stuart mcgill

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Dr. Stuart M. McGill

Josh Basham BChiroSc (MQ), Wayne Hedley BChiroSc (MQ), Luke Nisbett BChiroSc (MQ), Daniel Murray BChiroSc (MQ), Jack Rogers BChiroSc (MQ), Justin Ryan BChiro

Sc (MQ), Martin Schutte BChiroSc (MQ), Michael Smith BChiroSc (MQ)

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Objectives

Outline the his contribution to spinal biomechanics, injury prevention and rehabilitation

Describe his rehabilitation and functional protocols

Critically evaluate these methods based on their support in the available literature

Department of Chiropractic

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Biography- Roles & Qualifications

Dr Stuart McGill (Associate Professor) Director of the Spine Biomechanics Laboratory, University of Waterloo, Ontario Canada.

B.PhysEd (Toronto), M.Sc (Ottawa) PhD (Waterloo)


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Biography - Achievements

A highly recognized researcher and lecturer in spinal biomechanics, function, rehabilitation and injury prevention

Currently over 200 publications

Editorial board of several scientific journals including Spine

Numerous academic awards and invited lectureships

Runs spine-related workshops and clinical courses worldwide


Backbone and wingspan: Spines in flight, 2011

5Department of Chiropractic

PublicationsMcGill has published 3 textbooks,170 journal papers, 140 refereed conference papers, 50 keynote addresses, 330 other invited addresses and 150 self initiated addresses

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Assessment of Methodology- Literature Search


Primary Database Search of Mantis, Cochrane, Pubmed, ScienceDirect, Cinahl and Medline: 113 journal papers found & 2 commissioned and positioned papers (once duplicates were removed)

Secondary Database Search via websites and libraries: 3 textbooks, 2 DVDs and 57 journal papers (once duplicates were removed)

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Assessment of Methodology- Intended search terms: MeSH


(“Stuart M. McGill” OR “spinal biomechanics”OR “Spine Biomechanics Laboratory (University of Waterloo, ON, Canada)” OR “lumbar stabilisation” OR “spinal rehabilitation” OR “low back pain” OR “lumbar disc injury”)

Chiropractic Association of Australia CAA, (2012)

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Assessment of Methodology- Inclusion/Exclusion Criteria


To obtain the highest level of McGill’s work in the field of spinal biomechanics, rehabilitation and fitness we only included:

Literature where Stuart M. McGill was listed as the top three contributing authors

Literature that was available in Primary Medical Journals

Literature involving spinal biomechanics, spinal rehabilitation/stabilisation/fitness, low back pain, lumbar injury and disc injury

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Contributions to Research


in vitro and in vivo facilities

development of the ‘McGill model’ virtual spine

Generation of hypotheses regarding spinal injury mechanism, prevention, rehabilitation, and optimum performance

University of Waterloo Spine Biomechanics Laboratory

‘…to understand how the low back functions; to understand how it becomes injured; and, knowing this, formulate and investigate hypotheses related to prevention of injury and optimal

rehabilitation of the injured back, and ultimate performance of the athletic back.’

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Contributions to Research- McGill Model: Virtual Spine

High speed cameras capture joint movement caused by load placed in the upper

Reaction moments at L4-5 generated through linked-chain equation

Reaction moments converted into 3-D motion at L4-5 through pelvic and spine markers


PART ONE

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Contributions to Research- McGill Model: Virtual Spine

determines how the forces are transferred into load placed upon

the spine and paraspinal tissues based on:

The kinematics of the individual’s spine

the deformation characteristics of passive tissues

muscle activation via surface EMG


PART TWO

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Description of Research- Understanding Spinal Stability


McGill’s key findings of Spinal Stability;

Co-activation of musculature

Superposition of multidirectional muscle fibers

Muscle contraction produces a force and stiffness

Stiffness created by muscle contraction will always act to stabilize

“Super Stiffness” the stability provided by the co-activation of the musculature

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Description of Research- Protocols for Back Rehabilitation Exercises

1.Corrective exercise2. Perfect motion and motor patterns3.Build whole body and joint stability4. Increase endurance5. Build strength6. Develop speed, power and agility


Protocol for Back Rehabilitation Exercises- The 6 Stage Approach

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Description of Research- The “Big 3”


The Curl Up

The Bird-Dog

The Side Bridge

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Evaluation


McGill’s biomechanical research is of high quality

There are some potential biases arising from subject demographics

Rehabilitation and injury prevention protocols are evidence-based and well- reasoned

There is a need for clinical trials (RCTs) to determine the efficacy across the general population and different subgroups

16Department of Chiropractic

Conclusion McGill has made a field-leading contribution to spinal biomechanics

research

Rational development of scientific research findings in to clinical applications

Challenged existing ‘clinical wisdom’ and has explained observed phenomena

Has provided an evidence-based framework for further research into spinal injury prevention, rehabilitation and optimum performance

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References


(1) Waterloo Uo. McGill, Stuart M. 2012 [cited 2012 09/10]; Available from: (2) Waterloo Uo. Stuart McGill Research. 2012 [cited 2012 08/10]; Available from: http://www.ahs.uwaterloo.ca/~mcgill/. (3) McGill S. Low Back Disorders: Evidence-Based Prevention and Rehabilitation. 2nd ed. Champaign, IL, USA: Human Kinetics Publishers; 2007. (4) McGill S. Ultimate Back Fitness and Performance. 4th ed. Waterloo, Ontario, Canada: Backfitpro Inc; 2009(5) Waterloo Uo. Spine Biomechanics Laboratory. 2012 [cited 2012 08/10]; Available from: http://www.ahs.uwaterloo.ca/kin/people/SpineBiomechanicsLab.html.(6) McGill SM, Juker D, Axler C. Correcting trunk muscle geometry obtained from MRI and CT scans of supine postures for use in standing postures. Journal of Biomechanics. 1996;29(5):643-6(7) McGill SM, Norman RW. Effects of an anatomically detailed erector spinae model on L4L5 disc compression and shear. Journal of Biomechanics. 1987;20(6):591-600.(8) McGill SM, Norman RW. Dynamically and statically determined low back moments during lifting. Journal of Biomechanics. 1985;18(12):877-85.(9) McGill SM. Lumbar loads from moments about three orthopaedic axes: Developing the architecture of a 3-D occupational low back model. Journal of Biomechanics. 1992;25(7):810.(10) McGill SM. A myoelectrically based dynamic three-dimensional model to predict loads on lumbar spine tissues during lateral bending. Journal of Biomechanics. 1992;25(4):395-414.(11) Cholewicki J, McGill SM, Norman RW. Comparison of muscle forces and joint load from an optimization and EMG assisted lumbar spine model: Towards development of a hybrid approach. Journal of Biomechanics. 1995;28(3):321-31.(12) Sutarno CC, McGill SM. Force velocity investigation of the erector spinae muscles. Journal of Biomechanics. 1994;27(6):744.(13) McGill S, Juker D, Kropf P. Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine. Journal of Biomechanics. 1996;29(11):1503-7.(14) McGill S. Ultimate Back Fitness and Performance. 3rd ed. Waterloo, Canada: BackFit Pro Inc; 2004.(15) Kavcic, N., Grenier, S.G., and McGill, S.M. (2004a) Determining tissue loads and spine stability while performing commonly prescribed stabilization exercises. Spine, 29(11): 1254-1265.(16) Kavcic, N., Grenier, S., and McGill, S. (2004b) Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine, 29(11):1254-1265.(17) Brown, S. H. M. and S. M. McGill (2005). "Muscle force-stiffness characteristics influence joint stability: a spine example." Clinical biomechanics (Bristol, Avon) 20(9): 917-922.(18) Callaghan, J.P., and McGill, S.M. (2001) Intervertebral disc herniation: Studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clinical Biomechanics, 16(1): 28-37.(19) Axler, C., and McGill, S.M. (1997) Low back loads over a variety of abdominal exercises: Searching for the safest abdominal challenge. Medicine and Science in Sports and Exercise,29(6):804-811.

http://www.ahs.uwaterloo.ca/~mcgill/

http://www.ahs.uwaterloo.ca/kin/people/SpineBiomechanicsLab.html

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• (20) McGill, S.M., Karpowicz, A. (2009) Exercises for spine stabilization: Motion/Motor patterns, stability progressions and clinical technique. Archives of Physical Medicine and Rehabilitation, 90: 118-126.

• (21) McGill, S. M., A. Childs, et al. (1999). "Endurance times for low back stabilization exercises: Clinical targets for testing and training from a normal database." Archives of Physical Medicine and Rehabilitation 80(8): 941-944

• (22) Nahin R. Observational Studies and Secondary Data Analyses To Assess Outcomes in Complementary and Integrative Health Care. National Center for Complementary and Alternative Medicine; 2012 [cited 2012 8/10]; Available from: https://nccam.nih.gov/research/blog/observational-secondary.

• (23) Brown SHM, McGill SM. A comparison of ultrasound and electromyography measures of force and activation to examine the mechanics of abdominal wall contraction. Clinical biomechanics (Bristol, Avon). 2010 2010 Feb (Epub 2009 Oct;25(2):115-23.

• (24) McGill SM, Andersen JT, Horne AD. Predicting performance and injury resilience from movement quality and fitness scores in a basketball team over 2 years. Journal of strength and conditioning research / National Strength & Conditioning Association. 2012 2012;26(7):1731-9.

• (25) McGill SM, Axler CT. Changes in spine height throughout 32 hours of bedrest. Archives of Physical Medicine and Rehabilitation. 1996;77(10):1071-3.

• (26) McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: Clinical targets for testing and training from a normal database. Archives of Physical Medicine and Rehabilitation. 1999;80(8):941-4.

• (27) McGill SM, Hughson RL, Parks K. Changes in lumbar lordosis modify the role of the extensor muscles. Clinical Biomechanics. 2000;15(10):777-80.

• (28) McGill SM, Karpowicz A. Exercises for spine stabilization: motion/motor patterns, stability progressions, and clinical technique. Archives of Physical Medicine and Rehabilitation. 2009 2009;90(1):118-26.

• (29) Moreside JM, McGill SM. Quantifying normal 3D hip ROM in healthy young adult males with clinical and laboratory tools: hip mobility restrictions appear to be plane-specific. Clinical biomechanics (Bristol, Avon). 2011 2011 Oct (Epub 2011 May;26(8):824-9.

• (30) Moreside JM, McGill SM. How do elliptical machines differ from walking: a study of torso motion and muscle activity. Clinical biomechanics (Bristol, Avon). 2012 2012 Aug (Epub 2012 Apr;27(7):738-43.

• (31) Preuss RA, Grenier SG, McGill SM. Postural control of the lumbar spine in unstable sitting. Archives of Physical Medicine and Rehabilitation. 2005 2005;86(12):2309-15.

• (32) Scannell JP, McGill SM. Lumbar posture--should it, and can it, be modified? A study of passive tissue stiffness and lumbar position during activities of daily living. Physical therapy. 2003 2003;83(10):907-17.

• (33) McGill SM, Marshall LW. Kettlebell swing, snatch, and bottoms-up carry: back and hip muscle activation, motion, and low back loads. Journal of strength and conditioning research / National Strength & Conditioning Association. 2012 2012;26(1):16-27.


https://nccam.nih.gov/research/blog/observational-secondary.

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• (34) Cambridge EDJ, Sidorkewicz N, Ikeda DM, McGill SM. Progressive hip rehabilitation: the effects of resistance band placement on gluteal activation during two common exercises. Clinical biomechanics (Bristol, Avon). 2012 2012 Aug (Epub 2012 Mar;27(7):719-24.

• (35) McGill SM, Karpowicz A, Fenwick CMJ, Brown SHM. Exercises for the torso performed in a standing posture: spine and hip motion and motor patterns and spine load. Journal of strength and conditioning research / National Strength & Conditioning Association. 2009 2009;23(2):455-64.

• (36) Fenwick CMJ, Brown SHM, McGill SM. Comparison of different rowing exercises: trunk muscle activation and lumbar spine motion, load, and stiffness. Journal of strength and conditioning research / National Strength & Conditioning Association. 2009 2009;23(2):350-8.

• (37) Banerjee P, Brown SHM, Howarth SJ, McGill SM. Torso and hip muscle activity and resulting spine load and stability while using the ProFitter 3-D Cross Trainer. Journal of applied biomechanics. 2009 2009;25(1):73-84.

• (38) Vera-Garcia FJ, Elvira JLL, Brown SHM, McGill SM. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2007 2007 Oct (Epub 2006 Sep;17(5):556-67.

• (39) Moreside JM, Vera-Garcia FJ, McGill SM. Trunk muscle activation patterns, lumbar compressive forces, and spine stability when using the bodyblade. Physical therapy. 2007 2007 Feb (Epub 2007 Jan;87(2):153-63.

• (40) Freeman S, Karpowicz A, Gray J, McGill S. Quantifying muscle patterns and spine load during various forms of the push-up. Medicine and science in sports and exercise. 2006 2006;38(3):570-7.

• (41) Balkovec C, McGill S. Extent of nucleus pulposus migration in the annulus of porcine intervertebral discs exposed to cyclic flexion only versus cyclic flexion and extension. Clinical biomechanics (Bristol, Avon). 2012 2012 Oct (Epub 2012 Jun;27(8):766-70.

• (42) Yates JP, McGill SM. The effect of vibration and posture on the progression of intervertebral disc herniation. Spine. 2011 2011 Mar;36(5):386-92.

• (43) Yates JP, Giangregorio L, McGill SM. The influence of intervertebral disc shape on the pathway of posterior/posterolateral partial herniation. Spine. 2010 2010 Apr;35(7):734-9.

• (44) Marshall LW, McGill SM. The role of axial torque in disc herniation. Clinical biomechanics (Bristol, Avon). 2010 2010;25(1):6-9.

• (45) Scannell JP, McGill SM. Disc prolapse: evidence of reversal with repeated extension. Spine. 2009 2009 Feb;34(4):344-50.


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