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教学课件课件PPT医学培训课件教育资源教材讲义
Internal Oblique Kendall McCreary, 1983 Psoas Major Psoas Works with erector spinae, multifidus deep abdominal wall Works to balance anterior shear forces of lumbar spine Can reciprocally inhibit gluteus maximus, multifidus, deep erector spinae, internal oblique transverse abdominus when tight Extensor mechanism dysfunction Synergistic dominance during hip extension Hamstrings superficial erector spinae May alter gluteus maximus function, altering hip rotation, gait cycle Find iliac crest Location of L4-5 interspace Pelvic Position Norm: 15- 20° angle made between the horizontal and line crossing ASIS and PSIS; APT: if 15- 20° What Do We See? Pelvic Position Lateral View Testing Muscle Endurance Local-Quadratus Global-Back extensors and Abdominals Biering-Sorensen 1984 demonstrated that a decreased torso extensor endurance predicts greater risk of back problems. Balance of three muscle groups are involved in spine stability during any task and critical for the athlete Test one – Abdominal Bracing – sit-up posture with back rest at 60E angle – back rest removed HOLD Test two – Lateral Muscles –Full side bridge position legs extended and top foot in front – non wt. arm to opposite shoulder. HOLD Test three-Back Extensors –upper body over table feet are fix hands resting on opposite shoulders - HOLD Mean Endurance Times(sec) and Ratios Normalized to Extensors Mean age 21 92M 137F Times: Ext 161 M 185 F Flex 136 M 134 F RSB 95 M 99 F LSB 99 M 78 F Ratios: Flex/Ext 0.84M 0.72F RSB/LSB 0.96M 0.96F RSB/Ext 0.58M 0.40F LSB/Ext 0.61M 0.42F 测试动作 男 女 右侧桥Gluteus medius (74%) Ext oblique (69%) Lumbar multifidus (44%) Longissimus (40%) 95 75 左侧桥 99 78 abdominal bracing 136 134 back extensor endurance test 160 185 俯桥测试 四点俯桥保持60″ 举起右上肢保持15″ 举起左上肢保持15″ 举起右下肢保持15″ 举起左下肢保持15″ 举起左下肢和右上肢保持15″ 举起右下肢和左上肢保持15″ 回到起始四点俯桥位保持30″ Assessment of Quadratus Lumborum Local Core Muscle 95% of muscle activation is an Isometric Contraction Side bridge – M
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