMENT OR ENHANCING HUMAN MOVEMENT PERFORMANCE IT IS LIKELY TO BE INEFFECTIVE. What about facilitating an individual to expand what they can feel/experience in their body and explore beyond their current movement vocabulary (if this is of interest to them)? IF OF INTEREST TO THE PERSON THAT’S FINE..I quite often get people who are not coming to me for recovery, but who simply adore having bodywork and want “treatment” so support their general health and well-being.
YES, TOUCH HAS A VERY IMPORTANT ROLE IN SUPPORTING SELF REGULATION.
Do you ever work with patients who are asymptomatic? YES OCCASSIONALY Could a Process Approach be used here too? What would it mean? Identifying and amplifying behavioural traits that are beneficial to general health? YES, FOR SOME TOUCH AND CONTACT WITH ANOTHER PERSON IS VERY IMPORTANT FOR SELF-REGULATIONLET ME KNOW IF YOU ARE STILL THERE
What is your opinion about using hands-on treatment to meet patient expectations?
VERY IMPORTANT
What about the placebo effect of having been touched where it hurts? Do you consider this to have any value?
THERE IS THE PLACEBO, BUT TOUCH IS BEYOND PLACEBO. IT IS HAS AN IMPORTANT ROLE IN HUMAN BEHAVIOUR AND WELL-BEING. HAVE A LOOK AT SECTION 3 IN MY BOOK SCIENCE AND PRACTICE OF MT…You write that obstacles are “often complex bio-psychosocial processes and
rarely structural or postural”. But what about the link between these two areas? Isn’t the point of osteopathy to use the body as the way in/access point to support positive change in the person?
THERE IS NO LINK BETWEEN POSTURE AND DEVDLOPING LBP. IT HAS NEVER BEEN SHOWN
If these obstacles are truly separate, wouldn’t that mean that we should refer most of our patients to non-manual therapists?! OSTEOPATHY IS MORE THAN JUST TECHNIQUES. THESE CONSIDERATIONS WOULD BE INCLUDED IN THE OVERALL MANAGEMENTRe posture and pain while walking. You are taking an evasive posture to reduce the pain. If you sprained your ankle you would use the same strategy. However, your new posture is a protective strategy. Let me know if you are still there..
Hi SR
For some reason I have just received your correspondance. give a few minutes to consider it (many questions:-))