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The Function of the Spine: Theory and Application

Serge Gracovetsky has put on YouTube the conference that he gave in 2007 at the Harvard Medical School in Boston 2007. YouTube can only show videos of 15 minutes maximum. So I have cut the 31 minutes presentation in about three 11 minutes pieces. View them at.

Part # 1 of 3 : http://www.youtube.com/watch?v=B-SMUA3QfVw

Part # 2 of 3 : http://www.youtube.com/watch?v=fLNZCNM8XtU

Part # 3 of 3 : http://www.youtube.com/watch?v=dZBjfAmmkp4

Workshop details

The analysis of movement is traditionally done by first describing the anatomy in terms of rods linked by joints to which muscles and ligaments are attached. Then using a variety of techniques, a 'best' solution for a task is obtained and validated using EMG techniques. This results in a representation of the function of the musculo-skeletal system which is then used to diagnose and treat patients.

This approach is rooted in the desire to find a unique "best" solution ("best" stable posture, "best" gait sequence etc.) to circumvent the redundancy inherent to mathematical models. However, a close examination reveals that the attractive concept of a single best solution fundamentally disregards the visco-elastic nature of collagen and other biological material and contradicts the second law of thermodynamics.

It is proposed that structural stability is not necessarily a desirable property of most living systems. There are considerable evolutionary benefits in being an unstable machine in a relentless gravitational field. Indeed, what kind of stability do we have when the loss of the central nervous system will have us collapse in the gravitational field? The various representations of the function of the spine have serious implications on the diagnosis and treatment of patients.

Clinical data can no longer be interpreted through that narrow structural stability lens, and the many less than successful back surgeries are, amongst many factors, a vivid testimony that something is not right.

To compound the problem, the clinician's performance analysed by blind studies demonstrates that the diagnostic of low back pain assumes that the patient will describe his condition in an objective way. When a contradiction arises between the clinical examination and the physical examination, clinicians are overwhelmingly swayed by reported pain. It seems reasonable to ask if there are better ways to integrate the patient's measured function and symptoms with the reported pain.

Technology that permits an unprecedented access to musculo-skeletal information will be discussed together with a model of using artificial intelligence techniques that can integrate clinical information. This mix of rigor and experience can be shown to compensate for the inherent limitations of the clinician natural sensors.

These ideas generated a considerable amount of unsolicited criticism. But peer review is the essence of academic work, and it is hope that a reasonably controlled discussion would help to clarify the merit of that approach and the direction of future research.

Outline of the course

Friday morning - The Theory: What is the function of the cervical and lumbar spines in flexion-extension (with and without weights) and locomotion? How can the head (as a sensory platform) be stabilised at minimum energy expenditure regardless of the motion of the shoulders? What is the cycle of energy transfer during gait and how does the gravitational field control the transfer and storage of energy liberated by the hip extensors to propel the body forward? How important is the coupled motion of the spine in the energy recovery and distribution process? What is the role of collagen in slowing down the rate of increase of entropy and the degradation of energy? How can we integrate the entire musculoskeletal system into one energy efficient functional unit? The presentation will be followed by a 60 minute discussion.

Friday afternoon - Application of the Theory: How to measure the function of the spine? What to measure? What are the invariants of movements that are dependant upon the pathology and not upon the voluntary decisions of the patient? How to avoid the standard statistical mistakes in interpreting the differences between the average responses of the normal and abnormal ? How to define a Range of Normality versus the Range of Motion? How to integrate the objective measured data in order to reach a diagnosis? How does the technology perform with respect to the clinician in blind controlled studies? What is the real impact of reported pain in the clinical diagnosis of low back pain? Examples of diagnoses and patient follow up. The presentation will be followed by a 60 minute discussion.

Teacher: Serge Gracovetsky

See "Science & Humour with Dr Serge Gracovestky" 

Part 1 at http://www.youtube.com/watch?v=qgh2C8M50Iw

Part 2 at http://www.youtube.com/watch?v=8810_CpLRlI 

Date: Friday, 9 September 2011

Venue: Room G02, British School of Osteopathy, 275 Borough High Street London SE1 1JE

Cost: £85 (early bird £75 pre 31/05/11; student discount £60; BSO student discount £55)

To book: +44 (0)7526 925734 or info@bodyworkcpd.co.uk

"This course is not run or managed by the BSO, and the BSO does not in anyway endorse the course content of any external provider"

    

 

Presenters

Joanne Avison

Maggie Brooks-Carter

Willie Fourie

Steven Goldstein

Roger Golten

Serge Gracovetsky

George Kousaleos

David Lauterstein

Stephen Levin

Dr Peter Levy

Paul Lewis

Greg Morling

Divo Müller

Gilad Naaman Perry

Sol Petersen

Jerry Powell

Art Riggs

Robert Schleip

Ralph Stephens

James Waslaski

     
 

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