Fizioterapija Bobath - za odrasle - Mulligan Slavena Pavicic

30/06/2020

02/05/2020

10/02/2020

04/01/2020

🔈 THE BRACHIAL PLEXUS - INNERVATION OF THE UPPER LIMB

The brachial plexus (plexus brachialis) is a somatic nerve plexus formed by intercommunications among the ventral rami (roots) of the lower 4 cervical nerves (C5-C8) and the first thoracic nerve (T1). The plexus, depicted in the images below, is responsible for the motor innervation of all of the muscles of the upper extremity, with the exception of the trapezius and levator scapula.

20/11/2019

🔈 THOMAS TEST

🔒 PURPOSE
The Thomas Test or Iliacus Test or Iliopsoas Test is used to measure the flexibility of the iliopsoas muscle group, the Re**us Femoris, as well as the M. Tensor Fascia Latae and the artorius. Measuring the flexibility of this muscle is not useful, because we don’t have a standard meeting length of muscle. The most important aspect of this test is that of the range of motion the hip, as various diseases such as patellofemoral pain syndrome, lower back pain, osteoarthritis and rheumatoid arthritis, may be related to this impaired range of motion.

🔒 TECHNIQUE
The patient should be supine, using the whole length of the table. The patient must then maximally flex both knees, using both arms. This ensures that the lumbar spine is flexed and flat on the table and avoids a posterior tilt of the pelvis.The patient then lowers the tested limb toward the table. During the test the contralateral hip is held in maximal flexion.The length of the iliopsoas is measured by the angle of the hip flexion.

A modified version of the test is one in which the patient lies down on their back, at the very edge of the table, with both legs hanging freely. The patient must then flex their knee and pull it back to their chest as close as they can, using both arms while doing so. The other leg can hang down.The lumbar spine must remain flat and in contact with the table during the test. The physiotherapist controls the opposite leg to ensure that it maintains full contact with the table.

➖ Negative result: The lower back and the sacrum should remain on the table. The hip can make a 10° posterior tilt or a 10° hip extension. The knee must be able to make a 90° flexion.

➕ Positive result: When the patient is not able to maintain their lower back and sacrum against the table. Otherwise if the hip has a large posterior tilt or hip extension greater than 15°, or if the knee is not able to meet flexion of 80° or more.

11/11/2019

HEADACHES AND MYODURAL BRIDGES

• Recent anatomical studies have found that the deep suboccipital (top of the neck) muscles are connected to the dura matter (the covering of the spinal cord) by ligaments.
• Pulling on a suboccipital muscle moves the dura matter, in cadavers.
• The suboccipital muscles often atrophy (waste away) in headache sufferers.

Can headaches be affected by using Active Release Techniques (ART) on the the suboccipital muscles: superior oblique, inferior oblique, re**us capitis posterior major and minor? The suboccipital muscles are important little muscles which control fine neuromuscular control of the head.

Recent studies have added to our knowledge of the possible connections between headaches and the myodural bridges:

Enix et al did microscopic evaluations to confirm that ligaments called the myodural bridges emanate from the suboccipital muscle bellies, and attach to the dura mater in 75% of specimens. These myodural bridges have a hypothetical role in human homeostasis, and they may contribute to certain neuropathological conditions as well. The presence of a neural component within the myodural bridges suggests that they may serve another function aside from simply anchoring the muscles to the dura mater. Such a connection may be involved in monitoring dural tension and may also play a role in certain cervicogenic pathologies (neck pain and headaches).

They noted that manual traction of the re**us major in cadavers resulted in gross dural movement from the spinal root level of the axis (C2) to the spinal root level of the first thoracic vertebra.
Fernández-de-Las-Peñas found that the greater the headache intensity, duration or frequency, the smaller the cross sectional area of the re**us minor and re**us major muscles. He also foundthat there was a correlation between hyper-tenderness and atrophy of the re**us minor. In these cases pressing on the re**us minor reproduced the patient’s headaches.

The re**us minor was also found to have atrophied by Hallgren, in chronic head pain sufferers. He proposed a theory that whiplash could lead to nerve damage which causes the re**us minor to atrophy. His photo in the picture shows the myodural bridge #4.

ART is a hands-on soft tissue treatment of ligaments, muscles, tendons, and nerves. It provides a quick way to make a tight muscle loose, as well as treating conditions such as: tennis elbow, frozen shoulder, shoulder tendinitis, and plantar fasciitis. The technique involves the therapist putting pressure on a tissue, while the patient stretches to move the tissue slowly out from under the contact. The treatment hurts a bit, but only in a way that makes the patient know it is working. The technique works by increasing the nervous system’s tolerance to stretch.

22/10/2019

17/10/2019

There's little evidence ice is good for injuries like rolled ankles. Now, some researchers suspect it may delay the healing process.