copyright M.J. Davidson
ISOMTT
Meeting Meersburg
May 14 - 18, 1998
Michael J. Davidson OMT, PT and Acupuncturist
Graduated OMT study in 1991
examined by David Lamb*, Lasse Thue,
M. Jonquière MD. PhD, doctor in manual
medicine and H. van der Berg.
Started as an OMT-teacher in 1993
Director of a private practice in
Amsterdam since 1981
copyright M.J. Davidson
Who are we ?
PT with a specialization in OMT,
according to the educational
standards of IFOMT
copyright M.J. Davidson
What are we doing ?
We give treatment, advice and
training:
to cure,
and
to prevent
Important is that we have the tools and
skills to create favorable conditions
to achieve our goals
copyright M.J. Davidson
Service-model
Diagnosis Consult
Test-treatment
Accompany Short term
Support patient
Support multidisciplinair
Treatment
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Service-model(2)
Treatment crisis-intervention
regular treatment
medium length treatment
long term treatment 1
long term treatment 2
copyright M.J. Davidson
To Motivate
“People who think that they have no
time for exercises, sooner or later
must make time to be ill”
(The Conduct of Life, Edward Stanley, 1826 - 1893)
copyright M.J. Davidson
To Discriminate
“The devices are only as good as the
examiners who are using them”
(Anderson and Lipscomb, A.J.S.M.)
copyright M.J. Davidson
EN-Tree
copyright M.J. Davidson
Medical Training Therapy
Or how to integrate the musculo-
skeletal part of the human body and
the cardio vascular part with: respect for pain
knowledge of the pathology
laws of training
in osteo- and arthro-kinematics
applied to: patients and
(top) sport(wo)men
copyright M.J. Davidson
Physiological
What is treatable, and what
increases the performance: strength / power
endurance
velocity
coordination
stretchability and contractability
copyright M.J. Davidson
How do we establish
the treatable factors
OMT examination of
complaints
Biomechanical chain
Autonomic nervous
system
Segmental
Psychological
Local
Organic
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What are our Goals ?
A-specific: Impairments
Disabilities
Handicaps
Specific: Based on our OMT examination in AMNM &
CCRS
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Medical Training Therapy
A = Arthron
M = Muscular
N = Neurogenic
M = Mechanism
(V) = Vascular
C = Cardio
C = Circulatory
R = Respiratory
S = System
copyright M.J. Davidson
AMNM(V)
Diagnostic part for :
musculo-skeletal part of the body
First fourteen steps (of 28)
copyright M.J. Davidson
CCRS
Diagnostic part for:
physiological part of the body
also first fourteen steps (of 28)
copyright M.J. Davidson
Setup for an individual
Rehab program (1)
1. Anamnesis
2. Antropometric profile
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Antropometric profile (1)
Weight
Length
Quetelet index / BMI
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Antropometric profile (2)
Skinfold Biceps
Triceps
Subscapular
Suprailiac
copyright M.J. Davidson
Antropometric profile (3)
Fat-free mass
Skeleton weight knee width left + right
wrist width left + right
copyright M.J. Davidson
Antropometric profile (4)
Physiological data bloodpressure (rest)
Hr in rest
Hr max
Shuttle run test a-cyclic(al) test
copyright M.J. Davidson
Antropometric profile (5)
Astrand (bike-)test:
VO2-max (l/min)
VO2-max / kg low / fair / average / good / high
cyclic(al) test
estimated value about the condition
copyright M.J. Davidson
Antropometric profile (6)
Spirometry vital capacity
peakflow
one second value
copyright M.J. Davidson
Antropometric profile (7)
Conconi test by bike or treadmill
respiratory (heart rate)
lactic acid (4 m/moll)
aerobic-anaerobic threshold
Conclusion CCRS
copyright M.J. Davidson
Setup for an individual
Rehab program (2) 3. diagnosis about the positioning of
the bones (in the joints)
4. diagnosis of movement
(osteokinematic / arthrokinematic)
5. hypo- or hypermobility or
instability
6. Pain provocation and/or painrelief
=evaluation of the arthron
copyright M.J. Davidson
Setup for an individual
Rehab program (3)
7. Muscular evaluation Strength ( power)
Endurance
Coordination
Speed (velocity)
Stretchability and contractability
8. Isokinetics
9. Isometrics
10. Isodynamics
copyright M.J. Davidson
Setup for an individual
Rehab program (4) 11. neurologic evaluation adverse mechanical tension
slump test
12. CMN / PMN central motorneuron lesion
peripheral motorneuron lesion
13. Vascular component
14. Conclusion AMNM
Conclusion after
the first 14 steps
EN-TreeM pulley
copyright M.J. Davidson
Now you have
Individual starting points in
AMNM:
specific for the primary lesion and
involved tissues
CCRS:
specific in physiology, body-figure
and shape
copyright M.J. Davidson
I. Individuality and Specificity
II. Starting points -> goals -> methods
copyright M.J. Davidson
The choice of the goals
depends on:
choice in (a-)specific goals, not just
the medical diagnosis
actuality of the pathology
the opinion of the patient /customer/
sports(wo)man
copyright M.J. Davidson
Choice of the Method
depends on
musculo skeletal
A. primary lesions (AMNM{V})
B. local, segmental, biomechanical
chain and or autonomic nervesystem
involvement
physiological
copyright M.J. Davidson
Matwejew Training always gives an adaptation
in the human body to the load /
intensity of the training.
The goal is that this adaptation
brings us to a better performance by: super compensation
optimal load
specificity
law of diminishing returns
reversibility (= recurrence)
Load
Fatigue Recovery
Supercompensation
Ph
ase 1
Ph
as
e 2
Ph
as
e 3
Ph
ase 4
Phase 1: Energy consumption
Phase 2: Recovery
Phase 3: Supercompensation
Phase 4: decrease to begin situation
Physiological
Intensity of the training method in relation to
the aerobic / anaerobic threshold
copyright M.J. Davidson
Musculo-skeletal(1)
Strength
Endurance
Speed
copyright M.J. Davidson
Individual 1Rmax. Two way’s of calculate patients 1Rmax.
maximum test
warming up
without weight experience the ROM
nervous system
sub-maximum test
how many times can a movement uninterrupted be
repeated
see Holten diagram
energy supply
copyright M.J. Davidson
Holten diagram
25%
30%
35%
40%
45%
50 %
55%
60%
65%
70%
75%
80%
85%
90%
95% 2
4
7
11
16
22
25
30
ca. 35
ca. 40
ca. 45
ca. 50
ca. 60
ca. 70
ca. 80
Percentage of the
maximum power/strength Number of repetitions
copyright M.J. Davidson
Musculo-skeletal(2)
Different type’s of strength
e.g. strength-endurance load <<<=60%
repetitions 15 - 60
rest 0 - 1 minute
series 3 - 6
maximum power
explosive strength
speed strength
copyright M.J. Davidson
Endurance(1)
Aerobic endurance
endurance training extensive
Fartlek
intensive
extensive interval interval endurance
copyright M.J. Davidson
Endurance(2)
Anaerobic endurance
with lactic acid
intensive interval training blocktraining
interval-pace training
pace training (repetition training)
copyright M.J. Davidson
Endurance(3)
Anaerobic endurance
without lactic acid
speed-endurance training
copyright M.J. Davidson
Sequence in MTT
Trunk stability (= central)
Extremities (= peripheral)
copyright M.J. Davidson
Sequence in MTT
From the massage table and a
manual resistence by the OMT to a
pulley-device, EN-Dynamic training
till sport- and work simulation
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Sequence in MTT
From isometric contractions till
dynamic exercises and from
symmetric(al) resistance nearby the
arthron to an a-symmetric resistance
with a long lever
copyright M.J. Davidson
Sequence in MTT
From a wide (support)surface to a
small one
Stimulation of the contractions by: exteroceptive stimulation(s)
in- and exhaling
eye-movements
copyright M.J. Davidson
Case Report
Mrs. Hoogewoning (64 years) disability & handicap level
spine problems
patient/customer
Mrs. van Elst (?) impairment level
spine problems
patient/sportswoman
copyright M.J. Davidson
Pn
eu
ma
tic
EN-Train
copyright M.J. Davidson
Nearby future??
PolicyHolder
HealthRisk’s
Symptoms
Diagnosis &
A B C D
Therapy
Insurancecompany
copyright M.J. Davidson
Nearby future??
A Premium based on costs
B Risk-management prevention & changing lifestyle
CDisease management managed care
multidisciplinair
DEfficiency
The End
I thank you for your attention !