A three-paradigm treatment model using soft tissue mobilization and guided movement-awareness techniques for a patient with chronic low pack pain: A case study

被引:15
作者
Cottingham, JT
Maitland, J
机构
[1] ROLF INST, BOULDER, CO USA
[2] VALLEY THERAPY INTERDISCIPLINARY CLIN, SCOTTSDALE, AZ USA
关键词
guided movement-awareness techniques; sacroiliac joint dysfunction; soft tissue mobilization;
D O I
10.2519/jospt.1997.26.3.155
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
It is not uncommon for physical therapists to report difficulty in treating certain subjects with chronic idiopathic low back pain. The purpose of this case study is to present a three-paradigm model of intervention that may be adapted to the treatment of such cases. The model consists of: 1) relaxation paradigm, consisting of pain modulation procedures; 2) corrective paradigm, involving manual techniques and exercise to correct specific 'faulty biomechanical alignment(s) leg., pelvic asymmetry); and 3) integrative paradigm, utilizing guided movement/mobilization techniques for improving the subject's overall pattern of posture and movement The case study of a young adult with chronic low back pain correlated with unilateral innominate bone rotation is presented to illustrate the three-paradigm approach. Over six sessions, the subject received a corrective (sessions 1-3) and an integrative treatment protocol (sessions 4-6) consisting of Rolf's method of soft tissue mobilization and Alexander's system of guided movement-awareness techniques. Before and after each session and alter a 4-week follow-up, the subject was assessed for sacroiliac joint pain using a compression technique, anterior relation of the innominate bones, pelvic angle in the standing position, and vagal lone as determined from heart rate variability. The therapist's visual analysis of sit-to-stand movement and the subject's sell-reports of pain were noted. A corrective paradigm protocol of soft tissue mobilization and exercise was unsuccessful in eliminating the subject's assessed anterior rotation of the innominate bone and associated low back pain for more than 1-2 days posttreatment. Only after the implementation of a third paradigm movement/mobilization protocol did the subject begin to exhibit sustained improvement through a 4-week follow-up. Interpretations of the results, appropriate selection of corrective and integrative protocols, and physiological mechanisms are discussed.
引用
收藏
页码:155 / 167
页数:13
相关论文
共 60 条
[1]  
ALEXANDER FM, 1984, USE SELF
[2]  
[Anonymous], 1937, ENDS AND MEANS
[3]  
[Anonymous], SPACIOUS BODY EXPLOR
[4]   ENHANCED RESPIRATORY MUSCULAR FUNCTION IN NORMAL ADULTS AFTER LESSONS IN PROPRIOCEPTIVE MUSCULOSKELETAL EDUCATION WITHOUT EXERCISES [J].
AUSTIN, JHM ;
AUSUBEL, P .
CHEST, 1992, 102 (02) :486-490
[5]  
BILLMAN G, 1990, AM J PHYSIOL, V258, P896
[6]  
CAPLAN D, 1987, BACK TROUBLE NEW APP
[7]   CHANGES IN INNOMINATE TILT AFTER MANIPULATION OF THE SACROILIAC JOINT IN PATIENTS WITH LOW-BACK PAIN - AN EXPERIMENTAL-STUDY [J].
CIBULKA, MT ;
DELITTO, A ;
KOLDEHOFF, RM .
PHYSICAL THERAPY, 1988, 68 (09) :1359-1363
[8]   THE TREATMENT OF THE SACROILIAC JOINT COMPONENT TO LOW-BACK-PAIN - A CASE-REPORT [J].
CIBULKA, MT .
PHYSICAL THERAPY, 1992, 72 (12) :917-922
[9]   SHIFTS IN PELVIC INCLINATION ANGLE AND PARASYMPATHETIC TONE PRODUCED BY ROLFING SOFT-TISSUE MANIPULATION [J].
COTTINGHAM, JT ;
PORGES, SW ;
RICHMOND, K .
PHYSICAL THERAPY, 1988, 68 (09) :1364-1370
[10]  
DENSLOW JS, 1962, J AM OSTEOPATH ASSOC, V62, P706