Movement Disorder

Question 1

Lower Quarter: Extension classification

• whats weak & whats tight
• rehab goals

Answer 1

tight hip flexors, weak abdominals and overactivation of paraspinals

Rehab goals:

• hip flexor stretching: supine heel slide
• abdominal strengthening: TA heel slides
• -> focus on oblique muscles to control pelvis rotation

Question 2

Lower Quarter: Flexion classification

• whats tight/weak
• rehab goals

Answer 2

tight hip extensors and weak/lengthened paraspinal muscles

Rehab goals:

• stretch hip extensors (glutes & hammies)
• strengthen back extensors: quadruped position exercises & side planks

Question 3

Patient education for extension classification

Lower Quarter

Answer 3

appear w/ excessive lordosis (ant pelvic tilt)

Supine: bend knees to reduce anterior pelvic tilt
Side lying: bend knees to flex LS
Prone: avoid!
Sitting: knees higher than hips to allow posterior tilt of pelvis, rest against back of chair

Question 4

Pt education for flexion classification

Lower Quarter

Answer 4

appears w/ flat back (post pelvic tilt)

Supine: place a small towel roll under LS
Side lying: assess spine curve & use pillows between knees to adjust
Sitting: use lumbar support, knees flexed to allow anterior tilt of pelvis

Question 5

Pt education for rotation classification

Lower Quarter

Answer 5

symmetry of leg movement is important, especially when sleeping

Supine: bend knees
Side lying: minimze lateral translation, use tower roll to obtain neutral position of the spine
Sitting: avoid crossing legs

Question 6

Principles behind movement system impairments

Answer 6

1. Movement induces pathology due to cumulative micro trauma
2. motor control is KEY, not strength
3. emphasis on correction the cause (movement problem) rather than the source of the pain (pathoanatomical structure that is symptomatic)

Question 7

Three things that you look at with QUALITY of movement

Answer 7

1. muscle recruitment w/ movement
   - i.e. hamstrings & glutes firing at the same time?
2. Muscle length
   - important for length-tension curve
3. Muscle strength
   - a lengthened muscle generates greater peak tension at a longer length

Question 8

most common movement disorder classification of the lower quarter

Answer 8

lumbar rotation w/ extension

due to facet syndrome, spinal stenosis, spondylolisthesis, spinal instability, DDD, OA, herniated disc

Question 9

Movement Disorder classifications of the Upper Quarter

- order of prevalence

Answer 9

1. Extension + rotation
2. Extension
3. Flexion + rotation
4. Flexion

Question 10

Objective findings w/ UQ Ext + rotation

Answer 10

MOST COMMON movement disorder of upper quarter

• forward head
• pain w/ rotation

Question 11

Objective findings w/ UQ Flex + rotation

Answer 11

• decreased lordosis

- excessive recruitment of rotators