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RESEARCH COMMENTARY
Ejona (Ona) Jeblonski, DPT, COMT
Fellow in Training, MAPS Accredited Fellowship in Orthopedic Therapy

Chris R. Showalter, PT, COMT, OCS, FAAOMPT
MAPS Fellowship Program Director

Mobilization Increases Dorsiflexion in Chronic Ankle Instability (CAI) Patients


 
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The American Back Society

The American Back Society (ABS) was founded in Oakland, California in 1982 as a non-profit organization dedicated to providing an interdisciplinary forum for health care professionals and scientists interested in relieving pain and diminishing impairment through proper diagnosis and treatment of patients suffering from spinal pathology.

MAPS faculty member Christopher R. Showalter MPT, OCS, COMT, FAAOMPT, FABS was recently featured in the Spring 2000 newsletter (p.14) following workshop presentations at the ABS Annual Conference in Las Vegas, in December, 1999.

Mr. Showalter presented: 
"Assessment and Treatment of the Spine: Characteristics of the Maitland-Australian Approach" and "The role of neurodynamics in the double crush and carpal tunnel patient"

Mr. Showalter was quoted:
"I don't believe that in the chronic population we see single diagnoses.  I think we see compensatory mechanisms which occur through out the body.  I don't think a disc is always just a disc.  I think a patient may have a disc and also adhesions that may be causing lack of movement at the facet joint.  Adhesions may be causing inappropriate movements in the dura or at other levels in the spinal canal.  So I think most of the patients we see are multifactorial in terms of musculoskeletal problems, particularly the chronics and particularly in spinal pain.  Irritability as a guidepost is very important in Maitland (concept) because it allows us to determine how vigorous we can be with this patient.  If they're irritable we have to be very careful with how vigorous we are and what and what rate of movement we use and what positions use and where in range we apply movement.  If they're not irritable you can feel relatively comfortable that you can be vigorous with them, gentle yet vigorous, never rough, and restore function more quickly in terms of range of motion. Treatment of the irritable disorder represents a challenge for physiotherapists and everyone else.  The dominant symptom of such a disorder is constant pain which is easily provoked and can take a long time to settle.  Some examples of irritable disorders which  may be encountered by physiotherapists and the rest of us are certain stages of the whiplash syndrome, severe trauma, and some of the acute inflammatory neuropathies like Guillain-Barre.  Rest plays an important part in treatment. However, appropriate movement can be beneficial for symptoms and perhaps more importantly will lessen the chances of post-inflammatory scarring" In the chronic population we see compensatory mechanisms occur throughout the body"  

MAPS editorial note: Portions of the above text transcribed by the ABS, were directly taken from a slideshow in which Mr. Showalter references the  work of Butler and Gifford (1996).  No plagiarism is implied or intended. 

MAPS faculty member Christopher R. Showalter MPT,OCS, COMT, FAAOMPT, FABS was recently featured in the Spring 1999 newsletter (p.9) following workshop presentations at the ABS Annual Conference in Las Vegas, in December, 1998.

Mr. Showalter presented:
"Assessment and Treatment of the Spine: Characteristics of the Maitland-Australian Approach"

Mr. Showalter was quoted:
" Manual physical therapy, in its broadest definition, implies the use of exercises, either passive or active, in an effort to assess, treat, and prevent a loss of function.  To a Maitland trained physical therapist the most important thing is assessment. A large percentage of the time spent with the patient is in assessment, because it is our belief that from an accurate assessment, accurate and appropriate treatment techniques will become plainly obvious.  Manual methods of treatment are recorded  in the early days of Hippocrates and the effectiveness of manual approaches has rightly been questioned, particularly recently.  It is a mixed body of knowledge out there and depending on what you read and when you last read it, you have to determine for yourself whether or not manual therapy is appropriate.  My personal belief is that it is a very strong discipline.  If you look at the number that actually incorporate manual therapy, whether it is chiropractic, whether it is osteopathy, whether it is the Maitland approach or the McKenzie approach, or muscle energy or any other areas, I think there is a very strong correlation for manual therapy in the management of spinal conditions.  The validity and reliability has also been supported in the literature.  I believe that to be true.  Studies come and studies go, but I think the majority of the literature supports the effectiveness and validity of manual therapy.  There is a strong correlation for manual therapy in the management of spinal conditions." 

You can visit the ABS website at www.americanbacksoc.org

 
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Looking for a COMT? This list of Certified Orthopedic Manual Therapists (or COMTs) includes all COMT graduates worldwide, as well as MAPS faculty. We suggest that you visit this page often to check course confirmation status and to find new courses which are added frequently. Our seminars incorporate the teaching of Geoff Maitland and others who have contributed to what has become known as the "Maitland-Australian Approach". Registering for classes is easy. Submit full payment with the registration form. Reservations are limited and are on a first come, first serve basis. Come meet our world-class faculty. Each of our faculty has experience in a wide variety of manual therapy practices and specialty areas.

 

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