Lumbar Mobility and Trunk Stabilization

Question 1

Disc Common Impairments

Answer 1

-Pain/muscle guarding
-slightly flexed and deviated from side
-Possible neuro
-Sx ^ with flexion, transition mmts, coughing
-Morning pain (increase disc height from hydration)

Question 2

Facet Common Impairments

Answer 2

-20s-50s
-Can have pain at all time
-decreased movilitty and joint play
-impaired posture and extension
-pain worse @ morning and night

Question 3

Nerve Root Common Impairments

Answer 3

Younger: disc protrusion
-SLR and Slump (+) equally
-pain with flexed postures

Older: Stenosis
-bony growth
-pain worse at end of day
-leg pain
-pain with extension and ipsi LSB
-SLR more positive than slump

Question 4

Gower’s Sign

Answer 4

-inability to return to erect from bending without use of hands
-Pt might pop back to reduce Sx

Question 5

Functional Instability

Answer 5

-Pain without x-ray/MRI
-loss of NM segmental control

Question 6

Structural Instability

Answer 6

-mechanical
-disruption of pasive structures

Question 7

Flexion Preference ADL and Education

Answer 7

-overhead activities
-SLS
-sitting with knees above hips
-Endurance: biking

Question 8

Extension Preference ADL and Educaiton

Answer 8

-Prone lying
-standing extension
-Walking

Question 9

Volitional Pre-emptive Abdominal Contraction

Answer 9

-VPAC

Abdominal Draw in Maneuver
Multifidus Activation
Pelvic Floor Muscle Activation
Abdominal Bracing Maneuver

Question 10

Abdominal Draw in Maneuver

Answer 10

-TrA/IO
-In hooklying
-ASIS are IO

Cues:
-pulls ASIS together
-blow out a candle
-pull stomach away from pants

Poor Activation Signs:
-Pulling ribs down
-PPT
-Quick contractions

Progression:
-Bent Knee fall out
-Supine March
-SLR

Question 11

Multifidus Activation

Answer 11

Cues (Prone):
-Palpate TPs
-Verbal cues: swell the muscle
-Tactile cues: palpate while they contract
-activate with TrA

Cues (Sidelying):
-manually resist rotation
-clam shell: resist
-UE facilitation: lats

Poor Signs:
-PPT
-Erector SPinae

Question 12

Abdominal Bracing

Answer 12

-set abs and continue breathing
-use for functional activity
-more stability
-PPT

Progression:
-limb loading
-side planks
-pertubations
-resistance
-extension

Question 13

Fundamental 6-Pack

Answer 13

TrA/IO
Multifidus
Pelvic Floor
Glute Max
Lat
Diaphragm

Question 14

Principals of Stabilization

Answer 14

-proximal stability for distal mobility
-develop NM control > strength and endurance > functional stability
-Develops awareness of muscles, control of patterns, automatic maintence of stability during activities