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Re: Janda Test?

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  • Re: Janda Test?

    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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