SPINE EXERCISE AND MANIPULATION INTERVENTIONS DPT – SEMESTER 7 Dr. Sarah Ehsan

Topics to be covered: Mid and lower thoracic and lumbar regions : stretching techniques Muscle performance: stabilization, muscle endurance, and strength training Stabilization training–fundamental techniques and Progressions

Techniques to increase lumbar flexion

Techniques to increase lumbar extension

Techniques to increase lateral flexibility for patients with structural scoliosis, gaining some flexibility prior to surgical fusion of the spine for correcting a scoliotic deformity. to regain flexibility in the frontal plane when muscle or fascial tightness is present with postural dysfunction. All of these exercises are designed to stretch hypomobile structures on the concave side of the lateral curvature.

Techniques to increase lateral flexibility

TRACTION AS A STRETCHING TECHNIQUE POSITIONAL TRACTION The value of positional traction is that the primary traction force can be directed to the side on which symptoms occur, or it can be isolated to a specific facet, making it beneficial for selective stretching.

Muscle performance: stabilization, muscle endurance, and strength training GOALS To activate and develop neuromuscular control of deep segmental and global spinal stabilizing muscles Develop endurance and strength in axial skeleton Develop balance control instable and unstable conditions

Stabilization Training : Fundamental Techniques and Progressions Stabilization training follows basic principles of learning motor control. 1. Patient develops awareness of muscle contractions and spinal positions. 2. Patient develops control of spine when performing simple extremity patterns and exercises 3. Patient demonstrates control of spine when progressing to complex exercises. 4. Patient demonstrates automatic maintenance of spinal stability and control in a progression of simple functional activities to complex and unplanned situations Proximal stability for distal mobility

Guidelines for stabilization training Kinaesthetic training activation of deep muscles Extremity motions Increase muscle endurance and strength Alternating isometrics and rhythmic stabilization of trunk Transitional stabilization (when moving from one place to another) Perturbation ( balance training)