Wk 3 Combine movements

Question 1

Two goals of combined movements.

If active mvts don;t bring on their concordant pain. need to follow onto this

Answer 1

combine mvts aims:

1. further stresses the lumbar spine for a clearer indication of their sensitivity state
2. Gives us an idea what movements that are dysfunctional which can be a influence on their treatment plan

Question 2

COMBINE mvts include:
flexion, extension
side flexion L and R

why:
stress the structures under a COMPRESSIVE OR STRETCH LOAD

ROATION not used in the quadrants- complicates it

Question:
- Someone comes with left sided back pain

next: Pain is on LEFT and when in spinal extension= look at two left quadrants
- investigate left posterior compressive AND left anterior stretch

Mention what combine movements we would use?

Answer 2

1. Extension with LSF:
   IF SYMPTOMS INCREASE:
   - it make it a left posterior compression problem = why targets the L posterior quadrant
2. Extension with RSF = aim for ant stretch load
   IF SYMPTOMS INCREASE:
   = Left anterior stretch problem - targets the L anterior quadrant

Question 3

what movement to choose in this combine movement?

• use the asterick movement in active movements that brings on symptoms to investigate further as the PRIMARY, then add other mvts

next movt should 2nd most painful and so on

Question 4

IF no clear asterick movement from active mvt Ax. what can u use to base your investigation off for comobien mvts?

Answer 4

• use aggrevating factors to hunt down a primary movement that brings on their concordant pain.

Question 5

LIST THE COMBINED MVTS x5

Answer 5

Extension LSF and RSF
Extension and rotation

= combine ext, SF and rot

Flexion LSF and RSF
Flexion and rotation

= combine flexion SF and rot

Question 6

What type of patient would you use sustained movements on?

Answer 6

1. Somatic pain patient. if their story brings a hx when they sustain the load brings on their symptoms
2. mainly:
   NEUROGENIC pt:
   - use time as the variable when closes the neural opening (IVF) to apply stress to bring on their neurogenic pain.

Rotation very useful mvt sustained to target loading neurogenic pain.
Possible response:
Hold them at EOR in rotation (seated):
Eg. neurogenic leg pain pt
1. Pain aggravates - so stop and do opposite side and compare
2. Nothing- wait increase time as stress to bring on a response
3. If leg pain relieves- good- gives clue that it is modifiable, mvt can be beneficial and suggest to emphaise this mvt.

Question 7

What idea does repeated movements give the PT?

give eg.s of movements

Answer 7

Helpful data on somatic type patients.
Gives idea we should load or unload the patient. (mobility or a control problem) eg. loose flexion control. unload excessive mvts into flexion and strengthen capacity of muscles eg. extensor muscles back, pelvis post tilted maybe are HS shorten and overactive, need stregthen, HF lengthened aim to strengthen

egs.List- osccilate and guide pt in repeated movements into neutral.

Aim of feels good recorrected- mobility proble
not everyone needs corrceting if it is a adpative repsonse- can link to relative flexibility ??

eg. rotation in lying pt active repeated movement
eg. extensiuon lin lying -half push up position. PT hold pelvis on plinth