What are the 3 aspects of lumbar stabilization?
- Movement re-education
- Body mechanics
- Physical (re)conditioning
What is movement re-education?
The teaching of proper form/ technique
What are body mechanic exercises?
- The use of body positions and movements that are not threatening or painful
What is physical (re)conditioning?
- Planned repetitive movements that break bad habits
What classification does lumbar stabilization exercise fit into?
Stage 1 Stabilization exercise + other classifications as needed
When are lumbar stabilization exercises required in stages 2 & 3?
If the patient cannot hold the lumbar spine neutral during exercise or function
Is lumbar stabilization rehabilitative or preventative?
Both.
What is the concept upon which Lumbar Stability programs are built on?
- Functional range
OR - Lumbar neutral
What is the definition of lumbar neutral? (old and current definition)
Old: “Normal” upright position
Current: Range of spinal motion in which the spine functions most efficiently and is least symptomatic
What is the normal functional range of the L-spine?
- Varies from patient to patient
What can change a patient’s functional range?
Changes in the patient’s condition.
What can a patient learn and master control of their functional range?
- Learn the asymptomatic range, and avoid exercises and movements that move beyond it
What is the goal of Lumbar stability programs?
- Maintain functional range in ALL activities through ENTIRE day
What are the 4 building blocks of the lumbar stability programs?
- Flexibility
- Strength
- Endurance
- Coordination
What are 5 causes of poor posture/ movement patterns?
- Habit
- Weak/ poorly conditioned muscles
- Poor motor control
- Impaired joint and/or muscle flexibility
- Pain
If a patient cannot tolerate upright posture, how can the exercises be performed?
- Recumbent
What are 3 methods of progression of lumbar stability exercises?
Stable –> Unstable surfaces
(recumbent –> quadriped –> bridge –> balls)
Cardinal plane –> Diagonal/ Multiplane motion
Large, simple gross movements –> Small, isolated, complex movements
(transfers –> sit and reach)
List the 5 step progression of the overall lumbar stability program.
- Produce and explore lumopelvic motion
- Determine functional range
- Maintain functional range statically
- Maintain functional range while performing mass body motions
- Maintain functional range while performing isolated extremity motions
Describe some “mass body motions” in which the functional range may need to be maintained.
- Transfers
- Car transfers
- Stairs, curbs
- Lift/lower
- Push/pull
How are “isolated extremity movements” progressed?
- Non-functional –> Functional motions
How is static passive prepositioning of the lumbar spine performed?
Using body/limb or pillows/ rolls to maintain functional range of the L-spine
ex)
- Hooklying with bolster under the knees
- Small towel roll under back
- Towel roll in lumbar lordosis while driving
In whom is passive prepositioning typically used?
- Very acute/ painful patients
What is static active prepositioning?
- Active muscle contraction holds FR and position
ex) holding range in a bridge position
What is dynamic stabilization?
- Continually altering tension in muscle groups to accommodate changing external loads
ex) Hold 2lbs against chest, and hold weights outwards, and bring them back towards the chest
- Lift and lower bridge position
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Cervical Exam145
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Cervical Manual Therapy43
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Muscle Energy19
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Trigger Points/ Tender Points51
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Cervical TherEx54
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TMJ Lecture 180
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TMJ Lecture 2 (Evaluation and Treatment)79
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Thoracic Spine - Review87
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Thoracic Spine - Exam41
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Thoracic Spine - Manual Therapy3
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T-spine Trigger Points0
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L-Spine Pathology66
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L-Spine classification systems61
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L-Spine MET9
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SIJ MET14
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Lumbar Stabilization25
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Pelvic Girdle - Biomechanics79
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Pelvic Exam13
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Waddell's Signs15
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Case Studies15
