Meziere (Mézières) Technique.

[physiobob]

Hi one and all,

Today I had a request from someone who was looking for a physio in London who uses Meziere Technique. I think this is something that is more common in France than the UK but to be honest I do not know anything about what the technique is or what is the approach to treatment. This particular person was suffering from 'RSI'.

Can anyone shed some light on this treatment approach? Thanks a lot

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[somasimple]

Hi,

It is the same thing as the Postural Global Reeducation
http://www.somasimple.com/forums/showthread.php?t=848

Nothing interesting and something to forget => No a bit of logic and science. I failed to found a single scientific study about it.

[physiobob]

Hi,

It is the same thing as the Postural Global Reeducation
http://www.somasimple.com/forums/showthread.php?t=848

Nothing interesting and something to forget => No a bit of logic and science. I failed to found a single scientific study about it.

It would be nice Bernard if you post a bit of information about this on this forum rather than adding simple links to your own

[somasimple]

Hi Physiobob,

I posted a link to a discussion that occured many months ago on SomaSimple.
If the information isn't relevent just delete it.

Just try to find some studies on the following official pages.
http://www.mezieres.net/home.php
http://www.methode-mezieres.com/

[emmi]

Hi, I am an Italian physiotherapist. Mezieres technique is widely used in Italy. It is also called Global Postural Re-education. There are other two similar, Souchard and Bienfait, both from France.

It is applied to patient suffering from back pain. It is based on eccentric elongation of the muscular posterior chain (paravertebral muscles, hamstrings, etc). The patient mainly is in supine position and use diaphragmatic breathing elongating the muscles actively. The position progresses to several adjustments that the therapist decides to do to facilitate lengthening (like abducted hips and flexed knees, or hips at 90° and legs straight up).

Treatments start from 30mins to progress to 45mins max. Once a week, usually for around 10 weeks. Personally I have used Bienfait technique, it's just a bit different. Anyway I believe there are other quicker and less boring techniques for back pain, not to mention that few patients are available to wait that long. I have heard from my colleagues though that they can solve the back pain, but no patients basically can change their posture (for example an hyperkiphosis stays as it is, and same for a hyper or hypolordosis)

I hope this help.
Emanuela

[pj5789p]

Apparently, the only Meziere's Method teacher in London (according to Time Out Health & Fitness guide) is a Frenchman called Joel Carbonnel, tel no. 020 8747 8583, email [email protected]. May be worth contacting him?

[emmi]

Sorry, I don't know anything about physio people in London. I know about the official teacher in Italy, as I am from there, moreover now I live in Australia and for example here the technique is totally unknown.

[somasimple]

Hi All,

What is a value of a 70 years old technique that is unable to stand a single study about its validity and outcomes?
Nothing at all, IMHO.

[physiok]

Hi!
Meziere is the ancestor of Postural Reconstruction, also called "Chaines Musculaires Method". It's still in use nowadays, but I'm not too sure Francoise Meziere would agree with all the people using her name.
There's an university diploma in Postural Reconstruction in France in several universities (Masters Level) and a couple of research thesis about it (sorry Bernard). You'll find some research published in Belgium and Canada too.
To my knowledge, the most scientific trainings out of the university are the Busquet (France) and Struyf-Denis (Belgique) with a huge background in anatomy and biomechanics to support them, they are based on Kapandji work.
I'm using this method (Postural Reconstruction) for 12 years now and have sorted out a couple of "desperate caseloads" that hadn't been improved by any other technique.
I'm currently working on the treatment of spastic diplegia in children and have nice results.

I hope this help.

[somasimple]

Hi Physiok,

Since you're a trained PT to the method, it would be fine to find "some research published in Belgium and Canada" for us.

Sorry physiok!

[physiok]

Cher Bernard,
Si vous avez la curiosite de chercher sur le web quelles universites proposent le DU de reconstruction posturale (Lyon entre autres), vous pourrez leur demander la liste des memoires de recherche soutenus a ce jour et obtenir copie de ceux qui vous interessent.
D'autre part, en utilisant les mots cles Postural Reconstruction et reconstruction posturale, vous aurez acces aux resumes des theses ecrites sur le sujet au Canada et en Belgique (si j'y suis arrivee, vous le pouvez certainement).
Si c'est au-dessus de vos forces, je vous enverrais les links en rentrant de vacances.
Accessoirement, j'ai fait un deug b, je ne gobe pas n'importe quoi en biomechanique, et les chaines musculaires tiennent vraiment la route.
Bonne recherche.

[somasimple]

Physiok,

I think (even if I'm french) that speaking English is more pleasurable on an English forum.

BTW, I made also a "Deug B" and I do not see any kind of relation with the subject. The human biomechanics aren't taught in a Deug B cursus.

You're just telling us that an old 60 method is valuable, why not? I just want to know why such an old method is unable to bring a peer reviewed paper on the scene.

Sorry but thesis are not really proves that a method works.

I'll wait for the links! I'm very patient.

[physiok]

www.capitalhealth.ca
www.ncbi.nlm.nih.gov key words muscles chains rehabilitation:
Am J Phys Med Rehabil. 2006 Jul;85(7):559-67. Links
One-year follow-up of two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial.Fernandez-de-Las-Penas C, Alonso-Blanco C, Alguacil-Diego IM, Miangolarra-Page JC.
Am J Phys Med Rehabil. 2005 Jun;84(6):407-19. Links
Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial.Fernandez-de-Las-Penas C, Alonso-Blanco C, Morales-Cabezas M, Miangolarra-Page JC.
Research and Teach Unit of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain.
Abstracts in english.

One or two other related studies with postural reconstruction as key words.

Just for a beginning Bernard
I wrote in french previously because the research I was speaking about was in french and had no interest for english speaking persons.
For the same reason I won't give the German links.

PS If you see no common point between mathematics, physics, muscles physiology and biomechanics, I'm wondering Bernard: what exactly are you talking about when you write biomechanic?

[somasimple]

If you see no common point between mathematics, physics, muscles physiology and biomechanics, I'm wondering Bernard: what exactly are you talking about when you write biomechanic?

Sorry guy but I do not see any relation with pain!

[somasimple]

And I do not see any relation with the cited condition and common LBP.
Sorry again.

[physioaz]

As a Portuguese physio I new about Mézieres many years ago.
In fact Mézieres, RPG (Souchard) and Chaines Musculaires (Busquet) are not the same but all come from Mézieres. The most used are RPG (Souchard) and CM (Busquet) and both are Ostheopats who work togheter from many years.
That's one reason why do not exists so many studies as other areas of medicine. Never the less, those méthodes and téchnics are not "quackeries", they work when you now how, when and with who. Like surgeons used to say "we prove our skills with the good cases". So, even you do not no why it works, you can use it because it works. And remember, in physiotherapy (and medicine, even in pharmacology - remember Vioxx and other stories) almost of we done everyday are not proven...

Best regards

[somasimple]

Sorry guy, I think that I'm defintely an open mind! But I'm asking to myself some questions: I have a "great" technique that works with all back problems. Why am I unable, despite the fact that 50% of the population is suffering, to take a bit of my time, achieving a peer reviewed study that just confirms my belief? Why I do not want that this suffering population just endds with its pain? With this study, the medical community will be able to give the miraculous care I have! Why, after 70 years, this miraculous method is not yet taught at Uni? Mezières, Souchard and Co... aren't responding to such questions? Why?

[physioaz]

Dear somasimple, off course you are an open mind or you never loss your time with such discussion. First of all I don´t use any one of this méthodes (maybe something of Busquet...), second I don´t believe in wonderful méthodes who solves everything or every cases. What I mean is that kind of therapies (manual therapy in general) comes or from medical doctors or from the so called "Alternative Medicines" (ostheopat.,chirop, etc...) and in this second group is not normal to use the cientific méthode, controlled studies, etc. So for many years a lot of "thécniques" are developed only in clinical basis. That not means it does not work, only never been study as they should because many of the praticioners simply used because it works...
About the knowlegde for all community, normaly the authors of the thécniques (father of the child) made books, manuals and courses. (A good business I must say, but its the same with all authors).
Publishing to prove anything so became important in last 20 years with the Evidence-Based theory, in the 50 before publishing are only good for authors and his curriculum, and remember that "alternative people" are good because solve problems not because write scientific articles, his curriculum are made in clinical field.
Sorry about so long post, but I like you understand that I want too, good studies in all fields of our practice that proven everything we do, but it does mean that things that are not proven yet are not good. besides don´t exist any study that prove they are a waste of time

Best regards

[somasimple]

Physioaz,

It is very easy to "porduce" a peer review paper.
Unfortunately a "good" theory behind Mezieres and Co is yet missing and the explanations do not fit with actual concepts of PT.

Writing a book is not a guaranty of efficiency neither a prove of scientific rationale.

[physioaz]

Somasimple,

In fact writting a book don´t prove anything, but all authors do it even those we think they got "good theories" (Cyriax, Maitland, etc..) and sometimes before they can prove their theories with scientific papers. As you know in manual therapy still very difficult prove things and are not only PT's working the area. Good or bad theories should be proven in both ways. (We can´t say something is bad because nothing proves it's good). If anyone says that a pencil in a ear cures cancer, I probably w'll be very ceptic, but we never knows... And remember, evidence-based practice is not science, is only the final product. Much of we call science born by mistake...

Best regards

[somasimple]

I'll will not not the pencil and we are waiting for evidences since 1950.

[physioaz]

Ok! I just understand your point, but it's quite amazing that something with no evidence can remains by 70 years among maybe hundreds of PT's...

[somasimple]

physioaz,

In the same vein: It's amazing that man believes to politics since thousand years; There is so much evidence that often promises remain... promises. despite of this, many parties have supporters that are believing that they are the only solution and hold the "truth".

Why such a miraculous method that saves so much people is just unable to make a single digest that may be seen by their peers?

That's is incredible. Mankind is suffering and Mezieres refuses to help it! That is a sufficent proof that the method is unable... at all.

[physiok]

Guys you're tiring!
Firstly Mezieres doesn't heal everything and doesn't pretend to. It's not all about LBP as well, and saying so tends to prove that you know absolutely nothing on what you're talking about.
Secondly when someone gives you links about evidence and research, maybe you could read them. Here's another one http://depulp.u-strasbg.fr/stage/page541117.html , with the University of Strasbourg that provides the training in Postural reconstruction, with a curriculum leading to a diploma approved by French State, and I would be surprised if they hadn't be provided with strong scientific evidence (not only RCT) in order to get that approval.
If you contact the University they can give you access to the thesis about postural reconstruction, and that may include RCT, case studies, MRI and EMG studies. As you don't seem to know, thesis are NOT referenced on Medline, but it doesn't mean they have no value!

Proving the efficacy of a technic is not all about RCT, as they are statistic results and you can make statistics say anything you want.
That's as well about knowing how and why it works, and on what, which includes doing it on volunteers under Xrays, doing comparative EMG , MRI before and after treatment to investigate what really happens.
That is the scientific approach, and I've been very shocked when Bernard asked me what was the relationship between pain and biomechanics, I learned that in my first year of studies!

Anyway I don't want to convince anybody, I know what i'm doing, why, and what i can't do, and as most physios I don't have time to do RCTs, nor enough patients presenting with the exact same LBP or else to give statistically significant results.
I keep thinking that muscles chains are a fantastic tool for assessment and treatment of any biomechanical disorders, perfectly consistent to use with PNF, Bobath, Maitland, Reflextherapies, Feldenkrais, electrotherapie and even acupuncture but that's just my own opinion, and will be my last post on the subject as I have patients to treat.

[somasimple]

Firstly Mezieres doesn't heal everything and doesn't pretend to.

Thanks to confirm that it does... Nothing.

BTW, a postural reconstruction is already a nonsense.
We do not change posture neither reconstruct them.

More, I found a French scientific rationale that confirms that universities are mandatory providing "good" courses as you seem to think it.
http://cura.free.fr/cura-en.html