Lumbo Pelvic Stability: Difference between revisions
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== Assessment == | == Assessment == | ||
Lumbopelvic stability can be assessed with either | Lumbopelvic stability can be assessed with either equipment or clinical measures such as palpation, active straight leg raise, lumbar lordosis, pelvic inclination and dynamic tests. Dynamic tests include runner pose, hopping tests, single-leg squat, dip test. <ref name=":0">Perrott MA, Pizzari T, Opar MS, Cook J. Athletes with a clinical rating of good and poor lumbopelvic stability have different kinematic variables during single leg squat and dip test. Physiotherapy theory and practice. 2021 Aug 3;37(8):906-15.</ref> | ||
== Muscles == | == Muscles == | ||
Pelvic floor muscles (PFM) are proven to activate during tasks that challenge lumbopelvic stability, which supports the hypothesized role of the PFM in control of the lumbar spine and | Pelvic floor muscles (PFM) are proven to activate during tasks that challenge lumbopelvic stability, which supports the hypothesized role of the PFM in control of the lumbar spine and pelvis. <ref>Vesentini G, Prior J, Ferreira PH, Hodges PW, Rudge M, Ferreira ML. Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis. European Journal of Pain. 2020 Nov;24(10):1865-79.</ref> | ||
== Physical Therapy == | == Physical Therapy == | ||
Revision as of 21:49, 20 January 2024
Original Editor - Kris Porter Top Contributors - Kris Porter, Kim Jackson, Sehriban Ozmen, Vidya Acharya and Rishika Babburu
This article is currently under review and may not be up to date. Please come back soon to see the finished work! (20/01/2024)
Definition[edit | edit source]
Assessment[edit | edit source]
Lumbopelvic stability can be assessed with either equipment or clinical measures such as palpation, active straight leg raise, lumbar lordosis, pelvic inclination and dynamic tests. Dynamic tests include runner pose, hopping tests, single-leg squat, dip test. [1]
Muscles[edit | edit source]
Pelvic floor muscles (PFM) are proven to activate during tasks that challenge lumbopelvic stability, which supports the hypothesized role of the PFM in control of the lumbar spine and pelvis. [2]
Physical Therapy[edit | edit source]
Training Principles for Phase 1[edit | edit source]
- Injury Prevention and Body Mechanics
- Total Health (Nutrition, Cardiopulmonary exercise)
- Movement Retraining Basics
- Core Setting
- Evidence for Stability Training for Low Back Pain (and pelvic pain) [3][4]
Criteria for Progression to Phase 2
Below outlines the criteria that each patient must accomplish before allowed to complete the phase 2 exercises. At times, some phase 2 exercises may be given when a patient has not met this criteria. But rarely, will a patient be given the entire cuff program and the big 4 without meeting this criteria. This is based on anecdotal evidence of how best to prevent injury.
- Able to engage the primary core muscles without compensatory firing or pain in non-weight bearing (supine or prone)
- Able to engage the primary core muscles without compensatory firing or pain in static weight bearing positions (standing)
- Core Endurance and Ratio Testing has been completed[5] [6][7]
- The Big 4 exercises (or modifications of each one) are tolerated for at least a single hold of 8 seconds[8]
Training Principles for phase 2[edit | edit source]
- Movement Retraining Intermediate
- Big 4 Exercises
Training principles for Phase 3[edit | edit source]
- Static Balance - Stable Surface
- Static Balance - Unstable Surface
- Dynamic Balance - Stable Surface
- Dynamic Balance - Unstable Surface
Training Principles for Phase 4[edit | edit source]
- Movement Retraining Advanced
- Big 4 Exercises - Advanced
Training Principles for Phase 5[edit | edit source]
- Advanced Strength Training and Postural Stability
CRITERIA FOR DISCHARGE FROM PHYSICAL THERAPY
Resources[edit | edit source]
- Lumbopelvic Ryhthm
- Lumbo-Pelvic Guidelines
- Lumbopelvic Manipulation Technique
- Lumbar Instability
- Exercises for Lumbar Instability
References[edit | edit source]
- ↑ Perrott MA, Pizzari T, Opar MS, Cook J. Athletes with a clinical rating of good and poor lumbopelvic stability have different kinematic variables during single leg squat and dip test. Physiotherapy theory and practice. 2021 Aug 3;37(8):906-15.
- ↑ Vesentini G, Prior J, Ferreira PH, Hodges PW, Rudge M, Ferreira ML. Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis. European Journal of Pain. 2020 Nov;24(10):1865-79.
- ↑ Gatti R, Faccendini S, Tettamanti A, Barbero M, Balestri A, Calori G. Efficacy of trunk balance exercises for individuals with chronic low back pain: a randomized clinical trial. journal of orthopaedic & sports physical therapy. 2011 Aug;41(8):542-52.
- ↑ Macedo LG, Maher CG, Latimer J, McAuley JH. Motor control exercise for persistent, nonspecific low back pain: a systematic review. Physical Therapy. 2009;89(1):9-25. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19056854.
- ↑ McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80(8):941-944.
- ↑ McGill S. Ultimate back fitness and performance. Waterloo Ont.: Wabuno Publishers; 2004.
- ↑ McGill S. Low back disorders: evidence-based prevention and rehabilitation. Second. Human Kinetics; 2007.
- ↑ Mcgill S, Karpowicz A. Exercises for Spine Stabilization: Motion/Motor Patterns, Stability Progressions, and Clinical Technique. Archives of Physical Medicine and Rehabilitation. 2009;90(1):118-126. Available at: http://www.archives-pmr.org/article/S0003-9993%2808%2901505-0/abstract
