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

2. 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

3. Techniques to increase lumbar flexion

4. Techniques to increase lumbar extension

5. 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.

6. Techniques to increase lateral flexibility

7. 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.

8. 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

9. 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

10. 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)