Cervicothoracic Spine VI Flashcards
(52 cards)
What are the four variables of stabilization?
Joint integrity
passive stiffness
neural input
muscle function
What does the abnormal movement of spinal segment under loaded conditions result in?
Pain / disability that changes instantaneous axis of motion
What is functional instability?
Instability that CAN be stabilized with muscle activity and/or positioning
What is mechanical instability?
Instability that CANNOT be completely stabilized with muscle activity and/or positioning
What gender is a risk factor for hypermobility?
Females more than males
What is the etiology of hypermobility?
traumatic or recurrent sprains (IDD)
age related joint changes
repetitive ext activities (dance)
creep due to persistent poor posture
adjacent joint hypomobility
connective tissue disorder
Where is hypermobility most common? (what level)
At C5-7
What are some symptoms of functional instability?
Recurrent and predictable pain
spine and referred pain
possibly paresthesias from nociplastic pain from sensitization
decreased pain with positional changes / support
increased pain with prolonged positions, looking up, sudden and strenuous ADLs like lifting etc.
catching
easy self manipulation
What are some signs of functional instability?
if acute - limited ROM with aberrant motion
limited and painful with ext/hyperext due to shearing followed by side bend
flx will tend to be better
Prom larger than arom
inconsistent block with combined motion
resisted / MMT strong and painless unless acute because global muscles not affected
negative neuro tests
positive PA stress tests
What would you possibly find with accessory motion testing with functional instability?
Possible hypomobility if hypermobile joint is stuck
upper thoracic indicated by neck side bend at end range rotation, limited neck side bend in 2/3 positions and or manubrial drop with ext during exam
What will segmental stability tests show with functional instability?
All positive
most often excessive anterior shearing
Will local muscles be inhibited with instability?
Yes
What are some symptoms of mechanical instability?
Unpredictable pattern of provoking activities
worsening symptoms with more frequent episodes
increased pain with even trivial and lesser ADLs
What are the signs of mechanical instability?
Positive stress tests that wont stabilize fully with repositioning and/or muscle activation
What are some tests and measures for mechanical instability?
Radiographs
- lateral flx end range and ext view
- may be spondylolossthesis, fx and slippage of vertebra
Md Rx prolotherapy for stabilization along with PT, or fusion surgery
What can be prescribed from the PT for hypermobility?
Postural ed
JM to increase adjacent joint hypomobilty
possible postural taping
MET with emphasis on stabilization of local muscles
What are some examples of age related joint changes?
Degenerative Joint Disease (DJD)
Osteoarthritis (OA)
Spondylosis if multiple spinal levels
Where are age related joint changes most common? (what level)
C5-7
Age related joint changes are the _______ common cause of disability in the US, existing in __ in __ adults.
MOST common
1 in 5 adults
What percentage of people over the age of 55 have age related joint changes?
80%
What joints are age related joint changes most common at?
Hip and knee followed by spine
What is protective for age related joint changes?
Physical activity
Where is articular cartilage located?
Covers ends of long bones and facets
2-4 mm thick
What makes up articular cartilage?
Chondrocytes
