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Flashcards in Lumbar Stabilization Deck (10):

3 subsystems that stabilize LS

1. Neuron control subsystem
- determines amount of stability needed & tells which muscles to contract w/ what force

2. Osteoligamentous subsystem
- PASSIVE stability: bones, ligaments, joint capsules, etc
- LIMITS neutral zone & STABILIZES elastic zone

3. Muscle subsystem
- ACTIVE stability
- controls ELASTIC zone


Neutral Zone

region around a neutral spine in the first few degrees of motion

very little resistance from passive structures and muscles

can think of it as Grade I and II mobs


Elastic Zone

end of neutral zone to the end of physiologic range

motion in this zone occurs w/ considerable internal resistance

think of it as Grade III and IV



Displacement under load (nonlinear relationship between load & displacement)
Greater displacement w/ prolonged load (sitting for long period of time)

Greater displacement w/ injury to the passive structures meaning an increase in the neutral zone and overactivation of the muscles

--> increase in neutral zone = instability
--> decrease in stiffness (aka elastic zone) = instability (hypermobility)


Motor Training in Patients w/ Instability
- what is it
- four elements
- 3 phases

Minds attempt to teach the body conscious control of a specific movement/muscle

high reps w/ step by step progressions using cues and feedback

Four elements:
1. proprioceptive and kinesthetic awareness
2. dynamic stability
3. preparatory and reactive muscle characteristics
4. conscious and unconscious functional motor patterns

3 phases:
1. static stabilization
2. transitional
3. dyanamic


Underlying factors leading to failure of stabilization training (4)

1. Negative prone instability test
2. Absence of aberrant motions
3. Absence of lumber hypermobility
4. Score of 9 or higher of FABQ


Two types of instability

1. Structural (dysfunction of passive structures)
2. Functional (related to dysfunction of muscle or neural subsystem)


Items for predictive success w/ stabilization training (4)

1. Age less than 40
2. presence of abberant motions
3. positive prone instability test
4. average SLR (no neurological symptoms)

Must have 3 or more of these to have a 67% probability of success w/ stabilization training


Leg Load Tests - biofeedback (supine)

Testing for appropriate contraction of the TrA w/o spine movement

1. patient is supine w/ cuff inflated to 40 mmHg under lumbar spine
2. Draw abdominal wall in w/o moving spine or pelvis
3. Hold for 10 seconds & breath normally
4. Progress to marching & heel slides

Correct response: Pressure remains same

Incorrect response: pressure increases due to posterior pelvic tilt, or pressure decreases w/ marching due to anterior tilt


Prone Leg Load Test - biofeedback

1. patient is prone w/ cuff inflated to 70 mmHg under abdomen
2. draw abdominal wall up w/o moving the spine or pelvis
3. Hold for 10-15 seconds, breathing normally

Correct response: Pressure will decrease 6-10mmHg

Incorrect response: Pressure increases due to trunk flexion, ant pelvic tilt, or depressing rib cage OR no drop in pressure (less than 2) which would be a poor result and poor contraction of TrA