Articles

Asymmetry of arm-swing not related to handedness:

Authors: Kuhtz-Buschbeck, Brockmann, Gilster, Koch, Stolze,

Gait and Posture 27 (2008) 447-454

During my recent certification process to become a PRC, I found an article whose findings are supported by PRI science.  I felt like I had stumbled upon a pot of gold!  I want to share the wealth with PRI nation!

This 2008 article identified a predominant trend of patterned posterior arm swing occurring more on the left than the right in subjects walking at various walking speeds.  They found this event to not be related to handedness. The author’s provide insight into why this pattern of movement was observed including underlying mechanisms of side differences in muscle tone and/or strength and also neural motor programming.  PRI’s apriori understanding of normal human asymmetry, the development of adaptive muscular recruitment patterns around a left AIC, right BC and a left type1 scapular pattern can explain why the authors observed this pattern. 

 Around the time of finding this evidence, I had two clients who demonstrated L AIC/RBC patterns. Because of these patterns of movements they had developed asymmetries of a left and right triceps and posterior deltoid muscle groups.  Their pictures are below:

The left arm swing findings are understood when you consider that left arm swing occurs during left trunk rotation of the right stance phase of gait and that the human body is always oriented to be in this right stance phase pattern.  PRI courses and previous blogs provide excellent and thorough explanations for why our body has a right stance dominant pattern, so I will not describe them in depth.  Anatomical asymmetries that orient our spine to the right create imbalance in the AICs with the left AIC becoming more influential and orienting the pelvis and lumbar spine to the right.  As a compensation to a right oriented spine the thorax rotates back to the left creating an imbalance in the BCs with the right BC becoming more dominant.  This pattern of counter-rotation, between the pelvis and ribcage, will be the dominant pattern occurring during walking, so even though a person will move into a left stance of gait they may not achieve full and opposite counter-rotation.   Thus the left arm will always have a tendency to move more frequently and activate more into extension or posterior flexion as the authors described it vs. into flexion or anterior flexion.  The degree to which a person is limited in moving out of their LAIC/RBC and into a RAIC/LBC will vary and the results of this study show this.  Clinically, I have observed this and have found that the individual needs for a PRI program will vary from one person to the next person.

In closing, I think one of the take home messages from this article is that the underlying pattern of a LAIC and RBC can be observed in a real world situation, walking.  The power of PRI is that it understands why the person maybe walking in an unbalanced manor, it provides an evaluation to determine the extent to which a person’s systems are influencing the patterned movement and it provides a management program that helps people become sensory-motor aware and find the floor to maintain balanced walking.

Posted March 17, 2015 at 4:41PM
Categories: Articles

Due to my fascination of our asymmetrical and lateralized human body, I decided to investigate further into this concept and how it manifests functionally as well as rhythmically throughout our systems. In PRI, we are typically focusing on creating a reciprocal and alternating neuromuscular system. However, our neuromuscular system is connected with all the other systems in our body. There appears to be a coupling between autonomic, central, endocrine, and gastrointestinal systems which, in parallel with our neuromuscular system, are also asymmetrical and rhythmically shifting. “Asymmetry, Lateralization, and Alternating Rhythms of the Human Body” has been broken up into 5 parts describing this phenomenon in addition to the story of how and why our asymmetry came to be. It can also be accessed at on my website where I have written on other various topics that relate to PRI. 

CLICK HERE to read Part 1 of “Asymmetry, Lateralization, and Alternating Rhythms of the Human Body.” 

Posted February 23, 2015 at 3:14PM
Categories: Articles

The image posted is a Letter to the Editor submitted to USDF Connection in response to Dr. Clayton's article in Oct issue: "Unique Seminar Focuses on Measuring Rein Tension"  (http://connection.epubxp.com/i/386281/0  article p. 26 - 31).  The Letter to the Editor supports on-going research by a variety of experts in the usefulness of the "new" rein tension measuring device as a diagnostic tool for equine lameness, joint dysfunction and restrictions in the spine, pelvis, neck, and jaw, and training tool for horse-rider interaction.  The Letter calls attention to the results of a particular questionnaire that supports the science of PRI and attempts to briefly and "all-inclusively" explain how the L AIC and R AIC muscle chains affect horse-rider interaction and performance.  (Obviously all 8 muscle chains are involved, but I thought a simple explanation would be appreciated by the readership.) 

I encourage you to read the article itself, not only because it is interesting but also because it raises PRI questions about horses.

Lilla

Emily Soiney emailed this gem of an article (which she found while putting together the PRI Integration for Yoga affiliate course) to both Ron and I last week, and I can honestly say that Ron probably hasn't slept the same since then! If you are interested in reading more about lateralization related to the CNS and ANS, be sure to print this article off and add it to your must read list!

Lateralized rhythms of the central and autonomic nervous systems by David Shannahoff-Khalsa

Posted September 2, 2014 at 9:22PM
Categories: Articles

Takashi Onuki, ATC, CSCS recently helped write an article in a Japanese magazine, Tarzan (which is similar to our Men's Health magazine here in the States) discussing PRI and asymmetry. He has also taken the time to translate the article for us so we can share the article with all of you. To view this article in English, click HERE, and to view the Japanese version click HERE! As a result of the overwhelming interest for PRI in Japan, we are hoping to take a PRI course or two to Japan next summer! Stay tuned for more information!
 

Posted August 27, 2014 at 9:08PM
Categories: Articles Science

Kentaro "Kenny" Ishii, ATC, PRT was featured in the spotlight article in Cramer's First Aider Newsletter. If you haven't seen this newsletter in your inbox, Kenny did a great job discussing PRI and his work as the Head Athletic Trainer and Rehabilitation Coordinator with Sporting KC MLS team. CLICK HERE to read the article!

John Nyland did a nice job commenting on sports specialization in his editorial article in the June issue of JOSPT. If you have access to this article, be sure to take a look at it. Experiencing diversification in "physical, cognitive, affective and psychosocial environments" at all ages, probably also contributes to transfer of learning between cognitive, psychobehavioral and physical neurological processes.

Posted June 23, 2014 at 9:42PM
Categories: Athletics Articles

I have the benefit of being associated with some outstanding thinkers and PRI practitioners.  Whenever and wherever we get together, conversation eventually drifts toward discussion of PRI principles and application.  One of our greatest challenges has been to unravel the foundations from which Ron Hruska evolved the Postural Restoration Institute system of evaluation and treatment that we all utilize with such great success. 

The following are just a couple of questions that we have posed and our attempts to reach conclusions and greater understanding.  If anything it may stimulate some thought and initiate some discussion.

What are we actually measuring when we place a patient on the treatment table and perform our PRI testing algorithm and what is our goal for treatment?

I clearly recall a conversation over lunch between Eric Oetter, Mike Robertson, and myself during the PRI Pelvis Restoration course at the Cantrell Center for Physical Therapy and Wellness. We were discussing the concepts of adaptive capacity, adaptive potential, movement variability, what we are actually measuring when evaluating a patient on the treatment table, and how this affects performance.  

Our conclusion was that what we are actually measuring as PRI-educated therapists and coaches is the capacity of our client/athlete to adapt to the ever chaotic nature of the environment they are perceiving.  Positive findings during examination such as a positive Adduction Drop Test, limited apical expansion, or loss of shoulder rotation was merely indicative of a human system incapable of demonstrating variability ultimately controlled by the central nervous system.  More specifically an autonomic nervous system shift toward sympathetic dominance.

I was reminded of this PRI lunch after reading a blog post recently that referenced the following study:

http://www.ncbi.nlm.nih.gov/pubmed/24502841

In essence, what the researchers found in the study was that pain-free subjects demonstrated variability in the muscle activity of the erector spinae during a repetitive lifting task and those with low back pain did not demonstrate this variability as well as experiencing increased pain during the task.

The authors’ conclusion was that reduced variability of muscle activity may have important implications for the provocation and recurrence of LBP due to repetitive tasks.

Needless to say, this study is somewhat validating for our discussion group of PRI faithful.

Truth be told, after searching there are many studies that support our lunchtime conclusion; and movement variability as a favorable concept in human function is not a new concept having its foundations in dynamic systems theory. 

From Shumway-Cook and Woollacott’s Motor Control:  Translating Research into Clinical Practice:

“… in dynamic systems theory, variability is not considered to be the result of error, but rather as a necessary condition of optimal function.  Optimal variability provides for flexible, adaptive strategies, allowing adjustment to environmental change, and as such is a central feature of normal movement.”

What the PRI model provides is a non-invasive real-time measurement of system variability determined by autonomic nervous system tone.  While EEG, heart rate variability, or galvanic skin response may be preferred methods to determine autonomic tone, these are not tools commonly used by a practicing physical therapist in a clinical setting or a coach in the training room nor would they be practical. 

The goal of treatment then becomes restoring an optimal level of variability to the system to allow for optimization of behavior and maximization of performance.

We came up with a statement that encompassed our entire discussion that included the influence of variability on pain and performance.  I still have the notes on my iPhone dated 8/24/13: 

"Restoring variability to the human system is the ultimate goal to promote neuroplastic change creating a relatively permanent change in behavior that provides adaptability within the system to cope with variability in the environment."

In PRI terms, our goal is help a patient achieve neutral (restore variability) and then recruit the appropriate PRI planar families (neuroplastic change to remap the three planes in the brain… Thanks to Zac Cupples!) to restore reciprocal and alternating movement (change behavior to cope with the environment).

How did Ron Hruska arrive at the concept of using simple, common orthopedic tests as effective PRI measurement tools?

As mentioned above, as physical therapists our measurement tools are limited by practicality.  If we look at PRI from a strictly biomechanical perspective, the PRI methodology provides for a low barrier of entry to a PT who has never been exposed to its concepts before.  Myokinematic Restoration looks, sounds, and feels like biomechanical course, but we all know that it is not.  This is a brilliant way to provide understanding to a group with more than a few preconceived notions, right?

While I certainly cannot speak for Ron, and I’m willing to be wrong, I believe there is more to this process, and this came from a conversation I had with Eric Oetter over Sunday breakfast.

From our first day in an introductory PRI course we are shown that asymmetry because of in-utero development and positioning, brain hemispheric dominance, asymmetrical vestibular development, and internal anatomical differences is normal, expected, and predictable.  Determining patterning that represents discord in the system then seems to be impossible until your realize that the skeletal system, is inherently symmetrical.  Therefore there is no better way for a physical therapist to determine the state of the system as a whole than identifying asymmetries or patterns via our typical orthopedic testing.

The brain processes and integrates all sensory inputs, internal and external, and generates behavior, including motor behavior, based on our perceptions with respect to the environment, emotional status, and previous experiences.  I don’t think it’s unreasonable to consider that the ability to produce reciprocal and alternating movement is not only an effective measure of autonomic tone but also a key measurement of overall health.

Bill Hartman, PT

Posted June 13, 2014 at 7:17PM
Categories: Clinicians Articles

Check out this newly released article by Emily Soiney, titled "Taking Yoga to the Next Level-Postural Restoration-Inspired Yoga for the Athlete: The Frontal Plane". Emily is also busy preparing for the first PRI Integration for Yoga affiliate course which will be held in Portland, OR on September 13-14th! Additional seats have just been opened for this course, so if you are interested in attending be sure to reserve your seat today. CLICK HERE to register!

Michael Mullin, ATC, PTA, PRC was featured in this month's issue of Training and Conditioning. If you received your issue in the mail, be sure to check out Michael's article titled "Finding Balance" on pages 28-33, or CLICK HERE to access the online version. The hard copy however features photos which do not accompany the online version, and is a great resource for clinicians and patients as well. Great job Michael!

If interested, you can sign up for a free subscription to this publication, Training and Conditioning.

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