Download Chapter 14 Spine Structure - PHT 1228c Therapeutic Exercise II

The Spine: Structure,
Function, and Posture
Chapter 14
Part IV: Exercise Interventions by Body
Region
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POSTURE AND BIOMECHANICAL
INFLUENCES
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Functional Components of the
Spine
 Anterior Pillar
 Posterior Pillar
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Motions of the Spine
 Six Degrees of Motion
– Flexion/extension
– Side bending
– Rotation
– Anterior/posterior shear
– Lateral shear
– Compression/distraction
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Arthrokinematics of the
Zygapophyseal (Facet) Joints
 Cervical Spine
 Thoracic Spine
 Lumbar Spine
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Structure and Function of the
Intervertebral Discs
 Annulus Fibrosus
 Nucleus Pulposus
 Cartilaginous End-plates
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Intervertebral Foramina
 Located between each vertebral segment in
the posterior pillar
– Anterior boundary: intervertebral disc
– Posterior boundary: facet joint
– Superior and inferior boundaries: pedicles of the
superior and inferior vertebrae of the spinal
segment
 Size is affected by spinal motion
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Biomechanical Influences on
Postural Alignment
 Curves of the Spine
 Gravity (the gravity line)
– Ankle-anterior
– Knee-anterior
– Hip-variable with sway
– Trunk-bodies of cervical and lumbar vertebrae
– Head-anterior to AO joint
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Stability
 Postural Stability in the Spine
 Inert Structures: Influence on Stability
 Muscles: Influence on Stability
– Role of global and segmental muscle activity
Segmental Muscle Activity
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Muscle Control in the Lumbar
Spine
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
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
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Abdominal Muscles
Transverse Abdominis Stabilization Activity
Erector
Multifidus Stabilization Activity
Thoracolumbar (Lumbodorsal) Fascia
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Muscle Control in the Cervical
Spine
 Mandibular Elevator Group
 Suprahyoid and Infrahyoid Group
 Rectus Capitis Anterior and Lateralis, Longus
Colli, and Longus Capitis
 Multifidus
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Role of Muscle Endurance
 Inactivity has been shown to change
muscle fiber composition, leading to
decreased muscular endurance during
sustained or repetitive activities
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Stability
 Neurological Control: Influence on Stability
– Feedforward control and spinal stability
 Effects of Limb Motion on Spinal Stability
– Localized muscle fatigue
– Muscle imbalance
 Effects of Breathing on Posture and Stability
 Effects of Intra-Abdominal Pressure and the
Valsalva Maneuver
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IMPAIRED POSTURE
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Etiology of Pain
 Effect of Mechanical Stress
 Effect of Impaired Postural Support from Trunk
Muscles
 Effect of Impaired Muscle Endurance
 Pain Syndromes Related to Impaired Posture
–
–
–
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Postural fault
Postural pain syndrome
Postural dysfunction
Postural habits
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Common Faulty Postures:
Characteristics and Impairments
 Pelvic and Lumbar Region
– Lordotic posture
– Relaxed or slouched posture
– Flat low back posture
 Cervical and Thoracic Region
– Round back (increased kyphosis) with forward
head
– Flat upper back and neck posture
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Common Faulty Postures: Characteristics
and Impairments (cont'd)
 Frontal Plane Deviations, Scoliosis, and LE
Asymmetries
– Scoliosis
• Structural
• Nonstructural
– Frontal plane deviations from LE asymmetries
• Characteristic deviations
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MANAGEMENT OF IMPAIRED
POSTURE
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General Management Guidelines
 Awareness and Control of Spinal Postures
– Posture training techniques
• Axial extension (cervical retraction) to decrease a
forward head posture
• Scapular retraction
• Pelvic tilt and neutral spine
• Thoracic spine
• Total spinal movement and control
– Reinforcement
– Postural support
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General Management Guidelines
(cont'd)
 Posture, Movement, and Functional Relationships
– Relationship of impaired posture and pain
– Relationship of impaired posture and extremity function
 Joint, Muscle, and Connective Tissue Mobility
Impairments
 Impaired Muscle Performance
 Body Mechanics
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General Management Guidelines
(cont'd)
 Ergonomics
 Stress Management/Relaxation
– Muscle relaxation techniques
• Cervical and upper thoracic region
• Lower thoracic and lumbar region
– Conscious relaxation training for the cervical region
– Modalities and massage
 Healthy Exercise Habits
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Independent Learning Activities
 Critical Thinking and Discussion
 Laboratory Practice
 Case Studies
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