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: 

Posterior chain

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 diaphragmatic chain is constituted by the anterior deep muscle of the cervical spine, sternocleidomastoid,
scalenes, anterior fascial tissues of the thoracic spine, diaphragm, psoas, adductors, and anterior tibialis muscle.
 

Anterior-internal chain

The anterior-internal chain of the pelvic girdle is constituted by the psoas and adductor muscles.

 

Scapular girdle chain

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.

 
 
 
Forskellige øvelser fra træningsprogrammet:
 
Stræk af post chain
Forskellige øvelser
Stræk af post pelvis chain
 
Eksentrisk øvelse for rygmusklerne