Diaphragmatic assessment & treatment

Question 1

Diaphragm is part of the…

Answer 1

inner unit of your core

Question 2

When doing diaphragm function testing in supine what do you look for/ask yourself?

Answer 2

1. what is the rib cage doing laterally and posteriorly
2. what are the compensatory movements
3. assess throughout the rib cage

Question 3

How do you assess diaphragm function

Answer 3

have fingers in lower intercostal spaces.

Change position moving from anterior to posterior

Question 4

What are compensatory movements to watch for when assessing diaphragm function

Answer 4

Accessory muscle use
Abdomen protruding
Ribs not moving properly

Question 5

How do you perform an intra abdominal pressure test in supine

Answer 5

Visual assessment and palpation

lift patient legs to 90 90 when they are in supine, remove your hand and look what is happening at abdominals

Question 6

What are signs of inappropriate intra-abdominal pressure

Answer 6

• Movement of the umbilicus upwards
• Chest lifting to a high position
• Anterior tilt of the pelvis and hyperextension

Question 7

What are signs of good intra-abdominal pressure

Answer 7

• if the chest is maintained in caudal position and the lower chest widens during inspiration
• Proportional activation of all parts of abdominal wall
• Lower abdomen have fully rounded appearance, no central ridge with concavities at the lower latearl part of the abdomen

Question 8

What does movements of the umbilicus during intra abdominal pressure testing indicate

Answer 8

an over active upper rectus abdominis muscle

Question 9

what does the chest lifting to a high position during intra abdominal pressure testing indicate

Answer 9

That there is little or no activation of the latero-dorsal aspect of the abdominal wall

Question 10

What does anterior tilt of the pelvis and hyperextension of L/S and T/L junction during intra abdominal pressure testing indicate

Answer 10

hyperactivity of the paravertebral muscles

Question 11

What does the lower abdomen having a central ridge with concavities at the lower lateral part of the abdomen during intra abdominal pressure testing indicate

Answer 11

a rectus abdominis dominant activation with insufficient intra-abdominal pressure

Question 12

Is breathing typically harder in sitting or supine

Answer 12

sitting - have to work against gravity - will see difference in clinical populations

Question 13

What is treatment for tight pec minor?

Answer 13

roll towel and have it between scaps - apply pressure on coracoid to deepen stretch

Question 14

What is treatment for tight scalenes

Answer 14

stretch by pulling neck with your hand laterally

Question 15

What is treatment for tight intercostals

Answer 15

supine massage

Question 16

with diaphragm release how long do you typically hold the pressure

Answer 16

10-30 seconds

Question 17

when stretching accessory muscles how long do you typically hold the stretch? how many reps?

Answer 17

> 30 seconds

3-5 reps

Question 18

What is the treatment progression for core

Answer 18

Inner layer - isolation, unison, start with diaphragm
Outer layer - gradual, isolation vs. unison
With function or activity - depends on clients goals