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MULTISEGMENTAL STABILITY : A Primary Goal in Musculo-skeletal Rehabilitation. The Introduction of a New Rehabilitative Tool

BioMed Central|1
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  • Medicine
  • Physics


Temp ACO 34 Volume 10 • Number 1 • July 2002 MULTISEGMENTAL STABILITY A Primary Goal In Musculo-skeletal Rehabilitation The Introduction of a New Rehabilitative Tool Wayne Haynes D.C., D.O.(Syd). * INTRODUCTION There is a growing body of evidence to strongly support the use of labile surfaces in training and rehabilitating the neuro-musculo-skeletal system1. Most of this evidence supports the notion that labile surface exercises stimulate the activation of muscular contraction strategies originating from segmental and multi-segmental spinal reflexes and reactions. Local stabilization muscles primarily contribute to these muscular strategies and act to “stiffen” joint segments. There are primarily two strategies involving the neuro- musculo-skeletal system in order to achieve whole body stability and orientation: • Spinal segmental muscular stiffness. • Multi-segmental muscle stiffness. SPINAL SEGMENTAL MUSCLE STIFFNESS Spinal segmental muscular stiffness provides a safe and stable environment for the large global musculature to influence joint position during locomotion. Lumbar spinal segmental stability is provided by the reactive contraction of the “web of muscles” surrounding a motion segment2. This web of muscles reactively contracts when there is a sudden change to a joints stable orientation. It also “stiffens” a motion segment and reduces the neuro-muscular neutral zone (NNZ)3. The muscles generally span one motion segment and contract tonically irrespective of the direction of force generated by its contraction. This contributes to a perturbation of the biomechanical structure. Spinal segmental muscular stiffness is not trained and rehabilitated by the same techniques used in multi- segmental spinal stability programs. The muscular contraction strategies vary greatly in the functional applications, muscular recruitment synergies used, neurologic patterns of activation, morphologic evolution and ontogenic development. Additionally, segmental spinal stab

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