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This long awaited text presents a new approach to therapeutic exercise for the back, based on the evidence from detailed studies undertaken by the authors over a number of years. The approach focuses on stabilization training of the muscles affecting the back. It also demonstrates the practical clinical relevance of their findings.
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assessment /).\ �� iU1 CHURCHILL LIVINGSTONE 9 4 rr rlO 780443ln058028 Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain Scientific Basis and Clinical Approach Carolyn Richardson PhD BPhty (Hons) Associate Professor and Reader, Department of Physiotherapy, University of Queensland, Australia Gwendolen Jull MPhty, GradDipManipTher FACP Associate Professor and Reader, Department of Physiotherapy, University of Queensland, Australia Paul Hodges PhD BPhty (Hons) NHMRC Postdoctoral Research Fellow, Prince of Wales Medical Research Institute, Sydney, Australia Julie Hides PhD MPhtyST BPhty Clinical Supervisor, Joint Stability Assessment Clinic, Department of Physiotherapy, University of Queensland, Australia Foreword by Manohar M Panjabi PhD DTech Professor, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT USA /).\ �� UI CHURCHIll LIVINGSTONE EDINBURGH LONDON NEW YORK PHILADELPHIA SYDNEY AND TORONTO 1999 CHURCHill LIVINGSTONE An imprint of Harcourt Brace and Company Limited C Harcourt Brace and Company Limited 1999 b is a registered trade mark of Harcourt Brace and Company Limited 1999 All rights reserved. No part of this publication may be reproduced. stored in a retrieval system, or transmitted in any form or by any means, electronic. mechanical, photocopying. recording or otherwise. without either the prior permission althe publishers (Harcourt Brace and Company Limited, 24-28 Oval Road, London NWI 7DX), or a licence permitting restricted copying In the United Kingdom issued by the Copyright Licensing Agency lid, 90 Tottenham Court Road. london. W1 P OlP. The right of Carolyn Richardson, Gwendalen Jull, Paul Hodges and Julie Hides to be identified as the authors of this Work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. First published 1999 ISBN 0 443 058024 British library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging In Publication Data A catalog record for this book is available from the Library of Congress. Note Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors and the publishers have, as far as it is possible, taken care to ensure that the information given in this text is accurate and up to date. However, readers are strongly advised to confirm that the information, especially with regard to drug usage. complies with latest legislation and standards of practice. Printed in the United Kingdom Contents Foreword Preface vii ix Acknowledgements SECTION 1 1. 7. xi SECTION 2 SECTION 4 Introduction The reason for change problems in the local muscles of the lumbopelvic region 125 9 3. Traditional views of the function of the muscles of the local stabilizing system of the spine 21 4. A new perspective on the stabilization role of the transversus abdominis 41 10. <