M3 Reading Guide 2: Mvt./Coordination deficits

Question 1

What 9 key factors aid in recognition of non-pregnant patients who may benefit from stabilization?

Answer 1

1. Younger age (under 40)
2. 3 or more prior episodes
3. Increased frequency of episodes
4. Generally greater flexibility
5. Aberrant movement: instability catch or thigh climbing, painful arc mid-range during lumbar flexion/extension
6. Average SLR over 91˚
7. Lumbar hypermobility (PAIVM)
8. No centralization or peripheralization (no directional preference)
9. • prone instability test

Question 2

What are the two main exercise approaches to spinal stabilization.

Answer 2

• specific stabilization

- general stabilization

Question 3

LBP: deep vs. superficial muscle activation

Answer 3

• activation of deep trunk muscles (TrA and MF) is delayed or reduced
• superficial muscles are often overactive

Question 4

Goal of specific stabilization

Answer 4

retrain normal stabilizing motor patterns of coordination between superficial and deep trunk muscles

Question 5

What is the emphasis of general stabilization?

Answer 5

• exercises designed to improve endurance and stabilizing function of superficial trunk muscles
• without regard to preferential activation of the deep muscles

Question 6

What is the goal of any stabilization program?

Answer 6

Optimum control of the spine to meet patient’s functional demands

Question 7

What are the three phases of skill acquisition in learning spinal stabilization?

Answer 7

1. cognitive (what to do)
2. associative (refining mvt pattern)
3. automatic (developing skill)

Question 8

How does abdominal bracing fit into spinal stabilization training?

Answer 8

• encourage co-contraction of abd wall and paraspinals at low levels in supine
• then used in functional activities

Question 9

Abdominal bracing: what is the recommended max duration for holding?

Answer 9

• no longer than 7-8 seconds

- endurance builds through reps rather than duration

Question 10

What are the “big 3” exercises for challenging trunk muscles, sparing the spine of excessive compression, and ensuring stability? (include muscle groups for each)

Answer 10

1. Curl up with rectus abdominus
2. Side bridge for obliques, TrA, and QL
3. Bird dog in quadruped for back extensors

Question 11

How are the big 3 exercises performed initially and how are they progressed?

first 3 stages

Answer 11

• ID and correct abnormal motion
• build whole body and joint stability
• increase endurance

Question 12

How are the big 3 exercises performed initially and how are they progressed?

Stages 4-5

Answer 12

development of:

• strength
• speed
• power
• agility

necessary for athletes

Question 13

What is the role of the gluteals in spl stabilization?

Answer 13

• accurate gluteal activation is necessary for a healthy spine
• especially during squatting activities

Question 14

What are ways to activate and strengthen gluteals?

Answer 14

• clamshell (hip abd in SL/standing)
• bridging
• double/single leg squats
• lunges
• etc