Zusammenfassung
Manuelle Therapie ist eine Behandlungsform zur Schmerzverringerung und Wiederherstellung der Funktionsfähigkeit von Wirbelsäulen- und Extremitätengelenken. Aufgrund welcher Mechanismen Manuelle Therapie diese Wirkungen erzielt, ist noch nicht ermittelt.
Zweck der vorliegenden Studie war es, die Auswirkungen posterior-anteriore Mobilisation der LWS mit einer bestimmten Kraft, Frequenz und Dauer auf segmentale Steifheit zu beurteilen. Außerdem sollten auch jegliche sonstigen spezifischen segmentalen oder multisegmentalen Auswirkungen angewandter P.-a.-Mobilisation bestimmt werden.
Falls es hinsichtlich der Auswirkungen von Mobilisation auf symptomfreie und unter Kreuzschmerzen leidende Personen Parallelen gibt, ist anzunehmen, dass posterior-anteriore Mobilisation ihre Wirkung vielleicht auf andere Weise erzielt als durch eine Veränderung der Steifheit.
Abstract
Manual therapy is a treatment modality to reduce pain and restore function of the spinal articulations and the extremity joints. The mechanisms of how manual therapy achieves its effect have not yet been found.
This study’s purpose was to evaluate the effect of posteroanterior mobilisation on lumbar segmental stiffness with a given force, frequency and time. In addition, any specific segmental or multi-segmental effects from applied posteroanterior mobilisation were supposed to be established.
It is suggested that if parallels between asymptomatic subjects and lower back pain sufferers in relation to the effects of mobilisation, posteroanterior mobilisation may achieve its effect by mechanisms other than by altering posteroanterior stiffness.
Schlüsselwörter
Posterior-anteriore Mobilisation - segmentale Steifheit - LWS
Key words
Posteroanterior mobilisation - segmental stiffness - lumbar spine
Literatur
-
1
Allison G T, Edmondston S J, Roe C P. et al .
Influence of Load Orientation on the Posteroanterior Stiffness of the Lumbar Spine.
Journal of Manipulative and Physiological Therapeutics.
1998;
21
1-5
-
2
Blomberg S, Hallin G, Gran K. et al .
Manual Therapy with Steroid Injections - A New Approach to Treatment of Low Back Pain.
Spine.
1994;
19
569-577
-
3
de Vries H A.
Quantitative Electromyographic Investigation of the Spasm Theory of Muscle Pain.
American Journal of Physical Medicine.
1966;
45
119-134
-
4
Di Fabio R P.
Efficacy of Manual Therapy.
Physical Therapy.
1992;
72
853-864
-
5
Edmondston S J, Allison G T, Gregg C D. et al .
Effect of Position on the Posteroanterior Stiffness of the Lumbar Spine.
Manual Therapy.
1998;
3
21-26
-
6 Grieve G P. Common Vertebral Joint Problems. Edinburgh; Churchill Livingstone 1988
-
7
Harms M C, Bader D L.
Variability of Forces Applied by Experienced Therapists during Spinal Mobilization.
Clinical Biomechanics.
1997;
12
393-399
-
8
Latimer J, Lee M, Adams R. et al .
An Investigation of the Relationship between Low Back Pain and Lumbar Posteroanterior Stiffness.
Journal of Manipulative and Physiological Therapeutics.
1996;
19
587-591
-
9
Lee R, Evans J.
Load - Displacement - Time: Characteristics of the Spine under Posteroanterior Mobilisation.
Australian Journal of Physiotherapy.
1992;
38
115-123
-
10
Lee M, Esler M A, Mildren J. et al .
Effect of Extensor Muscle Activation on the Response to Lumbar Posteroanterior Forces.
Clinical Biomechanics.
1993;
8
115-119
-
11
Lee M, Latimer J, Maher C.
Manipulation: Investigation of a Proposed Mechanism.
Clinical Biomechanics.
1993;
8
302-306
-
12
Lee M, Lau H, Lau T.
Sagittal Plane Rotation of the Pelvis during Lumbar Posteroanterior Loading.
Journal of Manipulative and Physiological Therapeutics.
1994;
17
149-155
-
13
Lee M, Liversidge K.
Posteroanterior Stiffness at Three Locations in the Lumbar Spine.
Journal of Manipulative and Physiological Therapeutics.
1994;
17
511-515
-
14
Lee R, Evans J.
An In Vivo Study of the Intervertebral Movements Produced by Posteroanterior Mobilisation.
Clinical Biomechanics.
1997;
12
400-407
-
15
Lee M, Latimer J, Maher C.
Normal Response to Large Posteroanterior Lumbar Loads - A Case Study Approach.
Journal of Manipulative and Physiological Therapeutics.
1997;
20
369-371
-
16
Lee M, Steven G P, Crosbie J. et al .
Variations in Posteroanterior Stiffness in the Thoracolumbar Spine: Preliminary Observations and Proposed Mechanisms.
Physical Therapy.
1998;
78
1277-1287
-
17
Maher C, Adams R.
Reliability of Pain and Stiffness Assessments in Clinical Manual Lumbar Spine Examination.
Physical Therapy.
1994;
74
801-811
-
18 Maitland G D. Vertebral Manipulation. Oxford; Butterworth-Heinemann 1986 5th ed
-
19
McCollam R L, Benson C J.
Effects of Posteroanterior Mobilisation on Lumbar Extension and Flexion.
Journal of Manual and Manipulative Therapy.
1993;
1
134-141
-
20
Petty N J.
The Effect of Posteroanterior Mobilisation on Sagittal Mobility of the Lumbar Spine.
Manual Therapy.
1995;
1
25-29
-
21
Shirley D, Lee M, Ellis E.
The Relationship Between Submaximal Activity of the Lumbar Extensor Muscles and Lumbar Posteroanterior Stiffness.
Physical Therapy.
1999;
79
278-285
-
22
Threlkeld J A.
The Effects of Manual Therapy on Connective Tissue.
Physical Therapy.
1992;
72
893-902
-
23
Viner A, Lee M, Adams R.
Posteroanterior Stiffness in the Lumbosacral Spine.
Spine.
1997;
22
2724-2730
-
24
Zusman M.
Spinal Manipulative Therapy: review of some proposed mechanisms, and a new hypothesis.
Australian Journal of Physiotherapy.
1986;
32
89-99
-
25
Zusman M.
The Meaning of Mchanically Produced Responses.
Australian Journal of Physiotherapy.
1994;
40
35-39
-
26 Zusman M. What does Manipulation Do?. Boyling J, Palastanga N, Grieve’s Modern Manual Therapy New York; Churchill Livingstone 1994 2nd ed
Susanne Walcher
Course Coordinator of Masters of Manipulative Therapy
School of Physiotherapy, Curtin University of Technology
Bentley Campus, Perth, WA
Australia
