L-Spine MET

Question 1

How is Type I movement of the L-spine observed?

Answer 1

• Pt prone: L-spine in neutral

- Look for prominence of 2 or more adjacent transverse processes

Question 2

On which side will the prominence be felt with a NSR lesion in the L-spine? Why?

Answer 2

• It will be felt on the left
• Type I movement –> side bending and rotation in opposite directions
• Prominence felt on side to which vertebrae are rotated

Question 3

Describe the treatment of neutral lesion in the lumbar spin.

Answer 3

• Pt sidelying on the table on the side contralateral to the prominence/ concave side
• Therapist facing patient
• Pt’s hip flexed 75 degrees
• Raise Pt’s feet and ankles causing truncal side bending to the restrictive barrier until movement is felt
• Have patient hold their legs in the air or resist towards or away from the table; have the patient relax; repeat 3-5 times from new barriers

Question 4

In what position is an extended lesion found in the L-spine?

Answer 4

• Seated flexion

Question 5

On which side will the patient’s ERSR lesion be found?

Answer 5

The right side; Type II side bending/ rotation occur in the same direction

Question 6

Describe treatment of an extended lesion of the L-spine.

Answer 6

• Pt sidelying on side contralateral to prominence with arm positioned behind the patient
• Flex both the patient’s hips and knees towards the movement barrier/ until movement is palpated at the targeted segment
• Patient’s upper arm reaches towards the floor, rotating the trunk until movement is palpated
• Pt’s feet are dropped off the edge of the table towards the floor creating side bend
• Resist the movement of the feet upwards or downwards; hold 6 - 10 seconds; relax and repeat from a new barrier 3 -5 times

Question 7

In what position is a flexed lesion found in the L-spine?

Answer 7

• Prone extension

Question 8

On which side of the patient will a FRSL lesion be found?

Answer 8

Left side because rotation and sidebend occur in the same direction

Question 9

Describe treatment of a flexed lesion in the L-spine.

Answer 9

• Pt sidelying on the side with the prominence
• Extend lower leg to movement barrier
• Rotate trunk and shoulder girdle posteriorly to the movement barrier
• Flex top hip to 45 degrees, and the knee 90 degrees, and rest the knee on the table
• Lift the foot towards the ceiling to sidebend the trunk into the movement barrier
• Have Pt attempt to lower the foot to the table for 6 - 10 seconds; relax, move to new barrier; repeat 3 - 5 times