Term
| 3 subsystems involved with spinal stability |
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Definition
| osteoligamentous, neural control, muscle |
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Term
| passive system of spinal stability |
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Definition
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Term
| active system of spinal stabiliity |
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Definition
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Term
| tissues of the passive subsystem of spinal stability (5) |
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Definition
| bone, ligament, facet joints, fascia, disc |
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Term
| two important muscles of the active subsystem |
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Definition
| transversus abdominus, multifuidus |
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Term
| abnorminal activaiton of this muscle is often associated with acute and chronic lbp |
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Definition
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Term
| when should training of the transversus abdominis be introduced for acute LBP for more rapid recovery |
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Definition
| early activation/training |
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Term
| which muscle creates a rigid cylinder through bony and fascial attachments |
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Definition
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Term
| which muscle of lubmar stabilization increases intra abdominal pressure |
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Definition
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Term
| what muscle of lumbar stabilization is a tonic muscle with type 1 fibers predominante |
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Definition
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Term
| muscle of lumbar stabilization that functinos at 20-30% of a MVC |
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Definition
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Term
| muscle of lumbar stabilizaiton which provides segemental stiffness and controls motion |
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Definition
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Term
| muscle of lumbar stabilizaiton which is found to be responsible for up to 2/3 of spinal stiffness |
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Definition
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Term
| muscle of lumbar stabilizaiton which is found to have a decreased cross sectional area and atrophy observed unilaterally on same side of LBP and at corresponding spinal levels |
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Definition
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Term
| muscle of lumbar stabilizaiton which specific segmental strengthening possible and correlates with decreases in LBP and increased function |
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Definition
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Term
| muscle of lumbar stabilizaiton which are part of the global system (4) |
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Definition
| rectus abdominis, internal/external obliques, lateral fibers of QL, lumbar iliocostalis (TV) |
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Term
| Global vs Local System: which eccentricaly decelerates spine |
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Definition
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Term
| Global vs Local System: controls rotation of spine as a whole |
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Definition
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Term
| Global vs Local System: prime movers and create more general stabilization |
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Definition
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Term
| Global vs Local System: muscles of local system (6) |
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Definition
| iliocostalis and longismus thoracic (LV), medial fibers of QL, diaphgragm, lumbar multifidus, transversus abdominis, posterior fibers of internal oblique |
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Term
| Global vs Local System: segmental stabilization |
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Definition
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Term
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Definition
| portion of teh total physiologic range of intervertebral motion |
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Term
| how does movement occur within the neutral zone |
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Definition
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Term
| what surround the normal neutral position of the segment |
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Definition
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Term
| when does the elastic zone start? |
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Definition
| at the end of the neutral zone |
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Term
| when does the elastic zone end |
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Definition
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Term
| how does motion occur within the elastic zone |
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Definition
| considerable internal resistance |
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Term
| lumbo pelvic stability is provided through what 3 myofascial systems |
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Definition
| thoracolumbar fascia, fascia lata, abdominal fascia |
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Term
| each fascial system has 2 important similarities |
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Definition
muscles attached to fascia exert a tensile force by pulling on fascia
muscles within fascial envelopes exert a pushing force which also increases tension on the fascial walls |
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Term
| abdominal mechanism: functions: how does it provide support to the spine |
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Definition
| anterior and anterolateral support |
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Term
| abdominal mechanism: functions: increases tension to what tissues |
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Definition
| thoracolumbar and abdominal fascia |
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Term
| abdominal mechanism: functions: checks shear in which direction |
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Definition
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Term
| abdominal mechanism: functions: checks anterior shear via what |
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Definition
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Term
| abdominal mechanism: functions: checks anterior shear via control of pelvis in which plane |
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Definition
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Term
| abdominal mechanism: functions: controls rate and apmlitude of torsion to what part of the spine? |
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Definition
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Term
| abdominal mechanism: functions: can increase compression at what joints (2) |
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Definition
| sacroiliac jts and pubis (force of form and force closure model) |
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Term
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Definition
trauma
age-related degeneration
muscle insuffiency
combo of above |
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Term
| 3 anatomic changes associated with instability |
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Definition
decreased disc height
joint capsule laxity
ligamentous laxity |
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Term
| physical evidence of instability can be seen on the bones d/t what? |
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Definition
| wolff's law. osteophyte and traction spurs where stresses are greatest and thinner bone at areas where load is diminished |
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Term
| Kirkaldy-Williis and Farfan model of instability: 3 steps |
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Definition
dysfunction
isntability/hypermobility
re stabilization |
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Term
| Kirkaldy-Williis and Farfan model of instability: typical peak incidence of disabling symptoms is what age |
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Definition
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Term
| Common Features of Clinical Instability: postures |
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Definition
| status worse with prolonged postures |
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Term
| Common Features of Clinical Instability: hx of (3) |
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Definition
low grade pain between acute episodes
catches in back
dancing, gymnastics, improper stretching |
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Term
| Common Features of Clinical Instability: what type of frequent self tx and its problem |
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Definition
| frequent manipulaito with short term results |
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Term
| Common Features of Clinical Instability: rapid fluctiuation in what |
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Definition
| in function from normal to incapacitaiton |
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Term
| Key examination findings of instability: inconsistent response to what testing |
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Definition
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Term
| Key examination findings of instability: worse with what position |
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Definition
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Term
| Key examination findings of instability: better in what position |
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Definition
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Term
| Key examination findings of instability: AROM? |
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Definition
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Term
| Key examination findings of instability: what happens during flexion |
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Definition
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Term
| Key examination findings of instability: this clinical sign |
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Definition
| Gower's signs (thigh climbing) |
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Term
| Key examination findings of instability: what takes place of lumbar flexion/extension |
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Definition
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Term
| Key examination findings of instability: 2 positive findings |
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Definition
general ligamentous tests (Beighton's scale)
stress radiographs |
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Term
| Key examination findings of instability: pain with what |
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Definition
| spring testing and increased mobility |
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Term
| mgmt of stabilization: exercise should include what |
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Definition
| co-contraction of trunk extensors and flexors in a position of comfort, maintaing proper poisition while carrying out normal function |
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Term
| what is successful stabilizatio |
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Definition
| fixing one part of the body while permitting movement of surrounding parts |
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Term
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Definition
age under 40
slr >91
(+) prone instability test
hypermobility with spring testing
aberrant motions with flexion extension |
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Term
| what are considered aberrant motions with flexion/extension |
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Definition
| painful arc, gower's sign, instability catch, reversal of lumbopelvic rhythm |
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Term
| stabilization cpr: how many factors must be present for a positive outcome |
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Definition
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Term
| prediciting failure for stabilization: 4 |
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Definition
negative prone instability
absence of aberrant motoins
FABQ <9
no hypermobility with spring testing |
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Term
| 3 principles of stabilization of training |
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Definition
conscious activiation and control of key muscles of trunk and pelvic girlde must be achieved before trunk stabilization can be progressed
training initially in mid positoin (neutral) lessens risk of adverse stress on injured structures
too much resistance on a weakened muscle can be inhibitory, causing loss of control and substitution |
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Term
| Overview of a stabilization program: step 1 of 4 |
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Definition
| re-activating the stabilizing muscles (proper sequencing, always pain free) |
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Term
| Overview of a stabilization program: step 2 of 4 |
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Definition
| re-train their holding capacity (low level contraction sustained for seconds to minutes) |
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Term
| Overview of a stabilization program: 3 of 4 |
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Definition
retrain their ability to automatically contract appropriate with other synergist to support and protect the spine
requires thousands of repetitions
most programs reference in literature 10-12 weeks in duration |
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Term
| Overview of a stabilization program: 4 of 4 |
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Definition
retrain to automatically activate under varous loads and skills
msut incorporate into functional tasks and movement patterns |
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