It has been estimated that of the western population, 85% of adults will suffer from back pain sometime through out their lifetime, with 15% of the population currently suffering from low back complaints. There are many different professionals with a wide variety of treatment interventions seeking to help low back sufferers. These interventions range from a medical doctor prescribing oral or injected medications, and /or surgery. There are multiple non-invasive interventions that include physical therapy, chiropractic, massage therapy, yoga, Pilates, Egoscue, biofeedback, acupuncture, meditation, ARROSTI, back school, to name a few. Despite significant scientific effort, not one method or approach has emerged as a gold standard treatment for musculoskeletal disorders. One of the difficult issues in determining the type of treatment to be given is that 85% of spinal medical diagnoses cannot be diagnosed specifically, with many variations of similar conditions reacting differently to the same intervention.

I was introduced to a new and dynamic rehabilitation concept called Active Therapeutic Movement (ATM). This treatment has emerged that uses the human body in an upright, weight bearing functional position, attempting to find a pain-free movement position, so that the person is able to produce a pain free full range of motion (ROM). By eliminating the painful movement, the person's central nervous system is able to transition from a painful abnormal muscle activation pattern to a more normal muscle pattern. While being stabilized in a pain-free position, the body when asked to produce isometric (increase muscle contraction without movement) exercise, the central nervous system can function without risk of increasing damage to the surrounding tissue and eliminating abnormal muscle guarding patterns.

The key is producing a pain-free range of motion. We know that lack of motion is detrimental to producing functional ROM as well as too much range of motion. Since pain is the body's defense against further injury, the secret is to impart meaningful motion without pain or the risk of increasing damage to the surrounding tissue. Restoring motion enhances local tissue healing and provides for normalization of neurological function and proper proprioception (feedback from the joints and tissues).

The ATM2 concept uses an upright table with restraining belts to find a pain free active movement, and then while maintaining the pain free position begin exercising using resistance in the new pain-free motion. The ATM2 concept is not a strengthening system but rather a neuro-muscular re-activation system. It allows the body part to move in a normal pain free manner. This environment that occurs when the pain is eliminated allows for activating the normal muscular activation strategy. This unique method to train patients to move into their impaired movement pattern without causing pain allows for re-establishment of normal muscle firing patterns and better neuromuscular control. This can happen immediately following the treatment with sustained relief benefits. It has been shown to resolve back disorders by more than half the usual time frame for producing relief with other physical therapy intervention.

Marovino T. Spinal pain and neuromuscular deficiency. Practical Pain Management: 70-72, July/August 2009.

Bigos SJ, Holland J, Holland C, et al. High quality controlled trials on preventing episodes of back problems: systematic literature review in working age adults. Spine Journal, 9: 147-168, 2009.

Machado LAC et al: Analgesic effects of treatments for non specific low back pain. A meta-analysis of placebo controlled randomized trials. Rheum, 2008.

Hodges PW. The role of the motor system in spinal pain: implications for the rehabilitation of the athlete following lower back pain. J Sci Med Sport, 3(3): 243-253, Sep, 2000.

Kennedy J. Active therapeutic movement (ATM) therapy in a chiropractic clinic. The American Chiropractor: 30-31, May, 2007.

Categories

• General Health
• Physical Therapy

Archives

• September 2009