Thoracolumbar Spine VI- Hypermobility/Instability/ ARJC Flashcards
The four variables of stabilization?
1.
2.
3.
4.
joint integrity (cartilage)
passive stiffness (ligament)
neural input
muscle function
What are the two types of instability?
function and mechanical
Abnormal movement of spinal segments under loaded conditions, results in P!/disability that changes the ______ ______
instantaneous AOM
_______ instability- instability that CAN be stabilized with m. activity and/or positioning
Functional
Hypermobility is more prevalent in biological _______
females
What are some causes of hypermobility/instability?
Traumatic or recurrent sprains i.e., IDD
Age-related disc changes
Repetitive ext activities like gymnastics, dance, power lifting
Creep due to persistent poor posturing
Adjacent joint hypomobility
Generalized hypermobility is a ______ ______ order
connective tissue
Hypermobility is MOST common at the ___-____ level and more common in the ____ and _____ planes
L4; S1
frontal
sagittal
With hypermobility, the _____ is less controlled
AOM
Benign Joint Hypermobility Syndrome if:
____ major criteria present
___ major and ____ minor criteria present
_____ minor criteria present
2; 1; 2; 4
Which type of instability has:
Predictable P!
Spine and referred P!
Possible paresthesia’s from nociplastic pain due to sensitization
NO clear directional preference
Functional
_______ Instability:
↓ed P! with positional changes and support
↑ed P! with:
Prolonged positions
Prolonged and repetitive
- Forward bending
- Arching
- Strenuous activities
- Possibly, sudden motions
- Catching
- Easy self manipulation
Functional
With functional instability:
Hx- often < ____ years of age
ROM- if acute, there will be limited and P!ful _______ motion
40
abberant
With functional instability, the ROM is primarily limited and painful with _____ because of increased _______ _______ shearing followed by ______
EXT
anterior vertebral
SB
With functional instability and FLX may be limited with UE assistance returning from FB… what is this called?
Gower’s sign
With hypermobility, ______ ROM is more notable than _______ ROM particularly in ___-______ vs WBing
Passive
Active
Non- WBing
With hypermobility, combined motion will have an _________ block
inconsistent
If it’s NOT acute, it’s often WNL or excessive except for _______ that may still be limited with creasing
EXT
Signs of aberrant (deviating) AROM with functional instability:
P!ful ____ of motion, primarily in sagittal plane
Uncoordinated _______ primarily in sagittal plane
________ sign
_____/_____ compensations
Positive if ≥ ___ present
arc
motion
Gower’s
LE/Pelvis
1
With functional instability:
Resisted/MMT- if ____ may be P!ful
Most often _____ and ______ bc the global muscles are not affected
acute
strong; painless
With functional instability, neuro tests will be __ except possibly a ______ with pinwheel sensation and brisk DTRs
-
hyperesthesia
With functional instability, there will be P! with ____ _____ and there are mixed findings with _______ depending on severity
PA pressures
distx
With functional instability and accesory motion, there is possible ________ if the ________ joint is stuck
Possible adjacent hypomobility with
- ___ rotation
- ____ jt. motion
- _____ hyperextension
hypomobility; hypermobile
T10
SI
Hip
Special Tests for hypermobility:
Possible + prone LE _____ test
+ segmental _______
( _______ shear)
+ ______
extension
stability; anterior
ASLR
