Everyone talks about mobility and seems to intuitively know that mobility is important. Why do you think people fail to recognize the need for stability?
Mike Robertson, C.S.C.S. - Profile Page | parsimpjomet.tk
In other words, is it truly short or is it just stiff? If a tissue is truly short as you might see after a post-operative immobilization period , you need to get cracking on longer-duration stretching and manual therapy. As proof, just look at some of the brightest physical therapists at the forefront of the industry.
Most of their teachings are heavily geared toward stabilization exercises. These practices transiently increase range of motion so that we can build stability within new postures. Mike, something that discussed in the first lecture really stuck with me. You talk about the components of dynamic stability, with one of those being dynamic ligament tension. MR: When dynamic ligament tension was first described, it simply applied to how the connective tissue of muscles around a joint often blends into the capsular tissue.
Good examples of this are how the rotator cuff muscles blend into the glenohumeral joint capsule, and how the quadriceps blends into the retinaculum tissue of the knee.
Peter A. Robertson
Studies have shown that contraction of these muscles produces stiffness, of stability of the capsular tissue and joint. This is a huge component of what we try to achieve when we train the musculature to stabilize a joint. As our understanding of the fascial system continues to evolve, I think the concept of dynamic ligament tension can also be applied here as well.
Through fascial connections through the body, muscle contraction can cause stability in other places throughout the kinetic chain. Our job is to maximize this potential. Another cue that I really liked was when you were discussing the plank. What do you hope to accomplish by doing this? It is very rare that I see someone do this and actually perform a plank without being in a flexed hip position. I want them to start from the floor and pull up so that what they are engaging their anterior core to do the work and not their iliopsoas.
I was in full-on geek heaven during your presentation on training around lower body and spine injuries. What are some of the most common injuries that you see on a day-to-day basis, and what are some quick-and-dirty tips to help train around them? Best images about Wellness on Pinterest Strength Dead lifts. Just Because Robertson Training Systems. Dorsiflexion Stretch start and finish T Nation.
Pathogenesis Diagnosis and Treatment of Lumbar Zygapophysial Pinterest Appropriate exercise can help to alleviate the pain associated with spondylolisthesis and strengthen your back. However I do love the material on the bottom as it is one solid piece that couldn t fall apart like the Frees do I also liked the pliability of the upper.
Layout Eric Cressey. Illustration of the spine showing a spondylolsis defect. Acute Injuries of the Lumbar Neural Arch in Adolescents Radsource With that in mind at the attendees request I sent a follow up email to all of them with a list of some of the best resources books manuals and DVDs. PLF for single-level degenerative spondylolisthesis.
The purpose of this study was to compare patient-reported outcomes PROs , morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. Two-year resource use was multiplied by unit costs based on Medicare payment amounts direct cost. Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate indirect cost.
Total cost was used to assess mean total 2-year cost per QALYs gained after surgery. Objective To compare baseline characteristics and surgical and nonoperative outcomes in degenerative spondylolisthesis DS and spinal stenosis SpS patients stratified by predominant pain location i. Summary of Background Data Evidence suggests that degenerative spondylolisthesis DS and spinal stenosis SpS patients with predominant leg pain may have better surgical outcomes than patients with predominant low back pain LBP.
Patients were classified as leg pain predominant, LBP predominant or having equal pain according to baseline pain scores. Baseline characteristics were compared between the three predominant pain location groups within each diagnostic category, and changes in surgical and nonoperative outcome scores were compared through two years.
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Longitudinal regression models including baseline covariates were used to control for confounders. DS and SpS patients with predominant leg pain had baseline scores indicative of less severe symptoms. Leg pain predominant DS and SpS patients treated surgically improved significantly more than LBP predominant patients on all primary outcome measures at one and two years. Surgical outcomes for the equal pain groups were intermediate to those of the predominant leg pain and LBP groups.
The differences in nonoperative outcomes were less consistent. Conclusions Predominant leg pain patients improved significantly more with surgery than predominant LBP patients.
However, predominant LBP patients still improved significantly more with surgery than with. Adjacent segment disease after instrumented fusion for adult lumbar spondylolisthesis : Incidence and risk factors. A potential long-term complication of lumbar fusion is the development of adjacent segment disease ASD , which may necessitate second surgery and adversely affect outcomes.
The objective of this is to determine the incidence of ASD following instrumented fusion in adult patients with lumbar spondylolisthesis and to identify the risk factors for this complication. We retrospectively assessed adult patients who had undergone decompression and instrumented fusion for lumbar spondylolisthesis between January and December The incidence of ASD was analyzed.
Potential risk factors included the patient-related factors, surgery-related factors, and radiographic variables such as sagittal alignment, preexisting disc degeneration and spinal stenosis at the adjacent segment. A total of patients mean age, Mean duration of follow-up was Eighteen patients The occurrence of ASD was not affected by patient-related factors, the types, grades and levels of spondylolisthesis , surgical approach, fusion procedures, levels of fusion, number of levels fused, types of bone graft, use of bone morphogenetic proteins, sagittal alignment, preexisting adjacent disc degeneration and preexisting spinal stenosis at caudal adjacent segments.
Our findings suggest the overall incidence of ASD is Published by Elsevier B.
Michael Robertson (rugby league)
Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years. Minimally invasive transforaminal lumbar interbody fusion MIS-TLIF for lumbar spondylolisthesis allows for surgical treatment of back and leg pain while theoretically minimizing tissue injury and accelerating overall recovery. Although the authors of previous studies have demonstrated shorter length of hospital stay and reduced blood loss with MIS versus open-TLIF, short- and long-term outcomes have been similar.
As such, we set out to assess previously unstudied end points of health care cost and cost-utility associated with MIS- versus open-TLIF.
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Two-year resource use was multiplied by unit costs on the basis of Medicare national allowable payment amounts direct cost and work-day losses were multiplied by the self-reported gross-of-tax wage rate indirect cost. Descriptive epidemiology and prior healthcare utilization of patients in the Spine Patient Outcomes Research Trial's SPORT three observational cohorts: disc herniation, spinal stenosis, and degenerative spondylolisthesis. Prospective observational cohorts. To describe sociodemographic and clinical features, and nonoperative medical resource utilization before enrollment, in patients who are candidates for surgical intervention for intervertebral disc herniation IDH , spinal stenosis SpS , and degenerative spondylolisthesis DS according to SPORT criteria.
Intervertebral disc herniation, spinal stenosis, and degenerative spondylolisthesis with stenosis are the three most common diagnoses of low back and leg symptoms for which surgery is performed. There is a paucity of descriptive literature examining large patient cohorts for the relationships among baseline characteristics and medical resource utilization with these three diagnoses. Multiple logistic regression was used to generate independent predictors of utilization adjusted for sociodemographic variables, diagnosis, and duration of symptoms.
After adjusting for age, gender, diagnosis, education, race, duration of symptoms, and compensation, Medicaid patients used. Degenerative spondylolisthesis DS in the setting of symptomatic lumbar spinal stenosis is commonly treated with spinal fusion in addition to decompression with laminectomy. However, recent studies have shown similar clinical outcomes after decompression alone, suggesting that a subset of DS patients may not require spinal fusion.
Identification of dynamic instability could prove useful for predicting which patients are at higher risk of post-laminectomy destabilization necessitating fusion. The goal of this study was to determine if static clinical radiographs adequately characterize dynamic instability in patients with lumbar degenerative spondylolisthesis DS and to compare the rotational and translational kinematics in vivo during continuous dynamic flexion activity in DS versus asymptomatic age-matched controls. A volumetric model-based tracking system was used to track each vertebra in the radiographic images using subject-specific 3D bone models from high-resolution computed tomography CT.
Static clinical radiographs underestimate the degree of AP translation seen on dynamic in vivo imaging 1. DS patients demonstrated three primary motion patterns compared to a single kinematic pattern in asymptomatic controls when analyzing continuous dynamic in vivo imaging. Continuous in vivo dynamic imaging in DS reveals a spectrum of aberrant motion with significantly greater. Clinical significance of achieving a flexion limitation with a tension band system in grade 1 degenerative spondylolisthesis : a minimum 5-year follow-up. Retrospective clinical study.
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To evaluate the effect of the limitation of flexion rotation clinically and radiologically after interspinous soft stabilization using a tension band system in grade 1 degenerative spondylolisthesis. Although several studies have been published on the clinical effects of limiting rotatory motion using tension band systems, which mainly targets the limitation of flexion rather than that of extension, they were confined to the category of pedicle screw-based systems, revealing inconsistent long-term outcomes. Sixty-one patients with a mean age of At follow-up, the patients were divided into 2 groups on the basis of their achievement or failure to achieve flexion limitation.
The clinical and radiological findings were analyzed. A multiple linear regression analysis was performed to determine the prognostic factors for surgical outcomes. At a mean follow-up duration of Statistically significant improvements were noted only in the flexion-limited group in all clinical scores. The preoperative extension angle was identified as the most influential variable for the flexion limitation and the clinical outcomes. The effects of the limitation of flexion rotation achieved through interspinous soft stabilization using a tension band system after decompression were related to the prevention of late recurrent stenosis and resultant radicular pain caused by flexion instability.
The aim of this study is to evaluate the effect of depression, anxiety, and optimism on postoperative satisfaction and clinical outcomes in patients who underwent less than two-level posterior instrumented fusions for lumbar spinal stenosis and degenerative spondylolisthesis.
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Postoperative satisfaction of subjects assessed using the North American Spine Society lumbar spine questionnaire was comparatively analyzed against the preoperative psychological status. The correlation between patient's preoperative psychological status depression, anxiety, and optimism and clinical outcomes VAS and ODI was evaluated.
VAS and ODI scores significantly decreased after surgery p Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adult isthmic spondylolisthesis. The guideline is intended to reflect contemporary treatment concepts for symptomatic isthmic spondylolisthesis as reflected in the highest quality clinical literature available on this subject as of June The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with isthmic spondylolisthesis.
This is a guideline summary review. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questionsto address in the guideline. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence.
Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when. A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis. A variety of surgical methods are available for the treatment of adult isthmic spondylolisthesis , but there is no consensus regarding their relative effects on clinical outcomes. To compare the effects of different surgical techniques on clinical outcomes in adult isthmic spondylolisthesis.