Week 11

Question 1

What do studies show about pilates and cycling on lower back pain?

Answer 1

same benefits —> type doesn’t matter, just DO exercise (specifically, controlling posture)

Question 2

Where did Core stability come from?

Answer 2

• Local and global stabilising muscles theory –> focuses so specifically and not whole body function
• People assumed delay in transverse abs —> that was the problem of back pain = NOT TRUE

Question 3

Panjabi’s model of spinal stability

Answer 3

• More in line with what we know

- Spine unstable, but stable with all muscles, tendons etc (like tent pole vs tent)

Question 4

Muscle most important for stability?

Answer 4

• Evidence looking at what is the stable spinal structure

- No one muscle thats any more important for stability

Question 5

(EXAM) Transverse abdominus muscle does/doesn’t play PRIMARY role in trunk stability

Answer 5

doesn’t! –> all muscles are equally important

Question 6

“Research has shown decreased stabilisation endurance in individuals with chronic low back pain” – what is wrong with the statement

Answer 6

• Terms are contradictory (stabilisation endurance??)

- Evidence for muscle specific fatigue is extremely limited

Question 7

“All core stabilisation exercises must first start with the concept of the drawing-in manoeuvre”

“Drawing in manoeuvre should be kept with weightlifting” – thoughts?

Answer 7

Not useful!

Question 8

“McGill is a proponent of the abdominal bracing technique where the patient is advised to stiffen the trunk to prevent spinal movement” — thoughts?

Answer 8

only 20-30% brace was most effective (not max brace)

Question 9

What is stability (and bracing technique)?

Answer 9

• Muscles closer to the ground are working the hardest
• Bracing technique did not make difference (with people in lower back pain), but it changed muscle activation in an unpredictable manner

Question 10

Are descriptive measures of the ‘movement’ enough to discriminate people with and without back pain

Answer 10

• Trends in ‘stability’ analysis are moving beyond ‘segments and muscles’ towards the movement system as a whole, and how is the movement system being controlled
  
  • Is the movement system able to cope with unpredictability?? (Back pain can flare in unpredictable situations)
  • Is it ‘stiff’, i.e. not showing much variability over time, is this good or not?

Question 11

Local Dynamic Stability (LDS)

Answer 11

Assesses the sensitivity of movement to small perturbations that occur naturally due to internal (reflex responses, activation changes, muscle length variations) or small external disturbances (floor pressure, grip, etc.)
- (more variance = less dynamic stability)

Question 12

Local Dynamic Stability (LDS) predicts those who are most likely to …

Answer 12

fall in older individuals

Question 13

In summary local dynamic stability is look at how movement patterns…

Answer 13

should be, then how much they deviate from movement pattern