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Now one of the most powerful of the British multinationals discount periactin 4mg mastercard allergy testing baltimore, the Wellcome Foundation is particularly powerful because its multinational axis is Anglo-American buy discount periactin 4mg on-line allergy vs cold. The corporation has built upon and concretised many of the older political discount periactin 4 mg free shipping allergy forecast usa, cultural and social power structures which straddle the Atlantic generic 4mg periactin with amex allergy shots and flu vaccine. The company which produces the pharmaceuticals is now called the Wellcome Foundation; its operations include production sites at Beckenham, Berkhamsted and Dartford, and a sales and technical enquiries centre at Crewe. The Wellcome Trust is also situated in Euston Road, in a large Victorian building which has recently been refurbished as a life science centre. There is a series of academic and administrative units, in London and other major British cities, either wholly or partly supported by the Wellcome Trust, the function of these units varying from research to teaching and charity administration. The Wellcome Trust, set up as a charity on the death of Henry Wellcome in 1936,t is now one of the biggest medical research funders in Europe. Up until 1986 the Trust controlled 100% of the shares of the Wellcome drug producing company. In 1986, however, the Trust sold off just over 25% of Wellcome plc, floating 210,800,000 shares at 120p each. In July 1992 there was a second share flotation when the Trust disposed of a further 288 million shares, so reducing its holding to 40%. This second flotation was the largest for a private company ever seen in Britain; it raised £2. Henry Wellcome nominated two Americans to handle the legal matters relating to his will and the continuing Wellcome empire. Following the first share flotation in 1986, Wellcome went from strength to strength. Dragged into the Twenty First Century For years Wellcome was regarded as a qualitatively different type of company from other drug companies; its Trust and its links within the British ruling elite gave it access to both academia and government on an unparalleled scale. With the changing economic climate of the eighties, however, even Wellcome found it difficult to keep up the front of a benign and philanthropic enterprise. This was probably precipitated by the move in the late seventies into the new and profitable area of genetic engineering and medical biotechnology, as well as by American pressure on the Foundation to become more market orientated. In 1982, the Company made a first move towards the area of biological research, setting up Wellcome Biotechnology. In October of that year Wellcome announced its desire to sell its human vaccine production, which finally went to the small British firm Medeva plc. He pronounced that scientifically interesting projects were to take a back seat to those with commercial promise. He instigated a vigorous cost cutting programme, which included the loss of 40 head office jobs. Between them they launched a cost control programme, tightening capital expenditure controls, capping research and development spending and trying to improve efficiency. More than any other Anglo-American company, Wellcome has pursued an economic policy overshadowed by this relationship, a policy principally shaped by Rockefeller financial and political interests. Seventy years after the beginning of public philanthropic involvement of Rockefeller interests in medical research in Britain and America, Wellcome still represents one of their major British bases. Sir Oliver Franks, who died in 1992, was Chairman of the Wellcome Trust for almost twenty years between 1965 and 1982; he had an impeccable Rockefeller background. Originally a civil servant and then a banker, he was a Trustee of the Rhodes Trust between 1957 and 1973. From 1947, on its inception, until 1979, he was a Trustee and later Chairman of the Pilgrim Trust, an archetypal Anglo-American cultural and philanthropic organisation. From 1961 to 1970, almost concurrent with his time at the Wellcome Trust, he was a Trustee of the Rockefeller Foundation. Lord Swann was a member of the Ditchley Foundation, which organises meetings, conferences and seminars attended by defence and security experts from America and Britain. Sir Alistair Frame, who became Chairman of the Wellcome Foundation in 1985, was previously the Director of Rio-Tinto-Zinc, one of the most committed Anglo-American corporations. Unlike other pharmaceutical companies, the Wellcome complex plays a commanding role in the British industrial military complex. The Commission, set up by David Rockefeller in the early seventies, has acted since then as a shadow world economic policy meeting. Made up of industrialists, academics and politicians, especially in the field of foreign policy, it has at its core a group of multinationals whose corporate management is determined to break down all boundaries to world capitalism and its trade. The Commission has discussed and resolved questions about the most important foreign policy initiatives of the last twenty years, usually decades before these questions entered the public domain. Pursuing trade exchanges and bases in communist countries, it opened up factories and marketing windows in Hungary, the Soviet Union and Romania. In March 1989, as a sign of philanthropic goodwill, Wellcome sent 75 tons of baby products worth £500,000 to Poland. All these contemporary strategies, consolidation in Western Europe, integration and ascendancy in Eastern Europe, capitalising on the run-down communist economies, and development in Japan, are global strategies of the Rockefeller Trilateral Commission. The object of developing trade with Eastern Europe, has been the ending of the cold war and the integration of economic and financial structures across Europe. Japan is the third staging post of the Trilateral Commission, which intends to integrate the Japanese markets with those of Europe and America. The Crisis of Profit and Ethics Few pharmaceutical companies have avoided the public backlash which comes with damaging or unpopular drugs: Wellcome is no exception. By the early seventies, Wellcome was involved in major market conflicts over drugs which were said to have adverse effects. In 1973, both Wellcome and Burroughs Wellcome were criticised over their antibacterial drug Septrin (United Kingdom) or Septra (United States) when a number of articles and papers appearing in 12 America and in Canada suggested that other antibacterials were safer for certain conditions. During this trial, it was never an agreed matter of fact that the actual vaccine given to Susan Loveday was the one made by Wellcome. After a five-month hearing, the judgement in the Loveday case was given in April 1988. The original allegation had been that the vaccine given to Susan Loveday had caused permanent brain damage. Lord Justice Stuart-Smith ruled that there was insufficient evidence to prove that the pertussis vaccine could cause permanent brain damage. In June 1992, the Irish Supreme Court found in favour of another claimant, Margaret Best who had sued Wellcome on behalf of her son Kenneth Best. Chapter Twenty One The Pollution of Science The third Industrial Revolution will be knowledge-driven, science-driven and enterprise-driven. In this new world, we will need the Parliamentary and Scientific Committee as never before to bring together the scientists who open up the possibilities of the future, the men of enterprise who harness their discoveries and the legislators who must enable both to flourish for the 1 betterment of the people. For the last half-century, industrialists and academics in the United States have fought an uncompromising battle to keep science in the forefront of public consciousness and, more importantly, before Congress and the Administration. Key campaigning organisations have ensured that, regardless of their social value, multi-million dollar scientific projects have gone ahead. A vital aid in the struggle to lower labour costs, its continual advance assures growing profit for a smaller and smaller elite. It becomes so inequitable that, while only an elite understand the new developments, the majority grow daily more ignorant of the forces which shape the society in which they live. This is especially true of the life sciences and bio-technology which are increasingly shaping the patterns of life and death in advanced societies. The problems which beset post industrial societies cannot necessarily be solved by the application of science: they are often problems of alienation and community.

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The inter-rater reliability findings javelin efficiently requires a combination of the primal demonstrate that the primal movement functional patterns ‘lunge’ buy 4mg periactin with mastercard allergy eats, ‘twist’ and ‘push’ order periactin 4mg line allergy medicine loratadine side effects. A deficiency in any assessment tool is a reliable tool for assessing func- of these patterns buy periactin 4mg amex allergy medicine quiz, or getting these patterns in the wrong tional mobility in the elderly generic periactin 4 mg overnight delivery allergy testing negative. These findings cannot order, will be significantly detrimental to the perfor- be assumed to apply to all senior citizens since this mance outcome. Hence, in training for the event of was a small group of subjects chosen from a sample javelin, it would be wise to incorporate these three of convenience. There was also an unequal distribu- movement patterns into the conditioning program. To tion of male and female subjects, all of whom regu- train a javelin thrower mainly with squats and standing larly participated in a weekly exercise program cable pulls is not likely to enhance their performance provided at the retirement community center. These findings support the use of primal move- For the mum who is a part-time office worker, the ments in physical therapy assessment of functional lunge, the pull and the push are less likely to be useful disability in the elderly as well as showing promise movement patterns in which she should become for use in physical therapy interventions and as a adept. For her, it is far more important to be successful predictor of falls in the community-dwelling elderly in her environment, to be good at the squat pattern, population. Squatting with optimal determine the efficacy of primal movements as a func- form is the start point for good seated posture. This starts office simple key assessments to look out for, and which are workers in an inappropriate and detrimental spinal applicable as foundation observations in any given posture before they even begin their multiple hours movement pattern. These key assessment features are at their desk (see ‘Neutral spine philosophy’ above). The ability to be able to bend with appropriate and It is noted that handedness, footedness or ‘laterality’ effective biomechanics is a critical skill for a parent patterns contribute to postural imbalances – particu- who has to pick up the children and lift other loads larly in the frontal plane. Striations observed under No hip-back dissociation in lifting dynamic load – especially in frontal and Ability to adopt hip-back dissociation on demand transverse plane, e. Instead, laterality patterns are a dysfunctional the critic may question how motivated the workers result of imbalanced use and therefore a consequence were, this study does demonstrate that there is a likely that must be corrected for if the patient is to biome- benefit in terms of productivity by ‘framing’ work chanically optimize (or ‘survive’) their environment. The whole concept of biomechanical attractors – and in particular instinctive sleep postures and archetypal Barriers to rehabilitation success rest postures – suggests that, if such postures were utilized in the work or home environment, corrective There are two major barriers to rehabilitation success: stretching may not be needed at all. In addi- Strides in this direction have been achieved in some tion, many patients attending naturopathic clinics do workplaces in Germany (Cranz 2000) where floor- so because they are in pain – not because they want based, seated and standing workstations are utilized. This means that a part, or parts, It is the floor-based workstation that specifically offers of their body have reached the point where the rate its own secondary range of working postures – the of cumulative stress has outpaced their rate of healing. As has been discussed above, it To add extra load to such a system through corrective is not that sitting should be made more comfortable exercise may further compromise an already compro- – quite the opposite. To ignore this warning system is akin to taking a painkiller in order Time to play sport. To try to ‘cushion’ or dampen this In this day and age, many patients attend health system (as is the objective of most modern ergonomics clinics with pain conditions or health complaints that approaches) is the equivalent of bandaging an ankle are largely caused by a sedentary lifestyle and the in order to play sport. The problem is being acknowl- inability to express a perceived stress, such as a dead- edged, but not really addressed. With the rapid evolu- line or monthly target, with physical reaction, such as tion of the communications age, with connectivity and running or fighting. Making time for exercise and wireless gadgetry, multiple workstations are becom- stretching is a major challenge for many patients. As soon as the patient is symptom-free, ticular the gait patterns, health of most synovial joints they most commonly ‘forget’ to do their stretches or can be maintained, ranges of motion, proprioception, exercises, until something else goes wrong some coordination and many of the body’s natural pumping months down the line. Neither are we designed to exercise for exercise’s sake (see functional exercise above). Physiological load refers to the cumulative total of Historically, exercise has had a significant purpose, stressors on the individual’s system. Such physiological played out by many a sports person and is exactly load results in increased adrenal stress and commonly why people will usually work themselves several reaches a point where adding further load to the figu- times harder chasing after (hunting) a ball, than they rative ‘camel’s back’ is literally enough to break it. Exercise as a stressor Studies have shown that working a longer day does Before advising patients to exercise, in whatever form not always pay dividends in terms of productivity. Anyone who • Poor digestion/↓ salivation has chronic pain has a corresponding limbic-emo- • Constipation tional load – as pain is stressful and disrupts function. As a result, • Night sweats the patient will most likely have visceral symptoms – • Orgasm/genital inhibition as adrenaline shuts down digestive and assimilative processes, sending the body into a catabolic state. Parasympathetic indicators: literature on training and adaptation to training is • Strong or excessive digestion taken from young elite sportsmen and women who: • Hyperactive bowel; colicky • have higher levels of growth hormone than • Incontinence your average middle-aged patient • Orthostatic failure upon rising • have a greater training age8 than the average • ↓ Respiratory rate patient • Poor sleep quality; hibernation • may be eating more healthily than the average • ↑ Mucus secretions patient • Nervousness; depression; somnolence • have a greater genetic propensity for • Hands warm and dry adaptation (hence the reason they are elite • ↑ Gag reflex athletes). To many, the way that they relax is drive is so exhausted, they have drifted into increased by going for a run, playing a game of squash, or doing parasympathetic tone (Wolcott & Fahey 2000). This is an ‘adrenaline sport’ such as rock-climbing, parachute commonly a sign of significant adrenal fatigue (Wilson jumps or bungee jumping. In physics this may be seen to result in an apparent decreased stress level, but the Stress and breath underlying dysfunction has not been effectively dealt with. Stressors come in many guises: from work stress to relationship stress, financial stress to postural stress, chemical stress to electromagnetic stress. All of these 8Training age equates to the number of years that the patient stressors will result in an elevated respiratory rate has been training with that methodology. A soccer player, for and, potentially, a subsequent breathing pattern dis- example, may have ‘soccer age’ of 20 years, but may have only just started training his lunge pattern with a barbell for one order. Such breathing pattern disorders may have a season – therefore his training age for lunging with a barbell profound effect on the physiology of the body is 1. Respiratory influences on health are Chapter 9 • Rehabilitation and Re-education (Movement) Approaches 387 discussed more fully in Chapter 10. Mouth breathing Nose breathing Reflexively mouth breathing and accessory breath- ing are associated, while nose breathing and dia- Accessory breathing Diaphragmatic breathing phragmatic breathing are associated (Chek 1994). In the lower lobes there ↓ Neck stability ↑ Neck stability is a greater preponderance of parasympathetic affer- • Tongue on floor of mouth • Tongue in physiological ent receptors, while reciprocally in the upper lobes rest position there are more sympathetic afferent receptors. When mouth breathing, cold unfiltered air enters the lungs ↑ Left brain activity ↑ Right brain activity and will only service the upper lobes (Douillard 2001), Fight, flight, fright, tight Rest, digest, decongest, presumably due to bronchoconstriction. The deeper, tension-less longer inhalation with nose breathing (and, inciden- tally, humans are the only animal in which obligate Catabolic Anabolic nose breathing is no longer ‘obligatory’) allows for Compromised visceral Facilitated visceral health greater stretching of the alveoli, which results in health increased production of endogenous nitric oxide. Nitric oxide is a potent sympathetic inhibitor (as well Compromised venous/ Facilitated venous/ as a stimulator of immune function) – so this is a sec- lymphatic return lymphatic return ondary way that deep breathing will decrease sympa- thetic and reciprocally increase parasympathetic tone (Douillard 2001). This results in the myriad bene- to switch the patient from a sympathetically charged fits described in Table 9. Since parasympa- facilitated by running barefoot, as this means signifi- thetic stimulation is associated with rest, digestion, cant attention must be paid to the upcoming ground tissue repair and anabolic processes, most patients beneath the feet. Such attention with the eyes results benefit from parasympathetic-enhancing exercises. For further discussion manipulating the respiratory environment to breathe of barefoot running, see ‘Primal patterns, Gait’, using the nasal airway only, helps to enhance perfor- above. Indeed, maintaining a higher level of parasympathetic activity during running and other sports performance Muscular system as expression makes good sense, when one considers that many of psychological state sports involve right-brained creative expression as much – if not more – than left-brained logical, strate- Since the muscles are an innervated continuation of gic expression. It is being in the right brain that is nervous system expression, Keleman (1989) suggests equated with being ‘in the zone’. This is breathing stimulates sympathetic activity and there- consistent with Schleip’s (2003a) observation that the fore left brain function, meaning that ‘thinking outside myofascial system provides more afferent feedback to the box’ becomes a challenge (Chek 2006). This may the central nervous system than any of the special pose a real problem for anyone requiring a creative senses. As well as their afferent feedback, they are also capacity in their work or home life. Water may well be the connection between breath and while a common observation of Westerners made by chi (or prana). Water is one of the most diamagnetic Traditional Chinese Medicine is that they are often yin substances known to science, while oxygen is one of (water) deficient. Just like an If we place on this foundation the fact that all of the electrical circuit, the polar opposite properties of water traditional breath-based disciplines (e. Westerner attending a tai chi class may come away It is well established that, historically, towns and cities unmoved by their experience.

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Maxim) 1 ➤ Synonyms: Siberian ginseng 2 ➤ General comments: Siberian ginseng is a shrub with effects largely similar to 3 those of ginseng cheap 4mg periactin fast delivery allergy symptoms skin, but is native to Siberia discount periactin 4mg with amex allergy testing two year old. The herb consists of the 6 dried roots and/or rhizomes buy periactin 4mg with mastercard allergy testing dc, and sometimes the dried prickly stems ofEleu- 7 therococcus senticosus R buy 4mg periactin allergy treatment in gurgaon. Eleutheroside B and other components were found 16 to increase the stress tolerance of animals in many stress models (immobi- 17 lization test, swim test, cold stress, etc. The fluid extract increased the 18 number of lymphocytes, especially T lymphocytes, and killer cells in 19 healthy volunteers. Intern Praxis 32 (1992), 187; Trute A, 13 Gross J, Mutschler E, Nahrstedt A: In vitro antispasmodic compounds of the 14 dry extract obtained from Hedera helix. Planta Med 63 (1997), 125–129; 15 Trute A, Nahrstedt A: Identification and quantitative analysis of phenolic 16 dry extracts of Hedera helix. In humans, English lav- 30 ender taken by inhalation was shown to take action in the limbic cortex 31 (similarly to nitrazepam). English lavender combines well with other calming and sleep- 4 promoting herbal preparations. Z Naturforsch 46c (1991), 1067–1072; Hausen B; 10 Allgeriepflanzen, Pflanzenallergie. English plantain prep- 26 arations have a short shelf-life, because aucubigenin is unstable. Aqueous 27 English plantain extracts promote wound healing and accelerate blood co- 28 agulation. Aucubin is assumed to protect the liver and soothe the mucous 29 membranes when inflamed. Eucalyptus oil inhibits prostaglandin synthesis and has weak hyper- 49 emic effects when applied topically. The drug also has expectorant, 50 Plant Summaries—F secretomotor, antitussive, and surface-active surfactant-like effects and 1 improves lung compliance. It also should not be used 8 by patients with inflammations of the gastrointestinal or biliary tract or se- 9 vere liver diseases. Liniment: 19 Rub a few drops of 20% eucalyptus liniment onto the affected area of the 20 skin. Signs include a drop in blood pressure, circulatory disorders, col- 25 lapse, and respiratory paralysis. Eur J Med Res, 3(11) 37 (1998), 508–510; Riechelmann H, Brommer C, Hinni M, Martin C: Response 38 of human ciliated respiratory cells to a mixture of menthol, eucalyptus oil 39 and pine needle oil. The herbal preparations are syrups and 2 powdered extracts in capsules and tablets. The essential oil and flavonoids play a role in its su- 8 dorific (sweat-producing) action, but no scientific investigations are avail- 9 able on this subject. Some research in human cell cultures demonstrates antiviral and im- 11 munomodulating effects. Two small clinical trials showed shortening of re- 12 covery time in patients with influenza. The essential oil and 50 Plant Summaries—E saponins have antimicrobial, weakly spasmolytic, antiexudative, and 1 aquaretic effects. Planta Med 61 (1995), 158–161; Hiller K, Bader G: Goldruten- 28 Kraut–Portrait einer Arzneipflanze. A dose-dependent reduction of the den- 20 sity of respiratory fluid (bronchosecretolysis) occurs. When used in vitro, fennel is antimicrobial, gastric motility- 25 enhancing, antiexudative, and presumably antiproliferative. Should not be used for more than 2 weeks without 45 consulting an experienced practitioner. Deutsche Apotheker Ztg 135 (1995), 1425–1440; 8 Massoud H: Study on the essential oil in seeds of some fennel cultivars un- 9 der Egyptian environmental conditions. Some are used to make 21 fabrics, whereas others are used to produce flaxseed oil, a valuable foodstuff 22 and medicinal product. The herb consists of the ripe, dried seeds of 25 Linum usitatissimum and preparations of the same. Some commercial flaxseeds 4 have been identified in the past that contain levels of cadmium beyond recom- 5 mended government limits. It has a very low rate of side effects and does 12 not interfere with the physiology of the bowels. The herb consists of the dried bark 21 of branches and twigs of Rhamnus frangula L. The liquefaction of the bowel 29 contents leads to an increase in intestinal filling pressure. Frangula bark should not be used by children under 10 years of age 34 or by pregnant or nursing mothers. Plant Summaries—F ➤ Herb–drug interactions:Because of the loss of calcium, the drug can increase 1 the effects of cardiac glycosides if taken concurrently. In North America, cascara sagrada (Rhamnus purshianus) is more com- 5 monly used in this way. Flavonoids (rutin), fumaric acid, and hydroxycinnamic acid 21 derivatives (caffeoylmalic acid) are also present. Z Allg Med 34 (1985), 1819; Hahn R, 48 Nahrstedt A: High Content of Hydroxycinnamic Acids Esterified with (+)-D- 49 Malic-Acid in the Upper Parts of Fumaria officinalis. Planta Med 59 (1993), 50 Plant Summaries—F 1 189; Roth L, Daunderer M, Kormann K: Giftpflanzen, Pflanzengifte. Clinical 11 studies demonstrated that the herb inhibits platelet aggregation, increases 12 the bleeding and coagulation times, lowers serum lipids in some individu- 13 als, and enhances fibrinolytic activity. Garlic must be crushed to 26 release allicin immediately before it is used in any way. The herb consists of the peeled fresh 3 or dried rhizomes of Zingiber officinalis R. Gingerols, diarylheptanoids (gingerenones A and B), and starch 7 (50%) are also present. It also 10 has known antibacterial, antifungal, molluscacidal, nematocidal, and anti- 11 platelet effects. The majority of clinical trials per- 36 formed showed a benefit for postoperative nausea, motion sickness, and 37 morning sickness, but a few studies showed no effect. In addition, it increases cere- 7 bral tolerance to hypoxia, reduces the age-related reduction of muscarin- 8 ergic choline receptors and α2-adrenoceptors, and increases the hip- 9 pocampal absorption of choline. In animals, bilobalide and ginkgolides 10 were found to improve the flow capacity of the blood by lowering viscosity, 11 inactivating toxic oxygen radicals and improving the circulation in cerebral 12 and peripheral arteries. Clinical, controlled double-blind 15 studies in humans have confirmed the results of animal experiments (gink- 16 go was found to improve the memory capacity and microcirculation and 17 reduce the viscosity of plasma). Several reports have indicated 29 modest benefit in controlled studies for Alzheimer’s and non-Alzheimer’s 30 dementia. Used for 6 to 8 weeks for treatment of vertigo and tinnitus; longer use 40 is only justified if some improvement can be registered. According to some 41 studies use for at least 3 months is necessary for full effect. Also improvement of walking performance in intermittent claudica- 2 tion has been shown. Despite some positive trials, memory enhancement in 3 healthy persons remains controversial. Treatment should not be initiated be- 4 fore consulting a qualified health care provider. Internationale und statis- 11 tische Klassifikation der Krankheiten und verwandter Gesundheitspro- 12 bleme. Urban & Schwarzenberg, München Wien Balti- 13 more 1994; Dingermann T: Phytopharmaka im Alter: Crataegus, Ginkgo, 14 Hypericum und Kava-Kava.

Journal of Bodywork and Movement Therapies 8(4):286–287 Nella C 2005 The effects of the menstrual cycle on core stability cheap periactin 4 mg with visa allergy medicine yellow. Cellular Signalling Neumann D 2002 Kinesiology of the musculoskeletal 8(7):517–524 system discount 4 mg periactin allergy symptoms september. American 259(5):118–125 Thorsons purchase periactin 4 mg on-line allergy symptoms on right side of face, Wellingborough cheap 4mg periactin overnight delivery allergy medicine 003, p 26 Lovejoy C 2005 The natural history of human gait and Nicholson W 1998 Fire and cooking in human posture. Gait and Posture evolution, rates of genetic adaptation to change, hunter- 21:95–112 gatherers, and diseases in the wild. In: Vleeming A, Mooney V, Dorman T, Snijders muscles acting in parallel combinations. American C, Stoeckart R (eds) Movement, stability and low back Surgeon 52(5):273–277 pain – the essential role of the pelvis. Churchill Livingstone, New York O’Connor J, McDermott I 1997 The art of systems thinking. Thorsons, Wellingborough Lovejoy C, McCollum M, Reno P, Rosenman B 2003 Developmental biology and human evolution. Annual O’Rahilly R, Müller F 2003 Human embryology and Reviews of Anthropology 32:85–109 teratology. Wiley-Liss, New York Chapter 9 • Rehabilitation and Re-education (Movement) Approaches 413 O’Reilly J, Ritter D, Carrier D 1997 Hydrostatic Roithmann R, Demeneghi P, Faggiano R, Cury A 2005 locomotion in a limbless tetrapod. Churchill 71(4):478–484 Livingstone, Edinburgh Sahrmann S 2002 Diagnosis and treatment of Oschman J 2004 Our place in nature: reconnecting with movement impairment syndromes. Journal of Alternative and 23–27 Complementary Medicine 10(5):735–736 Sahrmann S 2005 Diagnosis and treatment of Oxford Park Academy 2006 Sponges – phylum porifera. Panjabi M, Abumi K, Duranceau J, Oxland T 1989 Medicine and Science in Sports and Exercise 20(5 Spinal stability and intersegmental muscle forces. Spine 14(2):194–200 Schaefer R 1987 Clinical biomechanics, Parker J 1998 Heart monitor training, 2nd edn. Palgrave Schleip R 2003a Fascial plasticity – a new Macmillan, Basingstoke, p 161–163 neurobiological explanation. Journal of Platzer W, Kahle W, Frotscher M 2000 Color atlas and Bodywork and Movement Therapies 7(1):11–19 textbook of human anatomy: locomotor system Schleip R 2003b The stretching debate. Thieme, Stuttgart Bodywork and Movement Therapies 7(2):104–116 Poliquin C 2006a Modern trends in strength training. Blackwell Scientific, London, p 127–130 University of Chicago Press, Chicago Shils M, Olsen J, Shike M 1994 Modern nutrition in Raff R 1996 The shape of life – genes, development, and health and disease. Churchill Livingstone, Edinburgh Slosberg M 1988 Effects of altered afferent articular input on sensation, proprioception, muscle tone and Ritz P, Salle A, Simard G et al 2003 Effects of changes in sympathetic reflex responses. In: Vleeming A, Anatomy 131(3):373–385 Mooney V, Dorman T, Snijders C, Stoeckart R (eds) Robinson G 2006 Plant cell cytoskeleton. Churchill Livingstone, New York, plants/cytoskeleton p 103–114 Rocabado M, Iglarsh Z 1990 Musculoskeletal approach Sole R, Goodwin B 2000 Signs of life – how to maxillofacial pain. Basic Books, New York, p Philadelphia ix–11 414 Naturopathic Physical Medicine Spiegel K, Leproult R, Van Cauter E 2003 Impact of Wallden M, Patel A 2008 A caveat to the feed-forward sleep debt on physiological rhythms. Canadian Medical Association Journal 174(6):801–809 Stokes B 2002 Amazing babies: essential movement for your baby in the first year. Stanley Weinberg R, Gould D 1999 Foundations of sport and Thornes, Cheltenham exercise psychology, 2nd edn. Journal of Bodywork and Movement Therapies 4:4 Tetley M 2000 Instinctive sleeping and resting posture: an anthropological and zoological approach to Wharton C 2001 Metabolic man – ten thousand years treatment of low back and joint pain. Annals of the New York Willard F 1996c Somatic dysfunction generated by Academy of Sciences 860:539–542 nerve root irritation. Journal of Bodywork and Movement Therapies 7(2):80–96 Willard F 1997 The autonomic nervous system. Eubios Journal of Williams & Wilkins, Baltimore Asian and International Bioethics 9:12–13 Willard F 2001 Somatovisceral interactions at the spinal Vines G 2005 Put a wild wobble in your walk. Course Notes, British College of Scientist 2531:51 Naturopathy and Osteopathy, London Vleeming A 2003 Movement, stability and low back Willard F 2002 Viscerosomatic and somatovisceral pain. Williams & Mooney V, Dorman T, Snijders C, Stoeckart R (eds) Wilkins, Baltimore Movement, stability and low back pain – the essential role of the pelvis. Churchill Livingstone, New York, Williams P 1995 Skeletal muscle – non-myofibrillar p 53–71 structures of the sarcoplasm. Churchill Livingstone, Edinburgh, p 739–764 Vojta 2006 What is reflexlocomotion and how does it work? Mineral and Williams P, Goldspink G 1978 Changes in sarcomere Electrolyte Metabolism 23(3–6):201–205 length and physiological properties in immobilized muscle. Journal of Bodywork and Movement Therapies (in Williams R 1956 Biochemical individuality. Acupuncture and Electro- cruciate ligament injuries in women as determined by therapeutic Research 4:27–35 hormone levels. However, this should chanical, biochemical and/or psychosocial/emotional not be taken to mean that the treatment methods needs. The objective of their inclu- chanical/musculoskeletal conditions – such as painful sion in the chapter is to offer a sense of the scope and tenosynovitis affecting the elbow, for example – natu- potential influence on health, deriving from physical ropathic physical medicine requires attention to the medicine interventions, rather than creating a veri- context out of which this problem has evolved, calling table cookbook of therapeutic choices. Some of the manual methods that are described – The individual’s history, posture and current activ- both specific and general – appear to be effective in ities, as well as biochemical and psychological status, assisting homeostatic regulation of physiological may all have an influence of what appears to be a functions (Hoag 1977, Kuchera & Kuchera 1991). In addition, nutritional, tional settings, whether the condition can be specifi- botanical and/or homeopathic strategies that encour- cally diagnosed or not. Chapters 7 and 8, and historically in Chapter 3) have Additionally, stress coping and other strategies could been demonstrated to benefit patients with a variety be advised to avoid behavioral changes. This combi- of named conditions or syndromes (see evidence/ nation of inputs, to an apparently localized condition, citations in Chapters 3, 7 and 8, and in this chapter). By extrapolating such evidence, there emerge general As mentioned, one focus of this chapter is towards constitutional guidelines regarding useful therapeutic identifying practical, evidence-informed, physical physical medicine approaches that may variously medicine clinical approaches to named conditions or improve immune function, lymphatic drainage and syndromes, deriving from the osteopathic, chiroprac- circulation, encourage a more balanced autonomic tic, physical therapy, massage, hydrotherapy and function, and assist respiration and elimination, as more general therapeutic literature, in the hope that well as modulating pain, while enhancing other this will encourage their use as part of comprehensive physiological functions. These asso- naturopathic care is provided, in which manual and/ ciated complementary modalities and methods are, or hydrotherapeutic and/or electrotherapeutic inter- however, not detailed. These commonly have no specific objective Thus, in naturopathic terms, they are seen to be in mind, but possess the potential to offer multiple, influencing or stimulating the vis medicatrix naturae to health-enhancing benefits. In this way naturopathic principles can be seen to have been translated into practical clinical approaches. Naturopathic physical medicine The massage paper mentioned above described (and manipulative therapy) defined the work of the German physician Georg Groddeck In Chapter 1 (Box 1. Groddeck’s This is an important document, with elements of its approach, over 100 years ago, showed ‘the importance content worthy of repeating, in order to emphasize of a combination of psychosomatic medicine and the unique nature of naturopathic physical medicine, naturopathy for contemporary medicine’ (Häfner in which practitioners with a wide range of integrated 2005). For for more than half of their patients, for less than half these reasons, although the majority of respondents in of their patients, or never (see Table 10. However, as mentioned earlier, naturopathic manipulation is more likely to also involve soft tissue manipulation and mobilization strategies than would be utilized by most chiropractors. Other insurance companies list the Note: The conditions selected for this list, from the numbers of individuals consulting each of these pro- data in the report, are those where strong evidence vider groups specifically – acupuncture, naturopathy, exists for benefit deriving from receipt of application etc. The percentages of major diagnostic categories The only physical therapies that are part of the assigned to those attending naturopathic physicians naturopathic scope of practice used in more than 5% were (with the percentages of these diagnoses ascribed of the visits were naturopathic manipulation, to patients attending conventional medical practition- physiotherapy (Washington only), and hydrotherapy ers in brackets): (Washington only). Naturopathic manipulation 8 15 Clearly many practitioners identified more than one title to describe their clinical practices, which is per- Physiotherapy 1 13 fectly understandable considering the eclectic nature Hydrotherapy 4 10 of modalities employed in naturopathy. The survey notes that: ‘The practices of herbal medi- Ultrasound 2 9 cine and naturopathy make up a sizeable component Mechanotherapy 2 7 of the Australian healthcare sector, with approxi- mately 1.

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