Global Posture Reeducation
Global Posture Reeducation (GPR).
GPR har i et enkelt studie vist god effekt på alle 5 effektmål i BASMI, og er det eneste træningsprogram, som vist at kunne forbedre modificeret Shobers test.
Muligvis kan det være værd at overveje, at prøve at træne bevægelighed efter principperne i GPR. Der mangler erfaring med at arbejde med GPR til patienter med morbus Bechterew i Danmark.
In France, Italy, and Spain there is a physical therapy method called “Global Posture Reeducation” (GPR), which was developed by Phillipe Souchard based on 20 yrs of clinical experience. This method deals with the existence of different muscle chains:
The posterior static chain is constituted by the spinal posterior muscles (suboccipital muscles, cervical posterior ligament, iliocostalis,latissimus dorsi), pelvic region (pyriformis, obturators, gemellus), hamstrings, and gastrocnemius muscles.
The anterior-internal chain of the pelvic girdle is constituted by the psoas and adductor muscles.
The anterior-internal chain of the scapular girdle is constituted by subscapular and mayor pectoralis muscles
All these muscle chains are constituted by gravitational muscles (i.e., erector spine muscles, piriformis muscle, scalene muscles, suboccipital muscles, etc.) which work in synergist function depending on the muscle chain (e.g., the muscular function of the posterior static chain of the body is to permit the standing position against gravity). According to this method, the analytic stretching of any muscle could be expanded to include secondary adaptative or maladaptative changes in the rest of the muscle chain, so that the analytic stretching of any individual muscle would be inefﬁcient, if not associated with a stretching of the whole muscle chain. Therefore, the GPR method employs speciﬁc strengthening and ﬂexibility exercises in which these shortened muscle chains are stretched and strengthened.