Lumbopelvic Flashcards
biomechanical stability - subsystems
passive subsystem
-vertebrae, IVDs, joint capsule, passive component of muscle
active subsystem
-muscles and tendons
neural control subsystem
-feedback ssytems from mechanoreceptors and enural control centers
biomechanical spinal instability
- what is it
- causes
“abnormally large intervertebral motions”
causes
-structural damage to the passive subsystem
-impaired function of the active subsystem
-control effors in the neural subsystem
how is biomechanical spinal instability quantified
by a “neutral zone”
what is the “neutral zone”
a region around the neutral position where motion is produced with minimal internal resistance
clinical spinal instability
- what is it
- related hypothesis
what
-a decrease in the capacity of the stabilizing systems of the spine to maintain the intervertebral neutral zones within the physiological limits so that there is no neurological dysfunction, no major deformity, and no incapacitating pain
hypothesis
-neutral zone size, passive and active spinal function are inter-related
–size of neutral zone increases with inadequate muscle force or damage to passive structures
problems with the neutral zone idea
can only be measured in vitro
-active and neural control subsystems not included
interventions based on spinal “instability”
-spinal fusion
-external immobilization (bracing)
test question: passive subsystem instability
-how would your patient present with this deficit
hyperactive/spasming surrounding musculature
increased motion
test question: passive subsystem instability
-what tests and measures would you use to isolate
test active systems to rule out
compare AROM to PROM
-look at passive mobility tests (spring, PIVM)
active subsystem instability
-how would patient present
pain with AROM
decreased willingness to move
history
-pain as day progresses (muscular fatigue)
active subsystem instability
-what tests and measures would you use to isolate
MMT
gait analysis
neural control subsystem instability
-how would your patient present with this deficit
poor control of movement/aberrant motions
uncoordinated movement
neural control subsystem instability
-tests and measures
GIllet test (double to single-leg test)
instability as a clinical term/diagnosis
a vague descriptor
cannot measure/quantify in vivo
might make patients fearful (words matter)
does not serve to guide interventions
