Stanbridge - T4 - TE2 - W2 - Spine & Posture (Part2)

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Questions and Answers

What is the primary function of the nervous system in the context of muscle response?

To coordinate muscle response by modulating stiffness and movement (correct)

To facilitate rapid muscle regeneration

To provide sensory feedback for muscle relaxation

To enhance muscular endurance through improved blood flow

What occurs in healthy control prior to limb muscle movement?

Decreased proprioceptive feedback from the spine

Increased flexibility of limb muscles

Postural responses of trunk muscles (correct)

Heightened pain sensitivity in the extremities

Which factor can negatively impact neuromotor control according to the fear avoidance model?

Engagement in physical therapy

Cognitive behavioral therapy

Fear of movement or activities (correct)

Increased exercise intensity

How does inspiration affect spinal stability?

It increases stability through back extensor activation Signup and view all the answers

What is the consequence of limb-girdle musculature contraction without proper spinal stabilization?

It causes excessive stress on spinal structures Signup and view all the answers

What is the primary distinction between postural fault and structural impairments?

Postural fault has no associated structural impairments. Signup and view all the answers

Which statement accurately reflects the current discourse on posture within the PT community?

Opinions vary on the relationship between posture and pain symptoms. Signup and view all the answers

Which of the following strategies aids in developing healthful exercise habits to prevent spinal injuries?

Utilizing relaxation techniques and stress management. Signup and view all the answers

What is a key component in distinguishing between global and segmental muscle activity related to spinal stability?

Segmental stability requires activation of specific local muscles. Signup and view all the answers

Which of the following accurately describes the impact of postural alignment on pain syndromes in the spinal region?

Not all individuals with poor posture will experience pain. Signup and view all the answers

Which characteristic is NOT associated with normal posture?

Deviations in alignment without compensation. Signup and view all the answers

What does the term 'spinal stability' primarily encompass?

The interaction of muscle, inert, and neurological structures. Signup and view all the answers

What is a major contributor to instability in the spine?

A combination of factors Signup and view all the answers

Which type of muscles are responsible for providing dynamic support to individual spinal segments?

Deep segmental muscles Signup and view all the answers

Which statement accurately describes the function of global muscles in spinal stability?

They stabilize the spine primarily through compression. Signup and view all the answers

What results from inactivity in relation to muscle endurance?

Decreased muscle endurance due to fiber size reduction Signup and view all the answers

Which muscle is NOT classified as a global muscle in the lumbar region?

Multifidi Signup and view all the answers

What is a characteristic of deep segmental muscles in the spine?

They have a higher percentage of Type I muscle fibers. Signup and view all the answers

What is the main drawback of using global muscles for spinal stability?

They lead to stress on inert tissues at end ranges. Signup and view all the answers

In comparison to global muscles, what is a unique trait of deep segmental muscles?

They maintain stability by having direct attachments to each spinal segment. Signup and view all the answers

What is the significance of Type I muscle fibers in postural muscles?

They ensure high endurance and stabilization. Signup and view all the answers

What is a characteristic consequence of Postural Dysfunction?

Adaptive shortening of soft tissues Signup and view all the answers

Which postural condition is often linked to weak abdominals?

Lordotic Posture Signup and view all the answers

What causes pain in a Flat Low Back Posture?

Decreased shock absorption due to lack of normal curves Signup and view all the answers

What happens to the pelvis in a Relaxed and Slouched Posture?

The pelvis shifts anteriorly Signup and view all the answers

Which muscles are typically weak and elongated in a Swayback posture?

Rectus abdominis Signup and view all the answers

Which postural deviation is characterized by increased T/S kyphosis and forward head?

Round Back Posture Signup and view all the answers

What impairment is often seen with sustained faulty posture?

Adaptive shortening of soft tissues Signup and view all the answers

What is a potential source of pain in a Relaxed and Slouched Posture?

Stress to ilio-femoral ligaments Signup and view all the answers

What contributes to the development of Flat Back Posture?

Over-emphasis on flexion exercises Signup and view all the answers

What is a primary consequence of impaired timing of anticipatory activity in the multifidus muscle for patients with low back pain?

Decreased amplitude of muscle activity Signup and view all the answers

Which of the following characterizes the changes in cervical extensor muscles documented in C/S pain studies?

Widespread atrophy and fatty replacement Signup and view all the answers

What neural control change occurs in individuals with C/S pain?

Heightened activity of superficial muscles Signup and view all the answers

How does recurrent low back pain affect muscle activation duration?

Decreases duration of activation Signup and view all the answers

Which statement best describes the effects of decreased strength in C/S pain patients?

Decreased ability to generate torque and efficiency Signup and view all the answers

What impact does altered afferent input from neck muscles have in C/S pain patients?

Negatively affects eye gaze stability and head orientation Signup and view all the answers

What is the result of decreased precision noted in C/S pain studies?

Diminished strength and overall performance Signup and view all the answers

Which muscle change is associated with altered muscle recruitment in C/S pain?

Diminished neural control of muscles Signup and view all the answers

Why is neurological control significant in spinal stability?

It is critical for maintaining functional stability Signup and view all the answers

What maladaptive behavior is observed in response to increased mechanical demand in patients with recurrent low back pain?

Decreased duration of activation in deep muscle fibers Signup and view all the answers

Study Notes

Therapeutic Exercise II: PTA 1010

Course covers spine part 2 (Posture)
Objectives include describing normal and abnormal postures, recognizing common pain syndromes, the interactive role of spinal structures, and differentiating global and segmental muscle activity.
Further objectives include instructing patients in programs to improve postural alignment, implement exercise programs for individuals with spine conditions, and teach healthy habits, ergonomics, and relaxation techniques for injury prevention.
The course outline includes Posture and related pain syndromes, Generalized Guidelines for Management if Spinal Impairments, and Spinal Stability.

Posture and Pain Syndromes

Slides 123-132 present a recent article discussing posture, perceptions, and spinal dysfunction, which is considered a current hot topic in the PT community.
Some believe posture is the main source of symptoms, while others believe poor postures are a normal part of life.
The background and objectives of a study regarding the perceptions and beliefs of physiotherapists on optimal standing and sitting postures were investigated.
The study used an online survey with three sections: perceived importance of posture education, choice of optimal sitting and standing postures, and demographic information.
Key results show 93.9% of physiotherapists considered postural education importantly
Three sitting and two standing postures were most commonly selected as "optimal".
Six major themes in the justifications of optimal postures were identified: natural spinal curvatures, muscle recruitment & energy expenditure, optimal pelvis position, neutral spine, stereotypes for ideal posture, and line of gravity (for standing).
Clinical implications highlight the importance for clinicians to understand patients' strong postural beliefs, especially how these beliefs may influence how they are treated.
These beliefs can lead to potentially harmful treatment advice that creates unnecessary problems.

Three categories describe pain created by posture: postural fault, postural pain syndrome, and postural dysfunction.
Postural fault: deviations from normal alignment without structural impairments (e.g., slouching).
Postural Pain Syndrome: pain resulting from sustained faulty postures for extended periods. Pain is relieved with activity. No structural impairments yet.
Postural Dysfunction: pain due to prolonged poor posture or following trauma/surgery. This includes adaptive shortening of soft tissues and muscle weakness. Examples include stroke patients and those with knee replacements.
Common faulty postures include issues in the pelvic/lumbar region (lordosis, slouching, flat back), cervical/thoracic region (forward head, kyphosis, flat upper back), and frontal plane deviations (scoliosis, lower-extremity asymmetries).
Different postural presentations and the associated problems are discussed with detailed descriptions and figures.

Spinal Stability

Three subsystems provide spinal stability: inert structures/bones and ligaments (passive system), muscles (active system), and neural control system.
Spinal stability issues may result from a combination of inert tissue damage, insufficient muscle strength/endurance, or poor neuromuscular control.
The active subsystem, composed of all muscles working together, is crucial for spinal stiffness and stability during all movements. Global muscles are involved in compression, while deep segmental muscles are directly attached to the segments for dynamic support.
The need for proper neuromuscular control is essential for maintaining balance, and proper timing and strength of muscles is important.
The Valsalva maneuver, a forceful exhalation against a closed glottis, can affect intra-abdominal pressure which affects spinal stability, however, improper execution can be dangerous and is not recommended.
Spinal posture, its various deviations, and their impact on the supporting musculature and potential injury points are examined.
Understanding and handling segmental instability, neutral spine/neutral zone concept, and assessment methods including muscular activation tests and positional endurance tests are critical topics.

Management of Impaired Posture

Postural training techniques create kinesthetic awareness focusing on correcting spinal positioning.
Important considerations include flexibility exercises, strength & endurance training, proper body mechanics, stress management/relaxation, and establishing healthier exercise habits.
Different phases of treatment, such as acute and chronic phases, have tailored protocols (including exercises) for managing spinal impairments.

Additional Considerations

Various types of spinal impairments (e.g., spondylolisthesis) and their treatment options are addressed.
The importance of cardiopulmonary endurance and exercises that are suitable for managing specific postural conditions are discussed.
Exercises for various spinal regions (e.g., cervical, lumbar), including posture and stability exercises, and their progressions are illustrated, as well as strategies for assessing spinal stability.

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Description

Test your understanding of the nervous system's role in muscle response and spinal stability. This quiz covers neuromotor control, postural faults, and factors affecting exercise habits. Challenge yourself with key concepts relevant to physical therapy and spinal injuries.