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Evaluations and Treatment of the Cervical Spine, 2nd Edition: Summary
POSTURAL EXAM
Selective Functional Movement Assessment (SFMA): Each client performs seven fundamental movement patterns regardless of chief compliant, with four possible results: • Nonpainful and functional • Nonpainful and dysfunctional • Painful and functional • Painful and dysfunctional TREATMENT Education • Gives clients a reason or rationale for rehabilitation and how selected interventions can be beneficial to them • Pain Neuroscience Education (PNE) : ○ Clients understand more about multifactorial nature of pain ○ Understand the pain experience from a biological and physiological perspective ○ Encourage clients to be active participants in their condition Therapeutic Exercise • Neck pain with mobility deficits : ○ Acute: Cervical ROM exercises; scapular and upper extremity strengthening ○ Subacute: Neck and shoulder girdle endurance ○ Chronic: “Mixed exercise,” including coordination, posture, proprioception, stretching, strengthening, endurance, and aerobic conditioning • Neck pain with movement coordination impairments : ○ Acute: Multimodal approach—posture, ROM, strengthening, endurance, flexibility, coordination, aerobic, functional exercise ○ Chronic: Progressive submaximal strengthening exercises, endurance, flexibility, coordination • Neck pain with headaches : ○ Acute: Active mobility exercises; self-SNAG exercises ○ Subacute: Self-SNAG exercises ○ Chronic: Cervical stretching; cervical and scapular strengthening, endurance, coordination • Neck pain with radiating pain : ○ Acute: Mobility/strengthening of the cervical spine ○ Chronic: Stretch/strengthen cervical muscles • Deep cervical flexor muscle training : ○ Using a blood pressure cuff or biofeedback device such as the Stabilizer, by Chattanooga Group, Inc. ○ Client is supine with biofeedback inflated to 20 mm Hg
UPPER CROSSED SYNDROME Pattern of tightness and weakness. When viewed laterally, the pattern forms the letter X, hence the name. • TIGHT (shortened): ○ Suboccipitals ○ Sternocleidomastoid (SCM) ○ Levator scapulae ○ Pectoralis major/minor ○ Scalenes ○ Upper trapezius • WEAK (lengthened):
○ Deep neck flexors ○ Serratus anterior ○ Middle trapezius ○ Lower trapezius
Screening Tools Functional Movement Screen (FMS): Measures seven fundamental movements and requires basic FMS equipment to administer. Determines if the movement pattern is one of three
categories: • Optimal • Acceptable • Dysfunctional
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