Archive for the ‘Continuous Passive Motion (CPM)-Motion Assisted Adjusting-Leander Technique’ Category

Continuous Passive Motion (CPM)-Motion Assisted Adjusting-Leander Technique

August 13, 2011

Kevin G. Parker, D.C.-One of the corrective techniques that I use in my office can have a few names.

MAA-Motion Assisted Adjusting, CPM-Continuous Passive Motion, or Leander Technique.

Other names of similar techniques:  Motorized flexion-distraction (Leander), manual flexion-distraction (Cox), Disc decompression, decompression-traction or non-surgical spinal decompression…which has become the most widely used non-surgical approach to treating back pain.

Some of you may have heard of  the “concept” of CPM from the Back2Life machine infomercials on tv.  Our office treatment tables are much more advanced and specific–but it did bring the idea of CPM and spinal motion to the viewing audience.

Back pain, back pain with radiating leg pain, sciatica, spinal disc problems, and many other spinal conditions can be effectively treated by using the above listed techniques.

For a great animation of what the vertebral joints and discs look like as they are traction-ed or decompressed: Link

Let’s look at CPM in more detail. 

Leander Eckard, DC developed his first CPM table in 1981. His tables are now in operation in more than 39 countries worldwide.

Dr. Kevin G. Parker with Dr. Leander Eckard-middle 1990’s.

The Leander table is able to provide a unique type of movement that allows a gentle stretching (“distraction”) of the individual vertebral spinal segments with each flexion cycle of the table.

CPM provides healthy motion in areas which may have become less mobile due to painful spasms, slight fixations or “locking” of a vertebral segment, or migration of the disc out of its normal position.

We are able to isolate the spinal problem, and assist the CPM by applying gentle manual pressure to each vertebral segment.

The result is considered a “de-compression” of the spine and its discs.

When a disc bulges, ruptures, or herniates, it can put pressure on the sensitive spinal nerve roots.

CPM combined with gentle distraction allows the disc to assume a more normal, central position again and correction of the “stuck” vertebral segments.

This movement of the disc away from the nerve root can reduce nerve inflammation, eventually relieving the associated back pain or back and leg pain.

Because discs rely on a process called “imbibition” to absorb nutrients and fluid from surrounding tissues, CPM or Flexion-Distraction can improve disc health when disc degeneration has occurred.

This technique has a relaxing effect on the spine overall, and patients report feeling increased flexibility and motion after treatment.

Image 1-Excess scar tissue with no motion(stuck joint) #2 shows joint motion=Healthy joint tissue

Flexion-Distraction is applied in combination with appropriate physiotherapies, in a series of treatments. The amount of treatments will vary on the patient and condition.

Specific therapeutic exercises are used, consistent with patient progress. Important home care instructions and supplements are a crucial part of treatments.

Dense radom scarring in the connective tissue

Normal Connective tissue

A More detailed description of the table below

A specialized articulated treatment table is used providing a patient’s spine to continuous passive motion for a short period of time for the purpose of analyzing the degree of motion or fixation (stuck joint) of the spine and other spinal structures. (Vertebrate, ribs, discs, ligaments, muscles, etc.)

This technique enables a corrective force to be introduced into the restricted spinal area and allows post palpation verification of that correction in all areas of the spine.

This continuous passive motion or flexion-distraction technique incorporates the use of an articulated bench upon which the patient lies face down.

The patient grasps a soft foam bar with hands over their head and gently pulls against the slow moving caudal section of the table, which flexes the lumbar spine.

The patient’s spine can also be moved into lateral flexion (sideways motion) during the flexion process by manual effort on the part of the doctor. This option is very therapeutic with scoliosis patients.

I also incorporate the Myofascial Release Technique to the spinal muscles during the CPM. Also, Class 4 laser is used when appropriate.

The continuous passive motion of the table results in intermittent traction to the spine allowing the doctor to palpate each individual vertebral motion unit of the entire spine.

This motion slightly tractions the spine in a predictable and repetitious manner.

This table allows the doctor to make specific corrections and restore vertebral motion, simply by holding hand/digital pressure on the spine while the table is in motion.

The individual disc spaces are evenly stretched open (decompressed) and allowed to close gently, each time the table cycles.

Typically this occurs twenty-nine times a minute, although the speed of the table can be slowed down for acute conditions.

This repeated axial distraction/relaxation on the spinal disc brings about a gentle pumping and decompressing action.

This motion increases the metabolite exchange to the disc and ligaments and allows for the absorption of nutrients.

This motion allows the disc to “suck in” nutrients and re-hydrate.

The discs are not the only benefactors of this motion. The facets (joints of the vertebrate) are brought into action and benefit greatly by the continuous passive motion effect.

There are many published research journal articles on the healing benefits of motion to the discs and joint capsules.

In cases of facet syndrome, where a jamming has brought about swelling, pain and loss of motion– this gentle flexion and relaxation tends to rehabilitate those injured tissues.

In the thoracic spine, the rib heads are often “locked” on patients and minutely fixated, which can cause a great deal of pain.

This repeated spinal flexion and motion from the table allows for myofascial tissue healing and increase motion of the rib/costal articulations.

Videofluoroscopy (Motion x-rays) of the spine in motion on the motorized flexion table has shown the great extent of motion introduced to all spinal segments from the sacrum to the skull.

In the normal course of the treatment– motion is introduced to every segment of the spine– from the acetabular cavity (hip joint)– including sacroiliac articulations up to the base of the skull.

Motion equals life. If you don’t use it….you lose it.

Dr. Leander Eckard with his plane in the early 80’s.

Rest in Peace Dr. Leander Eckard-June 11, 1941 to June 24, 2008

Other good articles:

Massive disc herniation can heal-Ann R Coll Surg Engl. 2010

Spinal Decompression Case Study (Case Study: 12mm Herniated Disc with Extrusion with Pre- and Post-Spinal Decompression MRI Images) from our office with Before and After MRIs.

Healing Time of Soft Tissue

Back Pain-Insider Secrets revealed-San Fran Gate 2012

A New Gatekeeper for Back Pain

Why Does Back Pain Recur?

Fibroblast cells in Healing

Fish oil-Neurosurgeon for the Pittsburgh Steelers

Foam Roller for Back Pain

Exercise Makes Us Feel Good-NY Times 2011

Gluten Free Diet helped Nerve Pain-Neurology 2010

Inflammation-13 Tips To Fight Inflammation

Laser Therapy in Rehabilitation-Irvine California

Low Back Pain Studies 2010

Magnesium Deficiency

Muscle Trigger points vs Acupuncture points

Neck pain-Journal of the American Board of Family Practice 2004

Nerve ingrowth into chronic painful disc-Lancet 1997

Nerve Supply of the lumbar disc-JBJS 2007

Omega 3’s-Molecular Neurobiology-January 2011

Omega 3′s and Nerve pain-Clinical Journal of Pain 2010

Self Movement Screen

Sitting-Can sitting too much kill you? Scientific American Jan 2011

Vit. D-What We Have Learned About Vitamin D Dosing

Exercise and Chiropractic-part of the anti aging strategy.

Spinal Rehabilitation and Chiropractic

If you are suffering from: Sports Injuries, Sprains, Strains, Car accident,  Herniated Disc, Disc Bulge, Degenerative Disc Disease, Neck pain, Headaches, Low back pain, of just want to feel better and have better life performance– please call our office in Irvine, California- at 949.857.1888 or visit our website at ADJUST2IT to learn more about Functional Fitness Chiropractic, Sports massage, Myofascial Release, Corrective Exercise, Non Surgical Spinal Decompression, Class IV laser,  and Functional Nutrition.