#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Myths about the Stabilization System


Authors: E. Lederman
Authors‘ workplace: CPDO Ltd., 15 Harberton Road, London, UK
Published in: Rehabil. fyz. Lék., 15, 2008, No. 2, pp. 63-73.
Category: Original Papers

Overview

The principle of core stability has gained wide acceptance in training for prevention of injury and as a treatment modality for rehabilitation of various musculoskeletal conditions in particular the lower back. There has been surprising little criticism of this approach up to date. This article will re-examine the original findings and the principles of core stability and how well they fare within the wider knowledge of motor control, prevention of injury and rehabilitation of neuromuscular and musculoskeletal systems following injury.

Key words:
core stability, transverses abdominis, chronic lower back, neuromuscular rehabilitation


Sources

1. HODGES, P. W., RICHARDSON C. A.: Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine, 21, 1996, 22, s. 2640-2650.

2. HODGES, P. W., RICHARDSON, C. A.: Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J. Spinal. Disord., 11, 1998, 1, s. 46-56.

3. FREEMAN, M. A., DEAN, R. M., HANHAM, I. W:. The etiology and prevention of functional instability of the foot. J. Bone Joint Surg. Br., 47, 1965, 4, s. 678-685.

4. JULL, G. A., RICHARDSON, C. A.: Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. J. Manipulative Physiol. Ther., 23, 2000, 2, s. 115-177.

5. RICHARDSON, C. A. et al.: The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine, 27, 2002, 4, s. 399-405.

6. SAPSFORD, R. R. et al.: Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol. Urodyn, 20, 2001, 1, s. 31-42.

7. HODGES, P. W. et al.: Contraction of the human diaphragm during rapid postural adjustments. J. Physiol., 505, 1997, Pt 2, s. 539-548.

8. HODGES, P. et al.: Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: in vivo porcine studies. Spine, 28, 2003, 23, s. 2594-2601.

9. MISURI, G. et al.: In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects. Eur. Respir. J., 10, 1997, 12, s. 2861-2867.

10. BENDAVID, R., HOWARTH, D.: Transversalis fascia rediscovered. Surg. Clin. North Am, 80, 2000, 1, s. 25-33..

11. GILLEARD, W. L., BROWN, J. M.: Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Phys. Ther., 76, 1996, 7, s. 750-762.

12. FAST, A. et al.: Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain. Spine, 15, 1990, 1, s. 28-30.

13. MOGREN, I. M., POHJANEN, A. I.: Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine, 30, 2005, 8, s. 983-991.

14. ORVIETO, R. et al.: Low-back pain during pregnancy. Harefuah, 119, 1990, 10, s. 330-331.

15. BASTIAENEN, C. H. et al.: Effectiveness of a tailor-made intervention for pregnancy-related pelvic girdle and/or low back pain after delivery: Short-term results of a randomized clinical trial [ISRCTN08477490]. BMC Musculoskelet Disord., 7, 2006, 1, s. 19.

16. LEBOEUF-Y, C.: Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine, 2000, 2, s. 226-237.

17. MIZGALA, C. L., HARTRAMPF, C. R., Jr., BENNETT, G. K.: Assessment of the abdominal wall after pedicled TRAM flap surgery: 5- to 7-year follow-up of 150 consecutive patients. Plast. Reconstr. Surg., 93, 1994, 5, s. 988-1002, discussion 1003-1004.

18. SIMON, A. M. et al.: Comparison of unipedicled and bipedicled TRAM flap breast reconstructions: assessment of physical function and patient satisfaction. Plast. Reconstr. Surg., 113, 2004, 1, s. 136-140.

19. CONDON, R. E., CARILLI, S.: The Biology and Anatomy of Inguinofemoral Hernia. Semin. Laparosc. Surg., 1, 1994, 2, s. 75-85.

20. BERLINER, S. D.: Adult inguinal hernia: pathophysiology and repair. Surg. Annu, 15, 1983, s. 307-329.

21. HODGES, P. W., RICHARDSON, C. A.: Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp. Brain. Res., 114, 1997, 2, s. 362-370.

22. CRESSWELL, A. G., ODDSSON, L., THORSTENSSON, A.: The influence of sudden perturbations on trunk muscle activity and intra-abdominal pressure while standing. Exp. Brain. Res., 98, 1994, 2, s. 336-341.

23. MacDONALD, D. A., LORIMER MOSELEY, G., HODGES, P. W.: The lumbar multifidus: Does the evidence support clinical beliefs? Man. Ther., 11, 2006, 4, s. 254-263.

24. MOSELEY, G. L. et al.: The threat of predictable and unpredictable pain: differential effects on centra nervous system processing? Aust. J. Physiother., 49, 2003, 4, s. 263-267.

25. MOSELEY, G. L., NICHOLAS, M. K., HODGES, P. W.: Pain differs from non-painful attention-demanding or stressful tasks in its effect on postural control patterns of trunk muscles. Exp. Brain Res., 156, 2004, 1, s. 64-71.

26. MOSELEY, G. L., HODGES, P. W.: Reduced variability of postural strategy prevents normalization of motor changes induced by back pain: a risk factor for chronic trouble? Behav. Neurosci., 120, 2006, 2, s 474-476.

27. RADEBOLD, A. et al.: Muscle response pattern to sudden trunk loading in healthy individuals and in patients with chronic low back pain. Spine, 25, 2000, 8, s. 947-954.

28. RICHARDSON, C. A., JULL, G. A.: Muscle control-pain control. What exercises would you prescribe? Man. Ther., 1, 1995, 1, s. 2-10.

29. LEDERMAN, E.: The science and practice of manual therapy. 2nd ed., London, Elsevier, 2005..

30. O’SULLIVAN, P. B.: Lumbar segmental ‘instability’: clinical presentation and specific stabilizing exercise management. Man. Ther., 5, 2000, 1, s. 2-12.

31. HUBLEY-KOZEY, C. L., VEZINA, M. J.: Differentiating temporal electromyographic waveforms between those with chronic low back pain and healthy controls. Clin. Biomech. (Bristol, Avon), 17, 2002, 9-10, s. 621-629.

32. ARENA, J. G. et al.: Electromyographic recordings of low back pain subjects and non-pain controls in six different positions: effect of pain levels. Pain, 45, 1991, 1, s. 23-28.

33. MARRAS, W. S. et al.: Functional impairment as a predictor of spine loading. Spine, 30, 2005, 7, :s. 729-737.

34. NOUWEN, A., VAN AKKERVEEKEN, P. F., VERSLOOT, J. M.: Patterns of muscular activity during movement in patients with chronic low-back pain. Spine, 12, 1987, 8, s. 777-782.

35. VAN DIEEN, J. H., CHOLEWICKI, J., RADEBOLD, A.: Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine. Spine, 28, 2003, 8, s. 834-841.

36. SHIRADO, O. et al.: Concentric and eccentric strength of trunk muscles: influence of test postures on strength and characteristics of patients with chronic low-back pain. Arch. Phys. Med. Rehabil., 76, 1995, 76, 7, s. 604-611.

37. McGILL, S. M. et al.: Coordination of muscle activity to assure stability of the lumbar spine. J. Electromyogr. Kinesiol., 13, 2003, 4, s. 353-359.

38. CORDO, P. J. et al.: The sit-up: complex kinematics and muscle activity in voluntary axial movement. J. Electromyogr. Kinesiol., 13, 2003, 3, s. 239-252.

39. MOSELEY, G. L., HODGES, P. W., GANDEVIA, S. C.: External perturbation of the trunk in standing humans differentially activates components of the medial back muscles. J. Physiol., 547, 2003, Pt 2, s. 581-587.

40. URQUHART, D. M., HODGES, P. W.: Differential activity of regions of transversus abdominis during trunk rotation. Eur. Spine J., 14, 2005, 4, s. 393-400.

41. URQUHART, D. M. et al.: Abdominal muscle recruitment during a range of voluntary exercises. Man. Ther., 10, 2005, 2, s. 144-153.

42. ANDERSSON, E. A. et al.: EMG activities of the quadratus lumborum and erector spinae muscles during flexion-relaxation and other motor tasks. Clin. Biomech. (Bristol, Avon), 11, 1996, 7, s. 392-400.

43. WHITE, S. G., McCNAIR, P. J.: Abdominal and erector spinae muscle activity during gait: the use of cluster analysis to identify patterns of activity. Clin Biomech. (Bristol, Avon), 17, 2002, 3, s. 177-184.

44. CHOLEWICKI, J., PANJABI, M. M., KHACHATRYAN, A.: Stabilizing function of trunk flexor-extensor muscles around a neutral spine posture. Spine, 22, 1997, 19, s. 2207-2212.

45. VAN DIEEN, J. H., KINGMA, I., VAN DER BUG, P.: Evidence for a role of antagonistic cocontraction in controlling trunk stiffness during lifting. J. Biomech., 36, 2003, 12, s. 1829-1836.

46. HIDES, J. A. et al.: Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine, 19, 1994, 2, s. 165-172.

47. MANNION, A. F. et al.: Increase in strength after active therapy in chronic low back pain (CLBP) patients: muscular adaptations and clinical relevance. Schmerz, 15, 2001, 6, s. 468-473.

48. MANNION, A. F. et al.: Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength. Spine, 26, 2001, 8, s. 897-908.

49. NG, J. K. et al.: Fatigue-related changes in torque output and electromyographic parameters of trunk muscles during isometric axial rotation exertion: an investigation in patients with back pain and in healthy subjects. Spine, 27, 2002, 6, s. 637-646.

50. NG, J. K. et al.: EMG activity of trunk muscles and torque output during isometric axial rotation exertion: a comparison between back pain patients and matched controls. J. Orthop. Res., 20, 2002, 1, s. 112-121.

51. HELEWA, A. et al.: An evaluation of four different measures of abdominal muscle strength: patient, order and instrument variation. J. Rheumatol., 17, 1990, 7, s. 965-969.

52. HELEWA, A., GOLDSMITH, C. H., SMYTHE, H. A.: Measuring abdominal muscle weakness in patients with low back pain and matched controls: a comparison of 3 devices. J. Rheumatol., 20, 1993, 9, s. 1539-1543.

53. HORTON, J. F., LINDSAY, D. M., MACINTOSH, B. R.: Abdominal muscle activation of elite male golfers with chronic low back pain. Med. Sci. Sports. Exerc., 33, 2001, 10, s. 1647-1654.

54. HUBLEY-KOZEY, C. L., VEZINA, M. J.: Muscle activation during exercises to improve trunk stability in men with low back pain. Arch. Phys. Med. Rehabil., 83, 2002, 8, s. 1100-1108.

55. VEZINA, M. J., HUBLEY-KOZEY, C. L.: Muscle activation in therapeutic exercises to improve trunk stability. Arch. Phys. Med. Rehabil., 81, 2000, 10, s. 1370-1379.

56. SOUZA, G. M., BAKER, L. L., POWERS, C. M.: Electromyographic activity of selected trunk muscles during dynamic spine stabilization exercises. Arch. Phys. Med. Rehabil., 82, 2001, 11, s. 1551-1557.

57. SUNG, P. S.: Multifidi muscles median frequency before and after spinal stabilization exercises. Arch. Phys. Med. Rehabil., 84, 2003, 9, s. 1313-1318.

58. STEVENS, V. K. et al.: The effect of increasing resistance on trunk muscle activity during extension and flexion exercises on training devices. J. Electromyogr. Kinesiol., 2006.

59. STEVENS, V. K. et al.: Electromyographic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers. Eur. Spine J., 2006.

60. KAVCIC, N., GRENIER, S., McGILL, S. M.: Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine, 29, 2004, 11, s. 1254-1265.

61. HODGES, P. W. et al.: Three dimensional preparatory trunk motion precedes asymmetrical upper limb movement. Gait Posture, 11, 2000, 2, s. 92-101.

62. CHOLEWICKI, J., IVANCIC, P. C., RADEBOLD, A.: Can increased intra-abdominal pressure in humans be decoupled from trunk muscle co-contraction during steady state isometric exertions? Eur. J. Appl. Physiol., 87, 2002, 2, s. 127-133.

63. BROWN, S. H., VERA-GARCIA, F. J., McGILL, S. M.: Effects of abdominal muscle coactivation on the externally preloaded trunk: variations in motor control and its effect on spine stability. Spine, 31, 2006, 13, s. E387-393.

64. GEORGOPOULOS, A. P.: Neural aspects of cognitive motor control. Curr. Opin. Neurobiol., 10, 2000, 2, s. 238-241.

65. LUSCHER, H. R., CLAMANN, H. P.: Relation between structure and function in information transfer in spinal monosynaptic reflex. Physiol. Rev., 72, 1992, 1, s. 71-99.

66. BEITH, I. D., HARRISON, P. J.: Stretch reflexes in human abdominal muscles. Exp. Brain. Res., 159, 2004, 2, s. 206-213.

67. CHOLEWICKI, J. et al.: Neuromuscular function in athletes following recovery from a recent acute low back injury. J. Orthop. Sports Phys. Ther., 32, 2002, 11, s. 568-575.

68. CARPENTER, D. M., NELSON, B. W.: Low back strengthening for the prevention and treatment of low back pain. Med. Sci Sports Exerc., 31, 1999, 1, s. 18-24.

69. BARKER, K. L., SHAMLEY, D. R., JACKSON, D.::Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability. Spine, 29, 2004, 22, s. E515-519.

70. POOL-GOUDZWAARD, A. L. et al.: Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction. Int. Urogynecol. J. Pelvic Floor Dysfunct., 16, 2005, 6, s. 468-474.

71. LEINONEN, V. et al.: Back and hip extensor activities during trunk flexion/extension: effects of low back pain and rehabilitation. Arch. Phys. Med. Rehabil., 81, 2000, 1, s. 32-37.

72. BEITH, I. D., SYNNOTT, R. E., NEWMAN, S. A.: Abdominal muscle activity during the abdominal hollowing manoeuvre in the four point kneeling and prone positions. Man. Ther., 6, 2001, 2, s. 82-87.

73. URQUHART, D. M., HODGES, P. W., STORY, I. H.: Postural activity of the abdominal muscles varies between regions of these muscles and between body positions. Gait Posture, 22, 2005, 4, s. 295-301.

74. ROELS, B. et al.: Specificity of VO2MAX and the ventilatory threshold in free swimming and cycle ergometry: comparison between triathletes and swimmers. Br. J. Sports Med., 39, 2005,12, s. 965-968.

75. KARST, G. M., WILLETT, G. M.: Effects of specific exercise instructions on abdominal muscle activity during trunk curl exercises. J. Orthop. Sports Phys. Ther., 34, 2004, 1, s. 4-12.

76. STANTON, R., REABURN, P. R., HUMPHRIES, B.: The effect of short-term Swiss ball training on core stability and running economy. J. Strength Cond. Res., 18, 2004, 3, s. 522-528.

77. BEILOCK, S. L. et al.: When paying attention becomes counterproductive: impact of divided versus skill-focused attention on novice and experienced performance of sensorimotor skills. J. Exp. Psychol. Appl., 8, 2002, 1, s. 6-16.

78. McNEVIN, N. H., WULF, G. CARLSON, C.: Effects of attentional focus, self-control, and dyad training on motor learning: implications for physical rehabilitation. Phys. Ther., 80, 2000, 4, s. 373-385.

79. McNEVIN, N. H., SHEA, C. H., WULF, G.: Increasing the distance of an external focus of attention enhances learning. Psychol. Res., 67, 2003, 1, s. 22-29.

80. WULF, G. et al.: Enhancing the learning of sport skills through external-focus feedback. J. Mot. Behav., 34, 2002, 2, :s. 171-182.

81. WULF, G. et al.: Attentional focus on suprapostural tasks affects balance learning. Q J. Exp. Psychol. A, 56, 2003, 7, s. 1191-1211.

82. REEVES, N. P. et al.: The effects of trunk stiffness on postural control during unstable seated balance. Exp. Brain Res., 174, 2006, 4,: s. 694-700.

83. VAN DIEEN, J. H., HOOZEMANS, M. J., TOUSSAINT, H. M.: Stoop or squat: a review of biomechanical studies on lifting technique. Clin. Biomech. (Bristol, Avon), 14, 1999, 10, s. 685-696.

84. KINGMA, I. et al.: Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading. Ergonomics, 47, 2004, 13, s. 1365-1385.

85. LAY, B. S. et al.: Practice effects on coordination and control, metabolic energy expenditure, and muscle activation. Hum. Mov. Sci, 21, 2002, 5-6, s. 807-830.

86. MINETTI, A. E.: Passive tools for enhancing muscle-driven motion and locomotion. J. Exp. Biol., 207, 2004, Pt 8, s. 1265-1272.

87. ANDERSON, T.: Biomechanics and running economy. Sports Med., 22, 1996, 2, s. 76-89.

88. KIBLER, W. B., PRESS, J. SCIASCIA, A.: The role of core stability in athletic function. Sports Med., 36, 2006, 3, s. 189-198.

89. HELEWA, A. et al.: Does strengthening the abdominal muscles prevent low back pain—a randomized controlled trial. J. Rheumatol., 26, 1999, 8, s. 1808-1815.

90. NADLER, S. F. et al.: Hip muscle imbalance and low back pain in athletes: influence of core strengthening. Med. Sci Sports Exerc., 34, 2002, 1, s. 9-16.

91. O’SULLIVAN, P. B. et al.: Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine, 22, 1997, 24, s. 2959-2967.

92. HIDES, J. A., JULL, G. A., RICHARDSON, C. A.: Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine, 26, 2001, 11, s. E243-248.

93. GOLDBY, L. J. et al.: A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine, 31, 2006, 10, s. 1083-1093.

94. STUGE, B. et al.: The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a two-year follow-up of a randomized clinical trial. Spine, 29, 2004, 10, s. E197-203.

95. ARIYOSHI, M. et al.: Efficacy of aquatic exercises for patients with low-back pain. Kurume Med. J., 46, 1999, 2, s. 91-96.

96. VAN DER VELDE, G. MIERAU, D.: The effect of exercise on percentile rank aerobic capacity, pain, and self-rated disability in patients with chronic low-back pain: a retrospective chart review. Arch. Phys. Med. Rehabil., 81, 2000, 11, s. 1457-1463.

97. CAIRNS, M. C., FOSTER, N. E., WRIGHT, C.: Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine, 31, 2006, 19, s. E670-681.

98. NILSSON-WIKMAR, L. et al.: Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: a randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine, 30, 2005, 8, s. 850-856.

99. FRANKE, A. et al.: Acupuncture massage vs Swedish massage and individual exercise vs group exercise in low back pain sufferers—a randomized controlled clinical trial in a 2 x 2 factorial design. Forsch Komplementarmed Klass Naturheilkd, 7, 2000, 6, s. 286-293.

100. KOUMANTAKIS, G. A., WATSON, P. J., OLDHAM, J. A.: Supplementation of general endurance exercise with stabilisation training versus general exercise only. Physiological and functional outcomes of a randomised controlled trial of patients with recurrent low back pain. Clin. Biomech. (Bristol, Avon), 20, 2005, 5, s. 474-482.

101. RASMUSSEN-BARR, E., NILSSON-WIKMAR, L. ARVIDSSON, I.: Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man. Ther., 8, 2003, 4, s. 233-241.

102. VAN TULDER, M. et al.: Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine, 25, 2000, 21, s. 2784-2796.

103. HASENBRING, M., HALLNER, D., KLASEN, B.: Psychological mechanisms in the transition from acute to chronic pain: over- or underrated?. Schmerz, 15, 2001, 6, s. 442-447.

104. MacGREGOR, A. J. et al.: Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis Rheum., 51, 2004, 2, s. 160-167.

105. GALLAGHER, S. et al.: Torso flexion loads and the fatigue failure of human lumbosacral motion segments. Spine, 30, 2005, 20, s. 2265-2273.

106. REID, D. A., McNAIR, P. J.: Factors contributing to low back pain in rowers. Br. J. Sports Med., 34, 2000, 5, s. 321-322.

107. FAIRCLOUGH, J. A., EVANS, R., FARQUHAR, G. A.: Mechanisms of injury—a pictorial record. Br. J. Sports Med., 20, 1986, 3, s. 107-108.

108. RENSTRÖM, P.: An introduction to chronic overuse injuries. In: Oxford Textbook of Sports Medicine (ed. Harries et al.). Oxford: Oxford University Press., 1996, s. 531-545.

109. DE LOOZE, M. P. et al.: Abdominal muscles contribute in a minor way to peak spinal compression in lifting. J. Biomech., 32, 1999, 7, s. 655-662.

110. BIGGEMANN, M., HILWEG, D., BRINCKMANN, P.: Prediction of the compressive strength of vertebral bodies of the lumbar spine by quantitative computed tomography. Skeletal. Radiol., 17, 1988, 4, s. 264-269.

111. MAIGNE, J. Y. et al.: Pain immediately upon sitting down and relieved by standing up is often associated with radiologic lumbar instability or marked anterior loss of disc space. Spine, 28, 2003, 12, s. 1327-1334.

112. SNIJDERS, C. J. et al.: Oblique abdominal muscle activity in standing and in sitting on hard and soft seats. Clin. Biomech. (Bristol, Avon), 10, 1995, 2, s. 73-78.

113. HARRISON, D. D. et al.: Sitting biomechanics part I: review of the literature. J. Manipulative Physiol. Ther., 22, 1999, 9, s. 594-609.

114. HEDMAN, T. P., FERNIE, G. R.: Mechanical response of the lumbar spine to seated postural loads. Spine, 22, 1997, 7, s. 734-743.

115. GABBETT, T. J.: Reductions in pre-season training loads reduce training injury rates in rugby league players. Br. J. Sports Med, 38, 2004, 6, s. 743-749.

116. SMITH, L. L.: Tissue trauma: the underlying cause of overtraining syndrome? J. Strength Cond. Res., 18, 2004, 1, s. 185-193.

117. VERA-GARCIA, F. J. et al.: Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J. Electromyogr. Kinesiol., 2006.

118. CRESSWELL, A. G., BLAKE, P. L., THORSTENSSON, A.: The effect of an abdominal muscle training program on intra-abdominal pressure. Scand. J. Rehabil. Med., 26, 1994, 2, s. 79-86.

119. MENS, J. et al.: Possible harmful effects of high intra-abdominal pressure on the pelvic girdle. J. Biomech., 39, 2006, 4, s. 627-635.

120. DAVIS, K. G. et al.: The impact of mental processing and pacing on spine loading: 2002 Volvo Award in biomechanics. Spine, 27, 2002, 23, s. 2645-2653.

Labels
Physiotherapist, university degree Rehabilitation Sports medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#