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Evaluations and Treatment of the Cervical Spine, 2nd Edition: Summary
POSTURAL EXAM
• 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 ○ Gentle head nod “yes” motion performed to an increase of 2 mm Hg ○ Hold for 10 seconds/rest for 30 seconds ○ Monitor for substitution of superficial neck flexors (SCM), cervical retraction, and head lift
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
Selective Functional Movement Assessment (SFMA): Each client performs seven fundamental movement patterns regardless of chief compliant, with four possible results:
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