Name: Lumbar Spine Posterior to Anterior Mobilization
Uploaded: 2023-04-26T01:01:54.000Z
Duration: 30 min 3 s
Description: Learn the proper technique for lumbar spine anterior-to-posterior mobilization in this instructional video designed for clinicians and movement professionals. As part of a comprehensive rehabilitation program, this manual joint mobilization technique may aid in pain reduction, improving range of motion, and the management of lower back dysfunction.

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https://stream.mux.com/ZY2xi20060000uB3jZLYJ1IQZXZBCnHLYqTtg8Rnkuv01rI.m3u8

Learn the proper technique for lumbar spine anterior-to-posterior mobilization in this instructional video designed for clinicians and movement professionals. As part of a comprehensive rehabilitation program, this manual joint mobilization technique may aid in pain reduction, improving range of motion, and the management of lower back dysfunction.

Introduction to Manual Therapy Techniques and Scope of Practice

Preparing for Posterior to Anterior Mobilizations

Understanding Lumbar Anatomy for Effective Palpation

Performing Central PA Mobilizations

Employing Unilateral PA Mobilizations

Special Techniques for Palpating Lumbar Facets

Assessment and Reassessment in Manual Therapy

Lumbar Spine Posterior to Anterior Mobilization

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Joint mobilizations for the lumbar spine and sacroiliac joint. Types of mobilizations, self-administered mobilizations, comparing muscle energy techniques (MET) and interventions for lumbopelvic hip complex (LPHCD), low back, and SI joint. Optimal intervention for SIJ pain, low back pain, anterior pelvic tilt, knee bow out, knee bow in, and asymmetrical weight shift.  The risk of adverse events, validity, efficacy, screening, and reliability of spine and SI joint mobs.

Joint Mobilization: Lumbar Spine and Sacroiliac Joint

Predictive Model of Lumbopelvic Hip Complex Dysfunction (LPHCD): Signs of lumbopelvic hip complex dysfunction, muscle, joint, fascia, nervous system, neuromuscular recruitment, subsystem, and core muscle contribution. Exercise selection related to lower cross syndrome, anterior pelvic tilt, posterior pelvic tilt, knee bow in, knee bow out, and forward lean.

Lumbopelvic Hip Complex Dysfunction (LPHCD)

The patient should be prone, face-down in a "cut-out" or headrest.

The patient's arms should be supported in a comfortable position; however, not in full shoulder flexion (hands under forehead). Shoulder flexion may increase tension in the 

The table should be low enough so that leaning forward slightly allows the practitioner to get their chest over the lumbar spine, with arms fully extended and thumbs in position over the affected segment.

Ideally, the set-up would allow the practitioner to oscillate pressure by gently rocking the torso (not by using grip or triceps strength).

Note: It is worth spending some time reviewing the anatomy of the sacroiliac joint and practicing on a plastic model before practicing the technique on a colleague.

Central Posterior to Anterior (PA) Mobilization

Place the lateral aspect of the hypothenar eminence on the spinous process of the intended segment.

Place the other hand over the palpating hand by saddling the palpating hand between fingers 2 and 3 of the top hand.

Check body mechanics to ensure the chest is over the target segment and the arms are straight.

Apply force in posterior to anterior direction with a slight inclination toward the client's chest.

Find the spinous process of the affected segment, or the segment exhibiting stiffness.

Generally, the facet is a half segment lower than the spinous process of the associated superior vertebrae.

Slide your thumbs (thumb over thumb) into the laminar trough over the facet.

 activity may increase segmental stiffness, implying the patient should be relaxed and comfortable during PA mobilizations (69). Further, the least stiffness is exhibited when PA mobilizations are performed with a slight cranial inclination bias (70).

Once you have located the segment you wish to mobilize, start with small test oscillations to locate the facet, feel for articular motion, and identify any exquisite tenderness.

When you are satisfied with your test motions, identify the amount of pressure required to reach the first resistance barrier (just before articular motion), and then identify the amount of pressure needed to reach the end of articular motion.

Note: The end of articular motion is the point at which any further increase in pressure does not result in additional arthrokinematic motion.

Identify the mid-point between the first resistance barrier and articular end-range; approximately 50% resistance.

Grade III - Larger oscillations between the first resistance barrier and approximately 50% resistance. Note, these oscillations are large compared to grade IV oscillations, but are still very small motions.

Grade IV - Small oscillations at 50% resistance or more.

Continue oscillating until you feel a change in tissue resistance/joint stiffness.

Lumbar Spine Posterior to Anterior Mobilization

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