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sperle33
10-16-2000, 05:06 AM
I assume that the authors are talking about Vladimir Janda's method for
assessing muscle length (one of those tests is the Modified Thomas
Test). Dr. Janda is a Czech medical doctor who has over the years
asserted that much musculoskeletal pain is from, in part, a chronic
shortening of certain muscles which cause alterations in normal muscle
activation patterns.(1-6) The muscles prone to this
shorenting are:

Gastrocsoleus
Tibialis posterior
Hamstrings
Iliopsoas
Tensor fascial lata
Rectus femoris
Short hip adductors
Sartorius
Piriformis
Lumbar Erector Spinae
Quadratus Lumborum
Pectoralis Major
Upper Trapezius
Levator scapula
Scalenes
Sternocleidomastoid
Flexors of upper limb

Although I have most of what Janda has published in English there is
supposedly much more published in Czech and German. However, I am
unaware of any RCTs that have evaluated the effectiveness of his
treatment approach even though it has become accepted by many members of
the chiropractic and physical medicine professions. I am not aware of
any studies that have investigated the and psychometric properties of
these tests.
At present Dr. Janda is in the U.S. conducting seminars.

If my assumption is correct Janda takes a muscle to its end range and
assesses the end-feel (i.e., the springiness of the muscle when one
pushes it into the barrier of its motion). A hard end-feel would allow
for a presumptive diagnosis of chronic muscle shortening. Janda then
describes a method treatment that has been termed Post-Facilitation
Stretching (PFS). PFS stretching is accomplished by having the patient
contract the muscle in question against resistence with a maximum effort
for about 10 sec. Then the muscle is stretched ballistically and held
in the new stretch position for 10 sec. This process is repeated a few
times per treatment session. Such treatment in my experience often
results is an obvious change in the end-feel and an sustainable increase
in range of motion.

More information concerning Janda's work can be obtained from OPTP.com.
Also in a texts by Liebenson(7) and Hammer(8)

1. Janda V. Muscles as a pathogenic factor in back pain. IFOMT
Conference. Christchurch, New Zealand, 1980:1-20.
2. Janda V. The relationship of hip joint musculature to the
pathogenesis of low back pain. International Conference on Manipulative
Therapy. Perth Western Australia, 1983:28-31.
3. Janda V. Rational Therapeutic approach of chronic back pain
syndromes. Symposium chronic back pain, rehabilitation and self help.
Turku, Finland, 1985:69-74.
4. Janda V. Pain in the locomotor system - A broad approach. In:
Glasgow
EF, Twomey LT, Scull ER, Kleynhans AM, Idczak RM, eds. Aspects of
Manipulative Therapy. 2nd ed. New York: Churchill Livingstone,
1985:148-51.
5. Janda V. Muscle weakness and inhibition (pseudoparesis) in back
pain
syndromes. In: Grieve GP, ed. Modern Manual Therapy of the Vertebral
Column. New York: Churchill Livingstone, 1986:197-201.
6. Jull GA, Janda V. Muscles and motor control in low back pain:
Assessment and management. In: Twomey LT, Taylor JR, eds. Physical
therapy of the low back. New York: Churchill Livingstone, 1987:253-78.
7. Liebenson C, ed. Rehabilatation of the spine: A practitioner's
manual. Baltimore: Williams & Wilkins, 1996.
8. Hammer WI, ed. Functional Soft Tissue Examination and Treatment
by
Manual Methods: The Extremities. 2nd ed. Gaithersburg, MD: Aspen
Publishers, Inc,, 1999. (Hammer WI, ed.


--

__________________________________________________ ___________________
Stephen M. Perle, D.C. "A man who knows that
Associate Professor of Clinical Sciences he is a fool is not
University of Bridgeport College of Chiropractic a great fool."
Bridgeport, CT 06601 Chuang Tzu
E-mail: perle@bridgeport.edu
http://www.bridgeport.edu/chiro/
__________________________________________________ ___________________

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