Spine Management (stabilization group)

Question 1

Why would you choose a stabilization program for lumbar spine?

Answer 1

to eliminate repetitive injury to the IV discs, facet joints, and related structures

Question 2

What is is neutral spine?

Answer 2

• Position that is least symptomatic, optimizes function and is individualized for each patient
• most often located near the mid-range of flex/ext
• position of optimal balance of ligaments, discs, and muscles that enhances the capacity of the spine to absorb loads in all directions

Question 3

Is neutral spine a static or dynamic position?

Answer 3

Dynamic

• functional range of most comfort for each patient
• not a “fixed” position for the patient, the “neutral range” will change as the patient’s spinal condition improves: + During the Pain Control Phase the neutral range may be very limited, but as the patient improves the defined range may improve.

Question 4

muscles position the spine in Neutral Spine Position during voluntary movement by the patient; provide overall stability

Answer 4

Global muscles

- i.e., recuts abdominis, IAO, EAO, erector spinae

Question 5

muscle “hold” or “maintain” the neutral spine position during functional movements

Answer 5

Deep segmental muscles

• attach directly to the vertebral segments and provide segmental stability
• once global muscles position the spine in neutral, these HOLD the neutral position

Question 6

This stabilization training principle teaches the pt awareness of movement, find neutral spine position

Answer 6

Kinestetic training

Question 7

This stabilization training principle teaches stabilization of neutral spine in neutral spine position

Answer 7

activation of deep segmental mucles

Question 8

What is the progression of activation of stabilization training?

Answer 8

1. Activate segmental m’s
   2 Extremity motions added
2. increase muscle endurance and strength
3. Alternating isometric contractions and rhythmic stabilization (Supine –> prone –> sitting/kneeling –> standing)
4. Transitional stabilization (pt changes position with extremity motion)
5. Perturbation (balance) training (unstable surfaces)

Question 9

What is the first step in back stabilization program and is crucial for progression?

Answer 9

• teach pt to find neutral spine
• pt needs to be able to recognize when quality of neutral spine deteriorates and then be able to go through process of self correction

Question 10

How do you activate the TA?

Answer 10

draw the belly button toward the spine