Low Back Disorders: Evidence-based Prevention and Rehabilitation

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Human Kinetics, 2007 - Health & Fitness - 312 pages
2 Reviews

Access the latest research and applications to build effective prevention and rehabilitation programs for your patients or clients with Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition. Internationally recognized low back specialist Stuart McGill presents original research to quantify the forces that specific movements and exercises impose on the low back, dispels myths regarding spine stabilization exercises, and suggests prevention approaches and strategies to offset injuries and restore function.

Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition,
presents a clear exposition of back anatomy and biomechanics and demonstrates how to interpret the latest research on low back involvement for clinical applications. The text also contains detailed information on injuries associated with seated work and sport and ergonomic issues related to manual handling of materials. With Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition, you will

-gain valuable information on measured loading of the back during specific activities and apply it to avoid common—but counterproductive—practices in back rehabilitation;

-learn how to analyze each patient's or client's unique physical characteristics and lifestyle factors to tailor preventive measures and treatments to individual needs;

-learn how to help patients and clients progress through the stages of rehabilitation: corrective exercise, stability or mobility, endurance, and strength; and

-acquire the information necessary to design an effective injury-prevention program.
This fully updated second edition expands knowledge of low back disorders and best practices in several areas. Enhanced algorithms guide progessive therapeutic exercise, and specially designed patient assessment provocation tests aid you in determining the cause of back troubles, guide your choices in the best ways to eliminate problems, and improve the development of appropriate activities for functional gain. Whereas the first edition focused on increasing spine stability, the second edition provides new information on dealing with both regional instability or mobility and regional stiffness present in individuals where most of the motion occurs at a single spinal segment.

With an expanded repertoire of pain-free motion exercises and additional information on ways to find and adjust stabilization exercises, Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition, offers you new tools to help your patients and clients achieve pain-free exertion.

The text includes exercises and activities that provide a solid foundation of physical work in preparation for more advanced activities in sports and occupations. Also, the process of transitioning into performance exercise is outlined with an explanation of the critical stages of the performance pyramid, including the design of appropriate corrective exercise, building joint and whole-body stability, enhancing endurance, training true strength, and transitioning to ultimate performance.

Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition,
presents foundational information and corresponding clinical applications in a clear, well-sequenced format. Part Ibuilds your knowledge of lumbar function and injury. Part IIdemonstrates how to use this knowledge to build evidence-based injury-prevention programs by assessing risks, creating ergonomic interventions, and training personnel. Part IIIfocuses on improving rehabilitation techniques, including specific diagnostic and provocative tests, with specific therapeutic exercises proven to enhance performance and reduce pain through a continuum from corrective exercise to stability and mobility, endurance, strength, and power.

Additionally, the text offers these practical features to guide your learning and inform your practice:

-More than 475 photos, graphs, and charts support the research and the scientific basis for the text's conclusions.

-More than 50 tests and exercises with step-by-step instructions help you develop successful programs for your patients and clients.

-Special sections highlight how the anatomical, biomechanical, and research results can be applied to clinical situations.

-Extensive discussions on individualizing treatment for clients or patients help you improve your assessment skills by learning what questions to ask and what avenues of investigation to pursue with each patient or client.

-Reproducible handout sheets for each of the 25 basic rehabilitation exercises, which include photos and blank lines for instructions, enable the creation of instruction sheets tailored to the current needs and progress rates of each patient or client.
Cutting-edge research and evidence-based application strategies from the leading spine specialist in North America make Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition, the authoritative text for study, care, and treatment of the low back. Its unique approach to back care will guide you in developing intervention, rehabilitation, and prevention programs to address the unique needs of each patient or client and develop a strong scientific foundation for your practice.

  

What people are saying - Write a review

Review: Low Back Disorders: Evidenced-Based Prevention and Rehabilitation

User Review  - Kayla Purdum - Goodreads

Good for learning proper strengthening of low back. First free read I did at chiropractic school. Very educational Read full review

Review: Low Back Disorders: Evidenced-Based Prevention and Rehabilitation

User Review  - Lee - Goodreads

Anyone struggling with lower back injuries or working with people with lower back disorders should pick this up. Some of his ideas are pretty much a-DUH but how he effortlessly explains himself is brilliant. Read full review

Contents

Scientific Foundation
1
Introduction to the Issues
2
The Unfortunate Adverse Impact on Bad Backs
3
Is It True That 85 of Back Troubles Are of Unknown Etiology?
5
Is It True That Most Chronic Back Complaints Are Rooted in Psychological Factors?
6
Does Pain Cause Activity Intolerance?
7
IllAdvised Rehabilitation Recommendations
8
Can Back Rehabilitation Be Completed in 6 to 12 Weeks?
10
NIOSH Approach to Risk Assessment
125
1993 Guideline
126
Snook Psychophysical Approach
127
Ergowatch
128
Biological SignalDriven Model Approaches
130
EMGAssisted Optimization
131
Reducing the Risk of Low Back Injury
133
Compensation Board StatisticsAn Artifact?
134

Should the Primary Goal of Rehabilitation Be Restoring the Range of Motion?
11
A Final Note
14
Scientific Approach Unique to This Book
15
In Vivo Lab
16
Development of the Virtual Spine
21
Epidemiological Studies on Low Back Disorders LBDs
22
Three Important Studies
23
Do Workers Experience LBDs Because They Are Paid to Act Disabled?
24
Does Pain Have an Organic BasisOr Is It All in the Head?
25
Are Biomechanical Variables and Psychosocial Variables Distinct?
28
How Do Biomechanical Factors Affect LBD?
29
What Are the Lasting Physiological Biomechanical and Motor Changes to Which Injury Leads?
30
What Is the Optimal Amount of Loading for a Healthy Spine?
31
What Are the Links Between Personal Factors and LBD?
32
What the Evidence Supports
33
Functional Anatomy of the Lumbar Spine
35
Vascular Anatomy
36
Posterior Elements of the Vertebrae
41
Intervertebral Disc
44
Muscles
47
Muscle Size
48
Muscle Groups
49
Abdominal Muscles
56
Psoas
60
Quadratus Lumborum
61
Muscle Summary
62
Longitudinal Ligaments
63
Other Ligaments in the Thoracolumbar Spine
65
Lumbodorsal Fascia LDF
66
A Quick Review of the Pelvis Hips and Related Musculature
67
Clinically Relevant Aspects of Pain and Anatomic Structure
70
Can Pain Descriptors Provide a Reliable Diagnosis?
71
Normal and Injury Mechanics of the Lumbar Spine
72
Kinetics and Normal Lumbar Spine Mechanics
76
Loads on the Low Back During Various Exercises
87
Dubious Lifting Mechanisms
91
IntraAbdominal Pressure
92
Lumbodorsal Fascia
94
Hydraulic Amplifier
95
Biomechanics of Diurnal Spine Changes
96
Muscle Cocontraction and Spine Stability
97
Injury Mechanisms
98
Injury Mechanics Involving the Lumbar Mechanism
99
Biomechanical and Physiological Changes Following Injury
108
Motor Changes
109
Specific Patterns of Muscle Inhibition Following Injury
110
Myths and Realities of Lumbar Spine Stability
113
Quantitative Foundation of Stability
114
Potential Energy as a Function of Height
115
Potential Energy as a Function of Stiffness and Elastic Energy Storage
117
Muscles Create Force and Stiffness
118
Sufficient Stability
119
Injury Prevention
123
LBD Risk Assessment
124
Studies on the Connection Between Fitness and Injury Disability
135
LBD Prevention for Workers
136
What Are the Ways to Reduce the Reaction Moment?
138
Should One Avoid Exertion Immediately After Prolonged Flexion?
143
Should IntraAbdominal Pressure IAP Be Increased During Lifting?
144
Are Twisting and Twisting Lifts Particularly Dangerous?
145
Is There Any Way to Make Seated Work Less Demanding on the Back?
148
Some ShortAnswer Questions
150
LBD Prevention for Employers
152
Injury Prevention Primer
154
A Note for Consultants
157
The Question of Back Belts
158
Scientific Studies
159
Biomechanical Studies
161
Studies of Belts Heart Rate and Blood Pressure
162
Psychophysical Studies
163
Low Back Rehabilitation
165
Building Better Rehabilitation Programs for Low Back Injuries
166
Finding the Best Approach
167
Stages of Patient Progression
169
Establish Stability Through Exercises and Education
181
Develop Endurance
182
Guidelines for Developing the Best Exercise Regimen
183
Basic Issues in Low Back Exercise Prescription
184
Evaluating the Patient
189
First ClinicianPatient Meeting
190
Some Provocation Tests
192
A Note on Motion Palpation
198
Some Functional Screens
199
The Stiff Spine
203
Testing for Aberrant Gross Lumbar Motion
204
Testing Muscle Endurance
210
Developing the Exercise Program
213
Clinical Wisdom
214
Flossing the Nerve Roots for Those With Accompanying Sciatica
216
Identifying Safe and Effective Exercises
217
Incorporating and Patterning the Muscles
218
Selecting Safe and Effective Exercises
220
A Sample
221
Exercises That May Be Used in a Stabilization Program
222
Advanced Exercises
230
Safely Increasing Challenges
231
Safely Progressing Back Exercises
233
Occupational and Athletic Work Hardening
236
Low Back Exercises Only for Athletes
238
Looking Forward
241
EPILOGUE
243
HANDOUTS FOR PATIENTS OR CLIENTS
244
APPENDIX
268
GLOSSARY
274
REFERENCES AND ADDITIONAL READINGS
276
INDEX
301
ABOUT THE AUTHOR
312
Copyright

Common terms and phrases

Popular passages

Page 281 - Group (1998). A comparison of peak vs cumulative physical work exposure risk factors for the reporting of low back pain in the automotive industry.
Page 288 - CA 1999 Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Archives of Physical Medicine and Rehabilitation 80(9):1 005-1 01 2 439.
Page 290 - JL; and TORVIK. PJ: Biomechanics of Anterior Cruciate Ligament Failure. An Analysis of Strain-Rate Sensitivity and Mechanisms of Failure in Primates.
Page 294 - The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration.
Page 281 - The effect of compensation involvement on the reporting of pain and disability by patients referred for rehabilitation of chronic low back pain.
Page 281 - Rantanen J, Hurme M, Falck B, et al. The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation. Spine 1993; 18 : 568-74.
Page 297 - JF (1992) An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers.
Page 293 - McGill, SM 1992, A myoelectrically based dynamic three-dimensional model to predict loads on lumbar spine tissues during lateral bending...

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About the author (2007)

Stuart McGill, PhD, is a professor at the University of Waterloo at Waterloo, Ontario, Canada, and a world-renowned lecturer and expert in spine function, injury prevention, and rehabilitation.

McGill has written more than 200 scientific publications on the topics of lumbar function, low back injury mechanisms, investigation of tissue loading during rehabilitation programs, and the formulation of work-related injury avoidance strategies. He has received several awards for his work, including the Volvo Bioengineering Award for Low Back Pain Research from Sweden.

McGill has been an invited lecturer at many universities and delivered more than 200 addresses to societies around the world. As a consultant, he has provided expertise on assessment and reduction of the risk of low back injury to government agencies, corporations, professional athletes and teams, and legal firms. He is one of the few scientists who consults and to whom patients are regularly referred.

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