Date post: | 02-Jun-2018 |
Category: |
Documents |
Upload: | autumn-carter |
View: | 222 times |
Download: | 0 times |
of 14
8/10/2019 Asana Based Exercises Low Back Pain
1/14
@
The
Yoga ReviewVol. III, No.
1,
1983
Asana-based
Exercises
or
the
management of
Low
Back
Pain
T. V. ANANTHANARAYANAN
Krishnamacharya
Yoga
Mandiram,
Madras-600018
and
T. M. SRINIVASAN
Founder
Member
Biomedical Engineering
Division,
I.
I. T., Madras.600036.
Abstract-Low
Back Pain
is
an
endemic disorder afficting
a
large
percentage
of
peopte.
The
aeliological
factors are mostly
psychosomatic
along with
postural
defects,
occupational
predispositions
and
sendentary
life
styles. Though several
rehabilitative
techniques
re
prescribed,
no systematicanalysis
of
these
are
available.
The
present
study
evaluatesseveralsimple asanas n
the basis
of biomechanical
principles.
These
studies
also select a set of
asanas
which work on the
back with
increasing
intensity.
A series of
tests are evolved to assess
he
physiological
debility
of
a
patient.
These
test
results form the basis
of
selection of
asanas
to
be
prescribed
to
the
patient.
A
chart
is
finally
provided
to
enable
he
therapist
to
increase
tho
intensity of asanas
so that the
muscles of the low
back
can be
strengthened
ystematically
and
progressively.
The
results of
clinical
trials on 16
patients
using
this method of asanas
selection
and
rehabilitation
indicates the
usefulnes
of
this
method for
the man-
agement
of
low back
pain,
Only
regular
practitioners
of
these
exercises
mprove
while inditrerent or improper practice has no rehabilitative value.
45
8/10/2019 Asana Based Exercises Low Back Pain
2/14
46
T.
V.
Ananthanarayanan and
T,
Itt, S,inivasan
l. lntroduction
Next to the brain
itself,
the
spinal c,
rd i the most
important
structure
in
the human
body for maintenan(e
oi
postural
equil ibrium
and
for communication. The
spine consists of seven cervical,
twelve
thoracic,
five
lumbar, five
fused
sacral
and
three to
four
fused
coccygeal
vertebrae.
Viewed
in the frontal
plane
the
spine is straight and
symmetrical.
Looking
from
the side however,
there
are
three
curvatures,
an
S
curve
with an
additional
C fused
at
the
bottom
of
S.
These
curves
give
the spine
increased
flexibility
and
better
shock absorbing
capacity
while
retaining appropriate
stiffness. The
intravertebral disc is a
mult i funct ional
element subjected to many types of
loads.
Activ i t ies
such
as
umping
increase the
load
on
the
discs.
Short
durat ion loads
(such
as
during weight
l i f t ing)
can
cause
irreparable
damage to
the
discs. The intravertebral discsconsti tute approximately one th i rd of
the
overal l
length of the lumbar spine,
whi le
n
the
rest
of the
vertebral
column,
the
rat io
is
down to
one
fi f th
only
(Finneson,
1980).
' this
increased
soft
t issue-to-hard
issue
atio as wel l as the
fact
that lumbar
spine
is
a
primary
weight
bearing
structure
accounts
for
LPB
ll .ow
Back
Pain) which is
so
widely
experienced.
In this
paper, spinepain
refers
o those
pain
not
related
to
nor
contr ibuted
by
infect ion, tumor,
disease,
fracture
or
by fracture
dis-
location.
Spine
pain
is
reported
most
frequently
in
the
lumbar
region
fol lowed
by cervical and
thoracic regions, in
that order.
There
are
a
large number of pain sensit ive structures in the spine. The annular
f ibres,
ongitudinal igaments, apsular
structures,osseous
tructures
etc
,
in
the
spinal
iystem
have
various
nerves
innervating
them.
Spine
pain
can
come
rom
physical,
chemicalor inf lammatory
problems
associates
with these nerves. There is also referred
pain
whose
origin
is
not
understood,
We sholl
deal
only with LBP
which has
none
of
the
above
pathology associated
with
it.
The
important
nonorganic
caused of
LBP
are
as follows:
il
Biomechanical
abuse
of
the
body:
Intense
and
sudden exher-
t ions, postural abnormal i t ies and occupational predisposit ions al l in
this
category.
Examples nclude
weight
i f ters,
long
distanceprofessional
drivers and secondarvscol iosis.
8/10/2019 Asana Based Exercises Low Back Pain
3/14
Exercises
or
Low
Back
Pain
ii) Obesity,
pregnancy and
postnatal
recovery: In all
these
cases,
the mechanism
of
pain generation
is
similar
to
those
in
the category
of
weight-lifters. The excess
weight
pushes
the centre of
gravity
farther
away
from
the spine
with the increased ever
arm
putting
excess
pressure
on
the lumbar system.
ii i) Sedentary
ife styles: It has
been suggested Krauss,
1965) hat
LBP
can
be
called
a
'hypokinetic
disease',
implying underutilization
of
the spinal and associated muscles.
Several muscles of
the
back
and
abdomen
are
involved in distributing
and supporting the
load on
the
lumbar vertebra if
a
person
stands
or
lifts extra
weights. This
is a very common causeof LBP with age
related degeneration
setting
in
due to
lack of exercise.
iv) Stress: A strong correlation between psychological tension
and LBP is
impl icated in
some
studies
(Sarno,
1978)
wherein the term
tension
myocytis
is suggested. The
term tension refers
to
psychic
camponent
which
is
the
precipi tat ive
cause
of
LBP. Tbe
muscle
pathology
may
have secondary
nflammatory changes.
I t
may be
a local
disorder of c ontract i le
state of
a
muscle
eading o
muscle
spasm
(Sarno,
1978).
Often,
the
abovo
factors are in
col lusion
to
produce
LBP.
The
hypokinetic
act iv i ty makes
the muscles
wcak
and unable to
support
normal structural
weight
whi le the
stress
produces
tense and
short-
ened muscles with restr icted
movements.
Doran and Newal l
(1975)
report that
f rom
a
sample of
262
patients
treated
in
dif ferent ways
(spinal
manipulat ions,
physiotherapy, corsets,
analgesics
and combi-
nation
of
these),
56
per
cent st i l l
had
back
ache
at
the
end
of
one
year.
However,
other studies
(e.
9.
Lindstrom
and Zachrisson,
1970)
indicate
that
physical
therapy
has an
important role
in
the
manage-
ment
of LBP an d sciat ica. The emerging
consensusof
opinion
of
many studies
(Nachemson,
1969)
is
that
exercise s very important
component
which should
be
performed
isometrical ly especial ly
or
abdominal
and
quadriceps
muscles.
The
back
muscles
may be
exercised
isornetr ical ly
r isotonical ly.
Further,
the
prograrn should
consist
of
relaxation
and
Iimbering
exercises
long
with
those hat
promote
elast i -
ci ty. The latter is necessary ince reduced elast ic i t l ' Ieads to lumbar
f lexion
or torsion
movement
which may further stretch
a muscle
or
tendon,
precipi tat ing
he cycle of
low
back
pain.
These two
cordinal
47
8/10/2019 Asana Based Exercises Low Back Pain
4/14
48 T
l'.
Ananthansrayanan
and T. M.
Srinivasan
aspects namely, relaxation
and
improved
elasticity
-
can be effectively
met
through
asana
and
pranayama
pract ice.
Further,
isometrics can
also be incorporated or abdominal strengthening. However, the treat-
ment of
LBP
in India
is
l imited mostly
to
tract ion
and
diathermy.
Very
l i t t le act ive
part ic ipat ion
is
el ic i ted from the
patient
during
physiotherapy.
The
physiotherapy
pract iced
here
s fair ly
outdated and
no
novel
procedures
uch
as
proprioceptive
aci l i tat ion
is
incorporated.
Though
yoga
asanas
are
attempted
in
isolated inst i tut ions
methods
to rat ional ize
ts appl icat ion
o
LBP have not been worked
out.
Even
in wel l
-
establ ishedhospitals,
the
causative
factors,
the
individual
differences,
progression
of
exercises, est
methods for suitabil i ty
and
stagesof exercise
egimen
etc
have
not
been
worked
out.
The
present
study hopes
o f i l l
this
much
required
cl inical
understanding
of
the
role
of
asanas
nd
pranayamas n
the
management
f low
back
pain
through
the
appl icat ion
of simplebiomechanicalprinciples.
2.
Biomechanics
of Asanas
Asanas
involve slow and steady movements
and
muscles
stretch
during maintenance
f
a
posture.
The asana exercises hus
fal l in
the
category
of
isometrics
and muscle
relaxation
achieved
due
to
stretch.
In
the
use
of asanas as a
therapeutic tool , s low
stretch
is
a
very
important method
for
achieving
muscle
elaxation
and
improved
motor
funct ion.
This
is
simi lar to r ehabi l i tat ion
echniques that
are
currently
known
as Proprioceptive
Neuromusclar
Faci l i tat ion.
Relar,at ion
of a
muscle
indicated
by
lowered
discharges rom
the
muscle
ibres)
s
obtain-
ed by stretching the muscle very slowly and maintaining the stretch
over
prolonged
periods
of
t ime
(Srinivasan,
98l).
Thus,
asanas
and
counterposes
work on
the muscles
through isometrics
and further
muscles
relax
through intense stretch. The feedback
mechanisms
n-
volved
also change
with
improved muscle
control
due
to
stretch
carried
out
by the
patient
himself
whi le
this
element s
absent i f
the
stretch s
through externa l means
i. e.,
through
electr ical
st imulat ion
or through
manipulat ion
by
the
therapist
(Vinod
Kumar, 1982).
A range of
postures
can
be selected
rom
the avai lable
i terature
on asanas
(Smith,
1980).
These sele:t ions
are made
on
the
basis
of
the work
brought on the low back by these asanas.
The asanas
are
l isted
n Table
I, along
with the major
muscles
hat
are
activated
during
the
exerc ises.
Since these
asanas work
on
low
back muscles,
heseare
selectcd
or
the therapeutic
egimen. Each asanas s
also
graded
on
the
8/10/2019 Asana Based Exercises Low Back Pain
5/14
Exercises
for
Low
Back
Pain
basis
of
force
which
it
exerts
on tho
joint
during
each
type of
movement. This
is also indicated
in
Table
L
The
biomechanical
calculat ion
proceeds
as
fol lows
(Ananthanarayanan,
1983).
Consider a
hypothetica l case of a
person
of l '76 cm height and 60 kg
weight.
The
lengths of different
parts
of the body
(such
as head
and
torso, upper
armn
hand,
high, leg
aud
foot)
are
assumed
for
this
person
and the
portion
of
body
weight
along with the centre of gravity
is
assigned
on
the basis
of
avai lable
studies. From
this,
the
moment of
force of each
body segment
about the
point
of atta chment s computed.
These
are
then added up depending
on the number
of
segments
hat
are moved while an
asana is
performed.
For
example,
n
Uttandsan(r,
the
tors:, upper
arm,
lower
arm and
the
band
are
moved
about
the
hip
joint;
the total monrents of t trese parts amourrt to l57i kg cm.
Simi lar ly ,
each asana
is
c lass ihed n
the
basis
of the
body
parts
moved
and
hence
the moment of force
generated
about the
hip
joint
The
act ' ra l values
computed
are
shown in
Table
I"
[ t is
ev ident that
ihe
higher
he moment,
he
greater
s
the force
recrui ted
n
the t ack
muscles.
To mai i t ta in the
asana
posi t ions,
thus
greater
work
is
put
on these
rnuscles. ln i t i i r t ly ,
depending on
t- ie
intcnsi ty of LBP, asanas
having
ryp
ot
movement
m
u 5c te|5
invol
va o
osono
mcmcnt ot thc
joint
'ficcdcd
lo
movc
body
port
ogornst
grovi ty)
llaD
srtcrlslon
grluteus
moxtmrJs
r?ctur
tmoris
(gemi
i.adirFf(,s
Seni mcribrengsui)
"91
wipodopcotom
\----a
shqlobhcsqno
870
kg
cms
kg
cn6
zJ
I
Hip
f lcrron
padls
moJor
r l [ ioc
us
(
pe
ctrmus
go
or
ru s
tensor fosc,oe totoc)
o.E
qponosono
ey\
supinc
beflt
leg flcxrorr
s
voJrosono
N
to
ut
onosono
4)
ooschi
motonosono
370
00
kg cms
185,
00
kg
cm s
1
264.
80
kg
cm s
1571
53
lgcms
1
571. 53
ko
cu,"
Table
I.
Major
muscles nvolved and
forces
at
the bip during cli f t 'erent sanas
contd.)
49
8/10/2019 Asana Based Exercises Low Back Pain
6/14
50
T,
V. Ananthanarayanan
nd
T.
M. Srlnivasan
Iypa
ot
rf iovamGnt
murglcs invol
rd
otqnq
nentdttldt
sre
lotnt
neEc'3d o
fiic{3 body
port ogslnst gmvitY)
I r 'Jnl i art tn;10n
tqcro rP|mut
(semr
iptndlr t
mul
i l lou
J*1"
chgkrsYehqrsng
**g
bhu
6ngqsort
/s
.---.9
rholsbhqrenc
ni ltgib{;
1126,
i lB
smt
ZZtl.66
r9nit6
Trunh
ltcr ion
raElur
obdorninua
arlcrnql
ono
Internsl
ob{iqu.B
"dt
rytrr beni
l.g
ttsrlofi
s"*'t
tupine
irur*
tlairirl
*/
porchl'lutcnd|onq
r t r ,09
Hg
6rn
l?63,6t kS
cme
157]. t3
Fgrf l i
Tablo I"
Major
musclesnvolved
and
forccs
at the hip
during differentasanas
smaller
momont
and hence
esserwork
on
low
baek rnuscles hould
be
recommended.Howdlver,n
l i terature, ead
and torso i ft
( lying
down)
is
prescribed
arly n
rehabil i tation
hich
wil l
put enorme,us
train
oR
back
muscle
and
is thus
eontraindicated
n
the
present
study.
The
present iomechanicalri teria hus enablea gradedselectionf asanas
so
that he
ow baekmuslces re
slowlyand
progressively
trengthened
by
proscribing
ncroasinglyif l icultasatts
br
practice.
3.
Test and Trcatment$chedules
The above
sumrnarized
methodof
grading
asanas
s
the
basis
for
rehabil i tation
f
tBP. However,
efore
proceeding
ith rehabil i tatior:,
i t
is necessaryo
assess
he
abil i tyof
the
patient
o
cnrry out
the
basic
movements
F'or this,
a seriesof seven
ests are
introduced
on
the
basisof
muscle
est ing
devisedby Krauss
(1965).
Charts
I
to
7
summarize
he ests
o
be
conducted,
he contraindicated
satlasn each
group. The patient s instructedo carry out the exercises nd his
inabi l i ty r
pain
duringa
movemeRt
i l l determine he
evel
at
which
these
excrcises
hould be started. The
general
ules o bc
fol lowed
(and
ecornmended
y
several orkers;
re
8/10/2019 Asana Based Exercises Low Back Pain
7/14
Exercises
or
60cro
sprnotr
.scmi
spinolrs
mul
tr t
du s
quodrctq
lumbo?urn
Low Back
Pain
CHART
I
CHART 2
5t
lESl
t: -
lor up 'pcr
bock
, j ;
="F"
+rl
LJL
I
ri I
Lr I
o9l
potrert
to
o?cD
bocl
|-4
^J L
dJ
rt
towcr
bock
ond
lcgs
ore
gt i l i
D
A-
,^
/L-
IESI ?: .
tor
Quodrotus tu iborum
pu $
I
a--/\-
slor br@lhino
il
o.A-
r
z
p
it
euooiotus
tunborvm r3
tttlt
+:.
8/10/2019 Asana Based Exercises Low Back Pain
8/14
52
rES"
3
?or
o
9oo9 l tLtocus
to t
stiftncss
I
aN ,
D
l
)
ll
e::1
IV
AVO|D:-
-'l
^
tor
wcok
psoos
r t t rocus
*l V
tor
gt i l l
Psoos
it taocus
;|
Nt {
VT
a'G,.-
psoos
moror
i l laocus
gl,utcus
mo
tmus
7cctus lemorrs
scmi tcndrnosus
SCmi
membronosus
CHART 3
CHART
4
IEST
4: .
loi
towcr bocl gtutcus ond
hohgtE
)
st 'cngth
o=-
-
--J
"E1
l
AVOID
At
s londinq
posturcs
'nr t rot ry
-
unt r l the
musc(ca
qofn
s t re^9th
8/10/2019 Asana Based Exercises Low Back Pain
9/14
Exercises
or
Low
Back Pain
53
TLS?
5
,
fet
hom; t r ing
strl lnc
ts
e_
J-
E-ff
:i_
_:-
)
a_-_tt
(
onr lpr rsror ,
l l
a
i
8/10/2019 Asana Based Exercises Low Back Pain
10/14
54 T,
V.
Ananthanarayanan
nd
T. M.
Srinivasan
mov4
qams
ond
hqdd
i :
;1::1.'J
*'
sro'd'u
Samt
glnOl lS
cOpt l l s
sPtcnrg5
9qP113
;plcnrus
ag.vlcts
CHART
7
l.
Sit-upsare
contraindicated
n pat ients with
acute
and subacute
lumbar pain and
definitely
ot
advisable
or
older
patients'
2.
Isometric abodminal
exercises
are
preferable being
milder) o
back extension xercises.
3.
Deepknee
bending
laces
nordinate
stress n
the
knee.
4. Toe.touching
and sti ff leg
raisedo
not
relax
the
back but can
put
great
strain on back
muscles.
Once the
ist
of
asanas
are determined
rom
the
set, the actual
sequence
s worked
out on the
principle
of
alternate
pose
and counter-
pose.
Let
us consider
specific ase
of
test result
conducted
on a male
patient,37
years
old,
176
cm height,60
kg weight,
a
professional
execu-
tive.
The
test
results
rom the
Charts
I
to 7
is as follows :
-o-Jr
- ) ,
I
-ln
UL
t
I
-
8/10/2019 Asana Based Exercises Low Back Pain
11/14
Exereises
or
Law Back
Poin
Since
no
asana
in
this sequence
s
contraindicated,
he entire
sequenee
s retained.
Rest
may
be
incorporated between3
and 4
and after the completionof the asanas. Simple breathing schedules
are
carried out
with
the patient seated n
a
chair.
The
practice
of
prescribinggentle
exercises
oordinated with
easy
breathing
or
LBP
patients
whose
muscles
are in spasm inds support
n White and Punjabi
(1978)
also. Variations n
breathing
attern
include
ong exhalation
and holdingbreathafter exhalation,
he
latter
beingparticularly seful
as
an
abdominal
exercise.
This
then
is
the
criteria
or
selection
f an
exercise
chedule
nd a sequenceuildup o be
prescribed
o
a
patient.
4.
Results
nd Discugsion.
A
total
of
16
persons
etween
ges
2
and
60
were taken
for testing
and for therapeutic schedule. All patients bad LBP without any
pathology testi f iod
by medical
personall ,
with
5
out
of 16
having
LBP
for
more
than
5
years.
The
sample
consisted
f
8
females
3
post-
natal,
I
retroverted uterus, 2 age-related
egeneration,
tension
myocytis
and
I due to
exertion)
and
8
males
4
tension
myoeytis,
due
to intense xertion,
gait
related BPi.
The
pationts
were interviewed
ndividually
during
which
he
details
of medical
istory,occupation,
onsion
rtate,
doctor's recommcndations
etc,
were
noted"
Each
patient
is
then
examined
on the
basis
of
Cbavts
tlrrough
and be
subjective
eports,
mobil i tyof
joints,loeation
and ntensityof
pain
tc arenotod. The seguences built up on tbebasis
of these
ests
asdiscussedarl ier The course f therapywas
usually
to
6 individual
nneetings
nce
a week
asting
about
an
hour. Duringeach
subsoqunt
isit,
he
improvoments
re
noted
and
the exercise chedule
is
made
progressively
ore dsmandingso that the muscle
strength
can
be
buil t up,
thus incorporating
preventive
aspect
also in thsse
sched
les.
After a six month
practice
of asanas,
questionnaire
as
cir-
culated o each
patient
to
assess
he
changes rought about by
the
treatment,
Of thc 6 people reated,l reported signi f icantesseningf LBP
and
the
remaining
reportedsl ight improvement
i th pract ice
but
recurrence f
pain
i i
pract ice
s discontinued.
Hence, egular i ty
of
pract ice
s
essentia lor
the
nrDrovementn
the
condi t ion,
55
8/10/2019 Asana Based Exercises Low Back Pain
12/14
56
T. V. Anarxthanaravanan
nd
T. M.
Srinivasan
The
main
points
to conclude
rom the
patient
response
after
a six
month
followup is as follows
:
l .
Overwhelming
majori ty
( l l
out
of
16,
nearly
70
percent)
reported
signif icant improvement
n
their condit ions
with
near
normal
mobi l i ty
and
absence f
pain.
2. Those
who
reported recurrence of back
pain
also reported
irregulari ty
of
pract ice.
3
The
assigned
xercises
n the
basisof
biomechnical
omputat ion
is a safe
rnethod
with
easy
ntroductory
postures
fol lowed
by
those
which
worked with
greater
intensity on
the
back.
Severalsimple exercises erived from asanas have been analyzed
in
this
study
through
principles
of
biomechanics
so
that an
objective
basis s
provided fot
assessing
he
activity of low
back muscles during
these
postures.
A
series
of
test
protocol
has been
worked
out for
testing
the flexibility
and strength
of
low
back muscles.
The
patients
can be tested
with
this
protocol
and the test results indicate
the
level
at
which
this
asanas
may
be
prescribed,
o
that
the
back
is
not over-
strained
ini t ial ly.
Extension
of
these
calculat ions
to avai lable
reha-
bi l i tat ive echniques
ract iced
elsewhereshows
clearly
the
unsuitabi l i ty
of
those which
can be vry
severe
on
an
already
weak oack.
A cl inical
study
on l6
patients
hrough
the
present
method
of asana
select ion
nd
progressive ui ldup
has
clearly
shown that
an overwhelming
majori ty
(about 70
percent)has a
good
recovery ro m low back pain.
Asana
pract ices are characterized
by
slow
movements, isometric
muscle
contract ion
an,Jstretch
of antagonist muscles
The
slorv
move-
ments
provide a low energ y
cost and
hence at igrc is avoided.
Isometrics
are
those
n which
the muscle
s contracted
under
constar)t
ength;
here s
no
movementof
the
oint,
however
since
he
musclecarries
weight,work
is
done by
i t In cases
f
joint
Cisart iculat ion
t is
st i l l
poss ib le
to keep
the
muscleact ive
through
the
pract ice
of
isometrics.
The musclestretch
has
ery important
impl icat ions
n ntusc le
ynarnics. Herein the muscle
is both
relaxed
reduced
activ i iyt
and
the feedback rom
the
muscle s
altered so that muscle ccntrol can be readjusted. For example, in
cases
f ;
say,
spast ic i ty ,
a
readjustment
of
a lpha
motoneuron discharge
is
possib le hrough
changes
n
ref lex response
n
a muscle
dur ing
stretch.
This modulat ion
of
motoneuron
activ i ty is
not
possible
i f the l imb
is
8/10/2019 Asana Based Exercises Low Back Pain
13/14
Exercises
or
Low Back
Pain
moved
passively
by the therapist.
Further, the
work
done
by
the
muscles
can
be
increased hrough the
introduction
of
breathing
during
asaRas.
The
asanasaught hereare
dynamic and
with
counterposos.
Slow
repetitive
ostures
help o
activate
both
the
agonistand the antagonist
during
movemnt.
Thus, sudden isor,netriowo,rk s not
assigned
o
the
muscle
especially
boso
which
are
weak
due o
disuse. Further, during
slow
movements
he
joints
and the
connectivs
issues aro
stretched
gradually
without extreme lexion
and
associated angerof
damage,
Movement
also
irnplies ncreased
ci'reul,a.tion
nd' warrning
up
of
the
muscles.
Breathing
n
syncronism
with
movements
for
example, low
exhalation
during
forward
bending)
add to tbe
depth oF
rnovements.
Breathingalso ndicates o the practitioner whether the ptrysicrrl imits
of exercises
being
reached
whon
breathing beoomes ifficult
or
comes
in
spurts. It
alsoputs
more
work on the muscle o that muscle
one
improves.
Low
BackPain
LBP)
s a
wide spreadmalady
affi icting
more
than
50
per
centof
the
population
at
any
one
time,
in any country.
The
exercises uggested
ereare hopefullyan
improvement
over the
previous
ones.
However, ntense
nvestigation
and
long
followup
are
required
before
prescribing
ny
set of
exercises
ased
on
asanas
as
final thera-
peutic egimen or
low
back
pain.
Acknowlsdgment
The
authors
wish
to
place
on
record
the
advise
and
constant
vigilance
f
Sri Desikachar during
the
course
of
developmentof these
procedures.
References
l.
Ananthanarayanan
T,
v.
(1983)
'Management
of
Low
Back
pain;
Biomechaniccl
analysis
of asanas
nd
pranayama'
MS
thesis,
Bionredical
Engg.
IIT Madras,
India.
2. Daniels
L. and Worthingham
C.
(1980)
,Muscle
Testing,
W.
B.
Saunders
Co.,
pa .
pp
t6.74.
3. Doran.
ML
and
Newall, DJ
(1975).
'Manipulation
in
treatment
of
low
track
pain..
A mult icentre
tudy'
BMJ.
Vol
2,
pp
l; l -164.
4. Finneson,
B.
E.
(1980)
Low
Back Pain'
J. B.
Lipprncott
Co.,
Pa.
ppZ2O-241
57
8/10/2019 Asana Based Exercises Low Back Pain
14/14
58
T.
V. Ananthanarayanan
nd
T. M.
Srinivasan
5.
Krauss,
(1965).
'
Back Acke
.
stess
and
tension,,
George
Allen and Unwin,
pp9-4,77-110.
Lindstrom,
A and
Zachrisson,
M.
(1970)
physical
therapy
on
low
back
pain
and
Sciatica'
Scand
Jr Rehal
Med,
Yol
2,
pp
37.42.
Nachemson,
A
(1959)
Physiotherapy
for low
back
pain
patients,
ScandJr of
Rehab
Med.
Vol I,
pp
85-90.
Sarno,
J. E.
(1978)'Therapeutic
exercise
for
back
pain'
in Theropautic
Excrcises
(ed)
J.
V. Basmajian,
Williams
& Wilkins
Co.,
Baltimore,pp40g-429.
smith'
M. J'
N.
(1980)
'An
lllustrated guide
to
Asanas
and
pranayama',
Krishnamacharya
Yoga
Mandiram,
Madras.
srinivasan,
T. M.
(1981)
'Electrophysiological
correlates
during
yogic
practices,,
The
Yoga Review,
Vol
I No. 4
pp
165-173.
vinod Kurnar,
K.
(1982),
'Micro'processor
based
neurological (n
Reflex)
monitor-
ing'. MS Thesis, BiomedicalEngineeringDivision, IIT, Madras, pp 51.
while'
A.
A. and Punjabi,
M.M. (1978)
'clinical
Biomechanict
f the
spine, J.
B.
Lippincott
Co.,
Pa,
pp
277-344.
,
o
D
6.
7,,
8.
9.
10.
l l .
12.