Download CBP Final Exam 100% VERIFIED ANSWERS 2024/2025 CORRECT and more Exams Physics in PDF only on Docsity! CBP Final Exam 100% VERIFIED ANSWERS 2024/2025 CORRECT +/- Tz H denotes: anterior (+) or posterior (-) head carriage +/- Tx H denotes: left (+) or right (-) translation of the head Anterior head carriage involves _____________ of the lower curve & _____________ of the upper curve. flexion; extension *vice versa for posterior head carriage* A right translation of the head results in _____________ of the lower curve & _____________ of the upper curve. right flexion; left flexion *lower curve = ipsilateral -- upper curve = contralateral* TRUE/FALSE: The lower body (lumbars) respond in the same way to translation as right or left translation of the head. TRUE -- lw'r = ipsilateral / up'r = contralateral What is the normal curvature of the neck? lordotic -- extension What happens if our neck curvature transitions into kyphotic (flexion) vs. lordotic? decreased nervous system function: - decreased circulation - decreased ATP production (energy) What are the 4 types of nerve interference? #1. direct compression #2.CNS stretch/tension (mechanical) #3. deforming mechanoreceptors #4. electrical Direct compression make up _____________% of nerve interference? 5% *very small %* What are examples of direct compression? disc bulge/herniation stenosis What is the cause of interference w/ CNS stretch/tension? nerves swell when conducting action potentials -- if nerve stretched it can't swell as much -- decrease in conduction • When the nerve depolorizes, mechanically changes with gates and________ physically. + Rx = ___________ - Rx = ___________ flexion; extension + Rz = ___________ - Rz = ___________ right lateral flexion; left lateral flexion ___________ is the founder of CBP. Donald Harrison *gave us "normal"* In CBP, posture is read from the ___________ to the ___________. bottom; top *due to gravity* How do we position the patient to look at the posture? Feet hip width apart, eyes closed bring head to rest at what feels neutral. TRUE/FALSE: Sagittal curves vary greatly b/w males, females, and different races. FALSE ARA (absolute rotation angle) are the sum of all the ___________. RRA (relative rotation angles) TRUE/FALSE: Segmental translation DOES NOT equal total translation. TRUE What shape is the cervical spine? full circle What shape are the thoracic & lumbar spines? eclipse The thoracic spine has a greater curve at the ___________ portion. While the lumbar spine has a greater curve at the ___________ portion. T spine = upper; L spine = lower What is the ARA of the cervical spine (C2-C7)? -42 degrees of extension What is the ARA of the thoracic spine (T3-T10)? +37 degrees of flexion What is the ARA of the lumbar spine (L1-L5)? -40 degrees of extension What is the APL (atlas plane line)? -29 degrees of extension What is the SBA (sacral base angle)? +40 degrees of flexion Name the anterior landmarks when evaluating posture. medial malleolus pubic symphysis episternal notch AC joint glabella philtrum Name the y axis landmarks when evaluating posture. heel of feet glutes... assassassass Name the side landmarks when evaluating posture. lateral malleolus greater trochanter middle of shoulder (glenohumeral joint) ear hole tragus What should you look at to determine if the head is in flexion or extension? location of the ear hole - external auditory meatus What happens in the first phase of care? Relief or Restoration phase (adjust the patient 3-4 xames per week for 2-3 weeks to increase rom) What happens in the second phase of care ? Structural Rehabilitation- 3x wk, for 12 weeks - it takes a lot to change this! What are some methods that the second phase of care is achieved. a) mirror image postural exercises - muscle strength for endurance against gravity. b) Mirror image adjustment- effect the mechanoreceptors (a lot of input!) a. You have a patient stretched in mirror image and then stimulate areas of high mechanoreception.--> remapping What do you progress to with mirror image exercise after you have done 5-10 sets of 20 reps isometrically? add resistance starting with 1-3 sets of 10 reps. When do you need to make sure they are doing their exercises correctly ? At minimum once per month at the re-eval. You should engage in active contraction for all mirror image exercises but especially______. rotational corrections. How long do you start with traction? 1-3 minutes to patient tolerance How many minutes do you add to every traction? add 1-3 minutes per visit to patient tolerance. How long does it take to get muscles to relax and get out of elastic change? 5 minutes Minimum threshold of creep? 10 minutes Maximum effective creep before it stops having effect? 15 minutes How long do ligaments take to recover? 24 hours When should you never ever use a Denner roll? Never with upper back hyperkyphosis No flexion/extension instability After 36 visits,_______% improvement is expected. 50 RRA L4-L5 is -19 degrees at neurtral and the patient has +TZT will the RRA increase away from zero, do nothing or decrease towards zero. • L4-L5 means lower lumbar • +TZT = anterior translation of the ribcage • -19 means extension, anterior translation mean flexion, it will be less -, closer to 0. If RRA C5-c6 is -8 degrees at neurtral and your patients posture is -TzH. will the RRA increase away from zero, do nothing or decrease towards zero. • C5-C6 means lower cervical • -TzH + = posterior translation of the head→ flexion upper cervical, extention lower cervical • - means extension → more negative What is the relationship between posture and structure? Posture is the outward manisfestation of structure What should you additionally try to detect when visualizing a high shoulder in a patient? A high shoulder will often have an accompanying compensatory lateral lateral flexion of the head What should you have a patient do prior to posture analysis? Remove their shoes, take some steps before coming to rest, close their eyes, and have them nod up and down a few times. What should you look for globally in terms of posture analysis? Relationship of the head over the thoracic spine (head to rib cage) and the thoracic spine to the pelvis (compare scapula to PSIS). What anatomical landmarks should you check for alignment from the front of a patient? 1. midstance 2. pubic symphysis 3. jugular or episternal notch 4. philtrum (concavity above middle of upper lip) 5. glabella (between eyes) What anatomical landmarks should you check for alignment in a lateral visualization of a patient? 1. lateral malleolus 2. greater trochanter 3. AC joint 4. EAM/tragus Describe the curves of a spine geometrically Cervical lordosis is based off a circle Thoracic kyphosis is elliptical with more curvature at the top Lumbar lordosis is ellpitical with more curvature at the bottom What are the axes of the right hand rule with regards to translation? C7 is X, index is Z, thumb pointed up is Y Positive translation is in the direction of fingers, ie +X to the left, +Z forward in the sagittal plane, +Y up What is the cause of the majority of lumbar related issues in CBP? thoracic displacement What are the 6 types of structural spinal displacements? 1. segmental rotations and translations (within normal joint ROM) 2. postural rotations and translations with associated spinal coupling/ displacement patterns 3. sagittal plane buckling (S curves, kyphosis) - column under pressure/trauma can results in a change of curvature, 1/3 anterior, 2/3 posterior 4. Euler buckling in the AP view - usually caused by impact injury, resembles scoliosis 5. true scoliosis - subtype of Euler buckling 6. segmental displacement/instability - typically impossible to find outside of cases involving trauma (eg. retro, spondy) (SP SETS) What are the 4 types of nerve interference emphasized in CBP? "D.C.M.E." <- thats what she said lol 1. direct compression of the nerve (rare, <5%) - nerve root compression or spinal cord stenosis 2. CNS deformation from abnormal posture/ spinal alignment 3. deformation of mechanoreceptors from abnormal posture/ spinal alignments 4. electrical 2 and 3 are the most commonly observed types of interference What is the Alf Breg model of flexion/extension with regards to nerve interference (how does posture affect the CNS)? The cord is impaired and stress during flexion, and is unencumbered during extension. Mechanical tension upon the spine=bad, results in: 1. increase in pressure 2. altered ATP production in the mitochondria 3. nerve transmission impairment "PAN" pressure, ATP, nerve How does poor posture affect mental acuity? 90% of the brain output is dedicated to posture (position of physical body in response to gravitational field) This only allows 10% for all other physiologic processes. Poor posture thereby affects thinking, healing, and metabolism. Every spinal position has ___ loads. What are they? Each position has 2 loads, a compression (slack) and tension load What are the 4 goals of CBP care? "(Ap-L) (Sp-a) (Funky) (Health)" 1. normal AP and lateral posture - center of mass of head, rib cage, pelvis vertically aligned in AP and lateral views 2. normal spine alignment - AP view: vertical alignment, lateral view: Harrison model, or average spinal model 3. normal function (eg. ROM, muscle strength) 4. health and system improvements - quality of life, based on standards of neck disability index, oswestry low back index, SF36 or health status questionaire What are the 2 general categories of CBP care? "R&R & R" 1. relief or restoration of functional ROM 3-4x/week for 2-4 weeks until pain remisses or improves and/or until ROM improves (8- 16 visits) Patient comes back in if pain returns, ROM decreases. Treatment - segmental and global adjusting procedures, stretching techniques, myological techniques, ice, heat - acute to subacute phases 2. CBP structural rehabilitation - 3x/week for 12 weeks or 4x/week for 9 weeks. Positive and radiographic alignment, wait to x-ray to see an actual change in structure. Patient placed on maintenance or supportive care. *On average you see a 50% change primary treatment methods a. mirror image postural exercises - opposite of current posture - ligaments will cause changes b. mirror image adjustements - affect mechanoreceptors c. mirror image traction - restore ligamentous shape (requires 10-15 minutes to create shape change) d. nerve stretching PNF stretching in mirror image and ergonomic modifications -most posture changes take 5-10 years to cause pain, often result from trauma, ergonomics, aging What are the two most commonly used traditional chiropractic methods? 1. SMT or segmental adjusting (improves ROM and relief) 2. soft tissue mobilization What does the CBP acronym EAT stand for? Exercise - warms up tissue, easier to adjust Adjust - not focused on adjusting segment ---> focused on mechanoreceptors Traction What is the piezoelectric effect? Laying down of bone where force is applied What are the typical motions observed within the spine? The thoracic spine supports 60-75% of the body weight and affects lumbar motion. Head translation affects the cervical spine, with the upper curve moving contralaterally How can you address the relationship of one vertebral segment to another? The RRA is taken from George's line. Using a lateral x-ray, draw a line through the posterior superior and posterior inferior borders of two adjacent vertebrae. The intersection between the RRAs will be George's (posterior tangent) line. The ARA can be determined by drawing a posterior tangent line between the highest and lowest segments in a curve. What are CBP gravitational lines and how should they be drawn on an x-ray? Gravitational lines are always taken off the posterior inferior corner of the lower segment. Cervicals- posterior superior C1 lateral mass is compared to the posterior inferior body of T1. Thoracics - T1 or T3 body centroid aligned with T12 or T10 body centroid. Posterior inferior body of T12 aligned with the posterior inferior corner of the body of S1. Lumbars - posterior inferior points of T12-S1. Gravitational line is drawn up (superior) to posterior inferior corner of T12. Indicates anterior or posterior translation. Posterior inferior S1 to posterior inferior T12. How do you take a sacral base angle? Compare anterior and posterior superior points of the sacrum, draw a straight horizontal intersecting line in comparison. Sacral base angle is typically +40 degrees flexion, while lumbar will have -40 degrees extension. Sacral base and lumbar curves should ideally be mirror images of each other. How do you draw an APL (atlas plane line)? Normal atlas plane line should have -29 degrees of extension. = WNL Will have 4 points: 1. center of anterior tubercle 2. dot in center of posterior tubercle 3. center of lateral mass 4. center of the other lateral mass Measure compared to horizontal line. Often also compared to HPL (hard palate line). What should you have a patient do prior to posture analysis? Remove their shoes, take some steps before coming to rest, close their eyes, and have them nod up and down a few times. "4 S's"- shoes, steps, shut eyes, shake head up and down What should you look for globally in terms of posture analysis? Relationship of the head over the thoracic spine (head to rib cage) and the thoracic spine to the pelvis (compare scapula to PSIS), and pelvis over feet. Read from the bottom up F-->P, P-->T, T-->H What anatomical landmarks should you check for alignment from the front of a patient? Posture is read from the bottom up 1. midstance 2. pubic symphysis 3. jugular or episternal notch 4. philtrum (concavity above middle of upper lip) 5. glabella (between eyes) What anatomical landmarks should you check for alignment in a lateral visualization of a patient? Posture is read from the bottom up 1. lateral malleolus 2. greater trochanter 3. AC joint 4. EAM/tragus How do you find an RRA or ARA? RRA - Drawing tangent lines between individual segments and taking the angle between them. ARA- Draw a tangent line from the top of curve to the bottom of the curve. The sum of the RRAs will ALWAYS equal the ARA. In each portion of the spine, which segments should be taken into account when measuring the ARA and why? Cervical C2-C7 Thoracic T3-T10 Lumbar L1-5 C1 can be hard to differentiate in lateral x-rays. T1 sits above T12, T2 above T11. These vertebrae are removed from consideration if T1 and T2 cannot be made out clearly in a lateral film. For CBP purposes, when do the expected ARA values for the different regions of the spine apply? The body is in a neutral position. What are the standard ARA ranges for the spine? How do you place a patient in order to correct for a rotation of the pelvis around the Y axis (+/- RyP)? Turn the patient's feet to the side of the posterior hip (prone) What should the patient placement be to correct for a lateral translation of the pelvis (+/- TxP)? Patient on side opposite translation, with legs elevated How do you correct for an anteriorly flexed sacrum? Patient should be supine, block should be placed under apex of sacrum, thrust should be made into ASIS. What movements accompany anterior translation of the thorax (+TzT)? SBA = Flex/+Rx LL = Flex/+Rx UL =Extend/-Rx T = Extend/-Rx Overall T = hypokyphosis Overall L = hyperlordosis Levin dropped the screen after putting this up on the whiteboard, covered up all but the first letters. Remember my F'in Ex was a SLUT, flip everything for posterior translation. How will the RRA of L4-5 (neutral is -19 degrees) change in response to anterior thorax translation (+TzT)? Lower lumbars in +TzT will flex (+RxP), so the RRA should move closer to 0. [moving towards HYPERlordosis]-ac How will the RRA of L1-L2 (neutral is -5 degrees) change in response to anterior thorax translation (+TzT)? Upper lumbars in +TzT will extend (-RxP) so the RRA will decrease (move further away from 0, be more negative). [causing HYPERlordosis]-ac Pretty sure flexion always means hypolordosis/hyperkyphosis. - kc What movements accompany posterior translation of the thorax (-TzT)? SBA = Extend/-Rx LL = Extend/-Rx UL = Flex/+Rx T = Flex/+Rx Overall T = hyperkyphosis Overall L = hypolordosis How will the RRA of T11-12 (neutral is 3 degrees) change in response to posterior thorax translation (-TzT)? Thoracic vertebra in -TzT will flex (+RxT), so the RRA should increase (move farther away from 0). [causing HYPERkyphosis]-ac What is the goal of CBP care? Neutral posture with ideal curvature of the spine. How often should patients be scheduled for visits and what is the expected improvement? Patients should be scheduled as often as possible, preferably with no more than a 48 hour window between visits. 50% average improvement within 36 visits, 90% after 72 visits. When should you initiate an exercise routine with your patient? Never exercise in the first 1-2 weeks with a true acute injury. Chronic cases can begin exercises within 2-4 weeks of initial visit. How should you start a patient exercise routine? Start with isometric or pain free ROM, have them perform 1 set of 10 repetitions, with each position held for 3 seconds. Work up to 5-10 sets of 20 repetitions (100-200 reps), each held for 5-10 seconds. Progress to exercises with resistance (theraband), start with 1-3 sets of 10 repetitions depending on patient's tolerance. How often should patients be exercising? 3x a week in order to create an effective change. As patients will probably not be willing to commit to that level, request 5-7 days of exercise as a doctor so they feel more inclined to do 3. What is the goal of an exercise program, and how often should you monitor patient progress? The goal is to improve muscle strength in areas which may be leading to improper posture, retrain the cerebellum to hold new posture. Patients will more than likely not follow up on exercise routine, should be monitored at least once a month as part of a re-exam. What should you take into account when correcting for rotations with exercise? Rotations CANNOT be done in free motion. Need resistance AND/OR isometric contractions Specific Postural Adjustment: How would we adjust an Anterior Head Carriage (+TzH) 1. adjust with head posteriorly translated 2. Stabilize with hand on back of head Specific Postural Adjustment: How would we adjust an Anterior translation of the pelvis (+TzP) 1. Supine 2. plantar flex feet 3. elevate feet Specific Postural Adjustment: How would we adjust a -Y Rotation of Pelvis (-RyP) Turn feet to RIGHT (to the side of posterior hip) Specific Postural Adjustment: How would we adjust a Right translation of pelvis (-TxP) 1. Patient lays on Left side 2. lift legs (leg lift can be a postural adj or exercise) Specific Postural Adjustment: How would we adjust an Increased SBA (+RxP) 1. Ischial tuberosities on pelvic piece 2. PSIS above pelvic piece 3. Tell patient must to suck belly button toward spine, squeezing legs and tucking butt under (isometric) Specific Postural Adjustment: How would we adjust a decreased sacral base angle (-RxP) ASIS above pelvic piece (gives freedom to move) Where do you contact for adjustment? Anywhere there are receptors! How should we think about all adjustments? that theyre awesome :D Globally (adjusting cervicals with affect pelvis) The entire body (except where the adjustment is taking place) should be in _________ posture neutral Other notes about adjustments? -active adjustment (not passive, patient contracts) -receptors in dermis, CT, muscles, joints, etc. What are the normal biomechanics of an Anterior Thoracic Translation (+TzT)? segments all still flex and extend with translation / rotation like they should (just not to the same degree as is ideal) Presentation of Anterior Thoracic Translation (+TzT) Biomechanics. (from bottom to top) 1. more tilt to sacrum (SBA increases) 2. pelvic flexion on femurs 3. lower lumbars flex 4. Upper lumbar curve increases 5. T12 is anterior to S1 on lateral lumbar view 6. Thoracic curve flattens 7. Ribcage translated forward 8. Shoulder is anterior to hip joint How does Anterior Thoracic Translation (+TzT) Biomechanics Presentation affect the rest of the spine? (from bottom to top) Pelvic Tilt (Flexion, +RxP) Lower Lumbar (Flexion, +RxL) Thoracics (Extension, -RxT) For Example, a normal SBA is +40, with an Anterior Thoracic Translation, the SBA will ________ increase to +45 What effects will an Anterior Thoracic Translation have on L4/L5 RRA, given a Normal RRA between L4/L5 is -19 degrees extension? The RRA of L4/L5 will increase (for example, to -15) because lumbars are more in flexion If patient has an Anterior Thoracic Translation, but their L4/L5 doesn't increase (instead, more extended), they have _________ biomechanics abnormal If patient does NOT have anterior thoracic translation but has an L4/L5 RRA of -15 (instead of -19), they have _________ biomechanics abnormal What effect does an anterior Thoracic Translation have on Sacral Base Angle, given that the normal SBA is 40 degrees? 100-200 reps Reps are better than __________ one long exercise During exercises, we start ________ resistance, then ______ resistance start without (pushing into a block), then build __________ cannot be done in free movement. Need resistance and/or isometric contractions Rotations __________ do NOT need resistance. because gravity and weight of trunk or head is enough to use Translations ___________ Do not need resistance (as you have the weight) Translations and Rotations Goal of Exercises Muscle Strength and Neurological Changes When should we check on exercises Every month (during legal reexam) at minimal What does Traction try to address? ligaments and neurology What is the start time for traction? 1-3 minutes How many minutes should traction time be increased? 1-5 minutes What is the goal time for traction? 15-20 min (no longer, because this is how long creep takes) During traction, we should push the patient to? their limit (safely) ______ change is the average amount of change in cervical curves with all appropriate methods used 50% In traction, its takes ________ 5 min to stretch and relax (ELASTIC PHASE) after this, ________ start to become effected muscles; ligaments What is the full recovery time after a ligament has been deformed? 24-48 hours For traction, what is the best visit frequency 3x/week Under what circumstances is Denneroll Usage appropriate? (not the carbs kind lol) <- the answer to that is always tho 1. slight anterior, neutral, or posterior head carriage 2. thoracic spine has to be normal upper thoracic or hypokyphotic When do you not use the denneroll? (glutten free cuz they nasty as shiz) -if the patient has a huge anterior head carriage -if the patient has hyperkyphosis in the thoracic ARA'S: APL: -29 Cervical: -42 Thoracic: 37 Lumbar: -40 SBA: 40 Postural adjustments affect _________ Posture Mirror image adjusting targets _________ MECHANORECEPTORS Is the patient active during a postural adjustment? YES. In areas being adjusted by doing mirror image, patient _________ into mirror image contracts In neutral areas, where the patient does not move, patient __________ contract muscles 6. Thoracic curve flattens 7. Ribcage translated forward 8. Shoulder is anterior to hip joint How does Anterior Thoracic Translation (+TzT) Biomechanics Presentation affect the rest of the spine? (from bottom to top) Pelvic Tilt (Flexion, +RxP) Lower Lumbar (Flexion, +RxL) Thoracics (Extension, -RxT) For Example, a normal SBA is +40, with an Anterior Thoracic Translation, the SBA will ________ increase to +45 What effects will an Anterior Thoracic Translation have on L4/L5 RRA, given a Normal RRA between L4/L5 is -19 degrees extension? The RRA of L4/L5 will increase (for example, to -15) because lumbars are more in flexion If patient has an Anterior Thoracic Translation, but their L4/L5 doesn't increase (instead, more extended), they have _________ biomechanics abnormal If patient does NOT have anterior thoracic translation but has an L4/L5 RRA of -15 (instead of -19), they have _________ biomechanics abnormal What effect does an anterior Thoracic Translation have on Sacral Base Angle, given that the normal SBA is 40 degrees? SBA increases (for example, to 45) b/c SBA should flex more when thoracic cage is translated anteriorly What effect does an anterior Thoracic Translation have on Thoracic flexion/extension, given that the normal ARA for T3-T7 is +37 degrees? MORE extension Decrease to +20= normal (more extension) What effect does an anterior Thoracic Translation have on the overall ARA? Overall ARA= increase (same as Sacrum) Presentation of Posterior Thoracic Translation (-TzT) Biomechanics. (from bottom to top) 1. pelvis extension on the femurs 2. Lower Lumbar curve extension (L4-S1) 3. Upper Lumbar Curve Flexion (T12-L3) 4. T12 is posterior to S1 on lateral lumbar view 5. thoracic curve increases 6. shoulder is posterior to hip joint What effect does a Posterior Thoracic Translation have on L4/L5? L4/L5 extends more (from -19 to -22 degrees is normal) What effect does a Posterior Thoracic Translation have on SBA? SBA decreases as it extends more (40 to 30 degrees) What effect does a Posterior Thoracic Translation have on upper lumbars are thoracic spine? Upper lumbars are thoracic spine flex more (increases kyphosis) What effect does an Posterior Thoracic Translation have on the overall ARA? Overall ARA = decreases (same as sacrum) Presentation of Right Thoracic Translation (-TxT) Biomechanics epi sternal notch, sternum, xiphoid located to the right (not aligned with midline) Presentation of Anterior Head Carriage Biomechanics 1. upper thoracic kyphosis increases 2. shoulders are rounded 3. bite line is level 4. Ear in front of shoulders For Example, the RRA of C6/C7 is normally -8, with an Anterior Head Carriage, the RRA will _________ RRA increase to -7 or more (because lower cervical curve is flexing) For Example, the RRA of C2/C3 is normally -10, with an Anterior Head Carriage, the RRA will _________ decrease to -12 (because upper curve extends) Exercises are started when the patient is ________ not acute How many sets should be given to a patient to start with? 1 set of 10 How many reps should a patient do after starting with 1 set of 10? 1. slight anterior, neutral, or posterior head carriage 2. thoracic spine has to be normal upper thoracic or hypokyphotic When do you not use the denneroll? (glutten free) -if the patient has a huge anterior head carriage -if the patient has hyperkyphosis in the thoracic How much needs to take place for traction to actually work? 36 visits at 3-4 times per week What is EAT Exercise Adjustment Traction What is the proper series of events for traction to be successful? 1. 1-3 min per session or patient tolerance 2. Add 1-3 min per session or patient tolerance 3. Goal is 10-20 minutes of traction 4. Obtain adequate soft tissue CREEP (sustained Pressure) How often should traction be reassessed? with an x-ray 24-48 hours after procedure due to recovery time Denneroll Indications are Anterior head posture less then 40-50 mm Retro-listhesis of C-Spine Flat/Normal upper thoracic kyphosis C5-C7 posterior to ideal curve line Denneroll Contraindications Anterior head posture more than 40-50 mm Anterior-listhesis C4-C7 Increased upper thoracic kyphosis C5-C7 well anterior to normal curve line What tissues does mirror image adjustment affect? Mechanoreceptors and anywhere there are joints, atlas What kind of contractions does the body need? isometric, where everything is in neutral except for the part that is getting adjusted Patient has anterior translation of Pelvis A. Lie them supine and block ribcage B. Lie them supine and lift their feet C. Lie them down and have them dorsiflex their feet D. None of the above Lie them down and have them dorsi-flex their feet If patient has posterior translation of Pelvis Lie them down and have them plantar-flex their feet During Sideline Translation of Pelvis (Left and Right) what should you do to their feet? Raise their feet What is the point of Rotation for the Pelvis? S2 Tubercle +RxP is _____and where is the contact? Flexion of Pelvis (positive rotation) Contact PSIS -RxP is _______and where is the contact? Extension of Pelvis (negative rotation) Contact Ischial Tuberocity To increase pelvic flexion you must block below ASIS Rule for y axis rotation of pelvis: If the patient is lying prone you twist feet towards posterior butt cheek -y axis rotation of hip right cheek is posterior, person lays down supine/prone, turn feet right creating left rotation +y axis rotation of hip left cheek is posterior, person lays supine/prone, turn feet left creating right rotation ARA of C2-C7 with 0 mm degree translation - 42 degrees ARA of T3-T10 with 0 mm degre translation 44 degrees SBA= Flexion LL= Flexion UL=Extension T-Spine = Extension Overall T = Hypokyphosis Overall L = Hyperlordosis Biomechanics of T-Spine (Posterior Translation) SBA= Extension LL= Extension UL=Flexion T-Spine = Flexion Overall T = Hyperkyphosis Overall L = Hypolordosis Patient has +Tz of C2-C4 = 40mm (Anterior head translation) RRA of C6-C7 = -8 degrees at normal A. C6-C7= -8 B. C6-C7= -10 C. C6-C7= -5 C6-C7 = -5 Do acute patients exercise? No...shtbull they do, but "do you give your acute patients exercises?" no How many times per week should patients exercise for 3-4 times per week When can patients begin an exercise regimen? when acute stage sets (finishes) At what rate do patients begin exercise regimen? 1 set of 10 reps What is the ultimate goal of exercise? 5-10 sets of 20 reps at 5-10 seconds Postural rotations need to have movement resistance or isometric contractions. Rotations need resistance Postural translations Translations do not need resistance. performed within or at maximum ROM because movement of the center of mass is larger and requires more muscle activity Postural rotations combined with translations Can be performed within or at maximum ROM due to involvement of rotation Elastic phase during traction lasts approximately for the first 5 minutes Viscous/plastic deformation stage occurs from 5-20 minutes The stretched ligaments will return back to its original form and are reassessed with an x-ray with recovery time of 24 to 48 hours The ultimate goal of traction is being able to sustain it for 10-15 minutes. Denneroll should not be used with a case of Hyperkyphosis How many times per month should you check on exercises of the patient and why? 1 time per month because that's the reevaluation time What is the percentage of improvement after 36 weeks of treatment? 50%