FM2 - lower trunk and pelvis in prone

  1. What evaluations are appropriate?
    • VCT
    • LPM
    • mobility testing:

    • - forward bending
    • - backward bending
  2. What is the sequence for enhancing myofascial flexion mobility?
    1. Seated central parallel ironing (FM1):

    • FMP:
    • - forward bending in sitting - forward, L and R diagonals

    • treatment manual contact:
    • - fist, hands, elbow

    2. Prone suspended lumbar flexion (purpose is to provide traction between L5 - S1):

    • FMP:
    • - prone over edge of table (dorsum of feet in contact with floor)
    • - prayer position
    • - quadruped

    • 3. Standing knee flexion
    • - maintain posterior pelvic tilt while extending knees. 
    • - assess anterior and posterior structures
  3. What is the sequence for prone lower trunk rotation FMP (happy camper)?
    Pt position:

    - knees bent and close togther

    Evaluation:

    Lower quadrant mobility - AROM/PROM:

    - NM and M of motion during LTR

    Weight of leg to determine side with impedence

    • Efficient motion:- segmental return from superior to inferior to midline.
    • - trunk elongation on side LTR awaying from. 
    • - trunk folding on side LTR towards. 
    • - should see no extension fulcrum. 

    Treatment sequence:

    STM

    Knee flexion mobility- half prone (norwegian position)

    Hip mobility- block sacrum to assess (thomas position for restricted hip flexors)

    • Pelvic mobility- can also assess with standing pelvic shear for sacrum and innominate to stay level:
    • 1) sacral depression
    • 2) innominate depression

    • Trunk mobility
    • - anterior and posterior structures, impeding efficient trunk elongation and folding. 

    • Lumbar mobility
    • - PT position:
    • 1) stand ipsilateral to the side LTR is happening towards. 
    • - assess:
    • 1) SP is able to shear and rotate away. 

    • NMR:
    • - segmental return of each lumbar segment to come to midline from cranial to caudal direction
  4. What is the sequence for unilateral lower extremity extension (prone ballerina)?
    Evaluation:

    • - LPM with dowel
    • - weight of leg (PROM)
    • - quality and control (AROM)
    • 1)hip
    • 2) sacrum
    • 3) innominate
    • 4) L spine
    • 5) soft tissue

    • Strength
    • 1) contraindication is extension sensitivity
    • 2) test at varying ROM

    • Palpate and assess for Core first strategy (spinal stabilization):
    • 1) multifidi, rotators, pelvic floor
    • 2)TrA
    • 3)deep psoas, QL

    Order of contraction during stabilization:

    • prior to leg lifting:
    • - lumbar multifidi, deep psoas, QL
    • - deep hip external rotators

    • as leg lifts:
    • - hamstring
    • - gluts

    • as motion continues:
    • - paraspinals

    • Progression:
    • - quadruped
    • - standing

    Trace and isolate for dysfunctions

    • Patient assistance:
    • - subjective info on symptoms, motion, restriction

    • Treatment:
    • - mechanical
    • - NM
    • 1)initiate inhibited core muscles
    • 2) facilitation through cervical ipsilateral rotation
    • 3)facilitation through ipsilateral resisted scapular posterior depression
    • 4)facilitation through prolonged holds and tonic spread, then COI
    • 5)tapping of lumbar multifidi

    • - Motor control
    • 1)sequencing of activation

    • Position for training and treatment:
    • - prone
    • - prone over edge of table or ball
    • - sidelying 
    • 1) PNF pelvic PD
    • 2)facilitate PF (levator ani, coccygeus) and TrA muscles
    • 3) add LE extension pattern

    • Re-evaluation:
    • - sustained pressure to any muscle still not activating efficiently, while adding COI or prolonged holds. 

    • HEP for lumbar and hip extensors:
    • - prone ballerina
    • - quadruped ballerina
    • - supine unilateral bridging (reaching for the stars)
    • - sidelying cross extension
    • - standing cross extension
Author
toshimoshi
ID
316864
Card Set
FM2 - lower trunk and pelvis in prone
Description
IPA
Updated