T-Spine Interventions Flashcards
describe general intervention strategies for treating Scheurmann’s Disease
- postural control muscle performance
- activity modifications (aggravating)
- strengthen and stretch the trunk
- seated rotation
- extension in lying/prone
- thoracic extensor strengthening
- scapular abductor strengthening
- Bracing may be utilized
describe PT interventions that may be utilized when treating a patient with Ankylosing Spondylolitis
- spine extension and peripheral joint exercises
- breathing exercises
- prone lying (multiple times a day, 10 min at a time)
- for spine and hip extension
- sleep on firm mattress, avoid SL position
- swimming
T/F: Scoliosis is a condition that can be reveresed with rigorous PT
FALSE
we cannot correct the posture only manage/limit progression of curvature
List goals for conservative management of scoliosis
- strengthen postural muscles
- address muscle length/strength impairments of extremity muscles
- maintain/improve respiration and chest mobility
- address back pain
- resume functional tasks
- strengthen abdominals
T/F: there are standarized supported treatment protocols for T4 syndrome
FALSE
poor evidence supports standarized intervention
describe general intervention strategies for T4 syndrome
- thoracic manual techniques
- mobilizations
- thrust manipulations
- scapulothoracic motor performance
- thoracic extensor strengthening
what specific intervention may be used to treat disc lesions in the T-Spine?
Traction (used to address radicular symptoms)
continous or intermittent
pt positioned sitting or lying
duration: 2 min - 24 hours
list contraindications to traction at the T-Spine
- acute lumbago
- instability
- respiratory or cardiac insufficiency
- respiratory irritation
- painful reactions
- large (disc) extrusion
- medial disc herniation
- altered mental state
- includes pt being unable to relax
list common impairments that may be observed in zygopophyseal joint pain
- muscle guarding
- joint hypomobility
- acute irritation/dysfunction
- pain
- ROM: commonly motions that close joint
List interventions that may be used to treat zygopophyseal joint pain
- Manual therapy
- mobilizations
- oscillations
- stretch mobilizations
- manipulations
- mobilizations
- Exercise
- targeting pain and guarding inhibitions
- neuro re-education
what types of interventions may be used in the managment of rib dysfunction?
- rib mobilizations
- oscillations
- static stretch mobilizations
- rib manipulations
- soft tissue mobilizations
when treating TOS how should we approach treatment?
consider impairments and determine treatment goals based on ICF model
list interventions that may be used in the management of TOS
- Nerve glides
- work/activity modifications
- shoulder, upper rib/thoracic manual therapy
- T/S manipulations are great here
- scapulothoracic motor performance
- address tissue extensibility anterior trunk musculature
List 5 generalizations for treatment/intervention planning
- Stability vs Mobility
- Patient education
- Reduce pain
- address impairments
- improve functional activity performance and participation
List some examples of exercises that may help improve thoracic mobility
- quadruped thoracolumbar AROM
- flexion/extension
- rotation reaching diagonally in front/OH
- lying thoracic extension
- prone press up
- prone on elbows
- supine over soft object
- sitting rotation, extension
- assisted extension w/towel
what muscle groups should be targeted in resistance training for T-Spine related conditions?
peri-scapular musculature
thoracic paraspinals
what muscles will be targeted during a prone row?
Mid trapezius
Rhomboids
levator scapulae
List specific exercises that target the Lower Trap
- prone full can
- prone shoulder ER at 90º of shoulder abduction
- prone horizontal abduction with 90º shoudler abduction and ER
- bilteral shoulder ER in shoulder neutral
list specific exercises that target the rhomboids and levator scapula
- prone extension with shoulder ER
- prone row
- prone horizontal abduction with 90º shoulder abduction and ER
List modalities that may be used in treatment of T-Spine conditions
- Ultrasound
- thermal
- pain relief
- Cryotherapy
- pain relief
- E-Stim
- muscule activation/neuromuscular re-education
- pain relief (TENS)
- aid in healing (muscle pump)
List manual therapy mobilizations techniques that can be used at the T-Spine
- Prone Thoracic PA mobs
- Seated Thoracic extension mobilization
- Supine 1st rib mobilization
- Costotransverse mobilization
list manipulations that can be performed at the T-spine
- “The Screw” Mobilization/Manipulation Thrust
- Facet Gapping in Supine (“Pistol”)
- Seated Lower Thoracic Traction Thrust
- Upper Thoracic Distrction Thrust
what is moving on what during a prone thoracic PA mobilization?
spine segment on adjacent segments
what is moving on what during a seated thoracic extension mobilization?
inferior segment on superior segment
describe the target force for the seated thoracic extension mobilizations
Mobilizing → posterior aspect of bilateral upper arms for superior T segments into relative extension
Stabilizatin → dorsal surface of articular pillars (or spinous processes) of T segments of choice
describe the target force and relative structural movement during the “Screw” manipulation
- Mobilizaing
- cranial segment → dorsal surface ipsilateral articular pillar
- caudal segment → dorsal surface contralateral articular pillar
- Structural movment
- cranial segment facet on caudal segment facet
