1. VERTEBRAL JOINTS & BIOMECHANICS
Kellie Fokin, Kristen Classen, Kylie Quinn, Eric Mentzer

2. SPINAL RANGE OF MOTION Head Flexion Head Extension
3 minutes to discuss.
Head
Extension

3. SPINAL DEGREES OF MOTION

4. CLINICALLY ASSESSING RANGE OF MOTION
Physical Therapist Tools
The Patient - Questionnaire, Pain Scale, Gathering Info
Posture/Observations - Changes in Posture, Strength, Pain &/or Length
Neurological Screening - Reflexes, Sensation, & Strength
Measuring ROM - Flexion, Extension, Rotation, Bending (different regions)
Manual Exam - Checking Joint Motion, Smooth or Tight/Injured/Loose
c - Feel Skin Temperature, Texture, Pressure Points & Spams
Special Testing - If cause is elsewhere check … Thoracic Outlet
Thoracic Outlet
Temporomandibular Joint (Jaw) Thoracic Spine
Thoracic Spine
Nerve Tension
Ergonomics
3 minutes to discuss.

5. Proper Ergonomics

6. RANGE OF MOTION PATHOLOGIES
spondylosis
spondylolysis
spondylolisthesis - reduces extension
both cause decreased flexion and lateral flexion, have tight HS
spinal stenosis
foraminal stenosis
osteoporosis
abnormal curvatures
lumbar lordosis
(from weak abdominal wall, tight low back and hip flexors)
thoracic kyphosis
(from weak upper ES and neck flexors, tight hip flexors)
scoliosis
erector spinae muscle strain from heavy repetitive lifting
3 minutes to discuss.
ROM can be limited by:
→ thickness or elasticity of IV discs
→ shape and spatial orientation of IV joints and zygapophysial joints
→ tension of joint capsules
→ muscle and ligament tightness
→ attachment of ribs on thoracic vertebrae
→ amount of surrounding superficial tissues (ie subcutaneous fat, muscle bulk)
spondylosis - joint deterioration causing degenerative arthritis and rubbing of bone (articular facet joints)
spondylolysis - lamina or pedicle fracture from trauma
spondylolisthesis - misalignment (normally anteriorly)
spinal stenosis - reduced vertebral canal size; creates nerve/spinal cord impingement
foraminal stenosis - generally injury/trauma that causes swelling or knocks discs into misalignment
abnormal curatures
→ lumbar lordosis
→ thoracic kyphosis
→ scoliosis - lateral curvature of spine
→ myopathic scoliosis - asymmetrical weakness of intrinsic back muscles
ARTICLE
objective was to determine the effects of a 10 week dynamic back extension training program and its effects on back muscle strength, back muscle endurance and spinal ROM for healthy young adults
subjects - 73 female college students aged with no pmhx of lbp; randomly assigned to control or exercise group
exercise group - performed back extension exercises on floor 3x/wk for 10 weeks
control group - no training for 10 weeks
measurements
isometric strength of back muscle was tested in standing with spring dynamometer
stood on platform with knees fully extended and trunk flexed about 30 deg; hand bar positioned across thighs was pulled straight upward using back muscle
back extensor endurance test - lay prone over end of table with ASIS supported; held position as long as possible
inclinometric measurement - thoracic and lumbar spine ROM for flexion/extension; measured as L5-S1 and T12-L1
lateral bending - distance between tip of middle finger and floor
dynamic training
2x25 reps of back extension on floor with hands clasped behind head
results
exercise group had 21% increase in strength, .25% increase in endurance; endurance decreased by 8.87% in control group
significant differences between groups and within group (except L5-S1 flexion) with flexion/extension
conclusions
inactivity decreases spinal ROM, strength and quality of life
doing dynamic back extensor exercises for 10 weeks greatly improves strength and therefore ROM

7. REFERENCES Desjardyns, Lyndsey. "Functional Anatomy Part
7-Intrinsic Back Muscles." N.p., 08 July Web. 04 June 2015.
Moore, Keith. "Essential Clinical Anatomy." N.p., 5th Edition Book. 03 June 2015.
Yaprak, Y. (October 25, 2013). “The effects of back extension training on back muscle strength and spinal range of motion in young females.” Biology of Sport, 30, 3,
Medlej, Joumana. “Human Anatomy Fundamentals: Flexibility and Joint Limitations.” 06 March Web. 03 June 2015.
University of Maryland Medical Center (UMMC). “Rehabilitation of Cervical Spine.” 17 June Web. 03 June 2015.
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8. ACTIVITY Jeopardy Game http://www.superteachertools.us/jeopardyx/
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