Elsevier

Manual Therapy

Volume 5, Issue 1, February 2000, Pages 2-12
Manual Therapy

Masterclass
Masterclass. Lumbar segmental ‘instability’: clinical presentation and specific stabilizing exercise management

https://doi.org/10.1054/math.1999.0213Get rights and content

Abstract

Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model is proposed and evidence for the efficacy of the approach provided.

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  • Cited by (367)

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    Peter B. O'Sullivan, Dip Physio, Post Grad Dip Manip Physio, PhD, Private practitioner, West Perth, Lecturer, School of Physiotherapy, Curtin University of Technology, Selby Street, Shenton Park, WA 6008, Australia.

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