03 McKenzie and Treatments Flashcards Preview

7232 Ortho > 03 McKenzie and Treatments > Flashcards

Flashcards in 03 McKenzie and Treatments Deck (45):
1

What is the McKenzie extension progression?

1. standing extensions
2. prone extensions
3. prone extensions with self overpressure (belt fixation or lock and sag)
4. prone extensions with therapist overpressure
5. extension mobilization
6. extension manipulation

2

standing extensions

hands on butt or thighs for counterbalance and lean back

3

prone extensions

- prone
- hands under shoulders
- lift chest only as high as you can keep the hips on the ground
- relax lower body as much as possible

4

prone extensions with self overpressure

- arms straight
- deep breath in and out
- lock glutes and sag low back

5

prone extensions with therapist overpressure

Where are your hands?

over transverse processes

6

prone extensions with therapist overpressure

role of PT

- move with patient and add equal pressure throughout ROM
- don't block motion

7

Do prone extensions with therapist overpressure involve a lock and sag?

no

8

extension mobilization

CPA grades 3 and 4
(we didn't practice these)

9

extension manipulation

- we aren't learning this one
- very rarely use it, if ever

10

When would you progress to the next step in the McKenzie progression?

- they're getting better but are plateauing
- need more extension

11

patient "homework"

10 reps every hour you're awake

12

For extensions, does the position need to be held?

No, it's more the repetitiveness that's effective

13

What happens as you go down the continuum of the extension progression?

more force is being applied

14

What is the key principle of the McKenzie method?

Patients make themselves better until they aren't able to. Only then does the PT intervene

15

2 approaches to stabilization

can use one or both

- specific approach
- global approach

16

basic idea for the specific approach

- isolate the TRA and multifidus
- little activation of other muscles

17

Why would you want to only active the multifidus and TRA?

foundation for core exercises

18

basic idea for the global approach

strengthen all core muscles

19

ADIM

Abdominal
Drawing
In
Maneuver

AKA abdominal bracing

20

What muscle does the ADIM activate?

TRA

21

How to perform an ADIM

- hooklying position
- deep breath in
- draw belly button in and up while exhaling

22

What are the compensatory maneuvers often seen when people try to do ADIM?

- valsalva
- posterior pelvic tilt

23

Why don't you use a posterior pelvic tilt during ADIM?

research has shown it doesn't activate TRA as much

24

How can you use feedback to know whether the TRA is being activated?

- ultrasound
- BP cuff

25

How do you use a BP cuff to show TRA activation?

- place under lumbar spine
- pump up
- make sure the numbers don't increase

26

If the numbers increase on the BP cuff during ADIM, what is this indicative of?

posterior pelvic tilt

27

What do you typically pump the BP cuff up to for ADIM?

40 mmHg

28

BP cuff or ultrasound

Is one better than the other at detecting TRA activation?

no, both are good biofeedback mechanisms

29

Do you need to use BP cuff on every patient for teaching ADIM?

No, but patients who don't exercise often have a hard time grasping the concept, so it's a useful tool

30

First exercises for ADIM

- 10 reps at 10 sec
- can add more exercises to it once they get it

31

Why should you not tell the patient to suck it in when teaching ADIM?

they'll hold their breath

32

What are the 6 exercises you should always put in a core strengthening program?

1. ADIM
2. quadruped alternating LE/UE
3. planks
4. side planks
5. crunch
6. bridge

33

Why are the 6 exercises so important?

because they're the best at activating:

- TRA
- multifidus
- RA
- obliques
- lumbar extensors

34

What does ADIM activate?

- TRA
- multifidus

35

What should you remember about ADIM and the rest of the exercise progression?

It should be performed during all of them

36

The crunch targets

rectus abdominis

37

crunch
- elbow and eye position

- elbows in peripheral view so you don't pull the neck
- eyes on ceiling

38

bridge targets

lumbar extensors

39

How can you make the bridge more difficult?

- hands behind head or across chest
- single leg
etc...

40

another name for quadruped alternating UE/LE

bird dog

41

How might you help a patient maintain a neutral spine when performing a bird dog?

place a foam roller or other object on their back to prevent hip rotation

42

planks target

lumbar flexors

43

side planks target

obliques

44

How might you make planks harder?

upper and lower extremity lifts

45

Do the 6 exercises represent the specific or global approach?

more of a global approach