VERTEBRAL JOINTS & BIOMECHANICS Kellie Fokin, Kristen Classen, Kylie Quinn, Eric Mentzer

SPINAL RANGE OF MOTION Head Flexion Head Extension 3 minutes to discuss. Head Extension

SPINAL DEGREES OF MOTION

CLINICALLY ASSESSING RANGE OF MOTION Physical Therapist Tools The Patient - Questionnaire, Pain Scale, Gathering Info Posture/Observations - Changes in Posture, Strength, Pain &/or Length Neurological Screening - Reflexes, Sensation, & Strength Measuring ROM - Flexion, Extension, Rotation, Bending (different regions) Manual Exam - Checking Joint Motion, Smooth or Tight/Injured/Loose c - Feel Skin Temperature, Texture, Pressure Points & Spams Special Testing - If cause is elsewhere check … Thoracic Outlet Thoracic Outlet Temporomandibular Joint (Jaw) Thoracic Spine Thoracic Spine Nerve Tension Ergonomics 3 minutes to discuss.

Proper Ergonomics

RANGE OF MOTION PATHOLOGIES spondylosis spondylolysis spondylolisthesis - reduces extension both cause decreased flexion and lateral flexion, have tight HS spinal stenosis foraminal stenosis osteoporosis abnormal curvatures lumbar lordosis (from weak abdominal wall, tight low back and hip flexors) thoracic kyphosis (from weak upper ES and neck flexors, tight hip flexors) scoliosis erector spinae muscle strain from heavy repetitive lifting 3 minutes to discuss. ROM can be limited by: → thickness or elasticity of IV discs → shape and spatial orientation of IV joints and zygapophysial joints → tension of joint capsules → muscle and ligament tightness → attachment of ribs on thoracic vertebrae → amount of surrounding superficial tissues (ie subcutaneous fat, muscle bulk) spondylosis - joint deterioration causing degenerative arthritis and rubbing of bone (articular facet joints) spondylolysis - lamina or pedicle fracture from trauma spondylolisthesis - misalignment (normally anteriorly) spinal stenosis - reduced vertebral canal size; creates nerve/spinal cord impingement foraminal stenosis - generally injury/trauma that causes swelling or knocks discs into misalignment abnormal curatures → lumbar lordosis → thoracic kyphosis → scoliosis - lateral curvature of spine → myopathic scoliosis - asymmetrical weakness of intrinsic back muscles ARTICLE objective was to determine the effects of a 10 week dynamic back extension training program and its effects on back muscle strength, back muscle endurance and spinal ROM for healthy young adults subjects - 73 female college students aged 18-24 with no pmhx of lbp; randomly assigned to control or exercise group exercise group - performed back extension exercises on floor 3x/wk for 10 weeks control group - no training for 10 weeks measurements isometric strength of back muscle was tested in standing with spring dynamometer stood on platform with knees fully extended and trunk flexed about 30 deg; hand bar positioned across thighs was pulled straight upward using back muscle back extensor endurance test - lay prone over end of table with ASIS supported; held position as long as possible inclinometric measurement - thoracic and lumbar spine ROM for flexion/extension; measured as L5-S1 and T12-L1 lateral bending - distance between tip of middle finger and floor dynamic training 2x25 reps of back extension on floor with hands clasped behind head results exercise group had 21% increase in strength, .25% increase in endurance; endurance decreased by 8.87% in control group significant differences between groups and within group (except L5-S1 flexion) with flexion/extension conclusions inactivity decreases spinal ROM, strength and quality of life doing dynamic back extensor exercises for 10 weeks greatly improves strength and therefore ROM

REFERENCES Desjardyns, Lyndsey. "Functional Anatomy Part 7-Intrinsic Back Muscles." N.p., 08 July 2012. Web. 04 June 2015. Moore, Keith. "Essential Clinical Anatomy." N.p., 5th Edition 2015. Book. 03 June 2015. Yaprak, Y. (October 25, 2013). “The effects of back extension training on back muscle strength and spinal range of motion in young females.” Biology of Sport, 30, 3, 201-206. Medlej, Joumana. “Human Anatomy Fundamentals: Flexibility and Joint Limitations.” 06 March 2014. Web. 03 June 2015. University of Maryland Medical Center (UMMC). “Rehabilitation of Cervical Spine.” 17 June 2013. Web. 03 June 2015. Show

ACTIVITY Jeopardy Game http://www.superteachertools.us/jeopardyx/ 10 - 15 mins