Often, with the more difficult mechanical problems, their use is essential.’įor example, lumbar spine extension may be performed and, while maintaining that extension, side flexion may be added. Most commonly the shift occurs away from the painful side (Figure 11.7).Īccording to Edwards (1992): ‘Although the use of combining movements is not always necessary – adequ ate results being obtained by standard examination procedures – there are times when they are helpful. The shift is thought to result from the body finding a position of ease whereby the shoulders are displaced laterally in relation to the pelvis. ![]() Shifted posture (lateral shift) commonly arises from disc herniation or acute irritation of a facet joint.Kypholordosis consists of a forward-poking chin posture, elevation and protraction of the shoulders, rotation and abduction of the scapulae, an increased thoracic kyphosis, anterior rotation of the pelvis and an increased lumbar lordosis.Flat back consists of a posterior pelvic tilt and a flattening of the lumbar lordosis, extension of the hip joints, flexion of the upper thoracic spine and straightening of the lower thoracic spine.Sway back comprises hyperextension of the hips, an anterior pelvic tilt and anterior displacement of the pelvis.Creases in the posterior aspect of the trunk and, particularly, adjacent to the spine may indicate areas of hypermobility or instability of that motion segment.In reassessing the effect of a treatment, it is essential to evaluate progress from the perspective of the patient, as well as from the physical findings. At the beginning of each new treatment, assessment should determine the lasting effects of treatment or the effects that other activities may have had on the patient’s signs and symptoms.Subjective and objective markers are explained later in this chapter. Assessment is the keystone of effective treatment without which successes and failures lose all of their value as learning experiences. ![]() Following each treatment, the patient should be reassessed using subjective and objective markers in order to judge the efficacy of the physiotherapy intervention. ![]() Be aware of any improvement or deterioration in the patient’s condition as and when it occurs.
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