Movement control lumbar Flashcards
Lumbar instability
laxity around neutral resting position of spinal segment
Larger with intersegmental injury, and intravertebral disc degeneration
Smaller with simulated muscle force across motion segment
instability- is decreased ability to maintain neutral zone in physiological limits
what influences lumbar instability?
Passive-vertebra intravertebral disc, z joints ligaments
Active - muscles tendons
Neural - nerves, CNS directing and controlling active system
movement control, or stabilization classification
Promoting isolated contraction, and Cocontraction of the deep stabilizing muscles like Multifidis transversus abdominis
Strengthening of large, spinal stabilizing muscles, like erector spinae, and oblique abdominals
aberrant movements
Altered Lumbo pelvic rhythm
Gowers sign
Deviation from sagittal plane
Instability, catch, shake, or judder
Painful arc of motion
altered Lumbo pelvic rhythm
In forward, bending hip motion greater than’s number spine during the first third of the movement, and or lumbar spine motion, greater than hit motion during the last third of the movement
And returned upright, lumbar spine motion is greater than hit motion during the first third of the movement, and or hip motion greater than lumbar spine motion during the last third of the movement
gowers sign
Returned to upright, performed by using hands to climb up the thighs
predicting success with the stabilization rule
3 or more present
Age is less than 40 years
average SLR is greater than 91
Presence of aberrant movements during lumbar ROM
positive prone instability test
predicting improvement with the stabilization rule
Two or more present
Hyper mobility
FAPQpa greater than eight
Presence of aberrant movements during lumbar ROM
Positive prone instability test
predictors of success for stabilization
Positive prone, instability test
Aberrant movements present
Painful arc in flection , pain arc on return from flexion
Instability catch , Gowers sign, reversal of Lumbo pelvic rhythm
Average straight leg raise is greater than 91
Age is less than 40 years old
predictors of failure in stabilization
Negative prone instability test
aberrant movement absence
FAPQPA less than nine
No hyper mobility with lumbar spring testing
gaps in literature for stabilization
more RCT studies needed
Don’t know which approaches are most effective for acute low back with leg pain, acute low back pain without leg pain and chronic low back pain
Need to ID patient characteristics for optimum outcomes
how do you start an exercise program?
Begin with local stabilizers
Transverse abdominous, and Multifidis
you progress to maintaining local stabilizers with body movements
Functional optimization exercise, while maintaining core activation
Best for transverse abdominous activation
ADIM abdominal drawing in quadruped
Transversus abdominis is used more than internal oblique
It’s best isolate TA from IO
Best for transversus abdominis strengthening
Horizontal side support and abdominal crunch
Maintain transverse abdominous drawing in with these exercises
greatest activation of TA and IO together
greatest for Multifidis and gluteus maximus
Quadraped arm and leg lift or bird dog
Unilateral bridge
