Exercise techniques are often important in the treatment of spinal conditions. They may be used as an adjunct to mobilising procedures, to enable the patient to maintain the restored range of movement and to strengthen muscles which have become weak through disuse or inhibition by pain.
Assisted or resisted exercises-Joints can become stiff if the muscles which move them are weak; by strengthening these, mobility can be increased. Since each joint movement involves the tensing of a set of muscles and the relaxation of the opposing set, assisted and resisted movement strengthens the muscle by working it in both directions of movement. Assisted movement is when you work your muscles but the therapist helps with the range and direction; resisted movement is when the therapist pushes against you doing the movement.
Proprioceptive neuromuscular facilitation (PNF)-PNF is a system of exercise which aims to obtain maximum muscle activity by using sensory and auditory stimuli to increase the response of the neuromuscular system. Resistance and stretch are also applied to groups of muscles. All muscles function most efficiently in groups – both ‘working together’ and ‘working against’ groups. In essence, the patient performs or tries to perform movements against the manual resistance offered by the therapist in certain spiral and diagonal patterns of movement. The movements contain elements of flexion (or extension) together with a rotatory component, and are closely related to normal functional movement. Maximum contraction of strong muscles is used to reinforce the effort of weaker muscles in the pattern. The specific placing of hands to apply pressure, the use of the voice to stimulate ‘push’ or ‘pull’, the stretching of muscles to initiate movement, are stimuli used to encourage movement. PNF procedures are normally done with the patient lying supine. It is hard work for therapist and patient.
*64\111\2*
