Rehabilitation of the Spine: A Practitioners Manual

 

Description:

The gold standard resource in the field, Rehabilitation of the Spine: A Patient-Centered Approach provides a practical overview of all aspects of spinal rehabilitation. The 3rd Edition has been completely revised, with new information and new videos to bring you up to date. Comprehensive and easy to read, this reference is invaluable for chiropractors and physical therapists, as well as spine surgeons, physician assistants, and nurse practitioners involved in the care of patients with spine problems.

 

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Table of Contents:

 

Part I Overview

1. Input (Bio), Output (Psycho), and Upstream (Social) Factors in Disabling Back Pain

Introduction

The Social and Upstream Dimension: BPS

The Spine Disability Epidemic: The Modern Inactivity Crisis

Social Determinants of Behavior

The Role of the Individual and HCP

The BPS and Input Dimension

Spine Stability, Stiffness and Tensegrity

The Role of Agonist–Antagonist Muscle Coactivation in Maintaining Spine Stability

Mechanism of Injury

Load Management

The Output or BPS Dimension

Neuropathic Pain and Central Sensitization

What Is Sensitization?

Neurophysiology

2. Quality Assurance: The Scope of the Spine Problem and Modern Attempts to Manage It

Introduction

Scope of the Problem

Incidence

Course of LBP

The Broader Health Consequences of LBP

How Can Physicians Decide if LBP Has a Serious Cause?

What Doesn’t Work?

Implementation

Treatment of Neck Pain—What Is Effective?

Summary of Major Conclusions From Successive Guidelines

Recommendations for Acute LBP

Recommendations for cLBP

Recommendations for LBP With Radiculopathy

Recommendations for Pregnancy-Related LBP and Pelvic Pain

Recommendations for Acute Nonspecific Neck Pain

Recommendations for Persistent Nonspecific Neck Pain

Recommendations for Neck Pain With Radiculopathy

3. Putting the Biopsychosocial Model Into Practice

Introduction

The BPS Model

Overemphasis on a Structural Diagnosis

Overemphasis on Bed Rest

Overuse of Surgery

Abnormal Illness Behavior and Pain Education

TNE for Pain

Diagnostic Triage to Rehabilitation—The Benchmark

Reassurance/Diagnostic Triage

Reactivation Advice

Relief of Pain

Reevaluation of Structural, Functional, and Psychosocial Contributors to Continued Pain or Disability

Reconditioning

Referral

Practitioner Audit

Part II Basic Science

4. Active Care: An Evidence-Informed Approach to Self-Care for Patients with Spine Pain

Introduction

The Functional Paradigm in Diagnosis and Therapy

The Diagnostic Dilemma in Back Pain

The Rationale for Active Care

The Deconditioning Syndrome: Functional and Cognitive–Behavioral Aspects

The Clinical Examination of Function and Performance

Correlation Between Specific Performance Deficits and LBP

Cognitive–Behavioral Components

The Negative Effects of Immobilization and Bed Rest

A Patient-Centered Approach

Evidence of Active Care’s Effectiveness

Prevention

Acute Phase (First 4–6 Weeks)

Subacute Phase Reactivation and Exercise (From 4 to 12 Weeks)

Chronic Phase Reactivation and Exercise (After 12 Weeks)

Active Care and the Neck

5. The Role of the Behavioral–Environmental Context: Bridging the Tensions Between Biomechanics, Pain Science, and Function

Introduction

Function

Performance

Whole Versus Part Training

Ecologic Dynamics: How Does Environment Impact Skill Acquisition?

Perception–Action Coupling

Deliberate Practice

Injury

Biomechanics of Tissue Injury

Is Tissue Injury and/or “Damage/Degeneration” Related to Pain Severity?

The Fourth International Forum on Low Back Pain Research in Primary Care

Uncertainty in Injury Prediction

Cracking the Code: Load Management

Psychology

Self-Efficacy

HCP Beliefs About Spine Fragility

Thin-Slicing Giving Patients Appropriate Reassurance and Reactivation Advice

Psychology of Training and Performance

Guidelines for Interpreting the Meaning of Pain With Activity

Should We Have a Pain Avoidance or Pain Tolerance Strategy

Rehabilitative Exercises

Spine-Sparing Strategies

Quantity Versus Quality: A Debate We Need to Have

How Does the Body Resist Injury?

Load Sharing

Social/Environmental Perspective

Part III Patient Assessment

6. Diagnostic Triage

Measurable Objectives

Diagnostic Triage in Patients With Spinal Pain

The Red Flag

Serious or Ominous Conditions

Simple Backache Versus Nerve Root Problems

Special Populations

The Yellow Flag

Investigations in the Diagnostic Triage Process

Plain Radiography

CT Scans

Magnetic Resonance Imaging

Bone Scan

Electrophysiologic Testing

7. Assessment of Psychosocial Risk Factors of Chronicity—“Yellow Flags”

Introduction

Risk Factors of Chronicity

Phase of Care

Psychosocial and Other Factors

Fear-Avoidance Beliefs

Cervical and Upper Quarter Risk Factors

Assessment

Waddell Nonorganic LBP Signs

Prognostic Value of Waddell Signs

Evaluation

Nonorganic Neck Pain Signs

Other Methods of Detecting “Yellow Flags”

Treatment for Patients With High “Yellow Flags” Scores

8. Outcome Assessment

Introduction

What Outcomes?

Criteria Regarding Outcomes Assessment

Validity

Reliability

Responsiveness

Ceiling and Floor Effects

Practicality

Likelihood Ratio

Domains

Pain

General Health

Patient-Reported Outcome Measure Information System

Region-Specific Functional Disability Outcomes

Low Back Pain

Neck Pain

Upper Extremity

The Lower Extremity

Patient-Specific Functional Disability Outcome

Patient-Specific Functional Scale

Work Status

Patient Satisfaction Outcomes Assessment Tools

Symptom Satisfaction

Job Satisfaction

The Patient Satisfaction Subscales

Patient Expectation

Psychological Distress

9. Pain Mechanism Classification System Overview and Focus on the Motor/Autonomic Mechanism

Pain Mechanism Classification System Allows for Central Nervous System Subgrouping

Pain Mechanism Classification System Categories

Nociceptive: Inflammatory

Nociceptive: Ischemia

Peripheral Neurogenic

Central Sensitization

Affective

Motor/Autonomic

CNS Mechanism Interventions

Motor/Autonomic

Principles of Neuroplasticity and Cortical Reorganization

Cortical Representation

Objective Evaluation for the Motor/Autonomic Pain Mechanism

Objective Findings for Motor/Autonomic Pain

Two-Point Touch Discrimination

Motor Screening Tools

Left–Right Image Discrimination Testing

Intervention to Address the Motor/Autonomic Pain Mechanism

Training From the Brain to the Periphery

Sensorimotor Retraining Programs

10. Quantification of Physical Performance Ability

Introduction

Rationale—Why

Indications—When

PPA Test Methods—What

Flexibility/Mobility

Strength/Endurance

Balance/Motor Control

Aerobic Fitness

Implementation—How

11. Evaluation of Muscular Imbalance

Introduction

Evaluation of Tight Muscles

Upper Trapezius

Levator Scapulae

Pectoralis Major—Abdominal Part

Pectoralis Major—Sternal Part

Pectoralis Major—Clavicular Part

Pectoralis Minor

Sternocleidomastoid Muscle

Hip Flexors

Hamstrings

Adductors

Piriformis

Triceps Surae

Evaluation of Inhibited Muscles

Analysis of Muscular Imbalance in Standing

Gait Assessment

The Proximal Type

The Distal Type

The Arm Movements

Hypermobility

12. Movement Assessment: Screening, Performance, and Injury Prevention

Introduction

Why Should We Assess in the First Place?

Screening and Assessment

Movement Screening As an Entry Point to Healthy Lifestyle

Movement Screening As a Tool to Establish Risk

Movement Assessment As Part of a Training System

Movement Assessment and Performance

What Should be Included in a Movement Screen?

How to Apply Your Chosen Screen or Assessment

Future Work

Part IV Sustainable Recovery

13. Educating People About Pain

Introduction

Why Is Education So Important?

What Is Contemporary Pain Education?

What Skills and Knowledge Are Required to Implement Contemporary Pain Education?

Knowledge

The Biopsychosocial Model of Pain

A Neurologic Framework for the Biopsychosocial Model

Conceptual Change and Effectively Explaining Pain

What Is the Content of Contemporary Pain Education?

How to Explain Pain—The Quick Guide

The Curriculum

A Step-by-Step Process

14. Self-Care: Providing Reassurance and Reactivation Advice for the Spine Pain Patient

Introduction

Fear-Avoidance Beliefs and Chronic Disabling Pain

Step 1: Reassurance and Reactivation Advice

Identify Fears and Goals

Assurance That There Is No Serious Disease—Doesn’t Severe Pain Signify Serious Damage?

If Pain Is Not Caused by Serious Disease, Then What Is Causing My Pain? (Doesn’t Severe Pain Signify Serious Damage?)

Specific Reactivation Advice—“What Should and Shouldn’t I Do?”

Pain Relief Options

How Long Will It Last?—Recovery Expectations

Summary

Step 2: Cognitive Behavioral Approach

Social Cognitive Theory and Behavioral Change

Graded Exposure Training

Cognitive Behavioral Therapy

Neurophysiologic Aspects

Step 3: Multidisciplinary Biopsychosocial Approach

Motivation Issues

Compliance With Ongoing Active Treatment

15. Making the Shift From Treating Dysfunction to Treating Sensitivity in Rehabilitation

Introduction

Part I: The Point of Pain Science

Key Message: Pain Is an Alarm That Is Meant to Motivate an Action

Key Message: Multiple Factors Influence the Sensitivity of the Alarm

Key Message: Hurt Does Not Equal Harm

Key Message: The Person Adapts to Applied Stress

Part II: When Biomechanics Matter

Temporary Changes to Desensitize and Painful Condition

Joint Kinematic Relevance During High Load Activities

Mechanical Changes for the Interruption of Habits Associated With Pain

Matching Individual Function With the Demands of Sports and Tasks

Respect for the Adaptation to Imposed Stressors

16. A Cognitive Behavioral Therapy Program for Spinal Pain

Introduction

Psychological Risk Factors Deserve Psychological Interventions

Determining Risk

The Cognitive Behavioral Group Intervention

Strategies for Behavioral Change

Organization of the Sessions

New Initiatives

Potential Problems

17. The McKenzie Method of Mechanical Diagnosis and Therapy for the Classification and Rehabilitation of Spinal Problems

Introduction

MDT Classification: Definitions and Criteria

Classifying Derangement Syndrome

Classifying Dysfunction Syndrome

Classifying Postural Syndrome

Classifying OTHER MDT Subgroups

Management and Rehabilitation of the MDT Syndromes

Educational Component

Mechanical Component

Stages of Management of Derangement

Reduction and Maintenance of Derangement. Example: Flexion Principle

Recovery of Function of Derangement

Prevention of Recurrence

Force Progression, Force Alternatives, and MDT Procedure Examples

Force Progression

Force Alternatives

MDT Procedures and Examples

Lumbar Spine Procedure Examples

Extension Mobilization

Rotation in Flexion

Cervical Spine Example

Retraction and Extension With Traction and Rotation Mobilization (Supine)

Lateral Flexion Clinician Overpressure

Highlights of Supportive Studies

Assessment

Predicting Outcome

Treatment

Efficacy With Psychosocial Factors

Avoiding Potential Surgery and Cost-Saving Implications

Systematic Reviews and Guidelines

Part V High-Value Recovery Options for Return to Participation

18. Self-Correcting Drills for the Hip Hinge

Introduction

Hinge Stance Basic Principles

Neutral Spine Drills for the Hinge

Sitting Back to Achieve Neutral Spine: The Box Squat

Using the Wall to Teach Neutral Spine: The Face-the-Wall-Squat As a Drill to Correct a Rounded Back

Self-correcting Hinge Drills

Reaching Back to Find the Hinge: The Kiss the Wall With Your Butt Drill

Using Bands to Find the Hinge: The Tension Band Drill

Pushing Back to Find the Hinge: The Kettlebell Hinge Drill

Using a Dowel to Find the Hinge: The Stick Drill

Using an Incline to Find the Hinge: The 2 × 6 Board Drill

Troubleshooting

Proprioceptive/Interoceptive Troubleshooting

Mobility/Stability Troubleshooting

19. Periodization of a Torso “Stabilization” Training Program in Rehabilitation and Performance Optimization

Introduction

Scientific Underpinnings

How Muscles Stabilize the Spine

Motor Control Problems and Low Back Pain

Efficacy: Evidence of Effectiveness for Spine Stability Training

Safety: Is Spine Stability Training Safe?

Clinical Application

Training Basics

Psychology of Training

How to Determine an Appropriate Starting Point for a Patient’s Exercise Program

How to Progress a Patient’s Exercise Program

The Exercises

Stability Exercises (Block 1)

Advanced Stability Exercises (Block 2 and 3)

20. Cueing to Enhance Motor Learning and Transferability to Activities

Introduction: Learning

Attentional Focus: Internal Versus External Cues

Attentional Focus: Constrained Action Hypothesis

Attentional Focus: Neuromuscular

Velocity

Strength

Endurance

Attentional Focus Cueing Framework

Distance

Direction

Description

Attentional Focus: Practical Application

21. Sensory Motor Stimulation

Introduction

Sensory Motor Stimulation Background

Therapeutic Approaches

Basic Concepts of Motor Learning

Sensory Motor Devices and Aids

Indications for SMS

Methodology

Overview of Sensory Motor Training

The Small (Short) Foot

Postural Correction

Corrected Stance on One Leg

Lunges

Jumps

Balance Boards (Rocker and Wobble)

Balance Sandals

The Sequence

Miscellaneous SMS Tools

22. Neuromobilization Techniques: Evaluation and Treatment of Adverse Neurodynamic Tension and the Container

Introduction

General Concepts

Impact of Forces on Blood Supply

Pressure Changes

Phase of Healing

Treatment Recommendations

Precautions and Contraindications

The Lower Quarter

Evaluation of ANDT and the Container

Treatment of Lower Quarter ANDT and the Container

The Upper Quarter

Evaluation of ANDT: Upper Limb Neurodynamic Tests

Treatment of Upper Quarter ANDT and the Container

Part VI Building Robustness for Return to Sport and Activity

23. Programming From Rehabilitation to Performance

Introduction

The Importance of Capacity Building

Commence With the End in Mind

Considerations When Planning a Rehabilitation Program

Periodizing Rehabilitation

The Importance of Exit Criteria

Rehabilitation Workload Management

24. Dynamic Variable Resistance Training

Introduction

Principles

Creating Efficiency Through Movement Accuracy

Foundational Methods

Using the Right Tool

Layering Movement Complexity

Future of Functional Training

25. Rotational Sports and the Spine

Introduction

Ontogenesis of a Rotational Sport: The Ipsilateral Pattern

Forces and Motions in Golf and Other Sports

Biomechanical ROM in the Golf Swing

Force Development in Rotational Sports: The Stretch-Shortening Cycle

The Golf Swing Transition and Kinematic Sequence

The X-factor in Golf and Other Sports

Lumbar Intervertebral Forces in the Golf Swing

Factors That Correlate With Low Back Injury in Rotational Sports

Loss of Dynamic Stability and Ensuing ROM Deficits

The Role of Dynamic Stability in Performance and Durability

Structure and Function of Intra-abdominal Pressure

Disruptions to Dynamic Stability

Assessment of IAP and Dynamic Stability

Assessment of Joint ROM Relevant to Rotational Sports

Rehabilitation of Proper IAP and DNS stereotype

Performance Training for Rotational Athletes

Preparing the Athlete for Training and Competition

Performance Testing

A Basic Framework for Performance Training

26. Sparing the Spine in Barbell Training

Introduction

Mobility

Stability

Technique

Tension

Spinal Mistakes During Lifting

Increasing Tension

What to Do

27. Sparing the Spine in High-Intensity Training

About CrossFit

Critiques of CrossFit

High Injury Levels

High-Volume Olympic Lifting

GHD Sit-Ups

Best Practices

Group Management

Athlete Selection

Exercise Selection

Part VII Multimodal Options for Recovery

28. Manipulation of Key Joints

Introduction

Manipulation

The Sensory System and Articular Neurology

The Barrier Concept

Joint Restriction/Manipulable Lesion: What Characterizes a Manipulable Lesion?

Pre-manipulative Provocative Testing

Post-manipulative Side Effects

Manipulation Techniques

Spinal Transitional Areas

Craniocervical Region

Thoracolumbar Region

Lumbosacral Region

Extremity Joints

29. Manual Resistance Techniques

Introduction

Neurophysiology

Evidence About Stretching

Different Methods for Muscle Lengthening

Classification of Tense and Tight Muscles

Clinical Application

Rules for Application

Specific Procedures

Selected MRT Procedures

30. A New Approach to Postural Function

Part I: Straightening Program

Balance—“Aplomb”

Stabilization

Forward Movement

Clinical Tests

Part II: Practical Exercises

Exercise: Perception of the Body and Postural Program in Supine Lying

Exercise: Visualization of Leg Lifting

Exercise: Hook Lying Appreciation of the Role of the Ball and Socket Joints

Exercise: Supine Triple Flexion (Legs at 90/90)

Exercise: Lying Prone

Exercise: Sidelying

Exercise: Sidelying to Turning

31. Dynamic Neuromuscular Stabilization

Introduction

Theory of Central Control of Postural-Locomotor Functions

Posture as a Basic Prerequisite for Locomotor Function

Pathologies Involving Postural-Locomotor Function and the Breathing Pattern

Diagnostic—Therapeutic Concept of DNS

Practical Training of Postural-Locomotor Stabilization

32. Pilates Therapy: Exercises for Spinal Stability

Introduction

Background

What Is Modern Pilates

Research Into Pilates for Low Back Problems

Pre-Pilates Exercises

Stage 1—Pre-Pilates Basic Exercises

Stage 2—Modified and Basic Traditional-Classic Pilates

Stage 3—Intermediate and Modified Traditional Pilates

Pilates Equipment

33. Pelvic Floor: Integration Versus Isolation

Introduction

Pelvic Floor as Teammate

Understanding the System

Optimizing the System

The Role of Alignment

Defining Neutral Range

Harnessing the System: TAP

Teamwork and Alignment

Ribcage Position and Breath Mechanics

Pelvic Tilt Redefined

Clinical Assessment Steps

Assess Alignment and Teamwork: Involuntary Responses

Voluntary Control and Functional Testing

Clinical Tools

Optimize Alignment Passively

Optimize Breath Mechanics

Optimize Pelvic Floor Engagement

Optimize Teamwork

Optimize Awareness and Motor Control

Preparation and Recruitment Order

Build and Monitor System Automaticity

Build Inside-Out/Anticipatory to Reactive Recruitment

Embed Strategies through Function and Fitness

Appendix A: Where to begin?

34. Clinical Hypnosis and Mindfulness-Based Interventions in the Treatment of Spinal Pain

Problem of Chronic Pain

Clinical Hypnosis: A Brief Introduction and Key Terms

The Neurophysiologic Underpinnings of Hypnosis

The Efficacy of Hypnosis

Clinical Hypnosis for Chronic Pain

Specific Back Pain Trials

Clinical Hypnosis for Acute Pain

Improving Future Research

Clinical Hypnosis in Practice—A Few Words on Approach

An Introduction to Mindfulness

Brief History of Mindfulness

Types of Mindfulness-Based Interventions

The Efficacy of Mindfulness

Improving Future Research

One and the Same?

Suggestions for Integration in Practice

Clinical Hypnosis

Mindfulness

Suggestions for Training and Certification

Hypnosis

Mindfulness

35. Yoga Exercises Respecting Dynamic Neuromuscular Stability Principles in Senior Populations

Introduction

Yoga in Medical Rehabilitation

Principles for Implementing Yoga in Medical Rehabilitation

Improving Postural Instability and Muscle Imbalances With Therapeutic Yoga

Lower Cross Syndrome

Upper Cross Syndrome

Improving Shoulder Isolation and Shoulder Girdle Function

Improving Respiratory Function

Improving Hip Isolation

Closed Kinetic Chain

Open Kinetic Chain

Conclusion

Yoga Exercises for Senior Populations

36. Nutrition Considerations for Inflammation, Pain, and Rehabilitation

Introduction

Diet-Induced Inflammation

Direct and Surrogate Markers of Chronic Inflammation

How Diet-Induced Inflammation “Mutates” Musculoskeletal Anatomy

Non-resolving Inflammation

Reconceptualizing Mechanical Pain Syndromes in the Context of Diet-Induced Chronic Inflammation

Part VIII First Principles of Movement: A Systematic Approach

37. Integrated Approach to Regional Disorders

Introduction

Clinical Framework

Clinical Challenges

Summary

On Finding the “Key Link”—The Clinical Audit Process

The Art

Pairing Assessments With Active Interventions

“Best Practice” Keys to Recovery—The 7 Rs

Principles of Evidence-Based Neuromusculoskeletal Care

38. The Resilience Model

Introduction

The Disability Epidemic

Increased Life Span

Disability by the Numbers

Overdiagnosis

The Vaccine for Fragility

Scalable Principles to Sustainable Activity

The Four Principles

Blocked Versus Random Practice and Skill Transfer

Movement Variability

Dynamic Systems Theory

Metrics

The Role of Assessment

History

Red Flags

Finding the Why Behind the What

Yellow Flags

Identify the Patient’s Pain Triggers or Activity Intolerances

Load Management

Examination

The Role of Neurologic, Medical, Imaging, Orthopedic, and Range of Motion Tests

When Is Pain Relevant?

Beyond the Kinetic Chain Approach

Hallmark Dysfunctions

Movement, Not Posture, Is the Goal

Atlas of Key Tests

Education

Behavioral Nudges

Gamification

The Dilemma of Scalability and Personalization

Training

Introduction

The Role of Strengthening

Pacing

Identify Preparedness for Training

The Role of Stability

Training Variables

The Trainable Menu

The Movement Prep

General Physical Preparedness

Work Capacity

Sport Specific

Examples of Patient-Centered Programming

The Cool Down

Sustainable Activity Promotion Throughout the Life Span

Health Span and Life Span

The Shoulder as an Example

The Knee as an Example

The Hip as an Example

The Centenarian Ideal—Age Above 85

Fall Prevention: Ages 60 to 85

The Medicalization of Aging

Resistance Training in the Elderly

Tests

Resilient Aging: Ages 40 to 60

Investing in Your Future: 20 to 40 Years

Youth—Building the Foundation

Gender-Appropriate Training

The Youth Athlete and Problem of Overspecialization

Children—Forming Habits—Basic Movement Literacies—Play

Chronologic Versus Biologic Age-Appropriate Training

Toddler: 1 to 3 Years Old

Infant—Ontogenesis

39. A Clinical Framework Utilizing a Precision Approach

General Considerations

Introduction

A General Approach to Rehabilitation for Activity Limiting Musculoskeletal Pain

A Measurable, Outcome-Based Approach to Implementing the Four Principles

Integrating the Four Principles into the Clinical Process

The Disability Problem

Inactivity: Underpreparation

Overprotection, Nocebos, and Reassurance

The Future of Integrating Complex Systems Theory into Practice

The Kinetic Chain and Regional Interdependence

Patient Education

What is the Primary Function of Hominoids?

Why a Larger Brain?

Why Bipedalism?

Advantages of Bipedalism?

A Sample of Assessment Tests

Introduction

Functional Test Menu

Movement Preparation

Movement Prep Atlas

General Physical Preparation

Rehabilitation of Function

General Physical Preparedness

The Trainable Menu

How Does Pain Impact Training?

Why RT Is so Crucial

Using Overload: How to Determine How Much Is the Right Amount?

What Exercises to Start With?

How to Coach GPP

GPP Atlas: The Basic Training Elements

Accessory Trainable Menus

Introduction

Managing Complexity: A Systems Approach

Work Capacity

1st MTP Mobility

Hip Rotation Mobility

Thoracic Mobility

Antirotation (Torso Stiffness)

Frontal Plane (Lateral Pelvic Control)

Scapulothoracic Coordination

Case Management and Clinical Reasoning

The Role of Skepticism

The Precision N=1 Approach

The Four Principles

Cases

A Note on Pain and Exercise

Wellness Questionnaire

Part IX Interdisciplinary Management

40. Role of the Interventionist: Nonsurgical Management of the Spine Pain Patient

Introduction

Basic Principles

Advanced Diagnostic Steps

Imaging

Serology

Electrodiagnostics

Diagnostic Needling Procedures

The Role of Medication

Analgesics

Anti-inflammatories

Muscle Relaxants

Antidepressants

Anticonvulsants

Summary

The Role of Injections

Trigger Point/Muscle Injections

Joint Blocks

Epidural Corticosteroids

Postinjection Care

Chronic Pain Management Interventions

Cognitive Behavioral Approach

Multidisciplinary Pain Management

Interventionist Methods

41. Lumbopelvic Pain in Pregnancy

Introduction

Epidemiology

Etiology

Diagnosis

Treatment

42. The Role and Safety of Activity in the Elderly

Introduction

Health Span Versus Life Span

Cardiovascular Risks and Benefits

Cardiovascular Benefits Associated With Activity and Exercise in the Elderly

Cardiovascular Risks Associated With Activity and Exercise in the Elderly

Osteoporosis

Risk Factors

Role of Exercise

Knee Osteoarthritis

Function

Rehabilitation

Total Knee Arthroplasty

Demographics

Recovery Expectations

Rehabilitation

Hip Osteoarthritis

Function

Exercise

Total Hip Replacement

Recovery Expectations

Rehabilitation

Fall Prevention

The Problem

Associated Functional Deficits

Interventions

Frailty

The Problem

Interventions

Spinal Stenosis

Diagnosis

Potential Complications

Results

Exertional Risk Assessment

ACSM and AHA Risk Assessment Recommendations

Limitations of ACSM and AHA Risk Assessment Recommendations

Gill’s Recommendations for Screening Elderly Individuals for Cardiac Risk With Exertional Activities

Recommendations for Initiating and Progressing Mild to Moderate Exercise Programs in the Elderly

Technology, Community, and Health Care Provider Issues

43. Spine Surgery

Introduction

Indications for Surgery

Cervical

Thoracic

Lumbar

Spondylolysis

Types of Surgery

Cervical

Thoracic

Lumbar

Nonsurgical Procedures

Injections

Rhizotomy

Spinal Cord Stimulators

Rehabilitation

Cervical

Lumbar

Index

 

An aparitie	1 Dec. 2019
Autor	Dr. Craig Liebenson
Dimensiuni	22.23 x 5.08 x 28.58 cm
Editura	LWW
Format	Hardcover
ISBN	9781496339409
Limba	Engleza
Nr pag	1000
Versiune digitala	DA