|
Jon Newman -> Physical Stress Theory (June 3, 2004 5:22:00 AM)
|
I debated where to post this thread. I guess I am after people's opinions but hope for evidence to support those opinions where needed. This forum supposedly encourages that.
Anyway, I'm interested in your ideas regarding the following the following article:
Physical Therapy Volume 82 · Number 4 · April 2002
Tissue Adaptation to Physical Stress: A Proposed "Physical Stress Theory" to Guide Physical Therapist Practice, Education, and Research
Michael J Mueller and Katrina S Maluf
Here is the basic premise:
Fundamental Principle A—Changes in the relative level of physical stress cause a predictable response in all biological tissues. Physical stress is the force, or load, acting on a given area of tissue.
Fundamental Principle B—Biological tissues exhibit 5 characteristic responses to physical stress. Each response is predicted to occur within a defined range along a continuum of stress levels. The 5 qualitative responses to physical stress are decreased stress tolerance (eg, atrophy), maintenance, increased stress tolerance (eg, hypertrophy), injury, and death.
Fundamental Principle C—Physical stress levels that are lower than the maintenance range result in decreased tolerance of tissues to subsequent stresses.
Fundamental Principle D—Physical stress levels that are in the maintenance range result in no apparent tissue change.
Fundamental Principle E—Physical stress levels that exceed the maintenance range (ie, overload) result in increased tolerance of tissues to subsequent stresses.
Fundamental Principle F—Excessively high levels of physical stress result in tissue injury.
Fundamental Principle G—Extreme deviations from the maintenance stress range that exceed the adaptive capacity of tissue result in tissue death.
Fundamental Principle H—The level of exposure to physical stress is a composite value, defined by the magnitude, time, and direction of stress application.
Fundamental Principle I—Individual stresses combine in complex ways to contribute to the overall level of stress exposure.
Fundamental Principle J—Excessive physical stress that causes injury can occur through 1 or more of the following 3 mechanisms: (1) a high-magnitude stress applied for a brief duration, (2) a low-magnitude stress applied for a long duration, and (3) a moderate-magnitude stress applied to the tissue many times.
Fundamental Principle K—Regardless of the mechanism of injury, inflammation occurs immediately following tissue injury and renders the injured tissue less tolerant of stress than it was prior to injury.
Fundamental Principle L—The stress thresholds required to achieve a given tissue response may vary among individuals depending on the presence or absence of several modulating variables.
Is this the unification theory to PT practice? Does this describe our practice at an elemental level adequately? Is there anything missing? Thoughts and opinions welcome, while kudos given to those providing evidence.
jon
|
|
|
|