Lateral flexion

Trank Bend forward Bend backwards Bend sideways Rotate about the Long axis Flexion Extension Lateral flexion Axial rotation... 

Assessment of Trunk Posture An asymmetric trunk posture should be avoided (no trunk axial rotation or trunk lateral flexion). Absence of normal lumbar spine lordosis should be avoided. If the trank is inclined backward, full support of the lower and upper back should be provided. The forward trunk inclination should be less than 60°, on the condition that the holding time be less than the maximum acceptable holding time for the actual forward trunk inclination, as well as that adequate rest is provided after action (muscle fitness should not be below 80%). 

Patrick, L.M. and Chou, C. 1976. Response of the human neck in flexion, extension, and lateral flexion. Vehicle Research Institute Report No. VRl-7-3. Warrendale, PA, Society of Automotive Engineers. 

Schneider, L.W., Foust, D.R., Bowman, B.M. et al. 1975. Biomechanical properties of the human neck in lateral flexion. In Proceedings of the 19th Stapp Car Crash Conference, pp. 455 86. 

Lateral flexion Frontal Sagittal Term used to denote lateral movements of the head, neck, and trunk. 

Lateral flexion of the torso Rotation of the torso Transverse torsion of the torso Pressure intensity of the belt on the collarbone Muscular stress intensity of the neck X... 

One patient with Huntington s disease developed both parkinsonism and Pisa syndrome secondary to valproic add [359 ]. Pisa syndrome is an uncommon type of truncal dystonia manifested by persistent lateral flexion of the trunk. 

The various shapes and stmctures of the vertebrae may also affect their motions. The cervical vertebral bodies are sella-shaped, which encourages freedom of motion. The joints of Luschka modify the translatoiy lateral motion of the cervical vertebral bodies. The shingle effect created by the thoracic spinous processes can restrict extension. A similar restriction can occur in the lumbar region if the spinous processes are elongated. The ribcage restricts lateral flexion and unilateral joint rotation. 

The lumbar facets have craved surfaces. The superior facets are concave and face backward and medially. The inferior facets mirror them by being convex, facing forward and laterally. The rules of concave-convex relationship are evident with joint motion. Lateral flexion is a coupled roll-and-slide motion. This creates a slight rotary movement. As in the thoracic region, lateral flexion and rotation can be in the same or opposite directions. 

Lateral flexion right or left is a rotary motion that causes the side of upper vertebral body to approximate the one below it, right or left, accompanied by a contralateral translatory slide (Fig. 5-11). 

Each of these described coupled motions occurs in a single plane and on an instantaneous axis of rotation. If two of these coupled motions occur simultaneously, i.e., lateral flexion accompanying rotatiorr, then multiple planes are involved, and the combined motions occur on a helical axis of rotation... 

A diagnosis of somatic dysfunction, T4ESrRr, indicates that the motion of the foiuth thoracic vertebra on the fifth thoracic vertebra is greater in the directions of extension, right lateral flexion, and right rotation. These three coupled motions occur in three planes simultaneously on a helical axis of rotation (Fig. 5-12). The barriers to freedom of the described motion would all be in the opposite directions, but on a similar helical axis of rotation. 

Harrison Fryette, in Principles of Osteopathic Technique, discussed specific coupled motion patterns. Of relevance here, when the spine is at rest, normal lateral flexion in one direction will cause the vertebral body to rotate in the opposite direction. (This rule apphes oidy to the thoracic and lumbar regions.) If a group of vertebrae side-bend toward the right, the vertebral bodies will... 

There is no true lateral flexion at the atlantoaxial joint, only a wobble created by the articulation of the superior axial and inferior atlantal articular facets. Unlike most facets, these four facets are all convex in shape (Fig. 24-3). During rotation of the atlas on the axis to the right, the left articular facet of the atlas in effect slides uphill on the left articular facet of the axis, while on the right the atlas slides downhill on the axis. This wobble motion is not true lateral flexion. 

Lateral flexion is coupled with a contralateral translatory slide in the frontal plane. 

Lateral flexion of the sacrum occurs on a theoretical anteroposterior axis. 

What happens to symmetry of gait in short leg syndrome What happens to the comparative reversals of motions of lumbar rotation and lateral flexion if scoliosis is present Radiographs of patients with low back problems often show lateral flexion, rotation deformity of one lumbar... 

Unilateral erector spinae contraction will cause lateral flexion to the side of contraction, scoliosis with convexity to the opposite side, and extension of the spine. The patient walks with a stiff back, with no lumbar rotation or flexion. The spinal areas involved are usually at the fourth or flfth lumbar and first sacral segments. An acute anterior sacrum dysfunction on the same side may also be present. If findings include a raised iliac crest height, lumbar scoliotic convexity, and sciatic pain distribution, all on the same side, the prognosis for a speedy recovery is often good. If the pain is on the other side, the cause may be a prolapsed disk or some other serious pathologic condition, and both physician and patient may be in for a difficult time. 

Observation of an asymmetric pelvic swing or lilt noted should be followed by a hip drop test The findings on this test often concur with the gait observations, pointing toward lumbar lateral flexion restriction. 

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