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Flashcards in Lumbar Stabilization Deck (10):
1

3 subsystems that stabilize LS

1. Neuron control subsystem
- ACTIVE
- 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

2

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

3

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

4

Instability

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)

5

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

6

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

7

Two types of instability

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

8

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

9

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

10

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