B978-0-443-06857-7.00014-9, 00014 Combined Movement Theory
B978-0-443-06857-7.00015-0, 00015 Commissioning Editor: Rita Demetriou-Swanwick Development Editor: Veronika Watkins Project Manager: Frances Affleck Designer: Kirsteen Wright Illustration Manager: Gillian Richards Illustrator: Jennifer Rose
B978-0-443-06857-7.00016-2, 00016 Combined Movement Theory Rational Mobilization and Manipulation of the Vertebral Column PhD MCSP MMACP Fellow in Spinal Orthopaedics, Imperial College Healthcare, London, UK Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2010
B978-0-443-06857-7.00017-4, 00017 First published 2010, ã Elsevier Limited. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). ISBN 978-0-443-06857-7 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data A catalogue record for this book is available from the Library of Congress Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. The Publisher Printed in China The Publisher's policy is to use paper manufactured from sustainable forests
B978-0-443-06857-7.00018-6, 00018 Contents Contributors................................... vii Dedication.................................... ix Preface..................................... xi Acknowledgements................................ xiii Section 1 Combined Movement Theory..................... 1 1 Introduction to combined movement theory................... 3 2 Theoretical basis of combined movement theory................ 9, Louise Potter 3 The theory of clinical reasoning in combined movement theory....... 19 Roger Kerry 4 The principles of combined movement assessment.............. 51 5 Neurological assessment.............................. 69 6 Haemodynamics................................... 79 Roger Kerry, Alan J. Taylor 7 Principles and progression of combined movements............ 101 Section 2 Practical Combined Movement.................. 109 8 Upper cervical spine............................... 111 Gail Forrester, 9 Mid and lower cervical spine........................... 153 10 Thoracic spine................................... 165 11 Lumbo-sacral spine................................ 179 12 Sacroiliac joint................................... 189 13 Home treatment programmes.......................... 197 Index.............................................. 203
B978-0-443-06857-7.00019-8, 00019 Contributors Gail Forrester MSc MMACP MCSP PgCertEd Senior Lecturer in Physiotherapy, Department of Physiotherapy, Faculty of Health & Life Sciences, Coventry University, UK Roger Kerry MSc MMACP MCSP PGCHE Associate Professor, MSc Course Director, Division of Physiotherapy Education, University of Nottingham, Nottingham, UK PhD MCSP MMACP Fellow in Spinal Orthopaedics, Imperial College Healthcare, London, UK Ioannis Paneris BSc MCSP MMACP Extended Scope Practitioner, Clinical Specialist, Manchester Community Health, Manchester, UK Louise Potter BSc Osteopathy PhD Registered Osteopath, Medical School, University of Leicester, Leicester, UK Alan J. Taylor MSc MCSP Lead Physiotherapist, Nuffield Health and Wellbeing Centre, Nottingham, UK
B978-0-443-06857-7.00020-4, 00020 Dedication To B.G. Who so loves, believes the impossible. (Elizabeth Barrett-Browning)
B978-0-443-06857-7.00021-6, 00021 Preface To move is to change place, position or posture. Thus, the positions at the initiation and cessation of movement are integral to the analysis of movement. Combined movement theory (CMT) offers the investigator a framework to examine the influence of starting and finishing positions on movement impairment and use these positions to intervene therapeutically. This book is structured in two parts. The first part of the book details the theoretical concepts underpinning the combined movement approach, whilst the second part describes the practical application of the concept for each region of the spine. Significant contributions have been made by manipulative therapy colleagues and it was our intention to ensure that the book is a practical reference for those undertaking combined movement treatment as well as a resource for musculoskeletal practitioners generally. Aims The aims of this book are to provide readers with grounding in the principles of a method of spinal dysfunction assessment and treatment that facilitates: The recognition of when to consider combined movements theory in the management of spinal impairment and pain The expansion of the subjective and objective examination to more sensitively classify spinal impairment The management of spinal impairment with passive and active movements The management of spinal impairment with positioned muscular contractions The progression and regression of treatment based on position and grade of passive movement Selecting and applying manipulative techniques An understanding of spinal biomechanics, the physiological basis of manual therapy and clinical reasoning. Dr London 2009
B978-0-443-06857-7.00022-8, 00022 Acknowledgements My eternal thanks to the late Dr Brian Edwards for showing me that combinations of movement could offer speedy return of spinal function. His teaching, at the beginning of my career, has guided my practice for nearly 20 years. Many thanks to my contributing experts and to Heidi Allen, publisher, who, in addition to initiating this project, modelled for the pictures and video clips.