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Contents List of Tests and Exercises Why and How You Should Read This Book Acknowledgments Part I Scientific Foundation Chapter 1 Introduction to the Issues Legislative Landscape: The Unfortunate Adverse Impact on Bad Backs Deficiencies in Current Low Back Disorder Diagnostic Practices Is It True That 85% of Back Troubles Are of Unknown Etiology? Diagnosis by hypothesis testing Is It True That Most Chronic Back Complaints Are Rooted in Psychological Factors? Does Pain Cause Activity Intolerance? Inadequacies in Current Care and Prevention of Low Back Disorders Ill-Advised Rehabilitation Recommendations Can Back Rehabilitation Be Completed in 6 to 12 Weeks? Should the Primary Goal of Rehabilitation Be Restoring the Range of Motion? What are better alternatives in dealing with painful backs? Mechanical Loading and the Process of Injury: A Low Back Tissue Injury Primer A Final Note Chapter 2 Scientific Approach Unique to This Book In-Vitro Lab In-Vivo Lab How the Virtual Spine Works Development of the Virtual Spine Chapter 3 Epidemiological Studies on Low Back Disorders (LBDs) Multidimensional Links Among Biomechanical, Psychosocial, and Personal Variables Three Important Studies Do Workers Experience LBDs Because They Are Paid to Act Disabled? Does Pain Have an Organic Basis¿Or Is It All in the Head? Are Biomechanical Variables and Psychosocial Variables Distinct? What Is the Significance of First-Time Injury Data for Cause and Prevention? How Do Biomechanical Factors Affect LBD? Mechanical Loading and LBD: Field-Based Risk Factors What Are the Lasting Physiological, Biomechanical, and Motor Changes to Which Injury Leads? What Is the Optimal Amount of Loading for a Healthy Spine? What Are the Links Between Personal Factors and LBD? What the Evidence Supports Chapter 4 Functional Anatomy of the Lumbar Spine Basic Neural Structure Vascular Anatomy The Vertebrae Vertebral Architecture and Load Bearing Posterior Elements of the Vertebrae ,cona>Intervertebral Disc Progressive Disc Injury Muscles Muscle Size Muscle Groups Abdominal Muscles Psoas Quadratus Lumborum Muscle Summary Ligaments Longitudinal Ligaments Interspinous and Superspinous Ligaments Other Ligaments in the Thoraco-Lumbar Spine Normal Ligament Mechanics and Injury Mechanics Lumbodorsal Fascia (LDF) A Quick Review of the Pelvis, Hips, and Related Musculature Clinically Relevant Aspects of Pain and Anatomic Structure Tissue-Specific Types of Pain Can Pain Descriptors Provide a Reliable Diagnosis? A Final Note Chapter 5 Normal and Injury Mechanics of the Lumbar Spine Kinematic Properties of the Thoraco-Lumbar Spine Kinetics and Normal Lumbar Spine Mechanics Standing and Bending Forward Loads on the Low Back During Lifting Loads on the Low Back During Walking Loads on the Low Back During Pushing and Pulling Loads on the Low Back During Sitting Loads on the Low Back During Flexion Exercises Loads on the low back during various pushup exercises Loads on the Low Back During Extension Exercises Loads from Backpack Carriage Dubious Lifting Mechanisms Intra-Abdominal Pressure Lumbodorsal Fascia Hydraulic Amplifier IAP, LDF, and Hydraulic Amplifier: A Summary Other Important Mechanisms of Normal Spine Mechanics Biomechanics of Diurnal Spine Changes Spinal Memory Anatomical Flexible Beam and Truss: Muscle Cocontraction and Spine Stability Injury Mechanisms Summary of Specific Tissue Injury Mechanisms Injury Mechanics Involving the Lumbar Mechanism Staying Within the ¿Biomechanical Envelope¿ Sources of Motor Control Errors Biomechanical and Physiological Changes Following Injury Tissue Damage Pathogenesis, Pain, and Performance Injury Process: Motor Changes Specific Patterns of Muscle Inhibition Following Injury The Crossed-Pelvis Syndrome and Gluteal Amnesia Chapter 6 Lumbar Spine Stability: Myths and Realities Stability: A Qualitative Analogy Quantitative Foundation of Stability Potential Energy as a Function of Height Potential Energy as a Function of Stiffness and Elastic Energy Storage Muscles create force and stiffness Sufficient Stability Stability Myths, Facts, and Clinical Implications Part II Injury Prevention Chapter 7 LBD Risk Assessment Brief Review of the Risk Factors for LBD NIOSH Approach to Risk Assessment 1981 Guideline 1993 Guideline Snook Psychophysical Approach Lumbar Motion Monitor (LMM) 4D WATBAK Euler Angles and Orthopedic Moments Biological Signal¿Driven Model Approaches The Marras Model and the McGill Model EMG-Assisted Optimization Simple or Complex Models? The Challenge Before Us Chapter 8 Reducing the Risk of Low Back Injury Lessons From the Literature Compensation Board Statistics - An Artifact? Ergonomic Studies Rehab and Prevention Studies Studies on the Connection Between Fitness and Injury Disability Beyond Ergonomics - Is it time to "modify" the worker? LBD Prevention for Workers Should Workers Avoid End Range of Spine Motion During Exertion? What Are the Ways to Reduce the Reaction Moment? Should One Avoid Exertion Immediately After Prolonged Flexion? Should Intra-Abdominal Pressure (IAP) Be Increased While Lifting? Are Twisting and Twisting Lifts Particularly Dangerous? Is Lifting Smoothly and Not Jerking the Load Always Best? Is There Any Way to Make Seated Work Less Demanding on the Back? Some Short-Answer Questions LBD Prevention for Employers Injury Prevention Primer A Note for Consultants Reducing the Risk in Athletes Chapter 9 The Question of Back Belts Issues of the Back Belt Question Scientific Studies Clinical Trials Biomechanical Studies Studies of Belts, Heart Rate, and Blood Pressure Psychophysical Studies Summary of Prescription Guidelines Part III Low Back Rehabilitation Chapter 10 Building Better Rehabilitation Programs for Low Back Injuries Our Five-Stage Back Training Program Finding the Best Approach Stages of Patient Progression Stage 1. Detect and correct perturbed motion/motor patterns Stage 2. Establish Stability Through Exercises and Education Stage 3. Develop Endurance Guidelines for Developing the Best Exercise Regimen Developing a Sound Basis for Exercise Prescription Basic Issues in Low Back Exercise Prescription Chapter 11 Evaluating the Patient The Most Crucial Element in Evaluation First Clinician¿Patient Meeting Some Provocation Tests Compression tests Extension tests Neural tests Reflex testing Testing for lumbar joint shear stability A Note on Motion Palpation Distinguishing Between Lumbar and Hip Problems Some Functional Screens Posture Manual Tests for Control of Motion The ¿stiff¿ spine Control of torsional motion Testing for Aberrant Gross Lumbar Motion Testing Muscle Endurance Lateral Musculature Test Flexor Endurance Test Back Extensors Test Chapter 12 Developing the Exercise Program Preliminary Matters Philosophy of Low Back Exercise Design Clinical Wisdom Sparing the Back While Stretching the Hips and Knees Flossing the Nerve Roots for Those With Accompanying Sciatica Preliminaries to Training the Stabilizing Muscles Identifying Safe and Effective Exercises Beginner¿s Program for Stabilization - A Sample Chapter 13 Advanced Exercises Safely Increasing Challenges Labile Surfaces and Resistance Training Machines Safely Progressing Back Exercises Occupational and Athletic Work Hardening Low Back Exercises for High-Performance Workers or Athletes Low Back Exercises Only for Athletes Looking Forward Epilogue Patient/Client Handouts Appendix Glossary References Index About the Author
Library of Congress Subject Headings for this publication:
Back Injuries -- prevention & control.
Back Injuries -- rehabilitation.
Low Back Pain -- prevention & control.
Low Back Pain -- rehabilitation.