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Dead Bug Exercises for Stabilization

Not all back patients need to do dead bug exercises. Difficulty with these exercises means poor stabilization. Exercises should be part of the program until performed correctly. This progression includes trunk stabilization in supine, quadruped, standing, and functional activities.

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Dead Bug Exercises for Stabilization

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  1. Figure 18.26

  2. Figure 18.27a

  3. Figure 18.27b

  4. Figure 18.28a

  5. Figure 18.28b

  6. Figure 18.28c

  7. Figure 18.29

  8. Figure 18.30

  9. Figure 18.31

  10. Figure 18.32

  11. Figure 18.33a

  12. Figure 18.33b

  13. Figure 18.33c

  14. Figure 18.34

  15. Figure 18.35

  16. Figure 18.36

  17. Figure 18.37a

  18. Figure 18.37b

  19. Figure 18.38

  20. Figure 18.39a

  21. Figure 18.39b

  22. Dead Bug Exercises Not all back patients need to do dead bug exercises. Difficulty with these exercises means poor stabilization. Exercises should be part of the program until performed correctly. Only the extremities move during exercise.

  23. Dead Bug Exercise Substitutions Hips are allowed to roll. Patient rolls from side to side. Lumbar spine moves. Abdominal and gluteal muscles do not remain tense. Pelvic neutral is not maintained.

  24. Dead Bug Exercise Progression • Trunk stabilization in supine with arm or leg movement, then both • Trunk stabilization in quadruped with arm or leg movement, then both • Trunk stabilization in standing with arm or leg movement, then both • Trunk stabilization during functional activities

  25. Figure 18.40

  26. Figure 18.41

  27. Figure 18.42

  28. Figure 18.43

  29. Figure 18.44

  30. Figure 18.45

  31. Core Stability Also known as: • Pelvic stability • Spinal stability • Trunk stability • Lumbar stability

  32. Systems of Support for Stability • Inert tissues offer passive support. • Contractile tissues provide active support. • Neural tissues coordinate sensory feedback. • One or more systems may compensate for another system’s deficiencies, but increased stresses can result.

  33. Added Sources of Stabilization • Thoracolumbar fascia • Quadratus lumborum • Latissimus dorsi • Gluteus maximus and medius

  34. Stabilization of Lumbar Spine Abdominal muscles • Superficial (rectus abdominis): prime movers of trunk flexion, not stabilizers • Deep (transverse abdominis): primary stabilizers • Not often well conditioned • Primary stabilizers of trunk during overhead and lower-limb activity • Assistance from obliques

  35. Stabilization Spine patients should be assessed for posture Stabilization requires strength of: Transverse abdominis Internal obliques Multifidus Lateral and posterior hip muscles Core muscles

  36. Pelvic Stabilization • During sports: abdominal muscles and back extensors—essential for trunk stabilization to serve as base of support for arm and leg movement • In rehab: trunk stability before trunk muscle performance

  37. Other Factors • Just as trunk stabilization serves as a platform for arm and leg activities, hip stabilization serves as a platform for trunk movement. • Consider hip extensors, abductors, and adductors in rehab.

  38. Lumbar Neutral • Refers to overall movement of the lumbar spine, not movement between vertebrae • Lumbar neutral = midway between full flexion and full extension via anterior-posterior pelvic tilting • Basic to stabilization • Places minimal stress on tissues • Best position from which trunk functions

  39. Finding Pelvic Neutral • Start in sitting, supine, or standing. • Fingers on anterior superior iliac spine (ASIS). • Roll pelvis as far as possible forward. • Roll pelvis as far as possible backward. • Rock from each extreme to find the middle of the motion.

  40. First Exercise to Hold Pelvic Neutral • Start in supine hooklying position. • Place blood pressure cuff under lower lumbar spine. • Find pelvic neutral. • Inflate cuff to 40 mmHg. • Tighten gluteal muscles. • Tighten abdominal muscles. • Cuff inflation should remain steady throughout exercises

  41. Exercise Cues to Facilitate Multifidus • Keep pelvic neutral position. • Tighten pelvic floor muscles: Tighten as if stopping urination midflow.

  42. Exercise Cues to Facilitate Transverse Abdominis • Pull navel to spine. • Keep pelvic neutral position. • Place hand on ASIS or sternum or belly for feedback. • Pull in stomach harder as arm or leg moves away from body’s center. • Stop when position is lost.

  43. Early Exercise • Start with feet off floor, hips and knees flexed. • Lower one foot, then the other. • Gradually land foot away from buttock.

  44. Early Quadruped Exercise • Lift one leg, opposite arm. • Can add resistance.

  45. Figure 14.15a

  46. Figure 14.15b

  47. Figure 18.57a

  48. Figure 18.57b

  49. Figure 14.15c

  50. Figure 14.15d

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