The locomotor system
Peter Kopelman, Dame Jane Dacre in Handbook of Clinical Skills, 2019
With the patient supine on the couch, assess straight leg raising: Lift the leg by placing your hand underneath the ankle and passively flex the hip, keeping the knee extended. When the limit is reached, perform the sciatic stretch test by passively dorsiflexing the ankle. The test assesses irritation of the low lumbar and upper sacral nerve roots. The result is positive if the patient complains of sensory disturbance (pains, pins and needles, or numbness) anywhere below the knee.Now ask the patient to turn over. Remove the pillow from the head of the couch and place it under their pelvis and abdomen. This slightly flexes the lumbar spine and is a comfortable position for the patient. Palpate down the spinous processes in turn and along the erector spinae muscles, looking for tenderness.Then perform the femoral stretch test. This is the counterpart of the sciatic stretch test and assesses irritation in the upper lumbar nerve roots, which contribute to the femoral nerve. Passively flex the person’s knee and, holding the foot, gently extend the hip. If this provokes spasm of the quadriceps and the patient complains of sensory disturbance over the front of the thigh, the test is positive.
Trunk Muscles
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo in Handbook of Muscle Variations and Anomalies in Humans, 2022
Stevenson et al. (2014) describe a cadaver with a severe case of congenital scoliosis. The erector spinae muscles were severely atrophied on the left side and many parts were replaced by tendinous insertions. Erector spinae on the right side was comprised of typical fleshy muscle fibers but the tendons of iliocostalis inserted in a radial manner due to the abnormal thoracolumbar curvature (Stevenson et al. 2014).
Functional Rehabilitation
James Crossley in Functional Exercise and Rehabilitation, 2021
The subconscious strives for postures and positions of ease. We instinctively shift towards positions of strength, mobility and stability. If a client has weak erector spinae muscles, a rigid thoracic spine and poor balance, they will tend to shift into a flexed postion. There is always a subconscious drive to feel stable, safe and secure.
Effect of seat tilting on biomechanics of L4 in tractor drivers
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Yang Yang, Jian Qi, Jinghui Liu, Yaping Wang, Liangyuan Xu, Yizhuo Zhang, Liqing Cheng
From the results of the left/right erector spinae muscle in Figure 4, we can clearly see that the tilt of the tractor causes asymmetric activation of the driver's erector spinae. From the data obtained from the simulation, with the increase of tilt angle of the tractor, the difference value of the muscle activity of the driver's left and right erector spinae muscles is increasing. The difference between the muscle activity of the driver's left and right erector spinae muscle at 5° and 10° of tractor tilt was at 1.9%, and the difference between the maximum muscle activity of the driver's left and right erector spinae muscle at 15° of tractor tilt reached 3.29%. In both simulated and experimental data, we observed that the growth trend of the erector spinae muscles were essentially the same for both methods. The increasing tilt angle of the tractor to the left leads to an increase in muscle activity of the erector spinae muscles, and the increase in muscle activity of the left erector spinae muscle is greater than that of the right erector spinae muscle.
Effects of back extensor and hip abductor fatigue on dynamic postural stability in patients with nonspecific chronic low back pain: A case-control study
Published in Physiotherapy Theory and Practice, 2022
Shirin Tajali, Narges Roozbehfar, Mohammad Mehravar, Shahin Goharpey, Khadije Gayem
Control of dynamic balance is considered to be a prerequisite for most daily functions and is known to be affected in NSCLBP patients (Koch and Hänsel, 2019). Postural sway, as measured by the center of pressure (CoP) displacement, was reported to be higher in patients with NSCLBP than healthy subjects (Da Silva et al., 2018; Koch and Hänsel, 2019). It is assumed that postural control in these individuals is disrupted form both neuromuscular and biomechanical perspectives (Henry, Hitt, Jones, and Bunn, 2006; Hodges and Tucker, 2011; Koch and Hänsel, 2019). In fact, changes in the activity patterns of lumbopelvic muscles due to pain and injury as well as restricted range of motion in the lumbar spine have been documented in these individuals (Koch and Hänsel, 2019; Laird, Gilbert, Kent, and Keating, 2014; Penney et al., 2014). There is a trend toward higher co-activation of bilateral gluteus medius and erector spinae muscles in these individuals during standing (Cooper et al., 2016; Penney et al., 2014). This altered muscle recruitment has been explained as a strategy utilized by LBP patients to counter spinal instability and limit further motion in the respective area (Hodges and Tucker, 2011; Koch and Hänsel, 2019).
Are unstable support surfaces superior to stable support surfaces during trunk rehabilitation after stroke? A systematic review
Published in Disability and Rehabilitation, 2018
Tamaya Van Criekinge, Wim Saeys, Luc Vereeck, Willem De Hertogh, Steven Truijen
Although the majority of studies suggest that unstable support surfaces are superior to stable ones, several studies on healthy subjects provided evidence that not all exercises were superior and that some exercises only increase specific muscle groups [7,29]. For example, Lehman et al. [7] concluded that prone bridging resulted in increased activity of the rectus abdominis and external oblique muscles. The internal oblique and erector spinae muscles were not influenced by prone bridging on a physio ball [7]. On the other hand, Kong et al. [37] reported a high increase in internal and external oblique muscles, rectus abdominis and erector spinae muscles during prone bridging. Additionally, sitting on unstable surfaces without executing trunk exercises did not result in an increased activity of the superficial trunk musculature [38]. Further research is necessary to make clinical recommendations of which exercises are the most beneficial on unstable support surfaces to increase trunk muscular activity.
Related Knowledge Centers
- Back
- Muscle
- Tendon
- Skeletal Muscle
- Gluteus Maximus
- Gluteus Medius
- Gluteus Minimus
- Physical Therapy
- Sitting
- Sacrum