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MS II > Cervical TherEx > Flashcards

Cervical TherEx Flashcards

1
Q

What 3 classification groups of the C-spine are treated with stretching, coordination, strengthening and endurance?

A
  • Pain with mobility deficit
  • Pain with headache
  • Pain with movement coordination impairments
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2
Q

What are 2 treatments for the pain with radiating pain c-spine classification?

A
  • Nerve mobilization

- Traction

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3
Q

What are 2 treatment for impaired muscle performance?

A
  • Strength exercises

- Endurance exercises

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4
Q

What are 3 treatments for hypomobility of a joint in the c-spine?

A
  • ROM
  • Flexibility
  • Neural glide
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5
Q

What is the treatment for hypermobility of a c-spine segment?

A
  • Stabilization exercises
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6
Q

How are lengthened muscles treated?

A
  • Strengthen in shortened range
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7
Q

How are shortened muscles treated?

A
  • Stretching/ postural correction
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8
Q

Which muscle group is most commonly impaired in the c-spine?

A
  • Deep anterior cervical flexors
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9
Q

What group of muscles are the DNF of the c-spine similar to in the trunk?

A
  • Transverse abdominus/ core muscles
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10
Q

How can a patient activate their DNF muscles prior to movement of the head?

A
  • Chin tuck/ nod
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11
Q

Describe the least vigorous DNF exercise.

A
  • Slide back of head up wall
  • Palpate SCMs and scalenes to ensure they are not activating
  • Hold for 10 seconds
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12
Q

Describe the self-assist DNF exercise.

A
  • Pt supine
  • Hand supporting head
  • Hand helps patient lift head off table as well as provide a traction force
  • Hand can also assist in eccentric contraction
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13
Q

What are 2 ways to progress the self-assist DNF exercise?

A
  • Progress to unassisted active motion

- Progress to resisted motion with a 1lb sandbag on the forehead

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14
Q

What are 2 methods of deep cervical flexor with SCM and Scalene assistance exercises?

A

Towel roll:

  • Pt supine with towel roll under the head
  • The patient lifts their head off the mat while maintaining contact with the towel roll and a chin tuck to avoid dominance of superficial muscles

Incline:

  • Pt positioned sitting on a large incline
  • Patients lifts head off mat maintaining a chin tucked position
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15
Q

What modality is effective in the early treatment of the cervical extensors?

A
  • Nueromuscular stimulation (e-stim)
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16
Q

How are cervical extensors strengthened?

A
  • Pt is taught to apply resistance with a specific force vector with a direction and magnitude sufficient to cause a muscle contraction in the targeted tissue. (usually sidebending with rotation)
  • Pt may be lying or sitting, and reaches up over shoulder and behind head with hand and fingers to apply gentle ipsilateral sidebending and rotation
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17
Q

Describe an exercise targeting segmental activation of the cervical extensors?

A
  • Start in the sitting and forward flexed position (c-spine and some T-spine)
  • Begin segmental extension begining at the T-spine, then retracting the cervical region, then extending the upper C-spine and head TO NEUTRAL
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18
Q

Describe manual resistance of the cervical muscles, and progression.

A
  • Begin with gentle isometrics of side bending, flexion, extension, and rotation in different neck positions
  • Progress to dynamic, isotonic movements
  • Increase force and duration
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19
Q

Describe rotation and side bending exercises.

A
  • Pt hooklying with head on foam wedge, which patient rolls up and down in a controlled fashion

OR

  • Pt sidelying with a towel roll used as a fulcrum for sidebending
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20
Q

How are rotation and sidebending exercises progressed?

A
  • Multiplanar movements are introduced

hypertranslation needs to be controlled

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21
Q

What are the 6 causes of hypomobility?

A
  • Segmental articular mobility restriction
  • Capsular thickening and contracture
  • Degenerative bony changes
  • Segmental muscle spasm
  • Myofascial extensibility
  • Adverse neuromeningeal tension
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22
Q

What neck position creates a maximal downslope of the targeted vertebra?

A
  • Quadrant
23
Q

What neck position creates a maximal upslope of the targeted vertebra?

A
  • Flexion, contralateral flexion, and rotation
24
Q

How can a downslope ROM exercise be aided by the patient in their HEP?

A
  • Target with overpressure from the ipsilateral hand

OR

  • Use a towel to assist in motion
25
Q

How can an upslope ROM exercise be aided by the patient in their HEP?

A
  • Target with overpressure from contralateral hand

OR

  • Use towel to assist in motion
26
Q

By what 2 methods can an overstretch of the hypermobile segments above and below the hypomobile segments be prevented?

A
  • Position neck to lock out above and below the targeted segment
  • Stabilize with hand pressure
27
Q

What muscles are targeted by the 4 flexibility exercises/ tests of the c-spine?

A
  • Levator and Splenius Cervicis
  • Upper Trapezius and SCM
  • Middle and Anterior Scalenes
  • Sub Occipitals
    • Bilateral
    • Unilateral
28
Q

Describe the flexibility exercise that targets the levator scapulae and splenius cervicis muscles.

A
  • Grasp chair with ipsilateral side
  • Place head and neck into flexion, and contralateral rotation and side-bending
  • Lean trunk to contralateral side
  • Emphasize stretch with hand
  • Increase stretch by contracting ipsilateral lower trapezius
29
Q

Describe the flexibility exercise that targets the upper trapezius and SCM.

A
  • Grasp chair with ipsilateral hand
  • Position head and neck into flexion, contralateral sidebending, and ipsilateral rotation
  • Lean to contralateral side
  • Emphasize stretch with hand
  • Nod chin to sharpen stretch
30
Q

Describe the flexibility exercise that targets the middle and anterior scalenes.

A
  • Pt places contralateral hand over medial clavicle and first rib of ipsilateral side
  • Retract chin slightly
  • Position neck into extension, contralateral side bending, and ipsilateral rotation
31
Q

Describe the flexibility exercise that targets the suboccipitals.

A
  • Position one hand on the back of the head, and one on the chin
  • Flex upper C-spine with gentle distraction force
  • Maintain chin tuck
  • To focus stretch to one side, rotate 30 degrees
32
Q

What are the 4 basic treatments for hypermobility of the C-spine?

A
  • Postural correction exercises
  • Taping of scapula to reduce pull on segment
  • Manually stabilize hypermobile segment or perform cocontractions at involved levels
  • Gradually challenge c-spine musculature while preventing excessive motion at involved segment
33
Q

Describe the alternating isometric exercise for stabilization.

A
  • Head and neck positioned in neutral (to begin)
  • Isometric contractions applied in all cardinal planes with pressure applied on cranium (Hold for 6 - 10 seconds)
  • Progressed to different directions
  • Progressed to head and neck positioned out of neutral
  • Progressed to eyes closed
  • Progress from light force to significant (but, don’t break form)
34
Q

What 3 exercises target the DNF, extensors, lateral flexors, and rotators in stage 1 of stabillization?

A
  • AROM –> RROM of chin tuck in a variety of positions
  • AROM –> RROM of intersegmental extensors in a variety of positions
  • Supine head roll up/downhill on a foam wedge
35
Q

How can is co-activation initiated in stage 1 of stabilization?

A
  • Quadriped chin tuck with lower c-spine extension
36
Q

How are the stage 1 exercises progressed?

A
  • Increase in duration
37
Q

How are stabilization exercises progressed in stage 2?

A
  • Increase intensity and duration (while maintaining form)

- Coactivate C-spine to control positions during arm movements

38
Q

List the positions for co-activation of the C-spine form most to least stable.

A
  • Supine
  • Quadriped
  • Upright
  • Unstable surface (foam roller, wobble board, ball)
  • Include arm movement
  • Include hand held weights
39
Q

Is position of the c-spine harder to control during bilateral or unilateral arm movement ?

A

Unilateral

40
Q

Past what degree shoulder flexion does c-spine stability become more difficult?

A
  • 90 degrees
41
Q

How are stabilization exercises progressed in stage 3?

A
  • Intensity and duration

- Intersegmental control progressed to neck movements and functional tasks

42
Q

How are neck movements progressed in stage 3 stability exercises?

A
  • Straight plane –> Diagonal planes
  • Single plane –> Multiplanar movements
  • Whole body movements with neck not emphasized –> Neck emphasized
43
Q

What is important for positioning of a self- nerve glide?

A
  • Belt placed around shoulder and ipsilateral thigh in hooklying to depress shoulder
  • Make sure shouder is supported so it doesn’t fall into extension
44
Q

How is the nerve pulled from the distal portion?

A
  • Wrist movement
45
Q

How is the nerve pulled from the proximal segment?

A
  • Lateral flexion of the neck
46
Q

What is the position for a median nerve bias glide?

A
  • Shoulder depressed
  • Shoulder ER
  • Wrist extension
  • Forearm supination
  • Elbow flexion –> extension
47
Q

What is the position for a radial nerve bias glide?

A
  • Shoulder depressed and IR
  • Forearm pronated
  • Wrist flexed and ulnar deviated
  • Move from elbow flexion to extension
48
Q

What is the position for a ulnar nerve bias glide?

A
  • Shoulder depressed and ER
  • Shoulder abudcted to 90
  • Forearm pronated
  • Wrist and fingers extended
  • Move from elbow extension to flexion
49
Q

What is the treatment for FHP due to muscular imbalance?

A
  • Lengthen short muscles

- Strengthen long/ weak muscles

50
Q

What is the treatment for FHP due to neuromeningeal extensibility impairments?

A
  • Side flexion and elevation of the scapula
51
Q

What is the treatment for FHP due to articular hypomobility?

A
  • Manual therapy

- Mobility exercises

52
Q

What is the treatment for FHP due to proprioception impairments?

A
  • Postural correction
53
Q

What are the 2 types of FHP?

A
  • Forward head position with minimal midcervical lordosis

- Forward head position with excessive midcervical lordosis

54
Q

How often should postural correction exercises be performed?

A
  • As often as possible

MS II (20 decks)

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